33 000 deaths due to bacteria resistant to antibiotics: should drastically limit prescriptions?

Atlantico: Antibiotic-resistant bacteria killed 33,000 people in Europe in 2015. How to explain such a hecatomb?

Stéphane Gayet : There is a lot of talk about the resistance of bacteria to antibiotics in recent years. This topic is presented as a serious alert that no one would hear. All the articles invariably hold the same speech. However, these alarmist publications often hide essential aspects of this phenomenon and, moreover, have a strong tendency to distort reality to present it in a more disturbing way. It is therefore necessary to rectify misconceptions about the resistance of certain bacteria to antibiotics.

Eight misconceptions are addressed in the answers to the questions.

First idea received On one side there are antibiotic-sensitive bacteria and on the other hand antibiotic-resistant bacteria.

It's a simplistic vision, which is wrong. The resistance of bacteria to antibiotics is a phenomenon on the contrary nuanced to six levels. From the lowest level to the highest level, we distinguish: level 1which is the natural or systematic resistance, and which characterizes so-called wild bacterial strains, in other words those which have never been brought into contact with an antibiotic by man; the level 2 which is the so-called usual or common antibiotic resistance; the level 3multidrug resistance (strains of multidrug-resistant bacteria or BMR); the level 4which is the high resistance to antibiotics (highly resistant bacterial strains, called BHR); the level 5, ultra resistance to antibiotics (strains of bacteria called ultra-resistant or BUR); finally, the level 6 which is called pan resistance or also toto resistance to antibiotics (bacterial strains called pan or toto resistant: BPR or BTR).

More precisely, each case of resistance of a strain of bacteria to antibiotics is characterized by the number of antibiotics to which this strain resists and for each of them the degree of resistance to this antibiotic, which is also not binary, because this resistance can be: weak (diminished sensitivity); of average degree; high degree; total or major. The degree of resistance of a bacterial strain to a given antibiotic can be expressed quantitatively by the diameter of the inhibition exerted by a small disk impregnated with this antibiotic, placed on an agar completely invaded by the bacterial strain studied.

It can be seen that the resistance of bacteria to antibiotics is anything but a binary type phenomenon: on the contrary, it is particularly gradual and in addition there is no level 0 of bacterial resistance. But sometimes we'll talk about antibiotic-resistant bacteria for convenience.