What the Hedgehog knows about antibiotic resistance

Methicillin-resistant S. aureus (MRSA) is one of the most common antibiotic-resistant bacterial pathogens, causing approximately 171,000 invasive infections each year in Europe alone.
MRSA was first identified in 1960 shortly after the introduction of methicillin (celbenin) as a treatment option against penicillin-resistant S. aureus clones.

A group of 64 scientists have just published an open access study in Nature showing that MRSA predates human use of antibiotics by quite some time (emphasis mine):

The discovery of antibiotics more than 80 years ago has led to considerable improvements in human and animal health. Although antibiotic resistance in environmental bacteria is ancient, resistance in human pathogens is thought to be a modern phenomenon that is driven by the clinical use of antibiotics1. Here we show that particular lineages of methicillin-resistant Staphylococcus aureus—a notorious human pathogen—appeared in European hedgehogs in the pre-antibiotic era. Subsequently, these lineages spread within the local hedgehog populations and between hedgehogs and secondary hosts, including livestock and humans. We also demonstrate that the hedgehog dermatophyte Trichophyton erinacei produces two β-lactam antibiotics that provide a natural selective environment in which methicillin-resistant S. aureus isolates have an advantage over susceptible isolates. Together, these results suggest that methicillin resistance emerged in the pre-antibiotic era as a co-evolutionary adaptation of S. aureus to the colonization of dermatophyte-infected hedgehogs. The evolution of clinically relevant antibiotic-resistance genes in wild animals and the connectivity of natural, agricultural and human ecosystems demonstrate that the use of a One Health approach is critical for our understanding and management of antibiotic resistance, which is one of the biggest threats to global health, food security and development.

Larsen, J., Raisen, C.L., Ba, X. et al. Emergence of methicillin resistance predates the clinical use of antibiotics. Nature (2022). https://doi.org/10.1038/s41586-021-04265-w

Against the backdrop of current pandemics, this article suggests that we are barely scratching the surface of the deep complexity created by natural evolution. One Health is “an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes”.

The discovery is also “a stark reminder that zoonotic transmission of diseases between wildlife and humans is far more common than we realize,”

If what the Hedgehog knows is a prickly issue, I can only imagine what the Fox might telll us.

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Featured Image: pixabay

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