PhD student Carmine Slipski is using a mechanical approach to help solve the growing problem of antimicrobial resistance. A third-place winner of the 2018 3 Minute Thesis competition, his research looks to understand the role that efflux pumps play in strengthening bacteria against antimicrobials.

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Like many students at the University of Manitoba’s Department of Medical Microbiology and Infectious Diseases, Carmine Slipski’s interest in infectious diseases started with the medical disaster film Outbreak. Instead of diving into Ebola research, the inspiration for the movie (and another hotly researched topic at the National Microbiology Lab in Winnipeg), Carmine instead decided to focus his studies on a more pervasive medical concern: antimicrobial resistance.

Antibacterial elements are everywhere; our daily routines are full of antibacterial products like handsoap, toothpaste and cleaning products. The over-use of antibiotics and antibacterial cleaning products in the livestock industry is even more pervasive, and makes up 80% of the problem: animals are brought up from birth with antibiotics to make them grow faster and larger, and anti-septic cleaning products are in huge amounts to ensure ‘sanitary’ conditions.

When antimicrobials are overused in huge quantities, they can end making bacteria more resistant to a variety of drugs. This becomes a huge problem when people need to be treated with antibiotics, and their infection has developed resistance through exposure to antiseptics or biocides. This cross-resistance has become, as Carmine describes it, “a global issue that needs to be addressed.”

With growing resistance to antimicrobials, we are encountering untreatable infections for the first time. “By the year 2050, resistant infections are going to be responsible for 10 million deaths every year—more than cancer and traffic accidents combined.” The ‘last-resort antibiotics’ have proven ineffective in treating some diseases, and we are even seeing a resurgence in previously curable diseases like gonorrhea.

Carmine’s research focuses on examining efflux pumps – a resistance mechanism in cell membranes that can pump out antimicrobials. He hopes to create a better understanding of how the membrane’s composition affects efflux pumps and which antimicrobials they choose to pump out. If we understand how cell membranes choose what to let in or pump out of the cell, we can use that knowledge to our advantage in the fight against resistant infections.

Carmine chose E. coli as his model organism because the bacteria is well-studied, amenable to DNA mutations, and still a predominant pathogen in hospitals; this lets him focus on altering the membrane composition to see how it affects cell resistance.

This back-to-basics, building blocks approach could have global ramifications. If his research contributes to a better understanding of cell mechanics, it could create new ways to combat the problem of antimicrobial resistance before it becomes an epidemic. “Once the problem starts becoming a significant global issue, we might already be past the point of no return. As populations increase, that’s a big problem. We’re heading for a disaster.”

Despite the high stakes, Carmine remains cautiously optimistic, pointing out that we have been able to eradicate powerful diseases like smallpox through vaccines and that antibiotics have ushered in a new era of medicine. We can each do our own part by choosing products without unnecessary antimicrobials, but ultimately we need better clinical stewardship, and for our government to do more to limit industrial use to ensure that anti-biotics and vaccines continue to be effective. Alongside modern sanitation and vaccines, antibiotics are “one of the major pillars expanding our lifespan”, and if we don’t act now, “we may lose it.”

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