World War I Dysentery Bacterium Was Antibiotic Resistant Before The Antibiotic Age

A new genome sequence of a dysentery-causing microbe from the World War I era has provided more evidence that antibiotic resistance existed before the age of “magic bullet” drugs (Lancet 2014, DOI: 10.1016/s0140-6736(14)61789-x). In 1915, British Army Private Ernest Cable fell victim to poor sanitation in the trenches in Belgium, dying of severe diarrhea caused by the microbe Shigella flexneri. A bacteriologist sent a sample of the germ to London for preservation. Now 100 years later, Nicholas R. Thomson of the Wellcome Trust Sanger Institute and his colleagues decided to take a fresh look at Cable’s Shigella strain. With single-molecule real-time sequencing technology, Thomson’s team learned the 1915 microbe was resistant to both penicillin and erythromycin—long before either antibiotic was discovered and used therapeutically. The genome differs from a modern-day Shigella strain by only 2%, the researchers note, and those changes are largely associated with acquiring resistance to additional antimicrobials. Antibiotic resistance genes have been found in far more ancient samples than Cable’s, but knowledge of how his strain has changed over time is crucial information for researchers working toward a Shigella vaccine. Diarrheal disease still kills about 760,000 children annually because developing nations face sanitation issues much like those in the WWI trenches.