Vol. 1, Issue 5 ‣ August 2024
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Alexander Fleming: A Pioneer for Antimicrobial Stewardship
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On August 6th, 1881, Sir Alexander Fleming was born in Ayrshire, Scotland to Hugh Fleming and Grace Stirling Morton. After gaining an education at various schools in Scotland and London,he graduated with a Bachelor of Medicine and a Bachelor of Surgery from St. Mary's Hospital Medical School at London University, receiving a gold metal as the top medical student in 1908. Fleming served as a private in the London Scottish Regiment of the Territorial Army Volunteer Force from 1900 to 1914, where he became quite a recognized marksman. This marksmanship was admired by the captain of the St. Mary's rifle club who desperately wanted to recruit Fleming in order to improve his teams’ standings. Therefore, the captain convinced Fleming to not only join the club, but to pursue a career in research rather than surgery, since the latter would require him to transfer to another school. Unbeknownst to anyone, this is when Fleming's career as an esteemed bacteriologist would begin
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When World War I broke out, Fleming had moved up ranks to a captain in the Army Medical Corps where he worked in battlefield hospitals at the Western Front in France. There, he witnessed the death of many soldiers from sepsis resulting from infected wounds. Antiseptics were used to treat wounds, and Fleming began to observe that this treatment often worsened the injuries. In a 1917 article published in the medical journal, The Lancet, he described an experiment he conducted in which he explained why antiseptics were killing more soldiers than the infection itself.
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Antiseptics worked well on the surface, but deep wounds tended to shelter anaerobic bacteria from the antispectic agent; the antiseptics seemed to remove not only the beneficial agents that protected the patients, but the harmful bacteria as well. However, the antiseptics did nothing to remove the bacteria that were out of reach.¹ No one seemed to pay too much attention at the time to Fleming’s observation of the presence of anaerobic bacteria in deep wounds.
When he added nasal mucus, he found that the mucus inhibited the bacterial growth.² Surrounding the mucus area was a clear, transparent circle, indicating what we now refer to as the zone of inhibition. He continued these tests with sputum, cartilage, blood, semen, ovarian cyst fluid, pus, and egg white, which showed that the antimicrobial was present in all.³
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In the 1922 issue of the Proceedings of the Royal Society D: Biological Sciences, Fleming wrote, “In this communication I wish to draw attention to a substance present in the tissues and secretions of the body, which is capable of rapidly dissolving certain bacteria. As this substance has properties akin to those of ferments I have called it a Lysozyme.” This was the first recorded discovery of lysozyme.
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Keep reading to discover how Fleming's wartime observations led to his groundbreaking discoveries with lysozyme and penicillin, transforming modern medicine and earning him a Nobel Prize.
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Product Spotlight:
HardyDisk™ AST Rezafungin and
AST Sulbactam-Durlobactam
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New Therapies for Difficult-to-Treat Pathogens:
Sulbactam-Durlobactam and Rezafungin
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Sulbactam-Durlobactam (Xacduro) was FDA approved in May to treat hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) caused by Acinetobacter baumannii-calcoaceticus complex. HardyDisk™ AST Sulbactam-Durlobactam was subsequently FDA cleared 44 days later. The intravenous drug developed by Entasis Therapeutics Inc., provides a promising solution to treatment of carbapenem-resistant Acinetobacter baumannii (CRAB).
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Adapted from the WHO Manual for the Laboratory Identification and Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World
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Antimicrobial Susceptibility Testing (AST) is essential for identifying the most effective treatments for bacterial infections, echoing the legacy of Alexander Fleming's groundbreaking work with penicillin.
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Surveillance of Resistance
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Continuous surveillance of antimicrobial resistance patterns is crucial for informing public health strategies and clinical practices, especially in combating multidrug-resistant pathogens like CRAB.
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Standardized Testing Methods
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Standardized methods for performing AST ensure consistent and reliable results, vital for assessing the efficacy of new antimicrobial agents targeting resistant strains in clinical settings.
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Global collaboration among healthcare institutions is key to fighting antimicrobial resistance, as demonstrated by the development and approval of new therapies like sulbactam-durlobactam and rezafungin.
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Video/Catalog Spotlight:
Susceptibility Testing
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See our collection of HardyDisk™ Videos and Catalogs
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Megan Maloney Roesner, an award-winning journalist, marketer, and current Clinical Microbiology Laboratory Marketing Product Manager at Hardy Diagnostics, brings over 20 years of experience in brand management, healthcare marketing, and communications to her role.
If you have any suggestions for content, a comment, or a question, please contact Megan here.
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"A Culture of Service"
Hardy Diagnostics, 1430 West McCoy Lane, Santa Maria, CA, 93455, USA, +1.800.266.2222
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