Video Transcript

Michael Mosley lies on an operating table, partly covered in gauze.

Michael is in his early sixties, clean-shaven and with short straight gray hair.

Michael says FOR MORE
THAN 70 YEARS, WE'VE WAGED WAR
AGAINST BACTERIAL INFECTIONS
USING ANTIBIOTICS.
BUT IT'S A WAR WE'RE NOW
LOSING.
DRUG-RESISTANT SUPERBUGS...
ARE SPREADING.

A team of scientists cover Michael’s body in layers of gauze and a white substance to make a mould.

Michael says TO FIND OUT WHAT WE'RE UP
AGAINST, I'M DONATING MY BODY
TO AN EXTRAORDINARY EXPERIMENT.
WE ARE GOING TO UNLEASH
BACTERIAL HELL ON A CLONE
OF MY BODY.

Michael sees his clone and says WOO-HOO!
WE'RE HOPING THIS EXPERIMENT,
WHICH IS NOVEL AND RATHER
SPOOKY, WILL GIVE US A WHOLE
NEW INSIGHT INTO THE WAY THAT
BACTERIA FIGHT BACK AGAINST
ANTIBIOTICS.
THAT IS ABSOLUTELY REVOLTING.

A clip shows Michael’s clone break down.

A female scientist says IT'S FABULOUS!

Michael says I'LL SEARCH HIGH AND LOW
FOR RADICAL SOLUTIONS...

Michael pours liquid from a watering can into a bucket and says DIE, BACTERIA, DIE!

Michael says TO STOP THE SPREAD OF THE
SUPERBUGS.

A male scientist says WHEN I REMOVE THE BANDAGE, WE
SHOULD SEE QUITE A DIFFERENCE.

Michael says OH, YEAH!

Michael says IS IT TOO LATE TO PREVENT
ANTIBIOTIC ARMAGEDDON?
ME AND MY BODY ARE ABOUT
TO FIND OUT.

The name of the show reads "Michael Mosley versus the superbugs."

A man in his fifties walks in a doctor’s office and says HELLO.

The doctor says GOOD TO SEE YOU UPRIGHT.

The patient says WELL, IT'S NICE TO BE
UPRIGHT.

The doctor says COME AND HAVE A SEAT.

The patient says THANK YOU.

Michael walks in and says HI THERE.

Michael says A MONTH AGO, 57-YEAR-OLD
JOHN SHELTON WAS FIGHTING
FOR HIS LIFE AGAINST A SUDDEN
BACTERIAL INFECTION.

The doctor checks his breathing.

(EXHALING)

The doctor says GOOD.

John says WHEN I ARRIVED HERE, THEY
OPENED ME UP, THERE WAS A BIG
MESS.
IT WAS VERY, VERY INFECTED,
AND THE BACTERIA WERE ALREADY
WORKING THEIR MERRY HAVOC,
TRASHING MY BODY, SHUTTING DOWN
MY LUNGS, SHUTTING DOWN MY
KIDNEYS, SHUTTING DOWN
EVERYTHING, PRETTY MUCH.

Michael says YOU DON'T REMEMBER ANYTHING?

John says NOT A THING.

The doctor says HIS LUNG HAD ALMOST
COMPLETELY FILLED UP WITH
BACTERIA, OR INFECTION, AND
HE WASN'T ABLE TO OXYGENATE
HIS BLOOD.

Michael says BACTERIA CALLED STAPH AUREUS
CAUSED THE INFECTION.
(INHALING, EXHALING)

Michael says THEY WERE EVENTUALLY STOPPED
BY A CONCOCTION OF ANTIBIOTICS,
BUT FOR A WHILE IT WAS TOUCH
AND GO.

The doctor says BRILLIANT.

John’s wife says WHEN THEY THOUGHT HE'D HAD
A BRAIN HAEMORRHAGE... SORRY...
THAT WAS NOT A GREAT MOMENT.
YOU KNOW, JUST ONE DAY AT A
TIME, REALLY, AND YOU DO PLACE
YOUR FAITH IN THE FACT THERE'S
GOING TO BE ANOTHER ANTIBIOTIC
TO COME UP.

Michael says IT'S INTERESTING THAT, YOU
KNOW, THERE IS A LOT OF
TECHNOLOGY HERE, THERE IS
OBVIOUSLY A FANTASTIC STAFF
BUT, IN THE END, IT'S KIND OF
ANTIBIOTICS VERSUS BACTERIA.

John says THAT'S IT, SIMPLE AS THAT.
THERE'S NO DOUBT IN MY MIND
THAT, WITHOUT ANTIBIOTICS,
I WOULD NOT BE HERE.

(music plays)

Michael says BEFORE THE 1940S, UP TO A
THIRD OF DEATHS WERE CAUSED
BY BACTERIAL INFECTION.
A SIMPLE CUT COULD KILL YOU.
THEN CAME ANTIBIOTICS, DRUGS
ABLE TO KILL BACTERIA.
THE FIRST WAS PENICILLIN,
DISCOVERED BY ALEXANDER FLEMING
IN 1928.
MORE FOLLOWED, BUT THEN, THE
PIPELINE DRIED UP.
NO TOTALLY NEW ANTIBIOTICS
HAVE BEEN FOUND FOR MORE THAN
30 YEARS.
AND MORE AND MORE BACTERIA ARE
BECOMING RESISTANT TO OUR
DWINDLING STOCK...
INCLUDING SUPERBUGS, WHICH
THREATEN TO SEND MODERN
MEDICINE BACK TO THE DARK AGES.
700,000 PEOPLE ALREADY DIE
EVERY YEAR FROM RESISTANT
INFECTIONS, AND THAT FIGURE
IS ESTIMATED TO SOAR TO 10
MILLION BY 2050 IF ACTION
ISN'T TAKEN.
INCREASING NUMBERS OF PEOPLE
ARE FINDING THAT ANTIBIOTICS
ARE NO LONGER WORKING.
PEOPLE LIKE SLAWA.

Slawa is in her forties, with off the shoulder wavy blond hair and wears glasses, gray leggings and a pale gray sweater. She walks with crutches.

Slawa says "I stepped on a rusty nail and then I was taking antibiotics for a few years and all the antibiotic treatments, oxygen chambers, everything open my feet, clean the wound, cut the bone, nothing was working."

Michael says SLAWA'S FOOT IS SO INFECTED
WITH E. COLI, IT COULD LEAD TO
HER WHOLE LEG BEING AMPUTATED.
BE WARNED, THIS GLIMPSE INTO
A POST-ANTIBIOTIC WORLD IS
GRUESOME.
SO, IF YOU'RE SQUEAMISH, LOOK
AWAY NOW.

Slawa says "This is not the kind of life that I would like to have. I don’t want to have the pain."

A caption reads "Professor Anthony Coates. Institute of Infection and Immunity, Saint George’s, University of London."

Anthony is in his sixties, clean-shaven and bald. He wears glasses, a blue and white gingham shirt and a white coat.

He says IF WE DO NOTHING, MODERN
MEDICINE IN ALL ITS FINERY WILL
BECOME MUCH MORE HAZARDOUS.
CANCER THERAPY, IMMUNOTHERAPY...
I MEAN, JUST SIMPLE INFECTIONS
LIKE MENINGITIS, ALL OF THESE
THINGS BECOME MORE HAZARDOUS.
SO, ANTI-MICROBIAL RESISTANCE
IS THE BIGGEST SINGLE ISSUE
WHICH IS AFFECTING MODERN
MEDICINE AT THE MOMENT.

Michael says IN 2015, 34 MILLION
PRESCRIPTIONS WERE ISSUED FOR
ANTIBIOTICS IN THE UK ALONE.
HAVE WE CREATED SUPERBUGS BY
POPPING TOO MANY OF THESE
PILLS?

(music plays)

Michael says I WANT TO FIND OUT EXACTLY
WHAT ANTIBIOTICS DO AND WHY
BACTERIA ARE RESISTING THEM.
TIME FOR AN UNUSUAL EXPERIMENT.
SO, I HAVE DONE A LOT OF STRANGE
THINGS IN MY TIME, AND A LOT
OF SELF EXPERIMENTS, BUT
NOTHING QUITE LIKE THIS.
NOW, I'M IN PRETTY GOOD HEALTH
AND I ONLY TAKE ANTIBIOTICS
WHEN I ABSOLUTELY HAVE TO,
BUT I'M GOING TO EXPLORE WHAT
A POWERFUL ANTIBIOTIC DOES
TO MY BODY BY MAKING MY
BACTERIA VISIBLE.

He walks in a workshop and says IF YOU'D LIKE TO KNOW, I HAVE
NOT WASHED FOR TWO DAYS.

A woman says GREAT.

A man says ALL RIGHT!

Michael says WHEN I START DOING THESE
THINGS, I ALWAYS THINK, "OH,
IT SOUNDS LIKE A GOOD IDEA,"
AND WHEN I ACTUALLY GET THERE, I
START TO WONDER IF IT REALLY IS.
(LAUGHING)

Michael says ARTIST MELLISSA FISHER
SPECIALIZES IN CREATING
LIVING BIOLOGICAL SCULPTURES.

Melissa is in her thirties, with long slightly wavy brown hair and wears glasses and a striped sweater.

(MICHAEL LAUGHING)

Mark swabs Michael’s foot and Michael laughs.

Michael says OOOH!

Mark is in his forties, balding and with a goatee. He wears black trousers and a blue sweater.

Mark says RIGHT IN BETWEEN YOUR TOES.

Michael says WITH PROFESSOR MARK CLEMENTS
OF LINCOLN UNIVERSITY, SHE
IS LEADING A TEAM TO MAKE A
LIVING BACTERIAL SCULPTURE OUT
OF ME.

Mark gives Melissa a cotton swab and says SO, THAT'S THE...
THE RIGHT HERE.

Michael says STEP ONE: COLLECT BACTERIA
FROM ALL OVER MY BODY USING
COTTON-WOOL SWABS.

Mark says ON THE SKIN, YOU'VE GOT OVER
1,000 DIFFERENT TYPES OF
BACTERIA.
AND EACH PERSON IS UNIQUE.
ALL DIFFERENT PARTS OF THE BODY
WILL HAVE SLIGHTLY DIFFERENT
MICROFLORA, DEPENDING ON
WHETHER IT'S A MOIST AREA,
WHETHER IT'S A DRY AREA, OILY
AREA.

Michael says BY MOIST, I'M THINKING
ARMPITS, PROBABLY.

Mark says YEAH, THE VERY MOIST AREAS.
THE ARMPIT AND THE GROIN ARE
PARTICULARLY GOOD.

Michael says OKAY, I MIGHT DO MY OWN
GROIN.

Mark says YES, YEAH, YEAH.

Michael now lies on a table.

Michael says NEXT, I'M WRAPPED IN PLASTER
TO CREATE A MOULD OF ME.
WOO!
AND GIVEN A FULL BODY WAX
IN THE PROCESS.
OWWW!

Melissa says DO YOU WANT YOUR HAIR BACK?
(EVERYONE LAUGHING)

Michael says
OUR HOME FOR THIS EXPERIMENT
IS IMPERIAL COLLEGE IN LONDON.

A scientist says IT'S RIGHT ON THAT EDGE,
THERE.

Michael says HERE, OUR TEAM OF SCIENTISTS
AND SCULPTORS TURN MY BODY
MOULD INTO POSSIBLY THE WORLD'S
LARGEST PETRI DISH BY FILLING
IT WITH A NUTRIENT-RICH JELLY
CALLED AGAR.
GOOD MORNING, GANG.

A scientist says GOOD MORNING.

Michael says AFTER 12 HOURS, THE AGAR
JELLY HAS SET.
IT'S LIKE TUTANKHAMEN'S TOMB,
ISN'T IT?

A man says ALL RIGHT, SO NICE AND
GENTLY, UP AND OUT.

Michael says THERE'S TWO PARTS TO THIS
EXPERIMENT, WHICH IS WHY MY
RATHER SPOOKY CLONE IS SPLIT
IN HALF.

Melissa says THE FOOT'S OUT.

A scientist says WOO-HOO!
THAT IS WONDERFULLY WEIRD.

Michael says ON ONE SIDE, WE WANT TO GROW
BACTERIA FROM ALL OVER MY SKIN
TO SEE WHAT'S LIVING ON ME.
IT KIND OF LOOKS LIKE ME,
I MUST ADMIT.
A SLIGHTLY BALD VERSION OF ME.
(OTHERS CHUCKLING)
WOW.
ON THE OTHER SIDE, WE'VE ADDED
A BROAD-SPECTRUM ANTIBIOTIC
USED IN HOSPITALS AGAINST A
WIDE RANGE OF INFECTIONS.
OH!
BUT BEFORE WE EVEN GET THE
CHANCE TO ADD MY BACTERIA,
SOMETHING ELSE HAS SNUCK IN.
WHAT'S THE GREEN STUFF?
DOES THIS SUGGEST THE PRESENCE
OF BACTERIA ALREADY, THEN?

Mark says IT DOES.
ON THIS SIDE, WHERE WE DON'T
HAVE ANY ANTIBIOTICS, THEN
THERE HAS BEEN SOME GROWTH OF
BACTERIA.

Michael says RIGHT, SO, EVEN GIVEN THE
TINIEST OPPORTUNITY, THE
BACTERIA HAVE GOT STUCK IN.

Mark says THEY DO, THEY DO.
YES, YEP, YEP.
THEY'RE EVERYWHERE.

Michael says WE DON'T KNOW WHERE THESE
GREEN BACTERIA HAVE COME FROM.
BUT YOU CAN SEE THAT THE
ANTIBIOTIC EMBEDDED ON THE
LEFT-HAND SIDE HAVE SO FAR
STOPPED THE INVADER FROM
GROWING.
TIME TO ADD BACTERIA COLLECTED
FROM MY BODY.

Mark says THESE ARE ALL THE SWABS
WE'VE TAKEN OF YOUR BODY.
WE'RE GOING TO START WITH THE
BOTTOM OF THE FEET, SO NUMBER
20.

Michael says WE WANT TO MAKE VISIBLE
THE INVISIBLE MICROBES,
MAINLY BACTERIA, THAT LIVE
ON A HEALTHY HUMAN.
SO, WE'RE ADDING EACH OF MY
SAMPLES TO THE CORRESPONDING
PART OF MY CLONE.
LET'S SEE WHAT THEY MAKE OF
THEIR NEW HOME.

Mark says OKAY, WE CAN DO THIS.

Michael says OUR GIANT PETRI DISH IS
SEALED INTO AN AIRTIGHT CASE.
IT REALLY DOES FEEL LIKE THEY'RE
TAKING MY BODY AND EMBALMING IT.

A man says WHOA!

Mark says OH, THE FOOT'S GONE.

The man says OH, NO!

Michael says DESPITE A COUPLE OF RATHER
NASTY FOOT INJURIES,
MICROBIAL MICHAEL IS NOW READY
FOR OUR EXPERIMENT TO START.
WHICH MICROBES WILL THRIVE,
AND WHERE?
I WOULD EXPECT, WITHIN THE NEXT
FEW DAYS, WE'LL START SEEING
THEM EMERGE ON THAT SIDE.
THE QUESTION IS, WILL THEY BE
ABLE TO OVERCOME THE ANTIBIOTICS
AND START GROWING ON THIS SIDE?
THE TRUTH IS, WE HAVE
ABSOLUTELY NO IDEA WHAT IS
GOING TO HAPPEN NEXT, BECAUSE
THIS SORT OF THING HAS NEVER
BEEN DONE ON THIS SORT OF
SCALE BEFORE.
WE SIMPLY HAVE TO WAIT TO FIND
OUT.

(music plays)

Michael says TIME FOR A ROAD TRIP.
I WANT TO DIG DEEPER INTO
THE ROOTS OF THE CRISIS.
SO, WHY ARE MORE AND MORE
BACTERIA BECOMING RESISTANT?
IS IT SIMPLY THAT WE'RE
OVERDOING THE ANTIBIOTICS,
OR IS IT MORE COMPLICATED THAN
THAT?
I RECENTLY READ ABOUT A
FASCINATING DISCOVERY MADE HERE
IN NEW MEXICO, THAT'S CHANGED
THE WAY I THINK ABOUT
ANTIBIOTIC RESISTANCE.

He pulls over by a grassy field.

He says NOW, THIS IS THE SPOT.
GORGEOUS, ISN'T IT?
UNFORTUNATELY, WHAT I'M LOOKING
FOR IS NOT HERE, ON THE SURFACE.
IT IS DEEP UNDERGROUND.
AND I SAY "UNFORTUNATELY."
BECAUSE I'M PRETTY
CLAUSTROPHOBIC.
MY GUIDE IS DR. HAZEL BARTON.
HEY-HO!

Hazel is in her thirties, with mid-length straight brown hair in a ponytail and she wears a blue T-shirt and safety gear.

Hazel says HI, MICHAEL, HOW ARE YOU
DOING?

Michael says GLAD TO SEE YOU.
HAZEL'S A MICROBIOLOGIST
WHO SEARCHES FOR NEW SPECIES
OF BACTERIA LIVING DEEP UNDER
CARLSBAD NATIONAL PARK,
IN A VAST NETWORK OF CAVES.
THANK YOU.
WHAT'S THE LONGEST YOU'VE BEEN
DOWN HERE FOR?

Hazel says UM, EIGHT DAYS.

Michael says EIGHT DAYS?
COOL, JOURNEY TO THE CENTRE
OF THE EARTH.

Hazel says UM, YEAH, SO WE'RE GETTING
OFF THE TOURIST TRAIL HERE.

They start climbing down a dark cave.

Michael says BLIMEY.
IT GETS NARROWER, DOESN'T IT?

Hazel says IT'S QUITE BIG IN HERE.

Michael says YEAH, IT'S COOL.
IT WAS IN 2012 IN A CAVE MUCH
DEEPER THAN I'M ABLE TO GO
THAT HAZEL'S TEAM MADE THEIR
BREAKTHROUGH DISCOVERY.

Hazel says SO, THE KIND OF AREAS THAT
WE SAMPLED LOOK QUITE A BIT
LIKE THIS.

Michael says HAZEL TOOK A BUNCH OF
BACTERIAL SAMPLES FROM THE CAVE
AND SENT THEM OFF TO A LAB
FOR ANALYSIS.
THE RESULTS SHOCKED EVERYONE.

Hazel says SO, I SENT HIM JUST 100,
RIGHT?
HE STARTED TESTING THEM, AND
HE'S LIKE, "YOU'RE NOT GOING TO
BELIEVE THIS, BUT THEY ARE
RESISTANT TO EVERYTHING."
EVERYTHING THAT'S USED...

Michael says SO, THESE WERE BACTERIA YOU
FOUND ON A WALL IN A CAVE.

Hazel says MUCH MORE REMOTE THAN THIS,
MUCH FURTHER AWAY.

Michael says THAT HAD NOT SEEN HUMANS...

Hazel says WE KNOW HUMANS HAD NEVER BEEN
IN THERE, BECAUSE WE KNOW,
WE HAD THE EXPLORATION RECORDS,
SO THERE WAS NO IMPACT ON IT.
AND THEY WERE RESISTANT TO
PRACTICALLY EVERY ANTIBIOTIC
THAT'S USED IN THE CLINIC.

Michael says WOW.
THAT IS BOTH INCREDIBLY EXCITING
AND INCREDIBLY SCARY.
NOBODY HAD EVER THOUGHT THAT YOU
WOULD FIND RESISTANT BACTERIA
DOWN IN THE BOTTOM OF A BLOODY
CAVE.

(music plays)

Michael says THEY'D HAD NO INTERACTION
WITH HUMANS, BUT THE BACTERIA
HAZEL FOUND IN THE CAVE WERE
RESISTANT TO A HUGE ARRAY OF
ANTIBIOTICS WE USE IN MODERN
MEDICINE.
THIS RESISTANCE HAD CLEARLY
EVOLVED OVER MILLIONS OF YEARS
WITHOUT US HAVING ANYTHING TO
DO WITH IT.
WHY?
WELL, IT MAKES SENSE WHEN YOU
THINK OF ANTIBIOTICS NOT AS
MANMADE, BUT THE BYPRODUCT
OF WAR BETWEEN MICROBES.
THEY MAKE CHEMICAL WEAPONS TO
DESTROY THEIR ENEMIES AND
STEAL THEIR RESOURCES.

An animation shows a group of microbes shooting arrows at and destroying another group of microbes.

Michael says WEAPONS WE HAVE LEARNT TO
EXPLOIT AS ANTIBIOTICS.
THE BACTERIA LIVING DEEP IN THE
CAVE HAVE HAD MILLIONS OF YEARS
TO EVOLVE WEAPONS THAT CAN
TARGET AND DESTROY EVEN THEIR
TOUGHEST RIVALS.
THE BATTLE FOR SCARCE RESOURCES
LIKE NUTRIENTS AND ENERGY IS
PARTICULARLY BRUTAL DOWN HERE,
IN THE CAVES.

Hazel says IT'S REALLY STARVED DOWN
HERE.
THERE'S NO RESOURCES.
IT'S PROBABLY ONE OF THE MOST
STARVED ENVIRONMENTS ON EARTH
BECAUSE, IF YOU THINK ABOUT IT,
ANY ENERGY NEEDS TO COME IN
THROUGH THE ROCK, AND SO
THERE'S A BIG COMPETITION FOR
NUTRIENTS.

Michael says THE FEWER THE RESOURCES,
THE MORE INTENSELY THE MICROBES
BATTLE, AND THAT CREATES
RESISTANCE BECAUSE THE
BACTERIA UNDER ATTACK DON'T
JUST LIE BACK AND DIE.
WHEN BILLIONS OF BACTERIAL
CELLS ARE BOMBARDED, ALL IT
TAKES IS FOR ONE CELL TO
MUTATE ITS DNA...
IN SUCH A WAY THAT THE
ANTIBIOTIC CAN NO LONGER KILL
IT.
THIS ABILITY TO RESIST THEN
SPREADS, FAST.
SO, DEVELOPING RESISTANCE
TO ANTIBIOTICS IS AN ENTIRELY
NATURAL PROCESS, WHICH THE
BACTERIA OF CARLSBAD HAVE
TAKEN TO THE EXTREME.
SO, A FIERCE COMPETITION GOING
AROUND US ALL THE TIME.

Hazel says UH-HUH.

Michael says MICROBES PRODUCING
ANTIBIOTICS, BUT THIS IS ALL
HAPPENING MILLIONS OF YEARS
BEFORE FLEMING AND HIS FRIENDS
AT OXFORD ACTUALLY DEVELOPED
PENICILLIN.

Hazel says RIGHT, AND THAT'S WHAT WE
DISCOVERED DOWN HERE THAT KIND
OF BLEW EVERYBODY'S MIND, IS
THE THOUGHT THAT RESISTANCE
AND THAT ANTIBIOTIC BATTLE
IS BECAUSE WE'VE BEEN USING
ANTIBIOTICS, BUT IT CAN'T BE
DOWN HERE 'CAUSE THESE GUYS
HAVE NEVER SEEN THE ANTIBIOTICS
THAT FLEMING, AND EVERYONE HAS
MADE SINCE.

Michael says BUT IF RESISTANCE TO
ANTIBIOTICS ARISES NATURALLY,
WHAT DOES THAT MEAN FOR US?
LET'S SEE IF MICROBIAL MICHAEL
HAS ANY ANSWERS.

In the lab, the clone is white and a greenish shade of blue.

Michael says BLOODY HELL.
THAT IS GROTESQUE.
WE'VE LEFT HIM ALONE FOR A FEW
DAYS, AND THE BACTERIA SWABBED
FROM MY BODY HAVE RUN RIOT.
I'M HOPING IMMUNOLOGIST DR.
SHEENA CRUICKSHANK FROM
MANCHESTER UNIVERSITY CAN
HELP ME MAKE SENSE OF WHAT'S
HAPPENING.

Sheena is in her thirties, with long straight blond hair and wears a black and white striped top under a white lab coat.

Sheena says MICHAEL, MEET MICHAEL.

Michael says THAT IS SO WEIRD.

Sheena says I JUST THINK IT'S SO EXCITING
TO BE ABLE TO SEE...

Michael says IT IS BOTH EXCITING AND
REALLY, REALLY DISGUSTING,
I HAVE TO SAY.
THERE'S SOMETHING, AS WELL,
ABOUT SEEING ME DOWN THERE,
EFFECTIVELY COVERED WITH THIS
STUFF.

Sheena says I THINK YOU SHOULD BE LOOKING
AT THIS AS SHOWING YOU THE
AMAZING LIFE THAT'S LIVING ON
YOU.

Michael says WE'RE STARTING ON THE
RIGHT-HAND SIDE, WHERE THERE'S
NO ADDED ANTIBIOTIC.
THAT MEANS THESE
DIFFERENT-COLOURED BACTERIA
SHOULD BE PART OF MY NORMAL
SKIN FLORA.

Sheena says LOOK AT THIS AMAZING WHITE,
BLUE...

Michael says OKAY, I THOUGHT WHITE, BLUE
MEANT THERE WAS NOTHING GROWING
THERE, BUT THERE IS SOMETHING?

Sheena says NO, THAT'S ACTUALLY GROWING
OVER THE BLUE, AND THAT'S
REALLY EXCITING BECAUSE IT
SUGGESTS THAT PERHAPS IT IS
BATTLING WITH THE BLUE.

Michael says OKAY.

Sheena says IT'S COMPETING WITH IT.
AND I THINK THAT'S
STAPHYLOCOCCUS EPIDERMIDIS,
AND THAT'S A REALLY COMMON SKIN
BACTERIA.
AND WE ACTUALLY KNOW THAT SOME
BACTERIA MAKE ANTI-BACTERIALS,
SO THEY COMPETE WITH EACH OTHER
AND THEY KILL OTHER BACTERIA.
SO, PERHAPS THAT'S WHAT'S
HAPPENING HERE.

Michael says SO, WE'RE KIND OF SEEING
WARFARE IN ACTION BETWEEN THE
BACTERIA.

Sheena says ABSOLUTELY.

Michael says WHAT THIS SIDE OF THIS
EXPERIMENT IS SHOWING US VERY
COLOURFULLY IS HOW BACTERIA
IN A HEALTHY BODY KEEP EACH
OTHER IN CHECK AS THEY BATTLE
FOR SPACE AND NUTRIENTS.
BECAUSE MOST BACTERIA LIVING ON
US ARE HARMLESS OR BENEFICIAL,
IN A BALANCED ECOSYSTEM, THEY
LEAVE LIMITED ROOM FOR THE BAD
BUGS - THE PATHOGENS.
BEHIND THE SCENES, OUR TEAM IS
IDENTIFYING EXACTLY WHAT'S
GROWN USING DNA ANALYSIS.
AND THEY FOUND SOMETHING
POTENTIALLY NASTY UP MY NOSE.

Sheena says THIS IS REALLY INTERESTING.
IF YOU LOOK AROUND YOUR NOSE
THERE, AROUND YOUR NOSTRIL,
THERE IS STAPHYLOCOCCUS AUREUS
GROWING THERE.

Michael says THAT'S THE SORT OF ORANGEY...
THEY CALL IT THE GOLDEN STAPH,
DON'T THEY?

Sheena says YEAH.
A LOT OF PEOPLE, ABOUT A THIRD
OF PEOPLE, HAVE STAPHYLOCOCCUS
AUREUS IN THEIR NOSTRILS.
IT'S QUITE, QUITE NORMAL.
BUT A LOT OF PEOPLE ASSOCIATE IT
WITH BEING A PATHOGEN.
IN THE RIGHT CIRCUMSTANCES,
IT'S FINE.
IN THE WRONG, IT CAN BE DEADLY.

Michael says IF OUR IMMUNE SYSTEM TAKES
A HIT, SOME SPECIES AMONGST
OUR BACTERIA CAN GET OUT OF
CONTROL AND DO SERIOUS HARM.
THAT'S WHAT THE RELATIVES
OF THE GOLDEN STAPH AUREUS
IN MY NOSE DID TO PATIENT
JOHN SHELTON, OVERRUNNING HIS
BODY'S DEFENCES AND VERY
NEARLY KILLING HIM.
ON THIS SIDE OF THE EXPERIMENT,
MY BACTERIA ARE KEEPING EACH
OTHER IN CHECK, JUST AS I'D
EXPECT.
BUT ON THE OTHER SIDE, IT'S
A DIFFERENT STORY.
SO, WE'RE COMING ACROSS TO THE
SIDE WHICH WAS ACTUALLY ENRICHED
WITH ANTIBIOTICS, WASN'T IT?

Sheena says MM-HM.

Michael says PEER PAST THE FUG OF
CONDENSATION CAUSED BY SO MUCH
MICROBIAL ACTIVITY, AND OUR
TIME-LAPSE CAMERAS REVEAL THAT
EVEN ON THE SIDE WHICH IS
HEAVILY IMPREGNATED WITH
BROAD-SPECTRUM ANTIBIOTICS,
THERE ARE STILL BACTERIA
GROWING.
THOUGH, ADMITTEDLY, THERE ARE
A LOT LESS OF THEM.

Sheena says HERE, JUST HERE, AT THE TOP
OF THE HEAD, YOU CAN SEE,
THERE'S ACTUALLY QUITE A FEW
CLEAR ZONES.
SO, THAT SUGGESTS THAT CERTAINLY
THE ANTIBIOTIC IS DOING ITS JOB
IN AREAS, AND IT'S CERTAINLY
BEEN CONTROLLING IN THIS AREA
THE BLUE, WHICH WAS KIND OF
TAKING OVER EVERYTHING.

Michael says ONE OF THE THINGS THAT IS
VERY STRIKING TO ME IS ON THE
OTHER SIDE, THERE'S COMPETITION
GOING ON.

Sheena says MM-HM.

Michael says WHICH SUGGESTS THAT WIPING
OUT ALL YOUR BACTERIA IS A BAD
IDEA BECAUSE ACTUALLY YOU DO
WANT SORT OF GOOD BACTERIA,
IF YOU LIKE, TO KIND OF COMPETE
WITH THE PATHOGENS AND STOP THEM
ENCROACHING.

Sheena says ABSOLUTELY.

Michael says WHAT THIS DEMONSTRATES VERY
CLEARLY IS YOU SHOULDN'T TAKE
A BROAD-SPECTRUM ANTIBIOTIC
UNLESS YOU REALLY NEED TO.
AS THE CAVES OF NEW MEXICO
SHOWED US, THE MORE BACTERIA
ARE ATTACKED, THE MORE THEY
WILL RESIST.
BUT THERE IS ALSO AN
UNFORTUNATE FACT THAT
BROAD-SPECTRUM ANTIBIOTICS
CARPET BOMB FRIEND AND FOE
INDISCRIMINATELY.
THERE IS A LOT OF COLLATERAL
DAMAGE AMONGST THE BENIGN
AND BENEFICIAL SPECIES.
THIS ACCELERATES RESISTANCE
BECAUSE SURVIVING PATHOGENS
NOW HAVE LESS COMPETITION FOR
RESOURCES, AND THEY CAN
COLONISE THE WHOLE BATTLEFIELD.
IF ONE OF THESE SURVIVORS IS
RESISTANT TO MULTIPLE DRUGS
AND POTENTIALLY HARMFUL, IT'S
A SUPERBUG.
THE BAD NEWS FOR ME IS THE TEAM
HAVE FOUND TWO GROWING ON MY
CLONE.

The caption changes to "Doctor Andrew Edwards. Imperial College, London."

Andrew is in his forties, clean-shaven and with short graying hair. He wears glasses and a white lab coat.

He holds a petri dish and says ONE THAT IS PARTICULARLY
INTERESTING IS AN ORGANISM
CALLED ENTEROCOCCUS FAECIUM.
AND THIS IS AN ENTIRELY NORMAL
PART OF OUR GUT FLORA.
BUT IF IT GETS INTO THE WRONG
PARTS OF THE BODY, OR IF THE
PERSON HAS A COMPROMISED IMMUNE
SYSTEM, IT CAN CAUSE REALLY
SERIOUS INVASIVE INFECTIONS.
AND BECAUSE IT'S INHERENTLY
RESISTANT TO ANTIBIOTICS,
IT'S VERY, VERY HARD TO TREAT.

Michael says THE TEAM HAS ALSO FOUND
PSEUDOMONAS GROWING THROUGH
THE ANTIBIOTIC.
IT'S NOT PART OF MY SKIN FLORA,
BUT A TRAVELLING PATHOGEN
THAT CAN CAUSE INFECTION
AND PNEUMONIA IF IT GETS
INSIDE OUR BODIES...
SAY, THROUGH AN OPEN WOUND.
MICROBIAL MICHAEL HAS SHOWN ME
SUPERBUGS ON MY SKIN.
BUT WHAT ABOUT INSIDE ME, WHERE
SOME REALLY IMPORTANT STUFF
HAPPENS?
I'VE SENT OFF A VERY PERSONAL
SAMPLE TO BE ANALYZED.

The caption changes to "Doctor Lindsay Hall. Quadram Institute."

Lindsay is in her thirties, with straight red hair in a bob cut with bangs. She wears a white lab coat.

She says SO, WE'VE RECEIVED A POO
SAMPLE FROM MICHAEL.
AND WE WANT TO HAVE A LOOK
TO DETERMINE IF HE'S GOT ANY
RESISTANT BACTERIA.
WHEN YOU THINK ABOUT
ANTIBIOTICS, MOST OF US WILL
TAKE THESE ORALLY, AND ALSO
WE'LL TAKE IT WITH A DRINK OF
WATER, SO THEREFORE, THE
ANTIBIOTICS WILL HIT THE GUT
FIRST.

Michael says OUR GUTS AND INTESTINES ARE
HOME TO AT LEAST 1,000
DIFFERENT SPECIES OF BACTERIA.
BUT NOW, THERE'S NEW RESEARCH
ABOUT WHAT CAN HAPPEN TO THEM
WHEN WE TAKE ANTIBIOTICS.

Anthony says THE STRIKING THING ABOUT A
HEALTHY PERSON WHO TAKES AN
ANTIBIOTIC IS THAT, IN ALL
LIKELIHOOD, THEY WILL GET
RESISTANT BACTERIA IN THEIR
TUMMIES, IN THEIR COLON,
ACTUALLY, AFTER ABOUT SEVEN
DAYS.
AND WITH SOME ANTIBIOTICS,
THESE RESISTANT BUGS LAST IN
THEIR TUMMIES FOR UP TO A YEAR.

Michael says THAT SOUNDS LIKE ANOTHER
COMPELLING REASON NOT TO TAKE
ANTIBIOTICS UNLESS YOU REALLY
HAVE TO.
I'M HOPING MY GUT DOESN'T
CONTAIN RESISTANT BACTERIA.

Michael meets with Lindsay at a café and says RIGHT, SO YOU HAD MY POO
SAMPLES.
WHAT DID YOU FIND?

Lindsay says SO...

Michael says LINDSAY HAS TRIED GROWING
MY GUT BACTERIA ON PLATES
CONTAINING FOUR CLINICALLY
IMPORTANT ANTIBIOTICS.
PRESUMABLY, THESE PLATES SHOULD
BE CLEAR OF BACTERIA.

Lindsay shows him an image on a tablet and says YEAH.
IF YOU HAD SUSCEPTIBLE BACTERIA,
THEN THEY SHOULD BE CLEAR,
BUT AS YOU CAN SEE, THERE'S
MULTIPLE COLONIES ON EACH OF
THE PLATES, WHICH WOULD SUGGEST
THEY ARE RESISTANT TO THAT
ANTIBIOTIC.

Michael says THAT DOES SURPRISE ME.
I HAVEN'T HAD THAT MANY
ANTIBIOTICS IN MY LIFE.

Lindsay says WELL, I WAS GOING TO ASK,
WHEN WAS THE LAST TIME YOU HAD
A COURSE OF ANTIBIOTICS?

Michael says PROBABLY ABOUT FOUR YEARS
AGO.

Lindsay says YEAH, OKAY, SO THAT'S QUITE
A LONG TIME AGO, BUT MAYBE DOES
CORRELATE WITH SOME OF THE
DATA THAT WE'VE SHOWN.

Michael says THAT'S A NASTY SURPRISE.
I'VE GOT BACTERIA GROWING
INSIDE ME WHICH ARE RESISTANT
TO ALL FOUR ANTIBIOTICS -
ONE OF WHICH I'VE NEVER EVEN
TAKEN.
I KNOW THE NAME, BUT I THINK
I WOULD KNOW IF I'D HAD IT.

Lindsay says YEAH, YOU WOULD PROBABLY KNOW
IF YOU HAD VANCOMYCIN.
IT'S A LAST-RESORT ANTIBIOTIC,
SO THIS IS WHAT YOU GET IF
YOU'RE REALLY ILL.

Michael says OKAY.
THAT IS REALLY QUITE WORRYING,
I MUST ADMIT.

Lindsay says AND WHAT'S REALLY QUITE
STRIKING IS THE FACT THAT THE
MAIN CULPRIT IN TERMS OF HAVING
ANTIBIOTIC-RESISTANT GENES IS
E. COLI.

Michael says BLIMEY.
I HAVE E. COLI IN MY GUT, WHICH
IS RESISTANT TO EVERYTHING.

Lindsay says YES.

Michael says BLIMEY, THAT'S BAD NEWS!
OKAY, THAT'S NOT WHAT I WAS
HOPING TO HEAR.
THERE ARE LOTS OF DIFFERENT
STRAINS OF E. COLI.
A FEW ARE VERY NASTY.
WE DON'T KNOW WHAT STRAIN I'VE
GOT, BUT WE DO KNOW IT'S VERY
RESISTANT.
NOW, THAT WAS AN UNPLEASANT
SURPRISE.
IT'S ONE THING TO TALK ABOUT
ANTIBIOTIC RESISTANCE, BUT TO
DISCOVER THAT I'VE GOT THESE
E. COLI, AND THEY ARE RESISTANT
TO ALL SORTS OF ANTIBIOTICS IS,
I MUST ADMIT, WORRYING.
I'M NOT REALLY WORRIED BY
THE FACT IT'S E. COLI.
IT'S THE RESISTANCE BIT.
WHY?
WELL, ONCE RESISTANCE EMERGES
IN ONE SPECIES OF BACTERIA,
IT CAN SPREAD TO OTHER SPECIES.
IT'S ALL TO DO WITH THE WAY
THEY EXCHANGE GENES, AS
SHEENA CAN EXPLAIN.

Sheena says WE GET ALL OUR DNA FROM OUR
PARENTS, SO YOU GET HALF FROM
YOUR MOM, HALF FROM YOUR DAD.
THAT'S YOUR LOT.
YOU DON'T GET ANY MORE.
YOU MIGHT SEE THAT CHAP DOWN
THE CORRIDOR WHO NEVER CATCHES
A COLD AND THINK, "OH, I'D LOVE
TO BE ABLE TO STEAL THAT
ABILITY."
BUT WE CAN'T.
BUT IMAGINE YOU COULD.
IMAGINE YOU COULD STEAL DNA AND
SWAP DNA JUST AS EASILY AS YOU
SWAP YOUR E-MAIL OR YOUR
TELEPHONE NUMBER.
AND BASICALLY, BACTERIA CAN DO
THAT.
IT'S CALLED HORIZONTAL GENE
TRANSFER, AND THIS IS THE WAY
ANTIBIOTIC RESISTANCE CAN
SPREAD.

Michael says USING THIS TRICK, DIFFERENT
SPECIES OF BACTERIA SHARE
GENETIC INFORMATION...
INCLUDING THE ABILITY TO RESIST
A SPECIFIC ANTIBIOTIC.
THE BACTERIA DON'T EVEN HAVE
TO BE TOUCHING BECAUSE THEY CAN
ALSO PICK UP BITS OF GENETIC
INFORMATION LEFT IN THE
ENVIRONMENT AROUND THEM.
THAT MEANS THE E. COLI INSIDE
ME COULD, THEORETICALLY,
SHARE ITS GENES WITH OTHER
SPECIES, AND TURN MY GUT
INTO A FACTORY OF RESISTANT
BACTERIA.
AND WE HAVE PLENTY OF EVIDENCE
THAT REALLY DOES HAPPEN.
RESISTANCE IS SPREADING FROM
MICROBE TO MICROBE.
WHEREVER ANTIBIOTICS ARE USED
INTENSIVELY, SUCH AS HOSPITALS,
MORE RESISTANT BACTERIA EMERGE.
THEY SHARE THEIR GENES.
THEY MULTIPLY.
THIS EXPLAINS HOW SUPERBUGS
LIKE MRSA AND E. COLI CAN
RESIST SO MANY DIFFERENT DRUGS.
AND THEY DON'T STAY CONFINED
INSIDE OUR HOSPITALS...
BECAUSE, LIKE US, BACTERIA
CAN TRAVEL.
AND PEOPLE AREN'T THE ONLY
SOURCE OF RESISTANT BACTERIA.
GLOBALLY, HALF OF ALL
ANTIBIOTICS ARE GIVEN TO
ANIMALS.

An animation shows bacteria spreading from a hospital to the surrounding areas.

(COW MOOING)

Michael says IN COUNTRIES LIKE AMERICA AND
CHINA, THEY ARE EVEN WIDELY
USED AS GROWTH PROMOTERS.
(MOOING)
ANIMALS AND HUMANS ALIKE PUMP
OUT MORE AND MORE RESISTANT
BACTERIA.
BUT HOW FAR IS THE WAVE OF
RESISTANCE SPREADING?

(music plays)

Michael says IN CORNWALL, A PIONEERING NEW
STUDY HAS FOUND EVIDENCE THAT
RESISTANT BACTERIA ARE
TRAVELLING THROUGH OUR
WATERWAYS, OUT TO SEA, AND THEN
BACK AGAIN, INTO HUMANS.

The caption changes to "Doctor Anne Leonard. University of Exeter Medical School."

Anne is in her thirties, with mid-length straight brown hair in a ponytail and wears black leggings and a black jacket.

Anne says HI.
I'M GOING TO TALK TO YOU ABOUT
THE BEACH BUMS SURVEY.
WE RECRUITED 300 PEOPLE TO OUR
SURVEY, SURFERS AND PEOPLE WHO
DON'T SURF, AS WELL, AND ASKED
THEM TO COLLECT SWABS OF THEIR
FAECAL MATERIAL.
YOU TAKE THE SWAB, SEND IT BACK
TO US IN THE POST, AND THEN
WE TEST IT FOR THE PRESENCE
OF RESISTANT BACTERIA.
WHAT WE FOUND IS THAT A GREATER
PROPORTION OF SURFERS HAVE
RESISTANT BACTERIA IN THEIR GUTS
COMPARED TO PEOPLE WHO DON'T
SURF.
WE THINK THAT, IF YOU SWALLOW
A LOT OF SEAWATER, THAT SOME
OF THE BACTERIA THAT ARE
PRESENT IN THE SEAWATER SURVIVE
AND GO ON TO LIVE INSIDE...
INSIDE YOUR GUT.

Michael says IF RESISTANT BACTERIA CAN
MAKE IT OUT TO SEA AND THEN
INTO SURFERS, I COULD HAVE
PICKED UP THE RESISTANT
E. COLI IN MY GUT FROM, WELL,
JUST ABOUT ANYWHERE.
THE GOOD NEWS IS THAT IN THE UK
AND SOME OTHER COUNTRIES,
ANTIBIOTIC USE IN FARMING HAS
STARTED TO COME DOWN.
BUT THERE'S NO PUTTING THE
GENIE BACK IN THE BOTTLE.
RESISTANT BUGS ARE IN OUR
BODIES AND ALL AROUND US.

Thony says aTHERE ISN'T ANY DOUBT THAT
WE HAVE BEEN COMPLACENT, AND
WE HAVE WALKED INTO THIS HUGE
PROBLEM.
BUT HUMANS HAVE BEEN BETWEEN
A ROCK AND A HARD PLACE HERE.
THEY WANT TO USE ANTIBIOTICS,
BUT AS SOON AS THEY USE THEM,
RESISTANCE ARISES.
BECAUSE THEY ARE LIFE-SAVING,
IF YOU STOP USING ANTIBIOTICS,
PEOPLE DIE.

(MACHINE FLATLINING)

Anthony says AT THE END OF THE DAY,
WE NEED NEW ANTIBIOTICS.

(music plays)

Michael says TROUBLE IS, MODERN MEDICINE
HASN'T FOUND A TOTALLY NEW
TYPE OF ANTIBIOTIC IN MORE
THAN 30 YEARS.
EACH NEW DRUG INVOLVES A LONG
AND COMPLEX PROCESS OF CHEMICAL
ENGINEERING AND TESTING.
(BEEPING)
THEY ARE CERTAINLY DIFFICULT
TO MAKE FROM SCRATCH.
INSTEAD, SCIENTISTS HAVE RELIED
ON FINDING NEW MICROBES,
GROWING THEM AND THEN TRYING
TO IDENTIFY AND EXTRACT ANY
CHEMICALS WITH POTENTIAL
ANTIBIOTIC PROPERTIES.
ONE PROBLEM IS THAT MANY
MICROBES SIMPLY WON'T GROW
USING TRADITIONAL LAB
TECHNIQUES.
AND WITHOUT BEING ABLE TO GROW
THEM, WE WILL STRUGGLE TO
DEVELOP NEW ANTIBIOTICS.

(music plays)

Michael says TIME TO SEARCH OUT SOME NOVEL
SOLUTIONS.
HERE IN BOSTON, I'VE COME TO
MEET A MAVERICK MICROBIOLOGIST
WHO, I'M TOLD, HAS DEVELOPED A
WHOLE NEW WAY OF GROWING
BACTERIA AND, IN THE PROCESS,
DISCOVERED POSSIBLY THE FIRST
NEW CLASS OF ANTIBIOTIC IN
DECADES.
DR. SLAVA EPSTEIN HAS PROMISED
TO SHOW ME HIS SECRET.

Slava is in his fifties, with short brown hair and a graying beard. He wears cream trousers and a puffy black jacket.

They walk in a park with a shovel and a bucket.

Michael says DO YOU SEE A SUITABLE SPOT
SOMEWHERE AROUND HERE?

Slava says WE CAN FIND A SUITABLE SPOT
JUST ABOUT ANYWHERE ON THE
PLANET.
SO, THE FIRST THING THAT
HAPPENS, WE COLLECT SOIL.
WE COLLECT SOIL.
WE DON'T HAVE TO HAVE TOO MUCH
OF IT BECAUSE EVERY GRAM OF
SOIL IS EASILY A BILLION OR
10 BILLION CELLS.
BUT WHAT WE'RE GOING TO DO WITH
THE CELLS IN THE LAB IS GOING
TO BE VERY DIFFERENT.

Michael says TWO-THIRDS OF OUR MOST
IMPORTANT ANTIBIOTICS WERE
ORIGINALLY FOUND IN MICROBES
LIVING IN SOIL, A WELL WHICH
LOOKED LIKE IT HAD RUN DRY.
BUT NOW, SLAVA HAS THROWN OUT
THE 130-YEAR-OLD PETRI DISH AND
REPLACED IT WITH A DEVICE THAT,
TO MY EYES, LOOKS EQUALLY
LOW-TECH - A PLASTIC TRAY INTO
WHICH HIS ASSISTANT ADDS A
DILUTED SOLUTION OF THE SOIL
SAMPLE.

At the lab, Slava says IN THIS VIAL, THERE IS
ABOUT 100 CELLS.

Michael says 100 CELLS DOWN FROM A FEW
BILLION?

Slava says YES.

Michael says AND THESE ARE ALL BACTERIA?

Slava says THESE ARE ALL BACTERIA.
IT IS STARTING FROM THIS POINT
THAT THINGS ARE GOING TO BE
DIFFERENT, BECAUSE WE ARE NOT
GOING TO PUT THEM INTO A
PETRI DISH.
INSTEAD, WE ARE PREPARING THIS
DEVICE.
IT IS JUST A COLLECTION OF WELLS
WITH A POROUS BOTTOM.

Michael says OKAY.
SO, I HAVE TO SAY, THIS DOESN'T
LOOK THAT RADICAL.
NOT BEING A MICROBIOLOGIST,
I PROBABLY DON'T UNDERSTAND
WHY IT IS SO DIFFERENT.

Slava says IT IS RADICAL BECAUSE... HAVE
I EVER MENTIONED THE WORD
"NUTRIENT"?

Michael says NO.

Slava says BECAUSE THERE IS NONE.

Michael says OKAY.

Slava says WE DON'T NEED THEM.
UNLIKE THE PETRI DISH, WE DO
NOT.
WE DO NOT WANT TO CREATE
ARTIFICIAL CONDITIONS.
NOW, THAT WILL GO INTO THE SOIL
FROM WHICH THESE CELLS CAME
FROM.

Michael says AH!
THAT IS CLEVER.

Slava says SO, INSIDE...
THANK YOU.
INSIDE...

Michael says I GET IT AT LAST.

Slava says CHEMICALLY, IT WILL NOT BE
DIFFERENT FROM THE OUTSIDE.
SO, IF THE CELLS CAN GROW IN
NATURE...

Michael says YOU ARE RETURNING THEM
TO THEIR NORMAL ENVIRONMENT
RATHER THAN STICKING THEM
IN AGAR.

Slava says THEY SHOULD BE ABLE TO GROW
INSIDE.

Michael says AH!
BY PUTTING THE BACTERIA BACK
INTO THE SOIL THEY CAME FROM,
SLAVA IS ENCOURAGING THEM TO
GROW JUST LIKE THEY WOULD IN
THE WILD.
COMPARED TO USING AGAR JELLY,
THE RESULTS ARE ASTOUNDING.

Slava says THE DIFFERENCE IN COLONY
COUNT BETWEEN THE TWO METHODS
IS 30,000 percent.

Michael says WOW.
YOU CAN GROW 30,000 percent MORE CELLS
IF YOU DO IT THIS WAY THAN IF
YOU DO IT THE CONVENTIONAL WAY.

Slava says THAT'S CORRECT.

Michael says THIS TECHNIQUE MEANS THEY CAN
GROW BACTERIA THAT WOULD
NORMALLY BE MISSED, AND THEY
HAVE CREATED VERSIONS OF THE
DEVICE TO LOOK FOR NOVEL
BACTERIA IN ALL SORTS OF
ENVIRONMENTS, INCLUDING THE
HUMAN MOUTH.
VERY NEAT.

Slava says IT'S ALSO VERY SIMPLE.

(MICHAEL LAUGHING)

Slava says YOU CAN REALLY BUILD THESE
DEVICES IN YOUR GARAGE.

Michael says WHAT EXCITES ME ABOUT SLAVA'S
DISCOVERY IS IT MEANS THERE'S
CLEARLY A WHOLE WORLD OF
MICROBES OUT THERE, JUST
WAITING TO BE FOUND.
IMAGINE YOU ARE AN ANCIENT GREEK
LOOKING UP AT THE SKY.
YOU'D ONLY SEE A TINY HANDFUL OF
THE STARS AND PLANETS THAT ARE
ACTUALLY OUT THERE.
IN SOME WAYS, WE ARE A BIT LIKE
THAT ANCIENT GREEK WHEN IT COMES
TO THE MICROBIAL WORLD.
THERE IS A VAST GALAXY OF TINY
CREATURES, AND WE ARE CURRENTLY
ONLY AWARE OF A VERY SMALL
PROPORTION OF THEM.
WE NEED TO START LOOKING FOR
NEW ANTIBIOTICS MUCH FURTHER
AFIELD THAN THE SOIL UNDER
OUR FEET.
SOME SCIENTISTS THINK SEABEDS
COULD BE RICH IN ANTIBACTERIAL
POTENTIAL.
EASIER PICKINGS ARE WASHING UP
ON OUR SHORES WITH EVIDENCE
CLIPS OF SEAWEED CONTAIN
MICROBIAL AGENTS EFFECTIVE
AGAINST MRSA.
AND DEEP IN THE CAVES UNDER NEW
MEXICO, HAZEL BARTON'S TEAM
HAS DISCOVERED THAT MILLIONS
OF YEARS OF INTENSE BACTERIAL
WARFARE HAS PRODUCED CHEMICALS
WE MAY BE ABLE TO USE.

Hazel says ONE OF THE ORGANISMS THAT
WE FOUND MADE 38 NOVEL
ANTIMICROBIAL COMPOUNDS,
OF WHICH THREE WERE NEW
ANTIBIOTICS.

Michael says HM.

Hazel says SO, THE POTENTIAL IS THAT
PEOPLE TURN THEIR ATTENTION TO
THESE EXTREME ENVIRONMENTS LIKE
CAVES, LIKE THE DEEP OCEAN,
LIKE, YOU KNOW, THE ARCTIC WE
ARE GOING TO HAVE THIS EXPLOSION
IN NEW COMPOUNDS OVER THE NEXT
10-15 YEARS.

Michael says THE HUNT FOR ANTIBIOTICS IS
NOT JUST IN EXTREME
ENVIRONMENTS, BUT ANYWHERE
THAT'S HOME TO NOVEL MICROBES.
PROFESSOR MATT HUTCHINGS HAS
FOUND WHAT COULD BE A NOVEL
ANTIBIOTIC IN... AN ANT FARM.

Matt is in his late forties, clean-shaven and with short wavy gray hair. He wears glasses, jeans, a red and white gingham shirt and a gray coat.

Matt says IT'S AN AMAZING SYSTEM.
THEY'VE BEEN USING ANTIBIOTICS
FOR 50 TO 60 MILLION YEARS.

On a table, Matt puts an ant farm that consists of 3 containers connected by pipes.

Michael says THE SECRET MATT'S TEAM HAS
UNLOCKED IS IN THE RELATIONSHIP
BETWEEN THESE LEAF-CUTTER ANTS
AND THEIR FOOD SOURCE.

Matt says THE FUNGUS IS THE ONLY FOOD
FOR THIS WHOLE ANT COLONY.
AND IF THEY SMELL ANY FOREIGN
FUNGI THAT MIGHT CAUSE DISEASE
IN THERE, THEY CUT IT OUT,
THEY CARRY IT OVER TO THIS PART,
WHICH IS THE WASTE DUMP, WHICH
IS USUALLY OUTSIDE THE NEST.
THEY RUB THEIR BODIES AGAINST
IT, AND THEN THEY DIG IT BACK
INTO THE GROUND.
THE REALLY INTERESTING THING FOR
US IS THE REASON THEY RUB THEIR
BODIES AGAINST IT IS BECAUSE
THEIR BODIES ARE COVERED IN
ANTIBIOTIC-PRODUCING BACTERIA
THAT THE ANTS CAN USE TO DEFEND
THEIR FUNGUS AGAINST DISEASE.

Michael says MATT'S LAB HAS EXTRACTED
A COUPLE OF EXPERIMENTAL NEW
ANTIBIOTICS FROM THE BACTERIA
ON THE ANTS.
THEY HAVEN'T YET BEEN TESTED
ON HUMANS.
SO, TIME FOR PART TWO OF OUR
EXPERIMENT, USING MY BODY -
WELL, BITS OF MY BODY TO TEST
OUT SOME OF THESE NOVEL DRUGS.
WE'RE CREATING A BIOHAZARD
AND INFECTING DIFFERENT PARTS
OF ME WITH THREE OF THE MOST
COMMON MULTI-DRUG-RESISTANT
SUPERBUGS: MRSA, SALMONELLA
AND PSEUDOMONAS.
WHERE SHOULD I PUT IT, THEN?

Andrew says ON THE FINGERS.

Michael says ON THE FINGERS, IN THERE?
THEN, WE'LL TRY TO CURE THEM.
FIRST, I WANT TO SEE IF ANT
ANTIBIOTIC CAN TACKLE AN
INFECTION OF MRSA...
ON MY FACE.
MRSA CAN CAUSE SKIN INFECTIONS.
IF IT GETS INSIDE US AND
ATTACKS OUR LUNGS, IT CAN BE
PARTICULARLY DANGEROUS.
WE'VE GIVEN MY FACE A FEW DAYS
FOR THE BACTERIA TO TAKE HOLD.
SO, THIS IS THE ANT ANTIBIOTIC,
AND IT IS GENUINELY NEW AND
REALLY RATHER EXCITING BECAUSE,
AS YOU CAN SEE, IT'S REALLY
WORKING, BECAUSE THAT WHITE DISC
ON MY FOREHEAD THERE, THERE'S
A ZONE OF DEATH AROUND IT WHICH
SUGGESTS THAT IT REALLY IS
KILLING ALL THOSE BACTERIA.
SO THE GOOD NEWS IS, IT'S NEW
AND IT'S WORKING.
THE BAD NEWS IS IT'S PROBABLY
TEN, 15, 20 YEARS AWAY.

(music plays)

Michael says WHY SO LONG?
WELL, FINDING AN ANTIBIOTIC IN
NATURE IS JUST THE FIRST STAGE
IN AN EXPENSIVE AND VERY
COMPLICATED PROCESS.

Matt says TO DISCOVER A NEW ANTIBIOTIC,
I MEAN, YOU HAVE TO GO FROM THE
EARLY STAGE OF DISCOVERY - SO
ISOLATE BACTERIA FROM A PLACE
LIKE A LEAF-CUTTER ANT NEST -
GET THOSE BACTERIA GROWING ON
A PLATE, SOLVE THE CHEMICAL
STRUCTURE OF THAT ANTIBIOTIC
WHICH IS NOT TRIVIAL, AND THEN,
OF COURSE, YOU HAVE TO GET A
DRUG COMPANY INTERESTED BECAUSE
THEY'RE THE ONLY PEOPLE WITH
ENOUGH MONEY TO GET THINGS
THROUGH CLINICAL TRIALS.
THE REALITY IS, LESS THAN 1 percent ARE
ACTUALLY SUITABLE CANDIDATES
AND MAKE IT THROUGH TO ACTUALLY
GET THEM TO THE STAGE WHERE
THEY'RE APPROVED AS SAFE TO USE
IN HUMANS.
SO, IT CAN TAKE 15-20 YEARS
AND COST, WELL, BETWEEN HALF
AND 1 BILLION DOLLARS.

Michael says A TIME LAG OF 15 TO 20 YEARS
IS MASSIVE GIVEN THAT AROUND
700,000 PEOPLE ALREADY DIE
ANNUALLY BECAUSE OF
ANTIBIOTIC-RESISTANT BACTERIA.
SO, WHAT ARE WE GOING TO DO
UNTIL NEW DRUGS EMERGE?
FOR STARTERS, SURELY WE COULD
USE OUR EXISTING STOCK MORE
CAREFULLY.
HALF OF ALL HOSPITAL
PRESCRIPTIONS ARE FOR
BROAD-SPECTRUM ANTIBIOTICS.
AND GIVEN EVERYTHING I'VE
LEARNT, THAT CAN'T BE A GOOD
IDEA.
WHY DO DOCTORS CONTINUE TO USE
BROAD-SPECTRUM ANTIBIOTICS?
IT STRIKES ME AS LIKE CARPET
BOMBING EVERYTHING AND YOU'D BE
BETTER OFF IF YOU WERE A BIT
MORE TARGETED.

The caption changes to "Doctor Tim Walker. Nuffield Department of Medicine, Oxford University Hospitals."

Tim is in his thirties, clean-shaven and with short wavy gray hair. He wears glasses, jeans, a white shirt and a black sweater.

Tim says WELL, AS A DOCTOR, YOU'RE
CONFRONTED WITH A DILEMMA.
WHEN YOU SEE A NEW PATIENT,
YOU DON'T NECESSARILY HAVE THE
DIAGNOSIS IN FRONT OF YOU.
SO, YOU WANT TO SAVE THE
PATIENT, AND YOU WANT TO COVER
ALL THE EVENTUALITIES.
AND HENCE, YOU USE A
BROAD-SPECTRUM ANTIBIOTIC.

Michael says RIGHT, BECAUSE YOU DON'T KNOW
WHAT IT IS YOU'RE TRYING TO HIT.

Tim says EXACTLY.

Michael says TO USE TARGETED
NARROW-SPECTRUM ANTIBIOTICS,
DOCTORS NEED TO BE ABLE TO
QUICKLY DIAGNOSE THE SPECIFIC
INFECTION IN A PATIENT.
FOR SOME BUGS, LIKE THE ONES
THAT CAUSE TUBERCULOSIS, THAT
MEANS TAKING SAMPLES, GROWING
THE BACTERIA AND SEQUENCING
ITS DNA - A PROCESS THAT CAN
TAKE UP TO TEN WEEKS.
BUT TIM'S PART OF A TEAM
WORKING ON A PROTOTYPE GADGET
THAT COULD MASSIVELY SPEED UP
DNA SEQUENCING.
SO, YOU SEE THE PATIENT AND THEY
SPIT INTO YOUR POT.

Tim says YEP.
AND THE DNA FROM YOUR PHLEGM
GOES ON THERE.

Michael says OKAY.

Tim says YOU CLOSE IT.

Michael says AND THEN, IT...
THIS SEQUENCES IT?

Tim says THAT SEQUENCES IT.

Michael says BLOODY HELL.

Tim says NOW...

Michael says THAT IS REALLY, REALLY
IMPRESSIVE, I HAVE TO SAY.
THAT IS IMPRESSIVE.
SO, HOW QUICKLY WOULD YOU THEN
BE ABLE TO MAKE A DIAGNOSIS?

Tim says THE SEQUENCING OF THE GENOME
WILL TAKE LESS THAN AN HOUR.

Michael says YEAH.

Tim says THE ANALYSIS TAKES ABOUT TWO
MINUTES.

Michael says OKAY, RIGHT, OKAY.
TWO MINUTES AS OPPOSED TO TEN
WEEKS?

Tim says YES.

Michael says RIGHT, THAT IS REALLY
CRUNCHING IT, ISN'T IT?
AND THIS, PRESUMABLY, ISN'T
JUST FOR TB.

Tim says NO.
IT'S OF GREAT USE FOR TB, BUT
IT CAN BE USED FOR ANY
BACTERIUM.
IF YOU'RE ABLE TO GET A
DIAGNOSIS WITHIN MINUTES
OF SEEING YOUR PATIENT, IT
ENABLES YOU TO GIVE THE CORRECT
NARROW-SPECTRUM ANTIBIOTIC THAT
TARGETS JUST THOSE BACTERIA
THAT ARE CAUSING THE ILLNESS
AND NOTHING ELSE, SO IT'S
PRECISION BOMBING RATHER THAN
CARPET BOMBING.

Michael says IF TRIALS IN CLINICS OVER
THE NEXT COUPLE OF YEARS ARE
SUCCESSFUL, THIS DEVICE COULD
EXTEND THE LIFE OF ANTIBIOTICS
BY SLOWING THE PACE OF
RESISTANCE.
BUT WHAT IF WE COULD ALSO STOP
SOME BUGS FROM RESISTING
ALTOGETHER?
SOME COMMONLY PRESCRIBED
ANTIBIOTICS WORK BY GETTING
INTO BACTERIAL CELLS, AND WHEN
THEY HIT A LETHAL DOSE, THIS
CAUSES THE BACTERIA TO RUPTURE,
SOMETHING THEY HAVE EVOLVED
WAYS TO RESIST.
DR. JESS BLAIR IS PART OF A
TEAM FROM BIRMINGHAM UNIVERSITY
WITH A PLAN TO STOP THE
BACTERIA FIGHTING BACK.
SHE IS GOING TO TRY AND EXPLAIN
THE PRINCIPLE BEHIND HER
APPROACH USING A BUCKET AS A
BACTERIAL CELL.

Jess is in her thirties, with long straight blond hair and wears glasses, black leggings and a black coat.

She takes a bucket of water form a swimming pool and says OKAY, SO YOU'VE GOT A
WATERING CAN HERE FULL OF
ANTIBIOTIC.
IF YOU START POURING THAT INTO
OUR BACTERIAL CELL, WHAT WE
HOPE, THEN, IS THAT THIS WILL
KILL OFF THE BACTERIAL CELL.
SO, FOR ARGUMENT'S SAKE, LET'S
SAY OUR LEVEL AT WHICH THE
ANTIBIOTIC BECOMES TOXIC IS
HERE.
SO, YOU NEED TO KEEP POURING.
HOWEVER, BACTERIA HAVE A NIFTY
TRICK.
IN THEIR MEMBRANES, THEY HAVE
PUMPS CALLED EFFLUX PUMPS.

Michael says SO, I'M POURING IN
ANTIBIOTICS, AND THE BACTERIA
ARE JUST PUMPING THEM OUT.

She pumps water off the bucket and says PUMPING THEM STRAIGHT BACK
OUT AGAIN.
SO, NOW IT'S NOT LOOKING QUITE
SO GOOD.
SORRY, I'M GETTING YOUR FEET
WET.

Michael says YEP.

Jess says IT'S GOING TO BECOME A BIT
MORE DIFFICULT FOR YOU TO GET
THE ANTIBIOTIC TOWARDS OUR LINE
AT WHICH IT'S GOING TO BECOME
TOXIC.

Michael says RIGHT.

Jess says AND WHAT HAPPENS WHEN THEY
BECOME REALLY ANTIBIOTIC
RESISTANT IS THEY MAKE MORE
AND MORE OF THESE PUMPS.

Michael says OKAY, THAT'S A VERY NEAT
TRICK.
SO, WHAT CAN YOU DO ABOUT IT?

Jess says WELL, IN MY POCKET, I'VE
GOT A CABLE TIE TO SORT OF
DEMONSTRATE THIS.
SO, WE HAVE INHIBITED THE EFFLUX
PUMP.
SO, YOU'RE ABLE TO KEEP POURING
THE ANTIBIOTIC IN...

Michael says THERE WE GO!

Jess says AND WE'RE ABOUT TO REACH
THE LEVEL WHICH IS GOING TO KILL
OUR BACTERIAL CELL.

Michael says DIE, BACTERIA, DIE!
THERE WE GO.
OKAY, SO THAT'S THE THEORY.
I MEAN, HOW CLOSE ARE WE TO IT
IN PRACTICE?
WHEN I SAY "WE," I MEAN YOU,
OF COURSE.
(LAUGHING)

Jess says WELL, PEOPLE HAVE BEEN ABLE
TO FIND MOLECULES THAT DO THIS.
THE PROBLEM IS THERE'S NO
MOLECULES AT THE MOMENT WHICH
ARE ABLE TO BOTH INHIBIT EFFLUX
PUMPS, BUT ALSO ARE OKAY TO BE
GIVEN TO A PERSON.
MOST OF THE ONES THAT WE
CURRENTLY HAVE ARE TOXIC TO
PEOPLE.

(music plays)

Michael says BECAUSE SHE CAN'T TEST HER
INHIBITOR CHEMICAL ON A LIVING
HUMAN BEING, JESS IS GOING
TO TEST IT INSTEAD ON A
SALMONELLA INFECTION
IN MY HAND.
WHILE SHE DOES THAT, DR. ANDY
EDWARDS AND I ARE TRYING OUT
ANOTHER EXPERIMENTAL CHEMICAL
ON MY OTHER HAND, WHICH WE HAVE
INFECTED WITH MRSA.
ANDY WANTS TO SHOW ME WHAT HE
CALLS AN ANTIBIOTIC AMPLIFIER.
IT'S DESIGNED TO STOP THIS
SUPERBUG FROM RESISTING AN
EXISTING ANTIBIOTIC CALLED
CIPROFLOXACIN.

Andrew says SO, WHAT CIPROFLOXACIN DOES
IS TO BREAK UP BACTERIAL DNA.
IT SMASHES IT INTO LOTS OF
SMALL PIECES.
AND MRSA IS REALLY GOOD AT THEN
STICKING THAT BACK TOGETHER
AND SURVIVING.
SO, WHAT WE WANT TO DO WITH
OUR ANTIBIOTIC AMPLIFIER IS
PREVENT THE BACTERIUM FROM
STICKING THE DNA BACK TOGETHER
AGAIN.

Michael says MRSA HAS A VERY BAD
REPUTATION, DOESN'T IT?

Andrew says IT HAS A BAD REPUTATION FOR
A GOOD REASON.
SO, MRSA CAUSES LOTS AND LOTS
OF SURGICAL-SITE INFECTIONS
AND OTHER SKIN INFECTIONS,
PARTICULARLY IN HOSPITALS.
AND ONCE IT GETS INTO THE BLOOD,
VERY, VERY SERIOUS.
IT CAN ATTACH TO YOUR HEART,
BONES AND JOINTS.

Michael says SO, YOU'RE GOING TO TRY AND
MAKE THIS NON-RESISTANT AGAIN,
REVERSE IT IF YOU LIKE.

Andrew says THAT'S RIGHT, THAT'S RIGHT.
WE'RE TRYING TO OUTSMART THE
BUG.

(music plays)

Michael says ANDY'S ANTIBIOTIC AMPLIFIER
AND JESS'S PUMP INHIBITOR ARE
AMONGST A NUMBER OF SO-CALLED
RESISTANCE BREAKERS CURRENTLY
IN DEVELOPMENT.
THE RESULTS FROM OUR TEST
CERTAINLY SUGGEST THEY COULD
HAVE A PROMISING FUTURE,
THOUGH THE FIRST ONE IS EASIER
TO MAKE OUT ON A PETRI DISH
THAN ON MY AGAR HAND.
THIS IS THE PUMP INHIBITOR,
THE ONE THAT STOPS THE BACTERIA
PUMPING OUT THE ANTIBIOTICS,
AND THIS ONE IS WORKING RATHER
WELL.
YOU'VE GOT THE SALMONELLA
INFECTION HERE, AND IT IS
RESISTANT TO THE ANTIBIOTIC
WHICH IS IN THE REST OF THE
PLATE.
BUT HERE, IN THE MIDDLE, THAT
BIT THERE IS WORKING BECAUSE
THE AREA AROUND IT IS CLEAR.
SO, THAT'S PROMISING.
THAT'S GOOD.
NEXT, THE HAND THAT WAS
INFECTED WITH MRSA.
WHAT'S ENCOURAGING IS THE AREA
THAT I PAINTED ON THE BACK OF
THE HAND, HERE, WHICH WAS A
MIXTURE OF THE AMPLIFIER AND
THE ANTIBIOTIC, THAT IS CLEAN.
SO, THAT WOULD SUGGEST THAT THE
AMPLIFIER IS DOING WHAT IT
SHOULD DO, WHICH IS PREVENTING
BACTERIA FROM REFORMING THEIR
DNA, AND THEREFORE, THE
BACTERIA ARE BEING KILLED.
THAT ONE I GIVE HIGH MARKS TO.
THAT ONE WORKED.
THAT'S ENCOURAGING RESULTS
FROM ONE EXPERIMENTAL
ANTIBIOTIC AND TWO
RESISTANCE-BREAKERS.
BUT NONE OF THESE CURES WILL BE
READY TO USE ON YOU OR ME
ANY TIME SOON.
THE FINAL THING I WANT TO LOOK
AT IS SOMETHING WHICH WILL KILL
BACTERIA, BUT WHICH ISN'T
ACTUALLY AN ANTIBIOTIC.

Alex walks in a park and says THIS IS WHERE I NORMALLY
COME.

Alex is in his thirties, with short blond hair and wears cream trousers and a blue hooded jacket.

Michael says AT OXFORD UNIVERSITY,
MICROBIOLOGIST DR. ALEX BETTS
IS INVESTIGATING VIRUSES WHICH
NATURALLY ATTACK BACTERIA.

Alex says MIND YOUR FEET, 'CAUSE WE ARE
LOOKING FOR...
SOMETHING, ACTUALLY, A LOT
LIKE THAT.

Alex picks up animal feces and says PERFECT.

Michael says ALEX IS ONE OF A HANDFUL OF
SCIENTISTS IN THE UK WORKING
WITH BACTERIOPHAGES.

Alex says RIGHT-O.
ALL RIGHT, HERE WE GO.
OH, LOOK AT THAT.
ISN'T THAT DISGUSTING?
THIS IS A FRESH GOOSE POO,
AND FROM THESE, I CAN ISOLATE
THE BACTERIA AND THE VIRUSES
THAT ARE INSIDE THE DIGESTIVE
TRACT OF GEESE.
AND THAT I CAN TAKE BACK TO THE
LAB, AND IT SHOULD BE A TREASURE
TROVE OF THINGS THAT COULD
POTENTIALLY TREAT DISEASE
IN HUMANS.
LOVELY.

Michael says I WANT TO SEE IF ALEX'S
VIRUSES CAN CURE ME.
HERE WE GO.

Michael walks in the lab with his clone’s face and says I HAVE A GIFT FOR YOU, MY LOVELY
FACE.

Alex says FOR THE SCIENTIST WHO HAS
EVERYTHING.

Michael says IT'S QUITE WEIRD, ISN'T IT?

Alex says LOOK AT THAT NOSE!

Michael says THANK YOU, HA HA!

Michael says WHAT WE'RE GOING TO DO NOW IS
TEST A TYPE OF VIRUS ALEX
HAS ACQUIRED FROM A SEWAGE FARM
AGAINST A SUPERBUG PSEUDOMONAS.
THIS BUG CAUSES SEPTICAEMIA
AND PNEUMONIA.
IN SHORT, IT'S VERY NASTY.
SEPTICAEMIA

Alex says IT'S A POWERHOUSE
OF ANTIBIOTIC RESISTANCE.
IT'S A REAL PROBLEM.
AND IT'S BEEN ISOLATED FROM
FOOD, SOIL, DRINKING WATER,
EVEN REALLY EXTREME ENVIRONMENTS
LIKE AVIATION FUEL.
THIS THING CAN GROW ON PRETTY
MUCH ANYTHING, SO IT'S...

Michael says IT'S A GOOD TEST, BASICALLY.

Alex says VERY MUCH SO.
IF WE CAN BEAT THIS, THEN WE ARE
IN A GOOD POSITION.

Michael says SO, THESE ARE BILLIONS OF
VIRUSES, IS THAT RIGHT?

Alex says YES, INDEED.
THESE ARE VIRUSES THAT INFECT
AND KILL BACTERIA, JUST AS PART
OF THEIR NATURAL LIFE CYCLES.
IT'S NOT SOMETHING WE'VE
ENGINEERED IN THE LAB.

Michael says THESE IMAGES WERE TAKEN WITH
A HUGELY POWERFUL MICROSCOPE.
YOU CAN SEE THE TINY VIRUSES
KNOWN AS PHAGES CLAMPED ONTO
A SINGLE BACTERIAL CELL.
PHAGES ARE PARASITES ON
BACTERIA.
THEY INJECT THEIR GENETIC
MATERIAL INTO A CELL, FORCING
IT TO PRODUCE A HUGE NUMBER
OF NEW PHAGES.
THESE THEN BURST OUT OF THE
CELL, DESTROYING IT.
RESEARCH INTO PHAGES IS JUST
GETTING STARTED IN THE UK.
(BELLS RINGING)
BUT IN EASTERN EUROPE, THEY'VE
BEEN EXPERIMENTING WITH
VIRUSES THERAPEUTICALLY
FOR ALMOST A CENTURY.
AND IN THE POLISH CITY OF
WROCLAW, THERE'S A SPECIALIST
CLINIC THAT'S ACHIEVING REALLY
IMPRESSIVE RESULTS IN
TREATING PEOPLE WITH
ANTIBIOTIC-RESISTANT
INFECTIONS.

(SPEAKING POLISH)

Michael says REMEMBER THE GRUESOME WOUND
IN SLAWA'S FOOT?
HER E. COLI INFECTION IS SO BAD
AND SO UNTREATABLE, THERE'S
A SERIOUS RISK SHE WILL HAVE
TO HAVE IT AMPUTATED.
NOW, SHE'S HOPING PHAGES CAN
SAVE IT.

The caption changes to "Doctor Ryszard Miedzybrodski. Hirszfeld Institute of Immunology and Experimental Therapy."

Ryszard is in his forties, clean-shaven and with short brown hair. He wears glasses, a cream shirt, a polka dotted purple tie and a lab coat.

He says THROUGH OUR EXPERIMENTAL
PHAGE THERAPY, WE WANT TO
PROTECT HER AGAINST AMPUTATION.
I'M GOING TO APPLY PHAGE
PREPARATION INTO THE WOUND.
AND I SHOW YOU HOW I DO IT.
THIS IS A PHAGE PREPARATION
AGAINST E. COLI.

Michael says THE DOCTORS HOPE TO GET
SLAWA'S INFECTION UNDER CONTROL
AND THEN PERFORM AN OPERATION
TO SAVE THE FOOT.
LOOK AWAY FOR A MINUTE IF
YOU'RE SQUEAMISH.

Ryszard says THE PATIENT WILL HAVE
SURGERY, WHICH AIM IS TO CUT
THIS DEAD TISSUE, BUT WE APPLY
PHAGES BEFORE TO DECREASE A
LOT OF BACTERIA.

Slawa says "For the time being when I’m using the phages the pain I gone. It really helps me, yes. I want to have a dog, I want to have a normal life, I want to start travelling again. I just want to be back, yes."

Michael says AFTER SURGERY, SLAWA WILL
RECEIVE COMBINATION THERAPY
USING PHAGES AND TARGETED
ANTIBIOTICS.

Slawa says "I like my leg and I want to keep it. And even now when I have hole in my feet I still like them and I will be fighting."

(SLAWA LAUGHING)

Michael says IT WILL BE MONTHS BEFORE
SLAWA KNOWS IF THE THERAPY IS
WORKING.
FINGERS CROSSED.
IN THE MEANTIME, LET'S SEE HOW
MY VIRUS TREATMENT IS GETTING
ON.

Alex brings the face and says HERE WE GO.

Michael says OKAY, NOW, IT DOESN'T LOOK
OBVIOUSLY DIFFERENT.

Alex says SO, UNDER WHITE LIGHTS, THE
BACTERIA AREN'T PARTICULARLY
VISIBLE, 'CAUSE THEY HAVE
KIND OF A SIMILAR COLOUR TO
THE AGAR, BUT THERE'S THIS
NEAT TRICK.
THEY PRODUCE A MOLECULE THAT
FLUORESCES VERY INTENSELY
UNDER UV LIGHT.

He turns a UV flashlight over the face and says LOOK AT THAT.

Michael says YEAH!

Alex says AND HOPEFULLY, WHEN I REMOVE
THE BANDAGE...

Michael says YEAH.

Alex says WE SHOULD SEE QUITE
A DIFFERENCE.

Michael says OH, YEAH!
THAT IS VERY, VERY STRIKING,
ISN'T IT?

Alex says AND THAT IS BECAUSE THE
BACTERIA WERE UNABLE TO GROW
IN THERE.

Michael says RIGHT.
IT'S REALLY DONE THE BUSINESS,
HASN'T IT?

Alex says IT HAS DONE, YEAH.
THE VIRUSES ARE NATURAL
PARASITES.
THEY HAVEN'T EVOLVED TO
COMPLETELY OBLITERATE THEIR
HOSTS, BUT WHAT YOU WILL GET IS,
HOPEFULLY, IN THE CONTEXT OF
THERAPY WHERE YOU'RE TREATING
A PATIENT WITH AN IMMUNE SYSTEM,
THAT YOU'LL PUSH THE BACTERIA
FAR ENOUGH SO THE PATIENT'S
IMMUNE SYSTEM CAN TAKE CARE OF
WHATEVER'S LEFT.

(music plays)

Michael says THERE HAVE BEEN NO CLINICAL
TRIALS IN THE UK YET.
BUT I'M HOPING THAT ONE DAY
PHAGES WILL MAKE A SIGNIFICANT
CONTRIBUTION TO FRONTLINE
MEDICINE.

Alex says THEY'RE NOT GOING TO REPLACE
ANTIBIOTICS, BUT THERE ARE
CERTAIN ROLES THAT THEY CAN
FULFIL THAT WOULD EASE THE
PRESSURE ON OUR EXISTING
THERAPEUTICS, BUY US SOME TIME
TO DEVELOP NEW ANTIMICROBIALS,
AND IT CAN CERTAINLY BE USED
ALONGSIDE ANTIBIOTICS.
PHAGES ARE GOING TO HAVE TO STEP
UP AND TAKE A ROLE.

Michael says SO, WHAT HAVE I LEARNT
ABOUT ANTIBIOTIC RESISTANCE?
WELL, THE BIGGEST LESSON IS
THAT BACTERIA WILL NEVER STOP
EVOLVING WAYS TO FIGHT BACK,
WHICH MEANS WE NEED
A MULTI-PRONGED RESPONSE,
INCLUDING, OF COURSE, NEW,
BETTER-TARGETED ANTIBIOTICS.
IT'S GOING TO TAKE SERIOUS
RESOURCES TO TURN THINGS AROUND
AND PREVENT THE PROJECTED
DEATH TOLL.

Matt says IF TEN MILLION PEOPLE A YEAR
ARE GOING TO DIE BY 2050, THAT'S
NOT THAT FAR AWAY IF YOU
CONSIDER THAT IT TAKES 20 OR
25 YEARS TO GET A NEW DRUG
TO MARKET.
AND YOU DON'T JUST NEED ONE NEW
ANTIBIOTIC, YOU NEED A WHOLE
GENERATION OF NEW ANTIBIOTICS,
SO IT'S GOING TO COST TENS OF
BILLIONS OF DOLLARS, BASICALLY.
AND THE REALITY IS THAT IF
YOU SPEND A BILLION DOLLARS
GETTING AN ANTIBIOTIC TO THE
CLINIC, YOU PROBABLY WON'T MAKE
YOUR MONEY BACK.
SO, IT'S NOT GREAT BUSINESS.

Anthony says THAT MONEY HAS GOT TO COME
FROM SOMEWHERE AND, PRESUMABLY,
IT'S GOING TO BE AT A GOVERNMENT
LEVEL.
LAST YEAR, THE UNITED NATIONS
PASSED A RESOLUTION,
UNANIMOUSLY SIGNED BY 193
COUNTRIES, SAYING THAT ALL
COUNTRIES SHOULD GET TOGETHER
AND TAKE ACTION, SO I DO DETECT
MOVEMENT FORWARDS, BUT THESE
THINGS ARE SLOW.

Michael says IF WE FAIL TO ACT, WE RISK
PLUNGING MEDICINE BACK INTO
THE DARK AGES.
BUT I'M ENCOURAGED BY THE FACT
THERE'S A VAST WORLD OF
MICROBES OUT THERE, PACKED
WITH POTENTIAL ALLIES AS WELL
AS ENEMIES, A WORLD WHICH WE
ARE ONLY JUST BEGINNING TO
EXPLORE.
I'M ACTUALLY FEELING MORE
CONFIDENT THAN I WAS AT THE
BEGINNING OF THIS FILM THAT
WE WILL FIND WAYS TO COMBAT
THE THREAT OF ANTIBIOTIC
RESISTANCE.
I CAN ONLY HOPE THAT WHEN WE
DEVELOP NEW WEAPONS, WE WILL
TREAT THEM WITH GREATER CARE
AND RESPECT THAN WE HAVE IN
THE PAST.

Music plays as the end credits roll.

Presented by Michael Mosley.

Executive producer, Alan HAyling.

Produced and directed by Peter Gauvain.

Logo: Renegade.

Logo: BBC.

Copyright 2017, Renegade Pictures Limited.