[Music] we're under attack by microscopic soldiers billions of them they're getting stronger every day they have enormous genetic abilities the directions for human being are written in code three billion letters long these instructions tell our bodies how to live how to grow how to die researchers call this code the sequence [Music] welcome to secrets of the sequence I'm lucky Severson the number is almost impossible to believe the World Health Organization says 10 million people around the world die each year because antibiotics don't work anymore it's a growing problem and it's all because of a germs genes let us consult our guide to the genome since their discovery in the last century antimicrobial agents have substantially reduced the threat posed by infectious diseases over the years these medicines have saved the lives and ease the suffering of millions of people but these gains are not threatened by the advent of antibiotic resistant microbes these bacteria are their drug and sensitivity to resistance genes typically own little rings of DNA called plasmids these genes may code for efflux pumps to eject drugs from the cell or the genes may give rise to enzymes to degrade or inactivate the antibiotic when one bacterium develops such a gene it is passed on to all its descendants and that was a nightmare for Cynthia Schmidt and her daughter how do you feeling today good your hip feeling all right nine-year-old Berkeley is fine now but seven years ago she was facing surgery and a possible hip replacement the problem a superbug under this leg here we were on vacation and it's so typical your kids always get sick on vacation you know typical ear infection have had plenty of those went to the local doctor got some pink stuff and started taking that but she wouldn't get well you know a couple days later went back well maybe it's pneumonia let's do a chest x-ray no that's not what it is so we realized that we needed to get back home that she just wasn't getting better this antibiotic wasn't working when the family got home Berkeley's pediatrician realized that the infection had entered her bloodstream and migrated around her body settling in her hip so we immediately had to go to the hospital have that hip joint cleaned out the prognosis was terrible the doctor was saying well she's probably going to end up with a hip replacement in the next couple of years because this type of infection just kills off the bone you know and it's such a rich area and that they did suspect that it was one of these extremely antibiotic resistant bug that was in her system see the funny dog two year old Berkeley had to wear a special cast for six months the bug that was attacking her hip turned out to be Staphylococcus but in this case the staph bacteria were immune to amoxicillin and most other antibiotics two strains of resistant staph have now spread around the world University genetics labs are trying to find out how to fight them whereas for a certain bacterium we used to have maybe five or six or seven different choices that may be limited to two or three now and they're not always the same two or three most of the bacterial diseases still have effective therapy it's just that options are limited and getting more so daily bacteria can flourish anyplace they can find moisture but they've been kept in check for approximately 60 years by antibiotics usually antibiotics work most of the germs die but there are always a few that are slightly better able to cope with the drugs these stronger bugs reproduce while the lesser bogs die off natural selective breeding leads to drug resistance it's a very efficient system bacteria breed fast doubling their numbers every 20 minutes or so unchecked too can become 2 million and 7 hours and all those germs have other ways of picking up genetic information [Music] they have enormous genetic abilities they have genes that can jump from the nucleus to the cytoplasm and across from species to species on bridges they actually send pheromones to each other to know which one has a gene that could spread from one to another it's very interesting they're very promiscuous and they're very effective at evading our latest antibiotic it's a problem most serious in hospitals where today we can keep people alive much longer by giving them more and more powerful antibiotics hospitals tend to be an epicenter for a number of reasons the most ill patients in the community come there we do very aggressive therapy today both in terms of things like immunosuppressive steroids and also aggressive surgery and then these people wind up in critical care units where we're very aggressive in life support but the downside sometimes is there may be someone nearby who's been on a lot of antibiotics developing resistance and there's also some spread across patients that's very difficult to control and it's not just in hospitals the more antibiotics doctors prescribed to you and me and our children at home the more the bacteria were fighting develop resistance I'll give an example of a bacterium that we call the pneumococcus it's the most common cause of pneumonia in this country it's the most common cause of meningitis infection of the brain covering it's the most common cause of ear infections and children ten years ago we had five or six different antibiotics including penicillin at the current time about half of those bacteria are resistant to all but one or two antibiotics most frightening is the appearance of a super super bug a bacteria resistant to all of our antibiotics the scary part about the superbugs if you will is that even though the diseases they cause may not be any more severe if this infection can't be treated it goes on and on and on and now there are ways to bypass the natural selection process now the scientists can read the genes that make a germ resistant they can add these genes to other germs take anthrax it hasn't become antibiotic resistant because it's not that common in the environment the technology exists and it's not that sophisticated to actually introduce an antibiotic resistant trait into a bacteria like anthrax using pretty standard molecular biology techniques antibiotics work by destroying a bacterium cell walls or by fouling up a germs internal machinery by studying super bug DNA researchers could learn what defenses have evolved and more importantly how to dodge those defenses the result will be new antibiotics and an entirely new class of drugs targeting specific bacteria whether it's cell division or whether it's physical integrity or whether it's the ability to make energy or to reproduce or to make proteins so it's a really kind of race it's kind of a neck-and-neck proposition Berkeley was cured after some very aggressive treatment doctors tried one antibiotic after another finally settling on erythromycin which she took intravenously for six weeks long term shall most likely develop arthritis in her hip early in life a result of delayed development of the bone I tried to tell other moms to pay attention to these things even if it's a simple ear infection to not take it lightly I mean I'm living proof that it can be a lot worse and that you know anything is where you may suspect that it could be more than that to immediately get help we're fortunate that this particular bug did eventually respond to a more aggressive antibiotic treatment but what if it didn't I mean it could have been it could have been fatal at some point a vaccine that would protect against staph is in clinical testing right now researchers hope it will be effective against superbugs that are resistant to all other antibiotics the secrets of the sequence teaching materials were developed at Virginia Commonwealth University with funding from the National Academy of Sciences and the Pfizer foundation the original public television series secrets of the sequence was produced by ward television with funding from Pfizer the Pfizer foundation Oracle and the council for biotechnology information special thanks to member institutions of the series advisory board consisting of Virginia Commonwealth University Harvard University University of Wisconsin University of Michigan University of California at San Francisco and the MRC Laboratory of Molecular Biology Cambridge England