DNA from Dysentery-Stricken WWI Soldier Shows Antibiotic Resistance Before Penicillin

A solider who died from dysentery almost 100 years ago has shown antibiotic resistance was established years before penicillin was discovered.

As Armistice Day approaches marking the end of WWI, scientists at the Wellcome Trust Sanger Institute have identified a strain of bacteria that was resistant to penicillin 13 years before the world-changing drugs were identified.

With the world currently facing what has been described as an antibiotics apocalypse, scientists say their findings show more research is needed to combat dysentery.

The solider, believed to be Private Ernest Cable of the 2nd Battalion of the East Surrey Regiment, was 28 when he arrived at a hospital in Wimereux in France. He is thought to have presented with severe abdominal cramping and bloody diarrhoea.

He was diagnosed with dysentery, an intestinal infection that causes hundreds of thousands of deaths every year, and died shortly after.

Published in the Lancet, researchers note that poor sanitary conditions of trench warfare meant diseases like dysentery were prevalent.

Cable's bacteriologist collected a sample from the soldier and identified the bacteria as Shigella flexneri. It was deposited at the UK National Collection of Type Cultures (NCTC) – the first bacterial isolate to have been held there.

Researchers have now compared the strain with different strains of Shigella bacteria (now known as NCTC1) over the last century. Findings showed it had genes conferring to antibiotic resistance.

"The genome of NCTC1 provides insight into the evolution of bacillary dysentery during the 100 years since World War 1," the authors wrote. "Despite its isolation before the discovery and widespread use of antibiotics, NCTC1 was resistant to both penicillin and erythromycin, consistent with the ancient origins of antimicrobial resistance genes.

"Results of our genome studies suggest that S flexneri was already a well adapted pathogen and that it continues to respond to selection pressures."

The researchers concluded that Shigellae is becoming increasingly drug resistant and new treatments are desperately needed to combat the disease: "Advances in bacteriological diagnosis have been made and results from the application of the technology presented here suggest that prevention is the best approach to control Shigellae in view of their intrinsic antimicrobial resistance and targeted evolution.

"Continued efforts to improve hygiene and malnutrition in developing countries will have a substantial effect but these efforts are impeded by the low infectious dose of Shigellae. More than anything, specific therapies for Shigella, and particularly a licensed Shigella vaccine, are urgently needed."