When I was a Undergraduate Medical Student I had least understanding what Microbes mean to me, We were passing Microbiology

the examination, with little knowledge on few bacteria, when I became a post graduate my imagination changed and I am in the sea of microbes. In fact, of late I realised as we couldn't live without them. Microbes are everywhere - a largely unseen world of living things that support life processes some microbes cause disease, but most are harmless or even helpful. Microbes outnumber our own cells ten to one. They may live as individuals or cluster together in communities. Microbes live in the water we drink, the food we eat, and the air we breathe. Right now, billions of microbes are swimming in our intestines and mouth, and crawling on our skin! Don't worry, over 95% of microbes are good for us. Microbes include bacteria, viruses, fungi, algae, and protozoa. Many commensal and useful bacteria in our mouth prevent fungal growth. Our forearm is home to over 100 species of bacteria that keep our skin healthy. We also have about three pounds of useful bacteria in our digestive tract that help us digest food. They break down carbohydrates and provide us with essential vitamins. And we're not the only ones that benefit from a relationship with microbes. Every plant and animal unknowingly houses trillions of them. There is some evidence that microbes may have an indirect role in cancer. For example, some microbes cause inflammation, which appears to increase cancer risk. Microbes live in the farthest reaches of the atmosphere. Microbes may inhabit space beyond our world. The air around us is filled with microbes. Bacteria, fungi, algae, protozoa, and viruses float in air currents. The numbers of microbes in the air range from 10 to 10,000 per cubic meter. Think every time we are breathing many, many microbes are inhaled, however whatever we do we cannot avoid inhaling, never forget many common infections are Respiratory, in spite of mask we wear. A number of microbes also have more direct connections to cancer. H. pylori bacteria, a common cause of gastric ulcers, is also associated with cancers of the stomach and oesophagus. In our final MBBS surgery examination we all must tell that cause of Peptic ulcer was Curry, Hurry and Worry, I still remember some of the students snubbed when they failed tell these facts, thanks to science Warren and Marshall proved every one of us and our teachers, wrong with discovery of H.Pylori A number of viruses cause cancer as well: Hepatitis B and C greatly increase the risk of liver cancer; the sexually transmitted HPV (human papilloma virus) is associated with many cervical cancers; and EBV (Epstein-Barr virus, the cause of mononucleosis) is associated with lymphomas (cancerous white blood cells) and other cancers. Todays concern is action and reaction associated with Antibiotic use, in the past Antibiotics were like magic bullets, as with irrational use of Antibiotics the use of is a concern to the health and society with arise of multi drug resistant strains, as common man understands as SUPER BUGS. "Antibiotic resistance is an inevitable consequence of antibiotic use, the more you use them the more resistance you will get. To understand the basics, Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates, and co-workers - threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat. For this reason, antibiotic resistance is among *CDC's top concerns. Bacteria can also acquire resistance. This happens when a type of bacteria changes in a way that protects it from the antibiotic. Bacteria can acquire resistance in two ways: either through a new genetic change that helps the bacterium

survive, or by getting DNA from a bacterium that is already resistant. Antibiotic use promotes development of antibiotic-resistant bacteria and spread to many in the Hospital environment casing many Hospital acquired infection. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant Bactria may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria. The DNA that codes for resistance can be grouped in a single easily transferable package, and as Plasmids. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA. The emergence of antibiotic resistance creates a new challenge for public health, and there is no simple solution. Genetically, antibiotic resistance spreads through bacteria populations both "vertically," when new generations inherit antibiotic resistance genes, and "horizontally," when bacteria share or exchange sections of genetic material with other bacteria. Horizontal gene transfer can even occur between different bacterial species. Environmentally, antibiotic resistance spreads as bacteria themselves move from place to place; bacteria can travel via airplane, water and wind. People can pass the resistant bacteria to others; for example, by coughing or contact with unwashed hands. To treat a resistant infection and prevent resistance from spreading, doctors sometimes prescribe a broad-spectrum approach when they do not have optimal support of Microbiology Departments, and irrational physicians who treat the patients without scientific rationalism, this approach combines multiple antibiotics that attack bacteria in different ways. It can work better because it is unlikely that a single bacterium will be resistant to multiple antibiotics. Yet for the same reason, this approach kills many more friendly bacteria and can cause related health complications. The question remains, Can bacteria lose their antibiotic resistance? Yes, and it is possible antibiotic resistance traits can be lost, but this reverse process occurs more slowly. If the selective pressure that is applied by the presence of an antibiotic is removed, the bacterial population can potentially revert to a population of bacteria that responds to antibiotics. Do not forget the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and once again, kill unabated. Think before prescribe an antibiotic, we cannot kill all the Microbes we desire, many escape if we do not use rationalism in Antibiotic use? Prescribing an Antibiotic Today needs more wisdom than in the past? (Ref CDC on antibiotics) Dr.T.V.Rao MD Professor of Microbiology Freelance writer