IN nearly 30 years of playing cat-and-mouse with his “amazingly adaptable” bacterial adversaries, Dr. Stuart Levy M’65 has developed a “great deal of respect” for their ability to quickly change their form to fend off their antibiotic pursuers. “Bacteria do what they do very well,” he says. “They can afford to lose millions and millions of their numbers, and they certainly do. They take huge losses, over and over again. But then they suddenly adapt, and they come back with a vengeance.
    “It seems to me that bacteria represent a basic feature of this present world, which is ‘survive and propagate.’ And they do just that. It’s very clear that they’ve been here much longer than we have ñ we entered their world, after all. And as far as they’re concerned, we may be just a ‘passing feature’ in their history, which reaches back millions and millions of years. It’s a little disturbing to think about—but then, dinosaurs come and go, don’t they?”
    With the wide availability of antibiotics starting in the 1940s, it seemed that bacteria had met their match in human ingenuity. But the victory was shortlived, and the comeback is now in full force—helped along, ironically, by those very antibiotics. Combined with bacteria’s protean nature, rampant overuse of these drugs, by eliminating both vulnerable strains of disease bacteria and other, benign types of bacteria (innocent bystanders caught in the battle against disease), has created an environment in which drug-resistant strains of bacteria can develop and flourish as never before.
    Levy directs the Center for Adaptation Genetics and Drug Resistance at Tufts University School of Medicine, where he is also a professor of medicine and of molecular biology and microbiology. As a researcher, he has made major contributions to understanding the mechanisms of drug resistance in bacteria; he has also become a leading voice in educating the public about the “major world health threat” posed by antibiotic-resistant bacteria. He expressed his message succinctly in the title of his influential 1992 book: The Antibiotic Paradox: How Miracle Drugs Are Destroying the Miracle.
    Much of Levy’s public education work centers around the Alliance for the Prudent Use of Antibiotics (APUA), an international group dedicated to curbing antibiotic resistance which he co-founded in 1981. Currently, he is president. APUA’s Web site (www.healthsci .tufts.edu/apua) offers a wealth of information for physicians, researchers and consumers, from notices of relevant international meetings, to news reports about antibiotics and drug resistance, to instructions on proper handwashing technique.
    At 61, Levy swims daily laps at a downtown Boston pool and favors bow ties (“I tie my own—it’s a point of personal pride with me,” he says) with his white labcoat. A former president of the American Society for Microbiology, he was awarded the Society’s prestigious Hoechst-Roussel Prize in 1995 for his research. A major theme of his work has been how bacteria alter their genetic structure to build stronger cellular defenses against antibiotic drugs. In The Antibiotic Paradox, he describes how, through a variety of transfer processes, pieces of DNA or genes can move from one bacterial cell to another, including bacteria of very different types. “We now know that bacteria exchange genes readily in nature. Antibiotic resistance has allowed us to see just how extensive these transfers can be, because resistance genes are so easy to identify and follow.”

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Medical School alumnus and bacteria researcher Dr. Stuart Levy warns against the overuse of antibiotics, a potential public health nightmare for the 21st century.

BY TOM NUGENT
Photograph by Jon Chomitz