EvoluTIonARy BIology 5
Almost every hospital in the world treats casualties in this battle against
changing opponents, but as the use of antibiotics increases, so does the incidence
of bacteria that are resistant to those antibiotics; thus any gains made are almost
as quickly lost (see Figure 1.3). Why is this happening? Do the drugs cause drug-
resistant mutations in the bacteria’s genes? Do the mutations occur even without
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HIV-1 human
SIVcpz chimpanzee
SIVgor gorilla
SIVcpz chimpanzee
SIVmnd mandrill
SIVagm Afr. green monkey
HIV-2 human
SIVsmm sooty mangabey
SIVcol colobus monkey
Lemur
Cat
Rabbit
Horse
FIGURE 1.2 A phylogenetic tree showing
the history by which various immunodefi-
ciency viruses have evolved. Time runs from
left to right, and the common ancestor of
all the viruses is at the left (the “root” of the
tree). One lineage gave rise to the viruses
that infect primates: lemurs, monkeys, and
apes. These simian immunodeficiency viruses
(SIVs) are labeled with abbreviations of the
names of the infected species (e.g., SIVcpz in
chimpanzee). The human immunodeficiency
viruses HIV-2 and HIV-1 arose from SIVs that
infected monkeys and chimpanzees, respec-
tively. (After [25].)
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Qu: Should part (B) y-axis label be worded similarly to (A)? For example: “Prevalence of resistant isolates (%)”
Measure of drug use (volume)
1978 1980 1982 1984 1986 1988 1990 1992
Year
Drug use
Prevalence
of resistant
bacteria
0.9
0.8
40 1.0
1.1
1.2
1.3
1.4
(A) (B)
Prevalence of resistant bacteria (%)
20
0
60
80
100
Number of doses prescribed (millions)
2000 2002 2004 2006 2008 2010
Year
Carbapenem
prescriptions
Third-generation
cephalosporin resistance
Carbapenem
resistance
5
0
10
4
15
20
25
30
Percentage of isolates resistant^2
0
6
8
10
12
14
FIGURE 1.3 Evolution of drug resistance. (A) An increase
in the use of a penicillin-like antibiotic in a community in
Finland between 1978 and 1993 was matched by a dramatic
increase in the percentage of antibiotic-resistant isolates of
the bacterium Moraxella catarrhalisis from middle-ear infec-
tions in young children. (B) Resistance of the pneumonia-
causing bacterium Klebsiella pneumoniae to cephalosporin
and carbapenem antibiotics has recently begun to increase
in the United States. The use of carbapenems approximately
doubled during the period shown. (A after [15]; B after [23].)
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