Perspective - Journal of Evolutionary Medicine ( 2022) Volume 10, Issue 12

A Evolving Concept of Health and Disease is Being Established

Riccardo Baschetti*
Department of Life Sciences, Federal University of Minas Gerais, Brazil
*Corresponding Author:
Riccardo Baschetti, Department of Life Sciences, Federal University of Minas Gerais, Brazil, Email:

Received: 30-Nov-2022, Manuscript No. JEM-23-87466; Editor assigned: 02-Dec-2022, Pre QC No. JEM-23-87466 (PQ); Reviewed: 16-Dec-2022, QC No. JEM-23-87466; Revised: 21-Dec-2022, Manuscript No. JEM-23-87466 (R); Published: 28-Dec-2022, DOI: 10.4303/JEM/236100


Hospitalizations are frequently brought on by infections, which can develop into sepsis. Sepsis is a disease of the host’s inflammatory response to infection, leading to homeostasis imbalance and a syndrome of life-threatening organ failure, according to the most recent definition published in 2016. Systemic Inflammatory Response Syndrome (SIRS), a rapid Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score of 2 points, and a high possibly fatal risk are the clinical diagnostic criteria. Despite the introduction of new medications and improved therapies in recent years, sepsis mortality has not reduced. The most common reason for ICU admission and mortality is still sepsis.

Sepsis poses a major risk to public health and life because of the high death rate, which is partially brought on by failure to begin treatment as soon as it is clinically identified. One problem is that there are yet no reliable sepsis early diagnostic signs. Another issue is that early targeted therapy for patients with infectious disorders is hampered by the slow identification of microorganisms. Smears and cultures of clinical materials, such as blood, are two of the primary clinical procedures for the etiological diagnosis of sepsis. Blood culture has clear drawbacks as the gold standard for identifying bloodstream infections, such as being time-consuming and having limited sensitivity.


In 2019, antibiotic-resistant bacteria caused 1.27 million fatalities in humans globally. This estimate illustrates once more how serious a concern antibiotic resistance is for global health. By definition, bacterial pathogens are the causes of bacterial illnesses. Commensal bacteria are also sources of genes encoding adaptive features (non-housekeeping genes), such as virulence, heavy-metal resistance, and antibiotic resistance, which can spread to pathogenic bacteria. For this reason, commensal bacteria must be included in the list of public health issues. For instance, a recent study involving the Neisseria genus of bacteria revealed that four commensal Neisseria species had stronger phenotypic resistance profiles than four pathogenic Neisseria gonorrhoeae strains.

Three main processes account for gene transfer. Bacteria are capable of directly absorbing DNA from their surroundings as well as indirectly through the use of vectors like bacteriophages, conjugative plasmids, and conjugative integrative elements. For instance, a commensal Escherichia coli served as the best plasmid donor in a study evaluating the donor ability of a naturally obtained conjugative plasmid that conferred resistance to six antibiotics amongst 14 enterobacteria. These DNA transfer processes may take place inside microbiomes between various bacteria. Human microbiomes, which are made up of more than 1013 bacterial cells from hundreds of different species and include all the microorganisms (and their genomes) present in human tissues, are intricate systems. In the human body, the skin, mucosa, and gastrointestinal tract have particularly high concentrations and diversity of microorganisms, which may include both pathogenic and non-pathogenic bacteria.

A microbiome’s whole gene pool, comprising chromosomal genes and extra-chromosomal genetic components including bacteriophages, transposons, plasmids, and other mobile genetic elements, is referred to as the metagenome. Many microbiomes, including those of other animals, dirt, plant roots, sewage, etc., can be quite complicated. Antibiotics are typically used when an infectious illness manifests symptoms in both human and veterinary medicine. We contend here, however, that this does not always imply a connection between bacterial pathogenicity and antibiotic resistance.

Even if freshly introduced non-pathogenic bacterial cells cannot survive in a microbiome for longer than a few days, their mobile genetic material may have several opportunities to transfer to one of the other existing cells there and may afterwards stay for a very long time.

Numerous microbiomes, including the human gut, contain hundreds of different bacterial species. Additionally, bacteria can acquire foreign DNA through three main processes: I transformation, in which the bacteria directly ingest DNA from its surroundings; (ii) transduction, in which bacteriophages bring DNA from their previous hosts; and (iii) bacterial conjugation, in which the bacteria receive conjugative plasmids or integrative conjugative elements from neighbouring bacteria. A bacterial cell may take up DNA from cells that are phylogenetically unrelated to it, and conjugative plasmids can move between cells of several bacterial species.

Therefore, a gene pool that contains virulence and resistance genes can be shared by both harmful and non-pathogenic bacteria.


Furthermore, after obtaining certain plasmids, some bacterial populations that do not naturally possess virulence or resistance genes or mobile genetic elements can become powerful “amplifiers” of these genes. Some bacterial strains are good carriers of conjugative plasmids and may “amplify” the plasmid among them while rapidly spreading it to other cells in a microbiome. Escherichia coli strains and other enterobacterial species, soil bacteria, and most likely the majority of microbiomes all include these amplifiers.


Authors do not have acknowledgments currently

Conflict of Interest

There are no conflicts of interest.

Copyright: © 2022 Riccardo Baschetti.