“Amongst the NCTC strains is the oldest living example of cholera. It was taken from a soldier who was a patient in Alexandria, Egypt in 1916,” says Anna.
“I have a tendency to stalk sites like eBay for weird antiques, and I stumbled upon a purse made by a convalescent soldier in Egypt in 1916. And he embroidered on it ‘souvenir of Egypt 1916’. I thought this is the perfect object that we have to impregnate with the extracted DNA.”
“The idea is that there are layers of relics in the works, and the history of that organism.”
Nick commented on how the historical perspective on disease makes us rethink current notions.
“The strain in the NCTC collection, it's a weird strain. It has suffered a little bit over 100 years in storage, but what's interesting about it is that it's resistant to beta-lactam antibiotics. In 1916, we didn't even know about the existence of antibiotics, and we certainly hadn’t produced any – that was not for another few decades.”
Work by Matt Dorman, Senior Staff Scientist in Nick’s team, has shown that the resistance gene present in the 1916 strain of cholera is functional – it confers resistance to current therapeutic levels of beta-lactam antibiotics.
“There's this notion that we've invented superbugs and antimicrobial resistance. While we certainly didn’t invent them they have mostly been there long before we discovered antibiotics and have been adapting therapies to overcome high levels of resistance in these bugs,” says Nick. “Overall what we've done is just to encourage them to gain more and more complex patterns of resistance.”
The same is true of other bacteria, too. Genes that confer drug resistance are often found on plasmids, genetic elements that can transfer between bugs, and sometimes species.
“What humans have done is apply selective pressure. And that's really key. Because it also explains why, when we introduce a new antibiotic, about two years later we see the emergence of drug-resistant bugs that are disseminated around the world. They were already there.”
“This artwork grounds us, gives us an anchor point in time to frame our current questions.”
The 1840s cholera dress Anna worked on is also impregnated with the cholera DNA. It alludes to the Broad Street pump moment, when John Snow removed the handle from the water pump in Soho, London, to stop people from drinking the infected water after deducing it was the source of the cholera epidemic. His work is regarded as the founding of modern epidemiology. “It was mostly [sex workers] who drank from the Broad Street pump, apparently, and I did some research that showed that they'd be wearing slightly out-of-date clothes,” says Anna, “and so the dress is from five or ten years before that moment.”
“I've embroidered the pump on it, and I've embroidered the cholera bacterium on it. And there's a tiny little bacteriophage if you look really closely, on the bacterium. Because cholera, which was a complete revelation to me, it doesn't have a toxin - it is produced from a virus which it has to catch.”