Language lapse or sloppy semantics? Time for accessible words

Language! It sounds like something a teacher shouts across the school playground during a noisy recess. This week’s comment in the journal Nature calls us to task for our inconsistent, inaccurate and impenetrable use of language in connection with antimicrobial resistance (AMR). The authors rightly call out terms that do not communicate complicated ideas about resistance in digestible words and phrases.

Guilty, as charged.

Micrognome’s readers will be familiar with the language theme. These pages have spilled a lot of digital ink on the language of infection, its mechanisms and consequences. More recent entries have homed in on the language problems of AMR, not least the abstract nature of AMR and our need for a simple word or phrase to use in calling out its consequences; highly antibiotic resistant diseases.

Tongue-twister

Nature’s commentary gives us a good serving of bad language. We need to drop the complicated tongue twisters like antimicrobial resistance and multidrug resistant [insert your favourite bacterial name here]. How many frontline clinicians can accurately conjugate Graeco-Roman Linnean bacterial names? Even those bacterial names in common usage are often short forms that lack strict accuracy, so there is little scope for terminological pedantry. The commentary correctly identified the untreatable aspect of this phenomenon as a core feature. But if we take a look at just one common example, we can see that this is still a work in progress.

Nasty UTI

These figures shows bacteria growing on agar after incubating a sample of urine from a patient with a common urinary tract infection. These bacteria have then been cultured in a smooth lawn on a clear type of agar with disks that contain antibiotics.

E.coli growing on CLED agar, showing yellow colonies of concentrated bacteria.

Test for antibiotic resistance due to extended spectrum beta-lactamase (ESBL)

These disks are in pairs with (left) and without (right) a chemical that switches off a mechanism the bacteria from the urine specimen use to inactivate the antibiotics. If you have managed to follow the story so far you will notice how the circular halo of clearing around each disk is much larger on the left than the right. That is because the chemical added to the antibiotic protects the antibiotic against bacterial inactivation. Sometimes this approach can be used to treat a resistant infection. Complicated, isn’t it? For more information on antibiotic inactivating mechanisms read [here].

Sloppy semantics

If you read this far you either live an unhealthy life away from natural sunlight in a clinical lab, or have an unusual level of fascination with the natural world. The rest of the global population don’t connect with the granular detail of AMR and its pathological consequences. Our experience of disease is usually couched in terms of illness or sickness, and does not stretch to the invisible biological processes that keep the Micrognome and his tribe gainfully employed. So if there is improvement to be made in the language of infection, it needs to be translated into the language of infectious disease. Drug resistant infection may thus need a bit of adjustment, to drug resistant disease. Happy editing.

 

 

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