Antibiotic resistance began before discovery of penicillin, DNA from First World War shows In early 1915, Private Cable walked into No 14 Stationary Hospital in Wimereux, France, complaining of bloody diarrhoea and severe abdominal cramping. He was diagnosed with dysentery and by 13 March 1915 he was dead. A sample of the bacteria which killed him was taken by hospital bacteriologist Lieutenant William Broughton-Alcock and placed in storage for future study. Julie Russell, Head of Culture Collections at PHE, said: "It is tragic that Private Cable died of dysentery alongside many other soldiers during WW1 due to the terrible conditions in the trenches. Unfortunately, even 100 years later this bacteria is the cause of death of hundreds of thousands of people in developing nations each year. The root cause both now and back in the trenches in WW1 is poor sanitation. Bacteria are very efficient at changing to survive and Shigella bacteria have evolved to withstand antibiotic treatments. Bacteria constantly change (evolve) in their bid for survival. The genes which make a bacterium resistant to antibiotics are known to have existed in some cases even before the widespread use of antibiotics. The sample from Private Cable shows the genes for resistance to both penicillin and erythromycin which are both antibiotics used in medicine today. Widespread use of antibiotics is causing many more bacteria to become resistant. This bacteria was the very first to be submitted into the National Collection of Type Cultures which was started in 1920 to provide scientists with a reliable source of bacteria of known identity for their studies. It now holds over 5,000 bacteria and is housed at Public Health England sites near London and in Porton Down in Wiltshire. As part of the analysis of the evolution of Shigella flexneri, the NCTC1 isolate was compared to three other Shigella flexneri strains. One known as 2457T from a Japanese patient in 1954; strain 301 taken from Beijing in 1984 and a further epidemic strain from China from 2002. It was found that over time, the disease developed even more resistance. "When the four bacteria are compared side by side an evolutionary pattern can be seen," said author Dr Kate Baker, of the Wellcome Trust Sanger Institute. Genes that were absent from the 1915 strain that were present in all three of the later Shigella isolates we tested include genes that result in more severe disease (virulence genes) as well as even more antibiotic resistance genes. The study was published in the journal The Lancet.