a short preview on AMR, its global effect and new techniques to tackle.

1. Sourav Chakraborty
4th year, G.C.T.S
Ashram More, Asansol

2. CONTENTS
• UNDERSTANDING AMR ……………………..……………………………….
• ITS GLOBAL EFFECT …………………………………………………………
• ITS REASON TO PREVIAL IN 21ST CENTURY …………………………….
• HOW IT COULD TO STOPPED ……………………………………………….
• TARGETS FOR RESISTANT FREE ANTIBIOTICS ………………………..
– ANTIBIOTICS NETWORK BIOLOGY ……………………………………………………
– SPECIFY ANTIBIOTICS MEDIATED CELL DEATH ……………………………….......
– BACTERIOPHAGE TECHNIQUE ………………………………………………………..
• BACTERIOPHAGE TECHNIQUE ……………………………………………
• CONCLUSION …………………………………………………………………..

3. UNDERSTANDING AMR
Antimicrobial resistance (AMR) is when a microbe evolves to become more or
fully resistant to antimicrobials which previously could treat it. Resistance can appear
spontaneously due to random mutations; or more commonly following gradual buildup
over time, and because of misuse of antibiotics or antimicrobials. Microbes resistant to
multiple antimicrobials are called multidrug resistant (MDR); or sometimes superbugs.
Antimicrobial resistance is on the rise with millions of deaths every year. A few
infections are now completely untreatable due to resistance. All classes of microbes
develop resistance (fungi, antifungal resistance; viruses, antiviral resistance; protozoa,
antiprotozoal resistance; bacteria, antibiotic resistance).
Drug inactivation or modification: for example, enzymatic deactivation of penicillin G
in some penicillin-resistant bacteria through the production of β-lactamases.
Alteration of target site.
Inhibition of the drug target.
Reduced drug accumulation: by decreasing drug permeability or increasing active
efflux

5. o Ineffective treatment to microbial
attack due to over exposure to
antibiotics.
o Less potency to microbes(
delayed action).
o Hence more potent antibiotics
are required causing huge side
effects.
o In severe patients if resistance is
seen, even death maybe at stake. http://save-antibiotics.blogspot.in/

7.  Doctors prescribing antibiotics even without any serious infection.
 Ineffective diagnosis leading to prescribing broad spectrum antibiotics always.
 Less awareness on the dose and intake of antibiotics.
 Not completing antibiotic courses.
 Over exposure to bacterial environment due to improper sanitation in villages.
 High cost of selective antibiotics due to which common man preferring cheaper
same antibiotics in most infections.

9. PATIENT:
• Only take antibiotics when necessary
•Don’t save antibiotics for the next course
•Complete the whole course
•Don’t take antibiotics without prescription
•Don’t ask antibiotics to even be prescribed
•Maintain proper hygiene
FOR HEALTH CARE PROFESSIONAL:
• Not to prescribe antibiotics for viral infection
•Trying to prescribe only the best antibiotic for the purpose
•To know the trend of resistance in the region.

10. In the search for resistant free antibiotics development, researchers are
always searching for newer specific targets which are less susceptible for
mutation and resistant development. The targets are identified for each species
according to their life cycle and mode of replication and the most suitable targets
are chosen which can easily be either manipulated or inhibited. The targets that
will be discussed are unique in nature because of the techniques applied and still
are under research, still recent progress shows that they can really be efficient in
tackling resistant.
TARGETS FOR DISCUSSION:
• Antibiotic network biology.
•Bacteriophage technique.

11. Bioinformatics approach that utilizes screening of the genetic
information for understanding the bacterial cell and its
mechanism for drug resistance of other ways to kill the
bacteria
Helps for the selection and development of novel antibiotics for
selective action and for higher therapeutic action, due to
genetic information pertaining to resistance, it can be tackled

12. For example, recent screens for antibiotic susceptibility in a single-gene
deletion library of non-essential genes in E. coli and a transposon
mutagenesis library in Pseudomonas aeruginosa have provided
important insights into the numbers and types of genes that affect
treatment efficiency.
 BACTERIA – EXPOSED TO DIFFERENT ANTIBIOTICS.
EXPOSED FOR A PERIOD OF TIME SO THAT RESISTANCE
DEVELOPS TO MOST ANTTIBIOTICS.
Information pertaining to mutation mechanism obtained for all
The test gives a better understanding for which antibiotic would grow
resistance the least with time
 If no resistance occurs by any chance then a novel approach could be
developed with such a drug

13.  GENE EXPRESSION DATA THROUGH HIGH GENETIC SCREENS .
IDENTIFICATION OF BIOCHEMICAL PATHWAYS DONE BY THE BACTERIA.
IDENTIFICATION OF ITS MUTAGENIC PROPERTY.
METHODOLGY:
NOTES FOR THE EXPIREMENT:
• Choosing the time to be exposed to antibiotic is essential-
•For isolated microbes 11-14days
•For patients 5-9days
•For serious patients 1-2days
http://www.atsjournals.org/doi/abs/10.1164/rccm.200908-1210oc

14. Bacteriophages (Greek
for ‘eaters of bacteria’) are the
most abundant life forms on Earth,
with an estimated ten thousand
billion billion billion (1031)
bacteriophages inhabiting water,
plants, sewage and the digestive
tract of species ranging from
mosquitos to fish to humans. A
bacteriophage rapidly kills its
bacterial host, replicating itself in
the process, thereby creating an
escalating swarm that continues to
destroy until the host is eliminated.

15.  THESE ARE VIRUSES ONLY WHICH ITSELF INFECT THE BACTERIA
FOR HOST.
 THEY THEN DESTROY THE BACTERIAL CELL BY GROWING AND
REPLICATING.
 THEY THEN ITSELF GETS DESTROYED AND HENCE
ANTIBACTERIAL ACTION IS DONE.
BEST PART IS, IF RESISTANCE DEVELOPES THEN SINCE WE ARE
APPLYING A VIRUS THEN THEY EVEN CAN RESIST THE RESISTANCE
MECHANISM BY ALTERING THEMSELVES.

17. Our approach has several potential advantages compared to traditional
antibiotic therapy:
•Potential for fewer side effects
•Phage therapies are highly specific to their target bacterial species. They cannot kill
mammalian cells and have minimal impact on beneficial bacteria.
•Ability to treat multi-drug resistant bacteria
•Phages attack bacteria through a unique mechanism, therefore, they are likely to bypass
the bacterial defense processes aimed towards antibiotics, thereby providing an alternative
therapeutic option for difficult-to-treat, multi-drug resistant infections.
•Unique potential for resistance management
•Ability to disrupt biofilms
•Biofilms are almost impenetrable layers filled with aggregated bacteria and other
extracellular components, which shield the bacteria. These complex communities of
bacteria, present in the majority of infections, can render conventional antibiotics almost
completely ineffective. By contrast, some bacteriophages are able to penetrate biofilms and
replicate locally to high levels, producing a strong therapeutic effect.