3. ANTIBIOTICS
Antibiotics are medicines used to prevent and treat bacterial
infections (e.g. Gentamicin , Tetracyclin used to treat wide
variety of infections).
Antibiotic resistance occurs when bacteria change in response to
the use of these medicines.
Bacteria, not humans, become antibiotic resistant. These bacteria
may then infect humans and are harder to treat.
4. Antibiotic resistance V/S Antimicrobial
resistance
Antimicrobial resistance(AMR) is a broader term, shows
resistance to drugs to treat infection caused by other microbes
such as parasite(e.g. malaria), viruses(e.g. HIV) and fungi(e.g.
Candida).
Antibiotic resistance shows resistance only to those drugs to
treat infection caused by bacteria (ex. Mycobacterium
tuberculosis – Tuberculosis).
Bacteria Fungus
5. Causes: Over-
prescribing of
antibiotics
Patients not
finishing their
treatment
Over use of
antibiotics in
livestock and
fish farming
Poor
infection
control in
hospitals
Lack of new
antibiotics
being
developed
Source:WHO
Recently Colistin
banned in India
Superbugs have
returned to
haunt India’s
hospitals
A lack of
Research
6.
7. Intrinsic Resistance
It occurs naturally.
1.Lack Target:
• no cell wall; innately resistant to Penicillin.
2.Innate efflux pumps:
• Drug blocked from entering cell or outward export of
drug.
3.Drug inactivation:
• By producing certain enzymes that inactive the function
of antibiotics.
8. Acquired Resistance
Mutations:
• It refers to the change in DNA structure of the gene.
• Occurs at a frequency of one per ten million cells.
• Often mutants have reduced susceptibility.
• E.x. Point mutation (gyrA and gyrB) causes multi-
drug resistant(MDR) tuberculosis.
9. Contd.
Plasmids
• Extra chromosomal genetic elements can replicate
independently and freely in cytoplasm.
• Plasmids which carry resistant gene(r-genes) are called R-
plasmids.
• These r-genes can readily transferred from one R-plasmid
to another plasmid by the process Horizontal gene transfer.
( Conjugation,Transformation,Transduction)
10. MOST COMMON ANTIBIOTIC
RESISTANCE BACTERIA
Strain isolated from
Food sources.
Resistant to
fluoroquinolones
and other Beta-
lactum antibiotics.
Caused
Tuberculosis,
infectious
disease that
usually affects
the Lungs.
Resistant to
isoniazid and
rifampin .
Most virulent
strain.
Resistant to
ampicillin,
gentamicin.
Common in
hospitals.
Resistant to
methicillin
(derivative of
penicillin).
11. New Delhi metallo-beta-lactamase1
NDM1 is an enzyme , first
detected in Klebsiella
pneumoniae isolated from a
swedish patient of Indian
origin in 2008.
Resistant to a broad range
of beta- lactam antibiotics.
Why everyone should
concerned???
There are currently no new
drug in the research
pipeline that aim to stop
NDM1. Some strains of
E.coli and Klebsiella
pneumoniae are carriers of
this gene but the gene can
be transferred from one
strain to another through
Horizontal gene transfer.
Source: ICMR
12. How to tackle ???
WHO response
A Global Action Plan on
antimicrobial resistance, including
antibiotic resistance, was endorsed at
the World Health Assembly in May
2015. (different objectives)
The Global Antimicrobial
Resistance Surveillance System
(GLASS)
The WHO-supported system supports a
standardized approach to the
collection, analysis and sharing of data
related to antimicrobial resistance.
World Antibiotic Awareness Week
Held every November since 2015 with
the theme “Antibiotics: Handle with
care”
The Indian Ministry of
Health and Family Welfare
published the National
Action Plan for containing
AMR in April 2017
13. What should be done at individual level ???
Only use antibiotics when prescribed by a certified
health professional.
Never demand antibiotics from the doctor.
Never share or use leftover antibiotics.
Prevent infections by regularly washing hands,
preparing food hygienically.
Use safe and clean water.