Antibiotic resistance occurs when bacteria change in response to antibiotic use, making infections harder to treat. Bacteria, not humans or animals, become resistant. This leads to higher medical costs, prolonged hospital stays, and increased deaths. Antibiotic resistance threatens global health and can affect anyone, of any age, in any country. It occurs naturally but also because of misuse of antibiotics in humans and farm animals. This is making many infections like pneumonia, tuberculosis, and gonorrhea more difficult to treat.
FLOW OF THE SEMINAR
1. Definition – antibiotic resistance, Multi-resistance, cross-resistance in antibiotics
2. Evolution of resistance
3. Impact of resistance
4. The scenario of resistance: Global, India
5. Factors causing resistance
6. Mechanisms of resistance: Intrinsic and Acquired
7. Acquired mechanism of resistance
8. Quorum sensing
9. Mechanism of resistance in commonly used antibiotics
10. Methods for determining the resistance
11. Strategies to contain resistance
12. Antibiotic stewardship
13. Role of Pharmacologist
14. Initiatives undertaken by India to control resistance
Mechanism Antibiotic Resistance
Intrinsic (Natural)
Acquired
Chromosomal
Extra chromosomal
Intrinsic Resistance
Lack target : No cell wall; innately resistant to penicillin
2. Drug inactivation: Cephalosporinase in Klebsiella
3. Innate efflux pumps:
It is an active transport mechanism. It requires ATP.
Eg. E. coli, P. aeruginosa
Altered target sites
PBP alteration
Ribosomal target alteration
Decreased affinity by target modification
Beta-lactamase
Beta-lactamases are enzymes produced by bacteria that provide resistance to β-lactam antibiotics such as penicillins, cephamycins, and carbapenems
Major resistant Pathogen
1. PRSP- Penicillin resistant Streptococcus pneumoniae2. MRSA/ORSA- Methicillin-resistant Staphylococcus Aureus (Super bug)3. VRE -Vancomycin-Resistant Enterococci4. Carbapenem resistant pseudomonas aeruginosa5. Carbapenem resistant Carbapenem resistant 6. Extended spectrum beta-lactamase (ESBL)-producing bacteria
FLOW OF THE SEMINAR
1. Definition – antibiotic resistance, Multi-resistance, cross-resistance in antibiotics
2. Evolution of resistance
3. Impact of resistance
4. The scenario of resistance: Global, India
5. Factors causing resistance
6. Mechanisms of resistance: Intrinsic and Acquired
7. Acquired mechanism of resistance
8. Quorum sensing
9. Mechanism of resistance in commonly used antibiotics
10. Methods for determining the resistance
11. Strategies to contain resistance
12. Antibiotic stewardship
13. Role of Pharmacologist
14. Initiatives undertaken by India to control resistance
Mechanism Antibiotic Resistance
Intrinsic (Natural)
Acquired
Chromosomal
Extra chromosomal
Intrinsic Resistance
Lack target : No cell wall; innately resistant to penicillin
2. Drug inactivation: Cephalosporinase in Klebsiella
3. Innate efflux pumps:
It is an active transport mechanism. It requires ATP.
Eg. E. coli, P. aeruginosa
Altered target sites
PBP alteration
Ribosomal target alteration
Decreased affinity by target modification
Beta-lactamase
Beta-lactamases are enzymes produced by bacteria that provide resistance to β-lactam antibiotics such as penicillins, cephamycins, and carbapenems
Major resistant Pathogen
1. PRSP- Penicillin resistant Streptococcus pneumoniae2. MRSA/ORSA- Methicillin-resistant Staphylococcus Aureus (Super bug)3. VRE -Vancomycin-Resistant Enterococci4. Carbapenem resistant pseudomonas aeruginosa5. Carbapenem resistant Carbapenem resistant 6. Extended spectrum beta-lactamase (ESBL)-producing bacteria
Introduction to bacterial resistance to antibiotics, types of resistance, brief explaining & examples
The lecture was presented at Al-Mahmoudiya General Hospital at Wed, 17th Nov. 2021
Represented & updated as part of the training course for fresh appointed pharmacist at 16/5/2023
Antimicrobial resistance is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals, and antifungals) from working against it.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
updated statistics about antimicrobial resistance,causes and mechanism of antimicrobial resistances, national antimicrobial policy, national antimicrobial surveillance, new delhi b metallo-lactamase-1 bacteria
Study about antibiotic abuse in NICU of pediatric department in misurata medical center (MMC) in interval between 1/1/2018 to 28/2/2018 under supervision of community medicine department in faulty of medicine in misurate university
Introduction to bacterial resistance to antibiotics, types of resistance, brief explaining & examples
The lecture was presented at Al-Mahmoudiya General Hospital at Wed, 17th Nov. 2021
Represented & updated as part of the training course for fresh appointed pharmacist at 16/5/2023
Antimicrobial resistance is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals, and antifungals) from working against it.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
updated statistics about antimicrobial resistance,causes and mechanism of antimicrobial resistances, national antimicrobial policy, national antimicrobial surveillance, new delhi b metallo-lactamase-1 bacteria
Study about antibiotic abuse in NICU of pediatric department in misurata medical center (MMC) in interval between 1/1/2018 to 28/2/2018 under supervision of community medicine department in faulty of medicine in misurate university
a research presentation done by Augustine Mwaawaaru Level 400) and Matthew Frimpong Antwi (Level 300) students of( Presbyterian University College-Ghana on Antimicrobial resistance and the way foeward in Ghana. contact 0261825262
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. • Antibiotics are medicines used to prevent and treat bacterial
infections. Antibiotic resistance occurs when bacteria change in
response to the use of these medicines.
• Bacteria, not humans or animals, become antibiotic-resistant.
These bacteria may infect humans and animals, and the infections
they cause are harder to treat than those caused by non-resistant
bacteria.
• Antibiotic resistance leads to higher medical costs, prolonged
hospital stays, and increased mortality.
INTRODUCTION
3. 0 10 20 30 40 50 60
………. Age……….
Animals: pets, food Crops: food
Otitis, Tonsilitis Cystic fibrosis PCOD
Trauma: Pneumonia
Mother/ child birth
sepsis
Post surgical…
Prostheses;
STD’s
Cancers;
Neonatal
TB/ AIDS related infections
Antibiotic Use Over Life Time…..
12. Why ABR a global concern?
• New resistance mechanisms emerge and spread globally
threatening our ability to treat common infectious diseases,
resulting in death and disability of individuals who until
recently could continue a normal course of life.
• Without effective anti-infective treatment, many standard
medical treatments will fail or turn into very high risk
procedures.
13. Antibiotic Resistance…..?
Micro-organisms that are not
inhibited by usually achievable
systemic concentration of an
antimicrobial agent with normal
dosage schedule and / or fall in the
minimum inhibitory concentration
(MIC) range.
14.
15.
16.
17. Antibiotic resistance is one of the biggest threats to global health,
food security, and development today.
Antibiotic resistance can affect anyone, of any age, in any country.
Antibiotic resistance occurs naturally, but misuse of antibiotics in
humans and animals is accelerating the process.
A growing number of infections – such as pneumonia, tuberculosis,
gonorrhoea, and salmonellosis – are becoming harder to treat as the
antibiotics used to treat them become less effective.
Antibiotic resistance leads to longer hospital stays, higher medical
costs and increased mortality.
Key Facts…..
18. For example, 70 to 80 percent of diarrhea is caused by viral pathogens, for which
antibiotics are not effective. But nevertheless, around 40 percent of these cases are
attempted to be treated with antibiotics.
Patients insisting on antibiotics and physicians prescribing them as they do not have time
to explain why they are not necessary. Another cause can be physicians not knowing
when to prescribe antibiotics or being overly cautious for medical or legal reasons.
A third of people believe that antibiotics are effective for the common cold, and the
common cold is the most common reason antibiotics are prescribed even though
antibiotics are useless against viruses.
Key Facts…..
19. Types of Antimicrobial Resistance
Natural drug resistance:
Acquired drug resistance:
Adaptation (tolerance) :
Mutation and selection :
Single step chromosomal mutations :
Transmissible drug resistance :
Transferred resistance:
20. Natural drug resistance:
In this case, even before the introduction of the drug, there is a
resistance produced by the entire bacterial species to an antibiotic. It
may transpire as a result of the lack of suitable cell wall target site,
penetration of drug through the cell wall and susceptibility to
naturally produced agent that destroys the antibiotics.
e.g.; S. Pyrogens resistant to Neomycin.
Types of Antimicrobial Resistance
21. Acquired drug resistance:
In this type of resistance is associated with two types of mechanisms, the main
mechanisms involving intrinsic type of resistance and drug destroying enzymes e.g.
Methicillin resistance acquired by the microbe S. Aureus species of strains.
The development of resistance in a microbe in this case are due to the development
of misrepresented binding of penicillin on the receptors of microbes.
Eg. MRSA
Types of Antimicrobial Resistance
22.
23. Adaptation (tolerance) :
There are many chances of a laboratory isolated organism becoming
adapted to the environment and grow gradually in the presence of
low concentration of the drug. But it has no further importance
clinically. e.g. it is easier to treat gonococcal strains by enormous
use of penicillin.
Types of Antimicrobial Resistance
24. Mutation and selection :
Within a population of bacteria, mutants that are resistant to an
antibiotic arise spontaneously. When the bacteria are exposed to
the antibiotic, the sensitive organisms will be eliminated and the
resistant forms will proliferate. This selection pressure particularly
occurs in hospitals where initially it might be observed as the
microbes being sensitive to antibiotic and later on when tested it
might show the particular resistance to the drug.
Types of Antimicrobial Resistance
25.
26. Single step chromosomal mutations :
If it is there in an infective strain, there is chances of developing
resistance during the course of the treatment if a single drug is being
used. It may particularly apply in case of staphylococci to
streptomycin, rifampicin and erythromycin. The development of
resistant mutants occur at a high frequency in the case of above
drugs.
Types of Antimicrobial Resistance
27. Transmissible drug resistance :
Plasmids are extra chromosomal packets of DNA which may code
for antibiotic resistance which will be transferred to a sensitive
strain from an antibiotic resistant strain, which makes the sensitive
strain also to become an antibiotic resistant strain as that of the
previously resistant strain.
Types of Antimicrobial Resistance
29. Mechanism of Antimicrobial Resistance
Enzymatic inactivation of the antibiotic:
When a microbe which is capable to produce an enzyme, that digests
or breakdown the antibiotics referring to degradation of the active
molecule is termed as enzymatic inactivation e.g. the production of
penicillinase which belong to beta-lactamase class
30. Absence of a metabolic pathway required to activate the
antibacterial agent:
The microbes changes the pathway which is required to activate
an drug to show its action.
Mechanism of Antimicrobial Resistance
31. Alteration of the target:
Here the microbes changes the
receptor to which an antibiotic
attaches to produce an action.
Due to this change the drug
does not bind to the microbe
and thus doesn’t produce any
action e.g. in case of
erythromycin.
Mechanism of Antimicrobial Resistance
32. Altered transport of the antibiotic to its site of action:
The process involve the change in transportation mechanism and
where by the drug does not reach the active receptor to produce an
action.
Mechanism of Antimicrobial Resistance
33. Reduced cellular uptake:
The resistant microbes does not allow the drug to get inside the
microbe there by reducing the efficacy of the drug. This process
makes the drug incapable to produce any effect e.g. in case of
tetracycline.
Mechanism of Antimicrobial Resistance
34. Increased efflux Pumps:
It’s a process of self-defence adopted by an microbe, where there is
an reverse pumping of antibiotic which has gained access into the
microbes, so that its thrown out of the cell and this process
ultimately results in ineffectiveness of the medicament e.g. in case
of tetracycline.
Mechanism of Antimicrobial Resistance
35. Impact of antibiotic resistance
Clinical: A proportion of people who will be infected with the
resistant strain and thus will be difficult to treat the same with
the drugs normally used to treat the infections.
Financial: Financial burden on the patient and bed
occupancies in a hospital it was recorded that the resistance
strain of microbes where hard to treat and thus required more
number of days to treat it when compared to that of sensitive
microorganisms.
36. Patient undergoing cancer chemotherapy, where after the chemo their white
blood cell count goes down and an infection at this stage becomes life
threatening due to decreased self-immunity.
The patients undergoing complex surgeries like cardiac bypass, joint
replacements etc. are prone to surgical site infections which can be of severe
type and cause fatality or increased length of stay in the hospital by prolonging
the recovery time.
Patients with rheumatoid arthritis where their immune system weakens due to
various medications used as well as the disease factor itself, can lead to
infectious outbreak in them. Thus it is necessary that an antibiotic is potent
enough to counter the infectious agents.
Patients undergoing dialysis always have chance of getting infection into the
blood and it is one of the most leading causes of mortality among the renal
failure patients.
High Risk Population
38. GUIDELINES FOR RATIONAL USE OF ANTIBIOTICS
Use antibiotics only when indicated.
Where appropriate, specimen for gram stain, culture and sensitivity testing
should be obtained before commencing antibiotic therapy
Choice of agent based on causative organism, safety, previous clinical
response, cost, ease of use and potential.
Adequate dose and duration of treatment is essential.
History of allergy or other ADR should be considered.
Prophylactic use of antibiotic should be restricted.
39. Role of Pharmacist in Combating Resistance:
To promote awareness among the population, for ethical or proper safe use of
antibiotics.
The pharmacist should also make it sure that a Judicious use of available antibiotics is
done at all times and it is only given or dispensed when they are recommended and
prescribed
The pharmacist’s role might be increased from mere dispensing to reviewing of
antibiotic orders, helping physicians with drug selection and deciding on duration of
therapy
If the virulence of the disease is high, the pharmacist should always advice on proper
hygienic precautions to be considered, by which we can control the cross-transmission
of resistant strains from persons to person can be avoided.