Antibiotic resistance in bacteria is a major challenge for the long-term use of antimicrobial agents. Bacteria can develop resistance through intrinsic or acquired mechanisms such as mutations or gaining new DNA. Resistance occurs through various methods like altering the antibiotic target, reducing drug accumulation in bacteria, or enzymatically inactivating the drug. Prudent antibiotic use and infection control practices can help limit the emergence and spread of drug-resistant 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
Antibiotic resistance I Mechanism I Types I Contributing factors.kausarneha
Antibiotic resistance in bacteria is a global threat of 21st century. Here is a brief discussion of Antimicrobial resistance or Drug resistance disease. If you want to study via video lecture on this visit on my YouTube channel : Microbiology WISDOM:
Here you can find further more such interesting topics.
Antibiotic resistance,introduction, cause, mechanism and solution of Antibiot...Dr. Sharad Chand
A illustrative representation of the antibiotic resistance, its introduction, cause, mechanism, examples and possible solutions of the antibiotic resistance. with pictorial illustrations for better understanding.
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
Antibiotic resistance I Mechanism I Types I Contributing factors.kausarneha
Antibiotic resistance in bacteria is a global threat of 21st century. Here is a brief discussion of Antimicrobial resistance or Drug resistance disease. If you want to study via video lecture on this visit on my YouTube channel : Microbiology WISDOM:
Here you can find further more such interesting topics.
Antibiotic resistance,introduction, cause, mechanism and solution of Antibiot...Dr. Sharad Chand
A illustrative representation of the antibiotic resistance, its introduction, cause, mechanism, examples and possible solutions of the antibiotic resistance. with pictorial illustrations for better understanding.
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
Antibiotics Resistance is a new issue in Microbiology-Medicine aspects, taken from Lange Review of Medical Microbiology, this purpose is for education only
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.
Resistance to antibiotics is one of the main important facts that most nations are working on. Actually, in USA, it is considered as a health problem to solve. Why it happens? Here is a review to answer this.
History
3 year old boy.
Taken to Pediatrician with fever and cough.
Started on Paracetamol and oral antibiotics.
One week later still low grade fever, tachypnea.
Referred to hospital.
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
Antibiotics Resistance is a new issue in Microbiology-Medicine aspects, taken from Lange Review of Medical Microbiology, this purpose is for education only
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.
Resistance to antibiotics is one of the main important facts that most nations are working on. Actually, in USA, it is considered as a health problem to solve. Why it happens? Here is a review to answer this.
History
3 year old boy.
Taken to Pediatrician with fever and cough.
Started on Paracetamol and oral antibiotics.
One week later still low grade fever, tachypnea.
Referred to hospital.
McKesson Case Study: Pharmacy Systems & AutomationForgeRock
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Alexey Shmelkin, CISSP, Senior Security Architect, Information Security
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provide an overview of the integration between EnterpriseRx, a pharmacy management system, and
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Pediatric fever can be a benign symptom of common childhood illness. But what about when it isn't? When bacterial or viral infection triggers Systemic Inflammatory Disease Syndrome (SIRS) it's known as pediatric sepsis. In the United States each year there are approximately 430,000 cases of pediatric sepsis, approximately 10% of which are considered pediatric severe sepsis. Of these, approximately 4,300 children die each year, often due to missed or delayed diagnosis. But today EMS plays a decisive role in the identi-fication and early treatment of these critically ill children. This program will show advanced EMS providers how to assess, treatment, and coordinate care for these very sickest children. Take home the knowledge of how you can make the biggest difference for our lit-tlest patients. www.Romduck.com www.RescueDigest.com
Following his third episode of gouty arthrits, a 50-year-old man sees you in the clinic. Each case was successfully treated acutely; however, your patient is interested in trying to prevent further episodes. He is not on regular medications and has a normal physical examination today. Blood work reveals an elevated serum uric acid level and otherwise normal renal function and electrolytes. A 24-hour urine collection for uric acid reveals that he is under-excreting uric acid. Suspecting that this is a case of recurrent gout, you place him on probenecid
Vaccines: Linking Awareness, Access, and ActionRx EDGE
This presentation was delivered at the PEPP (DTC Perspective’s “Patient Engagement through Physicians and Pharmacists” event).
The presentation dicusses the current landscape and the tactics and strategies currently being undertaken in this critical public health area. It also shares insights from pharmacy programs in the Tdap, flu, and shingles categories.
This presentation discusses about the etiology, clinical features, complications and management of Septic Shock.
The information compiled in this presentation (from medical textbooks and internet sources) does not belong to me, but has been done so for educational purposes
History
10 year old male with cerebral palsy, chronic lung disease.
Previously undergone a tracheostomy and gastric tube placement.
Prior admissions for aspiration pneumonia and tracheitis.
Presentation
Fever and abdominal distension.
Hypotensive, febrile, and tachycardic.
IV Admixtures continue to be an issue in everyday pharmacy operations. This presentation covers some things that can be done to help minimize those errors.
antibiotics in xdr organism,the mechanism of resistance ,cause of resistance ,effect of resistance, levels of resistance, classification, xdr organisms, gram positive and gram negative ,detection and latest idsa guidelines for management.
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We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
2. Antibiotic resistance in bacteria
Emergence of antibiotic resistance is a major factor
limiting long term successful use of an antimicrobial
agent.
Antibiotic resistance is a type of drug resistance where a
microorganism is able to survive exposure to an antibiotic.
Resistant organism: One that will not be inhibited or killed
by an antibacterial agent at concentrations of the drug
achievable in the body after normal dosage.
If a bacterium carries several resistance genes, it is called
multiresistant or, informally, a superbug or super bacteria.
3. Factors contributing for resistance
Misuse of antibiotics
< Use of antibiotics with no clinical indication (e.g, for viral
infections)
< Use of broad spectrum antibiotics when not indicated
< Inappropriate choice of empiric antibiotics
Overuse of antibiotics
Addition of antibiotic to the feed of livestock
Failure to follow infection control practices
4.
5. Settings that Foster Drug Resistance
Community
< Day-care centers
< Long term care facilities
< Homeless shelters
< Jails
6. Settings that Foster Drug Resistance
Hospital
< Intensive care units
< Oncology units
< Dialysis units
< Rehab units
< Transplant units
< Burn units
7. Antibiotic resistance in bacteria
Two types:
Intrinsic:
Naturally occuring trait
Species or genus specific
Acquired:
Acquired resistance implies that a susceptible organism has
developed resistance to an agent to which it was previously
susceptible, and can occur in two general ways: by mutation
(s) in the existing DNA of the organims or by acquisition of
new DNA.
Present in only certain strains of a species or of a genus
8. Genetics of Resistance
Mutational resistance:
A single chromosomal mutation may result in the
synthesis of an altered protein: for example,
streptomycin resistance via alteration in a ribosomal
protein, or the single aminoacid change in the enzyme
dihydtropteroate synthetase resulting in a lowered
affinity for sulfonamides
A series of mutations, for example, changes in
penicillin binding proteins (PBPs) in penicillin resistant
pneumococci
9. Genetics of Resistance
Resistance by acquisition of new DNA
– By Transformation
– Conjugation
– Transduction
Nature of elements involved in transferring DNA:
Plasmids: plasmid mediated resistance much more efficient
than the resistance ass. with chromosomal mutation
Transposons
14. Mechanisms of resistance (Contd.)
2. Alteration of Access to the target site (altered uptake or increased exit)
Involves decreasing the amt of drug that reaches the target by either:
Altering entry, for example, by decreasing the permeability of the cell wall,
Pumping the drug out of the cell (known as efflux mechanisms)
3. Enzymatic inactivation:
Enzymes that modify or destroy the antibacterial agent may be produced
(drug inactivation)
e.g.,
Beta lactamases
Aminoglycoside modifying enzymes
Chloramphenicol acetyl transferase
4. Bypass of an antibiotic sensitive steps
15. Mechanisms of resistance:
Resistance mechanisms can be broadly
classified into 4 types:
1. Alteration of the target site
– The target site may be altered so that it has a
lowered affinity for the antibacterial (antibiotic),
but still functions adequately for nomal
metabolism to proceed. Alternatively, an
additional target (e.g enzyme) may be
synthesized.
17. Resistance to β -lactams:
Resistance due to β -lactamases: most prevalent
Alteration in the pre-existing penicillin binding proteins
(PBPs)
Acquisition of a novel PBP insensitive to beta β –
lactams: e.g, methicillin resistance in Staphylococcus
aureus (MRSA)
Changes in the outer membrane proteins of Gram
negative organisms that prevent these compounds
from reaching their targets
18. Aminoglycoside Resistance:
Intrinsic and acquired resistance due to decreased
uptake
Acquired resistance is frequently due to plasmid
encoded modifying enzymes:
Three classes of aminoglycoside modifying enzymes:
Acetyltransferases,
Adenyltransferases and
Phosphotransferases
Ribosomal target modification
19. Tetracycline resistance
Most common antibiotic resistance
encountered in nature
Mechanisms:
Altered permeability due to chromosomal mutations
Active efflux or Ribosomal protection (by
production of a protein) resulting from acquisition
of exogenous DNA
20. Macrolide, Lincosamide and
Streptogramin resistance:
Intrinsic resistance is due to low permeability of
outermembrane protein
Acquired resistance occurs most often by
alteration of the ribosomal target
Drug inactivation and active efflux may also occur
21. Chloramphenicol resistance
Enzymatic inactivation:
– From acquisition of plasmids encoding
chloramphenicol acetyl transferase
Decreased permeability:
24. Cotrimoxazole (Sulfonamides and
trimethoprim) resistance
Intrinsic resistance: outer membrane
impermeability
Acquired resistance:
– Chromosomal mutations in the target enzymes
[low level resistance)
– Plasmid mediated resistance: high level resistance
25. Resistance to antimycobacaterial
agents
First line essential antituberculous agents:
Rifampin, isoniazid and Pyrazinamide
First line supplemental: Ethambutol and
Streptomycin
Second line: Para-aminosalicylic acid,
ethionamide, cycloserine, kanamycin,
amikacin, capreomycin, thiacetazone
26. Resistance to Rifampin:
– From spontaneous point mutations that alter the beta
subunit of the RNA polymerase (rpoB) gene
Resistance to Isoniazid:
– Mutations in the catalase peroxidase gene or inhA
gene
Resistance to Pyrazinamide:
– Mutations in the pncA gene, which encodes for
pyrazinamidase
Multidrug resistance/ XDR
27. Some resistant pathogens
Staphylococcus aureus:
Penicillin resistance in 1947
Methicillin resistance in 1961: MRSA causing carious
fatal diseases
Vancomycin resistance in the recent years: As VRSA
and VISA
Enterococci:
Penicillin resistance seen in 1983
Vancomycin resistant Enterococcus (VRE) in 1987
Even emergence of linezolid resistance
28. Some resistant pathogens (contd.)
Pseudomonas aeruginosa:
– One of the worrisome characteristic: low antibiotic
susceptibility
– Multidrug resistance common: due to mutation or
horizontal transfer of resitant genes
Acinetobacter baumanii
Multidrug resistance
Some isolates resistant to all drugs
Salmonella, Esherichia coli
Mycobacterium tuberculosis
29. Tests for detecting antibacterial resistance
Disk diffusion method
Screening method: eg, oxacillin resistance screening
for Staphylococcus, Vancomycin resitance screeening
for enterococci
Agar dilution method: by determining minimum
inhibitory concentration
Special tests: detection of enzymes mediating
resistance- colorometric nitrocefin and acidometric
method for beta lactamase detection
30.
31. Limitation of Drug Resistance
Emergence of drug resistance in infections may be minimized in the
following ways:
By prudent use of antibiotics; by avoiding exposure of
microorganisms to a particularly valuable drug by limiting its use,
especially in hospitals.
By maintaining sufficiently high levels of the drug in the tissues to
inhibit both the original population and first-step mutants;
By simultaneously administering two drugs that do not give cross-
resistance, each of which delays the emergence of mutants
resistant to the other drug (eg, rifampin and isoniazid in the
treatment of tuberculosis); and
By institution of infection control practices