INTERNATIONAL the two-way Gonorrhea Is Becoming Untreatable, U.N. Health Officials Warn August 30, 2016 · 5:12 PM ET REBECCA HERSHER A microscope image, magnified 600 times, of the bacteria that cause the sexually transmitted disease gonorrhea. BSIP/UIG via Getty Images We are running out of ways to treat gonorrhea, the World Health Organization ON AIR NOW NPR 24 Hour Program Stream http://www.npr.org/sections/thetwo-way/127602464/international/ http://www.npr.org/sections/thetwo-way/ http://www.npr.org/people/384067907/rebecca-hersher http://www.npr.org/ announced today. The U.N. health agency released new guidelines warning doctors that it no longer recommends an entire class of antibiotics, quinolones, because quinolone-resistant strains of the disease have emerged all over the world. S H O TS - H E A LT H N E W S Gonorrhea Evades Antibiotics, Leaving Only One Drug To Treat Disease Instead, the health agency recommends using cephalosporins, another class of antibiotic. The new protocol replaces guidelines that had not been changed since 2003. According to the WHO, 78 million people are infected with gonorrhea every year. Worldwide, health officials are concerned that overuse of antibiotics for other infections, such as urinary tract infections, will lead to widespread, untreatable strains of gonorrhea. In 2011, a super-resistant strain showed up in Japan. As NPR's Rob Stein has reported: "Gonorrhea has been plaguing humanity for centuries. But ever since penicillin came along a dose of antibiotics would usually take care of the disease. "'Gonorrhea used to be susceptible to penicillin, ampicillin, tetracycline and doxycycline — very commonly used drugs,' said Jonathan Zenilman, who studies infectious diseases at Johns Hopkins. "But one by one, each of those antibiotics — and almost every new one that has come along since — eventually stopped working. One reason is that the bacterium that causes gonorrhea can mutate quickly to defend itself, Zenilman said. "'If this was a person, this person would be incredibly creative,' he said. 'The bug has an http://www.who.int/mediacentre/news/releases/2016/antibiotics-sexual-infections/en/ http://www.npr.org/sections/health-shots/ http://www.npr.org/sections/health-shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-leaving-only-one-drug-to-treat-disease http://www.npr.org/sections/health-shots/2011/07/12/137797153/super-resistant-gonorrhea-strain-found-in-japan http://www.npr.org/sections/health-shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-leaving-only-one-drug-to-treat-disease incredible ability to adapt and just develop new mechanisms of resisting the impact of these drugs.'" The WHO shift to the new class of antibiotics will not fix that overall problem of bacterial creativity. In some countries, strains of gonorrhea are already resistant to the newly recommended class of drugs. The U.S. Centers for Disease Control and Prevention warned back.

1. INTERNATIONAL
the two-way
Gonorrhea Is Becoming Untreatable, U.N.
Health Officials Warn
August 30, 2016 · 5:12 PM ET
REBECCA HERSHER
A microscope image, magnified 600 times, of the bacteria that
cause the sexually transmitted disease gonorrhea.
BSIP/UIG via Getty Images
We are running out of ways to treat gonorrhea, the World
Health Organization
ON AIR NOW
NPR 24 Hour Program Stream
http://www.npr.org/sections/thetwo-
way/127602464/international/
http://www.npr.org/sections/thetwo-way/
http://www.npr.org/people/384067907/rebecca-hersher
http://www.npr.org/
announced today.
The U.N. health agency released new guidelines warning
doctors that it no longer

2. recommends an entire class of antibiotics, quinolones, because
quinolone-resistant
strains of the disease have emerged all over the world.
S H O TS - H E A LT H N E W S
Gonorrhea Evades Antibiotics, Leaving Only One Drug To Treat
Disease
Instead, the health agency recommends using cephalosporins,
another class of
antibiotic. The new protocol replaces guidelines that had not
been changed since
2003.
According to the WHO, 78 million people are infected with
gonorrhea every year.
Worldwide, health officials are concerned that overuse of
antibiotics for other
infections, such as urinary tract infections, will lead to
widespread, untreatable strains
of gonorrhea. In 2011, a super-resistant strain showed up in
Japan.
As NPR's Rob Stein has reported:
"Gonorrhea has been plaguing humanity for centuries. But ever
since penicillin came
along a dose of antibiotics would usually take care of the

3. disease.
"'Gonorrhea used to be susceptible to penicillin, ampicillin,
tetracycline and
doxycycline — very commonly used drugs,' said Jonathan
Zenilman, who studies
infectious diseases at Johns Hopkins.
"But one by one, each of those antibiotics — and almost every
new one that has come
along since — eventually stopped working. One reason is that
the bacterium that causes
gonorrhea can mutate quickly to defend itself, Zenilman said.
"'If this was a person, this person would be incredibly creative,'
he said. 'The bug has an
http://www.who.int/mediacentre/news/releases/2016/antibiotics-
sexual-infections/en/
http://www.npr.org/sections/health-shots/
http://www.npr.org/sections/health-
shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-
leaving-only-one-drug-to-treat-disease
http://www.npr.org/sections/health-
shots/2011/07/12/137797153/super-resistant-gonorrhea-strain-
found-in-japan
http://www.npr.org/sections/health-
shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-
leaving-only-one-drug-to-treat-disease
incredible ability to adapt and just develop new mechanisms of

4. resisting the impact of
these drugs.'"
The WHO shift to the new class of antibiotics will not fix that
overall problem of
bacterial creativity. In some countries, strains of gonorrhea are
already resistant to the
newly recommended class of drugs.
The U.S. Centers for Disease Control and Prevention warned
back in 2012 that one of
two drugs in the class of antibiotics the WHO now recommends,
cephalosporins, was
in danger of becoming useless to treat gonorrhea, at least in the
U.S, and
recommended that doctors stop prescribing it.
Since then, the CDC's recommended treatment for gonorrhea
has been a dual therapy,
with the two antibiotics ceftriaxone and azithromycin, but an
analysis in July warned
that the bacteria could even become resistant to that
combination.
S H O TS - H E A LT H N E W S
Despite Rise Of Superbugs, Syphilis Still Has A Kryptonite

5. As for when antibiotic options will run out altogether, Teodora
Wi of the WHO's
Department of Reproductive Health and Research tells the
journal Science, "We will
have to have new drugs in 5 years, I think."
The U.S. government is spending millions of dollars through the
CDC and National
Institutes of Health to develop new antibiotics and combat
resistance.
The WHO also revised its guidelines for treating two other
sexually transmitted
infections, chlamydia and syphilis. Neither is facing severe
antibiotic resistance.
Syphilis, for example, can be treated with a single dose of
penicillin, although there is a
worldwide shortage of the drug.
Although all three sexually transmitted diseases affect both men
and women, they can
http://www.cdc.gov/mmwr/volumes/65/ss/ss6507a1.htm
http://www.npr.org/sections/health-shots/
http://www.npr.org/sections/health-
shots/2016/06/10/480643381/despite-rise-of-superbugs-syphilis-
still-has-a-kryptonite
http://www.sciencemag.org/news/2016/08/world-may-soon-run-
out-drugs-treat-gonorrhea
http://www.sciencemag.org/news/2016/08/world-may-soon-run-

6. out-drugs-treat-gonorrhea
http://www.cdc.gov/std/gonorrhea/arg/
http://www.cdc.gov/std/treatment/drugnotices/bicillinshortage.h
tm
have particularly devastating effects on women if they are not
treated. Gonorrhea can
cause pelvic inflammatory disease and lead to dangerous ectopic
pregnancies. Syphilis
can pass from a pregnant woman to her fetus, and chlamydia can
make it difficult for a
woman to get pregnant.
stds gonorrhea world health organization
http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
http://www.npr.org/tags/158464957/stds
http://www.npr.org/tags/158464955/gonorrhea
http://www.npr.org/tags/132050186/world-health-organization
PUBLIC HEALTH
shots
Gonorrhea Evades Antibiotics, Leaving Only
One Drug To Treat Disease
Listen · 3:59 Download
Transcript
Queue
August 9, 2012 · 3:32 PM ET

7. Heard on All Things Considered
ROB STEIN
ON AIR NOW
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158464908
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Health officials say they're worried that one day there will be
no more antibiotics left to treat gonorrhea.
iStockphoto.com
There's some disturbing news out today about a disease we don't
hear about much
these days: gonorrhea. Federal health officials announced that
the sexually

8. transmitted infection is getting dangerously close to being
untreatable.
As a result, the federal Centers for Disease Control and
Prevention issued new
guidelines for how doctors should treat gonorrhea. The
guidelines are designed to
keep one of the remaining effective antibiotics useful for as
long as possible by
restricting the use of the other drug that works against the
disease.
"We are sounding the alarm," said Gail Bolan, who heads the
CDC's division of STD
prevention.
Gonorrhea has been plaguing humanity for centuries. But ever
since penicillin came
along a dose of antibiotics would usually take care of the
disease.
"Gonorrhea used to be susceptible to penicillin, ampicillin,
tetracycline and
doxycycline — very commonly used drugs," said Jonathan
Zenilman, who studies
infectious diseases at Johns Hopkins.
But one by one, each of those antibiotics — and almost every
new one that has come

9. along since — eventually stopped working. One reason is that
the bacterium that
causes gonorrhea can mutate quickly to defend itself, Zenilman
said.
"If this was a person, this person would be incredibly creative,"
he said. "The bug has
an incredible ability to adapt and just develop new mechanisms
of resisting the impact
of these drugs."
Another reason is that antibiotics are used way too frequently,
giving gonorrhea and
many other nasty germs too many chances to learn how to
survive.
http://www.cdc.gov/nchhstp/newsroom/2012/GCTx-Guidelines-
PressRelease.html
http://www.cdc.gov/
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm?
s_cid=mm6131a3_w
http://www.cdc.gov/nchhstp/newsroom/Experts.html
http://www.jhsph.edu/faculty/directory/profile/1254/Zenilman/J
onathan
"A lot of this is occurring not because of treatment for
gonorrhea but overuse for other
infections, such as urinary tract infections, upper respiratory
tract infections and so

10. forth," Zenilman said.
It got to the point recently where doctors had only two
antibiotics left that still worked
well against gonorrhea — cefixime and ceftriaxone.
But on Thursday, federal health officials announced that one of
their worst fears had
come true: Evidence had emerged that gonorrhea had started to
become resistant to
cefixime in the United States.
"We're basically down to one drug, you know, as the most
effective treatment for
gonorrhea," Bolan said.
Cefixime and ceftriaxone are in the same class of antibiotics.
That means it's only a
matter of time before ceftriaxon goes, too, she says.
"The big worry is that we potentially could have untreatable
gonorrhea in the United
States," Bolan said.
That's already happened in other countries. Totally untreatable
gonorrhea is popping
up in Asia and Europe.

11. So the CDC declared that doctors should immediately stop using
the cefixime.
"We feel we need to a take a critical step to preserve the last
remaining drug we know
is effective to treat gonorrhea," Bolan said.
About 700,000 Americans get gonorrhea every year. If
untreated, gonorrhea can cause
serious complications, including infertility and life-threatening
ectopic pregnancies.
"I think it should be a real clarion call to every American that
we've got a looming
public health crisis on our hands and potentially hundreds of
thousands of cases of
untreatable gonorrhea in this country every year," said William
Smith, who heads the
http://www.npr.org/blogs/health/2011/07/12/137797153/super-
resistant-gonorrhea-strain-found-in-japan
http://ncsddc.org/
National Coalition of STD Directors.
Officials know adopting the new guidelines won't be easy. For
one thing, ceftriaxone is
an intra-muscular shot instead of a pill. And they want doctors
to give it along with at
least one other antibiotic and test patients to make sure they're
cured.

12. But they know that all this will help only for a while, and that
they can't stop the clock
from ticking on the one drug left.
"We think it's only a matter of time based on the history of this
organism until
resistance does develop," Bolan said.
So scientists are searching for new combinations of antibiotics
that might work. And
officials are pushing for new weapons that might stay one step
ahead of gonorrhea and
the growing list of antibiotic-resistant infections.
stds gonorrhea antibiotic resistance infectious disease
http://www.npr.org/sections/health-
shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-
leaving-only-one-drug-to-treat-disease#
http://www.npr.org/sections/health-
shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-
leaving-only-one-drug-to-treat-disease#
http://www.npr.org/sections/health-
shots/2012/08/10/158464908/gonorrhea-evades-antibiotics-
leaving-only-one-drug-to-treat-disease#
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http://www.npr.org/tags/154099088/antibiotic-resistance
http://www.npr.org/tags/126568156/infectious-disease

13. Biology 101:
Fungal, Microbial & Plant Diversity
Section 18
Dr. Carol Chaffee
September 6, 2016
1
Daily Study Guide
B.7: Describe & give examples of the value of biodiversity &
the natural world
List the three key traits shared by all fungi
Describe the three key traits shared by all plants
Map the three key distinctions that divide plants into major
groups onto a phylogenetic tree
Describe the key features of the three major groups of protists
Illustrate the three methods of lateral gene transfer in bacteria
Explain why viruses fall somewhere between living & non-
living
2
Key Plant Traits
Like animals, plants are also mulitcellular.
Unlike animals, plants create their own food via photosynthesis
(use energy from the sun to convert carbon dioxide & water into
sugar), and don’t move
3

14. Key Distinctions of Plant Taxa
4
Non-vascular Plants
“Amphibians of the plant world”: mosses & worts
No ability to transport water
Grows low to ground
Found in wet environments
Rhizoids anchor plants instead of roots
5
Vascular Seedless Plants
Ferns & club mosses
Earliest vascular plants
Capable of transporting water
Enables larger, higher plants
Produces spores
No food source
Can be dispersed by variety of means
6
Gymnosperms
Produce cones or other non-flower reproductive structures
Seeds and pollen generally wind or animal dispersed

15. Pollen holds sperm
Seeds hold both zygote & food source
7
Angiosperms
Flowering plants
Most abundant & diverse group of plants
Seeds and pollen dispersed in variety of ways
Insects
Wind
Animals
8
Another Tree Exercise…
Break into groups of 3-5
Draw this tree showing the four major plant taxa
Map key distinctions onto this tree
Key Traits of Fungi
All fungi are decomposers
Key trait is external digestion, then absorbtion of nutrients
Generally classified based on reproductive structures
10

16. Plants, Fungi & Animals
Draw tree on board, what might a good trait be to differentiate
each node?
11
Examples of Fungi
Protists
13
Algae
Photosynthetic, but not plants
Grow only in water
Diverse group: single-cell diatoms to large giant kelp
Green algae most similar to plants
14
Microbes
Found in all domains of life
Characterized by mostly single-celled organisms
All bacteria & archaea

17. Some (but not all) protists
15
Bacteria
All bacteria are unicellular prokaryotes
Traditionally classified by physical characteristics & various
lab tests
Ability to survive on different types of media
Staining patterns using different types of staining agents
Ability to compare DNA sequences major advance in
understanding bacterial diversity
Few physical characteristics or observable traits make
classification difficult
Very few bacteria can actually be cultured in the lab
16
Horizontal Gene Transfer
Special means of exchanging genetic material between bacteria
Particular environmental conditions & special characteristics
necessary, i.e., doesn’t always happen
Three methods:
Conjugation = Direct transfer between two bacteria using a
special structure
Transduction = Transfer via a virus
Transformation = Fragments of DNA in the environment are
taken up by a bacterium