Question was in my mind how the bacteria learn the biochemical mechanisms of defense against antibiotics , l know it should have gens that produce defense ways , but how they have thes gens , how antibiotics produce resistance in bacteria for them self and another's ?
All that I tried to answer in this seminar and how can be treated or minimized .
. Antibiotics are medicines that help stop infections caused by bacteria. They do this by killing the bacteria or by keeping them from copying themselves or reproducing. The word antibiotic means “against life.” Any drug that kills germs in your body is technically an antibiotic. But most people use the term ...
For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
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• Phone : +919818894041,01142464041
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Misuse of Antibiotic | Antibiotics helpful or harmful ? Dr. Rajat Sachdeva
Antibiotic although it is effective on bacterial strain, but it may causes resistance to antibiotics when uses unnecessarily.
Over the Counter availability without prescription has been one of most important factor.
Antibiotics are only effective against bacterial infection not on Viral or fungal infection. These may cause side-effects or resistance against infection.
Call us for the best treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
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Learn More:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
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
Antibiotic originally was intended to cure and treat disease. However, because of lack of proper education and awareness campaign, antibiotics now are widely abuse and misuse. Such abuse and misuse of antibiotics today are the culprit why we have emergence of new diseases and Bacterial Resistance.
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.
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 are medicines that help stop infections caused by bacteria. They do this by killing the bacteria or by keeping them from copying themselves or reproducing. The word antibiotic means “against life.” Any drug that kills germs in your body is technically an antibiotic. But most people use the term ...
For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Misuse of Antibiotic | Antibiotics helpful or harmful ? Dr. Rajat Sachdeva
Antibiotic although it is effective on bacterial strain, but it may causes resistance to antibiotics when uses unnecessarily.
Over the Counter availability without prescription has been one of most important factor.
Antibiotics are only effective against bacterial infection not on Viral or fungal infection. These may cause side-effects or resistance against infection.
Call us for the best treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us on:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
Learn More:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
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
Antibiotic originally was intended to cure and treat disease. However, because of lack of proper education and awareness campaign, antibiotics now are widely abuse and misuse. Such abuse and misuse of antibiotics today are the culprit why we have emergence of new diseases and Bacterial Resistance.
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.
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
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
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
The perspective of antibiotic resistanceLimon Mirza
Antibiotic, Antibiotic resistance, Causes of antibiotic resistance, History of antibiotic, Bangladesh perspective of antibiotic resistance, Prevention & Control of antibiotic resistance
Relative or complete lack of effect of antimicrobial agent against a previously susceptible microbe/pathogen.
It is an evolutionary principal that organism adopt genetically to change in their environment.
since the doubling time of bacteria can be as short as 20 mnt, there may be many generations in even a few hours, providing ample opportunity for evolutionary adaptation.
The phenomenon of resistance imposes serious constraints on the options available for the treatment of many bacterial infections.
The resistance to chemotherapeutic agents can also develop in protozoa, in multicellular parasites and in population of malignant cells.
Today there are different strains of S. aureus resistant to almost every form of antibiotic in use.
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.
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.
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
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
The perspective of antibiotic resistanceLimon Mirza
Antibiotic, Antibiotic resistance, Causes of antibiotic resistance, History of antibiotic, Bangladesh perspective of antibiotic resistance, Prevention & Control of antibiotic resistance
Relative or complete lack of effect of antimicrobial agent against a previously susceptible microbe/pathogen.
It is an evolutionary principal that organism adopt genetically to change in their environment.
since the doubling time of bacteria can be as short as 20 mnt, there may be many generations in even a few hours, providing ample opportunity for evolutionary adaptation.
The phenomenon of resistance imposes serious constraints on the options available for the treatment of many bacterial infections.
The resistance to chemotherapeutic agents can also develop in protozoa, in multicellular parasites and in population of malignant cells.
Today there are different strains of S. aureus resistant to almost every form of antibiotic in use.
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.
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.
AMR & Alternative Stratergies - MicrobiologySijo A
Antibiotic resistance poses one of the most important health challenges of the 21st century.
The rise of multidrug-resistant bacteria has already led to a significant increase in human disease and death.
The U.S. Centers for Disease Control and Prevention estimates that approximately 2.8 million people worldwide are infected with antibiotic-resistant bacteria, accounting for 35,000 deaths each year in the U.S. and 700,000 deaths around the globe.
Molecular mechanisms of antimicrobial resistance in bacteria Jobir Nadhi
Molecular mechanisms of antimicrobial resistance in bacteria by highlighting the aspects of antimicrobial resistance
through a discussion of:
Bacterial strategies involved in resisting antimicrobial actions and
The molecular basis for bacterial resistance to
antimicrobial actions
some note kept in phrase are completed visualizing the picture.
No doubt that antibiotics are the life saver for us but taking them without prescription of doctor or not completing its course can turn them against us ,more precisely it makes the bacteria more powerful and hard to cure. They are not affected with antibiotic anymore this is known as Antibiotic Resistance
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.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. OBJECTIVES :
What are antibiotics ?
What are the antibiotic resistance ?
How the bacteria become resistant to antibiotics ?
What the mech. Of that resistance ?
What are the misuse of antibiotics ?
How we minimize misuse of antibiotics ?
Are we overuse antibiotics with example of misuse in Iraq and
right use in USA .
3. ANTIBIOTICS
Antibiotics, also called
antibacterials, are a type of
antimicrobial drug used in the
treatment and prevention of bacterial
infection.
Chemical Antibiotic: produced by a
microorganism that kills or inhibits
the growth of another
microorganism .
.
4. MECHANISMS OF
ANTIMICROBIAL DRUGS
1 Inhibition of cell wall synthesis
2 Inhibition of cell membrane
function
3 Inhibition of protein synthesis
inhibition of translation and
transcription of genetic material)
4 Inhibition of nucleic acid
synthesis.
5. the Right Antibiotic for Bacterial Infections
Does the prescribed antibiotic kill
the bacterium or merely stop it from
dividing?
What type of bacteria does it
target?
Which parts of the bacteria does it
target?
How is the antibiotic applied?
How long should the antibiotic be
used?
6. ANTIBIOTIC RESISTANCE
Antibiotic resistance is a specific type of drug
resistance when a microorganism has the ability
of withstanding the effects of antibiotics.
Antibiotic resistance evolves via natural
selection acting upon random mutation, but it
can also be engineered by applying an
evolutionary stress on a population.
Once such a gene is generated, bacteria can
then transfer the genetic information in a
horizontal fashion(between individuals) by
conjugation, transduction, or transformation.
7. RESISTANCE AND
SUSCEPTIBILITYDetermined by
in vitro activity,
pharmacologic characteristics,
and clinical evaluation.
The minimal inhibitory concentration(MIC) can be
comfortably exceeded by doses tolerated by the
patient.
Susceptible implies their MIC is at a
concentration attainable in the blood or other body
fluid at the recommended dose.
Resistant MIC is not exceeded by normally
attainable levels
8. ANTIBIOTIC RESISTANCE
Some microorganisms may'born' resistant,
some achieve' resistance by mutation or some
have resistance"thrust upon them" by plasmids
“Some are born great, some achieve greatness or
some have greatness thrust upon them”
10. ORIGIN OF DRUG RESISTANT
STRAINS
The resistant strains arise either
by
1.mutation and selection
It refers to the change in DNA
structure of the gene. Occurs at a
frequency of one per ten million
cells. Eg. Mycobacterium
tuberculosis,Mycobacterium lepra
MRSA.
Often mutants have reduced
susceptibility
11. ORIGIN OF DRUG
RESISTANT STRAINS
2 . genetic exchange
in which sensitive organisms receive
the genetic material ( part of DNA) from
the resistant organisms
the part of DNA carries with it
information of mode of inducing
resistance against one or multiple
antimicrobial agents.
12. Selective pressure
The influence exerted by some factor (such
as an antibiotic) on natural selection to
promote one group of organisms over
another.
In the case of antibiotic resistance,
antibiotics cause a selective pressure by
killing susceptible bacteria, allowing
antibiotic-resistant bacteria to survive and
multiply.
13. Sir Alexander Fleming In his
1945 Nobel Prize lecture
Fleming himself warned of the danger of
resistance
"It is not difficult to make microbes resistant to
penicillin in the laboratory by exposing them to
concentrations not sufficient to kill them, the same
thing has occasionally happened in the body... and by
exposing his microbes to non-lethal quantities of the
drug make them resistant.“
Resistant mutants selected at low antibiotic
concentrations are generally more fit than those
selected at high concentrations but can still be highly
resistance .
14. Sub-MIC selection
Selection of resistance at non-lethal antibiotic concentrations
1.Growth rate
2.tolerance
thought that the genetic and phenotypic changes that confer resistance
also result in concomitant reductions in in vivo fitness, virulence, and
transmission
Since the fitness cost and not the level of resistance is the most
influential parameter for selection of resistant cells at low levels of
antibiotics, de novo selected mutants enriched at sub-MIC are expected to
have very low fitness costs.
since selection for high fitness is strong at sub-MIC levels of antibiotics
it is less likely that the resulting resistance is reversed in the absence of
antibiotic, either by mutation or by competition with more fit susceptible
bacteria
the rate with which resistance mutations will arise is expected to be
higher at low concentrations of antibiotics
15. BIOCHEMICAL MECHANISMS
OF DRUG RESISTANCE
Prevention of drug
accumulation in the bacterium
Modification/protection of the
target site
Use of alternative pathways for
metabolic growth requirements
By producing an enzyme that
inactivates the antibiotic
16.
17. Practices Contributing
to Misuse of
AntibioticsInappropriate specimen selection and
collection
Failure to use stains/smears
Failure to use cultures and susceptibility
tests
Use of antibiotics with no clinical
indication(eg, for viral infections)
Use of broad spectrum antibiotics when
not indicated
inappropriate choice of empiric
antibiotics Drug
20. People can help tackle
resistance by
People can help tackle resistance by:
using antibiotics only when prescribed
by a doctor;
completing the full prescription, even
if they feel better;
never sharing antibiotics with others
or using leftover prescriptions.
21. Health workers and
pharmacists can help
tackle resistance by:
Optimize patient evaluation
Adopt judicious antibiotic
Immunize patients
enhancing infection prevention and
control;
prescribing and dispensing the right
antibiotic(s) to treat the illness.
Optimize consultations with other
clinicians
Educate others about judicious use of
antibiotics
22. Are we over use antibiotics
Rx
Cetriaxone
Suprax
itraconazole
fluconazole
miconazole
Clotrimazozol
Other
Mutation Mutations result from damage to DNA which is not repaired, errors in the process of replication, or from the insertion or deletion of segments of DNA by mobile genetic elements.
Insertions add one or more extra nucleotides into the DNA. They are usually caused by transposable elements, or errors during replication of repeating elements. Insertions in the coding region of a gene may alter splicing of the mRNA(splice site mutation), or cause a shift in the reading frame(frameshift), both of which can significantly alter the gene product. Insertions can be reversed by excision of the transposable element.
Deletions remove one or more nucleotides from the DNA.
. Chromosomal translocations: interchange of genetic parts from nonhomologous chromosomes.
transposable element (TE or transposon) is a DNA sequencethat can change its position within a genome, sometimes creating or reversing mutations and altering the cell's genome size.
Chromosomal inversions: reversing the orientation of a chromosomal segment.
Causes::::::::::::::: (1) spontaneous mutations (molecular decay), (2) mutations due to error-prone replication bypass of naturally occurring DNA damage (also called error-prone translesion synthesis), (3) errors introduced during DNA repair, and (4) induced mutations caused by mutagens.
mutagen is a physical or chemical agent that changes the genetic material, usually DNA, of an organism and thus increases the frequency of mutations above the natural background level By effect on
function
1_loss-of-function mutations, also called inactivating mutations, result in the gene product having less or no function (being partially or wholly inactivated). 2_Gain-of-function mutations, also called activating mutations, change the gene product such that its effect gets stronger (enhanced activation) or even is superseded by a different and abnormal function.
3_Dominant negative mutations (also called antimorphicmutations) have an altered gene product that acts antagonistically to the wild-type allele 4_Lethal mutations are mutations that lead to the death of the organisms that carry the
mutations effect on fitness ::
1_A harmful, or deleterious, mutation decreases the fitness of the organism.
2_beneficial, or advantageous mutation increases the fitness of the organism. Mutations that promotes traits that are desirable, are also called beneficial
3_ neutral mutation has no harmful or beneficial effect on the organism.
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Horizontal gene transfer (HGT) refers to the transfer of genesbetween organisms in a manner other than traditional reproduction.
Lateral gene transfer is a type of horizontal gene transfer which occurs between eukaryotic organisms. (LGT), it contrasts with vertical transfer, the transmission of genes from the parental generation to offspring via sexual or asexual reproduction.
HGT has been shown to be an important factor in the evolution of many organisms.
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Transformation, the genetic alteration of a cell resulting from the introduction, uptake and expression of foreign genetic material (DNA or RNA).[27] This process is relatively common in bacteria, but less so in eukaryotes.[28] Transformation is often used in laboratories to insert novel genes into bacteria for experiments or for industrial or medical applications. See alsomolecular biology and biotechnology.
Transduction, the process in which bacterial DNA is moved from one bacterium to another by a virus (a bacteriophage, orphage).[27]
Bacterial conjugation, a process that involves the transfer of DNA via a plasmid from a donor cell to a recombinant recipient cell during cell-to-cell contact.[27] Gene transfer agents, virus-like elements encoded by the host that are found in the alphaproteobacteria orderRhodobacterales.[29]
A transposon (jumping gene) is a mobile segment of DNA that can sometimes pick up a resistance gene and insert it into a plasmid or chromosome, thereby inducing horizontal gene transfer of antibiotic resistance.[27]
Selection of resistance at non-lethal antibiotic concentrations (below the wild-type minimum inhibitory concentration) occurs due to differences in growth .rate at the particular antibiotic concentration between cells with different tolerance levels to the antibiotic
Recent studies have shown that resistant bacteria can be selected at concentrations severahundred-fold below the lethal concentrations for susceptible cells.
Resistant mutants selected at low antibiotic concentrations are generally more fit than those selected at high concentrations but can still
be highly resistant
The underlying mechanisms of resistance development have been studied extensively in particular pathogen–antibiotic combinations. However, the broader questions of the driving forces behind where and how resistance arises and is selected and how resistance genes spread between different bacteria and different environments are complex and still not completely understood
It is intuitive that for most kinds of antibiotics a bacterium will still experience a reduction in growth even at concentrations just below the MIC even if growth is not completely prevented
minimum selective concentration (MSC) as the lowest concentration of an antibiotic that still selects for a given resistance mutation.
The fact that antibiotic levels several hundred-fold below the MIC of the susceptible strains can select resistant bacteria means that the sub-MIC selective window is much larger than the traditional selective window. In effect this means that concentrations of antibiotics commonly found in sewage water in European countries and the USA (see (9,14,15) and references therein) are high enough to enrich for resistant bacteria
is thought that the genetic and phenotypic changes that confer resistance also result in concomitant reductions in in vivo fitness, virulence, and transmission.
Since the fitness cost and not the level of resistance is the most influential parameter for selection of resistant cells at low levels of antibiotics, de novo selected mutants enriched at sub-MIC are expected to have very low fitness costs. It is therefore unlikely that the one-step high-level resistant mutants with relatively high fitness costs commonly found when high-level selection is performed will be selected (17). Instead, accumulation of mutations giving increasing resistance levels but having very low fitness costs is predicted to occur
First, since selection for high fitness is strong at sub-MIC levels of antibiotics it is less likely that the resulting resistance is reversed in the absence of antibiotic, either by mutation or by competition with more fit susceptible bacteria
gene duplication and amplification (GDA) constitutes an important adaptive mechanism in bacteria. For example, resistance to sulphonamide, trimethoprim and beta-lactams can be conferred by increased gene dosage through GDA of antibiotic hydrolytic enzymes, target enzymes or efflux pumps.
Quorum sensing is the regulation of gene expression in response to fluctuations in cell-population density. Quorum sensing bacteria produce and release chemical signal molecules called autoinducers that increase in concentration as a function of cell density.
Although it is still not completely understood why and how antibiotics increase the growth rate of pigs, possibilities include metabolic effects, disease control effects, and nutritional effects