MLS 044: CLINICAL BACTERIOLOGY

SESSION 9: ANTIMICROBIAL AGENTS – MECHANISMS OF

ACTION AND RESISTANCE
NAME: ANG, KIARA HANNEN L.
INSTRUCTOR: HANNAH A. BALANON

LESSON PREVIEW/ REVIEW (5 MINUTES)

You will accomplish the review activity below on Traditional Cultivation – Bacteriologic Culture
Media.
Identify which bacteria are specifically cultivated in the following media.
1. Anaerobic blood agar – anaerobic gram-positive cocci
2. Brucella agar – Streptococcus pneumonia, Streptococcus viridians, and Neisseria
meningitidis
3. Todd-Hewitt broth – beta-hemolytic streptococci
4. Hektoen enteric agar – Salmonella and Shigella
5. Lowenstein-Jensen – Mycobacterium species
6. CIN – Yersinia spp.
7. Regan Lowe – Bordetella spp.
8. Schaedler agar – anaerobic bacteria
9. HBT medium – Gardnerella vaginalis
10. Thayer-Martin – Neisseria gonorrhoeae and Neisseria meningitidis

Exercise 1. Classify the following antibiotics – Bacteriocidal or Bacteriostatic, Narrow or

with Broad-Spectrum
ANTIBIOTICS CLASSIFICATION AS TO CLASSIFICATION AS TO
ACTION SPECTRUM ACTIVITY
Amoxicillin Bactericidal Narrow-spectrum
1. Bacitracin Bactericidal Narrow-spectrum
2. Cephalexin Bactericidal Narrow-spectrum
3. Doxycycline Bacteriostatic Broad-spectrum
4. Rifampin Bactericidal Broad-spectrum
5. Clindamycin Bacteriostatic Broad-spectrum
6. Metronidazole Bactericidal Broad-spectrum
7. Aztreonam Bactericidal Broad-spectrum
8. Azithromycin Bacteriostatic Broad-spectrum
9. Tobramycin Bactericidal Broad-spectrum
10. Ciprofrloxacin Bactericidal Broad-spectrum
CHECK FOR UNDERSTANDING (30 minutes)
Multiple Choice and Rationalization
Each of the questions or incomplete statements that follow comprises four suggested
responses. Select the correct answer or completion statements in each case. Write your short
rationalization after each answer. This will be recorded as your quiz. One (1) point will be givem
to the correct answer and another (1) point for the correct ratio.

1. Which class of antibiotics is used for the treatment of serious gram-negative infections
as well as infections with Mycobacterium tuberculosis?

A. Cephalosporins
B. Penicillins
C. Tetracyclines
D. Aminoglycosides
Answer: D
Rationale: Aminoglycosides’ species range are Aerobic gram-positive and gram-negative
species, and Mycobacterium tuberculosis.
2. The most commonly used inhibitors of cell wall biosynthesis act on _____.

A. Transportation of lipid bound precursors across the cytoplasmic membranes.

B. Insertion of glycan units into the cell wall.
C. Transpeptidation linking and maturation.
D. Synthesis of precursors in the cytoplasm.
E. B and C
F. A and D
Answer: E
Rationale: It acts on insertion of glycan units into the cell wall and transpeptidation linking and
maturation because many antibacterial agents function by targeting bacterial cell wall synthesis.

3. Which characteristic describes the origin of antibiotics?

A. They are natural molecules.

B. They are synthetic molecules.
C. They are semisynthetic molecules.
D. A, B, and C
Answer: D
Rationale: The characteristics that describes the origin of antibiotics are natural, synthetic and
semisynthetic molecules.
 4. Microorganisms can exhibit antibiotic resistance by which of the following mechanisms?

A. Intrinsic
B. Acquired
C. Both A and B
D. Neither A nor B
Answer: C
Rationale: Intrinsic resistance in the innate ability of a bacterial species to resist the activity of a
particular antimicrobial agent through inherent structural or functional characteristics, allowing
tolerance of a particular drug or antimicrobial class while Acquired mechanism of resistance are
caused by changes in the usual genetic makeup of a microorganism and by the results of
altered cellular physiology ans structure.

5. Which mechanisms of antiobiotic resistance are intrinsic and acquired?

A. Efflux
B. Enzymatic
C. Biofilm
D. Acquisition of new targets
E. A and B
F. A and C
Answer: E
Rationale: Enzymatic activation of antimicrobial agents is one of the most commonly used class
of acquired and intrinsic resistance mechanism for beta-lactamase antibiotics. Efflux also plays
a major role in acquired and intrinsic resistance, intrinsic resistance of bacteria to certain
antibiotics is explained by the activity of efflux systems and impermeability.

6. Which of the listed antimicrobials act on cell wall biosysnthesis?

A. Beta-lactams and glycopeptides

B. Tetracycline and streptomycin
C. Macrolides and aminoglycosides
D. Fluoroquinolones
Answer: A
Rationale: Many antibacterial agents function by targeting bacterial cell wall synthesis.

7. The most sensitive method for the detection of B-lactam in bacteria is by the use of
_____.

A. Chromogenic cephalosporin
B. Penicillin
 C. Oxidase
D. Chloramphenicol
Answer: A
Rationale: Using of chromogenic cephalosporin is the most sensitive method for the detection of
B-lactam in bacteria.

8. How is monobactam (aztreonam) different from the other beta-lactams?

A. It has only one beta-lactam ring.

B. It binds only to transpeptidases of Gram – negative bacteria.
C. It binds only to transpeptidases of Gram – positive bacteria.
D. A and B
E. A and C
Answer: B
Rationale: Monobactam binds only to transpeptidases of Gram-negative bacteria unlike to other
beta-lactams, aztreonam is inactive against gram-positive.

9. Why is vancocymin not effective in inhibiting the growth of Gram – negative bacteria?

A. It cannot penetrate the outer membrane due to its large size.

B. It is prevented entry through a pumping mechanism (efflux)
C. It cannot bind to the ribosome due to target modification
D. A, B, and C
Answer: D
Rationale: Vancocymin in ineffectively in inhibiting the growth of Gram – negative bacteria
because it cannot penetrate the outer membrane due to its large size, it prevented entry through
a pumping mechanism (efflux) and it cannot bind to the ribosome due to target modification.

10. How do some bacteria develop resistance to penicillin?

A. Alteration of porins for Gram – negative bacteria

B. Alteration of transpeptidase
C. Production of beta-lactamase that will cleave C-N bond in beta-lactam ring
D. A, B, and C
Answer: D
Rationale: They resist through alteration of porins for Gram – negative bacteria, alteration of
tranpeptidase and production of beta-lactamase that will cleave C-N bond in lactam ring
because they destroy the beta-lactam ring of penicillin which makes it ineffectively.