NAME

UMER DASTAGIR PATHAN

CLASS
11TH SCIENCE

SUBJECT
BIOLOGY

TOPIC
To Study of Drug Resistance in Bacteria
Using Antibiotics
 To Study of Drug Resistance in Bacteria Using
Antibiotics

Abstract
An antibiotic is an agent that either kills or inhibits the growth of a microorganism. The term
antibiotic was first used in 1942 by Selman Waksman and his collaborators in journal articles to
describe any substance produced by a microorganism that is antagonistic to the growth of other
microorganisms in high dilution. This definition excluded substances that kill bacteria but that are
not produced by microorganisms (such as gastric juices and hydrogen peroxide). It also excluded
synthetic antibacterial compounds such as the sulphonamides. Many antibacterial compounds
are relatively small molecules with a molecular weight of less than 2000 atomic mass units.
With advances in medicinal chemistry, most modern antibacterial are semi synthetic
modifications of various natural compounds. These include, for example, the beta-lactam
antibiotics, which include the penicillin (produced by fungi in the genus Penicillium), the
cephalosporin, and the carbapenems. Compounds that are still isolated from living organisms are
the amino glycosides, whereas other antibacterial—for example, the sulphonamides, the
quinolones, and the oxazolidinones—are produced solely by chemical synthesis.
In accordance with this, many antibacterial compounds are classified on the basis of
chemical/biosynthetic origin into natural, semi synthetic, and synthetic. Another classification
system is based on biological activity; in this classification, antibacterial are divided into two
broad groups according to their biological effect on microorganisms: Bactericidal agents kill
bacteria, and bacteriostatic agents slow down or stall bacterial growth.

What is Antibiotic Resistance?

Antibiotic resistance is a form of drug resistance whereby some (or, less commonly, all) sub-
populations of a microorganism, usually a bacterial species, are able to survive after exposure to
one or more antibiotics; pathogens resistant to multiple antibiotics are considered multidrug
resistant (MDR) or, more colloquially, superbugs.
Antibiotic resistance is a serious and growing phenomenon in contemporary medicine and has
emerged as one of the pre-eminent public health concerns of the 21st century, in particular as it
pertains to pathogenic organisms (the term is especially relevant to organisms that cause
disease in humans). A World Health Organization report released April 30, 2014 states, "this
serious threat is no longer a prediction for the future, it is happening right now in every region of
the world and has the potential to affect anyone, of any age, in any country. Antibiotic
resistance–when bacteria change so antibiotics no longer work in people who need them to treat
infections–is now a major threat to public health."
In the simplest cases, drug-resistant organisms may have acquired resistance to first-line
antibiotics, thereby necessitating the use of second-line agents. Typically, a first-line agent is
selected on the basis of several factors including safety, availability, and cost; a second-line
agent is usually broader in spectrum, has a less favourable risk-benefit profile, and is more
expensive or, in dire circumstances, may be locally unavailable. In the case of some MDR
pathogens, resistance to second- and even third-line antibiotics is, thus, sequentially acquired, a
case quintessentially illustrated by Staphylococcus aureus in some nosocomial settings. Some
pathogens, such as Pseudomonas aeruginosa, also possess a high level of intrinsic resistance.
It may take the form of a spontaneous or induced genetic mutation, or the acquisition of
resistance genes from other bacterial species by horizontal gene transfer via conjugation,
transduction, or transformation. Many antibiotic resistance genes reside on transmissible
plasmids, facilitating their transfer. Exposure to an antibiotic naturally selects for the survival of
the organisms with the genes for resistance. In this way, a gene for antibiotic resistance may
readily spread through an ecosystem of bacteria. Antibiotic-resistance plasmids frequently
contain genes conferring resistance to several different antibiotics. This is not the case for
Mycobacterium tuberculosis, the bacteria that causes Tuberculosis, since evidence is lacking for
whether these bacteria have plasmids. Also M. tuberculosis lack the opportunity to interact with
other bacteria in order to share plasmids.
Genes for resistance to antibiotics, like the antibiotics themselves, are ancient. However, the
increasing prevalence of antibiotic-resistant bacterial infections seen in clinical practice stems
from antibiotic use both within human medicine and veterinary medicine. Any use of antibiotics
can increase selective pressure in a population of bacteria to allow the resistant bacteria to thrive
and the susceptible bacteria to die off. As resistance towards antibiotics becomes more common,
a greater need for alternative treatments arises. However, despite a push for new antibiotic
therapies, there has been a continued decline in the number of newly approved drugs. Antibiotic
resistance therefore poses a significant problem.
The growing prevalence and incidence of infections due to MDR pathogens is epitomized by the
increasing number of familiar acronyms used to describe the causative agent and sometimes the
infection; of these, MRSA is probably the most well-known, but others including VISA
(vancomycin-intermediate S. aureus), VRSA (vancomycin-resistant S. aureus), ESBL (Extended
spectrum beta-lactamase), VRE (Vancomycin-resistant Enterococcus) and MRAB (Multidrug-
resistant A. baumannii) are prominent examples. Nosocomial infections overwhelmingly
dominate cases where MDR pathogens are implicated, but multidrug-resistant infections are also
becoming increasingly common in the community.
Although there were low levels of pre-existing antibiotic-resistant bacteria before the widespread
use of antibiotics, evolutionary pressure from their use has played a role in the development of
multidrug-resistant varieties and the spread of resistance between bacterial species. In medicine,
the major problem of the emergence of resistant bacteria is due to misuse and overuse of
antibiotics. In some countries, antibiotics are sold over the counter without a prescription, which
also leads to the creation of resistant strains. Other practices contributing to resistance include
antibiotic use in livestock feed to promote faster growth.] Household use of antibacterial in soaps
and other products, although not clearly contributing to resistance, is also discouraged (as not
being effective at infection control). Unsound practices in the pharmaceutical manufacturing
industry can also contribute towards the likelihood of creating antibiotic-resistant strains. The
procedures and clinical practice during the period of drug treatment are frequently flawed —
usually no steps are taken to isolate the patient to prevent re-infection or infection by a new
pathogen, negating the goal of complete destruction by the end of the course (see Healthcare-
associated infections and Infection control).
Certain antibiotic classes are highly associated with colonization with "superbugs" compared to
other antibiotic classes. A superbug, also called multiseriate, is a bacterium that carries several
resistance genes. The risk for colonization increases if there is a lack of susceptibility
(resistance) of the superbugs to the antibiotic used and high tissue penetration, as well as broad-
spectrum activity against "good bacteria". In the case of MRSA, increased rates of MRSA
infections are seen with glycopeptides, cephalosporins, and especially quinolones. In the case of
colonization with Clostridium difficile, the high-risk antibiotics include cephalosporins and in
particular quinolones and clindamycin.
Of antibiotics used in the United States in 1997, half were used in humans and half in animals; in
2013, 80% were used in animals.

Antibiotics Resistance Fact

 Disease-causing bacteria can cause illness. Viruses can also cause illness
 Antibiotics are drugs used to treat bacterial infections. Viral infections do not respond
to antibiotic treatment.
 Antibiotics have been used for a long time and are frequently prescribed. Because of this
widespread use, the infectious bacteria the antibiotics were designed target have adapted
and changed, making the drugs less effective. This is antibiotic resistance.
 Antibiotics are not effective against viral infections such as the common cold,
most sore throats, and the flu. Using antibiotics when they are not needed contributes to
antibiotic resistance and unwanted side effects.
 The more antibiotics are used, the more resistant the bacteria can become because sensitive
bacteria are killed, but stronger germs resist the treatment and grow and multiply.
Repeated and improper use of antibiotics contributes to this process.
 The Food and Drug Administration (FDA) states antibiotic resistance is a common public
health problem because nearly all types of bacteria have become stronger and less
responsive to antibiotic treatment.
 Antibiotic resistance in children and older adults are of particular concern
due to high rates of antibiotic use. Once a particular bacterium becomes
resistant to an antibiotic, treating that infection becomes more difficult and, in some cases,
medically impossible. Untreated, bacterial infections can spread rapidly.

Why are Bacteria becoming Resistance to Antibiotics?

Antibiotic use promotes development of antibiotic-resistant bacteria. Every time a person takes
antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply.
Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant
bacteria.

While antibiotics should be used to treat bacterial infections, they are not effective against viral
infections like the common cold, most sore throats, and the flu. Widespread use of antibiotics
promotes the spread of antibiotic resistance. Smart use of antibiotics is the key to controlling the
spread of resistance.

Why is antibiotic resistance in bacteria a big problem?

Antibiotic resistance in bacteria is a serious global public health threat. According to the Centres
for Disease Control and Prevention (CDC), 2 million people in the U.S. develop antibiotic-
resistant infections each year, and at least 23,000 people die from those infections.

Resistant infections also place a burden on individuals and the medical system. Research shows
that resistant infections can lead to longer hospital stays, more doctor visits, longer recovery
times, and higher medical expenses. Antibiotic resistance has been shown to place a $20 billion
burden on the healthcare system annually.

When alternative drugs are available to treat resistant infections, they can be less effective,
produce more side-effects (more toxic), and can be more expensive.

Without effective ways to treat infections, medical procedures such as organ transplants,
chemotherapy, and major surgeries become higher risk.

Antibiotic resistant bacteria can cause infections that are hard-to-treat or untreatable. Examples
include:

 Urinary tract infection

 Blood infection (septicaemia)
 Pneumonia
 Wound and skin infection
 Sexually transmitted disease, particularly gonorrhea
  Tuberculosis

Need of this Experiment

Antibiotic resistance is becoming more and more common. Antibiotics and antimicrobial agents
are drugs or chemicals that are used to kill or hinder the growth of bacteria, viruses, and other
microbes. Due to the prevalent use of antibiotics, resistant strains of bacteria are becoming much
more difficult to treat. These "super bugs" represent a threat to public health since they are
resistant to most commonly used antibiotics. Current antibiotics work by disrupting so-called cell
viability processes. Disruption of cell membrane assembly or DNA translation are common
modes of operation for current generation antibiotics. Bacteria are adapting to these antibiotics
making them ineffective means for treating these types of infection. For example,
Staphylococcus aureus have developed a single DNA mutation that alters the organism's cell
wall. This gives them the ability to withstand antibiotic cell disruption processes. Antibiotic
resistant Streptococcus pneumoniae produce a protein called MurM, which counteracts the
effects of antibiotics by helping to rebuild the bacterial cell wall.

Fighting Antibiotic Resistance

Researchers are attempting to develop new types of antibiotics that will be effective against
resistant strains. These new antibiotics would target the bacteria's ability to become virulent and
infect the host cell. Researchers at Brandeis University have discovered that bacteria have
protein "switches" that when activated, turn "ordinary" bacteria into pathogenic organisms. These
switches are unique in bacteria and are not present in humans. Since the switch is a short-lived
protein, elucidating its structure and function was particularly difficult. Using nuclear magnetic
resonance (NMR) spectroscopy, the researchers were able to regenerate the protein for one and
one half days. By extending the time frame that the protein was in its "active state," the
researchers were able to map out its structure. The discovery of these "switches" has provided a
new target for the development of antibiotics which focus on disrupting the activation of the
protein switches.
Monash University researchers have demonstrated that bacteria contain a protein complex called
Translocation and Assembly Module (TAM). TAM is responsible for exporting disease causing
molecules from the inside of the bacterial cell to the outer cell membrane surface. TAM has been
discovered in several antibiotic resistant bacteria. The development of new drugs to target the
protein would inhibit infection without killing the bacteria. The researchers contend that keeping
the bacteria alive, but harmless, would prevent the development of antibiotic resistance to the
new drugs.
Researchers from the NYU School of Medicine are seeking to combat antibiotic resistance by
making resistant bacteria more vulnerable to current antibiotics. They discovered that bacteria
produce hydrogen sulphide as a means to counter the effects of antibiotics. Antibiotics cause
bacteria to undergo oxidative stress, which has toxic effects on the microbes. The study revealed
that bacteria produce hydrogen sulphide as a way to protect themselves against oxidative stress
and antibiotics. The development of new drugs to target bacterial gas defences could lead to the
reversal of antibiotic resistance in pathogens such as Staphylococcus and E.coli.
These studies indicate how highly adaptable bacteria are in relation to the application of
antimicrobial treatments. Antibiotic-resistant bacteria have become a problem not only in
hospitals, but in the food industry as well. Drug-resistant microbes in medical facilities lead to
patient infections that are more costly and difficult to treat. Resistant bacteria in turkey and other
meat products have caused serious public health safety issues. Some bacteria may develop
resistance to a single antibiotic agent or even multiple antibiotic agents. Some have even
become so resistant that they are immune to all current antibiotics. Understanding how bacteria
gain this resistance is key to the development of improved methods for treating antibiotic
resistance.