LABORATORY

MICP

Bachelor of Science in Nursing: MICP LAB

LAB MODULE LAB UNIT WEEK

5 1 - PRELIM PERIOD 5

Antimicrobial Agents In Therapy

 Implement a study habit to read and comprehend the following prior to online class
proper: unit objectives; lab module and lab learning videos.
 Actively search for unfamiliar medical terminologies and relate to discussions.
 Establish effective teacher- student interactions through participation in the
synchronous online class discussion. through LMS discussion board or through Online
Lab Class chat box. Ask relevant questions.
 Answer and submit lab unit tasks online if there is any.
 For additional direction read study guide prior to class proper

At the end of this unit, the students are expected to:

1. Define anti microbial agents

2. Explain characteristic of ideal antimicrobial agents
3. Classify antimicrobial agents
4. Explain mechanism of action of antimicrobial
5. Define and discuss antimicrobial resistance
6. Discuss mechanism by which microorganism develops resistance.
7. Advocate Microbial Stewardship

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 LAB INTRODUCTION

A
NTIMICROBIAL AGENTS

Antibiotics or Antimicrobials are substances produced from microorganisms or

synthetically. They are capable of inhibiting or destroying microorganism even at low
concentrations

 Antimicrobials are substances that kill or suppress microorganisms such as

bacteria, fungi and viruses
 First antimicrobials dates back to the Egyptians who used mouldy bread to
treat surface infections
 Beginning of the 20th century, Paul Ehrlich synthesized the first antimicrobial
agent known as Salvarsan, a drug used for treating syphilis
 Alexander Fleming discovered penicillin by noticing the growth of
Staphylococcus aureus was inhibited in presence of the mold produced by
Penicillium fungi. Led to the conclusion that microorganisms produce
substances to limit growth of other competing microorganisms.From that
moment onwards, new types of antimicrobial agents were developed such as
streptomycin, chloramphenicol, macrolide and tetracycline, causing a
significant decrease in the mortality rate due to bacterial infections.

H Here are the Classification of ANTIBIOTICS

According to spectrum of activity –

1.Broad spectrum - with wide range of activity
2.Narrow spectrum - with limited range of activity

According to antimicrobial activity –

1.bactericidal - capable of killing microorganism
2. bacteriostatic - only inhibit the growth of the organism

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According to absorbability from site of administration:
1.locally-acting – ex: topical agents (topical ointments & eyedrops)
2.systemically - acting- affects several body systems
(ex:antibiotics administered intravenously)

According to mechanism of actions

Agents that inhibits the synthesis of the bacterial cell wall - these agents act by inhibit the
different stages of peptidoglycan synthesis; by destroying an already formed peptidoglycan by
activating autolytic enzymes.

Ex: beta-lactam antibiotics - Penicillins (ampicillin, amoxicillin, benzathiane penicillin)

cephalosporins (ceftriaxone), vancomycin, bacitracin, cycloserine

1. agents that alter the function/permeability of the cell membrane

They disrupt the cell membrane - anti fungal drugs
(POLYENES – nystatins, amphoterin B)
They change permeability of a cell membrane - Azoles (clotrimoxazole, ketoconazole,- anti fungals )

2. agents that inhibits synthesis of proteins

They binds the ribosomes 30s ribosomal subunit: (AMINOGLYCOSIDES – streptomycin, gentamycin, and kanamycin)
50s ribosomal subunit - (chloramphenicol, macrolides, and lincosamines)

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 3. agents that act on the nucleic acid
They inhibit DNA replication- (quinolones, novobiocin & metronidazole)
 Inhibit the synthesis of folic acid -(trimethropim, sulfonamides and sulfones)
 Inhibits RNA synthesis- (rifampicin)

What is antimicrobial resistance?

 Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time
and no longer respond to medicines making infections harder to treat and increasing the risk of
disease spread, severe illness and death.

What accelerates the emergence and spread of antimicrobial resistance?

 AMR occurs naturally over time, usually through genetic changes.

 Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in
water, soil and air). They can spread from person to person or between people and animals,
including from food of animal origin.
 The main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials; lack
of access to clean water, sanitation and hygiene (WASH) for both humans and animals; poor
infection and disease prevention and control in health-care facilities and farms; poor access to
quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack
of enforcement of legislation.

Drug resistance in bacteria

 common bacterial infections such as urinary tract infections, sepsis, sexually transmitted infections,
and some forms of diarrhoea have high rates of resistance against antibiotics.
 For example, the rate of resistance to ciprofloxacin, an antibiotic commonly used to treat urinary
tract infection
 Escherichia coli for Klebsiella pneumoniaefluoroquinolone antibiotics for E. coli, (treatment of
urinary tract infections)

 - Staphylococcus aureus (part skin flora) - methicillin-resistant Staphylococcus aureus (MRSA) .

 - strains of N. gonorrhoeae -has resistance emerged to sulphonamides, penicillins, tetracyclines,
macrolides, fluoroquinolones, and early generation cephalosporins. In most countries, the
injectable extended-spectrum cephalosporin (ESC) ceftriaxone is the only remaining empiric
monotherapy for gonorrhoea.

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  Drug resistance in mycobacterium tuberculosis - new cases of rifampicin-resistant TB (RR-TB).
Majority have multi-drug resistant TB (MDR-TB), a form of tuberculosis that is resistant to the
two most powerful anti-TB drugs
 - Drug resistance in viruses - an increasing concern in immunocompromised patient with drug-
resistant HIV (HIVDR). People receiving antiretroviral therapy can acquire HIVDR. Latest WHO
ARV guidelines now recommend the adoption of a new drug, dolutegravir, as the preferred
first-line treatment for adults and children.
 Drug resistance in malaria parasites . Artemisinin-based combination therapies (ACTs) are the
recommended first-line treatment for uncomplicated P. falciparum malaria and are used by
most malaria endemic countries. In the WHO Eastern Mediterranean Region, P.
falciparum resistance to sulfadoxine-pyrimethamine led to artesunate-sulfadoxine-
pyrimethamine failures in some countries, necessitating a chang
 Drug resistance in fungi. Drug-resistant Candida auris, one of the most common invasive fungal
infections, is already widespread with increasing resistance reported to fluconazole,
amphotericin B and voriconazole as well as emerging caspofungin resistance.

Hi there, bibliophiles! Read Further in Chapter 8: Antimicrobial Agents (page 91)

Bartolome and Quiles. (2020) Microbiology and Parasitology:
A Textbook and Laboratory Manual for the Health Sciences.
2nd Edition. C&E Publishing House. Quezon City. QR65. B37
2020

For this, we will utilize the following interactive resources.

Video Link
Part 1 Microbiology - Antibiotics Mechanisms of Action https://www.youtube.com/watch?v=IVB
Video A CrzjOl40

Part 2 Antimicrobial Compounds & Resistance – Microbiology |

Video B Lecturio
Part 3 Antimicrobial Stewardship https://www.youtube.com/watch?v=jZg
Video C nJaOyo8c&t=31s

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 LAB TASKS

POINTS TO PONDER. Analysis

1. What are the instances that microbial control is necessary?

2. What is the ideal method of microbial control?
3. Your family is aware that you are a student nurse and frequently seeks your opinion. Your
brother inquires about his cough, which has been bothering him for the past two weeks. He is
coughing up mucous now, and he is convinced he is sick.
“It's bronchitis,” they say. He wants to know if he should use the amoxicillin he preserved
from a previous infection.What should you say to your brother? (adopted from Totora,
2019)
4. . Antibiotics are used in the feed of penned animals by livestock farmers.Because the
medications decrease the amount of bacterial illnesses and hasten the growth of the animals
Farm. Animals now receive more than half of all antibiotics used worldwide. Meat and milk that
has made it to the consumer's table. So, what are the dangers of using antibiotics in animal?
5. Penicillin is given to a patient with streptococcal sore throat for two days of a 10-day
regimen given by the doctor He then feels better because he feels better.saves the rest of the
penicillin for a later date After three more,he has a painful throat relapse after a few days.
Discuss the possible reason for the relapse

Make an active search:

1. Chemotherapy was coined by whom?
2. A certain genus of bacteria produces more than half of our antibiotics. What exactly is it?
3. Analyze the differences between synergism and antagonism.
4. Mutations in bacteria cause resistance to antimicrobial medicines. Horizontal gene transfer can
spread these alterations to other bacteria.

Congratulations on making it this far.

You deserve a cheer for your dedication to your microbiology studies.

The terms listed below are crucial for this lab module. Some of it needs to be actively
looked for.
TERMINOLOGIES

Antagonism -

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Antifungal agents -A drug that selectively eliminates fungal pathogens from a host with
minimal toxicity to the host

Antimicrobial Susceptibility Testing (AST) - A procedure used to determine which antibiotics a

specific organism or group of organisms are susceptible to.

Antiviral agents -Agents that are used to inhibit production of viruses that causes disease. Most
antiviral agents are only effective while the virus is replicating

Commensal bacteria: the skin and mucous membranes are continuously colonized by
commensal bacteria that do not cause disease unless the subject is weakened

Empiric therapy -

Extended-spectrum beta-lactamase - beta-lactamases are a family of enzymes responsible for

bacterial resistance to certain antibiotics such as penicillin.

Genotyping - determination of all the genes contained in the cells of an organism.

Immunoassay - diagnostic test based on an antigen/antibody reaction, enabling the detection

of infectious agents (bacteria, viruses, parasites) and pathogen markers.
In vitro diagnostics - analysis of biological samples (urine, blood, etc.) performed outside the
human body.
In vivo diagnostics - tests or research performed on a living organism.
Methicillin - a semi-synthetic penicillin used primarily against non-resistant Staphylococcus
aureus.
Molecular biology - technique that can detect a bacterium, virus, yeast, parasite or a biomarker
through the presence of DNA or RNA genetic sequences in a sample

Multi-resistant bacteria - bacteria are said to be multi-resistant to antibiotics when they are
sensitive only to a small number of the antibiotics customarily used in therapy, as a
consequence of the accumulation of natural and acquired resistances.

PCR (Polymerase Chain Reaction) - molecular biology technology for in vitro amplification of
genetic sequences, used to copy known DNA or RNA sequences in large quantities (by an order
of magnitude of a billion) from an initially small quantity. This technology is particularly useful
for detecting the presence of viruses

Superbug -

Superinfection -

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Synergism -

Tortora, G.J. (2014) Microbiology. Pearson: Singapore. 616.9041 T63 2014

Engelkirk, Paul G. (2019). Burton's microbiology for the health sciences, 8th ed. .
Philadelphia : LWW.616.01 E3 2007

Bartolome and Quiles. (2020) Microbiology and Parasitology: A Textbook and

Laboratory Manual for the Health Sciences. 2nd Edition. C&E Publishing House. Quezon
City. QR65. B37 2020

www.cdc.com
www.googlesearch
https://www.who.com

Useful website:
Mcq online
https://microbeonline.com/mcqs-in-microbiology-for-m-sc-entrance-examination/

About antimicrobial in pdf

https://www.lamission.edu/lifesciences/Steven/Micro20%20Chapter%2020.pdf

Podcast about antibiotic

https://asm.org/Podcasts/Editors-in-Conversation/Episodes/Discovering-new-antibiotics-EIC-9

/ avg-val