DRUG RESISTANCE

SEMINAR PRESENTED BY
HASSANA AL-MUSTAPHA
U04NS1056
SUPERVISED BY
DR. U. E UMANA
 INTRODUCTION

Chemotherapy is the primary means of treating

parasitic infections.
The potential for resistance was recognized as early
as in the 1940s when antibiotics were first
introduced.
Significant increase in resistance have been noted
only in the last two decades.

 INTRODUCTION
The emergence of drug resistance in several major
infectious disease including tuberculosis (TB),
Human-immunodeficiency virus(HIV)/Acquired
immune deficiency syndrome(AIDS), malaria,
bacterial infection and diarrheal diseases began to
be recognized as a global threat in 1990s.
 Definition
Drug resistance refers to the ability of an organism
such as the HIV virus, the TB bacillus or cancer
cells to over come the effect of a drug prescribed to
destroy it. For example the resistance of the HIV
virus to Azidothymidine(AZT) or that of TB to
antibiotics.
 Classification
Bacterial (antibiotic resistance)
Endo-parasites
Viruses
Fungi
Cancer cells
 Causes

Exposure to low level drugs.

Ability of the pathogenic organisms to mutate
Replication of cancer cells.
Treatment of animals with antibiotics.
Failure to complete a course of drug and over
prescription of antibiotics.
Unreliable access to drugs paired with incomplete
course.
 Promoters Of Resistance
In the hospital environment:
Increasing use of powerful
antibiotics.
Advanced medical technology.
Poor infection control practices in
hospitals.
 Promoters Of Resistance
Outside the hospital environment
Over use of drugs especially antibiotics in out
patient medicine.
The use of antibiotics in agriculture exert
selective pressure for the emergence of resistant
antibiotic strains.
Increasing number of children in close contact at
day care centre and by more national and
international travel.
 Drug Action
Drugs act by specifically interfering with cellular or
biochemical processes.
The two types of drugs are:
• Agonists- they stimulate and activate the
receptors.
• Antagonists – they stop the agonists from
stimulating the receptors.
Potential modification involved in
drug resistance
• Physiological adaptations
• Differential selection of resistant
individuals from a mixed population of
susceptible and resistant individuals.
• Spontaneous mutations followed by
selection.
• Changes in gene expression. (gene
amplification)
 Mechanism of drug resistance

. Alteration of the target site of the drug.

Enzyme inactivation of the drug.
Active transport of the drug out of the microbial
cell.
Decreased permeability of the microbial cell wall to
the drug.
 Mechanism of antibiotics resistance
Active transport systems
(efflux pumps) have been
described for the removal
of some antibiotics such as
tetracycline, macrolides
and quinolones from
bacterial cells.
Bacteria are intrinsically
resistant to many drugs
based solely on the fact that
drugs cannot penetrate cell
wall or cell membrane.
Mechanism of antibiotics resistance
By altering the target
site to which an
antibiotic must bind.
By producing enzyme
that inactivates the drug
known as I2 lactamases
for example I2 lactam
antibiotic (penicillin
and cephalosporin).
  
Antimicrobial (Drug) Resistance

• Diagram showing the difference between non-resistant

bacteria and drug resistant bacteria. Non-resistant
bacteria multiply, and upon drug treatment, the bacteria
die. Drug resistant bacteria multiply as well, but upon
drug treatment, the bacteria continue to spread.
 Treatments
Accurate and rapid
diagnosis.
Drug combination.
New drugs.
 Control
An ongoing program to decrease the use of
antibiotics both in the clinics and an agriculture
will be necessary.
The increase use of vaccine to prevent infections
can help limit the need for antibiotics.
The development of novel classes of antibiotics to
fight emerging resistant bacteria will be required.
 REFERENCE
Kaspers, G. J. L., R. Pieters, and A. J. P. Veerman,
editors. Drug Resistance in Leukaemia and
Lymphoma III ( New York: Plenum Press, 1999.
Broxterman, H. J., and N. Georgopapadakou.
"Cancer Research 2000: Drug Resistance, New
Targets and Drugs In Development." Drug
Resistance Updates 3 (June 2000): 133-138.
Stephen H. Gillespie, and Timothy D. McHugh the
biological cost f antimicrobial resistance