THINGS TO BE DISCUSSED
• Multi resistance antimicrobials
• Effects of some Antibiotics
• Research article
• Case study
• Future Horizons
MULTIDRUG RESISTANCE (MDR)
• MULTIPLE DRUD RESISTANCE OR MULTI DRUG RESISTANCE IS A CONDITION THAT ENABLES A DISEASE CAUSING AGENT TO DEVELOP RESISTANCE AGAINST CHEMICAL DRUGS ( ANTIBIOTICS)
MDRO’S (RESISTANT TO ONE OR MORE CLASSES OF ANTIMICROBIAL AGENTS)
• Methicillin resistant Staphylococcus aureus (MRSA)
• Vancomycin resistant enterococci (VRE)
• Vancomycin resistant Staphylococcus aureus (VRSA)
• Extended Spectrum beta-lactamase producing Enterobacteriaceae (ESBL)
Effects of some Antibiotics
• Tetracycline family (Oxytetracycline, Doxycyline)
• Erythromycin (Erythromycin Estotate, Erythromycin ethylsuccinate)
• Chloramphenicolum family(Chloramphenicol Palmitate, Thiamphenicol)
• Penicillin family(: Benzylpenicillin, Ampicillin Sodium, Amoxicillin)
LIVER ( FUNCTION------->DYSFUNCTION
• The liver has very complicated functions
• one of the most important is the detoxification of drugs such as antibiotics and its metabolites.
BUT
• Some antibiotics can cause allergic reactions while others can cause direct damage to their liver, which can be quite severe in patients with chronic liver disease.
• Tetracycline family----------> jaundice, fever, and fatty liver
• Erythromycin family-------------> cholestasis (bile retention) elevation of liver enzymes, Nausea
• Chloramphenicolum family------------> WBC and RBC counts drop, Glucoronic Acid+Antibiotics Accumulation in Liver
• Penicillin family-----------------> mostly “liver friendly” very often allergic reaction
RESEARCH WORK
ACQUIRED ANTIBIOTIC RESISTANCE GENES:
AN OVERVIEW
• Mechanisms of Resistance
• Genes responsible for them
• Mycobacterium gene aac(2)-Ib ACT 588 nt
• Mycobacterium geneaac(2)-Ic ACT 546nt
• Enterobacter gene aph(3)-Ib PHT 801nt
• Staphylococcus gene apmA ACT 822nt
• Staphylococcus gene lsa(B) orf3 Efflux 1,479nt
• Enterococcus gene tet(M) Ribosomal protection 1,920 nt
• The first case of VRSA involved a 40-year-old woman
• from Michigan who was undergoing dialysis, diabetes mellitus, hypertension, peripheral vascular disease, chronic renal failure
• During the last hospitalization, the patient developed MRSA bacteremia
• a number of catheterizations during this time and received a
• conjugal transfer of plasmid DNA, giving rise to the VRSA.
• conjugative plasmid into which the transposon Tn1546, containing vanA resistance
METHODOLOGY
• Genetic analysis
• Isolation & Detection
• Mobile genetic elements
• Conjugate Transposons
• Conjugative Plasmids
• The Acquisition of 2 resistance genes,
• resulted in an S aureus strain that was highly resistant to both oxacillin and Vancomycin.
• mobile genetic element called SCCmec, which contains the mecA resistance gene.44
• The mecA encodes PBP2a, a new penicillin binding
• protein with decreased affinity for oxacillin and most other -lactam drugs.
• High-level Vancomycin resistance
• occurred because of expression of vanA gene
• associated with alteration of the Vancomycin-binding site in the cell wall
• Vancomycin interferes with bacterial wall synthesis by binding with the terminal D-alanine-D-alanine
• Expression of vanA and other genes ,changes the dipeptide terminus from D-alanine-D-alanine to D-alanine-D-lactate
The continued evolution of resistance to antibiotics has led to wide ranging consultation at National and International levels as to how to;
•limit the spread of antibacterial resistance
•the development of new antibiotics to help redress the balance of resistance Vs available antibiotics
ROLE OF MOLECULAR BIOLOGY
• Genomics
• Proteomics
• Transcriptional profiling
“To not use too much so that the bacteria can become immune to the antibiotics and become
Superbacteria”
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