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Title: Bacterial resistance
Description: 2nd year Pharmacy notes, very good summary of points needed for bacterial resistance, great read for before exams. How resistance comes about, mechanisms of resistance and 'superbugs' that HCP's should be aware of in practice.
Description: 2nd year Pharmacy notes, very good summary of points needed for bacterial resistance, great read for before exams. How resistance comes about, mechanisms of resistance and 'superbugs' that HCP's should be aware of in practice.
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Bacterial resistance to antibiotics
Resistance to antibacterial drugs
• Inherent (natural resistance)
àe
...
G-‐ve bacteria – their outer membrane acts as a permeability barrier
• Acquired resistance
àWhen new antibiotic is used, resistance is acquired
àResults from changed in bacterial genome
Can be …
• àVertical evolution = Mutation and selection
...
àHorizontal evolution = exchange of genes between strains – bacteria
can swap genes by
• Conjugation
• Transduction
• Transformation
Conjugation = cell-‐ cell contact, DNA crosses a sex pilus
Transduction= Genes transported by a bacterial virus
Transformation= genes acquired from environment
Mechanisms of resistance
• Conversion of active drug to inert product by an enzyme
à Production of Beta lactamases, convert penicillin àpenicilloic acid (not
antibacterial)
àClavulanic acid inhibits beta lactamase
...
àAminoglycosides inactivated by adenyl/acetyl/nucleotidyl transferases
àChloramphenicol can be broken down by acetylation
• Reduction to cellular permeability
àCan be a change in the cell wall, antagonism of antibiotic (transport
process) or generation of an efflux pump (pump drug out of the cell)
àDoesn’t allow toxic levels of drug to be reached inside the cell
...
aureus – changes
penicillin binding proteins)
...
coli for UTI treatment
Spread of superbugs
• Harder to treat
• Resistant strains
• May also have more side effects
• Dominate in hospital settings
Clostridium difficile
• The overuse and misuse of antibiotics kills the normal flora of bacteria in
the body
...
difficile to take over and release toxins
...
• In 2004 Reporting of such cases became mandatory
Glycopeptide resistant enterococci (GRE)
• E
...
e
Title: Bacterial resistance
Description: 2nd year Pharmacy notes, very good summary of points needed for bacterial resistance, great read for before exams. How resistance comes about, mechanisms of resistance and 'superbugs' that HCP's should be aware of in practice.
Description: 2nd year Pharmacy notes, very good summary of points needed for bacterial resistance, great read for before exams. How resistance comes about, mechanisms of resistance and 'superbugs' that HCP's should be aware of in practice.