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By
Mr. Jadhav Akash Rajendra
M.Sc. II Biotechnology
Roll No. 125
MULTI DRUG RESISTANT BACTERIA
(MDR BACTERIA)
BRIEF HISTORY OF ANTIBIOTICS
• 1928- Penicillin discovered by Fleming
• 1932- Sulfonamide antimicrobial activity discovered ( Erlich)
• 1935- First unsuccessful attempt to use Sulfonamide to treat
a case of meningitis
• 1943- Drug companies begin mass production of penicillin
• 1948- Cephalosporins precursor sent to Oxford for synthesis
• 1952- Erythromycin derived from Streptomyces erythreus
• 1956- Vancomycin introduced for penicillin resistant
staphylococcus
THE MAGIC BULLETS
• Antibiotics revolutionised medicine
• The first antibiotic, penicillin, was discovered by Alexander
Fleming in 1929
• It was later isolated by Florey and Chain
• It was not extensively used until the 2nd World War when it was
used to treat war wounds
• After 2nd World War many more antibiotics were developed
• Today about 150 types are used
• Most are inhibitors of the protein synthesis, blocking the 70S
ribosome, which is characteristic of prokaryotes
RESISTANCE
• It took less than 20 years for, bacteria
to show signs of resistance.
• Staphylococcus aureus, which causes
blood poisoning and pneumonia,
started to show resistance in the 1950s.
• Today there are different strains of
S. aureus resistant to every form of
antibiotic in use.
MULTIPLE DRUG RESISTANCE:
Multiple drug resistance or Multidrug resistance is a
condition enabling a diseasecausing organism to resist
distinct drugs or chemicals of a wide
variety of structure and function
targeted at eradicating the
organism.
Organisms that display multidrug
resistance can be pathologic cells,
Including bacterial .
MDRO: DEFINITION
• Multidrug-Resistant Organisms (MDROs) are
defined as microorganisms that are resistant to one
Or more classes of antimicrobial agents.
• Three most common MDROs are:
1. Methicillin-Resistant Staph aureus (MRSA)
2. Vancomycin Resistant Enterococci: (VRE)
3. Extended Spectrum Beta-Lactamase producing
Enterobacteriaceae. (ESBLs)
1.METHICILLIN-RESISTANT STAPH AUREUS
(MRSA)
1. These are organisms that are not sensitive to common
penicillin based drugs such as methicillin, amoxicillin,
penicillin, oxacillin1.
2. Normal flora- lives on human skin, noses, vaginal tract.
3. May cause infections if enters the body
4. Contagious- through person to
person contact
5. Treatment - Vancomycin
VANCOMYCIN RESISTANT ENTEROCOCCI
(VRE)
• Enterococci resistant to Vancomycin Present in human body such as
urinary tract and GI tract.
• Contagious
• Hospital patients can get it from
contact via health care providers.
• Normal flora that may cause disease
especially in vulnerable populations:
• E.g. elderly, children and
immunocompromised patients.
EXTENDED SPECTRUM BETA-LACTAMASE
PRODUCING ENTEROBACTERIACEAE. (ESBL)
• ESBLs are plasmid-mediated beta lactamases described in gram
negative bacilli2
• E.g.. Klebsiella, Acinetobacter
• MOA – hydrolysis of beta- lactam ring in
• Penicillin's
• Narrow spectrum cephalosporins
• Beta-lactamase inhibitors inhibit ESBL producing strains
• Clavulanic acid
• Sulbactam
• Tazobactam.
ANTIBIOTIC PRESSURE AND RESISTANCE IN BACTERIA
WHAT FACTORS PROMOTE THEIR DEVELOPMENT AND
SPREAD ?
• Alteration of normal flora.
• Practices contributing to misuse
of antibiotics.
• Settings that foster drug
resistance.
• Failure to follow infectio
control principles.
NOSOCOMIAL INFECTIONS – ATTAINS HIGHER RESISTANCE.
• Major nosocomial pathogens increasingly resistant to antimicrobial
drugs include Escherichia coli, Staphylococcus aureus, coagulase-
negative staphylococci, Enterococcus species, and
Pseudomonas aeruginosa . Infections from methicillin- resistant
staphylococci, vancomycin resistant enterococci (VRE), and
aminoglycoside resistant Pseudomonas spp. are becoming common.
Nosocomial infections – Attains Higher Resistance.
Major nosocomial pathogens increasingly resistant to antimicrobial
drugs include Escherichia coli, Staphylococcus aureus, coagulase-
negative staphylococci, Enterococcus species, and Pseudomonas
aeruginosa . Infections from methicillin- resistant staphylococci,
vancomycinresistant enterococci (VRE), and aminoglycosideresistant
Pseudomonas spp. are becoming common.
PRACTICES CONTRIBUTING TO MISUSE OF
ANTIBIOTICS
• Inappropriate specimen
• selection and collection
• Inappropriate clinical tests
• Failure to use
• stains/smears
• Failure to use cultures and
• susceptibility tests
PROPOSALS TO COMBAT ANTIMICROBIAL
RESISTANCE
• Speed development of new antibiotics
• Track resistance data nationwide
• Restrict antimicrobial use
• Direct observed dosing (TB).
PROPOSALS TO COMBAT ANTIMICROBIAL
RESISTANCE
1. Use more narrow
spectrum
antibiotics
2. Use
antimicrobial
cocktails
THANK YOU!

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Akash jadhav ppt.

  • 1. By Mr. Jadhav Akash Rajendra M.Sc. II Biotechnology Roll No. 125 MULTI DRUG RESISTANT BACTERIA (MDR BACTERIA)
  • 2. BRIEF HISTORY OF ANTIBIOTICS • 1928- Penicillin discovered by Fleming • 1932- Sulfonamide antimicrobial activity discovered ( Erlich) • 1935- First unsuccessful attempt to use Sulfonamide to treat a case of meningitis • 1943- Drug companies begin mass production of penicillin • 1948- Cephalosporins precursor sent to Oxford for synthesis • 1952- Erythromycin derived from Streptomyces erythreus • 1956- Vancomycin introduced for penicillin resistant staphylococcus
  • 3. THE MAGIC BULLETS • Antibiotics revolutionised medicine • The first antibiotic, penicillin, was discovered by Alexander Fleming in 1929 • It was later isolated by Florey and Chain • It was not extensively used until the 2nd World War when it was used to treat war wounds • After 2nd World War many more antibiotics were developed • Today about 150 types are used • Most are inhibitors of the protein synthesis, blocking the 70S ribosome, which is characteristic of prokaryotes
  • 4. RESISTANCE • It took less than 20 years for, bacteria to show signs of resistance. • Staphylococcus aureus, which causes blood poisoning and pneumonia, started to show resistance in the 1950s. • Today there are different strains of S. aureus resistant to every form of antibiotic in use.
  • 5. MULTIPLE DRUG RESISTANCE: Multiple drug resistance or Multidrug resistance is a condition enabling a diseasecausing organism to resist distinct drugs or chemicals of a wide variety of structure and function targeted at eradicating the organism. Organisms that display multidrug resistance can be pathologic cells, Including bacterial .
  • 6. MDRO: DEFINITION • Multidrug-Resistant Organisms (MDROs) are defined as microorganisms that are resistant to one Or more classes of antimicrobial agents. • Three most common MDROs are: 1. Methicillin-Resistant Staph aureus (MRSA) 2. Vancomycin Resistant Enterococci: (VRE) 3. Extended Spectrum Beta-Lactamase producing Enterobacteriaceae. (ESBLs)
  • 7. 1.METHICILLIN-RESISTANT STAPH AUREUS (MRSA) 1. These are organisms that are not sensitive to common penicillin based drugs such as methicillin, amoxicillin, penicillin, oxacillin1. 2. Normal flora- lives on human skin, noses, vaginal tract. 3. May cause infections if enters the body 4. Contagious- through person to person contact 5. Treatment - Vancomycin
  • 8. VANCOMYCIN RESISTANT ENTEROCOCCI (VRE) • Enterococci resistant to Vancomycin Present in human body such as urinary tract and GI tract. • Contagious • Hospital patients can get it from contact via health care providers. • Normal flora that may cause disease especially in vulnerable populations: • E.g. elderly, children and immunocompromised patients.
  • 9. EXTENDED SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE. (ESBL) • ESBLs are plasmid-mediated beta lactamases described in gram negative bacilli2 • E.g.. Klebsiella, Acinetobacter • MOA – hydrolysis of beta- lactam ring in • Penicillin's • Narrow spectrum cephalosporins • Beta-lactamase inhibitors inhibit ESBL producing strains • Clavulanic acid • Sulbactam • Tazobactam.
  • 10. ANTIBIOTIC PRESSURE AND RESISTANCE IN BACTERIA WHAT FACTORS PROMOTE THEIR DEVELOPMENT AND SPREAD ? • Alteration of normal flora. • Practices contributing to misuse of antibiotics. • Settings that foster drug resistance. • Failure to follow infectio control principles.
  • 11. NOSOCOMIAL INFECTIONS – ATTAINS HIGHER RESISTANCE. • Major nosocomial pathogens increasingly resistant to antimicrobial drugs include Escherichia coli, Staphylococcus aureus, coagulase- negative staphylococci, Enterococcus species, and Pseudomonas aeruginosa . Infections from methicillin- resistant staphylococci, vancomycin resistant enterococci (VRE), and aminoglycoside resistant Pseudomonas spp. are becoming common. Nosocomial infections – Attains Higher Resistance. Major nosocomial pathogens increasingly resistant to antimicrobial drugs include Escherichia coli, Staphylococcus aureus, coagulase- negative staphylococci, Enterococcus species, and Pseudomonas aeruginosa . Infections from methicillin- resistant staphylococci, vancomycinresistant enterococci (VRE), and aminoglycosideresistant Pseudomonas spp. are becoming common.
  • 12. PRACTICES CONTRIBUTING TO MISUSE OF ANTIBIOTICS • Inappropriate specimen • selection and collection • Inappropriate clinical tests • Failure to use • stains/smears • Failure to use cultures and • susceptibility tests
  • 13. PROPOSALS TO COMBAT ANTIMICROBIAL RESISTANCE • Speed development of new antibiotics • Track resistance data nationwide • Restrict antimicrobial use • Direct observed dosing (TB).
  • 14. PROPOSALS TO COMBAT ANTIMICROBIAL RESISTANCE 1. Use more narrow spectrum antibiotics 2. Use antimicrobial cocktails