![DRUG RESISTANCE
IN MALARIA:
• Malaria is caused by the protozoan parasite
Plasmodium which is transmitted via the bite of
female Anopheles mosquitoes.
• Among the five species of Plasmodium parasites [P.
falciparum, P. vivax, P. ovale,P. malariae and P.
knowlesi] that infect humans are P. falciparum and P.
vivax
• Malaria has slow resistant to chloroquine,
mefloquine or piperaquine
• P. falciparum to amodiaquine and sulfadoxine-
pyrimethamine](https://image.slidesharecdn.com/drugresistanceppt-170913145410/85/Multidrug-resistance-in-Microbes-22-320.jpg)
Multidrug resistance in Microbes
- 1. Presented by: Arjun Kumar .K PG, Dept of Microbiology ANJA college .
- 2. OVERVIEW Multi drug resistivity of the microorganisms is an emerging one ,that almost all microbes are being developed a type of resistance within their cell to certain groups of drugs. These drugs are nothing but the antibiotics that we use or developing in our immune system Due to this resistivity character of microbes there will be no curation or less curation of the diseases, hence the pathogen gets adapted to our immune system This topic will gives an idea about the drug resistivity of various microbes with a fine description
- 3. DRUGS RESEMBLES ANTIBIOTICS: Antibiotics, also called antibacterials, are a type of antimicrobial drug used in the treatment and prevention of bacterial infections. They may either kill or inhibit the growth of bacteria There are different routes of administration for antibiotic treatment. Antibiotics are usually taken by mouth. In more severe cases, particularly systemic infections, antibiotics can be given intravenously or by injection.
- 5. Details of Antibiotics sold during 2005-2009 in India
- 6. WHAT IS MULTI DRUG RESISTANCE? Multiple drug resistance (MDR), or drug resistance or multi resistance is antimicrobial resistance shown by a species of microorganism to various antimicrobial drugs. MDR bacteria that resist multiple antibiotics; other types include MDR viruses, fungi, and parasites
- 8. Resistance is accelerated through inappropriate use of antimicrobials Standard treatment guidelines is not provided by physicians or provided but not adhered to. Drugs taken without prescription Inadequate monitoring of diseases (AMR surveillance programs) Irrational self-administration or prescription
- 9. Resistanceof microbeshas huge negativeimpacton human health • Longer duration of illness • Longer treatment • Higher mortality • Increased burden on health system • Patient acts as reservoir of resistant organisms which are passed to community and health- care workers • Huge economic impact
- 10. Mechanisms of antibiotic resistance: Reduced permeability or uptake Enzymatic inactivation Enhanced efflux Alternation or over expression of target Loss of enzymes involved in drug metabolism Enzymatic inactivation - β-lactamase(EC No 3.5.2.6) releases the β-lactam ring and inactivates the β-lactam antibiotics.
- 11. SOME ANTIBACTERIAL DRUGS: (BETWEEN 1910 -2010) Salvarsan Penicillin Bacitracin Polymyxin Isoniazid Sulfonamide Nitrofurans Pleuromutilin Metronidazole Vancomycin Cycloserine Novobiocin Rifamycin Lincomycin Fosfomycir Mupirocin Daptomycin Carbapenem Oxazolidinone Monobactam Streptomycin Cephalosporin Chloramphenicol Nalidixic acid
- 12. COMMON MULTIDRUG-RESISTANT ORGANISMS (MDROS): Vancomycin-Resistant Enterococci (VRE) Methicillin-Resistant Staphylococcus aureus (MRSA) Extended-spectrum β-lactamase (ESBLs) producing Gram- negative bacteria Klebsiella pneumoniae carbapenemase (KPC) producing Gram-negatives MultiDrug-Resistant gram negative rods (MDR GNR) MDRGN bacteria such as Enterobacter species, E.coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa
- 13. GENETIC EXCHANGE OF ANTIMICROBIAL RESISTANCE GENES Enterobacteriaceae Enterococci StaphylococciPseudomonas Campylobacter Vibrio cholerae Pneumococci Streptococci
- 14. ESCHERICHIA COLI – RESISTANCE TO CEPHALOSPORINS AND TO FLUOROQUINOLONES: • E. coli is part of the normal flora in the intestine in humans and animals. • cephalosporins is mainly conferred by enzymes known as extended spectrum beta-lactamases (ESBLs); these enzymes destroy many beta-lactam antibacterial drugs. • E. coli strains that have ESBL are generally also resistant to several other antibacterial drugs • E. coli resistance to fluoroquinolones were similar to those found for resistance to third-generation cephalosporins.
- 15. KLEBSIELLA PNEUMONIAE – RESISTANCE TO CEPHALOSPORINS AND TO CARBAPENEMS• Klebsiella are frequent colonizers of the gut in humans and other vertebrates Causes urinary tract, respiratory tract infections, bloodstream infections. • pneumoniae carries a resistance gene (chromosomally located betalactamase) that have resistance to ampicillin and amoxicillin • The presence of extended spectrum beta lactamase in klebsiella give resistance to cephalosporins and the carbapenems
- 16. STAPHYLOCOCCUS AUREUS – RESISTANCE TO METHICILLIN: • S.aureus is a Gram-positive bacterium that can be a part of the normal flora on the skin and in the nose and causes notable infections- skin, soft tissue, bone and bloodstream infections • S.aureus gets the resistance by the production of a betalactamase enzyme that inactivates drugs such as penicillin, ampicillin and amoxicillin.
- 17. STREPTOCOCCUS PNEUMONIAE – RESISTANCE TO PENICILLIN: • S. pneumoniae ( also known as pneumococci) is the leading cause worldwide of community-acquired pneumonia • It is resistant to penicillin
- 18. SALMONELLA – RESISTANCE TO FLUOROQUINOLONES • Bacteria of the genus Salmonella are a major cause of foodborne illness throughout the world(zoonotic pathogen) • These species are resistant to anti microbials like ampicillin, chloramphenicol, • streptomycin, • sulfonamides and • tetracycline
- 19. SHIGELLA SPECIES – RESISTANCE TO FLUOROQUINOLONES • Shigella species area major cause of diarrhoea and dysentery • These bacteria aretransmitted by ingestion of contaminated food orwater • Formerly, Shigellastrains wereless susceptible to cotrimoxazole, ciprofloxacin and fluoroquinolones
- 20. GONORRHOEAE DRUG RESISTANT: • Neisseria gonorrhoeae – decreased susceptibility to third- generation cephalosporins
- 21. MULTIDRUG-RESISTANT TUBERCULOSIS • Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis • Has slight resistance to rifampicin, isoniazid, ethambutol and pyrazinamide • MDR (multi drug resistant) TB is the name given to TB when the bacteria that are causing it are resistant to at least isoniazid and rifampicin • XDR TB (extensively drug resistant TB) resistant to at least rifampicin and isoniazid,fluoroquinolones,amikacin, kanamycin, capreomycin.
- 22. DRUG RESISTANCE IN MALARIA: • Malaria is caused by the protozoan parasite Plasmodium which is transmitted via the bite of female Anopheles mosquitoes. • Among the five species of Plasmodium parasites [P. falciparum, P. vivax, P. ovale,P. malariae and P. knowlesi] that infect humans are P. falciparum and P. vivax • Malaria has slow resistant to chloroquine, mefloquine or piperaquine • P. falciparum to amodiaquine and sulfadoxine- pyrimethamine
- 23. DRUG RESISTANCE IN HIV: • Human immunodeficiency virus (HIV) infects cells of the immune system, destroying or impairing their function. • HIV treatments with some drugs are failure • This have resistance to artesunate-mefloquine,dihydroartemisinin- piperaquine, atovaquone-proguanil • These drugs supress the viral load but don’t kill the virus
- 24. DRUG RESISTANCE IN INFLUENZA VIRUSES • Influenza imposes a global public health and economic burden for all populations • Influenza A and B viruses causes acute respiratory illness • TheA(H1N1) and A(H3N2) subtypes are currently in general circulation in human populations • Influenza has a less resistance to adamantanes and neuraminidase
- 25. CANCER MULTIDRUG RESISTANCE • Canceris a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. • The cancercells actively expel chemotherapy drugs from the interior and thus resists the drugs • They have resistance to mechlorethamine,methotrexate, Bendamustine, Busulfan,Carmustine Asparagin,Capecitabine etc.
- 26. ANTIBIOTIC RESISTANT INFECTIONS Diseases Agent Resistances Pneumonia S pneumoniae Penicillin Dysentery S dysenteriae Multiple resistances Typhoid S typhi Multiple resistances Gonorrhea N gonorrhoeae Penicillin and tetracycline Tuberculosis M tuberculosis Rifampicine and INH Nosocomial infections S aureus Methicillin, vancomycin E species Vancomycin Klebsiella, Pseudomonas Multiple resistances
- 27. ANTIBIOTIC SURVEILLANCE STUDIES IN VIRUDHUNAGAR DISTRICT • 100% resistant to penicillin • 100% of resistance to monobactam group except Enterococcus • Pseudomonas sp. showed resistance to both third and fourth generation cephalosporins at higher rates • 99.9% of the selected isolates were sensitive to imipenem during 2013 • 80% of isolates were sensitive to imipenem during 2014
- 28. LEADING GLOBAL DISEASES 0 1 2 3 4 Respiratory infections HIV Diarrheal diseases Tuberculosis Malaria Millionsofdeaths,worldwide,1998 S. pneumonia: Up to 55% resistance to penicillin in some regions HIV: Report of resistance to all marketed agents S. dyentariae: 90% resistance to cotrimoxazole S.Typhi: Outbreaks of multi-resistant strains in 11 countries M. tuberculosis: Multi-drug resistant tuberculosis P. falciparum: Chloroquine resistance in 81/92 countries
- 29. THE DEATH RATE WILL BE…..
- 30. Superbugs* are visible manifestations of our prolonged failure to preserve antibiotics Note: Methicillin resistant Staph aureus, MDR-and XDR Mycobacteria, ESBL producing Gram negative bacteria and NDM-1 producing enterobacteriaceae bacteria are few examples of superbugs because these fail to respond to large number of commonly used antibiotics Known but neglected. Need immediate action Known but inevitable