lecture 9) antibiotic resistance mechanisms Flashcards
what is antibiotic resistance?
resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by that microorganism
how can you measure antibiotic resistance?
antiobiotic resistance can be reflected by an increase in MIC
what is MBC?
minimum bacterial concentration
the minimum concentration of an antimicrobial that kills in vitro
what is the process of determining the MBC?
grow bacteria at different concentrations
plate bacteria on drug free plates
only bacteria that havent been killed will grow back
what is the difference between MIC and MBC?
MIC just looks at growth
MBC is a 2 step process (grow and plate)
how are the values of MIC and MBC correlated with what is used in a clinical setting?
using breakpoints
what is a breakpoint?
the chosen concentration of an antibiotic which defines whether a species of bacteria is resistant to the antibiotic
determines how the antibiotic will be administered
using breakpoints and MIC how is antibiotic resistance determined?
if the MIC is less than the BP the bacteria is susceptible to the antibiotic
if the MIC is greater than the BP the bacteria is resistant to the antibiotic
what are the units for breakpoints?
mg/L
what is a bacteriostatic agent in relation to antibiotic resistance?
an agent that reaches MIC levels in blood or tissues
what is a bacteriocidal agent in relation to antibiotic resistance?
an agent that reaches cidal levels in blood/tissues
describe a broad-spectrum agent in terms of MIC/BP
low MIC for many different bacteria types
describe a susceptible microbe in terms of MIC/BP
inhibited by an agent at a low MIC
describe a resistant microbe in terms of MIC/BP
inhibited by an agent at a high MIC
resistant microbes will only be killed at a dose higher than what a clinician will use
generations are used as an indication for the level of resistance of an antibiotic. describe this method of indication
the higher the generation of antibiotic used to treat the resistant bacteria, the worse the resistance
4 generations: 4th generation is the very very last resort as there is no generation after this and it is likely that the bacteria will become resistant to this one too
name 3 mechanisms of resistance
drug efflux pumps
drug inactivation - enzymes modify drug
drug inactivation - enzymes modify receptor
what mechanism of resistance do beta lactams use?
inactivation of drugs by enzymes - modify drug beta lactamase (enzyme produced by host) breaks down the beta lactam ring in penicillins that binds to a surface protein to prevent the formation of peptide bonds in the peptidoglycan later no beta lactam ring = no inhibiton of infection = bacteria resistant
what makes staphylococcus aureus resistant to penicillin?
presence of penicillinase which is a beta lactamase so will hydrolyse the beta lactam ring
what was used to treat S. aureus infections after they became resistant to penicilin?
methicillin
what infection is induced if S. aureus strains are resistant to methicillin?
MRSA (methicillin resistant staphylococcus aureus)
describe the mechanism of resistance that S. aureus has for methicillin
inactivation of drug using enzymes - modify receptor
resistant strains have an altered pen binding protein that prevents methicillin from binding to the protein. transcription not inhibited so neither is the infection
what genetic components make MRSA resistant?
staphylococcal casette chromosome is mec (SCC-mec)
SCC-mec = mobile genetic elements
each SCC-mec has a casette chromosome recombinase (CCr) and a mec gene complex
mecA encodes for a varient penicillin binding protein (PBP)
PBP has a lower affinity for beta lactams = resistant to virtually all beta lactams
what type of antibiotic is streptomycin?
aminoglycoside
what is streptomycin used to treat?
streptomyces ssp.
how does streptomycin act against streptomyces spp.?
protein synthesis inhibitor
targets 30S subunit that strep ssp. produces
why doesnt streptomycin kill the producer strain?
something attaches to the producer strain making it inactive
what is characteristic about aminoglycoside phosphotransferase (APH) in streptomycin resistance?
chromosomally acquired streptomycin resistance
what is the chromosomally acquired resistance to streptomycin commonly due to?
mutations in gene encoding ribosomal protein s12 and rpsL
what does rspL gene encode for in streptomycin resistance?
encodes for a protein that will be incorporated into a ribosome
strep will want to go there to inhibit the infection
if this gene is modified then the protein wont be there