Resistance Antibiotic Resistance

What are ? Mechanisms of resistance Managing antimicrobial resistance (AMR) Antibiotics are substances produced by micro-organisms that kill Resistance can develop in four main ways. The can: 1. Preventing infections and preventing the spread of resistance, other microorganisms. Most of them have been derived from soil for example, by improving hygiene practices. This is very effective 1. develop methods to inactivate or modify the antibiotic dwelling microbes, fungi and bacteria and some can in fact be in reducing the spread of infections, including those that are synthesised chemically. 2. alter its surface and so prevent the antibiotic from binding to it. resistant to antibiotics. This also helps to raise awareness of transmission routes. 3. change its metabolic pathways to circumvent the antibiotic Discovery 2. Surveillance in order to track transmission routes, measure the The HPRA (The Health Products Regulatory Authority) is 4. reduce the concentration of the antibiotic within it by either The ancient Greeks and Indians used mouldy bread to treat wounds extent of resistance and provide early warning of specific risks. a state agency whose role is to protect and enhance public (a) reducing the permeability of its surfaces so less antibiotic and animal health by regulating medicines, medical devices and various others noted the beneficial effects of similar compounds. 3. Promoting the responsible use of antibiotics around the world in enters, or and other health products. It regulates clinical trials and In 1928 noted that a common fungus, Penicillium order to minimise inappropriate use. This could involve restricting human organs for transplantation. It also monitors the safety notatum had destroyed bacteria in a Staphylococcus culture plate, (b) increasing the rate at which the antibiotic is actively pumped access to currently available antibiotics in order to preserve their of cosmetics. but it was not until the 1940s, when two chemists, Florey and Chain, out of the bacterial cell. effectiveness into the future. Some antibiotic classes might be developed a method of mass production that it became available for reserved for specific infections. Its aim is to make sure that health products that it regulates widespread use during the Second World War. Since then more than do what they are intended to do and are as safe as possible, 100 different antibiotic compounds have been found, most of them Factors that contribute to antibiotic resistance 4. Developing new drugs, vaccines and diagnostic tests and whether they are intended for the Irish market or for export. incentivising the development of new antibiotic classes for the future. from soil-dwelling bacteria. 1. Unnecessary prescription of antibiotics for viral infections against Until 2014 the HPRA was known as Irish Medicines Board which they are useless. Every time an antibiotic is taken it kills off (IMB). The new name better reflects its broader remit and How antibiotics work the more susceptibleAntibiotic members of the germResistance population but it also Gene transfer regulatory functions which now include: increases the chance that resistance will develop is some species Antibiotic resistance can be increased by the ability of bacteria to Antibiotics essentially work in two ways: of bacteria in the body. • Human medicines transfer their resistance to other bacteria. This transfer can occur in • Veterinary medicines 1. Bactericidal antibiotics kill the bacteria generally by either 2. The overuse of broad spectrum antibiotics because the actual two ways either vertically or horizontally. causative organism has not been identified. The broad spectrum • Clinical trials interfering with the formation of the bacterium’s cell wall or its 1. Vertical gene transfer is the normal way genetic information (genes) antibiotic kills many species and, if resistance develops in any • Medical devices cell contents. is one of these. is passed on in most organisms. This is when information is passed bacterial species in the animal or human, then it will be able to • Controlled drugs 2. Bacteriostatic antibiotics stop bacteria from multiplying from the parent to the offspring, i.e. from one generation to the next. by interfering with bacterial protein production, DNA reproduce more easily because there is little competition. The • Blood and blood components replication, or other aspects of their cellular metabolism, resistance genes may also transfer to other bacterial species. 2. Horizontal gene transfer is when genes are transferred within • Tissues and cells a generation from one individual to another or even from one e.g. tetracyclines, sulphonamides 3. Failure to finish a course of antibiotics. When an antibiotic is taken • Cosmetic products species to another. Bacteria are particularly good at this, using the most susceptible bacteria die first leaving a population that is • The protection of animals used for scientific purposes Some antibiotics are broad spectrum: these kill a whole range of loops of genetic material called plasmids. more resistant. If the course of antibiotics is stopped before all the • Organs intended for transplantation bacteria both Gram positive and Gram negative; some of which bacteria are killed then the animal or human may have a relapse Species 1 Species 2 are pathogenic. They may also kill the normal gut bacteria. and the bacteria that caused the infection will be much more Species 1 Narrow spectrum antibiotics affect only a small range of bacteria. resistant to the antibiotic and harder to kill. Fuctions of HPRA When antibiotics were introduced they were hailed as miracle Plasmid with • The HPRA grants licences to companies to make, 4. Residues in food. Many farm animals, especially those farmed antibiotic- pilus drugs. It seemed that the era of death from bacterial infections resistant distribute and market medicines after a review of their was over. However, in only a few short decades things have intensively, are routinely given antibiotics at certain times in their safety, quality and effectiveness. Vertical transfer changed dramatically. life even though they might not be sick. This reduces mortality • It continuously monitors medicines, medical devices and and increases live weight gain. There is a mandatory period after Horizontal transfer other health products, responding quickly to any safety Bacteria reproduce in such vast numbers that a random mutation treatment with antibiotics during which neither the animals nor or quality concerns. can quickly result in a resistant strain. Antibiotic resistance – more their products may be allowed to enter the food chain. This is • It produces safety and quality information to support the commonly known nowadays as antimicrobial resistance (AMR) done to allow time for all traces of the antibiotic to be eliminated. safe use of health products. – is the ability of certain organisms to adapt and continue to multiply • It inspects companies and facilities that test, make or in the presence of an antibiotic. (The term ‘antimicrobial’ also includes Multidrug resistant bacteria Even if foods containing residues of antibiotics are not allowed distribute health products to ensure that they comply with drugs that act against viruses, fungi and , in addition to protozoa to enter the food chain, the fact that an animal has been exposed Today there is concern about the increasing occurrence of multidrug relevant standards and legislation. those acting against bacteria.) to an antibiotic treatment at a prior time in its life may allow resistant bacteria especially in hospitals even in the community bacteria containing resistant genes to survive in food products at large. These bacteria, commonly referred to in the press as Resistant strains began to appear within a few years of the Find out more about the HPRA at www.hpra.ie introduction of antibiotics, so new antibiotics had to be found to derived from that animal. Unless food hygiene measures are ‘superbugs’, are resistant to almost all the known antibiotics. replace the ones to which resistance had developed. In the past adequate, bacteria with resistant genes may transfer resistance They include MRSA (methicillin-resistant Staphylococcus aureus, 30 years only two new classes of antibiotics have appeared, so to normal gut bacteria in those who consume the food products. Clostridium difficile and multi-drug resistant tuberculosis. The the problem of antibiotic resistance is becoming more serious. In Ireland all milk is routinely tested for antibiotic residues. Some emergence of gram-negative pathogens that are resistant to virtually The World Health Organisation has classified antimicrobial resistance countries allow farmers to purchase and administer antibiotics to all of the available antibiotics is a particularly serious problem for the as a “serious threat’ that ‘has the potential to affect anyone, of any their animals. Care must therefore be taken to ensure that food healthcare sector. Find this and other lessons on www.sta.ie age, in any country”. products in our shops and supermarkets are safe. Antibiotic Resistance Antibiotic Resistance

What are antibiotics? Mechanisms of resistance Managing antimicrobial resistance (AMR) Antibiotics are substances produced by micro-organisms that kill Resistance can develop in four main ways. The bacteria can: 1. Preventing infections and preventing the spread of resistance, other microorganisms. Most of them have been derived from soil for example, by improving hygiene practices. This is very effective 1. develop methods to inactivate or modify the antibiotic dwelling microbes, fungi and bacteria and some can in fact be in reducing the spread of infections, including those that are synthesised chemically. 2. alter its surface and so prevent the antibiotic from binding to it. resistant to antibiotics. This also helps to raise awareness of transmission routes. 3. change its metabolic pathways to circumvent the antibiotic Discovery 2. Surveillance in order to track transmission routes, measure the The HPRA (The Health Products Regulatory Authority) is 4. reduce the concentration of the antibiotic within it by either The ancient Greeks and Indians used mouldy bread to treat wounds extent of resistance and provide early warning of specific risks. a state agency whose role is to protect and enhance public (a) reducing the permeability of its surfaces so less antibiotic and animal health by regulating medicines, medical devices and various others noted the beneficial effects of similar compounds. 3. Promoting the responsible use of antibiotics around the world in enters, or and other health products. It regulates clinical trials and In 1928 Alexander Fleming noted that a common fungus, Penicillium order to minimise inappropriate use. This could involve restricting human organs for transplantation. It also monitors the safety notatum had destroyed bacteria in a Staphylococcus culture plate, (b) increasing the rate at which the antibiotic is actively pumped access to currently available antibiotics in order to preserve their of cosmetics. but it was not until the 1940s, when two chemists, Florey and Chain, out of the bacterial cell. effectiveness into the future. Some antibiotic classes might be developed a method of mass production that it became available for reserved for specific infections. Its aim is to make sure that health products that it regulates widespread use during the Second World War. Since then more than do what they are intended to do and are as safe as possible, 100 different antibiotic compounds have been found, most of them Factors that contribute to antibiotic resistance 4. Developing new drugs, vaccines and diagnostic tests and whether they are intended for the Irish market or for export. incentivising the development of new antibiotic classes for the future. from soil-dwelling bacteria. 1. Unnecessary prescription of antibiotics for viral infections against Until 2014 the HPRA was known as Irish Medicines Board which they are useless. Every time an antibiotic is taken it kills off (IMB). The new name better reflects its broader remit and How antibiotics work the more susceptible members of the germ population but it also Gene transfer regulatory functionsAntibiotic which now include: Resistance increases the chance that resistance will develop is some species Antibiotic resistance can be increased by the ability of bacteria to Antibiotics essentially work in two ways: of bacteria in the body. • Human medicines transfer their resistance to other bacteria. This transfer can occur in • Veterinary medicines 1. Bactericidal antibiotics kill the bacteria generally by either 2. The overuse of broad spectrum antibiotics because the actual two ways either vertically or horizontally. causative organism has not been identified. The broad spectrum • Clinical trials interfering with the formation of the bacterium’s cell wall or its 1. Vertical gene transfer is the normal way genetic information (genes) antibiotic kills many species and, if resistance develops in any • Medical devices cell contents. Penicillin is one of these. is passed on in most organisms. This is when information is passed bacterial species in the animal or human, then it will be able to • Controlled drugs 2. Bacteriostatic antibiotics stop bacteria from multiplying from the parent to the offspring, i.e. from one generation to the next. by interfering with bacterial protein production, DNA reproduce more easily because there is little competition. The • Blood and blood components replication, or other aspects of their cellular metabolism, resistance genes may also transfer to other bacterial species. 2. Horizontal gene transfer is when genes are transferred within • Tissues and cells a generation from one individual to another or even from one e.g. tetracyclines, sulphonamides 3. Failure to finish a course of antibiotics. When an antibiotic is taken • Cosmetic products species to another. Bacteria are particularly good at this, using the most susceptible bacteria die first leaving a population that is • The protection of animals used for scientific purposes Some antibiotics are broad spectrum: these kill a whole range of loops of genetic material called plasmids. more resistant. If the course of antibiotics is stopped before all the • Organs intended for transplantation bacteria both Gram positive and Gram negative; some of which bacteria are killed then the animal or human may have a relapse Species 1 Species 2 are pathogenic. They may also kill the normal gut bacteria. and the bacteria that caused the infection will be much more Species 1 Narrow spectrum antibiotics affect only a small range of bacteria. resistant to the antibiotic and harder to kill. Fuctions of HPRA When antibiotics were introduced they were hailed as miracle Plasmid with • The HPRA grants licences to companies to make, 4. Residues in food. Many farm animals, especially those farmed antibiotic- pilus drugs. It seemed that the era of death from bacterial infections resistant distribute and market medicines after a review of their was over. However, in only a few short decades things have intensively, are routinely given antibiotics at certain times in their safety, quality and effectiveness. Vertical transfer changed dramatically. life even though they might not be sick. This reduces mortality • It continuously monitors medicines, medical devices and and increases live weight gain. There is a mandatory period after Horizontal transfer other health products, responding quickly to any safety Bacteria reproduce in such vast numbers that a random mutation treatment with antibiotics during which neither the animals nor or quality concerns. can quickly result in a resistant strain. Antibiotic resistance – more their products may be allowed to enter the food chain. This is • It produces safety and quality information to support the commonly known nowadays as antimicrobial resistance (AMR) done to allow time for all traces of the antibiotic to be eliminated. safe use of health products. – is the ability of certain organisms to adapt and continue to multiply • It inspects companies and facilities that test, make or in the presence of an antibiotic. (The term ‘antimicrobial’ also includes Multidrug resistant bacteria Even if foods containing residues of antibiotics are not allowed distribute health products to ensure that they comply with drugs that act against viruses, fungi and , in addition to protozoa to enter the food chain, the fact that an animal has been exposed Today there is concern about the increasing occurrence of multidrug relevant standards and legislation. those acting against bacteria.) to an antibiotic treatment at a prior time in its life may allow resistant bacteria especially in hospitals even in the community bacteria containing resistant genes to survive in food products at large. These bacteria, commonly referred to in the press as Resistant strains began to appear within a few years of the Find out more about the HPRA at www.hpra.ie introduction of antibiotics, so new antibiotics had to be found to derived from that animal. Unless food hygiene measures are ‘superbugs’, are resistant to almost all the known antibiotics. replace the ones to which resistance had developed. In the past adequate, bacteria with resistant genes may transfer resistance They include MRSA (methicillin-resistant Staphylococcus aureus, 30 years only two new classes of antibiotics have appeared, so to normal gut bacteria in those who consume the food products. Clostridium difficile and multi-drug resistant tuberculosis. The the problem of antibiotic resistance is becoming more serious. In Ireland all milk is routinely tested for antibiotic residues. Some emergence of gram-negative pathogens that are resistant to virtually The World Health Organisation has classified antimicrobial resistance countries allow farmers to purchase and administer antibiotics to all of the available antibiotics is a particularly serious problem for the as a “serious threat’ that ‘has the potential to affect anyone, of any their animals. Care must therefore be taken to ensure that food healthcare sector. Find this and other lessons on www.sta.ie age, in any country”. products in our shops and supermarkets are safe. AntibioticAntibiotic Resistance Resistance Antibiotic Resistance

SyllabusSyllabus References References StudentStudent Activities Activities ExaminationExamination Questions Questions DidDid You You Know? Know? TheThe main main syllabus syllabus references references for for the the lesson lesson are: are: UseUse available available resources resources to to learn learn more more about about the the following following topics. topics. LeavingLeaving Certificate Certificate Biology Biology (HL) (HL) 2007, 2007, Q. Q.14 14 (b (b & &c) c) • •Necrotizing Necrotizing fasciitis fasciitis is isa aserious serious quick quick InIn each each case case summarise summarise your your findings findings in in a adiagram, diagram, poster poster or or spreadingspreading bacterial bacterial skin skin infection infection that that kills kills the the body’s body’s soft soft tissue. tissue. LeavingLeaving Certificate Certificate Biology Biology electronicelectronic presentation. presentation. (b)(b) (Necrotizing(Necrotizing means means ‘causing ‘causing tissue tissue death’). death’). It Itis isoften often referred referred (i)(i) Comment Comment on on the the difficulty difficulty of ofdefining defining viruses viruses as livingas living • • Distribution Distribution of of bacteria bacteria and and fungi fungi in in nature nature (3.1.2) (3.1.2) toto in in the the press press as as the the ‘flesh ‘flesh eating eating bug’. bug’. The The commonest commonest 1.1. The The different different families families of of antibiotics antibiotics and and how how each each works. works. organisms.organisms. causecause is isprobably probably Group Group A AStreptococcus Streptococcus but but it canit can also also • • UnderstandUnderstand the the term term ‘pathogenic’ ‘pathogenic’ (3.1.3): (3.1.3): Definition Definition and and role role bebe caused caused by by Clostridium Clostridium, Escherichia, Escherichia coli coli, Klebsiella, Klebsiella and and (ii)(ii) What What are are the the two two main main biochemical biochemical components components of of a avirus virus ofof antibiotics. antibiotics. Economic Economic importance importance of of bacteria. bacteria. Potential Potential 2.2. What What species species of of farm farm animals animals are are routinely routinely given given antibiotics antibiotics AeromonasAeromonas hydrophila hydrophila and and Staphylococcus Staphylococcus aureus aureus, many, many of of abuseabuse of of antibiotics antibiotics in in medicine medicine andand what what diseases diseases they they are are given given for? for? Are Are they they given given for for any any particle?particle? whichwhich have have antibiotic antibiotic resistant resistant strains. strains. The The bacteria bacteria attack attack thin thin otherother reason reason than than to to cure cure diseases? diseases? LeavingLeaving Certificate Certificate Agricultural Agricultural Science Science (iii)(iii) Name Name two two diseases diseases caused caused by by viruses. viruses. layerslayers (fasciae) (fasciae) and and produce produce toxins toxins that that can can damage damage and and kill kill 3.3. The The use use of of antibiotics antibiotics during during the the Second Second World World War War and and surroundingsurrounding tissue. tissue. • • The The cow. cow. Common Common diseases diseases – –cause, cause, symptoms, symptoms, prevention prevention (iv)(iv) Give Give an an example example of of a abeneficial beneficial application application of ofa avirus. virus. andand control. control. Bacteriology Bacteriology in in relation relation to to clean clean milk milk production. production. whichwhich classes classes of of soldiers soldiers were were given given priority priority to to receive receive this this • •The The damage damage to to tissue tissue can can restrict restrict blood blood flow flow and and prevent prevent the the scarcescarce resource. resource. antibioticantibiotic reaching reaching all all areas areas of of dead dead tissue tissue so so the the dead dead tissue tissue LeavingLeaving Certificate Certificate Chemistry Chemistry (v)(v) What What is isan an antibiotic? antibiotic? frequentlyfrequently has has to to be be surgically surgically removed removed even even to to the the extent extent of of • • Organic Organic natural natural products products – –range range and and scope scope and and two two 4.4. The The standard standard method method of of testing testing bacterial bacterial diseases diseases for for (vi)(vi) Antibiotics Antibiotics should should not not be be prescribed prescribed for for a aperson person suffering suffering removingremoving limbs. limbs. Healthy Healthy people people very very rarely rarely get get the the disease; disease; examplesexamples (7.4) (7.4) resistanceresistance to to particular particular drug drug groups. groups. fromfrom a aviral viral infection. infection. it isit isnormally normally those those with with an an underlying underlying health health condition condition and and a a 5.5. The The development development of of antimicrobial antimicrobial resistance resistance in in viruses viruses such such SuggestSuggest a areason reason for for this. this. loweredlowered immune immune response. response. It Itis isnot not caught caught by by contact contact with with an an asas AIDS AIDS and Antibioticand Influenza. Influenza. Resistance (c)(c) infectedinfected person. person. LearningLearning Outcomes Outcomes 6.6. The The top top ten ten multiple multiple drug drug resistant resistant diseases. diseases. (i)(i) What What is ismeant meant by by the the term term immunity? immunity? 7.7. How How the the human human body body defends defends itself itself from from disease disease (ii)(ii) Outline Outline briefly briefly the the role role of ofB lymphocytesB lymphocytes in in the the human human BiographicalBiographical Notes Notes OnOn completion completion of of this this lesson, lesson, students students should should be be able able to: to: immuneimmune system. system. 8.8. The The structure structure of of bacteriophages bacteriophages and and the the history history of of their their use use ErnestErnest Duchesne Duchesne (1874-1912) (1874-1912) • • Describe Describe the the difference difference between between an an antibiotic antibiotic and and an an asas a atreatment treatment for for bacterial bacterial diseases. diseases. (iii)(iii) Distinguish Distinguish between between active active and and passive passive immunity. immunity. antimicrobialantimicrobial substance substance InIn his his doctoral doctoral thesis thesis published published in in 1897, 1897, • • Outline Outline how how antibiotics antibiotics were were discovered discovered 9.9. How How bacteria bacteria are are identified identified including including the the use use of of Gram’sGram’s stain. stain. (iv)(iv) “Vaccination “Vaccination gives gives rise rise to to active active immunity”. immunity”. Explain Explain this this thethe French French physician, physician, Ernest Ernest Duchesne Duchesne • • Know Know the the two two ways ways antibiotics antibiotics work: work: bactericidal bactericidal and and 10.10. The The function function of of the the HPRA HPRA (formerly (formerly known known as as the the Irish Irish statement.statement. showedshowed that that the the fungus fungus Penicillium Penicillium glaucumglaucum had had the the ability ability to to treat treat some some bacteriostaticbacteriostatic and and be be able able to to explain explain the the difference difference MedicinesMedicines Board) Board) in in Ireland. Ireland. (v)(v) In In certain certain situations situations a aperson person is isgiven given a aspecific specific antibody antibody bacterialbacterial infections. infections. He He carried carried out out his his • • Distinguish Distinguish between between broad broad and and narrow narrow spectrum spectrum antibiotics antibiotics ratherrather than than being being vaccinated. vaccinated. • • Explain Explain what what is ismeant meant by by antibiotic antibiotic resistance resistance and and state state the the experimentsexperiments on on guinea guinea pigs pigs and and suggested suggested fourfour mechanisms mechanisms of of antibiotic antibiotic resistance resistance 1.1. Is Is this this an an example example of of active active or or passive passive immunity? immunity? thatthat the the toxin toxin produced produced by by the the fungus fungus could could possiblypossibly be be used used to to treat treat humans. humans. After After graduation graduation he he joined joined the the • • Describe Describe the the two two levels levels of of gene gene transfer; transfer; vertical vertical and and True/FalseTrue/False Questions Questions 2.2. Under Under what what circumstances circumstances might might an an antibody, antibody, rather rather armyarmy and and did did not not continue continue the the research. research. horizontalhorizontal thanthan a avaccination, vaccination, be be given? given? • • Name Name some some resistant resistant strains strains of of bacteria. bacteria. a)a) Antibiotics Antibiotics always always kill kill bacteria? bacteria? T T F F LikeLike many many good good ideas ideas these these were were stated stated and and discovered discovered before before 3.3. Comment Comment on on the the duration duration of of immunity immunity that that follows follows the the thethe scientific scientific community community was was far far enough enough advanced advanced to to fully fully b)b) Most Most antibiotics antibiotics are are derived derived from from soil soil dwelling dwelling organisms. organisms. T T F F administrationadministration of of an an antibody. antibody. understandunderstand the the implications. implications. Fleming Fleming was was lucky lucky to to notice notice the the c)c) HorizontalHorizontal gene gene transfer transfer occurs occurs between between different different species. species. T T F F GeneralGeneral Learning Learning Points Points samesame thing thing at at just just the the right right time time and and thus thus he he got got all all the the glory. glory. d)d) Fleming Fleming was was the the first first person person to to show show that that antibiotics antibiotics can can LeavingLeaving Certificate Certificate Biology Biology (HL) (HL) 2005, 2005, Q. Q.15 15 (b) (b) DuchesneDuchesne died died of of tuberculosis tuberculosis at at the the young young age age of of 37. 37. TheseThese are are additional additional relevant relevant points points which which are are used used to to extend extend curecure disease. disease. T T F F (i)(i) Draw Draw and and label label a adiagram diagram to to show show the the basic basic structure structure of of knowledgeknowledge and and facilitate facilitate discussion. discussion. e)e) All All bacteria bacteria are are pathogenic. pathogenic. T T F F a atypical typical bacterial bacterial cell. cell. • • The The transfer transfer of of genes genes between between species species has has been been big big news news f) f) YouYou should should stop stop taking taking a acourse course of of antibiotics antibiotics as as soon soon (ii)(ii) Other Other than than being being prokaryotic, prokaryotic, state state two two ways ways in in which which forfor the the last last number number of of years, years, especially especially in in relation relation to to GM GM food, food, asas you you feel feel better. better. T T F F a atypical typical bacterial bacterial cell cell differs differs from from a atypical typical human human cell cell ReviseRevise The The Terms Terms whilewhile bacteria bacteria have have been been quietly quietly doing doing it itfor for billions billions of of years years g)g) Using Using too too many many broad broad spectrum spectrum antibiotics antibiotics encourages encourages (e.g.(e.g. cell cell from from cheek cheek lining). lining). usingusing plasmids. plasmids. resistance.resistance. T T F F CanCan you you recall recall the the meaning meaning of of the the following following terms? terms? (iii)(iii) Describe Describe how how some some bacteria bacteria respond respond in in order order to to survive survive RevisingRevising terminology terminology is isa apowerful powerful aid aid to to recall recall and and retention. retention. • • TeixobactinTeixobactin is isthe the first first new new antibiotic antibiotic in in thirty thirty years years and and was was h)h) Many Many new new antibiotics antibiotics have have been been discovered discovered in inthe the last last whenwhen environmental environmental conditions conditions become become unfavourable. unfavourable. discovereddiscovered by by researchers researchers from from North-Eastern North-Eastern University University in in thirtythirty years. years. T T F F antibiotics,antibiotics, antimicrobial antimicrobial resistance resistance (AMR), (AMR), bacteria, bacteria, bactericidal, bactericidal, (iv)(iv) What What is ismeant meant when when a abacterium bacterium is isdescribed described as as BostonBoston using using an an electronic electronic chip chip to to grow grow the the microbes microbes in in the the i) i) NarrowNarrow spectrum spectrum antibiotics antibiotics kill kill a awhole whole range range of of bacteria. bacteria. T T F F bacteriostatic,bacteriostatic, broad broad spectrum, spectrum, broad broad spectrum spectrum antibiotics, antibiotics, soilsoil and and then then isolate isolate their their antibiotic antibiotic compounds. compounds. It Itappears appears to to beingbeing pathogenic? pathogenic? ClostridiumClostridium difficile, difficile, fungi fungi and, and, GramGram positive, positive, metabolicmetabolic pathw pathways,ays, j) j) AntimicrobialAntimicrobial compounds compounds kill kill viruses viruses and and parasites. parasites. T T F F bebe effective effective in in treating treating some some of of the the most most difficult difficult infections. infections. (v)(v) What What are are antibiotics? antibiotics? Use Use your your knowledge knowledge of of the the Theory Theory of of microbes,microbes, micro-organism, micro-organism, MRSA, MRSA, narrow narrow spectrum spectrum antibiotics, antibiotics, k)k) AntibioticsAntibiotics are are substances substances made made by by microorganisms microorganisms that that It Itworks works well well in in mice mice with with very very few few side side effects effects but but still still has has NaturalNatural Selection Selection to to explain explain the the possible possible danger danger involved involved in in pathogenic,pathogenic, plasmids, plasmids, protozoa, protozoa, residues, residues, Staphylococcus, Staphylococcus, killkill viruses. viruses. T T F F toto be be scaled scaled up up to to produce produce quantities quantities to to test test on on humans. humans. thethe misuse misuse of of antibiotics. antibiotics. sulphonamides,sulphonamides, Tetracyclines, Tetracyclines, tuberculosis, tuberculosis, vaccination. vaccination. PositivePositive tests tests on on mice mice do do not not guarantee guarantee success success in in humans. humans. CheckCheck your your answers answers to to these these questions questions on on www.sta.ie. www.sta.ie. CheckCheck the the Glossary Glossary of of terms terms for for this this lesson lesson on on www.sta.ie www.sta.ie AntibioticAntibiotic Resistance Resistance Antibiotic Resistance

SyllabusSyllabus References References StudentStudent Activities Activities ExaminationExamination Questions Questions DidDid You You Know? Know? TheThe main main syllabus syllabus references references for for the the lesson lesson are: are: UseUse available available resources resources to to learn learn more more about about the the following following topics. topics. LeavingLeaving Certificate Certificate BiologyBiology (HL) (HL) 2007, 2007, Q. Q.14 14 (b (b & &c) c) • •Necrotizing Necrotizing fasciitis fasciitis is isa aserious serious quick quick InIn each each case case summarise summarise your your findings findings in in a adiagram, diagram, poster poster or or spreadingspreading bacterial bacterial skin skin infection infection that that kills kills the the body’s body’s soft soft tissue. tissue. LeavingLeaving Certificate Certificate BiologyBiology electronicelectronic presentation. presentation. (b)(b) (Necrotizing(Necrotizing means means ‘causing ‘causing tissue tissue death’). death’). It Itis isoften often referred referred (i)(i) Comment Comment on on the the difficulty difficulty of ofdefining defining viruses viruses as asliving living • • Distribution Distribution of of bacteria bacteria and and fungi fungi in in nature nature (3.1.2) (3.1.2) toto in in the the press press as as the the ‘flesh ‘flesh eating eating bug’. bug’. The The commonest commonest 1.1. The The different different families families of of antibiotics antibiotics and and how how each each works. works. organisms.organisms. causecause is isprobably probably Group Group A AStreptococcus Streptococcus but but it itcan can also also • • UnderstandUnderstand the the term term ‘pathogenic’ ‘pathogenic’ (3.1.3): (3.1.3): Definition Definition and and role role bebe caused caused by by Clostridium Clostridium, Escherichia, Escherichia coli coli, Klebsiella, Klebsiella and and (ii)(ii) What What are are the the two two main main biochemical biochemical components components of of a avirus virus ofof antibiotics. antibiotics. Economic Economic importance importance of of bacteria. bacteria. Potential Potential 2.2. What What species species of of farm farm animals animals are are routinely routinely given given antibiotics antibiotics AeromonasAeromonas hydrophila hydrophila and and Staphylococcus Staphylococcus aureus aureus, many, many of of abuseabuse of of antibiotics antibiotics in in medicine medicine andand what what diseases diseases they they are are given given for? for? Are Are they they given given for for any any particle?particle? whichwhich have have antibiotic antibiotic resistant resistant strains. strains. The The bacteria bacteria attack attack thin thin otherother reason reason than than to to cure cure diseases? diseases? LeavingLeaving Certificate Certificate AgriculturalAgricultural Science Science (iii)(iii) Name Name two two diseases diseases caused caused by by viruses. viruses. layerslayers (fasciae) (fasciae) and and produce produce toxins toxins that that can can damage damage and and kill kill 3.3. The The use use of of antibiotics antibiotics during during the the Second Second World World War War and and surroundingsurrounding tissue. tissue. • • The The cow. cow. Common Common diseases diseases – –cause, cause, symptoms, symptoms, prevention prevention (iv)(iv) Give Give an an example example of of a abeneficial beneficial application application of ofa avirus. virus. andand control. control. Bacteriology Bacteriology in in relation relation to to clean clean milk milk production. production. whichwhich classes classes of of soldiers soldiers were were given given priority priority to to receive receive this this • •The The damage damage to to tissue tissue can can restrict restrict blood blood flow flow and and prevent prevent the the scarcescarce resource. resource. antibioticantibiotic reaching reaching all all areas areas of of dead dead tissue tissue so so the the dead dead tissue tissue LeavingLeaving Certificate Certificate Chemistry Chemistry (v)(v) What What is is an an antibiotic? antibiotic? frequentlyfrequently has has to to be be surgically surgically removed removed even even to to the the extent extent of of • • Organic Organic natural natural products products – –range range and and scope scope and and two two 4.4. The The standard standard method method of of testing testing bacterial bacterial diseases diseases for for (vi)(vi) Antibiotics Antibiotics should should not not be be prescribed prescribed for for a aperson person suffering suffering removingremoving limbs. limbs. Healthy Healthy people people very very rarely rarely get get the the disease; disease; examplesexamples (7.4) (7.4) resistanceresistance to to particular particular drug drug groups. groups. fromfrom a aviral viral infection. infection. it itis isnormally normally those those with with an an underlying underlying health health condition condition and and a a 5.5. The The development development of of antimicrobial antimicrobial resistance resistance in in viruses viruses such such SuggestSuggest a areason reason for for this. this. loweredlowered immune immune response. response. It Itis isnot not caught caught by by contact contact with with an an asas AIDS AIDS and and Influenza. Influenza. (c)(c) infectedinfected person. person.Antibiotic Resistance LearningLearning Outcomes Outcomes 6.6. The The top top ten ten multiple multiple drug drug resistant resistant diseases. diseases. (i)(i) What What is is meant meant by by the the term term immunity? immunity? 7.7. How How the the human human body body defends defends itself itself from from disease disease (ii)(ii) Outline Outline briefly briefly the the role role of ofB lymphocytesB lymphocytes in in the the human human BiographicalBiographical Notes Notes OnOn completion completion of of this this lesson, lesson, students students should should be be able able to: to: immuneimmune system. system. 8.8. The The structure structure of of bacteriophages bacteriophages and and the the history history of of their their use use ErnestErnest Duchesne Duchesne (1874-1912) (1874-1912) • • Describe Describe the the difference difference between between an an antibiotic antibiotic and and an an asas a atreatment treatment for for bacterial bacterial diseases. diseases. (iii)(iii) Distinguish Distinguish between between active active and and passive passive immunity. immunity. antimicrobialantimicrobial substance substance InIn his his doctoral doctoral thesis thesis published published in in 1897, 1897, • • Outline Outline how how antibiotics antibiotics were were discovered discovered 9.9. HowHow bacteria bacteria are are identified identified including including the the use use of of Gram’sGram’s stain. stain. (iv)(iv) “Vaccination “Vaccination gives gives rise rise to to active active immunity”. immunity”. Explain Explain this this thethe French French physician, physician, Ernest Ernest Duchesne Duchesne • • Know Know the the two two ways ways antibiotics antibiotics work: work: bactericidal bactericidal and and 10.10. The The function function of of the the HPRA HPRA (formerly (formerly known known as as the the Irish Irish statement.statement. showedshowed that that the the fungus fungus Penicillium Penicillium glaucumglaucum had had the the ability ability to to treat treat some some bacteriostaticbacteriostatic and and be be able able to to explain explain the the difference difference MedicinesMedicines Board) Board) in in Ireland. Ireland. (v)(v) In In certain certain situations situations a aperson person is is given given a aspecific specific antibody antibody bacterialbacterial infections. infections. He He carried carried out out his his • • Distinguish Distinguish between between broad broad and and narrow narrow spectrum spectrum antibiotics antibiotics ratherrather than than being being vaccinated. vaccinated. • • Explain Explain what what is is meant meant by by antibiotic antibiotic resistance resistance and and state state the the experimentsexperiments on on guinea guinea pigs pigs and and suggested suggested fourfour mechanisms mechanisms of of antibiotic antibiotic resistance resistance 1.1. Is Is this this an an example example of of active active or or passive passive immunity? immunity? thatthat the the toxin toxin produced produced by by the the fungus fungus could could possiblypossibly be be used used to to treat treat humans. humans. After After graduation graduation he he joined joined the the • • Describe Describe the the two two levels levels of of gene gene transfer; transfer; vertical vertical and and True/FalseTrue/False Questions Questions 2.2. Under Under what what circumstances circumstances might might an an antibody, antibody, rather rather armyarmy and and did did not not continue continue the the research. research. horizontalhorizontal thanthan a avaccination, vaccination, be be given? given? • • Name Name some some resistant resistant strains strains of of bacteria. bacteria. a)a) Antibiotics Antibiotics always always kill kill bacteria? bacteria? T T F F LikeLike many many good good ideas ideas these these were were stated stated and and discovered discovered before before 3.3. Comment Comment on on the the duration duration of of immunity immunity that that follows follows the the thethe scientific scientific community community waswas far far enough enough advanced advanced to to fully fully b)b) Most Most antibiotics antibiotics are are derived derived from from soil soil dwelling dwelling organisms. organisms. T T F F administrationadministration of of an an antibody. antibody. understandunderstand the the implications. implications. Fleming Fleming was was lucky lucky to to notice notice the the c)c) HorizontalHorizontal gene gene transfer transfer occurs occurs between between different different species. species. T T F F GeneralGeneral Learning Learning Points Points samesame thing thing at at just just the the right right time time and and thus thus he he got got all all the the glory. glory. d)d) Fleming Fleming was was the the first first person person to to show show that that antibiotics antibiotics can can LeavingLeaving Certificate Certificate BiologyBiology (HL) (HL) 2005, 2005, Q. Q.15 15 (b) (b) DuchesneDuchesne died died of of tuberculosis tuberculosis at at the the young young age age of of 37. 37. TheseThese are are additional additional relevant relevant points points which which are are used used to to extend extend curecure disease. disease. T T F F (i)(i) Draw Draw and and label label a adiagram diagram to to show show the the basic basic structure structure of of knowledgeknowledge and and facilitate facilitate discussion. discussion. e)e) All All bacteria bacteria are are pathogenic. pathogenic. T T F F a atypical typical bacterial bacterial cell. cell. • • The The transfer transfer of of genes genes between between species species has has been been big big news news f) f) YouYou should should stop stop taking taking a acourse course of of antibiotics antibiotics as as soon soon (ii)(ii) Other Other than than being being prokaryotic, prokaryotic, state state two two ways ways in in which which forfor the the last last number number of of years, years, especially especially in in relation relation to to GM GM food, food, asas you you feel feel better. better. T T F F a atypical typical bacterial bacterial cell cell differs differs from from a atypical typical human human cell cell ReviseRevise The The Terms Terms whilewhile bacteria bacteria have have been been quietly quietly doing doing it itfor for billions billions of of years years g)g) Using Using too too many many broad broad spectrum spectrum antibiotics antibiotics encourages encourages (e.g.(e.g. cell cell from from cheek cheek lining). lining). usingusing plasmids. plasmids. resistance.resistance. T T F F CanCan you you recall recall the the meaning meaning of of the the following following terms? terms? (iii)(iii) Describe Describe how how some some bacteria bacteria respond respond in in order order to to survive survive RevisingRevising terminology terminology is is a apowerful powerful aid aid to to recall recall and and retention. retention. • • TeixobactinTeixobactin is is the the first first new new antibiotic antibiotic in in thirty thirty years years and and waswas h)h) Many Many new new antibiotics antibiotics have have been been discovered discovered in in the the last last whenwhen environmental environmental conditions conditions become become unfavourable. unfavourable. discovereddiscovered by by researchers researchers from from North-Eastern North-Eastern University University in in thirtythirty years. years. T T F F antibiotics,antibiotics, antimicrobial antimicrobial resistance resistance (AMR), (AMR), bacteria, bacteria, bactericidal, bactericidal, (iv)(iv) What What is is meant meant when when a abacterium bacterium is is described described as as BostonBoston using using an an electronic electronic chip chip to to grow grow the the microbes microbes in in the the i) i) NarrowNarrow spectrum spectrum antibiotics antibiotics kill kill a awhole whole range range of of bacteria. bacteria. T T F F bacteriostatic,bacteriostatic, broad broad spectrum, spectrum, broad broad spectrum spectrum antibiotics, antibiotics, soilsoil and and then then isolate isolate their their antibiotic antibiotic compounds. compounds. It Itappears appears to to beingbeing pathogenic? pathogenic? ClostridiumClostridium difficile, difficile, fungi fungi and, and, GramGram positive, positive, metabolicmetabolic pathw pathways,ays, j) j) AntimicrobialAntimicrobial compounds compounds kill kill viruses viruses and and parasites. parasites. T T F F bebe effective effective in in treating treating some some of of the the most most difficult difficult infections. infections. (v)(v) What What are are antibiotics? antibiotics? Use Use your your knowledge knowledge of of the the Theory Theory of of microbes,microbes, micro-organism, micro-organism, MRSA, MRSA, narrow narrow spectrum spectrum antibiotics, antibiotics, k)k) AntibioticsAntibiotics are are substances substances made made by by microorganisms microorganisms that that It Itworks works well well in in mice mice with with very very few few side side effects effects but but still still has has NaturalNatural Selection Selection to to explain explain the the possible possible danger danger involved involved in in pathogenic,pathogenic, plasmids, plasmids, protozoa, protozoa, residues, residues, Staphylococcus, Staphylococcus, killkill viruses. viruses. T T F F toto be be scaled scaled up up to to produce produce quantities quantities to to test test on on humans. humans. thethe misuse misuse of of antibiotics. antibiotics. sulphonamides,sulphonamides, Tetracyclines, Tetracyclines, tuberculosis, tuberculosis, vaccination. vaccination. PositivePositive tests tests on on mice mice do do not not guarantee guarantee success success in in humans. humans. CheckCheck your your answers answers to to these these questions questions on on www.sta.ie. www.sta.ie. CheckCheck the the Glossary Glossary of of terms terms for for this this lesson lesson on on www.sta.ie www.sta.ie