Exercise 3E: Antibiogram

Members
Crystal Jade Mendoza Justine Gonzales Millare Steffi Muriel Oslyn Opilas Em Osias Ojochenemi Peters Tanja Philipp Jamie Pooten

Introduction
An antibiogram is the result of a laboratory testing for the sensitivity of an isolated bacterial strain to different antibiotics. It is by definition an in vitro-sensitivity. In clinical practice, antibiotics are most frequently prescribed on the basis of general guidelines and knowledge about sensitivity: e.g. uncomplicated urinary tract infections can be treated with a first generation quinolone, etc. This is because Escherichia coli is the most likely causative pathogen, and it is known to be sensitive to quinolone treatment. Infections that are not acquired in the hospital are called "community acquired" infections.

Objectives
To know some microorganism that is drug resistant and non-resistant. Be able to understand the effectivity against microorganism. To learn the microorganisms mechanism of action. To know some of the uses of antibiotic.

Figures/Tables/Results
Antibiotic Code Name Mechanism of Action Effectivity against which microorganism

SXT25

Sulfamethoxazole ***acts synergistically for bactericidal action ***normal bacterial utilization of PABA for the synthesis of folic acid Streptomycin
***a protein synthesis inhibitor

***Gardnerella vaginalis; it is sensitive to the TMP-SMZ disk ***susceptible forms of Streptococcus,Staphylococcus aureus (including MRSA), Escherichia coli, Haemophilus influenzae, and oral anaerobes ***Mycobacterium tuberculosis; Staphylococcus aureus ***Aerobic Gram-positive cocci, including some members of the Staphylococcus and Streptococcus ***Anaerobic, Gram-negative rod-shaped bacteria, including some Bacteroides, Fusobacterium, and Prevotella ***Gram-positive and Gram-negativebacteria, including most anaerobic organisms ***Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. ***Staphylococcus aureus

S10

DA2

Clindamycin

***bacteriostatic effect

C30

Chloramphenicol

***bacteriostatic drug that stops bacterial growth by inhibiting protein synthesis

OX1

Oxacillin

***narrow spectrum beta-lactam antibiotic of the penicillin class

RA5

Rifampin

***bacterial DNA-dependent RNA synthesis by inhibiting bacterial DNAdependent RNA polymerase

***Mycobacterium infections, Staphylococcus aureus, Listeria species, Neisseria gonorrhoeae, Haemophilus influenzae, andLegionella pneumophila,etc.
***Streptococci, Staphylococci, Clostridium, and Listeria genera

P10

Penicillin

***synergistic effect with aminoglycosides

KF30

Cephalothin

***firstgeneration cephalosporin antibiotic *** similar antimicrobial spectrum to cefazolin and the oral agent cefalexin

AK30

Amikacin

***high resistance against bacterial inactivation

*** Pseudomonas aeruginosa, Acinetobacter, and Enterobacter. Serratia marcescens and Providencia stuartii

Antibiotic FW_S_IV4

SXT25

S10

DA2

C30

OX1

RA5

P10

KF30

AK30

N
3.6 cm

O
2 cm

3.2 cm

G
3.6 cm

R
negative

O
0.4 cm

W
1 cm

T
negative

H
3.4 cm

FW_S_IV3 negative FW_HB4 N FW_HB5 FW_A11 FW_A19 FW_A18 FW_A10

O
2 cm

negative

G
1.8 cm

R
negative 2 cm negative 2 cm

O
1.4 cm 2.6 cm 1.5 cm 4.6 cm

W
negative 4.4 cm 1 cm 5.8 cm

T
1.2 cm 0.6 cm negative negative

H
2.4 cm 4 cm 3 cm 3.6 cm

NO
negative negative

GR
3 cm 4 cm

OW
negative negative

TH
3 cm 2 cm

Note: FW_S_IV4, FW_HB4, FW_A11 (SXT25, S10, DA2, C30), FW_A10 there is no growth of bacteria occurred.

Discussion
Many bacteria are known to be resistant to several classes of antibiotics, and treatment is not so straightforward. This is especially the case in vulnerable patients, such as patients in the intensive care unit. When these patients develop a "hospital-acquired" (or "nosocomial") pneumonia, more hardy bacteria like Pseudomonas aeruginosa are potentially involved. Treatment is then generally started on the basis of surveillance data about the local pathogens probably involved. This first treatment, based on statistical information about former patients, and aimed at a large group of potentially involved microbes, is called empirical treatment. Before starting this treatment, the physician will collect a sample from a suspected contaminated compartment: a blood sample when bacteria possibly have invaded the bloodstream, a sputum sample in the case of ventilator associated pneumonia, and a urine sample in the case of a urinary tract infection. These samples are transferred to the microbiology lab, which looks at the sample under the microscope, and tries to culture the bacteria. This can help in the diagnosis.

Streptomycin is an antibiotic that inhibits both Gram-positive and Gram-negative bacteria, and is therefore a useful broad-spectrum antibiotic.

Sulfamethoxazole (abbreviated SMZ or SMX) it is commonly used to treat urinary tract infections. In addition it can be used as an alternative to amoxicillin-based antibiotics to treatsinusitis. It can also be used to treat toxoplasmosis and it is the drug of choice for Pneumocystis pneumonia, which affects primarily patients with HIV.

Clindamycin used primarily to treat anaerobic infections caused by susceptible anaerobic bacteria, including dental infections, and infections of the respiratory tract, skin, and soft tissue, and peritonitis. In people with hypersensitivityto penicillins, clindamycin may be used to treat infections caused by susceptible aerobic bacteria, as well. It is also used to treat bone and joint infections, particularly those caused by Staphylococcus aureus. Topical application of clindamycin phosphate can be used to treat mild to moderate acne.

Chloramphenicol it is considered a prototypical broad-spectrum antibiotic, alongside the tetracyclines, and as it is both cheap and easy to manufacture it is frequently an antibiotic of choice in the developing world.

Oxacillin it is widely used clinically in the US to treat penicillin-resistant Staphylococcus aureus. However, with the introduction and widespread use of both oxacillin and methicillin, antibiotic-resistant strains called oxacillin-resistant Staphylococcus aureus (MRSA/ORSA) have become increasingly prevalent worldwide. MRSA/ORSA is treated using vancomycin.

Rifampicin can be used as monotherapy for a few days as prophylaxis against meningitis, but resistance develops quickly during long treatment of active infections, so the drug is always used against active infections in combination with other antibiotics. Rifampicin has some effectiveness against vaccinia virus.

Penicillin antibiotics were among the first drugs to be effective against many previously serious diseases, such assyphilis and infections caused by staphylococci and streptococci. Penicillins are still widely used today, though many types of bacteria have now become resistant.

Cephalotin. It was the first cephalosporin marketed (1964) and continues to be widely used. It is an intravenously administered agent with a similar antimicrobial spectrum to cefazolin and the oral agent cefalexin. Cefalotin sodium is commonly marketed under the trade name Keflin (Lilly).

Amikacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Amikacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth.

Answer to Questions:
Based on the test results, what is the best antibiotic? Penicillin is the best antibiotic because it has the greatest measurement in terms of distance (diameter) which is 5.8cm. Based on the test results, which bacteria is most resistant to the different antibiotics? The most resistant bacteria based on the test results were FW_A18 (unknown bacteria)

Conclusion & Recommendations

The overuse, underuse or misuse of medicines harms people and wastes resources. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant microbes may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria so I therefore conclude that not all antibiotic are safe and good especially when it is not taken in a correct manner.

References & Appendix

http://en.wikipedia.org/wiki/Antibiogram http://en.wikipedia.org/wiki/Sulfamethoxazole#Mechanism_of_action http://en.wikipedia.org/wiki/Streptomycin#Mechanism_of_action http://en.wikipedia.org/wiki/Clindamycin#Mechanism_of_action http://en.wikipedia.org/wiki/Chloramphenicol#Mechanism_of_action http://en.wikipedia.org/wiki/Rifampicin#Mechanism_of_action http://en.wikipedia.org/wiki/Amikacin http://en.wikipedia.org/wiki/Cefalotin http://en.wikipedia.org/wiki/Penicillin