Superbug

the antibiotic resistance gene

1. SUPERBUG PRESENTED BY :- KIRAN B.Sc BIOTECH 1 5 TH SEM 1

2. WHAT ARE ANTIBIOTICS ? Antibiotics, also known as antibacterial, are types of medications that destroy or slow down the growth of bacteria. 2

3. WHAT IS SUPERBUG ? If a bacterium carries several antibiotic resistance genes it is called multiresistant or informally a SUPERBUG or super bacteria . Gene can be transferred between bacteria in horizontal fashion by conjugation, transduction or transformation; thus a gene for antibiotic resistance which had evolved via natural selection may be shared . 3

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5. NDM-1 Gene Is a type of Carbapenem resistance gene, designated as bla NDM-1 . or also designated as NDM-1 gene. Named after the Indian capital In August 2010, by the Lancet general medical journal published an article about multi-drug resistant "superbug" infection, which they have named controversially New Delhi metallo-beta-lactamase or NDM-1 based on their assumed origin. 5

6. Origin and spread In December 2009 in a Swedish national who fell ill with an antibiotic-resistant bacterial infection that he acquired in India. The infection was unsuccessfully treated in a New Delhi hospital and after the patient's repatriation to Sweden, a carbapenem-resistant klebsiella pneumonia strain bearing the novel gene was identified. In March 2010 a study in a hospital in Mumbai found that most carbapenem-resistant bacteria isolated from patients carried the bla NDM-1 gene. 6

7. NDM-1 symptoms E .COLI SYMPTOMS :- Diarrhea ( usually associated with pain and crambing in abdomen) , nausea and vomiting , urinary tract infections . KLEBSIELLA PNEUMONIA SYMPTOMS :- Fever , cough , upper respiratory tract infections , foul odor released from the nose , congestion , haemoptysis , generalized skin infections. CITROBACTER SYMPTOMS :- Acute gastroenteritis is characterized by two or more symptoms of vomiting , urinary tract infections include a burning sensation of urinating . ENTEROBACTER SYMPTOMS :- Some symptoms of Enterobacter infections include bacteremia, lower respiratory tract infections, 7

8. TUBERCLOSIS SUPERBUG TB is caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis) and is spread mostly through the air.  M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. Drug-resistant TB is more challenging to treat – it can be complex and requires more time and more expensive drugs that often have more side effects Extensively drug-resistant TB (XDR TB) is resistant to most TB drugs; therefore the patients are left with treatment options that are much less effective. 8

9. What are the main types of drug resistant TB? There are two main types of drug resistant TB,  MDR TB  and  XDR TB . MDR TB is the type of drug resistant TB, when the bacteria are resistant to the TB drugs rifampicin and isoniazid XDR TB (extensively drug resistant TB) is defined as strains resistant to at least rifampicin and isoniazid. This is in addition to strains being resistant to one of the fluoroquinolones, as well as resistant to at least one of the second line inject able TB drugs amikacin, kanamycin or capreomycin. 2 9

10. Mechanism of antibiotic resistance 10

11. The four main mechanisms by which microorganisms exhibit resistance to antimicrobials are: 1) Drug Inactivation or Modification E.g. :- Production of Beta-lactamases by Staphylococci 2) Alteration of target site E.g. :- Altered Pencillin binding protein in MRSA 3) Alteration of metabolic pathway E.g. Aminoglycoside resistance in Gram negative bacteria. 4) Reduced drug accumulation a) Decreased uptake : Imipenem resistance in Pseudomonas b) Efflux: Erythromycin resistance in Streptococci & Staphylococci 11

12. CAUSES:- Uncontrolled, improper and indiscriminate use of antibiotics for therapy. Excessive use of cleaners, detergents & antibacterial . Antibiotics in livestock, animals, birds & agriculture Poor hand hygiene & failure of infection control measures Unnecessary use, lack of activity, insufficient doses 12

13. SUPERBUG IN UK A new superbug that is resistant to even the most powerful antibiotics has entered UK hospitals, experts warn. They say bacteria that make an enzyme called NDM-1 have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery. Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global. At least 17 of the 37 patients they studied had a history of travelling to India or Pakistan within the past year, and 14 of them had been admitted to a hospital in these countries - many for cosmetic surgery 13

14. Blame on India is it justified ? A joint study led by Chennai based Karthikeyan Kumarasamy, at university of Madras and UK based Timothy Walsh from department of immunity, infection and Biochemistry, department of Medicine, Cardiff University researchers sought to examine whether NDM-1 producing bacteria was prevalent in south Asia and Britain. They found the superbug in 44 patients in Chennai, and 26 in Haryana, besides 37 in the UK and 73 in other places across India, Pakistan and Bangladesh. 14

15. How to Overcome The Superbugs? Antibiotics are only effective against bacterial infections, and they should never be used for viral infections such as a cold or flu. Stopping the treatment early can allow resistant bacteria to survive and spread. Never take antibiotics without a prescription. Keep good hygiene to prevent infection. Do not save some of your antibiotic for the next time you get sick.   15

16. We need to preserve this resource by working together Combating superbugs: No action today, no cure tomorrow Antibiotics are a precious resource 16

17. THANKYOU 17