Bacteriology

7.

Antimicrobial Agents and Resistance

7.1.

Principles of Antimicrobial Therapy

7.1.1.

Selective Toxicity

7.1.2.

Spectrum of Activity

7.1.2.1.

7.1.2.2.

Narrow Spectrum

7.1.3.

Bactericidal vs. Bacteriostatic Agents

7.1.4.

Pharmacokinetics and Pharmacodynamics

7.1.4.1.

7.1.4.2.

7.1.4.3.

7.1.4.4.

7.1.5.

Minimum Inhibitory Concentration (MIC)

7.1.6.

Minimum Bactericidal Concentration (MBC)

7.2.

Mechanisms of Antimicrobial Action

7.2.1.

Inhibition of Cell Wall Synthesis

7.2.2.

Inhibition of Protein Synthesis

7.2.3.

Inhibition of Nucleic Acid Synthesis

7.2.4.

Injury to Plasma Membrane

7.2.5.

Inhibition of Essential Metabolite Synthesis

7.3.

Major Classes of Antibiotics

7.3.1.

7.3.1.1.

7.3.1.1.1.

Natural Penicillins

7.3.1.1.2.

Semi-synthetic Penicillins

7.3.1.1.3.

Extended-Spectrum Penicillins

7.3.1.2.

7.3.1.2.1.

First Generation

7.3.1.2.2.

Second Generation

7.3.1.2.3.

Third Generation

7.3.1.2.4.

Fourth Generation

7.3.1.3.

7.3.1.4.

7.3.2.

Aminoglycosides

7.3.2.1.

7.3.2.2.

7.3.2.3.

7.3.3.

7.3.3.1.

7.3.3.2.

7.3.3.3.

7.3.4.

7.3.4.1.

7.3.4.2.

7.3.4.3.

7.3.5.

Quinolones and Fluoroquinolones

7.3.5.1.

7.3.5.2.

7.3.5.3.

7.3.6.

Sulfonamides and Trimethoprim

7.3.7.

7.3.7.1.

7.3.7.2.

7.3.8.

7.3.8.1.

7.3.9.

Chloramphenicol

7.3.10.

7.4.

Antimicrobial Resistance

7.4.1.

Intrinsic Resistance

7.4.2.

Acquired Resistance

7.4.3.

Mechanisms of Resistance

7.4.3.1.

Alteration of Drug Target

7.4.3.2.

Enzymatic Inactivation of the Drug

7.4.3.2.1.

Beta-Lactamases

7.4.3.2.2.

Aminoglycoside-Modifying Enzymes

7.4.3.3.

Decreased Permeability

7.4.3.4.

7.4.3.5.

Development of Altered Metabolic Pathways

7.4.4.

Genetic Basis of Resistance

7.4.4.1.

Chromosomal Mutations

7.4.4.2.

Plasmid-Mediated Resistance

7.4.4.3.

Transposon-Mediated Resistance

7.5.

The Problem of Antibiotic Resistance

7.5.1.

Spread of Resistance Genes

7.5.1.1.

Horizontal Gene Transfer

7.5.1.2.

Clonal Expansion

7.5.1.3.

Selection Pressure

7.5.2.

Multidrug-Resistant (MDR) Organisms

7.5.2.1.

MRSA (Methicillin-Resistant Staphylococcus aureus)

7.5.2.2.

VRE (Vancomycin-Resistant Enterococci)

7.5.2.3.

ESBL-Producing Bacteria

7.5.2.4.

Carbapenem-Resistant Enterobacteriaceae

7.5.3.

Strategies to Combat Resistance

7.5.3.1.

Antimicrobial Stewardship Programs

7.5.3.2.

Development of New Drugs

7.5.3.3.

Combination Therapy

7.5.3.4.

Infection Control Measures

7.5.3.5.

Surveillance Programs

7.5.4.

Alternative Approaches

7.5.4.1.

Bacteriophage Therapy

7.5.4.2.

Antimicrobial Peptides

7.5.4.3.

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