This week in class we discussed antimicrobial action and antimicrobial susceptibility tests. This is very important for both patients and physicians in order to effectively treat infections. The mechanism of activity varies among agents and some commons ones include Inhibition of cell wall synthesis, disruption of cell membrane, inhibition of nucleic acid synthesis (RNA or DNA), interference with essential , metabolites (ex. folic acid pathway), and Inhibition of protein synthesis (binds to 30S or 50S ribosomal subunit). Beta Lactams act on the cell wall, while glycopeptides inhibit cell call synthesis. Vancomycin is a popular example. Interfering with protein synthesis is also a mechanism, and this is done by tetracyclines, aminoglycosides, and macrolides. In order to detect susceptibility, several methods can be used. Some of these include broth dilutions, microdolutions, and agar dilutions. Additionally, there are automated systems that are available. In order to determine susceptibility, we can use an E test, MBC, MIC, and the Schlicter Test.
The following link is to an article containing a case history of a 79-year-old man with end-stage renal disease due to hypertension. The man had positive blood cultures for MRSA that was resistant to vancomycin. Read the article to learn more!
http://www.nejm.org/doi/full/10.1056/NEJM199902183400704
I have always been interested in how the doctors know what antibiotics to use when treating bacterial infections. Now I know the basic principles in antibiotic selection.
ReplyDeleteI liked the comic that you posted. It should remind us the importance of using the right antibiotics for certain organisms. We have so many resistant microbes now that treatment is difficult.
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