Antibiotic resistance : understanding and responding to an emerging crisis / Karl Drlica, David S. Perlin.

Format:

Book

Author/Creator:

Drlica, Karl.

Contributor:

Perlin, David.

Language:

English

Subjects (All):

Drug resistance in microorganisms.

Drug Resistance, Microbial--immunology.

Immunity, Innate.

Medical Subjects:

Drug Resistance, Microbial--immunology.

Immunity, Innate.

Physical Description:

xvi, 271 pages : illustrations ; 26 cm

Place of Publication:

Upper Saddle River, N.J. : FT Press, [2011]

Contents:

1. Introduction to the resistance problem : MRSA is putting resistance in the news ; Humans live with many pathogens ; Antibiotics block growth and kill pathogens ; Broad-spectrum antibiotics also perturb our microbiomes ; Antibiotic resistance protects pathogens ; Antibiotic resistance is widespread ; Antibiotic resistance is divided into three types ; The development of new antibiotics is slowing ; Vaccines block disease ; Perspective

2. Working with pathogens : Pathogens are a diverse group of life forms ; Pathogen numbers are measured by microscopy and by detecting growth ; Molecular probes can be specific and highly sensitive ; Koch's postulates help establish that a pathogen causes disease ; Modern biology has refined Koch's postulates ; Pathogen studies focus on populations ; Perspective

3. A survey of antibiotics : Antibiotics are selective poisons ; Antibiotics are found in a variety of ways ; Antibacterial agents usually attack specific targets ; Antibacterial agents may have a generalized effect ; Most antifungal agents attack membranes and cell walls ; Antiprotozoan agents tend to be disease-specific ; Antihelminth agents are used with a variety of worms ; Antiviral agents are often narrow spectrum ; Human immunodeficiency virus (HIV) ; Influenza virus ; Herpes virus ; Antibiotic classes evolve ; Antiseptics and disinfectants decontaminate surfaces ; Perspective

4. Dosing to cure : Treatment strategies have been determined empirically ; Susceptibility testing guides antibiotic choice ; Testing for viruses bypasses pathogen growth ; PK/PD indices help determine antibiotic dosage ; Young children are not little adults ; Toxic side effects are determined empirically ; Duration of treatment is determined empirically ; Prophylaxis preempts disease ; Management programs control hospital antibiotic policy ; Self-medication is outside the guidelines ; Perspective

5. Emergence of resistance : Resistance can emerge in individual patients ; Spontaneous mutations are nucleotide sequence changes ; Emergence of spontaneous resistance often arises stepwise ; Mutant selection window hypothesis describes emergence of spontaneous resistance ; Mutations can be caused (induced) by antibiotic treatment ; Resistance arises from several molecular mechanisms ; Treatment time can contribute to resistance ; Mutator mutations increase mutation frequency ; Phenotypic resistance occurs without mutations ; Resistance may compromise antiseptic and disinfectant use ; Viral resistance can arise readily ; Resistance mutations can affect pathogen fitness ; Unintended damage can arise from treatment ; Perspective

6. Movement of resistance genes among pathogens : Horizontal gene transfer involves specific molecular events ; Recombination involves breaking and rejoining the DNA molecules ; Plasmids are molecular parasites ; Some plasmids move by conjugation ; Bacteriophages move bacterial genes by transduction ; Bacterial transformation involves uptake of DNA from the environment ; Transposition moves genes from one DNA to another ; Gene mobilization moves genes from the chromosome to a plasmid ; Integrons gather genes into an expression site ; Genomic islands help create pathogens ; Plasmid enzymes can be inhibited ; Perspective

7. Transmission of resistant disease : Spread of pathogens is highly evolved ; Infection control as local crisis management ; Tuberculosis is airborne ; Airborne viruses ; Digestive-tract pathogens ; Direct-contact pathogens ; Arthropod-borne pathogens ; Blood-borne infections ; Multiple-mode transmission ; Perspective

8. Surveillance : Surveillance is the first line of defense ; The denominator effect lowers surveillance accuracy ; Surveillance consortia collect and process data ; Molecular methods provide rapid pathogen identification ; Interpretation of surveillance studies ; Surveillance indicates resistance problems with gonorrhea ; Policy changes are occurring in agricultural practice ; Perspective

9. Making new antibiotics : New antibiotics are temporary solutions ; Model systems are used to speed drug discovery ; Natural products are a source of antibiotics ; High-throughput screening accelerates antibiotic discovery ; Rational drug design can identify antibiotics ; New antibiotics must have few side effects ; Antibiotic discovery faces a fundamental economic problem ; Perspective

10. Restricting antibiotic use and optimizing dosing : Antibiotic conservation: use less often when unnecessary and higher amounts when needed ; Human consumption of antibiotics correlates with resistance ; Limiting human consumption of antibiotics ; Agricultural use contributes to antibiotic consumption ; Antibiotic contamination of the environment is a byproduct of usage ; Clinical resistance and resistant mutants are not the same ; Dosing to eradicate susceptible cells may not halt emergence of resistance ; Keeping concentrations above MPC restricts mutant amplification ; Combining MPC with PK/PD targets ; Combination therapy restricts emergence of resistance ; Consideration of resistance during drug discovery ; Perspective

11. Influenza and antibiotic resistance : Seasonal influenza virus is controlled by vaccines ; Antiviral resistance has emerged among seasonal influenza virus ; Pandemic influenza can be a killer ; Avian flu H5N1 is a candidate for deadly pandemic flu ; Antibiotics may play an important role in pandemic influenza ; Antibiotic resistance occurs with avian flu H5N1 ; Bacterial pneumonia may create another resistance problem ; Perspective

12. Avoiding resistant pathogens : Consumer perspective differs from that of public health official or manufacturer ; Avoiding airborne infection is difficult ; Precautions can be taken with MRSA ; Sexually transmitted infections require renewed attention ; Arthropod-borne infections are on the move ; Contaminated food is common ; Avoid rounds of treatment interspersed with pathogen outgrowth ; Consume only with sound indications, choose optimal antibiotics ; Perspective

A course of action : Overuse ; Dosing ; Drug discovery and surveillance ; Resistance as a side effect

Appendix A: Molecules of life : The action of molecules defines life ; Proteins are molecular workers ; DNA is the repository of genetic information ; RNA plays several roles in life processes ; Carbohydrates store energy, form cell walls, and make rigid structures ; Lipids store energy and form membranes ; Cellular chemistry is organized into metabolic pathways

Appendix B: Microbial life forms : Bacteria lack nuclei and other organelles ; Fungi are eukaryotes having cell walls but not chloropasts ; Parasitic protozoa are eukaryotes lacking a cell wall ; Helminths are parasitic worms ; Viruses are inert until they infect.

Notes:

Includes bibliographical references and index.

ISBN:

9780131387737

0131387731

OCLC:

610144569