HES032 (Microbiology and Parasitology)

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session # 7

LESSON TITLE: Controlling Microbial Growth in Vivo Materials:

LEARNING OUTCOMES: Book, pen, notebook, and paper

At the end of the lesson, the nursing student can:

1. Identify the characteristics of an ideal antimicrobial agent;
2. Compare and contrast chemotherapeutic agents,
antimicrobial agents, and antibiotics as to their intended
purpose;
3. State the five most common mechanisms of action of
antimicrobial agents;
4. Differentiate between bactericidal and bacteriostatic agents;
5. State the difference between narrow-spectrum and broad-
spectrum antimicrobial agents; and,
6. Describe what is multi-drug resistance.
Reference:
Engelkirk, P., & Engelkirk, J. (2015). Burton's
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Microbiology for the Health and Sciences. 10
ed., Philadelphia: Lipincott Williams & Wilkins
Tille, P. (2014). Bailey and Scott’s Diagnostic
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Microbiology. 13 ed., Missouri: Elsevier Inc.

Daily Productivity Tip:

Know your distractions and avoid them as possible today. Study with your books to stay away from
gadgets like mobile phones and computer.

LESSON PREVIEW / REVIEW (5 minutes)

Let’s recall your previous knowledge! Fill in the blanks below.

STERILIZATION DISINFECTION

The elimination of most or all pathogens (except bacterial

Kills all microorganisms including (spores and viruses) spores) from nonliving objects.

Example: Example:

Dry Heat Sterilization Bleach (1:10 Hypochlorite)

Great! Now let’s begin.

MAIN LESSON (50 minutes)

Last session, you have learned information regarding the control of microbial growth in vitro. Another aspect of controlling
the growth of microorganisms involves the use of drugs to treat infectious diseases; in other words, using drugs to control
the growth of pathogens in vivo.

Chemotherapeutic agents are any drugs used to treat any condition or disease. The chemotherapeutic agents used to
treat infectious diseases are collectively referred to as antimicrobial agents. Thus, an antimicrobial agent is any chemical
(drug) used to treat an infectious disease, either by inhibiting or killing pathogens in vivo.

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 Antibacterial agents
Some antimicrobial agents are antibiotics. An antibiotic is Antifungal agents
a substance produced by a microorganism that is effective Antiprotozoal agents
in killing or inhibiting the growth of other microorganisms. Antiviral agents

Semisynthetic antibiotics are antibiotics that have been chemically modified to kill a wider variety of pathogens or
reduce side effects

Characteristics of an Ideal Antimicrobial Agent: Did you know?

1. Kill or inhibit the growth of pathogens Alexander Fleming accidentally

2. Cause no damage to the host discovered the first antibiotic
3. Cause no allergic reaction in the host when he noticed that growth of
4. Be stable when stored in solid or liquid form contaminant Penicillium notatum
5. Remain in specific tissues in the body long enough to be effective mould colonies on his culture
6. Kill the pathogens before they mutate and become resistant to it. plates was inhibting the growth
Mechanisms of Action of Antimicrobial Agent:
of Staphylococcus bacteria.He
gave the name “penicillin” to the
1. Inhibition of cell wall synthesis inhibitory substance being
2. Damage to cell membranes produced by the mould.
3. Inhibition of nucleic acid synthesis (either DNA or RNA synthesis)
4. Inhibition of protein synthesis
5. Inhibition of enzyme activity

Bacteriostatic drugs inhibit growth of bacteria, whereas Bactericidal agents kill bacteria.

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 Major Categories of Antibacterial Agent:

1. Penicillin Narrow Spectrum Antibiotics –

2. Cephalosporins Kills either Gram-negative or
3. Carbapenams Gram-positive bactera (Ex.
4. Aminoglycosides Vancomycin, Colistin and Nalidixic
5. Glycopeptides acid)
6. Macrolides Broad Spectrum Antibiotics –
7. Tetracyclines Kills both Gram-negative or
8. Fluoroquinolones Gram-positive bactera (Ex.
Ampicillin, Chloramphenicol,
Tetracycline)

β-lactam drug has a specific group or type of

bacteria against which it is considered to have
the greatest activity. The type of bacteria against
which a particular antimicrobial agent does and
does not have activity is referred to as that
drug’s spectrum of activity.

The β-lactam binds the enzyme, inhibiting

transpeptidation and cell wall synthesis. pacity to
produce and maintain their peptidoglycan layer.
The enzymes essential for this function are
anchored in the cell membrane and are referred
to as penicillin-binding proteins (PBPs).

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Multidrug Therapy

a single antimicrobial agent is not sufficient to destroy all the pathogens that develop during the course of a disease; thus,
two or more drugs may be used simultaneously to kill all the pathogens and to prevent resistant mutant pathogens from
emerging. Example: multidrug-resistant strains of Mycobaterium tuberculosis.

Remember these TB drugs:

Rifampin Isoniazid Pyrazinamide Ethambutol

How bacteria become resistant to drugs?

Some bacteria are naturally resistant to a particular antimicrobial agent because they lack the specific target site for that
drug (e.g., mycoplasmas have no cell walls and are, therefore, resistant to any drugs that interfere with cell wall synthesis).

Intrinsic resistance - resistance to a particular drug that is the result of some naturally occuring property of a bacterial
cell.

Acquired resistance – when bacteria become resistant to a drug that they were once susceptible to.

In addition, Bacteria can acquire resistance to antimicrobial agents as a result of chromosomal mutation or the acquisition
of new genes by transduction, transformation, and, most commonly, conjugation.

TAKE A QUICK BREAK. BREATHE SLOWLY. WRITE FREELY.

“Superbug” often refers to
multidrug-resistant bacteria and
other types of microbes (e.g.,
viruses, fungi, protozoa) that have
also become multidrug-resistant.

Think and Learn: What can you say about this, “All antibiotics are
antimicrobial agents but not all antimicrobial agents are antibiotics”?

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 30 minutes for this activity (20 points):

1. Which of the following is least likely to be taken into consideration when deciding which antibiotic to prescribe for a
patient?
a. patient’s age
b. patient’s underlying medical conditions
c. patient’s weight
d. other medications that the patient is taking
ANSWER: C
RATIO: All of the other factors are highly considered when administering antibiotic except for the patient's age.

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2. This drug inhibit production of folic acid (a vitamin) in those bacteria that require ρ-aminobenzoic acid (PABA) to
synthesize folic acid.
a. penicillin
b. sulfonamide
c. cephalosporin
d. aminoglycosides
ANSWER: B
RATIO: In bacteria, PABA is used in the synthesis of the vitamin folic acid. The drug sulfanilamide is effective in
treating some bacterial diseases because it prevents the bacterial utilization of PABA in the synthesis of folic
acid.
3. Which of the following is not a common mechanism by which antimicrobial agents kill or inhibit the growth of bacteria?
a. damage to cell membranes
b. destruction of capsules
c. inhibition of cell wall synthesis
d. inhibition of protein synthesis
ANSWER: B
RATIO: Destruction of capsules is not a common action of antimicrobial agent to kill bacteria.

4. Multidrug therapy is always used when a patient is diagnosed as having:

a. an infection caused by MRSA.
b. diphtheria.
c. strep throat.
d. tuberculosis.
ANSWER: D
RATIO: When a patient is having tuberculosis, one medication will not be sufficient to kill all the causing bacteria,
therefore, multidrug therapy may do the work.

5. Which of the following terms or names has nothing to do with the use of two drugs simultaneously?
a. antagonism
b. Salvarsan
c. Septra
d. synergism
ANSWER: C
RATIO: Among the given choices, salvarsan has nothing to do with the use of two drugs simultaneously.

6. Which of the following is not a common mechanism by which antifungal agents work?
a. by binding with cell membrane sterols
b. by blocking nucleic acid synthesis
c. by dissolving hyphae
d. by interfering with sterol synthesis
ANSWER: C
RATIO: Hyphae dissolution is not a common way by which antifungal drugs function.

7. Which of the following scientists discovered penicillin?

a. Alexander Fleming
b. Paul Ehrlich
c. Selman Waksman
d. Sir Howard Walter Florey
ANSWER: A
RATIO: Penicillin was discovered in 1928 by Scottish scientist Alexander Fleming as a crude extract of P. rubens

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8. Which of the following scientists is considered to be the “Father of Chemotherapy?”
a. Alexander Fleming
b. Paul Ehrlich
c. Selman Waksman
d. Sir Howard Walter Florey
ANSWER: B
RATIO: Paul Ehrlich was awarded a Nobel prize in Physiology or Medicine in 1908 for some of his pioneering work
and is considered the ‘father of modern Immunology and Chemotherapy’

9. All the following antimicrobial agents work by inhibiting cell wall synthesis except:
a. cephalosporins.
b. chloramphenicol.
c. penicillin.
d. vancomycin
ANSWER: B
RATIO: All of the given choices work by inhibiting the cell wall synthesis except for chloramphenicol where works by
interfering with the bacteria's production of the proteins needed to grow and multiply

10. All the following antimicrobial agents work by inhibiting protein synthesis except:
a. chloramphenicol.
b. erythromycin.
c. imipenem.
a. tetracycline

d. ANSWER: C
RATIO: Imipenem is in a class of medications called carbapenem antibiotics. It works by killing bacteria.

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

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LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help
you track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

Exit Ticket: One-minute paper

a. How do you feel about today’s session? __ Happy __ Satisfied __ Sad __ Confused

b. What question(s) do you have as we end this session? NONE

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Reading Assignment: For the next session, read chapter 12 of Burton’s Microbiology for the Health Siences, 10 ed.

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