Have you ever been prescribed a course of antibiotics by your doctor to treat a bacterial infection? Did you wonder how they worked? It’s likely that, provided you completed the course prescribed by your doctor, the antibiotics successfully treated your infection. But what if the bacteria causing your infection couldn’t be treated with antibiotics? This situation is faced by an increasing number of people and in the UK at least 5000 a year die from infections that can’t be treated with currently available antibiotics. But what makes bacteria resistant to infection, what is a ‘superbug’ and what are scientists doing about the problem?
This free badged course, Understanding antibiotic resistance, will introduce you to the science behind the problem of antibiotic resistance. You will learn about the history of antibiotics, what they are and how they work. You will learn how antibiotic resistance develops and spreads and look at the issues surrounding antibiotic resistance. Finally, you will look at some of the cutting edge ways that scientists are trying to tackle the problem of antibiotic resistance, from promoting good hygiene to developing new antibiotics from the soil.
Although this is an introductory course to antibiotic resistance, it assumes that you have a basic understanding of DNA and proteins. If you are unfamiliar with these concepts you might want to try our free OpenLearn course What do genes do? or listen to our set of audios at DNA, RNA and protein formation.
Enrolling on the course will give you the opportunity to earn an Open University digital badge. Badges are not accredited by The Open University but they're a great way to demonstrate your interest in the subject and commitment to your career, and to provide evidence of continuing professional development.
Once you are signed in, you can manage your digital badges online from My OpenLearn. In addition, you can download and print your OpenLearn statement of participation - which also displays your Open University badge.
The Open University would really appreciate a few minutes of your time to tell us about yourself and your expectations for the course before you begin, in our optional start-of-course survey.
Once you complete the course we would also value your feedback and suggestions for future improvement, in our optional end-of-course survey. Participation
will be completely confidential and we will not pass on your details to others.
This OpenLearn science course is produced with the kind support of Dangoor Education, the educational arm of The Exilarch's Foundation.
This course is accredited by the CPD Standards Office. It can be used to provide evidence of continuing professional development and on successful completion of the course you will be awarded 24 CPD points. Evidence of your CPD achievement is provided on the free Statement of Participation awarded on completion.
Anyone wishing to provide evidence of their enrolment on this course is able to do so by sharing their Activity Record on their OpenLearn Profile, which is available before completion of the course and earning of the Statement of Participation.
Earn this free Open University digital badge if you complete this course! The badge can be displayed, shared and downloaded as a marker of your achievement. The badge is awarded for completing the course and passing the quizzes.
Course learning outcomes
After studying this course, you should be able to:
- understand what antibiotics are and how they work
- understand how bacteria become resistant to antibiotics
- appreciate the issues surrounding antibiotic resistance
- know about the challenges in developing new antibiotics
- know about alternative approaches to tackling infectious diseases.
First Published: 13/03/2018
Updated: 03/09/2019
1) Quite a number of the graphics that have been included in the MS Word version of the course are of a very low resolution.
2) Introduction:
"What do genes do?"
About this free course
http://www.open.edu/openlearn/science-maths-technology/science/biology/what-do-genes-do/content-section-0
->
https://www.open.edu/openlearn/science-maths-technology/biology/what-do-genes-do/content-section-0
3) Activity 1 Bacterial growth phases
The drag-and-drop only worked for the fourth box across 2 browsers, though another example did work later on in the course.
4) Activity 5 Proving germ theory
Broken link
https://bigpictureeducation.com/history-germ-theory
5) Figure 7a
2 graphs were combined, though 7b is then correctly separated out thereafter.
6) Week 1 quiz:
Question 5:
"kidney transplants WILL no longer be done" is the required answer, although Professor Davis had stated:
"we MAY not be able to do them"
6) The "Well done!" page at the end of the quiz has 2 "Started on"'s.
7) Week 2: Figure 1
The 'Endoplasmic reticulum' and 'Mitochondrion' have not been labelled (the 'organelles' label does not differentiate between them).
8) "Video 3 A ß-lactam antibiotic in action"
The transcript states "
"but it is NOT itself a particularly powerful antibiotic. Why?"
...and then goes on to state that the antibiotic successfully causes strings to occur due to the inability to divide, and that lysis occurs within the strings. I am not thus clear that the achievement of lysis indicates relates to "NOT itself a particularly powerful antibiotic", presumably this statement refers to the lack of another function or the degree of lysis that is delivered?
10) 4.1
'Gram stRaining' -> 'Gram staining'
11) Week 3: Introduction
Missing transcript?
12) Week 4: Figure 9
Irrespective of the reference to all but invisible "black dotted line" and "bacteriophage DNA (in red)", the diagram and associated text was not found to be nearly as clear as one such as...
https://byjus.com/neet/transduction-in-bacteria/
13) 4.2
Answer: "gene transfer via conjugation" ... "Section 2.1"
-> Section 2.2
14) Week 5: "Video 1 The antibiotic resistance crisis" transcript:
"enteroccus faecium", should this be "enteroCOccus faecium"?
"methicilin-resistant", should this be "methicilLin-resistant"?
"Staphylococcus aEreus", should this be "Staphylococcus aUreus "?
prescriptoins -> prescriptions
"60% of sore throat diagnoses" -> perhaps this is an exaggerated statement, the respective GPs must have detected a bacterial infection (e.g., "strep throat") as per the NHS guidelines. Indeed, a pharmacist would have surely been consulted prior to a GP visit, especially given the difficulties in getting a GP appointment:
https://www.nhs.uk/conditions/sore-throat/
"90% of cases are caused by viruses" -> I do not recognise this assessment from the following, indeed how could this possibly be known without viral tests, barring usage with regard to "common colds and URTI":
https://bmjopen.bmj.com/content/bmjopen/4/10/e006245.full.pdf
existant -> existent
"Few new antibiotics are being developed" -> I am not clear that this remains the case, e.g.,
The WHO does concur, if from the perspective of the lack of innovative rather than derivative agents...
https://www.who.int/publications/i/item/9789240021303
...though...
"New Antibiotics for Multidrug-Resistant Bacterial Strains: Latest Research Developments and Future Perspectives"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125338/
"In December 2017, the UK Office of National Statistics (ONS) revised life expectancy down citing ‘fears of the re-emergence of existing diseases and increases in antimicrobial resistance’."
The ONS report currently states:
"Once the coronavirus pandemic has ended and its consequences for future mortality are known, it is possible that life expectancy will return to an improving trend in the future"
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2018to2020
"40 per cent of the population die prematurely from infections we cannot treat"
The emphasis of was on "Antimicrobial resistance", rather than specifically "antibiotic resistance".
[The underlying link to the referenced report is broken across UK Government, Kinds Fund and NHS sites and so I cannot access the underlying document.]
15) 6 The antibiotic discovery void
Figure 9
The associated link appears broken...
WHO, 2017a
file://///Users/rm24883/Downloads/www.who.int/medicines/areas/rational_use/antibacterial_agents_clinical_development/en
16) 7 Inadequate diagnostics and global surveillance
Figure 10 Establishment of national reference laboratory
The associated reference link appears broken...
World Health Organization (WHO) (2017b) Global antimicrobial resistance surveillance system (GLASS) report [Online]. Available at http://www.who.int/glass/resources/publications/early-implementation-report/en/ (Accessed 28 April 2018).
Perhaps the later version is appropriate (though this uses percentages)?...
"GLASS Report: Early Implementation 2020"
"Fig. 2.3. Establishment of national reference laboratory (NRL) in GLASS enrolled
countries, territories and areas, by region and year"
https://www.who.int/publications/i/item/9789240005587
Figure 11 Number of hospital surveillance site
The associated reference link appears broken.
17) 8 Case study: Neisseria gonorrhoeae
Transcript: broken link, perhaps the intended CDC link was...
https://www.cdc.gov/std/gonorrhea
18) Quiz
Question 4: I entered both "10 in 51" and then "1 fifth", both rejected in favour of 20%, with the stated answer as "One fifth" (which is obviously slightly incorrect).
19) 2.1 mtabolism -> metabolism
20) 3 Current status of antibiotics
Figure 4
The associated source link in the Reference section is broken.
file://///Users/rm24883/Downloads/www.pewtrusts.org/en/research-and-analysis/reports/2016/05/a-scientific-roadmap-for-antibiotic-discovery
->
www.pewtrusts.org/en/research-and-analysis/reports/2016/05/a-scientific-roadmap-for-antibiotic-discovery
21) Week 6 6 Case Study
a) Transcript:
mecanisms -> mechanisms
Cefolotin -> CefAlotin
FlemMing's -> Fleming's
critism -> critiCIsm
propogation -> propAgation
Clostridium difficCile -> Clostridium difficile
pleAthora -> plethora
b) effect -> affect
22) 7.1 Transcript vs. Activity answer:
"We got a very large number of anti-microbial compounds, about 30% of soil bacteria will make anti-microbials."
vs.
"The recovery rate by this method is 50% compared with only 1% of cells from soil samples cultured on a Petri dish"
...presumably this information would have only been provided from the reference, rather than the transcript?
23) 7.2
Should "gonglophorus" be "gongYlophorus"?
24) Reference: large proportion of broken links commencing "file::"
25) 8
Question 4
Alexander FlemMing -> Alexander Fleming
Question 5
L gonglophorus -> L gongYlophorus?
26) Weeks 7 and 8 have been swapped.
27) Week 7 Video 1:
reducTing -> reducing
theyre -> they're or they are
commercial -> commercially
28) 2.3
Figure 7:
a) the "20 seconds" text does not make it clear that what duration the Society were expecting, e.g., 60s?
b) the embedded link no longer exists...
https://www.rpharms.com/handwashing
...strangely enough the following apparently current link is mapped incorrectly?
https://www.rpharms.com/development/resources/essential-guides/handwashing
c) "On average, healthcare workers adhere to recommended hand hygiene procedure only 40% of the time (WHO, 2009)"
...I am not clear whether 40% would apply post-COVID-19?
Also, from...
https://apps.who.int/iris/rest/bitstreams/1311838/retrieve
...perhaps there is an underlying issue in that healthcare workers are not always in a position within LMICs to even adhere to the requirements...
"Basic services
By 2022, 60% of all health care facilities (HCFs) worldwide and in each of the Sustainable Development Goals’ regions
have at least basic water, sanitation and hygiene (WASH) services.
By 2025, 80% have basic WASH services.
By 2030, 100% have basic WASH services.
Higher service levels
By 2022, higher levels of service are defined and monitored in countries where universal basic
WASH services have been achieved already.
By 2030, higher levels of WASH services are achieved universally in 80% of these countries"
29) 3 Case study
a)
...handwashing has an annual WHO campaign, is the 2012 coverage still relevant?
[The BBC article references the BMJ evaluation that ran between: "1 July 2004 to 30 June 2008".]
The "Clean Your Hands campaign" URL site www.npsa.nhs.uk is offline.
b)
Activity 4 question 3
Whilst ICUa does indeed provide evidence of a correlation I am not clear that ICUb should have shown an increase of infections if all other test conditions remained the same?
30) 4.3.2 Detecting the pathogen
Doret -> DorTet
31) 4.3.4 The Nordmann/Dortet/Poirel test
Figure 13 - the text refers to a transition to 'orange', whilst the description (apparently correctly) states 'yellow', e.g.
https://journals.asm.org/cms/10.1128/JCM.00859-12/asset/36a24725-1e03-4a4b-b32c-d1dcedb355f7/assets/graphic/zjm9990919100001.jpeg
32) 5 quiz
Question 1: requests the selection of 4 strategies from the O'Neill report:
https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf
Effectively:
1. A massive global public awareness campaign ("Public awareness")
3. Reduce unnecessary use of antimicrobials in agriculture and their dissemination into the environment ("Antibiotics in agriculture and the environment")
5. Promote new, rapid diagnostics to cut unnecessary use of antibiotics ("Rapid diagnostics")
6. Promote development and use of vaccines and alternatives ("Vaccines and alternatives")
...however, the following is also present in the options ("Surveillance")...
4. Improve global surveillance of drug resistance and antimicrobial consumption in humans and animals ("Surveillance")
33) Week 8 2.1 Activity 3
"Martha Cokie" -> "Martha CLokie"?
34) 2.2 Activity 4 Question "4. Does the turbidity of the sample without lysin change during the experiment?"
Answer "No. The turbidity of the untreated sample does not change."
...the provided answer does not appear to be quite correct, since there is a noticeable, if only slight decline in turbidity.
35) 3
"antibiotics are just one weapon in bacteria’s defence arsenal"
...should the weapon be antibiotic resistance, rather than antibiotics themselves?
36) Quiz
a) "Bdellovibrio bacteriovorOus" or "Bdellovibrio bacteriovorus"?
b) Question 4: is it "Vibro" or "Vibrio"?
c) Question 12: "Guiseppe Brotzu" -> "Giuseppe Brotzu"?