national center for case study teaching in science antibiotic resistance answers

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The Fight Against Bacteria

Sammy’s Struggle with an STD

By Jessie M. Garcia

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This case study tells the story of “Sammy,” a freshman undergraduate student who is experiencing her first weeks on campus, in order to teach the importance of proper antibiotic usage, STD (sexually transmitted disease) screening, and prevention strategies. Sammy ends up contracting chlamydia and is prescribed a one-week treatment of the antibiotic doxycycline. However, once Sammy starts to feel better, she stops her treatment. This allows the chlamydia bacteria to proliferate, some of which are resistant to the antibiotics. The first part of the case study ties in topics such as antibiotic resistance, the theory of natural selection, and the detrimental consequences of improper antibiotic usage. The second part is optional and delves into STD screening and prevention strategies defined by the Centers for Disease Control and Prevention (CDC). Students access NCHHSTP AtlasPlus, an online interactive tool hosted by the CDC, to investigate trends and infection rates of chlamydia in their state. This case study is appropriate for advanced senior-level high school students or freshman undergraduate students with a background in general biology.

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• Understand the concept of antibiotic resistance.
• Be able to interpret and describe the growth cycle of bacteria, before and after antibiotic treatment.
• Identify a missense mutation in a DNA sequence.
• Understand the importance of proper antibiotic usage.
• Understand why early intervention is important for medicine and management of STDs.
• Describe five strategies to prevent and control STDs.

Antibiotic resistance; antimicrobial resistance; STD; STI; bacteria; chlamydia; sexually transmitted disease; infection; evolution; natural selection;

Subject Headings

EDUCATIONAL LEVEL

High school, Undergraduate lower division

TOPICAL AREAS

TYPE/METHODS

Teaching Notes & Answer Key

Teaching notes.

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Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

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• High School

Antibiotic Resistance Case Study Read and work through the case study. National Center for Case Study Teaching in Science. "Antibiotic Resistance: Can we ever win?" by Maureen Leonard Part I – Measuring Resistance Katelyn was excited to start her summer job in her microbiology professor's research laboratory. She had enjoyed Dr. Johnson's class, and when she saw the flyer recruiting undergraduate lab assistants for the summer, she had jumped at the opportunity. She was looking forward to making new discoveries in the lab. On her first day, she was supposed to meet with Dr. Johnson to talk about what she would be doing. She knew the lab focused on antibiotic resistance in Staphylococcus aureus, especially MRSA (methicillin-resistant S. aureus ). She still remembered the scare her family had last year when her little brother, Jimmy, got so sick. He'd been playing in the neighborhood playground and cut his lip when he fell off the jungle gym. Of course he always had cuts and scrapes—he was a fi ve-year-old boy! This time though his lip swelled up and he developed a fever. When her mother took him to the doctor, the pediatrician said the cut was infected and had prescribed cephalothin, an antibiotic related to penicillin, and recommended flushing the cut regularly to help clear up the infection. Two days later, Jimmy was in the hospital with a fever of 103°F, coughing up blood and having trouble breathing. The emergency room doctors told the family that Jimmy had developed pneumonia. They started him on IV antibiotics, including ceftriaxone and nafcillin, both also relatives of penicillin. It was lucky for Jimmy that one of the doctors decided to check for MRSA, because that's what it was! MRSA is resistant to most of the penicillin derivatives. Most cases of MRSA are hospital-acquired from patients who are already susceptible to infection, but the ER doctor explained that community-acquired MRSA was becoming more common. The doctor then switched the treatment to vancomycin, a completely different kind of antibiotic, and Jimmy got better quickly after that. Katelyn had dropped Jimmy off at swimming lessons just before coming to work at the lab. As she waited in the hallway for Dr. Johnson, she hoped that she would be at least a small part of helping other people like Jimmy deal with these scary resistant microbes. She was surprised when the professor burst out of the lab, almost running into her. "Hi Katelyn, I'm really sorry but I have to run to a meeting right now—they sprung it on me last minute. There are a bunch of plates in the incubator right now that need their zones of inhibition measured. I'll be back in a few hours," Dr. Johnson said as he rushed down the hallway with a stack of folders. Katelyn dug out her old lab notebook to look up what she was supposed to do. She found the lab where she and her fellow students had examined the antimicrobial properties of antibiotics using the Kirby-Bauer disk diffusion technique. Looking at the plates Dr. Johnson had told her about, she saw they had all been "lawned," or completely coated with microbes to make a thick hazy layer over the agar surface. She could also see paper disks with letters on them, and some of the disks had clear zones around them where the microbe had been inhibited (Fig. 1). Her notebook explained how to measure the zone of inhibition around the disks (Fig. 2). student submitted image, transcription available belowstudent submitted image, transcription available below 1.) What do you think the experimental question is? 2.) What hypotheses can you come up with to answer the experimental question?

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Final answer:

The experimental question in this case study is: How effective are different antibiotics in inhibiting the growth of Staphylococcus aureus, including MRSA? The hypotheses to answer this question are: 1) Different antibiotics will have varying degrees of effectiveness in inhibiting the growth of Staphylococcus aureus, with MRSA showing resistance to most penicillin derivatives, and 2) Vancomycin, a different kind of antibiotic, will be more effective in inhibiting the growth of MRSA compared to penicillin derivatives.

Explanation:

The experimental question in this case study is not explicitly stated, but it can be inferred as:

How effective are different antibiotics in inhibiting the growth of Staphylococcus aureus, including MRSA ?

Based on the information provided, the hypotheses that can be formulated to answer the experimental question are:

• Hypothesis 1: Different antibiotics will have varying degrees of effectiveness in inhibiting the growth of Staphylococcus aureus, with MRSA showing resistance to most penicillin derivatives.
• Hypothesis 2: Vancomycin, a different kind of antibiotic, will be more effective in inhibiting the growth of MRSA compared to penicillin derivatives.

Learn more about experimental question and hypotheses related to antibiotic resistance in staphylococcus aureus. here:

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The experimental question is focused on measuring the zone of inhibition of different antibiotics on Staphylococcus aureus. Some hypotheses to answer the question are: there will be a significant difference in the size of the zone of inhibition among different antibiotics, antibiotics related to penicillin will have a smaller zone than vancomycin, and the zone will be larger for MRSA compared to MSSA.

The experimental question in this case study is not explicitly stated, but based on the information provided, we can infer that the question is focused on measuring the zone of inhibition of different antibiotics on Staphylococcus aureus.

Some hypotheses that can be formulated to answer the experimental question are:

• There will be a significant difference in the size of the zone of inhibition among the different antibiotics tested.
• Antibiotics related to penicillin will have a smaller zone of inhibition compared to vancomycin, which is a different kind of antibiotic.
• The zone of inhibition will be larger for methicillin-resistant S. aureus (MRSA) compared to methicillin-susceptible S. aureus (MSSA).

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