Bacteria, penicillin action

Bacterial resistance to antibiotics has been recognized since the first drugs were introduced for clinical use. The sulphonamides were introduced in 1935 and approximately 10 years later 20% of clinical isolates of Neisseria gonorrhoeae had become resistant. Similar increases in sulphonamide resistance were found in streptococci, coliforms and other bacteria. Penicillin was first used in 1941, when less than 1 % of Staphylococcus aureus strains were resistant to its action. By 1947,3 8% of hospital strains had acquired resistance and currently over 90% of Staph, aureus isolates are resistant to penicillin. Increasing resistance to antibiotics is a consequence of selective pressure, but the actual incidence of resistance varies between different bacterial species. For example, ampicillin resistance inEscherichia coli, presumably under similar selective pressure as Staph, aureus with penicillin, has remained at a level of 30-40% for mai years with a slow rate of increase. Streptococcus pyogenes, another major pathogen, has remained susceptible to penicillin since its introduction, with no reports of resistance in the scientific literature. Equally, it is well recognized that certain bacteria are unaffected by specific antibiotics. In other words, these bacteria have always been antibiotic-resistant. 

Penicillin has an interesting mode of action it prevents the cross-linking of small peptide chains in peptidoglycan, the main cell wall polymer of bacteria. Pre-existing cells are unaffected, but all newly produced cells are abnormally grown. The newborn cells are unable to maintain their wall rigidity, and they are susceptible to osmotic lysis. 

The penicillins have the same type of action against bacteria. Fbnicillins prevent bacteria from using a substance that is necessary for the maintenance of the bacteria s outer cell wall. Unable to use this substance for cell wall maintenance, the bacteria swell, rupture, assume unusual shapes, and finally die (Pig. 7-1). 

Cephalosporins affect the bacterial cell wall, making it defective and unstable This action is similar to the action of penicillin. The cephalosporins are usually bactericidal (capable of destroying bacteria). 

Mode of action Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins, which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls bacteria usually lyse from ongoing autolytic enzyme activity... 

The introduction of techniques for mutagenesis by UV irradiation or by the use of chemicals considerably extended the applications of microbial studies to nutrition (Davis, 1954-1955). Auxotrophic mutants were produced with nutrient dependencies not shown in the untreated parental strains (Beadle and Tatum, 1940). The fortuitous discovery of penicillin by Fleming and its successful use in the treatment of infections (Florey) promoted exhaustive research into its mode of action. Eventually it was established that penicillin prevented the proliferation of gram-positive bacteria by blocking the synthesis of their cell walls... 

Much information on the mechanism of action and cross-resistance of purine analogues has been obtained in bacteria, some of which are quite sensitive to certain of these compounds in vitro. There is a great deal of variation in response of the various bacteria to a particular agent and of a particular bacterium to the various cytotoxic purine analogues. Some, if not most, of these differences are probably due to differences in the anabolism of the various compounds. Despite the fact that certain purine analogues have quite a spectrum of antibacterial activity in vitro, none has been useful in the treatment of bacterial infections in vivo because their toxicity is not selective—the metabolic events whose blockade is responsible for their antibacterial activity are also blocked in mammalian cells and thus inhibition of bacterial growth can only be attained at the cost of prohibitive host toxicity. In contrast, the sulpha drugs and antibiotics such as penicillin act on metabolic events peculiar to bacteria. 

An additional disadvantage with many penicillin and cephalosporin antibiotics is that bacteria have developed resistance to the drugs by producing enzymes capable of hydrolysing the P-lactam ring these enzymes are called P-lactamases. This type of resistance still poses serious problems. Indeed, methicillin is no longer used, and antibiotic-resistant strains of the most common infective bacterium Staphylococcus aureus are commonly referred to as MRSA (methicillin-resistant Staphylococcus aureus). The action of P-lactamase enzymes resembles simple base hydrolysis of an amide. 

The discovery of penicillin and its successful application in World War II inspired the antibiotic era, and a broad search for other cures for infectious diseases. Cancer has a totally different cause, as it arises through the malignant mutation of normal cells instead of from the actions of bacterial or other outside organisms. Penicillin destroys the bacteria cell walls, but not the mammalian cell membranes. Unless a dmg could be found that could tell the difference between a normal cell and a cancer cell, then it was not clear that there would be an effective cancer drug, that is until the first report by Goodman in 1946 that nitrogen mustard, developed as a war gas, was an effective chemotherapeutic for human leukemia. 

Penicillin is an antibiotic which destroys bacteria by covalently bonding a transpeptidase enzyme which closes up the cell wall during its biosynthesis. This is its biochemical mechanism of action. See Figure 15. 

All -lactam antibiotics are bactericidal. They interfere with the synthesis of the bacterial wall by inhibiting the bacterial ftanspeptidase enzymes essential for the construction of peptidoglycan of the wall. Some -lactams may be inactivated by the -lactamases (penicillinases) produced by bacteria and, thus, the activity of both penicillins and cephalosporins can be determined by their ability to withstand the destructive action of -lactamases also produced by the organism for its optimal protection. Bacterial resistance caused by -lactamase production... 

The application of electron microscopy to the study of fractionation of disrupted bacteria, and the subsequent isolation of homogeneous preparations of wall fractions, 2 have led to an increasing interest in their chemistry. This interest has been further stimulated by the recognition of the metabolic importance of the wall, and the discovery that the lethal action of such antibiotic substances as the penicillins is principally due to inhibition of wall synthesis (compare Ref. 33). 

Both the cephalosporins and the penicillins owe their antibacterial action to their ability to block bacterial cell-wall biosynthesis. Cephalosporin C is less active than the penicillins, but is less susceptible to enzymatic destruction by /3-lactamases, which are enzymes that cleave the lactam ring. In fact, the so-called resistance of staph bacteria to penicillins is attributed to the propagation of strains that produce /3-lactamase. Numerous semisynthetic penicillins and cephalosporins have been made in the hope of finding new broad-spectrum antibiotics with high activity but with greater /3-lactam stability. Several of these are in clinical use. 

James T. Park (1922- ) and Jack L. Strominger (1925- ) demonstrate that penicillin blocks the synthesis of the peptidoglycan of bacteria. This represents the first demonstration of the action of a natural antibiotic. 

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