Over the past century, access to effective antibiotics has saved millions of lives, and enabled major medical and surgical breakthroughs. The misuse and overuse of antibiotics, however, has contributed to a phenomenon known as antibiotic resistance.

“Antibiotic resistance is rising to dangerously high levels in all parts of the world, including Canada. It threatens our ability to treat common infectious diseases, resulting in prolonged illness, disability and death,” says Christine Peragine, Pharmacist and Clinical Research Fellow in Antimicrobial Stewardship and Infectious Diseases at Sunnybrook.

Antibiotic resistance is increasing the overall cost of health care, by contributing to lengthier hospital stays for patients and more intensive care unit admissions.

It’s also impacting many of the medical advancements we take for granted, like organ transplants, chemotherapy for cancer treatment, diabetes management and major surgeries. To be successful, these conditions and procedures require effective antibiotics, because they have a high risk of infection. If current trends continue, it will become more difficult to achieve good outcomes for patients.

Here’s what you need to know about antibiotic resistance:

What is antibiotic resistance?

Resistance develops when potentially harmful bacteria change in a way that makes them immune to antibiotics. Resistant bacteria survive, multiply and spread, causing more harm.

How does antibiotic resistance happen?

Drug resistance is a natural evolutionary phenomenon. When people take antibiotics for a bacterial infection, the antibiotic kills off the “weaker” organisms. However, there may be some organisms that are resistant to the antibiotic, so they aren’t killed off. This allows them to multiply and spread, meaning that the next generation of the bacterial infection will no longer respond to (or be killed off by) that antibiotic.

Why is antibiotic resistance a problem?

Antibiotic resistance is a problem because standard treatments become ineffective. An antibiotic that used to work on certain infections no longer does. People are unable to recover from infections, and may then spread those infections to others.

In Canada, the prevalence of resistant- and multi-drug resistant bacteria (also known as ‘superbugs’) is increasing. We are one step away from creating a superbug resistant to all commercially available antibiotics that would be capable of defeating every antibiotic in the medicine cabinet.

What can you do to reduce antibiotic resistance?

If you’ve been prescribed antibiotics, there are a few easy steps you can take to prevent antibiotic resistance:

1. Only take antibiotics in the way they have been prescribed to you

2. Don’t ask for antibiotics to treat viral infections like colds and the flu. Antibiotics have no effect on viruses, and won’t speed up your recovery from viral infections

3. Clean your hands often! It is possible to pass on antibiotic resistant bacteria to others, so prevent the spread of germs by practicing good hygiene

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But, did you know that bacteria and agar plates can be used to create art, too?

In the hospital’s Microbiology laboratory, samples taken from patient specimens are grown on agar plates, producing unique colonies and colours. Those culture plates are used to determine the kind of bacteria causing a patient’s infections, helping the care team select the most appropriate treatment.

Often, those colonies and colours can end up resembling art rather than a lab test. In fact, “agar art” is its own art form: for the past three years, the American Society for Microbiology (ASM) has held an agar art competition, accepting submissions from around the world.

This year, Sunnybrook laboratory technologist Linh Ngo entered that competition after finding inspiration in the Disney film Finding Nemo. “I was amazed at the similarities between the coral reef and the bacteria I work with in the lab, and I wanted to recreate that on agar plates,” she says.

Linh made the agar art in the six steps described below:

Start planning early

Linh says she first had the idea to create agar art of a coral reef last year, but missed the deadline. In November 2016, she started coming up with a concept for her submission. She also loves to draw, so she started sketching ideas. For example, Linh found inspiration for how to draw the brain coral (at the bottom of the image) in an online photo. Once she created a drawing she was satisfied, she was ready to start sketching it onto the actual agar plates.

Keep an eye out for colourful bacteria

Now that she had an idea of how she wanted the finished product to look, Linh and several of her colleagues started keeping an eye out for organisms that produced the vibrant colours she was looking for. For example, “some strains of Serratia marcescens produce a pigment called prodigiosin, which give the colonies a dark red/purple appearance, so when I finally came across a strain with that colour, I froze it for a few months,” Linh says.

Paint with a steady hand

After finding the organisms that would produce the colours she wanted, Linh used the tip of a pipette to “paint” with the bacteria on a series of five agar plates. “I had to be careful not to have any overlap of the different bacteria because if there was, it would alter the image. There was a lot of trial and error,” she says. When the original drawing she wanted to use as a guide didn’t work, she ended up painting freehand.

Be ready to experiment…

Finding the right organisms to work with was a time-consuming process. “Every time I used four to five types of bacteria on the same agar plate, the bacteria would grow into each other, and the colours and image would be ruined. So I had to figure out how to work with just two bacteria per plate,” Linh says. The colours she ended up using were derived from Serratia marcescens (purple), Staphylococcus aureus (pink, and a little green), Candida tropicalis (white) and Klebsiella pneumonia (grey, mucoid).

…and keep experimenting!

For the next step in the process, which involved putting the agar plates in an incubator, Linh also had to experiment with the incubation times. This is because different organisms are capable of lowering the pH in the medium and can cause a change in colour, especially when multiple organisms are present on the same plate. “By the time some bacteria produced the colour I was looking for, the colour of the other bacteria would have changed. It took several tries to get the timing right,” she says.

Don’t give up

In all, Linh estimates that she made about eight revisions to her original drawing, and went through dozens of test plates before perfecting her submission. Looking back, Linh says she should have given herself more time to prepare her agar art. “I had two months to make the agar art, but a few more weeks definitely would’ve been helpful. I almost ran out of time!”

Linh named her stunning image of a coral reef “Finding pneumo” (named after the movie that inspired her and one of the bacteria she used, Klebsiella pneumonia). The result far exceeded her expectations: she won second place in the ASM competition, beating out 264 submissions from 36 countries. Congratulations, Linh!

The post How it’s made: agar art appeared first on Your Health Matters.

Today is “Save Lives, Clean Your Hands” Day, and what better way to recognize it than with some hand washing myth busting? We talked to Dr. Mary Vearncombe, Medical Director, Infection Prevention and Control at Sunnybrook, who set the record straight on five hand washing myths:

1. What’s the best water temperature for washing my hands- cold, warm or hot?

You’re right if you guessed… warm! Surprised? “Using very hot or very cold water makes it less likely that you’ll wash your hands for long enough,” says Dr. Vearncombe. Plus, warm water is nicer to the sensitive skin on our hands. Remember, the action of rubbing soap on your hands is what lifts dirt and bacteria off your hands, which is then rinsed away by the water. You’re not going to ‘kill’ any bacteria by using scalding hot water to wash your hands!

2. How long do I need to wash my hands in order for them to be properly washed?

The minimum amount of time is 15 seconds. And that means 15 full seconds of rubbing soap in your hands (the time spent turning the taps on and off, and drying your hands, doesn’t count). One trick to make sure you’ve washed your hands for long enough? “It also takes 15 seconds to sing ‘Twinkle, Twinkle, Little Star’ in your head, so if you sing that to yourself while washing your hands, they should be properly cleaned by the end,” says Dr. Vearncombe.

3. What’s the best way to dry my hands?

Using a hand dryer that blows hot air is a no-no. “The action of blowing from the hand dryers stirs up all kinds of bacteria from the floor, and other parts of the room,” says Dr. Vearncombe. Instead, paper towels or towels are the best methods for drying your hands. Use them to blot your hands dry, rather than rubbing them, so you aren’t being as hard on your hands.

4. Are hand sanitizers more effective than soap and water?

Yes, alcohol-based hand sanitizer is as good as, if not better than, soap and water (as long as your hands aren’t visibly soiled). There are a number of reasons that hand sanitizer is the better choice, according to Dr. Vearncombe:

1. The alcohol in hand sanitizer kills bacteria, while soap and water only removes it
2. Hand sanitizers have moisturizers in them, which keeps the skin on your hands in better condition (especially if you work in health care and have to wash your hands often)
3. It’s faster. You still need to rub the sanitizer into your hands for 15 seconds, but that’s all you need to do- no adjusting the water temperature, drying your hands, etc.
4. Hand sanitizer can be where you need it, when you need it. It’s not always possible to have running water and soap nearby, but it is possible to have hand sanitizer within arm’s reach.

5. Do alcohol hand sanitizers cause bacterial mutation and resistance?

No, they do not. “This has been researched multiple times, but no evidence of bacterial mutation or resistance from alcohol hand sanitizer has ever been demonstrated,” says Dr. Vearncombe.

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