1. Introduction
2. Hospital-acquired infections Pennsylvania
3. Hospital-acquired infections USA
4. Antibiotic resistance
5. Resistance in the intensive care unit
6. Playing catch-up ball
7. Combating antibiotic resistance
8. How evolution works
9. Natural selcetion in a nutshell
10. Natural selcetion: bacteria
11. Transformational vs. variational evolution
12. Transformational and variational processes
13. Variational evolution: bacteria
14. Mutation
15. Macrolide antibiotics block protein synthesis
16. Single point mutation in green binding region
17. Mutation perspective
18. More complex mechanisms
19. Natural ecology of antibiotics, Fleming
20. Antibiotic producers resistant to own product
21. Lateral gene transfer
22. Lateral gene transfer to Enterococcus
23. What is the structure of selection?
24. Most resistant strains are commensals
25. Extremely high rate of drug use
26. Hospital staff act as disease vectors
27. High rate of patient turnover
28. Resistance in the community
29. Agricultural use
30. Farm to populace transfer
31. How can we intervene?
32. A model of a hospital
33. Translate model into equations
34. Studying the dynamics using numerical solution
35. Odds ratios can be misleading
36. Antibiotic cycling
37. Antibiotic cycling based on ecological principles
38. Cycling in a neonatal ICU
39. Clinical consequences
40. Modeling the efficacy of cycling
41. Total resistant infections
42. Total resistant infections by cycle length
43. Resistance increases with cycle period
44. Why doesn't cycling work? Scenario 1
45. Why doesn't cycling work? Scenario 2
46. Mixing creates a more heterogeneous environment
47. US infectious disease mortality in the 20th century
48. Acknowledgements
49. END
