The following videos provide helpful background and context for all PARE modules. A pencil and paper case study (described below) provides students with the context of antibiotic resistance.

Understanding Antibiotics and Antibiotic Resistance

  • Basic overview of bacterial targets of antimicrobial compounds 
  • Antibiotics as providing selective pressure for natural selection  
  • Mechanisms of resistance (e.g. efflux, pumps, inactivation of the antibiotic, etc.)

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Antimicrobial Resistant Bacteria Spread: Through the Environment and Human Exposure

  • Introduction of One Health concept 
  • Bacterial/organismal spread (through water, food, soil, animals, etc.) 
  • Molecular spread (transmission of resistance genes from bacterium to bacterium) 

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Why Is Antimicrobial Resistance a Public Health Issue?

  • Explanation of how antibiotic resistance in the environment is linked to human health 
  • Conditions in low income countries that contribute to resistance 
  • Conditions in high income countries that contribute to resistance 
  • Interview with Dr. Maya Nadimpalli (environmental resistance in low income countries)

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Spotlight on Antibiotic Resistance Genes of Clinical Significance

  • Why the genes studied in PARE are of interest to clinicians (blaNDM-1, blaCTX-M-15, tetA, tetO, tetM, armA, and mcr-1 
  • What antibiotic is inhibited by each gene product 
  • Mechanism of resistance for each 

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Tools of Bioinformatics

  • Molecular vs. culture-based approaches to environmental surveillance 
  • PCR-based vs. sequenced based molecular approaches 
  • The advantage of long-read, Nanopore sequencing technology for our work
  • Interview with Dr. Amy Pickering 

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Data Analysis Case Study

Analysis of data to study emergence of TcR on farms

In this case study, students synthesize information from different studies to arrive at a model to explain how human antibiotic resistant infections may be linked to antibiotic use on farms. Students are introduced development of antibiotic resistance within a population of bacteria through natural selection and the “One Health” concept that recognizes how the health of people is connected to our environment and the health of animals. Importantly, the evidence does not prove causation, but conveys to students how an accumulation of evidence compels us to adopt a particular model. The concept of selective pressure is reviewed.

Module Organization


Teacher lesson plan

PowerPoint teaching slides

Student worksheet with answers

Student worksheet (no answers)

Student handout (full story for instructors)

Student handout (Part 1)

Student handout (Part 2)

All files (.zip)

External Links

This case study is also part of the Great Diseases Infectious Disease curriculum.