Rise of the Superbugs

TEACHER GUIDE

For half a century, antibiotics have given us a powerful way to treat infections that once were

life threatening. Yet, the growing number of antibiotic-resistant bacteria is putting this golden

era of medicine at risk. Now, we ﬁ nd ourselves in a race to prevent bacterial infections from

once again becoming one of humanity’s major killers.

Rise of the Superbugs

ACTIVITY AT A GLANCE

PURPOSE: To show how populations of bacteria

become resistant to antibiotics via the process

of natural selection and human misuse

OVERVIEW: Students follow the story of a

teen who develops an infection related to injuries

resulting from a bicycle accident. They analyze

graphs of cultures that doctors grew to track how

the infecting bacteria responded to antibiotics.

The graphs show that, over six days, the teen’s

population of bacteria becomes increasingly

resistant to two antibiotics. Students deduce that

the teen picked up some bacteria resistant to the

initial dose of antibiotics at the hospital. Those

bacteria then grew to dangerous levels. Students

conclude the activity by making a recommendation

regarding the next course of action.

LEVEL: Grades 9–12

TIME: 2 class periods

CORE CONCEPTS

•

Bacteria can be resistant to different kinds

of antibiotics.

• After being exposed to antibiotics, a population

of bacteria can become resistant to antibiotics

through the process of natural selection.

MATERIALS

•

Student sheet for each student

• Student sheet for Going Further activity (optional)

STANDARDS CONNECTION

Life Science

• 5–8: Reproduction and Heredity; Populations

and Ecosystems; Diversity and Adaptations

of Organisms

• 9–12: The Cell; Biological Evolution; and Matter,

Energy, and Organization in Living Systems

Health

• Standard 1: Comprehend concepts related

to health promotion and disease prevention.

• Standard 3: Practice health-enhancing behaviors

and reduce health risks.

• Standard 4: Analyze the inﬂ uence of culture,

technology, and other factors on health.

PROGRAM CONNECTION

Before the advent of antibiotics, bacterial infections could be life threatening. With the

discovery of antibiotics and the development of methods to mass-produce them, many

bacterial infections became easily treatable. But the bacteria have fought back. Any population

of organisms faced with a challenge to its survival has the potential to adapt via the process of

natural selection. For example, many insects have become resistant to insecticides and many

continued

TEACHER GUIDE

BEFORE WATCHING

• What is an antibiotic? What types of diseases

do they treat? Have you ever taken antibiotics? If

so, which kind(s)?

An antibiotic is a substance that controls the growth

of bacteria, either by killing them or inhibiting their

ability to reproduce. They are used to treat bacterial

infections, such as bacterial pneumonia, staph, and ear

infections. Examples include bacitracin, cephradine,

ciproﬂ oxacin (cipro), erythromycin, nystatin,

penicillin, and tetracycline.

• What do you think it means for a disease to be

resistant to a drug, such as an antibiotic? List

some issues related to treating a disease caused

by bacteria that are resistant to antibiotics.

Issues include: Not being able to control the infection,

putting the patient at serious risk; giving resistant

bacteria the opportunity to pass their resistance on

to other bacteria in the patient’s body; and an increased

risk of spreading the resistant bacteria to others in the

community.

AFTER WATCHING

• How is the emergence of antibiotic-resistant

bacteria an example of natural selection?

This question is explained in the answer to student

sheet question 11.

• Discuss what our lives would be like if most

bacteria adapted to the presence of antibiotics and

became resistant to them.

• Ask why antibiotic-resistant bacteria are such

a big problem in hospitals.

Hospitals treat sick people. As a result, they have

a larger number and diversity of disease-causing

microorganisms than is typically found in the

community. Furthermore, hospitals regularly use

medicines that kill disease-causing microorganisms,

creating an environment that favors microbes resistant

to these medicines. Finally, while the skin is an

excellent barrier against microorganisms, it is often

broken in hospitals—many patients arrive with open

wounds, and it is often punctured by needles and cut

with medical implements as well.

• Discuss how human behavior helps resistant

strains of bacteria arise. Ask why the overuse and

misuse of antibiotics is risky, both for those who

overuse or misuse them and for the overall health

of the public.

weeds have become resistant to herbicides. Similarly, some types of bacteria have responded

to the increasing presence of antibiotics by becoming resistant to them. So bacterial infections

may once again become life threatening.

This program follows the case of an American teenager and his doctor battling against an

antibiotic-resistant bacterial infection. Antibiotic resistance is then placed in a public health

context by examining the large-scale ﬁ ght against antibiotic-resistant tuberculosis infection

in Peru. The program points out that even when treatments are available, the delivery of those

treatments presents yet another set of challenges.

This activity examines one process by which strains of antibiotic-resistant bacteria can arise.

PROGRAM CONNECTION (continued)

PROCEDURE

1. Distribute the student sheet. Have students

read about the teen with the antibiotic-resistant

infection on the student sheet and answer

question 1.

It is helpful to assign this reading prior to class and to

review the concept of natural selection.

2. Have students work individually, in pairs, in

teams, or as a class to complete the student sheet.

Students take on the role of epidemiologists, identifying

antibiotic-resistant infections and recommending the

best course of treatment. To do this, they analyze

continued

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TEACHER GUIDE

independent. Some genes that confer antibiotic

resistance are carried in plasmids. Bacteria in a

population can exchange plasmids. This exchange

can transfer antibiotic-resistant genes between

bacteria, including bacteria of different species.

Before beginning this Going Further activity, you may

want to review plasmids, restriction enzymes, and

gel electrophoresis.

GOING FURTHER

Have students analyze the provided electrophoresis

gel photograph and identify the points at which

Eva’s bacteria acquired antibiotic-resistant genes. The

handout entitled Identify the Genes Carrying Antibiotic

Resistance steps students through this analysis.

Bacteria have both chromosomal DNA and plasmids,

which are circular units of DNA. Plasmids can become

incorporated into the chromosomal DNA or remain

• Wrote thoughtful responses to student sheet

questions and supported conclusions with data

presented in the graphs.

• Explained how the development of antibiotic

resistant-bacteria illustrates the process of natural

selection.

• Correctly recommended that doctors treat Eva

with antibiotic B.

• Demonstrated an understanding of how our

use of antibiotics promotes the development of

antibiotic resistant-bacteria and that these bacteria

pose a serious threat to global health.

ASSESSMENT

Students’ responses to the questions on the student

sheet should incorporate the points discussed in the

answers (included in this section). In addition, consider

the following when assessing student work:

• Supported the team by contributing to the

discussion, listening to others’ ideas, working

together to analyze the graphs, and helping the

team develop a consensus.

• Understood how data are presented on a graph

and interpreted graphs correctly.

• Could articulate when the bacteria acquired

resistance to antibiotics A and C and how the

proportion of antibiotic-resistant and non-resistant

bacteria changed over the six days.

graphs showing the rate of growth of Eva’s bacteria,

which were collected at different times during the

course of the infection. See the Assessment section for

answers to the questions and for key discussion points.

In steps 2–11, students analyze the graphs showing

the growth of Eva’s population of bacteria, develop an

explanation of how her antibiotic resistance developed,

and recommend a treatment strategy. A complete

explanation should mention that the graphs show

when the bacteria acquired resistance to antibiotics A

and C and how the proportion of antibiotic-resistant

and non-resistant bacteria change over the six days.

Students should recommend that Eva be treated with

Antibiotic B. The following explanation summarizes

the key points.

• Figure 4 shows that the population of Eva’s bacteria

had no initial resistance to Antibiotics A, B, or C.

Therefore, she acquired her resistance in the hospital.

• Eva became infected with bacteria resistant to

Antibiotic A during her visit to the hospital

on Monday afternoon. Figure 5 shows that the

population declines as Antibiotic A kills the

susceptible bacteria. But the population of bacteria

resistant to Antibiotic A increases in the test tube.

By hour nine, their numbers increase dramatically.

• Tuesday morning, Eva took the left-over Antibiotic

A. This dose killed the remaining bacteria susceptible

to Antibiotic A, leaving only a population of bacteria

resistant to Antibiotic A. The graph line in Figure 6

shows that, by Tuesday evening, the population

of bacteria was completely unaffected by Antibiotic A.

• Figure 4 shows that, initially, a few bacteria in the

population of Eva’s bacteria are resistant to

Antibiotic D. Since Eva never takes Antibiotic D, the

proportion of these resistant bacteria does not change

over the week—they have no particular advantage

over the unresistant bacteria. Figures 4–8 show Eva’s

Antibiotic D-resistant population is the same each

time, increasing only slightly after being grown in a

test tube for 24 hours.

• Figures 6 and 7 show Eva’s population of bacteria

becoming resistant to Antibiotic C. Since there were

no Antibiotic C-resistant bacteria on Tuesday evening,

Eva must have acquired them after visiting the hospital

on Tuesday evening. Eva started taking Antibiotic C

Thursday. By Saturday, Eva’s bacterial population is

mostly Antibiotic C-resistant because nearly all of the

Antibiotic C-susceptible bacteria have been killed.

PROCEDURE (continued)

TEACHER GUIDE

ANSWERS TO RISE OF THE SUPERBUGS STUDENT SHEET

1. (a) What might explain why Eva’s infection is not

responding to treatment by antibiotics?

Some bacteria may be resistant to the antibiotics.

(b) What information about the infection would

you want in order to ﬁ nd a way to treat it?

It would be good to understand what kinds of

bacteria are present and whether they are resistant

to antibiotics.

3. Explain how the graphs in Figures 1–3 describe

the bacterial growth over the 24 hours.

No antibiotics: The number of bacteria increases

quickly.

Antibiotics and susceptible bacteria: The number

of bacteria declines quickly as the antibiotic kills them.

Antibiotics and some resistant bacteria: First,

the number of bacteria falls as the antibiotic kills

the susceptible bacteria. Then, because the resistant

bacteria have been reproducing, a point is reached

where the number of susceptible bacteria being killed

equals the increase of the resistant ones. As the

population of resistant bacteria continues to grow,

the curve stops dropping and begins to rise.

4. How will Dr. Hincapie use the three standard

graphs?

These standard graphs show the pattern of growth

in bacteria whose resistance to antibiotics is already

known. Knowing these growth patterns, he can

analyze the growth patterns from Eva’s bacteria in

order to identify antibiotic-resistant and antibiotic-

susceptible bacteria.

5. Were antibiotic-resistant bacteria present in the

tissue samples taken when Eva ﬁ rst arrived at the

hospital on Monday? (Figure 4) How can you tell?

Yes. The slight rise starting around hour 12 shows

that there were a small number of bacteria resistant

to Antibiotic D in the population of Eva’s bacteria

when she ﬁ rst arrived.

6. By Saturday, which antibiotics were the bacteria

resistant to?

Antibiotics A, C, and D.

7. At what point did the population of bacteria show

resistance to:

Antibiotic A – When Eva was at the hospital on

Monday afternoon, she picked up some bacteria

resistant to Antibiotic A. By taking the leftover

antibiotics on Tuesday morning, she killed most of the

bacteria susceptible to Antibiotic A, allowing those

resistant to it to ﬂ ourish. The population of resistant

bacteria increased dramatically over the week.

Antibiotic B – No bacteria were resistant.

Antibiotic C – When she returned to the hospital

on Thursday evening.

Antibiotic D – Eva had some bacteria resistant

to Antibiotic D even before her accident.

8. Explain the difference in the growth rates of

bacteria grown in the presence of Antibiotic A

on Monday versus on Tuesday.

Eva had no bacteria resistant to Antibiotic A on

Monday afternoon. (Figure 4) Yet, after her visit to

the hospital, Eva had acquired some bacteria resistant

to Antibiotic A. Figure 5 shows the population of

bacteria decreasing at ﬁ rst as the susceptible bacteria

die, but then grows as the resistant bacteria increase in

number. On Tuesday morning, Eva took some leftover

Antibiotic A. Figure 6 shows that, by Tuesday, all

the surviving bacteria are resistant to Antibiotic A.

(Figures 7 and 8)

9. Explain the difference in growth rate of the

bacteria resistant to Antibiotic C from Thursday

to Saturday.

As of Tuesday, Eva has no bacteria resistant to

Antibiotic C. However, Figure 7 shows that on

Thursday, there are a few bacteria resistant to

Antibiotic C—Eva must have picked some up when

she visited the hospital on Tuesday. Figure 7 shows

the population decreasing until hour 20, indicating

that most bacteria are still susceptible to Antibiotic

C. However, Figure 8 shows that by Saturday the

proportion of Antibiotic C-resistant bacteria has

increased. Since Thursday evening, Antibiotic C

has killed most susceptible bacteria. Figure 8 shows

the bacterial population decreasing at ﬁ rst,

as the remaining susceptible bacteria are killed.

Then the number of Antibiotic C-resistant bacteria

increases rapidly.

10. How is the growth of the bacteria resistant to

Antibiotics A, C, and D an example of natural

selection?

Environmental conditions determine which individuals

in a population are the ﬁ ttest. In this case, the

environment favored bacteria that were resistant

to Antibiotics A, C, and D; all others were killed.

Since only resistant bacteria continued to breed,

soon the entire population derived from these initial

bacteria and were resistant. Thus, the environment

selected for resistant bacteria, illustrating the process

of natural selection.

11. What advice about the next antibiotic to try

can Dr. Hincapie give to Eva’s doctors based

on these results?

Treat Eva with Antibiotic B.

TEACHER GUIDE

RELATED RX FOR SURVIVAL

WEB SITE FEATURES

(see pbs.org/rxforsurvival)

Why Global Health Matters: Learn why we should all

be involved in global health initiatives.

Deadly Diseases: Learn about some of the diseases

that are humanity’s most feared killers.

Global Health Champions: Learn about men and

women who have profoundly changed global health

outcomes and saved lives in many parts of the world.

Get Involved: Find meaningful ways to take action.

Dispatches from the Field: Hear ﬁ rst-person accounts

from people on the frontlines of health care.

LINKS

Alliance for the Prudent Use of Antibiotics

tufts.edu/med/apua

Learn about the efforts to promote the

responsible use of antibiotics at home and

abroad.

Antibiotics: The Untold Story

prairiepublic.org/features/healthworks/antibiotics/

index.htm

Examine our dependence on antibiotics as the

most common treatment for illness.

Evolving Ideas: Why Does Evolution Matter Now?

pbs.org/wgbh/evolution/library/11/2/e_s_6.html

Relates how evolving bacterial resistance

helps us understand disease treatment and

prevention.

Evolution of Antibiotic Resistance

pbs.org/wgbh/evolution/library/10/4/l_104_03.html

See resistant bacteria survive, divide, and

multiply in this animated NOVA feature.

National Library of Medicine

nlm.nih.gov/medlineplus/antibiotics.html

The NLM’s Antibiotics page contains detailed

information and recent articles on antibiotics.

BOOKS

Antibiotics: Actions, Origins, Resistance Christopher

Walsh. Cambridge: Harvard University Press, 2003.

Describes how antibiotics combat infection and

disease at the molecular level.

The Coming Plague: Newly Emerging Diseases

In a World Out of Balance

Laurie Garrett. New York:

Farrar, Straus & Giroux, 1994.

Tracks diseases that travel the world, which are

spreading faster and farther than ever before.

The Other End of the Microscope: The Bacteria Tell

Their Own Story

Elmer Koneman. Washington, DC:

American Society for Microbiology Press, 2002.

Tells the story of some bacteria upset at

their continued mistreatment at the hands

of humans.

Revenge Of The Microbes: How Bacterial Resistance is

Undermining the Antibiotic Miracle

Abigail A. Salyers,

Dixie D. Whitt. Washington, DC: American Society for

Microbiology Press, 2005.

Details the consequences of turning one

of our best weapons against disease into

a powerful enemy.

Infections and Inequalities: The Modern Plagues Paul

Farmer. Berkeley: University of California Press, 2001.

Examines how economic disparities are often

indicators of who will be treated and survive.

RESOURCES

Rx for Survival—A Global Health Challenge™ is a Co-Production of the WGBH/NOVA Science Unit and Vulcan Productions, Inc. Produced in association with Johns Hopkins

Bloomberg School of Public Health. ™

/©

WGBH Educational Foundation and Vulcan Productions, Inc. All third party trademarks are owned by their respective owners and

used with permission. Major funding for Rx for Survival—A Global Health Challenge is provided by the Bill & Melinda Gates Foundation and The Merck Company Foundation.

Rise of the Superbugs

On Monday, Eva went to the emergency room following a

fall from her bike. Fortunately, her only broken bone was a

ﬁ nger. But she suffered scrapes and cuts, including some

deep cuts on her legs. After spending several hours in the

emergency room having her wounds cleaned, stitched, and

bandaged, Eva returned home.

Tuesday morning, one of the deeper cuts on Eva’s legs was

red and felt warm. She had a few pills of an antibiotic left

over from her bout with strep throat that previous winter.

Thinking it might help to prevent infection, she took them

according to the prescription instructions.

Throughout Tuesday, the cut on Eva’s leg became

increasingly red, swollen, and painful. Eva felt awful and

returned to the hospital on Tuesday night. Her cut had

become infected. The doctors cleaned and restitched her

leg and prescribed a daily dose of Antibiotic A, a stronger

version of the same antibiotic Eva had taken at home just

that morning.

By Thursday, Eva’s infection had spread to the point where it was too painful to walk. In addition, Eva felt ill. She

returned to the hospital and this time was admitted. The doctors immediately administered a different kind of

antibiotic, Antibiotic C, directly into Eva’s bloodstream through an intravenous tube.

Friday, Eva felt better, and her leg became less painful and swollen. But on Saturday, it was clear that Eva had

taken a turn for the worse. The infection on her leg continued to spread, and she had become feverish. The

medical staff involved with Eva’s case held a meeting to plan the next steps in Eva’s treatment.

1. Answer the following questions:

(a) What might explain why Eva’s infection is not responding to treatment by antibiotics?

(b) What information about the infection would you want in order to ﬁ nd a way to treat it?

Streptococci, the bacteria that cause sore throats and tonsillitis, are usually

present in the body. These bacteria cause no harm until the immune system

is weakened in some way, such as by a virus or malnutrition.

DID YOU KNOW?

Stephen Schudlich ©WGBH Educational Foundation

STUDENT SHEET

RISE OF THE SUPERBUGS

3. Explain how the graphs lines in FIGURES 1–3 show how the number of bacteria changes over the 24 hours.

No antibiotics:

Antibiotics and susceptible bacteria:

Antibiotics and some resistant bacteria:

4. How will Dr. Hincapie use the three standard graphs?

FIGURE 3. Antibiotics and

a population with some

resistant bacteria.

The test tube

contains bacterial growth media

and antibiotics to which some of

the bacteria are resistant.

FIGURE 2. Antibiotics and

susceptible bacteria.

The test

tube contains bacterial growth

media and antibiotics known to

kill the bacteria used in the test.

FIGURE 1. No antibiotics.

The test tube contains bacterial-

growth media, which allows

the bacteria used in testing to

undergo unlimited growth.

2. Read the following story about a doctor who tested the bacteria causing Eva’s infection.

Dr. Hincapie, a conscientious intern interested in sports injuries, had followed Eva’s case since she arrived

at the emergency room after her bike crash on Monday. On each visit, he had taken samples of ﬂ uid and tissue

from Eva’s wounds. He wanted to analyze them to see how the cells in her immune system changed

as she healed.

As Eva’s condition worsened, he realized that the samples he had collected might hold clues as to why her

infection was not healing and what new treatments might work. Dr. Hincapie thought that bacteria that were

resistant to the antibiotics she had been given might be causing Eva’s worsening condition. To test this idea, he

grew cultures of bacteria from each of Eva’s visits. (

FIGURES 4–8) Dr. Hincapie compared the resulting graphs to

standard graphs. (

FIGURES 1–3) To make a standard graph, researchers grow 10,000 (10

) bacteria in a test tube

under known conditions. They measure the growth over 24 hours and graph the results. The standard graphs Dr.

Hincapie used in his comparisons are:

In any population, the individuals are not identical to each other—just look around the classroom! There

is always variation in a population. In bacteria, this includes variation in resistance to antibiotics. Some

bacteria may be resistant to antibiotics while others are susceptible. While antibiotics kill most bacteria,

some will be resistant and survive. Because the conditions determine which individuals in a population are

the most ﬁ t to survive, this is an example of natural selection.

Scottish researcher Alexander

Fleming accidentally discovered

penicillin in 1928. He observed

that a mold growing on one of

his Petri dishes had killed all the

bacteria growing nearby.

DID YOU KNOW?

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STUDENT SHEET

RISE OF THE SUPERBUGS

KEY FOR THE RESPONSE TO FOUR ANTIBIOTICS

Each sample begins with 10,000 (10

) bacteria. Hour zero represents

the bacteria in Eva’s blood at the time mentioned in the caption of

each ﬁ gure. The following 24 hours represent the growth occurring

in Dr. Hincapie’s test tubes. To understand whether or not Eva’s

bacteria are resistant, see how the population changes over 24 hours.

FIGURE 8.

Saturday morning after

spending Friday in the

hospital and taking

Antibiotic A since

Tuesday and Antibiotic C

since Thursday night.

FIGURE 7.

Thursday evening after

returning to the hospital

a second time and being

admitted. Eva had taken

Antibiotic A since Tuesday

morning. The doctors

prescribed Antibiotic C.

FIGURE 6.

Tuesday night after

returning to the hospital.

Eva had taken Antibiotic

A. The doctors prescribed a

new dose of Antibiotic A.

FIGURE 5.

Monday evening just

before leaving the

hospital, before any

antibiotics were taken.

FIGURE 4.

Monday afternoon

after arriving at the

hospital, before any

antibiotics were taken.

Using the standard graphs (FIGURES 1–3), Dr. Hincapie

can now analyze the results of the bacterial cultures he

grew from Eva’s tissues over the course of her infec-

tion. Examine FIGURES 4–8, and answer questions 5–11.

5. Were antibiotic-resistant bacteria present in the

tissue samples taken when Eva ﬁ rst arrived at the

hospital on Monday? (FIGURE 4) How can you tell?

6. By Saturday, which antibiotics were the bacteria

resistant to?

7. At what point did the population of bacteria show

resistance to:

Antibiotic A:

Antibiotic B:

Antibiotic C:

Antibiotic D:

8. Explain why the number of bacteria is so different

on Monday afternoon (FIGURE 4) compared to

Tuesday (FIGURE 6), after growing for 24 hours

in the presence of Antibiotic A.

9. Explain why the number of bacteria is so different

on Thursday (FIGURE 7) compared to Saturday

(FIGURE 8), after growing for 24 hours in the

presence of Antibiotic C.

Antibiotic A

Antibiotic B

Antibiotic C

Antibiotic D

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STUDENT SHEET

RISE OF THE SUPERBUGS

10. How is the growth of the bacteria resistant to Antibiotics A, C, and D an example of natural selection?

11. Based on the results of his testing, what advice should Dr. Hincapie give to Eva’s doctors about the next

antibiotic to try?

In bacteria, the genes for antibiotic resistance are often carried on plasmids (small circles of DNA) rather than

in the main bacterial chromosomal DNA. Plasmid DNA can be prepared and viewed using gel electrophoresis.

Dr. Hincapie wanted to determine which gene was responsible for the antibiotic resistance he observed in the

bacteria causing Eva’s infection. First, he isolated plasmid DNA from each of Eva’s original samples. Then, he

separated the plasmid DNA samples using gel electrophoresis. Here’s a photograph of his gel.

Dr. Hincapie recognized that the two larger pieces of DNA—

2100 base pairs and 1800 base pairs—were from plasmids found

in bacteria that cause infections. The brightness of a piece of DNA

on a gel reveals two things: larger pieces of DNA are brighter

than smaller pieces and larger amounts of DNA appear brighter

than smaller amounts. Knowing this, which bands on this gel do

you think contain a gene for resistance to:

Antibiotic A:

Antibiotic B:

Antibiotic C:

Antibiotic D:

WELL

NUMBER SAMPLE

DNA size marker

Monday, immediately after arriving at the hospital

Monday evening, just before leaving the hospital

Tuesday night after returning to the hospital

Thursday evening, after being admitted to the hospital

Saturday morning

WELL NUMBER

1 2 3 4 5 6

GOING FURTHER: Identify the Genes Carrying Antibiotic Resistance

2100 bp

1800 bp

1500 bp

1200 bp

1000 bp

900 bp

800 bp

700 bp

600 bp

517/500 bp

300 bp

Some bacteria exchange genetic material using a tiny

tube that connects them together. In this way, a drug-

resistant bacterium can pass its resistance on to others.

DID YOU KNOW?

Rx for Survival—A Global Health Challenge™ is a Co-Production of the WGBH/NOVA Science Unit and Vulcan Productions, Inc.

Produced in association with Johns Hopkins Bloomberg School of Public Health. ™

/©

WGBH Educational Foundation and Vulcan

Productions, Inc. All third party trademarks are owned by their respective owners and used with permission. Major funding for

Rx for Survival—A Global Health Challenge is provided by the Bill & Melinda Gates Foundation and The Merck Company Foundation.

STUDENT SHEET

RISE OF THE SUPERBUGS