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Super Bug

Antibiotics and Evolution

Kristy J. Wilson
School of Mathematics and Sciences
Marian University


Sam, a pre-med college student, routinely gets dialysis and develops a urinary tract infection. The infection is from a bacterium that the news media is calling a "superbug" from India. Sam does some internet searches to find out more information about his condition. He examines popular news stories, primary literature, and considers what the United States should do about the increased prevalence of antibiotic resistance. To explore this issue, students form groups in which they are a politician, a parent, or a doctor, with each student bringing different information to the discussion. The case also discusses evolutionary principles and how they connect to antibiotic resistance. The case was developed for an introductory biology course taken by science majors who are not majoring in biology. It could be used in any introductory biology course or even as an introduction for a specific course on evolution.


  • To demonstrate proficiency in the interpretation of graphs and/or charts.
  • To be able to apply evolutionary principles to a real-world scenario.
  • To be able to relate evolution to genetic changes and to predict what kind of genetic changes impact evolution.
  • To be able analyze and discuss genetic diversity and its impact on evolution, and to predict what would happen to species without diversity.


Antibiotics; evolution; superbug, infectious disease; DNA; mutation; plasmid; urinary tract infection; UTI; E. coli; Escherichia coli; bacteria; New Delhi metallo-beta-lactamase-1; NDM; NDM-1

Educational Level

Undergraduate lower division, Undergraduate upper division



Type Methods

Analysis (Issues), Discussion, Interrupted, Journal Article, Role-Play



Subject Headings

Biology (General) Evolutionary Biology Genetics / Heredity Microbiology Public Health Medicine (General) Nursing

Date Posted


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Kim Risley
University of Mount Union
Alliance, OH
Being intrigued by the title of this newly-released case study, I read through it and was surprised to find several typos within the case as well as in the references. The accurate name for this gene is NDM-1 standing for New Delhi metallo-beta-lactamase-1 gene. This gene gives the microorganism antibiotic resistance to many currently-used antibiotics. The case study lists both NDM-1 (correct)and NMD-1 (incorrect) in a chart, text, and references. Students may have issues finding correct resources if they search for NMD because this name is associated with nonsense mRNA decay, human melanoma and neuromuscular disease to name a few. Please be sure to update the gene name to NDM-1. The following may serve as an overview for resistance and NDM-1 from the New England Journal of Medicine (Perspective)

National Center for Case Study Teaching in Science
University at Buffalo
Buffalo, NY
Our thanks to Kim Risley for pointing out this error. We have corrected it in all of the files, including the answer key, for the case.