The Development of Antibiotic Resistance in E. coli
By Jonathan A.
Abstract
Purpose
Hypothesis
Experiment Design
Materials
Procedures
Research Report
Results
Data
Conclusion
Bibliogaphy

 
 
 

ABSTRACT

The purpose of this experiment was to determine if Escherichia coli has the ability to become resistant to the antibiotic ampicillin and if yes, conclude the amount of time involved and how effective the mutant ability is.  My hypothesis is that the bacterial zone size at five weeks of testing should be less than 13 mm zone size, therefore showing resistance to the test antibiotic.

To conduct this experiment you must make bacterial suspension for each developed week and incubate bacterial suspensions using Mueller Hinton agar plates.  Over a time period of five weeks record the zone of inhibition to the test antibiotic, ampicillin.

The results were that the average zone diameter of inhibition to ampicillin in the test E. coli strains met the testing requirements of a  less than 13 mm zone size, meaning resistant.  Over the five-week period each strain showed more resistance at a different rate.  Therefore E. coli has the ability to gain resistance to the antibiotic ampicillin, which may in turn be true for other bacteria and antibiotics.

My results indicate that my hypothesis should be accepted.  The average zone sizes of inhibition to ampicillin in the test E. coli strains meet the testing requirements of a  less than 13 mm zone size, meaning resistant.
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PURPOSE
The purpose of this experiment was to determine if Escherichia coli has the ability to become resistant to the antibiotic ampicillin and if yes, conclude the amount of time involved and how effective the mutant ability is.

I became interested in this idea from similar previous projects viewed and relatives in the prescription medicine field.  The project rose my interests further when I found that bacterial immunity to antibiotics was on the rise, and becoming a very important issue.  When choosing a topic I tried to stay in the microbiology field because it’s really interesting and I find it easier to work on something that I enjoy.

The information gained from this experiment could be found useful to those who work in the field of microbiology, those in the medical field, those having contact with antibiotics, including all antibiotic using citizens, and people who wish to know what they can do to prevent further growth of antibiotic resistance in bacteria.
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HYPOTHESIS
I hypothesize that having exposed the E. coli strains to increasing doses of ampicillin for five weeks will give the E. coli the ability to develop full or close to full resistance to the antibiotic, ampicillin.   The bacterial zone size around the ampicillin saturated disk, when tested at five weeks for susceptibility, should be or close to a less than 13 mm zone size (using the NCCLS interpretive standards, an E. coli isolate that produces an ampicillin inhibition zone diameter of a less than 13 mm is classified as resistant), therefore showing resistance to the test antibiotic.

I base my hypothesis on verbal interviews with a qualified supervisor in the field of microbiology and medical technology; and information collected about general bacteria, the specific bacteria genes E. coli, antibiotic resistance, and the antibiotic ampicillin.  An antibiotic is any substance produced by a microorganism, which harms or kills another microorganism, such as bacteria.  However, antibiotics do not harm viruses.  Some bacteria have become resistant to the effects of different antibiotics, by slowly being exposed to the particular antibiotic.  The resistance occurs when a minimum of one bacteria cell genetically acquires the ability to destroy the antibiotic.  That single cell of bacteria then divides (possibly at a rate of every 20 minutes) and produces a population that is no longer affected by that specific antibiotic.  For the most part E. coli is a harmless bacterium that can be found within the intestines of all humans.  E. coli has also been know to have the ability to exchange genetic information with other organisms gaining some of that organism’s characteristics.  The E. coli strain 0157:H7 is an example of this action.   E. coli strain 0157:H7 was infected with a bacterial virus and that particular virus had the ability to insert its own DNA into the bacteria’s chromosome without harming the bacterium.  Ampicillin is a semi-synthetic from of penicillin that has a special feature that penicillin does not; ampicillin has a resistance to stomach acid, which penicillin is highly sensitive to.  The bacterium E. coli has also been found to be sensitive to ampicillin.
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EXPERIMENT DESIGN
The constants in this study were:


The manipulated variable was the amount of time ampicillin was exposed each week to the eleven strains of E. coli.  All eleven strains of E. coli will be exposed to the same dose of ampicillin for that same week.

The responding variable will be the zone sizes around each ampicillin disk located on the agar plates.  To measure the responding variable I record the diameter of the zone size around the ampicillin disk using calipers.  The smaller the zone size around the ampicillin disk the more resistant the bacteria has become to the antibiotic.   Meaning the ampicillin disk did not kill the bacterium that was around the antibiotic.
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MATERIALS
   QUANTITY                      ITEM DISCRIPTION
1                             Colorimeter
55                            12mm x 75mm test tubes
15                            Mueller Hinton Agar Plates
+55                          Swabs
N/A                          Normal Saline at 0.9%
1                             35 degree Incubator
1                             Calipers
10                            BHI Agar Slants
11                            Strains of E. coli
55                            Ampicillin saturated disks
115.5 ml                    Tryptic soy broth
11,000 mg                 Ampicillin dilution (1mg to 1ml)
1 200mg                    Pipette
+60                          Pipette tips
+55                          Plastic pipettes
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PROCEDURES
I. Week one
*A. Before starting any experimentation the following safety procedures and equipment should be used at all times:
1. Wash hands thoroughly as well as frequently (before and after handling experiment equipment.
2. Latex glove should be used at all times.
3. Fluid impermeable lab coat worn at times.
4. Sterilize all working surfaces per hospital procedures.
5. Conduct work in a lab area not accessible to the public.
6. Use accepted aseptic procedures when transferring bacteria.

B. Making suspension strains of E. coli comply with testing needs
1. Gently dab E. coli strain # 1 with sterile cotton swab.
2. Smear E. coli strain #1 cotton swab on the inside of 12mmx75mm test tube.
3. Add saline to test tube at was just swabbed with E. coli strain #1 and tightly secure test tube screw cap.
4. Shake test tube at a reasonable rate.
5. Place test tube in colorimeter.
6. Test the light transmission of test tube contents.
7. For the proper amount of E. coli to saline, the colorimeter should read in the higher red zone (80% light transmission).
a. If colorimeter reads higher than 80% light transmission add more E. coli, gradually lowering the light transmission to 80%.
b. If colorimeter reads lower than 80% light transmission add more saline, gradually diluting the E. coli strain and increasing light transmission to 80%.
8. Once the test tube has met the 80% light requirement repeat steps B. 1-7 to all eleven E. coli strains.

C. Preparation of Mueller Hinton agar plates
1. Take E. coli suspension strain #1 and swab a coat of suspension on agar plate.
2. Using the same suspension swab an overlapping suspension coat over the first coat after the agar plate has been turned 90 degrees.
3. Once again using the same bacterial suspension swab another overlapping coat over the previous two, after the agar plate had been turned another 90 degrees.
4. The agar plate is finally finished when swabbed three times in three different directions.
5. Now place the ampicillin disks on the agar plate at equal distances apart.
6. Repeat steps C. 1-5 to all eleven E. coli suspensions.

D. Making trypitc soy broth (TSB) solution with suspension and ampicillin dilution
1. To empty test tube add 2.1mL TSB using pipette.
2. Add 200mg of ampicillin dilution (1mg to 1mL) to TSB.
3. Add 200mg of E. coli suspension to TSB+ampicillin solution.
4. Repeat steps E. 1-3 to all eleven E. coli strains.
5. Incubate all eleven E. coli solutions for given time period.

 E. Incubating
1. Incubate all eleven E. coli suspensions in Mueller Hinton agar plates for a minimum of 24 hours or longer.
2. After incubation time period measure the inhibition zones around all ampicillin disks for all eleven strains of E. coli.
3. Record inhibition zone diameters using calipers.
    What Mueller Hinton agar plates should look like after incubation.
    Disregarding zone sizes.
II. Week two
A. Partial reconfiguration of previous week
1. Repeat steps I.A.1-6, I.B.1-8 (with the exception of making bacterial suspensions from previous weeks TSB solutions), I.C.1-6, I.D.1-4, and I.E. 1-3.

III.Week three
 A. Reconfiguration of previous week
1. Repeat steps I.A.1-6, I.B.1-8 (with the exception of making bacterial suspensions from previous weeks TSB solutions), I.C.1-6, I.D.1-4, and I.E. 1-3.

IV. Week four
 A. Reconfiguration of previous week
1. Repeat steps I.A.1-6, I.B.1-8 (with the exception of making bacterial suspensions from previous weeks TSB solutions), I.C.1-6, I.D.1-4, and I.E. 1-3.

V. Week five
 A. Reconfiguration of previous week
1. Repeat steps I.A.1-6, I.B.1-8 (with the exception of making bacterial suspensions from previous weeks TSB solutions), I.C.1-6, I.D.1-4, and I.E. 1-3.
2. After recording all information autoclave and dispose all materials used in experiment.

* Should be done before all lab work, every week.
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RESEARCH REPORT

INTRODUCTION

 Bacteria are like living paint, covering nearly every surface imaginable and living within a variety of living and nonliving things.  Many are existing in a symbiotic condition in which they function as partners with other organisms.  Although life would not be the same without bacteria, bacteria have their bad side.  These bad bacteria (pathogenic) cause diseases, infections, and other unwanted illnesses.  We fight these bacteria using antibiotics; a natural defense used by other organisms that humans have adopted.  Escherichia coli is one of the most studied bacteria.  E. coli are found in every human being’s intestines.  E. coli are essential for producing the particular vitamins K and B-complex. Our bodies are dependent on E. coli for the production of these vitamins, our only source.  Although we are dependent on these helpful strains of E. coli there are some harmful strains of E. coli (like the O157:H7 strain of E. coli) that have been associated with a wide variety of diseases and infections, including meningeal (predominantly in the newborn), gastrointestinal, urinary tract, wound, and bacteremic infections in all age groups.  These categories of diarrheogenic E. coli also cause numerous types of diarrheal illnesses.  The prescription antibiotic ampicillin is a semi-synthetic form of penicillin.  Ampicillin is also proven effective against the bacteria family Enterobacteriaceae

MICROBIOLOGY

 Microbiology is the study of microorganisms; these include bacteria (Latin plural for bacterium), viruses (non-Latin plural for virus – virii), and fungi (Latin plural for fungus).  Microbiology is made up of several different studies.  These include:
BACTERIA
 Bacteria are sorted into two groups: helpful bacteria and harmful bacteria.  Some helpful bacteria live in human intestines and warm-blooded animals.  These bacteria help the digestion and destroy harmful organisms.  Intestinal bacteria, including the bacteria Escherichia coli, also produce vitamins needed by the human body, and help decompose (break down) dead organisms and animal wastes into chemical elements.  Other bacteria help change chemical elements into forms that can be used by plants and animals.
 Harmful bacteria prevent the body form functioning properly, destroying healthy cells.  These harmful bacteria enter the body through natural openings such as the nasal passage, mouth, and openings in the skin.  Diseases that bacteria have introduced to humans are cholera, gonorrhea, leprosy, pneumonia, syphilis, typhoid fever, and whooping cough.
Bacteria are absolutely necessary for all life on the human ecosystem.  Without bacteria, there would be no life, on earth.  Although it is a good thing that most bacteria die-out.  Bacteria are single-celled organisms.  A single bacterium cell like E. coli for example, divides every twenty minutes.  At this rate, in only 43 hours there would be enough E. coli to occupy the entire volume of the earth (1,090,000,000,000,000,000,000 cubic meters)!  In 45 hours these bacteria would weigh as much as the earth – 6,600,000,000,000,000,000,000 tons!  But most bacterial cells die because of the enormous competition for food, and other tiny organisms, which produce substances (antibiotics) that kill them.
 Bacteria are often classified on the basis of their physical shapes.
Bacteria can be spherical (cocci), rod-shaped (bacilli), or corkscrew (spirochetes).  Another classification system divides bacteria into gram-negative or gram-positive according tot he composition of their sell walls, a distinction identified by a staining technique call the gram strain.  Scientists also classify bacteria according to whether or not they require oxygen to survive.  Bacteria that require oxygen are called aerobic bacteria, or aerobes.  Bacteria that live without oxygen are called anaerobic bacteria, or anaerobes.
 Like all cells, bacteria contain genetic material known as deoxyribonucleic acid (DNA).  Bacterial DNA is not enclosed in a nucleus, as is the DNA of eukaryotic cells.  Like eukaryotic cells, bacteria have ribosomes, structures active in protein synthesis, but they are smaller and have a slightly different molecular structure.

ESCHERICHIA COLI

E. coli, the most significant species in the genus Escherichia, is recognized as an important potential pathogen in humans.  Being a gram-negative bacillus, it is a common isolate from the colon flora.  On most occasions it may become visible as a non-lactose-fermenter or as a mucoid colony, E. coli usually produces a dry, pink (lactose positive) colony with a surrounding pink area of precipitated bile salts on MacConkey agar.  A large amount of E. coli strains are motile and generally have both sex pili and adhesive fimbriae.  The presence of E. coli and other kinds of bacteria within our intestines is necessary for us to develop and operate properly, and for us to remain healthy.  Our bodies are dependent on E. coli for the development of the vitamins K and B-complex.  Although most strains are harmless, several are known to produce toxins that can cause diarrheal side effects.  The E. coli organism also possesses O, H, and K antigens.  E. coli, first described by Theodore Esherich in 1885 was considered a non-harmful member of the colon flora.  Since then, E. coli has been associated with a wide variety of diseases and infections, including meningeal (predominantly in the newborn), gastrointestinal, urinary tract, wound, and bacteremic infections in all age groups.  E. coli may cause numerous types of diarrheal illnesses.  There are five major categories of diarrheogenic E. coli.  These include the following: Enteropathogenic E. Coli
 The enteropathogenic E. coli strain has been recognized to cause infantile diarrhea since the 1940’s.  Particular O serogroups of EPEC were acknowledged in the late 60’s and 70’s as a cause of diarrhea, but only particular groups of H types within each serogroup were connected to the intestinal infections.  Studies in 1978 now show that EPEC strains cause distinct diarrhea.  Diarrheal outbreaks due to EPEC have occurred in hospital nurseries and day care centers.  Cases in adults are rarely seen.  Case characterization is established by the presence of low-grade fever, malaise, vomiting, and diarrhea.  Contaminated stools contain large amounts of mucus, but gross blood in not usually present.  When severe diarrhea in children younger than one year, infection with EPEC should be assumed.

Enterotoxigenic E. coli
 Diarrhea of infants and adults in tropical and subtropical climates, especially in developing countries, strains of enterotoxigenic (ETEC) should be the suspected cause.  In the United States and other developed countries, ETEC diarrhea, sometimes referred to as “traveler’s diarrhea”, is the most common cause of diarrheal diseases.  The ETEC infection is commonly acquired by consuming infected food or water.  The major contributing factors in the spread and transmission of the disease include poor hygiene, inadequate sources of drinking water, and lack of proper sanitation.  106 to 1010 organisms are necessary to initiate disease in an immunocompetent host.  Various protective mechanisms include stomach acidity have been described as inhibiting colonization and initiation of disease.  Which means those who are suffering from achlorhydria are at greater risk of inhibiting the disease than those without achlorhydria.  Colonization of ETEC begins near the small intestine.  Once established enterotoxigenic strains of E. coli release into the small intestine.
 Usually the disease caused by ETEC is characterized by non-bloody, watery diarrhea, nausea, abdominal cramps, and low-grade fever.  To date there is no evidence of mucosal penetration or invasion.  The infirmity may last from one day up to five days.

Enteroinvasive E. coli
 Strains of Enteroinvasive E. coli (EIEC) are very different from the strains of EPEC and ETEC.  EIEC strains create dysentery, with direct penetration, invasion, and destruction of the intestinal mucosa.  This diarrheal sickness is similar to that produced by Shigella.  The EIEC infections are found in adults and children.
 Clinical infection is characterized by fever, severe abdominal cramps, malaise, and watery diarrhea (stools containing pus, mucus, and blood).  While EIEC and Shigella have been discovered to be similar in morphology and in clinical presentation, the infective dose of EIEC necessary to produce disease in much higher than that of Shigella.

Enterohemorrhagic E. coli
 In 1982, the O157:H7 strain of E. coli was first recognized during an outbreak of hemorrhagic diarrhea and colitis. Strain serotype O157:H7 of the enterohemorrhagic E. coli (EHEC) has since then been associated with hemorrhagic diarrhea, colitis, and hemolyticuremic syndrome (HUS).  HUS is characterized by low platelet count, hemolytic anemia, and kidney failure.

 Illness brought on by EHEC is characterized by watery diarrhea that progresses to bloody diarrhea and cramping abdominal pain, with low-grade fever or no fever at all.  The stool of a contaminated person contains no leukcytes, which differentiates it from Shigella dysentery or EIEC strain infection.  The infection is potentially fatal to young children and the elderly.  Meats, such as undercooked hamburger, unpasteurized milk, and apple cider, have been known to spread the infection.

Cases of O157:H7 in the State of Washington
Year         Number of Reported Cases
1991                                 164
1992                                 300
1993                                 741
1994                                 174
1995                                 140
1996                                 187
1997                                 149
1998                                 144
1999                                 186

Enteroadherent E. coli
 Enteroadherent E. coli, most recently spoken as of enteroaggregatice E. coli (EAggEC), causes diarrhea by adhering to the mucosal surface of the intestine.  The following symptoms are the result to a EaggEC infection; watery diarrhea, vomiting dehydration, and occasionally abdominal pain.

ANTIBIOTICS

 An antibiotic is any substance produced by a microorganism, which harms or kills another microorganism.  However, antibiotics do not harm viruses.
 A majority of antibiotic substances are natural products that certain bacteria and fungi produce as a natural defense to send outside their cells.  About 90% of antibiotics used today come from bacteria.  Although these are all natural, some antibiotics are completely synthetic (made in a laboratory) and some are semi-synthetic (only altered).
 To determine which antibiotic works best against a specific bacterium, tests are done in laboratories, such as a susceptibility test.  On an agar plate a bacterium suspension is spread over the plate.  Then small, circular, sterile disks, saturated with an antibiotic are placed on the bacterium covered agar plate.  The plate is then incubated. After incubation the zone sizes around each disk are recorded for resistance or not.  Where no growth occurred around disk, the bacterium is sensitive.   Where growth around the disk occurs, the bacterium is resistant to that certain antibiotic. Some people are allergic to a particular antibiotic.  After taking an antibiotic, if you experience any one of the following symptoms:  feel sick to your stomach, acquire a rash, feel dizzy, or hear “ringing” in you ears, call your physician right away.  Any children taking an antibiotic should be monitored carefully for any of the above symptoms.
 One of the major problems we face today, is that many of the disease-causing bacteria have become resistant to the effects of different antibiotics.  This occurs when a (need only be one cell) bacteria population genetically acquires the ability to destroy the antibiotic.  This one resistant cell will divide and produce a population that is now no longer harmed by that particular antibiotic.  This is a great concern, because certain strains of disease-causing bacteria now have only one antibiotic remaining which will kill them.  Due to this concern there are tremendous efforts in finding new natural sources of antibiotics, and or make completely synthetic ones in the laboratory.  One of the reasons for the cause of this problem, is because of prior, indiscriminate use of antibiotics in human and domestic animal health (usually cattle and pigs).  In some countries of the world, one still does not need a prescription to use an antibiotic.
 Today we have the ability to chemically add or remove some things from the original structure of an antibiotic, and produce an altered form of the original material.  This altered substance is called a semi-synthetic antibiotic.  Such thing has taken place to the antibiotic penicillin, and its semi-synthetic form called ampicillin.  A particular kind of natural fungus (Penicillium – a kind of fungus that can grow on bread) produces penicillin.  However, penicillin is very sensitive to stomach acid, and will be broken-down before it can do any good fighting against the given infection.  This is the reason that penicillin is given with a shot.  The semi-synthetic derivative, called ampicillin has been made, because it is resistant to stomach acid.  This is the reason why ampicillin can be taken in tablet form (orally).

AMPICILLIN

 Ampicillin is a prescription drug, introduced in 1961, used to treat infections caused by certain bacteria, including the specific bacteria family Enterobacteriaceae.  Ampicillin is an antibiotic (drug produced by microbes).  It is a semi-synthetic form of penicillin, belonging to the penicillin group of drugs.
 The reason for the production of ampicillin is for two main reasons.  Ampicillin unlike penicillin, can kill some bacteria that that are not effectively killed by penicillin G, such as Salmonella bacteria, which causes a form of food poisoning.  Ampicillin is also resistant to the stomach acids found in humans.  Penicillin is sensitive to these stomach acids and is taken in the form of a shot unlike ampicillin which can be taken in pill form.
 There are different side effects when ampicillin is taken orally instead of in the form of a shot.  People who choose to take the shot may experience minor side effects such as insignificant rashes.  When taken orally (pill form) side effects may include diarrhea.  An alternative to ampicillin is the semi-synthetic penicillin called amoxicillin, which in turn produces fewer side effects involving the stomach and intestines.
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RESULTS
The original purpose of this experiment was to determine if Escherichia coli has the ability to become resistant to the antibiotic ampicillin and if yes, conclude the amount of time involved and how effective the mutant ability is.

The results of the experiment were that the average zone sizes, at the final episode of testing, of the Escherichia coli strains used during testing met NCCLS interpretive standards for an E. coli isolate that produces an ampicillin inhibition zone diameter of less than 13 mm, classifying tested strains as resistant.  Over the time period allowed the tested strains of E. coli made evident that in a matter of weeks bacteria can obtain the ability to show signs of resistance to the specific antibiotic used to terminate them.  Although the average zone size of tested strains met standards as of classifying E. coli resistant to ampicillin, all E. coli strains tested developed resistance at a varying rate.  Testing also showed individual bacterial mutant colonies within the more obvious zone of inhibition.  This could indicate inoculation with a mixed culture.  However, emergence of resistant mutants of the test isolate is a more likely reason for this particular growth pattern.
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DATA


WEEK 1 GRAPH/TABLE
WEEK 2 GRAPH/TABLE
WEEK 3 GRAPH/TABLE
WEEK 4 GRAPH/TABLE
WEEK 5 GRAPH/TABLE
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CONCLUSION
My hypothesis was that the bacterial zone size at five weeks of testing should be less than 13 mm zone size (using the NCCLS interpretive standards, an E. coli isolate that produces an ampicillin inhibition zone diameter of a less than 13 mm is classified as resistant), therefore showing resistance to the test antibiotic.

The results indicate that this hypothesis should be accepted.  The tested E. coli strains had bacterial zone sizes that meet the NCCLS interpretive standards as resistant; an E. coli isolate that produces an ampicillin inhibition zone diameter of less than 13 mm is classified as resistant.

With the outcome of these results of this particular experimentation, I wonder if these certain results would prove true for other bacteria and their specific antibiotic used against them.  I also wonder if in the case of using different bacteria and antibiotics it would change the amount of time needed to become resistant whether it be more or less. And furthermore I wonder if it is possible for bacteria strains to become resistant to more than one antibiotic.

These finding could prove to be useful to those in the medical field, microbiologists, and other areas of work related to bacterial resistance and those having contact with antibiotics, including all antibiotic using citizens. Therefore this studies results suggest that when given time and exposure E. coli has the ability to develop a resistance to ampicillin.

If I were to conduct this project again I would provide a wider variety of bacteria and antibiotics, including a larger number of test subjects within each group to get sturdier and reliable results.  I would also give bacteria more time to develop resistance if need.
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BIBLIOGRAPHY
Brown, John C. What the Heck is an Antibiotic. 18 Oct. 1995. Department of Molecular Biosciences. 10 Dec. 2001 <http://people.ku.edu/~jbrown/antibiotic.html>.

Brown, John C. What the Heck is an E. coli. 18 Oct. 1995. Department of Molecular Biosciences. 8 Dec. 2001 <http://people.ku.edu/~jbrown/ecoli.html>.

Brown, John C. What the Heck is Microbiology. 18 Oct. 1995. Department of Molecular Biosciences. 9 Dec. 2001 <http://people.ku.edu/~jbrown/whatmicro.html>.

Clark, Marie. Personal Interview. 12 Dec. 2001.

Ewing WH: Edwards and Ewing’s Identification of Enterobacteriaceae, 4th ed. East Norwalk, CT: Appleton & Lange, 1986, pp 2-3.

Johnson, Eugene M. "Ampicillin." The World Book Encyclopedia. Ed: Dale Jacobs. Chicago: World Book, Inc., 1999. 443.

Selecky, Mary. E. coli. 31 Feb. 1996. Washington Department of Health. 9 Dec. 2001 <http://www.doh.wa.gov/Topics/ecoli.htm>.

Washington J: Laboratory Procedures in Clinical Microbiology,
2nd ed. New York: Springer-Verlag, 1981, p 181.

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