14.5, 14.2, 13.1

Question 1

What is the main goal of controlling microbial growth?

Answer 1

Reduce microbial load and reduce infection or contamination

Question 2

What completely removes/kills all microbes from fomites?

Answer 2

Sterilization

Question 3

What inactivates/kill microbes on fomites? Some microbes may not be inactivated

Answer 3

Disinfectant

Question 4

What acts on microbes but not organism/tissue?

Answer 4

Antiseptic

Question 5

What reduces microbial load on fomite?

Answer 5

Sanitization

Question 6

What reduces microbial load on living tissue?

Answer 6

Degerming

Question 7

Which BSL poses moderate risk; restrictive access, has PPE, self closing doors, eyewash station, autoclave or sterilization method? What microbes/viruses is it made for?

Answer 7

BSL-2; S. Aureus, salmonella spp.

Question 8

Which BSL has potential to cause lethal infections by inhalation and has indigenous or exotic pathogens? What viruses and microbes does it contain?

Answer 8

BSL-3; M. tuberculosis, B. Anthracis, West Nile Virus, HIV

Question 9

Which BSL is most dangerous; often fatal, includes BSL-3 plus full biohazard suit, change clothing on entry, shower on exit, decontaminate all material on exit, lab must have own air supply? What viruses/pathogens does it have?

Answer 9

BSL-4; “Exotic” pathogens; ebola and Marburg viruses

Question 10

What level of clean is it when it must be sterile; items used inside the body (i.e. sterile tissue or bloodstream)?

Answer 10

Critical

Question 11

Which level of clean is needed for surgical instruments, catheters, IV fluids?

Answer 11

Critical

Question 12

Which level of clean does not require high level sterilization; items might contact non-sterile tissue (e.g. gut) but no penetrate tissue?

Answer 12

Semicritical

Question 13

What level of clean are GI endoscopes and respiratory therapy equipment?

Answer 13

Semicritical

Question 14

What level of clean does not require sterilization; items contact but do not penetrate intact skin?

Answer 14

Noncritical

Question 15

What level of clean are stethoscopes, bed linens, blood pressure cuffs?

Answer 15

Noncritical

Question 16

What can be used to observe the degree of control?

Answer 16

Microbial death curve

Question 17

These factors affect what?
- Length of exposure
- Concentration of agent
- Population level

Answer 17

Success of control

Question 18

What is it called when it shows how much time it takes to kill 90% (1 log reduction) of population?

Answer 18

Decimal reduction time (DRT)

Question 19

What is Narrow spectrum?

Answer 19

Targets specific group of microbes

Question 20

What is broad spectrum?

Answer 20

Targets wide variety

Question 21

What is the downside of broad spectrum?

Answer 21

Superinfection

Question 22

What is considered optimal dosage?

Answer 22

High drug efficacy but low adverse effects

Question 23

How is selective pressure (external agents which affect an organism’s ability to survive in a given environment) increased?

Answer 23

• misuse and inappropriate use of antimicrobials, subtherapeutic dosage, patient noncompliance

Question 24

What are mechanisms of resistance?

Answer 24

-Enzymatic modification or inactivation of the drug
- Modification of the antimicrobial target
- Overproduction of antimicrobial target
- Enzymatic bypass of antimicrobial target
- Prevention of drug penetration or accumulation

Question 25

What are “Superbugs”, (ESKAPE) Enterococcus faecium, Staphylcoccus aureusm Klebsiella pneumoniae, Acientobacter baumanii, Pseudomonas aeruginosa, and Enterobacter spp., and are difficult to treat and cause large # of nosocomial infections?

Answer 25

MDRs - multidrug-resistant microbes

Question 26

Are Vancomycin only effective against G+ or G-

Answer 26

G+

Question 27

What are the last line of defense?

Answer 27

Vancomycin and MRSA

Question 28

Which special resistance involves target modification of peptide component in cell wall; prevent binding?

Answer 28

VRE - Vancomycin-resistant enterococci

Question 29

Which special resistance involves horizontal gene transfer from patients infected with VRE and MRSA?

Answer 29

VRSA - Vancomycin-resistant S. Aureus

Question 30

Which special resistance involves the increase in targets; binding to outer cell

Answer 30

VISA - vancomycin-intermediate S. Aureus

Question 31

Which special resistance involves the acquisition of new low-affinity PBP; resistance to all B-lactams (target modification)

Answer 31

MRSA - Methicillin-resistant S. Aureus

Question 32

Which special resistance involves the resistance to penicillins, cephalosporins, monobactams, B-lactamase-inhibitors, but not carbapenems

Answer 32

ESBLs - Extended-spectrum B-lactamases

Question 33

Which special resistance is involved with the production of carbapenemases (B-lactamses that inactivate all B-lactams) and has efflux pumps and uptake prevention; some have developed pan-resistance (resistance to all antibacterials)?

Answer 33

CRE - Carbapenems-resistant Enterobacteriadeae

Question 34

Which special resistance is resistant to both rifampin and isoniazid?

Answer 34

Multidrug-resistant Mycobacterium tuberculosis (MDR-TB)

Question 35

Which special resistance is resistant to any fluoroquinolone and at least 1 of 3 others drugs used as a 2nd line of treatment

Answer 35

XDR-TB