9-1 Intro to Abx Flashcards
What are the 3 Factors that determine appropriate Abx therapy?
- Host Characteristics
- Abx abilities
- Infection SITE and Pathogen involved
List the 7 Sterile Body Sites and their associated fluids
“Pts Should Produce Sterile Blood Upon Probing”
ºPericardium = Pericardial Fluid
ºSubArachnoid Space = CSF
ºPleural Space = Pleural Fluid
ºSynovium = Synovial Fluid
ºBloodstream = Blood
ºUrinary Tract = DIRECT URINE FROM BLADDER
A: Define Contamination
B: example
A: Organism is inadvertently introduced to the pt during collection or processing smh
B: Coag-neg staph in blood of pt
A: Define Colonization
B: example
A: Organism is present at body site BUT IS NOT INVADING OR CAUSING HARM
Empiric Therapy
Giving Abx that will treat what’s LIKELY thought to be the pathogen (pre-lab)
A: Antimicrobial Susceptibility Testing includes ____ and _____ and is performed on individual _____ isolates once grown up and identified in _______
B: Define the 2 components
C: Which one should be Larger in #?
A: Antimicrobial Susceptibility Testing includes [Minimum Inhibitory Concentration-MIC] and [Minimum BacterioCIDAL Concentration-MBC] and is performed on individual BACTERIAL isolates once grown up and identified in CULTURE
B:
1. MIC= Minimum INHIBITORY Concentration of Abx needed to STOP Visible Bacterial Growth. (Can be further described in [3 Susceptibility Breakpoints] )
MBC= Minimum Abx Concentration needed to KILL BACTERIA and REDUCE INOCULUM BY 99.9%
C: MBC ≥ MIC
A: Susceptibility Breakpoints (3)
B: What do they describe?
A:
1) Susceptible= Organism’s MIC is within normal range and can be eradicated w/normal abx dose
2) Intermediate= Organisms’s MIC is at MAX DOSE OF ABX and so tx MAY be successful
3) Resistant= Organisms’s MIC EXCEEDS [Toxic MAX DOSE OF ABX] –> likely subOptimal outcome
B: [S.I.R.] further describe [MIC - Susceptibility Testing]
There are 4 test used to determine MIC. [MACROdilution vs. microdilution vs. [Disk Diffusion Kirby Bauer] vs. [E-test]
A: Describe MACROdilution
B: Why isn’t this performed routinely?
C: What type of MIC does this give you? [Exact vs. Range]
A: MACROdilution: [TWO fold serial dilutions of abx] are incubated with [bacterial inoculum] in several test tubes. 1st test tube to show NO VISIBLE GROWTH= [EXACT MIC]
B: (x) Labor and Resource intensive (x)
C: [EXACT MIC]
There are 4 test used to determine MIC. [MACROdilution vs. microdilution vs. [Disk Diffusion Kirby Bauer] vs. [E-test]
A: Describe microdilution
B: Why is this the preferred method?
C: Con of microdilution
D: List two companies that perform microdilution
E:What type of MIC does this give you? [Exact vs. Range}
A: microdilution: [serial dilutions of abx] are incubated with [bacterial inoculum] in several [microtiter plates/cassettes] and ELECTRONICALLY tested simultaneously
B: Automated Process
C: Small cassettes impede ability to test all abx concentrations –> Results are reported as [MIC Range]
D: Vitek and Microscan
E: [MIC Range]
There are 4 test used to determine MIC. [MACROdilution vs. microdilution vs. [Disk Diffusion Kirby Bauer] vs. [E-test]
A: Does [Disk Diffusion Kirby Bauer] Determine MIC?
B: What do the Zone Diameters tell you?
C: Quantitative or Qualitative Test?
[Disk diffusion Kirby Bauer] - DdKB
A: DOES NOT TELL YOU MIC !
B: Zone Diameters (measured in mm) correlates with [S.I.R. - Susceptibility Testing]
C: QuaLitative
There are 4 test used to determine MIC. [MACROdilution vs. microdilution vs. [Disk Diffusion Kirby Bauer] vs. [E-test]
A: Describe [E-Test]
B: Does [E-Test] Determine the MIC?
A: [E-test] Combines [Quantitative Serial Dilution] with [QuaLitative DdKB]. Plastic Strip with different concentrations of abx is placed on agar plate covered in bacteria.
B: YES. Area Where Ellipse crosses the strip = MIC
4 Criteria that’ll affect [Susceptibility Breakpoints: S.I.R.] for an Abx
“The PIG Criteria is Susceptabile”
- Pharmacokinetics of the Abx Drug
- General Activity of the Abx
- Infection SITE
- Clinical Data
Empiric therapy is based on ________ and _______. It is given _____(after/before) [culture and susceptibility reports] have returned
Empiric therapy is based on [DOC for most likely organism] and [regional susceptibility]. It is given BEFORE [culture and susceptibility reports] have returned
Describe the 3 Outcomes of Combination Therapy B: Combination therapy allows coverage of the entire ______ and prevents _____
ºAdditive: [[A and B]] = (A alone) + (B alone)
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ºAntagonistic: [[A and B]]
Name 4 Dz that BacteriCidals are specifically needed to treat
“You can only kill FOME with BacteriCidals”
- [Febrile neutropenia]
- Osteomyelitis
- Meningitis
- Endocarditis
