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4.2 Medical Microbiology > Add- Ons > Flashcards

Add- Ons Flashcards

1
Q

Types of care bundles

A
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2
Q

PVC care bundle

A
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3
Q

Vertical vs horizontal ipc programmes

A
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4
Q

Types of esbls

A

TEM and SHV
CTX-Ms
VEB and PER
GES

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5
Q

Endemic CTX

A

CTX-M-15

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6
Q

Endemic KPC CPE strain

A

ST-258

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7
Q

What CPE are we most concerned with

A

ST23-K1 - a hyper virulent and invasive K.pneumonia that’s spreading rapidly

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8
Q

Detection methods for cpes

A

Disks and mic etc
Colorimetric - Blue Carba
MALDI - hydrolysis
Immunochronatography - resist/carba-5
Check Direct CPE
GeneXpert CarbaR
LightMix

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9
Q

Resistance mechanisms in CRAB

A
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10
Q

Detecting CRAB

A

CHROMID-CARBA SMART bi plate
Coris Resist Oxa23
RAPIDEC CARBA NP - culture
RAPIDEC CARBA NP - blood culture
GeneXpert Carba R
Light Mix

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11
Q

Specific Adaptive tolerance of p. aeruginosa biofilm

A
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12
Q

Why three factors determine if a disinfection method might fail to work on biofilm

A

Biofilm thickness
Biofilm maturity
Presence of persister cells

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13
Q

DSB disinfection

A
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14
Q

P. Aeruginosa biofilm disinfection

A
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15
Q

Biofilm ast

A

Biofilm inhibitory concentration

Minimum biofilm eradication concentration

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16
Q

MIC of antimicrobials needed to remove biofilm in a patient

A
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17
Q

Biofilm ast on a surface methof

A

Modified Robbins device/Biofilm device reactor system

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18
Q

Biofilm novel strategies

A
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19
Q

C. Difficile hcai prevalence

A
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20
Q

Zoonotic c. Diff

A

RT 078

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21
Q

C. Difficile carriage

A
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22
Q

C. Difficile associated antibiotics

A
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23
Q

Region of tcd gene frequently mutated

A

CROP binding domain

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24
Q

Common ribotypes/sequence types in Ireland

A

ST11/RT027 predominates at 16%

ST8/RT002 follows at 13%

ST2/RT014 follows at 12%

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25
Q

Changing epidemiology of C.diff

A
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26
Q

Current C.diff treatment

A
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27
Q

Current C.diff treatment

A
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28
Q

New c.diff treatment

A

Bovine whey protein ‘mucomilk’
Tolevemer - linear polymer - toxin
Bezlotoxumab - MAB
Toxoid vaccines
Active vaccines

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29
Q

Disinfection for CDI

A

Alcohol rub not affected, soap needed
HW decreased from 16.75 to 9.49
ASW reduced c.diff by 32%

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30
Q

6 Ds of Antimicrobial Stewardship

A
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31
Q

CDI care bundle

A
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32
Q

MRSA strains

A

Sporadic: rarely cause infection
Epidemic: propensity to spread in HC environment

ST 22 predominates in Ireland, 80% of S.aures BSIs

Other mrsa infections by ST8, ST5, ST1

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33
Q

IPC of MRSA

A

HH reduces MrSA from 1.88 to 0.91, no affect on MSSA

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34
Q

Additional resistance in vre

A

Linezolid resistance since 2014
Mutation I’m 23S rRna inhibits it’s binding

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35
Q

Vre carriage study

A

Cuh study
0% community carriage
19.1% hospital carriage

87% vanA only

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36
Q

Vre infection control

A
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37
Q

Vre infection control

A
38
Q

HCAI intro

A
39
Q

5 aims of PPS

A
40
Q

What % of HCA pneumonia was associated with intubation in 2023

A

8%, rates have halved since 2017

41
Q

What % of HCA uTi was associated with catheterisation in 2023

A

40% an increase of 10% since 2017

42
Q

What % of HCA BSI was associated with invasive devices in 2023

A

30%

43
Q

Give percentages for each HCAI group for 2023

A

Pneumonia at 27% - down from 29 - up rank

UTI at 14.5% - no change - up rank

SSI at 14% - down from 18 - down rank x2

BSI at 8.6% - down from 10 - no change

Gastro at 8.5% - up from 8 - no change

44
Q

Pps common organisms

A

15% e.coli
15% s.aures
9% covid
9% c.diff
6.0% e.faecium
6% k.pneumonia

45
Q

Pps micro results

A
46
Q

Types of plasmids

A

R plasmid
Virulence plasmid
Degradative plasmid - toluene
Conjugative/Fertility plasmids

47
Q

4 types of mutations in vgt

A

Point -silent/missense/nonsense

Frame shift

Large scale

Spontaneous

48
Q

Hgt methods

A

Transformation
- lysed outside dna

Transduction - phages
- generalised
- specialised

Conjugation
- Hfr conjugation

49
Q

Pathogenicity islands

A
50
Q

4 main transposable elements

A

Insertion sequences
Composite transposons
Non-composite transposons
Retrotransposons

51
Q

Types of transposition

A
52
Q

Transposons that carries resistance to Beta lactams

A

Tn3

53
Q

Transposon for virulence

A

Tn916 in c.diff

54
Q

Transposons for ESBLs

A

Tn3 ESBL production in e.coli and k.pneumoniae

55
Q

Vre transposon

A

Tn1546

56
Q

Tn for cre

A

Tn4401

57
Q

Integrons in resistance

A

22-59% of GNs had integrons

Class 1 integrons in enterobacters carrying resistance to beta lactats, aminoglycosides and sulfonamides,

-> e.coli and k.pneumo esbls and aminoglucoside resistance

Class 1 in Salmonella against sulfonamides

58
Q

Incidence of tb

A

8.6 million cases
1.4million deaths

59
Q

Antibiotics have extended human life by how many years

A

23

60
Q

How long and how much does it take to get an antibiotic to market

A

15 years
800 million

61
Q

What are our novel antibiotics

A
62
Q

Two precision antimicrobial strategies

A

Targeting biofilm using enzymes

Upec binding
- mannosides fir uti - stop fimH adhesion

63
Q

New antimicrobial strategies

A
64
Q

New antimicrobial strategies

A
65
Q

Properties to consider when choosing an antibiotic

A
66
Q

Bs antibiotic

A

Norfloxacin

67
Q

An antibiotic that’s both bacteriostatic and cidal

A

Linezolid

Static to staph and enterococcus
Cidal to strep

68
Q

Examples of toxicity

A

Aminoglycosides are nephrotoxic
Isoniazid is hepatotoxic

69
Q

KADME

A

kinetics of absorption, distribution, metabolism, excretion

70
Q

Concentration dependent antimicrobials

A

Aminoglycosides
Fluoroquinolones

71
Q

Bactoprenol function

A

Transports NAM and NAG across cell membrane

72
Q

Peptidoglycan formation

A
73
Q

Liopoteichoic acid

A

Bringa about cell suicide - an autolysin

Trigger by B lactam antibiotics - bind BPB - NAM/NAGs build up and trigger liopteichoic acid

74
Q

A synthetic Penicillin

A

Augmentin

Amoxicillin + clavulanate for activity against b-lactamase enzymes

75
Q

Synthetic cephalosporin

A

Ceftazidime/avibactam for beta lactamase gns

76
Q

Synthetic monobactam

A

Aztreonam/avibactam got resistant gns

77
Q

Glycopeptides examples

A
78
Q

Antibiotics that target nucleic acids

A

Fluoroquinolones - dna gyrase + topoisomerase

Nitroimidazoles - mtz - ROS damage

Nitrofurans - reactive intermediates

Novobiocin - dna gyrase - gyrB

Rifampicin - binds rna polymerase preventing mrna synthesis

79
Q

Antibiotics targeting protein synthesis

A

30S:
- aminoglycosides (gentamycin, amikacin, tobramycin, streptomycin, neomycin)
- tetracyclines (tetracycline, doxyxycline, minocycline)
- glycylcyclines - tigecycline

50S:
- macrolides - azithreonam
- lincosamides - clindamycin
- chloramphenicol
- oxazolidines - linezolid
- streptogranins

80
Q

Mechanisms of aminoglycosides and tetracyclines

A

Aminoglycosides bind 30s and cause misreading of mRNA

Tetracyclines bind 30S and preventing binding of tRNA needed for adding amino acids to the growing protein chain

81
Q

Glycylcyclines such as tigecycline

A

NB - affective against acinetobacter one of only drugs that is

82
Q

Lunezolid function

A

Targets 23s rRNA in 59S subunit which prevents the formation of a functional 70S

This inhibits protein synthesis

83
Q

Improved linezolid

A

Tedizolid

Extended activity
Few gi side effects

84
Q

Antibiotics that affect the cell membrane

A
85
Q

Polymyxin

A
86
Q

Polyenes

A
87
Q

How is daptomycin great

A

Highly selective as it only targets liposomes containing phosphatidylglycerol which is only found in bacterial membranes - K+ efflux - death

Reduces expression of MecA in mrsa (not meC)

88
Q

Competitive inhibitors

A
89
Q

4 key characteristics of tb cell wall

A

Acid fast bacilli
Low permeability
High lipid content
Slow growers

90
Q

Tb cell wall

A

Tripartite complex:
- cross linked peptidoglycan
- highly branched arabinogalactan polysacchraides
- long chain mycolic acids-> free lipids and glycolipids such as PGM and PDIM

91
Q

TB pamps

A

4.2 Medical Microbiology (20 decks)

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