AMR

Question 1

What are antimicrobials used for?

Answer 1

To treat infections caused by bacteria (antibiotics), fungi and yeast (antifungals), parasite (antiparasitics) and viruses (antivirals)

Question 2

What is AMR?

Answer 2

Antimicrobial resistence - occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials.

Question 3

What are consequences of AMR?

Answer 3

There is limited treatment for infections, increased risk of transmission, accumulation of antimicrobial resistence-determinants

Question 4

What does panresistence mean

Answer 4

Resistence to all drugs

Question 5

What are the main drivers of AMR?

Answer 5

Overuse and misuse of antimicrobials, poor hygiene/sanitation, failure of infection control measures in healthcare or agriculture.

Question 6

What are the types of horizontal gene transfer?

Answer 6

Transformation, Transduction, Conjugation

Question 7

What are plasmids?

Answer 7

Small extra chromosomal DNA molecules that can replicate independently

Question 8

What are MDROs

Answer 8

Multidrug resistant organisms - organisms resistant to 3 or more classes of antimicrobial drugs

Question 9

Examples of Beta-lactam antibiotics

Answer 9

Penicillins, cephalosporins, carbapenems, monobactams

Question 10

Examples of Gram Positive Organisms

Answer 10

Staphyloccus species, Enterococcus spp

Question 11

What is Staphlococcus aureus?

Answer 11

A Gram positive cocci that is arranged in clusters. It is significant pathogen and commensal of microbiota of the skin and upper respiratory tract. It is the infection most often associated with the skin, UTI, BSI, osteomyelitis, food poisoning

Question 12

What antibiotic fights a staphylococcus aureus infection?

Answer 12

Cephalexin for uncomplicated skin infection.
Vancomycin for treatment of complicated infections including bacteraemia, deep-seated infections, pneumonia

Question 13

What does MRSA stand for

Answer 13

Methicillin-resistant Staphylococcus aureus

Question 14

What is Enterococci?

Answer 14

A Gram positive cocci that appears in chains or as diplococci. It is a lactic acid bacteria - produces lactic acid as a biproduct of fermentation. Causes UTIs, bacteraemia, endocarditis, meningitis

Question 15

What antibiotics fights Enterococcus spp?

Answer 15

Nitrofurantoin (nitrofuran class) for uncomplicated UTI.
Vancomycin (glycopeptide class) for invasive infections.

Question 16

How does vancomycin work?

Answer 16

Vancomycin binds to the D-Ala-D-Ala terminus of the peptidoglycan precursor, inhibiting transglycosylation and transpeptidation, consequently causing cell wall damage.

Question 17

How does Vancomycin-Resisant Enterococci (VRE) work?

Answer 17

They acquire the vanA or vanB gene that alters the D-Ala-D-Ala target of vancomycin.

Question 18

What are the treatment options for vancomycin-resistant strains?

Answer 18

Linezoid and daptomycin, final resort antibiotics, economic associations

Question 19

What is VRSA and what is it mediated by

Answer 19

Vancomycin-resistant Staphylococcus aureus mediated by a vanA gene cluster which is transferred from VRE via transposon.

Question 20

What are control measures of AMR bacteria?

Answer 20

Screening on admission, pre-procedure or on entering intensive wards, surveillance reporting, patient isolation, hygiene measures

Question 21

Where are MRSA swabs taken from and what are they plated on?

Answer 21

Nose, axilla, groin are plated on selective and differential commercial media in hospital labs.

Question 22

Where are VRE swabs taken from and what are they plated on?

Answer 22

Rectal are plated on selective and differential commercial media in hospital labs

Question 23

What is a bacteriophage?

Answer 23

A virus that targets bacteria

Question 24

Process of bacteriophage infecting host

Answer 24

A bacteriophage attaches itself to a susceptible bacterium and infects the host cell. Following infection, the bacteriophage hijacks the bacterium´s cellular machinery to produce viral components. New bacteriophages assemble and burst out of the bacterium in a process called lysis.

Question 25

What are Carbapenems?

Answer 25

Drugs of last resort, with broad spectrum activity against Gram neg and some Gram pos.

Question 26

What are CPEs?

Answer 26

Carbapenemase-producing Enterobacterales - are resistant to all antiboitics derived from penicillins and roughly half of all antibiotics are derived from penicillins.