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Infection And Immunity > An Infection Model And Antimicrobials > Flashcards

An Infection Model And Antimicrobials Flashcards

1
Q

Name the different mechanisms of infection

A 
Contiguous (direct) spread
Inoculation 
Haematogenous 
Ingestion 
Inhalation 
Vector 
Vertical transmission
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2
Q

What factors affect the patient’s risk of infection?

A 
Age 
Gender
Physiological state 
Genetics/epigenetics 
Pathological state/co-morbidities 
Social factors
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3
Q

What are the 2 types of time in relation to infection?

A 
Calendar time (time of year)
Relative time (since pt exposure)
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4
Q

What is the difference between exotoxins and endotoxins?

A

Exotoxins: deliberately released by microorganisms as a virulence factor
Endotoxins: released in bacterial cell breakdown

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5
Q

What are the 2 general types of treatment?

A

Specific

Supportive

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6
Q

What are the different outcomes of infection?

A

Cure
Chronic infection (+/- disability)
Death

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7
Q

Describe the different ways of classifying antibacterials

A

Bactericidial or Bacteriostatic
Broad vs Narrow spectrum
Target site
Chemical structure

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8
Q

Describe the ideal features of antimicrobials

A 
Selectively toxic 
Few adverse effects
Reaches site of infection 
Oral/IV formulation 
Long half-life 
No interference with other drugs
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9
Q

What are the different target sites for antimicrobials?

A

Cell wall synthesis
Protein synthesis
Nucleic acid synthesis
Cell membrane function

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10
Q

Name the classes of antimicrobials that interfere with cell wall synthesis

A

Beta lactams

Glycopeptides

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11
Q

Name the classes of antimicrobials that interfere with protein synthesis

A

Tetracyclines
Aminoglycosides
Macrolides

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12
Q

Name an antimicrobial class that interferes with nucleic acid synthesis and give some examples

A

Quinolones (rifampicin and trimethoprim)

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13
Q

Name an antimicrobial class that interferes with cell membrane function

A

Polymyxins (colistin)

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14
Q

How does penicillin work?

A

Binds to penicillin binding protein to prevent it linking parts of the cell wall together
Without it there is no rigidity of cell wall therefore the organism does not remain viable

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15
Q

How does vancomycin work?

A

Active against gram positive organisms

Sits on the cross linking chains and prevents penicillin binding protein from doing its job

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16
Q

How do fluoroquinolones work?

A

Inhibit 2 enzymes which deal with replication of nucleic acids
Prevents the organism from multiply
Broad spectrum Abx for gram positive and negative bacteria

17
Q

Describe the mechanisms of resistance of bacteria

A

Drug inactivating enzymes
Altered target
Altered uptake of drug (decreased permeability or increased efflux)
Genetic (mutation and horizontal gene transfer)

18
Q

Name the 3 mechanisms of horizontal gene transfer

A

Conjugation
Transduction (bacteriophages)
Transformation (directly through the cell wall)

19
Q

Define minimum inhibitory concentration

A

The lowest concentration of antibiotic that will have an inhibitory effect on the organism

20
Q

Name the 4 main classes of beta lactams

A

Penicillins
Cephalosporins
Carbopenems
Monobactams

21
Q

Penicillin is mainly activated against which organisms?

A

Mainly gram positive streptococci

Used to be staphylococci but most are resistant now

22
Q

Amoxicillins are mainly active against which organisms?

A

Gram negatives

23
Q

Flucloxacillin is active against…

A

Staphylococci and streptococci

Except MRSA

24
Q

Describe cephalosporins

A

Broad spectrum Abx but not active against anaerobes

Ceftriaxone has good activity in the CSF (therefore good for meningitis)

25
Q

Describe carbapenems

A

Very broad spectrum
Active against most gram negatives
Generally safe in a penicillin allergy

26
Q

Vancomycin is what type of Abx?

A

Glycopeptide

27
Q

Describe the features of vancomycin

A

Active against most gram positive
Some enterococci are resistant
Resistance in staphylococci is rare
Narrow therapeutic window

28
Q

Describe the features of tetracyclines

A

Broad spectrum not specifically used when there is a penicillin allergy
Usually for gram positives
Active against atypical pathogens in pneumonia
Active against chlamydia and some protozoa
Shouldn’t be given to children under 12 (stain teeth and bones)

29
Q

Describe the features of aminoglycosides

A 
Eg. Gentamicin 
Profoundly active against gram negatives 
Good activity in the blood and urine  
Potentially nephrotoxic 
Narrow therapeutic window 
Reserved for severe gram negative sepsis
30
Q

Describe the features of macrolides

A

Eg. Erythromycin
Alternative to penicillin for mild gram positive infections
Active against atypical respiratory pathogens

31
Q

Describe the features of quinolones

A 
Eg. Ciprofloxacin 
Inhibit DNA gyrase 
Very active against gram negatives 
Active against atypical pathogens 
Increasing resistance and risk of Clostridium difficile
32
Q

What is the mechanism of trimethoprim?

A

Inhibitor of folic acid synthesis

33
Q

Describe azoles (antifungals)

A

Active against yeasts and moulds

Inhibit cell membrane synthesis

34
Q

Describe polyenes (antifungals)

A

Inhibit cell membrane function
Topical treatment of candida
Can get some for IV treatment of systemic fungal infections

35
Q

Describe aciclovir (antiviral)

A

Inhibits viral DNA replication

Active against herpes simplex and varicella zoster

36
Q

How does Tamiflu work? (Oseltamivir)

A

Inhibits viral neuraminidase

Used for influenza A and B

37
Q

What is metronidazole?

A

An antibacterial and anti protozoal against

38
Q

Describe the features of cellulitis

A

Often caused by strep pyogenes
Spread through superficial dermis
Enzymatically breaks down the CT of the dermis - allowing the organism to spread
Swollen, hot, red, painful

39
Q

Describe the features of necrotising fasciitis

A

Mixed synergistic bacterial infections
‘Flesh-eating’
Death of the body’s soft tissue
Red/purple skin, severe pain, fever and vomiting
Most common areas = limbs and perineum
Typically enters through a break in the skin eg. Cut or burn

Infection And Immunity (9 decks)

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