anti-microbial resistance

Question 1

Describe conjugation

Answer 1

Requires cell to cell contact (co-location). bacterai then acquire a mobile piece of DNA e.g. a plasmid.

Question 2

Describe transformation

Answer 2

Direct uptake, incorporation and expression of exogenous genetic material from the cell’s surroundings - recipient cell then genetically altered. DNA from dead cells is released into the local environment and it is this genetic material that is taken up by the surrounding cells.

Question 3

What is the main genetic way that MRSA is resistant to beta lactams:

Answer 3

MecA - encodes a variant of the normal penicillin binding protein meaning methicillin binds with much reduced affinity.

Question 4

Where would you find a large chromosomal cassette of genes encoding resistance

Answer 4

hospital setting

Question 5

Where would you find a smaller chromosomal cassette of genes encoding resistance

Answer 5

community setting

Question 6

name two coliforms

Answer 6

E.coli and Klebsiella

Question 7

how is pseudomonas resistant to antibiotics

Answer 7

has efflux mechanism so can pump out any antibiotics given

Question 8

name 3 ways in which a biofilm can lead to development of resistance

Answer 8

1. The close proximity of bacteria to each other facilitates gene exchange including exchange of resistance determinants.
2. The channels for diffusion of nutrients are sometimes too small for antibiotics to penetrate well.
3. At the bottom of the biofilm nutrients penetrate in smaller amounts and so the bacteria replicate slower making them less susceptible to cell wall agents.

Question 9

define sepsis

Answer 9

life-threatening organ dysfunction that occurs as a result of a dysregulated host response to an infection

Question 10

what are the elements of a qSOFA score?

Answer 10

hypotension, confusion (reduced GCS), tachypnoea

Question 11

what are the sepsis 6

Answer 11

1. Blood cultures
2. Give antibiotics (follow empirical guidelines)
3. oxygen to achieve target saturation
4. measure lactate and haemoglobin
5. IV fluids
6. Monitor urinary output hourly