Antibiotic Resistance Flashcards

1
Q

What are the current major clinical problems?

A

MRSA

Carbapenem-resistant enterobacteriaceae (CRE)

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2
Q

How often do infections occur after surgery?

A

3%

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3
Q

What are some examples of CREs?

A

Escherichia coli
Klebsiella pneumoniae carbapenems
Salmonella

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4
Q

Is CRE gram-positive or gram-negative?

A

Gram-negative

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5
Q

What are the chances of dying with a CRE infection?

A

Approximately 50%

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6
Q

What are the resistance mechanisms of bacteria?

A

Keeping antibiotics outside of the cell
Destroy or inactive antibiotic
Modify molecular target of antibiotic

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7
Q

What is a difference between penicillin and vancomycin to gram-negative bacteria?

A

Penicillin can cross the outer membrane by the porin channels whereas vancomycin cannot

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8
Q

What does a mutation in ompF lead to?

A

impermeable porins leading to resistance

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9
Q

What is an example of a bacteria that has ompF and ompC?

A

E. coli

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10
Q

What is intrinsic resistance?

A

innate ability of bacteria to resist antibiotic through its normal structure/function e.g. cell envelope, ribosome structure

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11
Q

What is acquired resistance?

A

susceptible bacteria acquires resistance gene from another bacteria species/strain via HGT

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12
Q

What is HGT?

A

Horizontal gene transfer

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13
Q

What is an example of a bacteria with porin channels of low permeability?

A

Psuedomonas aeruginosa

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14
Q

Ampicillin is used to treat E. coli , what spectrum drug is it?

A

Broad

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15
Q

How do bacteria increase export of antibiotics?

A

Efflux pumps

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16
Q

How does bacteria work against beta-lactam antibiotics?

A

Beta-lactamases which are hydrolytic enzymes that destroy/inactivate the antibiotic

17
Q

Where is Staphylococcus aureus found?

A
Nose
Skin folds
Hairline
Perineum
Navel
18
Q

What relatively minor infections are caused by Staphylococcus aureus?

A

Abscesses
Impetigo
Minor skin infections

19
Q

What more serious problems are caused by Staphylococcus aureus?

A
Cellulitis
Post-operative infection
Pueruperal fever
Catheter infections
Toxic shock syndrome
20
Q

What does MRSA stand for?

A

Meticillin resistant staphylococcus aureus

21
Q

What percentage of S. aureus bacteraemias are MRSA?

22
Q

Why are there many HA-MRSA?

A

Puncturing of the skin

Catheters, IVs, surgery

23
Q

What is the difference between HA-MRSA and CA-MRSA?

A

HA-MRSA is more prevalent but CA-MRSA is more virulent

24
Q

How long did it take for S. aureus to become resistant to Meticillin?

25
What allow S. aureus to be MR?
Chromosomal macA encodes altered PBP2' (penicillin binding protein 2) - allows cell wall biosynthesis to continue
26
What allows rapid spread of vancomycin resistant S. aureus?
VanR genes are mobile (transposons, plasmids)
27
What are the new last resorts in treating MRSA?
Tigecycline | Linezoloid
28
How is MRSA screened for?
Nose swab (or armpit/groin) -> sent to lab
29
How to decolonise MRSA?
Nasal spray, body wash, shampoo with anti-MRSA Prontoderm Chlorhexidine glucognate Mupirocin