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**Host and Defense > Antibiotic Resistance > Flashcards

Antibiotic Resistance Flashcards

1
Q

How is antibiotic resistance acquired?

A

Mutation and horizontal gene transfer

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2
Q

How can resistant strains of antibiotics be selected?

A

By the misuse and overuse of antibiotics

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3
Q

What are the 3 major antibiotic resistance mechanisms?

A
  1. Prevent access to target
  2. Modify or protect antibiotic target
  3. Modification/inactivation of antibiotics
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4
Q

What are some examples of antibiotic tolerance mechanisms?

A
  • Biofilm formation
  • Persister cells
  • Spores
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5
Q

What are antibiotics synthesized by?

A

Molds or bacteria

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6
Q

Prior to antibiotics and vaccines what diseases caused one third of all deaths?

A
  1. Pneumonia
  2. TB
  3. Diarrhea and enteritis
  4. Diptheria
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7
Q

When and where was penecillin first discovered?

A

St. Mary’s hospital in London, September 1928, by Alexander Fleming

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8
Q

How many antibiotics have been developed since penicillin was introduced?

A

over 140

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9
Q

How many lives do antibiotics save each year in the USA?

A

over 200,000

*Adding 5-10 years to US life expectancy

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10
Q

What are the antibiotic targets?

A
  1. Cell wall synthesis/integrity
  2. RNA synthesis
  3. Amino-acyl-tRNA synthetase
  4. DNA replication/repair/segregation
  5. Protein synthesis
  6. Folic Acid synthesis (tetrahydrofolate)
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11
Q

Which antibiotics target Cell wall synthesis?

A
  1. B-lactams
  2. Glycopeptides
  3. Bactitracin
  4. Fosfomycin
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12
Q

Which antibiotics target RNA synthesis?

A

Rifampin

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13
Q

Which antibiotics target Amino-acyl-tRNA synthesis?

A

Mupirocin

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14
Q

Which antibiotics target DNA replication?

A

Quinolones
Fluoroquinolones
Metronidazole

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15
Q

Which antibiotics target protein synthesis?

A

Targeting of 30s:

  • Aminoglycosidese
  • Tetracyclines

Targeting of 50s:

  • Chloramphenicol
  • Macrolides
  • Lincosamides
  • Streptogramins
  • Everninomycin
  • Oxazolinonones
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16
Q

Which antibiotics target Folic acid synthesis?

A

Sulfanomides

Trimethoprim

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17
Q

What is the estimated number of illnesses caused by antibiotic resistance every year?

A

2,049,442

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18
Q

What is the estimated number of deaths caused by antibiotic resistance?

A

23,000

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19
Q

If the current trend continues, antibiotic resistant bacteria are expected to cause the premature death of how many people per year globally by 2050?

A

10-300 million

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20
Q

What are the steps of how antibiotic resistance happens?

A
  1. Lots of germs, a few are drug resistant
  2. Antibiotics kill bacteria causing the illness, as well as good protecting the body from infection
  3. The drug-resistant bacteria are now allowed to grow and take over
  4. Some bacteria give their drug-resistance to other bacteria causing more problems
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21
Q

Bacterial resistance facilitated by __________, ______, and by strong selective pressures from increased use of _______ in both clinical and agricultural settings

A
  1. Large numbers of bacteria
  2. HGT
  3. Antibiotics
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22
Q

What does it mean for bacteria to restrict antibiotic access?

A

Prevent drug from getting in or pump the drug back out before it affects the target

23
Q

What does it mean for bacteria to modify antibiotic target?

A

Target is altered structurally or target is over expressed, requiring much more drug

24
Q

What does it mean for bacteria to modify the antibiotic?

A

Drug is inactivated before affecting target

25
Q

T/F Bacteria can modify expression of bacterial factors needed to activate the antibiotic (like a prodrug)

A

True

*this is also a mechanism of resistance in addition to the main 3

26
Q

How would an antibiotic restrict access of antibiotic to target?

A

Alter envelop to inhibit uptake or boost expression of efflux pumps

27
Q

How would bacteria over express the target?

A
  • Change in promoter
  • Change in regulator
  • Change in Gene copy number
28
Q

How would bacteria Modify the target?

A
  • Mutation of gain of modifying enzyme

- Over expression of target

29
Q

What are two ways that a bacteria can inactivate the antibiotic?

A
  1. Inactivation by hydrolysis

2. Inactivation by steric hindrance

30
Q

What are 3 things that can be done by Aminoglycoside-inactivating enzymes to modify aminoglycosides?

A
  1. N acetylation
  2. O phohphorylation
  3. O adenylation

*These modifications disrupt hydrogen-bonding network used to bind 16s rRNA

31
Q

Flavodoxin activates Metronidazole in which bacteria?

A
  1. H. pylori

2. P. gingivalis

32
Q

KatG activates Isoniazid. Which bacteria would produce KatG

A

Mycobacterium TB

33
Q

Resistance is acquired by _______ and ______

A
  1. Mutation

2. Horizontal gene transfer

34
Q

In E. Coli, resistance to Streptomycin can arise due to a spontaneous mutation that occurs at what rate?

A

1 in a billion

**Fast growth and high numbers make this a significant rate

35
Q

List 4 multidrug resistant bacterial pathogens that are becoming increasingly common

A
  1. Extended-spectrum B-Lactamase producing Enterobacteriaceae
  2. Carbapenem-Resistant Enterobacteriaceae
  3. C. Diff
  4. Super Neisseria gonorrhea
36
Q

What contributes to the selection and spread of multi drug resistant strains of bacteria?

A
  1. Overuse of antibiotics
  2. Overpopulation
  3. Poor hygiene
  4. Travel
37
Q

Name a pathogen that is Priority 1 and is carbapenem resistant

A
  • Acinetobacter baumannii

- Pseudomonas aeruginosa

38
Q

Name a pathogen that is priority 1, carbapenem resistant, and ESBL producing

A

Enterobacteriacea

39
Q

Name a pathogen that is Priority 2 and is vancomycin resistant

A

Enterococcus faecium

40
Q

Name a pathogen that is priority 2 and is methicillin resistant, vancomycin-intermediate and resistant

A

S. aureus

41
Q

Name a pathogen that is priority 2 and is clarithromycin resistant

A

H. pylori

42
Q

Name a pathogen that is priority 2 and is fluoroquinolone resistant

A
  • Campylobacter spp

- Salmonellae

43
Q

Name a pathogen that is priority 2 and is fluoroquinolone and cephalosporin resistant

A

Neisseria gonorrhoeae

44
Q

Name a pathogen that is priority 3 and is penicillin-non-susceptible

A

Strep pneumo

45
Q

Name a priority 3 pathogen that is ampicillin resistant

A

H. flu

46
Q

Name a priority 3 drug that is fluoroquinolone resistant

A

Shigella

47
Q

What are 3 deterrents from the development of new antibiotics?

A
  1. Costs
  2. Pharmacokinetics
  3. Potential side effects
48
Q

T/F Bacteria that are normally susceptible to antibiotics may be able to tolerate the drugs under some conditions

A

TRUE

49
Q

Bacteria present within _____ are often protected from antibiotic treatments

A

biofilms

50
Q

What percent of human infections may involve biofilms

A

over 65%

51
Q

Antibiotic tolerance is important in what 4 types of pathogens?

A
  1. Within intracellular niches
  2. Spores
  3. Within biofilms
  4. Persister cell formation
52
Q

Name 6 ways that biofilms can enhance the ability of bacteria to tolerate antibiotics

A
  1. Extracellular matrix
  2. Increased stress resistance
  3. Increased genetic exchange
  4. Persister cell formation
  5. Decreased metabolism
  6. Altered protein expression
53
Q

What are persister cells?

A

Dormant bacteria that are insensitive to many stresses and antibiotic treatments

**Host and Defense (31 decks)

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