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Infectious Disease AB > Antibiotic resistance AB > Flashcards

Antibiotic resistance AB Flashcards

1
Q

What are the three classifications of antibiotic resistance, when described by mechanism?

A

Antibiotic inactivation
Alteration of target
Decreased uptake

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2
Q

What is an example of antibiotic inactivation?

A

Betalactamases

Pneumococcus and macrolides (erm)

Enzymatic modification of aminoglycosides

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3
Q

What is an example of alteration of antibiotic target?

A

Pneumococcus and penicillin

S aureus and methicillin-like antibiotics

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4
Q

What are two mechanisms of decreased uptake?

A

Reduced penetration

Antibiotic efflux

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5
Q

What is an example of intrinsic antibiotic resistance (i.e. the resistance has always been there) ?

A

E coli and penicillin or vancomycin

Klebsiella and amoxycillin

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6
Q

What is an example of acquired antibiotic resistance?

A

S aureus and penicillin

Pseudomonas and ciprofloxacin

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7
Q

Broadly speaking, what are the two genetic mechanisms of developing resistance?

A

Spontaneous DNA mutations (SNPs)

Acquisition of new DNA

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8
Q

Give an example of spontaneous DNA mutations in genetic mechanisms of resistance?

A

M tuberculosis

S aureus and Rifampicin

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9
Q

What are the modes of acquisition of new DNA in genetic mechanisms of resistance?

A

TRANSFORMATION - part of the bacterial chromosome integrated into another bacterial chromosome

CONJUGATION - mobile plasmid enters a different bacterium

TRANSDUCTION - bacteriophage

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10
Q

What is the gene involved in resistance of MRSA?

A

mecA gene

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11
Q

What is the main mechanism of resistance in MRSA?

A

Acquisition of altered penicillin binding protein

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12
Q

What are the two genes involved in the resistance of VRE?

A

VanA

VanB (Australia)

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13
Q

What is the mechanism in the resistance of VRE?

A

Encode for altered pentapeptide peptidoglycan precursor - decreased affinity

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14
Q

What is the treatment for VRE?

A

Linezolid
Tigecycline
Daptomycin

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15
Q

What is the mechanism of penicillin-non-susceptible S pneumoniae?

A

Altered penicillin-binding-protein (not beta-lactamase)

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16
Q

What are the four classes of beta-lactamase enzyme classes

A

A - Penicillinases
B - Metalloenzymes
C - Cephalosporinases
D - Oxacillinases

17
Q

What are the genes in penicillinase (A) resistance?

A

TEM
SHV (Klebsiella)
CTX-M

18
Q

What are the genes in the metalloenzyme (B) group?

A

NDM
VIM
IMP

19
Q

What is an example of inducible beta lactamase activity?

A

Class C (Cephalosporinases) - AmpC-type

ESCAPPM

20
Q

What are the ESCAPPM organisms?

A 
Enterobacter
Serratia
Citrobacter
Acinetobacter
Proteus (not mirebalis)
Providentia
Morganella
21
Q

What is the mechanism of resistance in ESBL?

A

Mutations in existing beta-lactamase genes (e.g. TEM, SHV)

Plasmid mediated transfer

22
Q

What is the treatment of ESBL?

A

Carbapenem
Colistin
Amikacin

23
Q

What are two examples of class B metallo-beta-lactimases?

A

Pseudomonas

Acinetobacter

24
Q

What is the mechanism of resistance in metallo-beta-lactamases

A

Plasmid mediated transfer (usually)

25
Q

What is the mechanism of aminoglycoside resistance?

A

Decreased permeability

26
Q

What is the mechanism of resistance in VISA?

A

Thickened cell wall (D-ala-D-ala)

27
Q

When is VISA commonly seen?

A

Mainly in dialysis patients or those with infected foreign bodies

28
Q

What do Van A and B genes code for?

A

D-ala-D-ala

29
Q

Which antibiotic should be be avoided with concurrent SSRI or Tramadol use?

A

Linezolid

30
Q

What are the anti-pseudomonal antibiotics?

A 
Tazocin
Ceftazadime
Cefepime
Meropenem (not ertapenem)
Tobramycin
Gentamicin
Ciprofloxacin
Aztreonam
Colistin
31
Q

Which antibiotics treat VRE?

A

Linezolid
Daptomycin
Tigecycline

32
Q

Which antibiotics treat VISA?

A

Linezolid

33
Q

In what setting should Fosfomycin be used?

A

PO agent

Mainly used for resistant UTIs (not pseudomonas)

34
Q

What does Colistin work well against?

A

Pseudomonas
Acinetobacter
E coli

Some Enterobacter, Klebsiella, Salmonella and Stenotrophomonas

NOT other ESCAPPM

35
Q

Which organisms are resistant to Meropenem?

A 
Legionella pneumophila
Enterococcus FAECIUM
Stenotrophomonas
Coxiella burnetti
MRSA
Candida albicans
M pneumoniae

Infectious Disease AB (11 decks)

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