Antibiotic Susceptibility Testing Flashcards
Bacteriostatic
Inhibits growth but does not kill
MIC
Minimum Inhibitory Concentration of an antimicrobial agent which inhibits the growth of microorganism. Should be determined for each antimicrobial to be used in therapeutics
Bacterial Resistance Mechanisms to Antibiotics
- Enzymes that inactivate or alter the antibiotic
- Barrier to entry (cell wall or outer membrane) Overproduces targeted sites
- Porins (decrease or prevent the uptake of the antibiotic)
- Efflux (pump the antibiotic out of the cell)
- Alter the antibiotic attachment site
- Produce a different enzyme that substitutes for the targeted one
Intrinsic Resistance
- Vancomycin is too large to cross the outer membrane of GN (they are inherently resistant)
- Anaerobes are resistant to aminoglycosides
- Almost all GNR express chromosomal beta-lactamases
- Enterococcus spp. target sites have low affinity for many antibiotics
Extrinsic Resistance
- Chromosomal mutations within the organism
- Nonchromosomal genetic elements transfers genetic info. between different genera and species (plasmids and transposons)
- DNA from environment
- Bacteriophages
Inhibitors of Cell Wall Synthesis
Beta-Lactam Class: Penicillins, Cephalosporins, Monobactam, Carbapenams
Bacterial Resistance Mechanisms against Beta-Lactams
- Produce degradative enzymes (Beta-Lactamases, Extended-spectrum beta-lactamases, Carbapenemase production)
- Alter the attachment site (PBP)
Extended-Spectrum Beta-Lactamases (ESBL)
Detection of ESBL: all penicillins, cephalosporins, and aztreonam should be reported as resistant
Carbapenemase
- Use to treat ESBL
- First seen in Klebsiella pneumoniae (aka Klebsiella pneumoniae carbapenemases (KPC)
- Now produced by others in the Enterobacteriaceae family, resistant to all β lactams, and many other non-β-lactam molecules
Penicillin Binding Proteins
- Enzymes responsible for building cell wall
- Intrinsic resistance: does not have the required PBP for beta-lactam drug
- Extrinsic resistance: Overproduction of the targeted PBP, Point mutation in the PBP gene that causes a decrease PBP affinity, Acquired foreign gene codes for a structurally different PBP
Inhibitors of Protein Synthesis
Aminoglycosides, Macrolide-Lincosamide-Streptogramin (MLS group), Oxazolidinones, Chloramphenicol, Tetracyclines
Inhibitors of DNA & RNA synthesis
Fuoroquinolones, Metronidazole, Rifampin
Inhibitors of Other Metabolic Processes
Sulfonamides, Trimethoprim, Nitrofurantoin
Acid Fast Bacteria
- Primary treatment: Streptomycin, Isoniazid, Rifampin, Ethambutol, Pyrazinamide
- Secondary treatment: Ethionamide, Capreomycin, Ciprofloxacin, Ofloxacin, Kanamycin, Cycloserine, Rifabutin
Tetracyline Side Effects
Causes discolored teeth and affect bone development in children