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Bacteriology and Mycology Exam 1 > Antimicrobial Resistance > Flashcards

Antimicrobial Resistance Flashcards

1
Q

define antimicrobial resistance

A

ability of microbes to resist whatever is trying to kill them

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2
Q

three major purposes of antiicrobial prescription

A

therapeutics – treat sick individual
metaphylactics – treat herd when one sick individual
prophylactics – seasonal treatment
growth promotion – banned in many places

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3
Q

what leads to AMR bacteria spread

A

unregulated use of anitmicrobials
use of contaminated feces or water in fertilizer
contaminated food or water

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4
Q

classical gram positive cell wall architecture

A

several layers of peptidoglycan with lipo/teichoic acid

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5
Q

mycobacterium cell wall architecture

A

peptidoglycan covered by mycolic acids (wax or lipids)

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6
Q

classical gram negative cell wall architecture

A

outer membrane of proteins and lipopolysaccharaides (lipid A and sugar or endotoxin) that hides peptidoglycans
thin layer of peptidoglycans

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7
Q

chlamydia cell wall architecture

A

cell wall without peptidoglycans
outer membrane with proteins and lipopolysaccharides (lipid A and sugar or endotoxin)

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8
Q

mycoplasma cell wall architecture

A

no cell wall
sterols in cell membrane
not stained by gram stain
resistant to antimicrobials acting on cell wall

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9
Q

porins

A

antimicrobials, nutrients, mineral go through these

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10
Q

biofilms

A

dense bacteria community

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11
Q

6 mechanisms of action of antimicrobials

A

-cell wall synthesis – B lactams deactivate cell wall synthesis enzymes
-metabolism – folic acid synthesis
-30S – protein syntehsis
-50S – protein syntehsis
-RNA polymerase – mRNA (RNA synthesis)
-DNA gyrase/topoisomerase (DNA syntehsis)

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12
Q

4 mechanisms of AMR

A

-reduced permeability – constrict porins so antimicrobials can’t enter
-efflux pumping (“vomiting”)
-drug inactivation by enzymes – cut antimicrobials
-target site change, modification, protection

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13
Q

what is an additional mechanism of AMR in addition to main 4

A

biofilm formation

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14
Q

biofilm characteristics

A

-induced extracellular polymer (matrix)
-low nutrient and oxygen supply to center
-dormant spore like cells in center for persistence

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15
Q

acquired resistance

A

-horizontal gene transfer
-free DNA transformation
-plasmid conjugation
-bacteriophage transduction

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16
Q

intrinsic (innate) resistance

A

-vertical gene transfer
-mycoplasma

17
Q

grow fast in 24 hours

A

-enterobactericeae
-gram negative bacilli
-non fastidious gram positive

18
Q

do not grow fast in 24 hours

A

-fastidious organisms
-bioterrorism agents
-anaerobic microbes

19
Q

ESKAPE

A

E – Enterococcus
S – Staphylococcus aureus
K – Klebsiella pneumoniae
A – Acinetobacter baumannii
P – Pseudomonas aeruginosa
E – Enterobacter

20
Q

isolation using bacterial cell culture media

A

-mannitol salt agar – Staphylococcus, Enterococcus, Listeria, Micrococcaceae
-Edward media – Streptococcus, Enterococcus
-Kenner fecal agar – Enterococcus
-MacConkey agar – Enterobacteriaceae, Enterococcus

21
Q

media for anaerobic bacteris

A

-broth – Brucella + hemin, vitamin K, lysed horse blood
-agar – Brucella blood agar + hemin, vitamin K, lysed horse blood

22
Q

media for aerobic bacteria

A

-broth – cation adjusted Mueller Hinton + lysed horse blood
-agar – cation adjusted Mueller Hinton + lysed horse blood

23
Q

disc diffusion for AMR detection

A

-solid media
-qualitative
-one disc represents one drug
-measure diameter of inhibition zone

24
Q

E test AMR detection

A

-solid media
-quantitative
-strip impregnated with drug
-MIC – minimum inhibitory concentration
-determine last concentration that inhibited growth

25
Q

agar dilution AMR detection

A

-solid media
-quantitative
-drug added to culture media
-between concentrations of 0.12 to 64 ug/mL

26
Q

macrodilution AMR detection

A

-liquid media
-quantitative
-determine last dilution that inhibited growth
-bacterial growth indicated by cloudiness

27
Q

microdilution AMR detection

A

-liquid media
-quantitative
-96 well plate with serially diluted in increased 2 fold concentrations of antimicrobial agents
-determine last dilution to inhibit growth
-growth indicated by dot of organismal growth

28
Q

what do guidelines instruct to include and why

A

genetically stable known reference bacteria strains
quality control

29
Q

quality control for B lactamase producing bacteria

A

E coli
K pneumoniae
A bacumannii

30
Q

quality control for nonfastidious bacteria for agar/broth dilution (MIC)

A

E coli
P aeruginosa
E faecalis
S aureus

31
Q

quality control for testing bacteria of bioterrorism

A

E coli
S aureus

32
Q

why would testing be invalidated

A

-no viable or pure growth of quality control strains
-cut off value inhibition zone by disc or MIC not within range defined by CLSI, EUCAST, ISO

33
Q

what are MIC cut off values for most antimicrobials

A

0.5 to 64 ug/mL

34
Q

steps of disc diffusion test protocol

A
  1. McFarland standards = 0.5
  2. 1-2x10^8 CFU/mL; rotate and press against glass
  3. 4mm thick MH agar
  4. rotate in 3-4 directions by swabbing each time
  5. rim swab around entire edge of plate
  6. 6mm diameter disc; place disc >24 mm from each other
  7. incubate
  8. measure inhibition zones
35
Q

control of fast spreading AMR

A

-surveillance – periodic survey of drug use pattern
-educate expertise for reducing drug use
-regulate, monitor, and evaluate is frug use is per set priority

36
Q

what can bacteria acquire AMR genes form

A

plasmid
phage
free DNA
parents

37
Q

AMR can be controlled by what broad interventions

A

-judicious drug use
-surveillance
-diagnosis
-discoveries
-collaborations
-policy and practice changes

Bacteriology and Mycology Exam 1 (26 decks)

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