Antimicrobial Resistance

Question 1

What are 11 specimens are responsible for AMR in the US?

Answer 1

Staph. aureus
Pseudomonas
Acinetobacter
Campylobacter
Eneterobaceriaceae - Enterobacter, Klebsiella
Mycobacterium tuberculosis
Enterococcus
Neisseria
Streptococcus

Clostridium dificile - waits in GIT as spores until patient is treated with antibacterials
Candidia auris

Question 2

What are 5 urgent AMR threats in the US?

Answer 2

1. Carbapenem-resistant Acinetobacter
2. Carbapenem-resistant Enterobacteriaceae
3. drug-resistant Neisseria gonorrhoaeae
4. drug-resistant Candida
5. Clostridium difficile

Question 3

What are 11 serious AMR threats in the US?

Answer 3

1. drug-resistant Campylobacter
2. drug-resistant Candida
3. extended-spectrum β-lactamase-producing Enterobacteriaceae
4. Vancomycin-resistant Enterococci
5. MDR Pseudomonas aeruginosa
6. drug-resistant nontyphoidal Salmonella
7. drug-resistant Salmonella typhi
8. drug-resistant Shigella
9. Methicillin-resistant Staph. aureus
10. drug-resistant Streptococcus pneumoniae
11. drug-resistant Tuberculosis

Question 4

What are 2 concerning AMR threats in the US?

Answer 4

1. Erythromycin-resistant group A Streptococcus
2. Clindamycin-resistant group B Streptococcus

Question 5

What 3 pathogens are on the watch list for AMR?

Answer 5

1. Azole-resistant Aspergillus fumigatus
2. drug-resistant Mycoplasma genitalium
3. drug-resistant Bordetella pertussis

Question 6

Morbidity and mortality threats by AMR bacteria:

Answer 6

• hospital cases = drug-resistant Streptococcus pneumoniae
• deaths = Clostridium difficile

Question 7

What are the 9 drivers for AMR emergence?

Answer 7

1. over-use of drugs
2. patients not taking drugs are prescribed
3. unnecessary drugs used in animals
4. poor infection control in hospitals and clinics
5. lack of rapid laboratory tests
6. poor hygiene and sanitation, water pollution, and lack of hand washing
7. exposure to heavy metals increases risk of metallo-β-lactamase production
8. effluent from drug factories, hospitals, and animal farms have high concentrations of drug residues
9. asymptomatic AMR bacterial carrier states

Question 8

What heavy metals are associated with AMR emergence?

Answer 8

• mercury
• cadmium
• copper
• zinc

(emergence of metallo-β-lactamase producing MDR microorganisms)

Question 9

How do humans, animals, and plants affect the development of AMR?

Answer 9

HUMANS/ANIMALS - excrete antimicrobials in urine and feces

PLANTS - sprayed tetracyclin and streptomycin on fruit trees

(pollutes environment, soil, and water)

Question 10

How does AMR spread between bacteria?

Answer 10

• conjugation: plasmid
• transduction: bacteriophages
• transformation: engulfs DNA from environment

Question 11

How does AMR spread between hosts, places, and ecosystems?

Answer 11

• sewages from drug factories, hospitals, and farms
• 7 Fs
• travel (people and pets) and trade (live animals, food, plants) = transportation

Question 12

What are the 6 goals (national action plans) to control AMR bacteria?

Answer 12

1. slow AMR emergence by using correct drug types, doses, and durations
2. national surveillance (One Health) by collecting data, detecting and tracking cases, and sharing information to make better policy decisions
3. rapid diagnostics
4. new antibiotics, therapeutics, and vaccine discovery
5. worldwide collaboration for surveillance, control, and research
6. policy and practice changes

Question 13

What policy and practice changes are used to control AMR bacteria?

Answer 13

• improve GHP
• reduce prophylactic use of antibiotics
• waste/sewage control
• control metal waste disposal (cans)
• One Health approaches