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PID > antimicrobial resistance > Flashcards

antimicrobial resistance Flashcards

1
Q

consequences on animal and public health

A
  • increased patient mortality and morbidity

- risks of zoonotic transmission

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2
Q

economic consequences

A
  • more visits, lab tests, therapies
  • prolonged hospitalization
  • reduced weight gain
  • loss of customers/reputation by vets
  • costs for hospital/farm decontamination
  • costs for surveillance and intervention programs
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3
Q

human burden of AMR in US

A
  • causes approx 23,000 deaths in US every year

- responsible for approx 2 million infections every year

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4
Q

AMR found in hospitals

A
  • Carbapenem-resistant K. pneumoniae
  • multi-drug resistant A. baumannii
  • vancomyocin- resistant enterococcus
  • multidrug-resistant- P aeruginosa
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5
Q

AMR found in hospitals and community (inc. animals)

A
  • methicillin- resistant S. aureus (MRSA)

- ESBL-producing E. coli

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6
Q

AMR in community

A
  • penicillin resistant S. pneumoniae

- multidrug resistant N gonorreheae

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7
Q

AMR in developing country

A

-multidrug-resistant Shigella

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8
Q

mechanisms of bacterial resistance **

A
  • target modification- MRSA/ MRSP

- enzymatic drug invasion- ESBL

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9
Q

resistance phenotypes in foodborne zoonotic bacteria

A
  • Salmonella- resistance to cephalosporins or fluoroquinolones
  • campylobacter- resistant to macrolides or fluoroquinolones
  • antibiotic therapy only recommended for invasive infections
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10
Q

emerging resistant bacteria in animals- Beta lactam resistant (cephalosporin MDR bacteria)

A
  • Staphylococcus aureus (MRSA), in pigs mainly, infections occur in companion animals and dairy cows, low food transmission risk
  • staphylococcus pseudintermedius (MRSP)- mainly in dogs, animal infections, low food transmission
  • Escherichia coli (ESBL producers)- all animals, all animal infections, high risk of food transmission
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11
Q

MRSA

A
  • methicillin resistant staphylococcus aureus
  • S. aureus that has acquired resistance gene (mecA) encoding a penicillin binding protein (PBP2A) with low affinity to most B-lactams (penicillins and cephalosporins)
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12
Q

MRSA population based on multilocus sequence typing

A
  • pigs: CC9, CC398
  • horses: CC8, CC398– primary (Pig MRSA)
  • companion animals: CC22
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13
Q

livestock-associate MRSA CC398

A

-farm workers can be directly exposed, expose families, transmit to community, infect hospital

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14
Q

MRSP

A
  • methicillin resistant staphylococcus pseudintermedius
  • S. pseudintermedius that has acquired mecA
  • approximately 70% of cases are skin and wound postsurgical infections acquired in clinic
  • antimicrobial choice may be hard because MRSP strains may be resistant to all antibiotics for vet use
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15
Q

MRSP in humans

A
  • human infections= rare, generally due to transmission from household pet
  • prevalence of human carriage= higher among dog owners and vet staff
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16
Q

ESBL

A
  • extended spectrum beta lactamase
  • enzyme hydrolyzing/inactivating most B-lactams (except carbapenems) produced by gram neg bacteria
  • geographical difference (most prevalent in south east asia), increasing trend
  • need whole genome sequencing for typing
17
Q

ESBL classification

A
  • true ESBLs are susceptible to B-lactamase inhibitors such as clavulanic acid
  • three main classes: CTX-M (most prevalent in animals and humans), SHV, TEM
  • each class is classified into variants based on sequence identity (CTX-M-1,2,3…)
  • frequency of each variant depends on host and geographical factors
  • most common ESBL in animals is CTX-M-1
  • false ESBL (resistant to B-lactamase inhibitors) is widespread in small animals and limited to Europe in poultry (CMY-2)
  • most western countries CTX-M-15 is most prevalent in human E-coli infections
18
Q

mutation

A
  • usually in antimicrobial target gene/protein-

- contributes to resistance

19
Q

horizontal gene transfer

A
  • how bacteria acquire resistance
  • 3 distinct mechanisms:
  • -transformation (uptake of free DNA)
  • -transduction (transfer mediated by phage delivery)
  • -conjugation (transfer cell to cell contact)

PID (5 decks)

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