Antimicrobial resistance Flashcards
What are antimicrobials
Antibiotics
Antivirals
all antimicrobial drugs
What is antibiotic resistance
Ability of bacteria to protect themselves from the antibiotic
What is the difference between clinical antibiotic resistance and lab resistant antibiotics
Whether its resistant at clinically achievable concentrations or lab concentrations
What is an antibiotic
A drug that kills or inhibits the growth of microorganisms
Resistant antibiotics
Antimicrobial will not inhibit bacterial growth at clinically achievable concentrations
Susceptible antibiotics
Antimicrobial will inhibit bacterial growth at clinically achievable concentrations
What is the definition of resistance (non-MDR)
Laboratory confirmed resistance to particular antibiotic agent
Definition of MDR (multi drug resistance)
Non-suceptibility to at least 1 agent in 3
PDR definition (pan drug resistance)
Non-suceptability to all antimicrobial categories
XDR definition (extremely drug resistant)
Non-suceptibility to at least 1 agent in all but 2 or fewer antimicrobial categories
What is innate resistance
Was never susceptible to antibiotic
What is acquired resistance
Developed resistance
May be result of novel mutation, or transfer of genes causing resistance
How do resistant bacteria make susceptible bacteria resistant
By transferring resistant genes
conjugation or transformation
what is vertical transmission of antibiotic resistance
Bacterium accumulates mutations making it resistant
Mutations are passed on to subsequent generations
What is horizontal transmission of antibiotic resistance
Resistant genes are swapped from one microbe to the other
How does horizontal transmission of resistance occur
Transformation
- bacteria scavenge resistant genes from dead cells
Transduction - resistant genes transferred between bacteria
Conjugation
-genes transferred between bacteria via tubes called pills
Mechanisms of resistance
Inactivation of antibiotic Impermeability to cell wall Efflux - pumps antibiotic out the cell By-pass Bind to PBPs which make it resistant Altered targets
What factors drive antibiotic resistance
Human misuse or overuse Animal misuse or overuse Environmental contamination Health-care transmission Travel Mass drug administration
Where are the most antibiotics prescribed
In the community
What is antimicrobial stewardship
The optimal selection, dosage, and duration of antimicrobial treatment that results in the best clinical outcome and minimal impact on subsequent resistance
Common prescribing drivers for AMP
No need for antibiotic unnecessarily Excessive amounts given Too broad spectrum Too long duration Low dose or inadequate frequency Previous and repeated course of antibiotics
