Antimicrobial Resistance Flashcards
Define intrinsic resistance.
The innate ability of an organism to resist the action of an antimicrobial as a consequence of its innate structural or functional characteristics.
Define antimicrobial resistance.
The acquired ability of a microbe to resist the effects of an antimicrobial.
List 4 drug types that commonly contribute to viral antimicrobial resistance.
1 - HAART drugs (protease inhibitors and reverse transcriptase inhibitors).
2 - DNA polymerase inhibitors.
3 - Neuraminidase inhibitors.
4 - Nucleoside analogues (e.g. aciclovir).
How do nucleoside analogues work?
By terminating viral DNA chains.
List 4 drug types that commonly contribute to bacterial antimicrobial resistance.
1 - Cell wall acting agents.
2 - Nucleic acid synthesis inhibitors.
3 - Protein synthesis inhibitors.
4 - Anti-tuberculosis drugs.
List 4 drug types that commonly contribute to fungal antimicrobial resistance.
1 - Polyenes.
2 - Imidazoles.
3 - Triazoles.
4 - Echinocandins.
List 2 drug types that commonly contribute to protozoa antimicrobial resistance.
1 - Quinolines.
2 - Antifolates.
Give an example of a drug that commonly contributes to parasitic antimicrobial resistance.
Benzimidazoles.
List 3 drugs that target the bacterial cell wall and membrane.
1 - Penicillins.
2 - Glycopeptides.
3 - Polymyxins.
List 3 drugs that target bacterial nucleic acid synthesis, giving examples where relevant.
1 - Folate antagonists.
2 - DNA gyrase inhibitors, e.g. quinolones.
3 - RNA polymerase inhibitors, e.g. rifamycins.
List 3 drugs that target bacterial protein synthesis.
Drugs targeting the 50S subunit:
1 - Macrolides.
2 - Lincomycins.
Drugs targeting the 30S subunit:
3 - Tetracyclines.
Describe the process of the development of antimicrobial resistance.
1 - Some bacteria are already resistant to an antimicrobial.
2 - An opportunity for drug resistant colonies to grow is created by the selective pressure of an antimicrobial.
3 - Expansion of drug resistant bacteria.
4 - Persistence of drug resistance after selective pressure has been removed.
List 6 mechanisms of antimicrobial resistance.
1 - Enzymatic inhibition of antimicrobial drugs.
2 - Changes in inner / outer membrane permeability.
3 - Mutations in target sites.
4 - Antibiotic efflux pumps.
5 - Protection of the target site.
6 - Overproduction of the target site.
List 3 ways by which de novo resistance can come about.
1 - Point mutations.
2 - Transferred resistance.
3 - Inducible resistance (due to the presence of an inducing agent).
List 3 common cases of bacterial resistance.
1 - Methicillin resistant Staphylococcus aureus (MRSA).
2 - Vancomycin resistant Enterococci spp. (VRE).
3 - Extended spectrum beta-lactamase producing Enterobacteriaceae spp. (ESBL).
What are the classifications of resistance in tuberculosis?
- Multidrug resistant tuberculosis (resistant to rifampicin and isoniazid).
- Extensively drug resistant tuberculosis (resistant to rifampicin, isoniazid and fluoroquinolones).
List 6 factors that accelerate antimicrobial resistance.
1 - Drug prescribing.
2 - Drug access.
3 - Drug quality.
4 - Veterinary use.
5 - Global travel.
6 - Socioeconomic and environmental factors, e.g. treatment of sewage.
List 2 ways by which antibiotic effectiveness can be measured in vitro.
1 - By measuring the minimum inhibitory concentration (MIC) for the microbe against different antibiotics.
2 - By detecting resistance mutations by PCR.
Define minimum inhibitory concentration.
The minimum in vitro concentration which an antibiotic can inhibit growth.
List 2 ways by which bacterial growth can be measured.
1 - Disc diffusion.
2 - Graded antibiotic concentration strips.
List 4 organisations involved in the management of antimicrobial resistance.
1 - Global antimicrobial resistance surveillance system (GLASS).
2 - Global antibiotic research and development partnership (GARDP).
3 - Interagency coordination group on antimicrobial resistance (IACG).
4 - Public health England.
