antimicrobial resistance&water

Question 1

when did Fleming discover penicillin

Answer 1

1928

Question 2

when were sulfonamides introduced and by who

Answer 2

1935; ehrlich

Question 3

when was MRSA first noted

Answer 3

1968

Question 4

what are some resistant bacteria

Answer 4

multi-drug resistant mycobacterium tuberculosis; penicillin resistant stretococcus pneumoniae; vancomycin-resistant enterococci (VRE); carbapenem resistant enterobacteriaciae (CRE)

Question 5

what are the 4 important principles of antimicrobial resistance

Answer 5

1. antimicrobial use SELECTS for resistant populations; 2. organisms resistant to one antimicrobial often become resistant to MULTIPLE drugs; 3. antimicrobial resistance in one area will eventually appear in OTHER areas; 4. once antimicrobial resistance appears, it is UNLIKELY to decline spontaneously

Question 6

what are the 2 main issues for antimicrobial resistance

Answer 6

preservation of antimicrobials for human medicine/health; preservation of antimicrobials for vet med and animal health

Question 7

what is the driving force for antimicrobial resistance

Answer 7

imprudent use of antimicrobials

Question 8

what is imprudent use of antimicrobials

Answer 8

use of antimicrobials when not needed; use of wrong antimicrobial; use of broadspectrum antimicrobial when a narrowspectrum will work; wrong dosage or dosing interval

Question 9

what is imprudent use of antimicrobials

Answer 9

use of antimicrobials when not needed; use of wrong antimicrobial; use of broadspectrum antimicrobial when a narrowspectrum will work; wrong dosage or dosing interval

Question 10

4 uses of antimicrobials in veterinary medicine

Answer 10

therapy, metaphylaxis, prophylaxis, growth promotion/feed efficiency

Question 11

what does therapy consist of

Answer 11

injection, in-feed, in-water, individual or group

Question 12

what does metaphylaxis consist of

Answer 12

same as therapy but is done when one animal is sick to pre-emptively treat the others

Question 13

what does prophylaxis consist of

Answer 13

in-feed, GROUP; treating entire group pre-emptively

Question 14

which obligations must veterinarians balance?

Answer 14

oath to protect animal health and promote public health at the same time

Question 15

which obligations must veterinarians balance?

Answer 15

oath to protect animal health and promote public health at the same time

Question 16

what are current activities for reducing AMR

Answer 16

chief veterinary officers (prescription only, surveillance/data collection), senate hearings, user pay initiatives, phasing out growth promotants, targeted reduction of use

Question 17

what is the Canadian experience with emerging antimicrobial resistance

Answer 17

salmonella heidelberg resistant to 3rd generation ceftiofur

Question 18

why is S. heidelberg resistance a problem

Answer 18

frequent pathogen in humans that can be invasive (causing sepsis); limited treatment options for children and pregnant women

Question 19

why are the treatment options limited for children and pregnant women if they are infected with ceftiofur resistant S. heidelberg

Answer 19

can’t use fluoroquinolones in them

Question 20

what is one of the single biggest drivers of infectious disease

Answer 20

water quality

Question 21

what types of diseases are related to water

Answer 21

water-borne, water-washed, water-based, water-vector/related

Question 22

water-borne diseases

Answer 22

disease caused by ingestion of water contaminated by human or animal excrement that contains pathogenic organisms

Question 23

water-washed diseases

Answer 23

disease caused by poor personal hygiene, skin and eye contact with contaminated water

Question 24

water-based diseases

Answer 24

disease caused by parasites found in intermediate organisms living in contaminated water

Question 25

water-vector/related diseases

Answer 25

disease caused by insect vectors that breed or feed near contaminated water

Question 26

some important water-borne pathogens

Answer 26

E. coli, campylobacter, vibrio cholera, cryptosporidium

Question 27

factors in re-emergence of zoonotic pathogens

Answer 27

changing patterns of water use, population factors, increased travel/recreational activities, water scarcity, climate change, severe weather events, conflicts/disasters, increased urbinization, increased demand for animal protein and fresh vegetables, increased antibiotic use, increasingly concentrated animal husbandry practices, density of domestic pets, international trade patterns, ecosystem disturbance

Question 28

factors in re-emergence of zoonotic pathogens

Answer 28

changing patterns of water use, population factors, increased travel/recreational activities, water scarcity, climate change, severe weather events, conflicts/disasters, increased urbinization, increased demand for animal protein and fresh vegetables, increased antibiotic use, increasingly concentrated animal husbandry practices, density of domestic pets, international trade patterns, ecosystem disturbance

Question 29

what was the water contaminated with in Walkerton

Answer 29

E.coli (VTEC) and campylobacter

Question 30

what is pulsenet canada used for

Answer 30

food and waterborne disease outbreaks

Question 31

how long can E. coli 0157 survive in soil

Answer 31

56-130 days

Question 32

how long does E. coli 0157 survive in a slurry of manure

Answer 32

10 days

Question 33

how can you minimize risk from animal waste

Answer 33

farm biosecurity; vaccination; waste treatment before release

Question 34

what are examples of waste treatment that can be done on farm

Answer 34

composting, air drying, lagoon/storage, digestion (anaerobic or aerobic)

Question 35

what are examples of waste treatment that can be done on farm

Answer 35

composting, air drying, lagoon/storage, digestion (anaerobic or aerobic)

Question 36

how is cryptosporidium parvum (bovine) transmitted

Answer 36

from human to cattle and cattle to human

Question 37

how is cryptosporidium hominus transmitted

Answer 37

human to human (NOT human to cattle)

Question 38

how is cryptosporidium spread

Answer 38

water contaminated with feces of infected person or animal feces; contact with infected person

Question 39

what is the primary means to remove cryptosporidium from water

Answer 39

physical removal by filtration

Question 40

why can cryptosporidium only be removed by physical filtration

Answer 40

oocysts are resistant to chemical disinfection

Question 41

why can cryptosporidium only be removed by physical filtration

Answer 41

oocysts are resistant to chemical disinfection

Question 42

what does cryptosporidium cause

Answer 42

asymptomatic infections and symptomatic infection (profuse watery diarrhea, cramping, abdominal pain)

Question 43

how long does cryptosporidiosis last

Answer 43

self-limiting and usually lasts 3-4 days (no longer than 30d)

Question 44

infective dose of cryptosporidium

Answer 44

10 oocysts

Question 45

when are crypto oocysts infectious

Answer 45

immediately upon excretion

Question 46

when does shedding of crypto oocysts stop

Answer 46

usually 2 weeks after symptoms end

Question 47

how long do crypto oocysts remain infective outside the body

Answer 47

2 to 6 months in a moist environment

Question 48

most common sources of crypto infection

Answer 48

recreational water (ex. water parks), contact with livestock, drinking water, and person to person transmission

Question 49

factors that contribute to risks of crypto water-borne outbreaks

Answer 49

small oocyst size, wide range of host specificity, close associations between animals/humans, large numbers of oocysts excreted, low infective dose, oocyst resistance to chlorine, infectious upon excretion

Question 50

what are characteristics of water-borne outbreaks

Answer 50

high proportion of population affected, illness experienced through all age groups, affected persons have epidemiological link to one community/water source

Question 51

general water-outbreak causes

Answer 51

inadequate disinfection, cross-connections, inadequate control over treatment process (esp. filtration), interruption in treatment, disruption in service, infiltration of polluted water/sewage

Question 52

general water-outbreak causes

Answer 52

inadequate disinfection, cross-connections, inadequate control over treatment process (esp. filtration), interruption in treatment, disruption in service, infiltration of polluted water/sewage

Question 53

information for waterborne outbreak investigation

Answer 53

water plant process monitoring data, public health and clinical lab results, physician visits for gastroenteritis, school/daycare absences, nursing home diarrheal rates, sales of anti-diarrheal drugs

Question 54

what is the indicator organism used for water testing

Answer 54

E. coli

Question 55

why is E. coli used as an indicator organism

Answer 55

present in large numbers in mammal feces, readily detectable, doesn't grown in natural water, persistence and removal from water are similar to other pathogens

Question 56

criteria for water testing

Answer 56

E. coli must not be detectable in any 100mL sample

Question 57

what does water testing frequency depend on

Answer 57

population size

Question 58

what indicator organism is used in marine water

Answer 58

enterococci

Question 59

what indicator organism is used in marine water

Answer 59

enterococci

Question 60

which infectious organisms are not routinely tested for

Answer 60

giardia and crypto