Current & Advanced Treatments for Sexually Transmitted Bacterial Infections Flashcards

1
Q

one of the most common sexually transmitted infections (STIs)

A

chlamydia

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2
Q

what species of bacteria are linked to chlamydia that mainly infect humans

A

chlamydiae -
chlamydia trachomatis
chlamydia pneumonia

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3
Q

symptoms of chlamydia (4)

A

(can have no symptoms)

pain when urinating

unusual discharge from vagina, penis, rectum

in females, pain in abdomen, bleeding after sex, bleeding between periods

in males, pain and swelling in testicles

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4
Q

causes of chlamydia (2)

A

unprotected vaginal, anal, oral sex
infected semen or vaginal fluid getting into eye

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5
Q

complications of chlamydia in females (2)

A

spread to womb, ovaries, fallopian tubes
increased risks of cervical cancer

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6
Q

what condition can chlamydia cause in females

A

pelvic inflammatory disease (PID)

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7
Q

symptoms of pelvic inflammatory disease (PID) (3)

A

infertility

increased risk of ectopic pregnancy

if untreated during pregnancy, can cause premature labour

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8
Q

complications of chlamydia in males (2)

A

can cause epididymitis
can cause epididymo-orchitis

(both can affect fertility)

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9
Q

what are the first line treatments of chlamydia (2)

A

azithromycin

doxycycline

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10
Q

what is the dose/ duration of azithromycin

A

single dose

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11
Q

what is the dose/ duration of doxycycline

A

7 day course

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12
Q

between azithromycin and doxycycline, which is prescribed first?

A

initially azithromycin and then doxycycline if needed, but due to resistance other way around since 2019

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13
Q

what is azithromycin classed as

A

macrolide antibiotics

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14
Q

what is azithromycin a derivitave of

A

semi synthetic derivative of erythromycin

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15
Q

what is epididymitis

A

inflammation of epididymis

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16
Q

what is epididymo-orchitis

A

inflammation of epididymis and testicles

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17
Q

is azithromycin delivered at a high or low concentration

A

high concentration

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18
Q

how is azithromycin administered

A

intramuscular injection at site of infection

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19
Q

why is azithromycin administered as an intramuscular injection at site of infection

A

to ensure tissue concentration is high but plasma concentration is low - highest bioavaliability

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20
Q

what other infections are azithromycin used for

A

respiratory, urogenital, dermal and other bacterial infections

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21
Q

mechanism of action of azithromycin

A

binds at polypeptide exit tunnel of 50S subunit of bacterial ribosome

inhibits mRNA translation thus

inhibits bacterial protein synthesis

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22
Q

is azithromycin bacteriostatic or bacteriocidal

A

bacteriostatic

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23
Q

what is meant by bacteriostatic

A

stops bacteria from reproducing, but doesn’t kill them

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24
Q

what are the two mechanisms of azithromycin resistance

A

alteration of ribosomal components via methylation aka changes antibiotic target and prevents antibiotic binding to it

upregulation of drug efflux pump activity, therefore decreasing intra-bacterial accumulation aka pushing drug out

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25
Q

one mechanism of azithromycin resistance is alteration of ______ components via methylation

A

ribosomal

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26
Q

one mechanism of azithromycin resistance is alteration of ribosomal components via ____

A

methylation

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27
Q

one mechanism of azithromycin resistance is ____ drug efflux pump activity, therefore decreasing intra-bacterial accumulation

A

increased

28
Q

one mechanism of azithromycin resistance is increased drug efflux pump activity, therefore ______ intra-bacterial accumulation

A

decreasing

29
Q

one mechanism of azithromycin resistance is increased drug efflux pump activity, therefore decreasing ____ _____ _____

A

intrabacterial accumulation

30
Q

in azithromycin resistance, what efflux pump contributes

A

Mef transporter

31
Q

doxycycline’s mechanism of action is ____ to azithromycin

A

similar

32
Q

what is doxycycline’s mechanism of action

A

inhibits protein production by binding the 30S subunit (same as azithromycin but different subunit)

33
Q

is doxycycline bacteriostatic or bacterocidal

A

bacteriostatic

34
Q

what are the two mechanisms of doxycycline resistance

A

increased expression of efflux pumps

increased expression of ribosomal protection proteins e.g. via methylating ribosomal subunits

35
Q

how are we infected by chlamydia

A

chlamydia bind to receptors on membrane

undergo endocytosis

internalise and replicate

burst from cell and infect new cells

36
Q

what is the interaction between chlamydia and receptor binding

A

chlamydia binds to platelet derived growth factor receptor-β (PDGFR-β), a RTK

(new preventative medications working towards temporarily inhibiting cells from making PDGFR-β to prevent spread of infection)

37
Q

what is growth factor receptor-β (PDGFR-β)

A

a RTK - receptor tyrosine kinase

38
Q

new medications working towards temporarily inhibiting cells from making PDGFR-β to prevent spread of infection. what method does this use

A

gene therapy

39
Q

what does gene therapy in treating chlamydia rely on

A

small interfering RNA (siRNA)

40
Q

what does siRNA do

A

promote recruitment of RISC

41
Q

what does recruitment of RISC from siRNA cause

A

degradation of mRNA preventing protein synthesis

aka cells will not produce PDGFR-β and chlamydia cannot bind to these receptors, cannot enter cell

42
Q

how can the uptake of siRNA be facilitated

A

using nanoparticles

43
Q

what other role do siPDGFR-β nanoparticles play in already infected cells (chlamydia)

A

trigger autophagy cascade

44
Q

what is autophagy

A

the regulated mechanism of the cell that removes unnecessary or dysfunctional components

degrades invading pathogen

45
Q

what bacteria is gonorrhoea caused by

A

Neisseria gonorrhoeae or gonococcus

46
Q

how else can gonorrhoea be indirectly spread

A

can be passed from a mother to her baby during childbirth

47
Q

symptoms of gonorrhoea (4)

A

pain when urinating

unusual discharge from vagina, penis, rectum

in females, pain in abdomen, bleeding after sex, bleeding between periods

in males, swelling of foreskin, pain, swelling in testicles

48
Q

how is gonorrhoea spread

A

unprotected vaginal, anal, oral sex

49
Q

first line treatment of gonorrhoea

A

oral azithromycin and intramuscular ceftraxione

50
Q

the first line treatment of gonorrhoea is oral azithromycin and intramuscular ceftraxione. how much is administered

A

single dose of both antibacterial agents

51
Q

what type of drug is ceftraxione classed as

A

belongs to the β-lactam family of antibiotics

52
Q

ceftriaxone mechanism of action (5)

A

binds to and inhibits transpeptidases/ transamidases

these catalyse cross linking of peptidoglycan polymers which form bacterial cell wall

prevents final linking stage of cell wall synthesis, leading to weakened cell wall

water can enter bacterial cells

cells lyse due to osmotic pressure within cell

53
Q

is ceftriaxone bacteriostatic or bactericidal

A

bactericidal

54
Q

ceftriaxone mechanism of resistance (2)

A

mutation of transamidases e.g. of target site preventing binding

increased drug efflux pump activity and decreased drug influx pumps

55
Q

what medication has been developed in response to antibiotic resistant gonorrhoea

A

zoliflodacin

56
Q

what does zoliflodacin in the treatment of gonorrhoea target

A

bacterial type 2 topoisomerases

57
Q

zoliflodacin mechanism of action

A

during unwinding topoisomerase 2 enzymes enzymes cut both strands of the DNA

topoisomerase 2 then sticks the DNA back together to release tensions in the DNA, preventing supercoiling

supercoiling can cause DNA to break, triggers apoptosis

zoliflodacin stabilises topoisomerase 2 in a conformation, preventing it from ligating DNA back together

causing accumulation of double strand DNA breaks

triggers bacterial cell death

58
Q

is zoliflodacin bacteriostatic or bactericidal

A

bactericidal

59
Q

Zoliflodacin shows ____ efficacy for human Topo II enzymes to date

A

little

ideal as does not affect human cells, just bacterial

60
Q

what else can zoliflodacin be used for

A

antibiotic resistant chlamydia

61
Q

what bacteria is syphilis caused by

A

treponema pallidum

62
Q

symptoms of syphilis (5)

A

small painless sores or ulcers on penis, vagina, anus, mouth

blotchy red rash that affects palms of hands or soles of feet

small skin growths like warts that can develop in women on vulva or in both men and woman around anus

white patches in mouth

tiredness, headaches, joint pains, fever, swollen glands in neck, groin, armpits

63
Q

if left untreated, what can syphilis cause

A

neurosyphilis

64
Q

what population is neurosyphilis most often found in

A

in HIV-positive patients as they are immunocompromised

65
Q

first line treatment of syphilis (3)

A

doxycycline

erythromycin (works same as azithromycin, but poorer ADME)

benzathin penicillin

66
Q

how is benzathin penicillin administered

A

single intramuscular injection

67
Q

how long is doxycycline and erythromycin recommended for

A

14 days