Exam 3 Flashcards

1
Q

Methicillin Resistant Staphylococcus aureus (MRSA)
gram?
shape?
catalase?

A

gram positive
spherical, clusters
positive

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2
Q

MRSA normal microbiota

A

25% to 30% of population colonized in nose
Anterior nares
Skin

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3
Q

MRSA type of infection

A

Opportunistic infection
Carriers—Community-acquired infections
Autoinfection common

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4
Q

MRSA symptoms

A
Boils
Warm to the touch
Pus
Superficial skin infections
if absess in subcutaneous skin=more serious=antibiotics
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5
Q

MRSA Treatment

A

drain boils, resolve on own
Vancomycin or teicoplanin-Now strains of MRSA showing resistance to these antibiotics
Vancomycin intermediate-resistant Staphylococcus aureus (VRSA) - 1997
New antibiotics approved by FDA
Linezolid (Zyvox)
Daptomycin (Cubicin)

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6
Q

MRSA Medical Emergency

A
Spreading skin infection
Bone
Joints
Organs
Bacteremia
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7
Q

Methicillin Resistance

A

in 1959 was first semi-synthetic penicillin designed against penicillinases
S. aureus developed resistance UK 1961
Outbreaks in U.S. in late 1960’s
So prevalent that methicillin use is discontiuned in the U.S.
Resistant to other antibiotics – oxacillin, penicillin, amoxicillin, cephalosporins

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8
Q

Healthcare Aquired MRSA

A

Have weakened immune systems
Have wounds and open sores
Lots of exposure to antibiotics

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9
Q

Community Acquired MRSA

A

Young adults
Often sports teams or living in dormitories
More contagious but less virulent

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10
Q

MRSA Prevention

A
Wash hands constantly
Barrier methods like gloves and gowns
Lots of disinfection
Correct handling of laundry
Don’t share personal items like soap or razors
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11
Q

difference between antibiotic and antimicrobial

A

antibiotic: used to kill microbes
antimicrobial: used to kill and prevent further growth of microbes

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12
Q

chemotherapy

A

the treatment of disease by the use of chemical substances, especially the treatment of cancer by cytotoxic and other drugs.

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13
Q

history of antibiotics

A

Alexander Fleming 1928
Penicillium notatum
Used beginning in 1940s

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14
Q

characteristics that make antibiotics effective

A

selectively toxic
Gram positive bacteria

Gram negative bacteria

Fungi and intracellular bacteria

Viruses

AND target something essential

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15
Q

selectively toxic

A

Chemotherapeutic agents should act against the pathogen and not the host

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16
Q

how do we characterize antibiotics

A

Bacteriocidal vs bacteriostatic

Broad spectrum vs narrow spectrum

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17
Q

Minimal Inhibitory Concentration (MIC)

A

lowest dose of drug needed to control microbial growth

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18
Q

Therapeutic dose

A

drug level for clinical treatment

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19
Q

Toxic dose

A

drug level at which it becomes toxic to host

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20
Q

action of antimicrobial drugs

see picture

A
Inhibiting cell wall synthesis
Inhibiting protein synthesis
Inhibiting nucleic acid synthesis
Injury to cell membrane
Inhibiting synthesis of essential metabolites
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21
Q

Inhibition of cell wall synthesis

A
Penicillin
Figured out the mode of action in 1956
Active against growing cells only
Poor activity against gram – bacteria
Destroyed by acid
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22
Q

Penicillin

A

contains beta-lactum ring(square)

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23
Q

solution to resistance

A
Produced semi-synthetics
Penicillinase resistance
Active against Gram - 
Acid resistance
Less allergenic
Reach CNS
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24
Q

Antibiotics that affect cell wall

Monobactams

A

Low toxicity

Gm- like Pseudomonas

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25
antibiotics that affect cell wall | Cephalosporins
``` Structure similar to penicillin Resistant to penicillinase Effective against Gm- Most injected Expensive ```
26
Antibiotics that affect the cell wall polypeptide antibiotics Bacitracin
Effective against Gm+ | Topical causes nephrotoxicity side effect
27
Antibiotics that affect the cell wall polypeptide antibiotics Vancomycin
Glycopeptide Effective against penicillinase Toxicity problems—limit use Last line antibiotic for resistant Staphylococcus aureus strains
28
Antibiotics that affect the cell wall | Isoniazid (INH)
Inhibits mycolic acid synthesi What bacteria would it be useful against? Tuberculosis Good penetration ability
29
Antibiotics that affect the cell wall | Ethambutol
Inhibits incorporation of mycolic acid into cell wall | Used in combination to control resistance
30
Antibiotics that affect Protein Synthesis | Chloramphenicol
``` Inhibit peptide bond formation Broad spectrum Inexpensive Ready diffusion Aplastic anemia ```
31
Antibiotics that affect Protein Synthesis | Aminoglycosides
``` Cause misreading Effective against Gm- Toxic side effects Kidney damage Auditory nerve damage Examples Streptomycin Gentamicin ```
32
Antibiotics that affect protein synthesis | Tetracycline
``` Interfere with tRNA Benefits Broad spectrum Long retention time Penetrate tissue Problems Not very bio-degradable Side effects Tooth discoloration in children Liver damage in pregnant women ```
33
Antibiotics that affect protein synthesis | Macrolides
Gram+ only Few side effects—children Block tunnel
34
Injury to cell membrane | Polymyxin B
``` Bacteriocidal Gram- Some toxicity so generally used topically Triple antibiotic ointment Polymyxin B Bacitracin Neomycin (aminoglycoside) ```
35
Inhibitors of Nucleic Acid Synthesis | Rifamycins
``` Inhibits synthesis of mRNA Penetrates tissue Enters CNS Side effect Red urine, feces, saliva, tears, and sweat ```
36
Inhibitors of Nucleic Acid Synthesis | Quinolones
Inhibits DNA gyrase Bacteriocidal Nalidixic acid—UTI’s
37
Inhibitors of Nucleic Acid Synthesis | Fluoroquinolones
Synthetic quinolones Broad spectrum Nontoxic Ciprofloxacin--anthrax
38
Competitive Inhibition of Essential Metabolites | Sulfonamides (sulfa drugs)
Not antibiotics Early therapy Bacteriostatic Blocks folic acid synthesis
39
E Test
Gradient of antibiotics | Minimal Inhibitory Concentration
40
Therapeutic Index
ratio between the toxic dose and the therapeutic dose | Measure of the relative safety of the treatment
41
Antibiotic Resistance Mechanisms
Block entry Inactivation of resistance enzymes Alteration of target molecule Efflux of antibiotic
42
Factors Leading to Resistance
``` Horizontal gene transfer: plasmids -Hospitalization -World travel Overuse -Patient demand -Immunosuppression Misuse -Improper prescription -Failure to follow treatment -Long-term, low-dose use -Use in animal feeds ```
43
how are Microbial traits controlled or influenced by heredity.
``` Shape Metabolism Structure Ability to cause disease Everything ```
44
Why are chemotherapeutic agents that work on the peptidoglycan cell wall of bacteria a good choice of drug?
humans and animal hosts lack peptidoglycan cell walls
45
To know flow of genetic information from genes to proteins
Understand how to control bacterial growth | How stop protein synthesis
46
inhibiting cell wall synthesis
- inhibiting synthesis of peptide cross links - inhibiting bonding of NAG and NAM - inhibiting lipopolysaccharide synthesis - inhibiting mycolic acid synthesis
47
injuring the plasma membrane
inhibiting mycolic acid synthesis
48
interfering with DNA replication
interfering with dna polymerase | interfering with dna gyrase
49
interfering with RNA synthesis (transcription)
interfereing with RNA Polymerase
50
interfering with protein synthesis
- interfering with attachment of trna to mrna - interering with activity of 30S and 50S ribosomal unit - interfering with peptide bond formation, catalyzed by the ribosome
51
which action of antimicrobial drugs would be bacterioSTATIC
inhibition of protein synthesis
52
a cell dies from penicillin because...
it undergoes lysis
53
The antibiotic tetracycline binds to the 30S subunit of the ribosome to...
interfere with the tRNA binding with the mRNA ribosome complex
54
Genome | Eukaryote v. Bacteria
Eukaryotes—all the chromosomes | Bacteria—chromosome and plasmids
55
DNA
``` Nitrogenous bases -adenine -guanine -cytosine -Thymine Deoxyribose Phosphate ```
56
Bacteria DNA
``` Single chromosome Haploid Circular chromosome No histones--packaged by DNA gyrase Attached to the plasma membrane ```
57
Eukaryote DNA
``` Multiple chromosomes Diploid or greater Linear chromosomes Histone packaging Found in the nucleus ```
58
DNA  RNA  Protein
DNA  DNA: Replication DNA  RNA: Transcription RNA  Protein: Translation
59
1st step in DNA replication
The first step in DNA replication is the separation of the two DNA strands that make up the helix that is to be copied
60
History of TB
Ancient disease—common in Greek and Egyptian writings Epidemic in Europe and North America from 18th and into the 20th Centuries Known at the White plague or consumption #1 killer of people during this time Better ventilation in homes and at work sites
61
TB Causative agent
Mycobacterium tuberculosis Acid Fast bacterium Mycolic acid #1 single infectious disease killer
62
symptoms of TB
``` Acute respiratory infection Persistent cough with blood Constant fatigue Loss of appetite and weight loss Fever and night sweats ```
63
transmission of TB
Transmitted by aerosols—prolonged contact
64
Lungs of TBpatient
Grows in alveoli--causes tubercula in lungs Small lumps Body forms granulomas to defend
65
Latent TB infection
carrier
66
Active TB infection
``` Only 10% of infected people develop the infection Elderly and children Immunocompromised Smokers People who live in crowded conditions Without treatment very few survive ```
67
Diagnosis of TB
``` Mantoux PPD Skin Test Inject tuberculin under skin of forearm After 48-72 hours measure welt 15 mm or more is positive Confirm with chest X-ray ```
68
treatment of TB
``` Multiple drug therapy Isoniazid Rifampin Pyrazinamide Ethambutol Streptomycin 6 months to a year ```
69
Prevalence of TB
less prevalent and less deaths | more people develop multi drug resistance bc not following directions probably
70
Horizontal Gene Transfer (HGT)
Exchange of genes between two DNA molecules to form new combination of genes Importance Increased survivability Contributes to genetic diversity
71
Horizontal gene transferq
genes passed between bacteria Transformation Conjugation Transduction
72
vertical gene transfer
genes passed from parent to offspring
73
HGT transformation
``` Uptake of DNA from the environment First discovered in 1928 by Griffith Working with Streptococcus pneumoniae Causes lethal respiratory infection Requires a capsule for virulence Capsule gene can be eliminated ```
74
cells capable of transformation
``` Recipient cells=Competent cells Few species are naturally competent Haemophilus Bacillus Streptococcus ```
75
conjugation
Transfer of DNA through pilus or direct contact Fertility plasmid present in one cell--Donor Self replicates Contains genes Make pilus Enzymes to move the DNA across pilus Cured if nonessential Recipient cell does not contain the F plasmid
76
Transduction
Transfer of DNA by a virus Two mechanisms Generalized transduction by lytic virus Specialized transduction by lysogenic virus
77
Generalized Transduction
``` Host DNA gets degraded during viral replication Virus packages host DNA in capsid Defective virus Able to infect new host cell No viral DNA to replicate New host genes ```
78
Specialized Transduction
Lysogenic viruses Becomes prophage—incorporates into genome Get activated by some trigger Come out of host genome and take host DNA with Still able to replicate and infect new host
79
vibrio cholorae
``` Found in brackish water Infectious dose: 106 in water 104 in food Not very resistant to acid Serotype (150) O1 Classical-–first 5 epidemics El Torr—current epidemic O139 ```
80
cholera symptoms
``` Acute, diarrheal illness Sudden onset of watery diarrhea Rice water stool 5 gallons of water a day Dehydration No fever 1:10 people Death Dehydration Electrolyte imbalance Mortality: 50% left untreated ```
81
Enterotoxin Cholera
Makes epithelial cells highly permeable to water Coded by the ctxAB gene Carried by the CTX phage Specialized transduction
82
cholera transmission
``` Fecal-oral Water Raw foods Undercooked foods Washing foods in contaminated water Found in copepods and algae ```
83
cholera treatment
``` IV fluids ORT Oral Rehydration Therapy Sugar-salt solution Vaccination Oral Short duration Mortality: 1% ```
84
cholera today
``` Seven pandemics since 1817 Four in the U.S. 1832 1849 1866 1887 Public health measures put into place Cleaned up refuse Contained animals Instituted water treatment ```
85
Failure in Public health-cholera
``` Brought to Peru in 1991 Ship ballast water from Asia Chlorinating water kills the bacterium Lima, Peru—water system built by English Handles a population of 230,000—population now 7 million ```