Hospital acquired bacterial infections Flashcards

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1
Q

Define the following:

a. Antimicrobial
b. Antibacterial
c. Antibiotic

A

a. Antimicrobial
Interferes with growth and reproduction of a microbe
b. Antibacterial
Commonly used to describe agents that reduce or eliminate harmful bacteria
c. Antibiotic
Type of antimicrobial that is used as medicine for humans and animals

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2
Q

What is a health-care associated infection?

A

Infections that occur after exposure to healthcare

Infection starts >48 hours after admission to hospital

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3
Q

Why do health-care associated infections cost money to the healthcare system?

A

They increase the length of stay at hospital

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4
Q

List some medical interventions that can increase the risk of infection.

A
Catheterisation 
Intubation 
Lines (e.g. central venous lines) 
Chemotherapy 
Prosthetic material
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5
Q

State some other factors that increase the risk of infection in the hospital setting.

A

Dissemination by healthcare staff

Concentration of ill patients

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6
Q

What are the ESCAPE pathogens? Which are Gram +ve and which are Gram -ve?

A
  • Enterococcus faecium
  • Staphylococcus aureus
  • Clostridium difficile
  • Acinetobacter baumanii
  • Pseudomonas aeruginosa
  • Enterobacteriaceae (Pathogenic e coli, Klebsiella pneumoniae, Enterobacter species)

ESC are Gram-positive
APE are Gram-negative

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7
Q

What is the main problem with the ESCAPE pathogens?

A

They are antibiotic resistant

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8
Q

What is the most frequent cause of bacteraemia by a Gram-negative bacterium?

A

E. coli

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9
Q

What does E. coli frequently cause?

A

UTI

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10
Q

Which antibiotics is E. coli resistant to in many countries?

A

Cephalosporins

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11
Q

Which antibiotics is E. coli still sensitive to?

A

Carbapenems

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12
Q

State the target proteins and the method of resistance to the following classes of antibiotics:

a. Cephalosporins
b. Carbapenems
c. Methicillin
d. Vancomycin

A

a. Cephalosporins (𝛽-lactam)
Target: Penicillin binding proteins (PBP)
Resistance: Extended-Spectrum Beta-Lactamase (ESBL)

b. Carbapenems (𝛽-lactam)
Target: PBP
Resistance: Carbapenemase enzymes

c. Methicillin (𝛽-lactam)
Target: Penicilin Binding Protein
Resistance: alternative target (PBP2A), which has low affinity for methicillin and can function in its presence

d. Vancomycin
Target: peptidoglycan precursor
Resistance: synthesis of a different peptidoglycan precursor

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13
Q

What is Extended spectrum

b-lactamase (ESBL) encoded on?

A

Plasmid

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14
Q

What are carbapenemases encoded on?

A

Transposon

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15
Q

What types of infections does Klebsiella pneumoniae tend to cause?

A

UTI

Respiratory tract

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16
Q

Which group of patients are at risk of Klebsiella infection?

A

Immunocompromised

17
Q

Which classes of antibiotics are Klebsiella widely resistant to?

A

Cephalosporins, fluoroquinolones and aminoglycosides

Carbapenem resistance in the US

18
Q

Which group of patients are at risk of P. aeruginosa infection?

A

Immunocompromised

19
Q

Which class of antibiotics is P. aeruginosa widely resistant to?

A

Carbapenems

20
Q

What is the most important cause of antimicrobial resistant infection in the world?

A

MRSA

21
Q

What is Enterococcus faecium widely resistant to?

A

Vancomycin

NOTE: causes blood stream infections