IFD 2024 Flashcards
Bacteria with ESBLs
GN aerobic eg E. coli, kleb
Defining feature of ESBL in terms of ABX resistance
Resistant to 3rd gen cefalosporin
Eg ceftriaxone ceftazadime
Most common ESBL gene
CTX-M
IV choice of treatment for ESBL
Carbapenams
Other
Ceftazidime-avibactam
Oral choice of treatment for ESBL
Fosfomycin
Only beta lactas (x2) with same oral to IV bioavailability
Amoxicillin
Cephalexin
Po=IV bioavailability
Metro
Co trimoxazole
Clindamycin
Cipro
Doxy
Rif
Linezolid
Fluconazole
Amoxi
Cephalexin
3 most common candida species
Albicans, glabrata, parapsilosis
Side effects voriconazole
LFT derangement
Visual SEs
Photosensitivity
Benefit of liposomal ambisome over conventional AM-B
Less nephrotoxic
Better CNS penetration
Less infusion related SEs
When shouldn’t evhinocandins eg caspofungin be used
CNS and urinary tract infections - less penetration
Mechanism of methicillin resistance
Mec-A gene
Encoded PBP2a, which has a poor affinity to all beta-lactam antibiotics
Beta lactam Antibiotics
Penicillins
Cephalosporins (1-4)
Carbapenams
Glycopeptides
Vancomycin
Teicoplanin
In what situations should daptomycin not be used
poor CNS penetration
Inactive against surfactant
vanA vs vanB resistance
Van a - resistance to vanc and teicoplanin
Van b - vanc resistance only
Gene conferring resistance for ESCAPPM
Amp-C
Treatment for ESCAPPMs
Carbapenams
Ceftazidime-avibactam
Cefepime -rarely
ESCAMPPM organisms
Enterobacter sp
Serratia sp
Citrobacter freundii and braaki
Acinetobacter sp
Proteus sp (not miribalis)
Providencia
Morgonella morganii
Treatment for VRE
linezolid
Daptomycin
Tigecycline
VACS Organisms (tropical marine bacteria)
Vibrio sp
Aeromonas sp
Chromobacterium violaceum
Shewanella sp
All GNB
