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BDS4 CDS Oral Surgery > Infection Symposium Summary > Flashcards

Infection Symposium Summary Flashcards

1
Q

ANTIBIOTIC RESISTANCE

Define intrinsic resistance.

A

Common structural feature i.e. thick capsule.

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2
Q

ANTIBIOTIC RESISTANCE

Define acquired resistamce.

A

Mutation or acquisition of new DNA.

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3
Q

ANTIBIOTIC RESISTANCE

What are three mechanisms of antibiotic resistance ?

A

Altered target site.
Enzymatic inactivation.
Decreased uptake.

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4
Q

ANTIBIOTIC RESISTANCE

Mechanisms of antibiotic resistance - explain ‘altered target site’ mechanism and an example of a microbe.

A

Bacteria alters binding site for antibiotic drug.
e.g. viridans group S. Mitis - penecillin resistant due to modified penicillin binding proteins.

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5
Q

ANTIBIOTIC RESISTANCE

Mechanisms of antibiotic resistance - explain ‘enzymatic inactivation’ mechanism and an example of a microbe.

A

Ezymes released by bacteria which alters antibiotic binds i.e. release of beta lactamase enzymes by hydrolysing beta lactam ring in common in all beta-lactam antibiotics preventing them from binding to PBPs and inhibiting cell wall synthesis.
Example - P. Intermedia and fusobacterium.

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6
Q

ANTIBIOTIC RESISTANCE

Mechanisms of antibiotic resistance - explain ‘decreased uptake’ mechanism.

A

Thick LPS capsule making it difficult for antibiotics to penetrate.

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7
Q

ANTIBIOTIC STEWARDSHIP

Define antibiotic stewardship.

A

Multidisciplinary team action plan to promote responsible antimicrobial use.

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8
Q

ANTIBIOTIC STEWARDSHIP

National Action Plan - what two ways do they suggest dentists practice antibiotic stewardship.

A
  1. Reduce need for and unintentional exposure to antimicrobials through prevention i.e. OH, national OH programmes.
  2. Optimise use of antimicrobials by making appropriate clinical decisions.
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9
Q

ANTIBIOTIC STEWARDSHIP

What antibiotics is S. Anginosus sensitive to ?

A

PenV and amoxicillin.

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10
Q

ANTIBIOTIC STEWARDSHIP

What antibiotic should be used in first line therapy for odontogenic infection ?

A

PenV - lowest spectrum - effective against streptococci, anaerobes, select gram-negative cocci.

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11
Q

ANTIBIOTIC STEWARDSHIP

What is the second line antibiotic for odontogenic infection ?

A

Amoxicillin - wider spectrum antibiotic, more effective against gram negative cocci and other bacteria (vs. PenV).

Always review patient 24-48 hours after commencing amoxicillin therapy.

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12
Q

ANTIBIOTIC STEWARDSHIP

What is the first line antibiotic used to treat periodontal infection ?

A

Metronidazole.
Effective against strict anaerobes i.e. P. Intermedia, fusobacterium nucleatum, P. Gingivalis.

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13
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is the ideal specimen for dental abscess ?

A

Pus aspirate - less salivary contamination.

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14
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What bacteria are associated with dental abscess ?

A

Strict anaerobes i.e. S. Anginosus (+ cocci), P. Intermedia (- bacilli).

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15
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is your first line antibiotic of choice for management of dental abscess ?

A

PenV (second line - amox).

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16
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What microbes are associated with periodontal abscess ?

A

S. Anginosus and P. Intermedia.

17
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What microbes are associated with pericoronitis ?

A

S. Anginosus and P. Intermedia.

18
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What are the predisposing factors contributing to osteomyelitis ?

A

MRONJ, ORN, Paget’s, implants, compoud fractures, impaired defence.

19
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What microbes are most commonly associated with osteomyelitis ?

A

S. Anginosus, S. Aureus, Actinomyces israelii.

20
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is the uses for microscopic examination and gram staining ?

A

Determines gram +/- bacteria or presence of microbes.

21
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is the uses for culture and sensitivity testing ?

A

Assessment of microbe sensitivity to antibiotics.

22
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is the used for PCR testing ?

A

Shows specific microorganisms responsible for infection through DNA and RNA sequencing - giving accurate diagnosis of causative agent.

23
Q

MICROBIOLOGICAL TESTING AND SAMPLING

What is PCR testing ?

A

Molecular biology technique used to amplify and detect specific DNA sequences in a biological sample.
Used for detection of infectious agents, genetic mutations, and other biomarkers associated with diseases.

24
Q

MICROBIAL TESTING AND SAMPLING

What are the benefits of PCR testing vs. culture and sensitivity testing ?

A

Faster results.
Greater sensitivity.
Greater specificity - less likely for false positive results.
No live organisms required.

25
Q

MICROBIAL SAMPLING

You want to sample periodontal pocket for responsible pathogens causing periodontal disease - what is your best method of sampling ?

A

Paper point swab of subgingival plaque.
Then PCR testing.

26
Q

MICROBIAL SAMPLING

You want to sample denture stomatitis to determine the treatment you should provide for your patient - what is your best sampling technique ?

A

Swab (if pseudomembranous) or mouthrinse.

27
Q

MICROBIAL SAMPLING

Your patient has a severe odontogenic abscess and requires systemic treatment - what is your preferred method of sampling ?

A

Pus aspirate.
Then PCR testing.

28
Q

MICROBIAL SAMPLING

You wish to sample bacteria of multiple persons in research of the bacteria causing caries - what is your best method of sampling and testing ?

A

Oral swab - easier.
Then microscopic examination and gram staining if you want to determine - gram +/- or cocci/bacillus or anaerobic/aerobic ?
If you wish more specific information i.e. exactly what bacteria is causing the caries - PCR testing.

29
Q

MICROBIOLOGY

What are the two bacteria responsible for caries ?

A

S. Mutans and lactobacillus.

30
Q

MICROBIOLOGY

What is the microbe associated with implant failure/infection ?

A

Pseudomonas aeruginosa.

31
Q

MICROBIOLOGY

What are the three microbes associated with endodontic infection ?

A

E. Faecalis, fusobacterium neucleatum, prevotella.

32
Q

MICROBIOLOGY

What is the microbes associated with PA abscesses ?

A

Anaerobes - fusobacterium, prevotella.
Facultative anaerobes - actinomyces, streptococci.
Enteric bacteria - E. faecalis.

33
Q
A

BDS4 CDS Oral Surgery (18 decks)

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