Introduction

Question 1

What are the 5 key results of your thesis?

Answer 1

1) Research gap in dynamics of transduction of AMR
2) Using an interdisciplinary approach, show that transduction can lead to multidrug resistance in just 7h
3) Phage predation is best represented as a frequency-dependent process, with a link between burst size and growth
4) Phage and antibiotics can work synergistically to kill bacteria or drive multidrug resistance evolution
5) There is likely substantial AMR diversity within host in S aureus which changes over time, potentially due to transduction

Question 2

Are most bacteria commensal or pathogens?

Answer 2

Both! E.g. E coli, S aureus

Question 3

What type of relationship is a commensal relationship?

Answer 3

Benefit for one, neutral for the other

Question 4

What was the first antibiotic?

Answer 4

Arsphenamine, 1907

Question 5

What is the percentage of antibiotics prescribed in hospital that are given for prophylaxis?

Answer 5

25%

Question 6

What is the percentage of hospital patients receiving antibiotics?

Answer 6

35%

Question 7

What is the percentage of antibiotic prescribing in hospital that is empiric?

Answer 7

75%

Question 8

What are the four types of resistance mechanisms?

Answer 8

1) limiting uptake of antibiotic
2) efflux of antibiotic
3) target modification
4) antibiotic neutralisation

Question 9

What was the origin of SCCmec?

Answer 9

Another staphylococcus species, maybe fleurettii or sciuri

Question 10

What is an example of an antibiotic with no resistance mechanism known yet?

Answer 10

Daptomycin, only sporadic resistance reported

Question 11

What is an example of an incentive used to reduce antibiotic use?

Answer 11

NHS quality premium, rewards clinical commissioning groups for reduced broad-spectrum use, found to be effective (57% drop in prescribing)

Question 12

Can you briefly describe the subscription model trialed in the UK

Answer 12

The aim is to pay not based on usage of antibiotic, but based on its health benefit (ie its usefulness), so with a fixed fee

Question 13

What is a bacterial isolate?

Answer 13

By definition it’s when you separate a single strain from a population

Question 14

What are fluoroquinolones used to treat for

Answer 14

Strep pneumo, acinetobacter baumanii, e coli…

Question 15

How does lysogenic immunity work?

Answer 15

This is due to the repressor proteins expressed by the prophage to prevent replication, which also neutralises lytic phage activity

Question 16

What is the size of SCCmec?

Answer 16

20-60kbp

Question 17

What controls transformation in S aureus?

Answer 17

Depends on sigma H transcription factor, which itself is only activated depending on specific environment conditions, as experiments have shown that not all media work

Question 18

What is the red queen hypothesis?

Answer 18

The interactions between species shape evolution, so species are constantly evolving as others in their environment are doing the same