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SA Microbiology > L02: Vaccine Guidelines (Brown) > Flashcards

L02: Vaccine Guidelines (Brown) Flashcards

1
Q

Non-core vaccine

A
  • licensed

- use based on geographical and lifestyle exposure with assessment of risk-benefit ratios

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2
Q

Core canine vaccines (2006 AAHA)

A

1) Canine adenovirus-2 (CAV-2); (MLV parenteral)
2) Canine distemper virus (CDV) (MLV or rCDV)
3) Canine parvovirus (CPV-2) (MLV)
4) Rabies 1 year (killed) or 3 year (killed)

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3
Q

Non-core canine vaccines (2006 AAHA guidelines)

A

1) Parainfluenza virus (CPIV)
2) Bordetella bronchiseptica (killed bacterin - parenteral; cell wall Ag extract - parenteral)
3) Bordetella bronchiseptica (live avirulent bacteria) + Parainfluenza virus (MLV) - intranasal application

Recommended for at-risk:

4) Borrelia burgdorferi (lyme borreliosis; killed bacterin or recombinant)
5) Crotalus atrox toxoid (rattlesnake vax)

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4
Q

Non-core canine vaccine that has adverse rxns or has better alternative

A

Distemper-measles virus (MLV)

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5
Q

Canine vaccines that are NOT recommended (insufficient validation)

A

1) Porphyromonas sp. (periodontal disease vaccine)
2) Babesia vaccines
3) Canine herpesvirus vaccine
4) Canine parvo (KILLED)
5) Canine adenovirus-1 (MLV and killed)
6) CAV-2 (killed or MLV-oral)
7) Canine coronavirus (CCV) (killed and MLV)
8) Leptospira interrogans + canicola and icterohaemorrhagiae serovars (killed bacterin)

#2 and 3 licensed in EU
#1 has conditional USDA license
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6
Q

Overall feline vaccination guidelines

A

Only vax if:

  • realistic risk of exposure
  • agent causes significant dz
  • potential benefits outweigh risks
  • no more frequently than necessary
  • greatest # possible in at risk populations
  • appropriately to protect human/PH
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7
Q

Core feline vax

A

1) Feline Calicivirus (FCV)
2) Feline herpesvirus -1 (FHV-1)
3) Feline leukemia virus (FeLV) for all kittens
4) Panleukopenia (FPV)
5) Rabies

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8
Q

Non-core, highly recommended feline vax

A

1) FeLV for adult cats

* Need to test prior to vaccine administration!*

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9
Q

Non-core, recommended for at risk cats only, feline vaccines

A

1) Bordetella bronchiseptica - intranasal only
2) feline immunodeficiency virus (FIV)
3) Chlamydophila felis (use in multi-cat environments with confirmed clinical disease) - conjunctival inoculation of vaccine may cause CS of infection

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10
Q

Feline vaccines generally NOT recommended unless at risk

A

Feline infectious peritonitis (FIP)

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11
Q

Reasons vaccines fail

A

1) Maternal-derived Ab neutralizes vaccine virus
2) vaccine poorly immunogenic
3) animal is poor responder and fails to recognize vaccinal Ag (underlying immune deficiency)

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12
Q

Active immunization succeeds in >98% of puppies if last vaccine dose given at which age?

A

14-16 wks

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13
Q

Does maternal Ab affect oral immunization?

A

NO

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14
Q

Only practical way to ensure a puppy’s immune system has recognized the vaccinal Ag

A

Testing for Ab

  • should test at least 2 weeks after final puppy vaccine
  • if positive, booster @ 1 yr, then q3yrs
  • if negative, repeat vax + serology. If negative again, pup may be serological non responder and may be unprotected or have cell-mediated immunity or innate immunity affording some protection
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15
Q

Antimicrobial groups that are critically important in both humans and vet med

A

1) aminoglycosides
2) cephalosporins (3rd + 4th gens)
3) macrolides
4) penicillins
5) quinolones
6) tetracyclines

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16
Q

AVMA recommendations for judicious therapeutic use of abx

A

1) adhere to guidelines
2) parasite control
3) nutritional counseling
4) dental health care
5) client ed. And preventative health care programs
6) appropriate hygiene + husbandry
7) use of abx only justified if bacterial infection LIKELY to occur
8) confine use to appropriate clinical indications
9) therapeutic alternatives should be considered first
10) C/S results aid in appropriate selection of abx
11) use narrow spectrum abx when possible
12) treat for shortest effective period possible
13) caution with use of abx used to tx refractory infections in humans AND animals

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17
Q

1 prescribed abx

A

Ampicillin-clavulanate (Clavamox) - also has the worst % of confirmed cases before use

2-5:

2) Cephalexin or cefazolin
3) Enrofloxacin
4) Amoxicillin or ampicillin
5) Doxycycline

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18
Q

Which abx has the highest % of confirmed AND not confirmed infections before use?

A

Doxycycline

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19
Q

Top 3 worst abx in terms of vets not performing culture before use

A

1) clavamox
2) cefazolin or cephalexin
3) amoxicillin or ampicillin

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20
Q

Why is resistance not a new event

A

Most abx have natural origin

Ex: resistance to penicillin occurred the same year it was discovered

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21
Q

Methods of sensitivity testing

A
  • Kirby Bauer Disk Diffusion
  • Broth dilution
  • estrip test (combo of first 2)
  • PCR arrays for specific genetic mutations (in development)
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22
Q

Minimum Inhibitory Concentration (MIC)

A

Lowest concentration of an antimicrobial agent that prevents visible growth in agar or broth dilution susceptibility test

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23
Q

Minimum Bactericidal Concentration (MBC)

A

Lowest dilution where NO bacteria survive

-not routinely determined

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24
Q

Breakpoint

A

MIC or zone diameter value used to indicate susceptible S, intermediate I, and resistant R

NI = not interpreted (means no established breakpoint)

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25
Q

Efficacy Ratio

A

MIC obtained by broth dilution

-tool to evaluate relative efficacy of different antimicrobial drugs

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26
Q

Core vaccine

A

Recommended for all animals; may include non-core if legal or endemic reasons

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27
Q

Main targets or antibacterial drugs

A

1) cell wall biosynthesis
2) protein biosynthesis
3) DNA replication and repair

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28
Q

Which classes of abx target cell wall biosynthesis?

A

Beta-lactams
Glycopeptides
Cephalosporins

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29
Q

Which classes of abx target protein biosynthesis?

A

Macrolides
Tetracyclines
Aminoglycosides
Oxazolidinones

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30
Q

Which class of abx targets DNA replication and repair?

A

Fluoroquinolones

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31
Q

Intrinsic resistance

A

Innate ability to resist activity of antimicrobial

Natural insensitivity

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32
Q

Causes of intrinsic resistance:

A
  • lack of affinity of drug for bacterial target
  • inaccessibility of drug into bacterial cell
  • extrusion of drug by chromosomally-encoded active exporters
  • innate production of enzymes that inactivate drug
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33
Q

Anaerobic bacteria are naturally resistant against which abx? Why?

A

Aminoglycosides; lack of oxidative metabolism to drive uptake of aminoglycosides

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34
Q

Aerobic bacteria are naturally resistant to which abx and why?

A

Metronidazole; inability to anaerobically reduce drug to its active form

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35
Q

Gram + bacteria are naturally resitant to which abx and why?

A

Aztreonam (a beta-lactam); lack of penicillin binding proteins that bind and are inhibited by this beta lactam abx

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36
Q

Gram - bacteria are naturally resistant to which abx? WHy?

A

Vancomycin; vancomycin can’t penetrate the outer membrane

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37
Q

Klebsiella spp. Are naturally resistant to which abx? Why?

A

Ampicillin; Klebsiella produces beta-lactamases that destroy ampicillin before the drug can reach the PBP targets

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38
Q

Lactobacilli is naturally resistant to which abx and why?

A

Vancomycin; lack of appropriate cell wall precursor target to allow vancomycin to bind and inhibit cell wall synthesis

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39
Q

Pseudomonas aeruginosa is naturally resistant to which abx and why?

A

Sulfonamides, trimethoprim, tetracycline, chloramphenicol; lack of uptake resulting from inability of abx to achieve effective intracellular concentrations

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40
Q

Enterococci are naturally resistant to which abx and why?

A

Aminoglycosides due to lack of sufficient oxidative metabolism to drive uptake of aminoglycosides

All cephalosporins due to lack of PBPs that effectively bind and are inhibited by these beta-lactam abx

41
Q

Acquired Resistance

A

Previously susceptible microbe obtains ability to resist activity of drug

Mechanisms:

  • mutation of chromosomal genes involved w/ bacterial physiology/cell structures
  • acquisition of foreign resistance genes (horizontal gene transfer)
  • combo of both
42
Q

Genetic transfer occurs by 3 methods:

A

1) Conjugation
2) Transformation
3) Transduction

43
Q

Conjugation

A

Transposon or copy of plasmid transferred from one bacteria to another
*relies on a competent cell w/ ability to take it up and integrate it into its own DNA

Ex: Enterobacteriaciae encode fertility factor that allows them to better integrate and move from one organism to another

44
Q

Transformation

A

Genes transferred from one bacterium to another as naked free-floating DNA released from a dead bacteria

45
Q

Transduction

A

Bacterial DNA transferred via a virus that infects another bacteria

46
Q

MOA of beta-lactams

A

Target bacterial wall synthesis; blocks cross-linking of enzymes of peptidoglycan layer of cell wall

47
Q

MOA of beta-lactam resistance

A

Beta-lactamase or penicillin binding proteins (PBPs)

48
Q

How does clavulanate amoxicillin (Clavamox) work better than just penicillin?

A

Clavulanate Inactivates the beta-lactamase by forming a slowly hydrolysing acyl enzyme intermediate

Amoxicillin blocks cell wall crosslinking transpeptidase, also by forming a slowly hydrolysing covalent acyl enzyme intermediate

49
Q

Primary mechanisms of resistance *

A

1) Impermeable barrier
2) Efflux pumps
3) Resistance mutation
4) Drug inactivation

50
Q

Bacterial resistance mechanism to erythromycins and tetracyclines

A

Efflux pumps (pump it out before can reach lethal concentrations), target modification

51
Q

MOA of macrolides, lincsamides, streptogramins (MLS)? How has resistance developed to these abx?

A

MOA: target protein synthesis (binds 50s ribosomal subunit)

Resistance due to reduced intracellular uptake and target modification

52
Q

MOA of aminoglycosides? How has resistance developed to this abx?

A

MOA: targets protein synthesis (binds to 30s ribosomal subunit)

Resistance due to structural modification to the antibiotic, target modification, decreased uptake/efflux pumps

53
Q

MOA of tetracyclines and MOA of resistance to it?

A

MOA: targets protein synthesis

Resistance due to drug efflux, target modification

54
Q

MOA of fluoroquinolones and MOA of resistance?

A

MOA: targets DNA replication/repair by targeting DNA gyrase and topoisomerase IV of the bacteria; inhibits supercoiling

Resistance due to mutation of DNA gyrase genes and DNA topoisomerase IV genes (target modification), efflux pumps

55
Q

MRSP

A

Methicillin-resistant staphylococcus pseudointermedius

56
Q

Spectrums of abx activity

A

Broad
Intermediate
Narrow
(May change w/ acquisition of resistance genes)

57
Q

Broad spectrum includes action against:

A

Both Gram + and Gram - organisms

58
Q

Common broad spectrum abx

A

Tetracyclines
Phenicols
Fluoroquinolones
3rd and 4th gen. Cephalosporins

59
Q

Narrow spectrum

A

Limited activity and are primarily only useful against particular species of microorganisms

60
Q

Narrow spectrum abx again Gram + bacteria

A

Glycopeptides

Bacitracin

61
Q

Narrow spectrum abx against gram - bacteria

A

Polymixins

62
Q

Narrow spectrum abx against aerobes

A

Aminoglycosides

Sulfonamides

63
Q

Narrow spectrum abx against anaerobes

A

Nitroimidazoles

64
Q

MOA of glycopepties and MOR (mech. Of resistance)?

A

MOA: inhibit the last stages of cell wall assembly by preventing cross-linking reactions

MOR: target modification, production of false targets

65
Q

MOA of beta-lactams and MOR

A

MOA: target and bind to penicillin-binding proteins, inhibit bacterial bell wall synthesis

MOR: enzymatic destruction of beta-lactam rings, target (PBP) modification, efflux pumps

66
Q

MOA of Rifampicins and MOR

A

MOA: interacts with the beta-subunit of the bacterial RNA polymerase to block RNA synthesis

MOR: target modification

67
Q

MOA of sulfonamides and MOR

A

MOA: targets dihydropteroate synthase (DHPS) and prevents addition of para-aminobenzoic acid, inhibiting folic acid synthesis

MOR: target modification

68
Q

Aminoglycosides MOA

A

Target peptidyl transferase in protein synthesis

69
Q

Aminoglycoside abx

A 
Streptomycin
Dihydrostreptomycin
Neomycin
Kanamycin
Gentamycin
Amikacin
70
Q

Streptomycin & dihydrostreptomycin spectrum

A

Narrow-spectrum aminoglycosides active against aerobic gram negatives

71
Q

Neomycin & kanamycin spectrum

A

Expanded-spectrum aminoglycosides active against several gram positives and many gram negative aerobes

72
Q

Gentamicin and amikacin spectrum

A

Expanded-spectrum aminoglycosides active against an expanded spectrum including Pseudomonas aeruginosa

73
Q

Common uses of aminoglycosides

A
  • control of local and systemic infections caused by aerobic (usually gram - ) bacteria
  • septicemia, tracheobronchitis, pneumonia, osteoarthritis, UTI, GI tract infection, skin wounds, topical ear and eye meds
74
Q

Contraindication of aminoglycosides

A

Potential for nephrotoxicity; don’t use if plasma creatinine >5 mg/dL

75
Q

Penicillin G spectrum

A

Narrow spectrum penicillin active against most aerobic and anaerobic gram positives, including Clostridium spp.

More active against strep than staph

76
Q

Disadvantages of penicillin G

A
  • sensitive to beta-lactamase degradation
  • inactive against most gram negative organisms
  • widespread resistance
77
Q

Spectrum of ampicillin

A
  • Gram positives (including alpha and beta-hemolytic strep, sensitive staph)
  • most Clostridia spp.
  • SOME gram negs (E. Coli, Salmonella, Pasteurella multocida)
78
Q

Spectrum of amoxicillin

A

Same as ampicillin with slightly better activity against gram negatives

Most anaerobic bacteria are sensitive

79
Q

Spectrum of clavulanate-potentiated amoxicillin (Clavamox)

A

Gram positives AND gram negatives, including staph, strep, corynebacterium, clostridium, escherichia, Klebsiella, Shigella, Salmonella, Proteus, Pasteurella

More effective due to combo of beta-lactamase inhibitors and broad spectrum penicillins

80
Q

First generation cephalosporins and spectrum

A

Cefazolin
Cephalexin
Cephalothin
Cefadroxil

Spectrum: mainly gram positive cocci

81
Q

Second gen. Cephalosporins and spectrum

A

Cefamandole
Cefaclor
Cefoxitin

Spectrum: E. Coli, Klebsiella, Proteus, haemophilus influenzae

82
Q

3rd gen. Cephalosporins and spectrum

A 
Cefpodoxime (Simplicef)
Cefovecin
Ceftazidime
Cefoperazone
Ceftiofur (Excede, Naxcel in LA)

Spec: enterobacteriaceae, pseudomonas aeruginosa, gram positive cocci

83
Q

4th gen. Cephalosporins and spectrum

A

Cefepime
Cefpirome
Cefclidine

Similar spectrum as 3rd gen but more resistant against beta-lactamases

84
Q

Tetracycline MOA

A

BIND REVERSIBLY TO BACTERIAL 30S RIBOSOMES AND INHIBIT PROTEIN SYNTHESIS

85
Q

Name 4 tetracyclines

A

1) tetracycline
2) DOXYCYCLINE
3) oxytetracycline
4) chlortetracycline

86
Q

Spectrum of tetracyclines

A

Gram + and -
Some anaerobes
Chlamydia, mycoplasmas, some protozoa
Rickettsiae (ie. Anaplasma, Ehrlichia)

87
Q

Fluoroquinolone MOA

A

Target DNA gyrase which helps DNA supercoiling

88
Q

Name 5 fluoroquinolones

A

1) enrofloxacin (Baytril)
2) Ciprofloxacin
3) Difloxacin
4) Orbifloxacin
5) Marbofloxacin

89
Q

Fluoroquinolones have synergistic effect with which abx?

A

Beta-lactams
Aminoglycosides
Clindamycin
Metronidazole

90
Q

Fluoroquinolones should NOT be used prophylactically or for anaerobes

A

They are second line drugs!

Use for serious infections and short term therapy only!

91
Q

Spectrum of activity of fluoroquinolones

A

Most aerobic gram negatives, and some gram positives

PARTIALLY effective against gram negative enterics and pseudomonas spp.

Variable against enterococcus and streptococcus

NOT effective against anaerobes*

92
Q

Common uses of fluoroquinolones

A
  • deep-seated infections and intracellular pathogens
  • respiratory, intestinal, urinary, and skin infections
  • bacterial prostatitis, meningoencephalitis, osteomyelitis, arthritis
93
Q

Fluoroquinolones should be avoided in which animals?

A

Immature animals; high prolonged dosages in growing dogs produces cartilaginous erosions leading to permanent lameness

94
Q

Target of macrolides

A

Interferes with protein synthesis by reversibly binding to the 50 S subunit of the ribosome, preventing translocation to keep peptide chain growing

95
Q

Macrolides are active against which bacteria?

A

Most aerobic and anaerobic G+ bacteria

Mycobacterium, Mycoplasma, Chlamydia, and Rickettsia

Generally not active against G- bacteria

96
Q

Target of lincosamides

A

Bind to ribosome subunit causing premature dissociation of peptidyl-tRNA from ribosome

97
Q

Name 2 lincosamides

A

Clindamycin

Lincomycin

98
Q

Which abx targeted by lincosamides?

A 
Staph, strep
Anaerobic organisms
Bacteroides
Fusobacterium
Clostridium perfringens
Actinomyces sp.
Peptostreptococcus sp.
Propionibacterium sp.

SA Microbiology (10 decks)

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