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BDS4 Oral surgery > Microbiology & Antimicrobials > Flashcards

Microbiology & Antimicrobials Flashcards

1
Q

name a gram positive cocci bacteria and give the colour and shape

A

s. anginosus
purple
round

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2
Q

name a gram negative cocci bacteria and give the colour and shape

A

veillonella species
red / pinkish
round

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3
Q

name a gram positive bacilli bacteria and give the shape

A

actinomyces israelii
rod shaped

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4
Q

name a gram negative bacilli bacteria and give the shape

A

prevotella intermedia

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5
Q

what does aerobic mean

A

requires oxygen

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6
Q

what does capnophilic mean

A

requires carbon dioxide

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7
Q

what does facultative mean

A

can grow with and without oxygen

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8
Q

what does strictly anaerobic mean

A

grows without oxygen
oxygen might even be toxic for these bacteria

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9
Q

what antibiotic works on strict anerobes

A

metronidazole only

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10
Q

how does antimicrobial resistance occur

A

occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications used to cure the infections they cause ineffective

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11
Q

what are the 2 types of resistance

A

intrinsic resistance

acquired resistance
- mutation
- acquisition of new DNA

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12
Q

name mechanisms of antibiotic resistance

A

changes to the target site (binding proteins of the antibiotics no longer able to bind to the bacteria)

enzymatic inactivation (enzymes destroy antibiotics or prevent binding to target sites eg beta lactamase enzyme destroys the antibiotic)

decreased uptake

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13
Q

what is an endogenous infection

A

= bacteria thought to originate from our own endogenous flora (minority)
As opposed to the exogenous type of infections you can get from classic pathogens such as staphoreous (although some people believe you can get cross infection from certain organisms in the acute dental abscesses)

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14
Q

give examples of bacteria found in acute dento-alveolar infections

A

streptoccus anginosus
prevotella intermedia

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15
Q

what are the treatment principles of dental abscesses

A

localised infection
establish a diagnosis - need to take a good history and carry out a thorough examination
document it
remove the source of the infection

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16
Q

what is the microbiology of pericoronitis

A

predominantly mixed oral anerobes eg P intermedia
S. anginosus group

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17
Q

what is treatment of pericoronitis

A

local measures
antibiotics only if there is systemic signs and symptoms

18
Q

treatment of dry socket

A

does not require antibiotic treatment
treatment is under LA
Debridement
packing with antimicrobial gels or gauze strips

19
Q

what is osteomyelitis predisposed by

A

MRONJ
impaired vascularity of bone due to radiotherapy or pagets disease
foreign bodies (implants)
compound fractures - communication either intra- or extra-orally
impaired host defence - diabetes

20
Q

microbiology of osteomyelitis of the jaws

A

anaerobic gram negative rods
anerobic streptococci
streptococcus anginosus
staphylococcus aureus (any infection in the bone we worry about S. aureus infections as this affects the choice of antibiotic we can use and usually require a long course)

21
Q

microbiology of salivary gland infection

A

s. aureus
mixed anaerobes

22
Q

treatment of salivary gland infection

A

drainage
flucloxacillin and metronidazole

23
Q

what must you always do in the context of acute alveolar infections

A
  1. document diagnosis following history and examination
  2. document antibiotic choice, dose, route and duration
  3. document a review date (for an acute infection it usually should be within 24-48 hours)
  4. document deviation from guidance
24
Q

what is SOI

A

Severe odontogenic infection

25
Q

what is ludwigs angina

A

bilateral infection of the submandibular space

most common bacteria: anaerobic gram negative bacilli (P. intermedia), steptococcus anginosus, anaerobic streptococci

26
Q

what is sepsis

A

infection + SIRS

27
Q

What is SIRS

A

systemic inflammatory response syndrome

2 or more of:
1. temp <36 or >38
2. pulse >90/min
3. resp rate >20/min or (PaCO2 <4.3)
5. WCC <4 or >12

28
Q

are antibiotics used to treat sepsis

A

yes
the sooner you administer antibiotics the greater the chance of the patient surviving sepsis

but reassess antimicrobials daily:
- optimise
- reduce resistance
- avoid toxicity
- reduce costs

29
Q

what is sepsis

A

life threatening organ dysfunction caused by dysregulated host response to infection

30
Q

what is septic shock

A

sepsis + unresponsive to fluid resuscitation
subset of sepsis with circulatory and cellular / metabolic dysfunction associated with higher risk of mortality

31
Q

what are the treatment principles for SOI and ludwigs angina

A

primary care
- diagnosis
- seek advice / help

secondary care
- diagnosis
- sepsis 6
- national early warning score (NEWS-2)

32
Q

what is the sepsis 6

A
  1. give high flow oxygen
  2. take blood cultures
  3. give IV antibiotics
  4. give a fluid challenge
  5. measure lactate
  6. measure urine output
33
Q

what is a break point

A

chosen concentration (mg/L) of an antibiotic which defines whether a species of bacteria is susceptible or resistant to the antibiotic

34
Q

what is clinical resistance

A

when infection is highly unlikely to response even to maximum doses of antibiotic

35
Q

what are confounding variables of resistance in the lab

A
  • inoculum size, growth phase, planktonic, pH, atmosphere
  • breakpoint calling
  • biofilm
36
Q

what are confounding variables of resistance clinically

A

co-morbidities, pus collections, foreign bodies, site of infection
biofilm
pharmacokinetics
pharmacodynamics

37
Q

what are pharmacokinetics

A

how antibiotics are distributed through the body

38
Q

what are pharmacodynamics

A

how the antibiotic classes interact with the bacteria

39
Q

what is antimicrobial stewardship

A

preserve antimicrobial medicines by taking measures to promote their control

40
Q

3 ways to contribute to antimicrobial stewardship

A
  1. prevention of dental disease
  2. prevent spread of disease (wash hands / SICPS / get vaccinated against the flu)
  3. antibiotics dont cure toothache

BDS4 Oral surgery (7 decks)

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