Resistance In Gram -ve Flashcards
Critical priority negative bacteria
Enterobacterales
Enterobacterales examples
•E. Coli
•klebsiella
Gram negative resistance mechanisms
•efflux pumps
•reduced permeability
•site alterations
•beta lactamases
Types of beta lactamases
•ESBLs - extended spectrum beta lac
•CPE - carbapenemase producing Enterobacterales
How to class beta lactamases
•ambler classification
•4 classes - A->D
What do class A C D beta lactamases have in common
Serine core
What core do class B beta lactamases have
Metal
Example of ESBLs
E. Coli and Klebsiella
Example of CPE
Mainly Klebsiella (>1% E Coli)
CPE meaning
Carbapenemase-producing Enterobacterales
ESBL meaning
Extended spectrum beta lactamases
Beta lactamase inhibitors
•clavulanate
•Tazobactam
Types of ESBLs (enzymes)
•TEM
•SHV
•CXT-M
•OXA
•others
What is an ESPL
Plasmid carried by some Enterobacterales that assists with resistance to beta lactamases in particular
What are used to manage ESPLs
•Carbapenems (bad for reserving antibiotics)
•infection control
ESPLs additional problems
•plasmids with ESBL usually have other resistant genes to other antibiotics
•beta lactamase inhibitor combinations antibiotics don’t work
What class are ESPLs
Mostly Class A
Types of Carbapenemases
•class B
•few class A
•1 class D
Carbapenemases (enzymes)
•GES 5 + 12, KPC - Class A
•IMP, VIM, NDM - Class B
•OXA 48 - Class D
Carbapenemases producer bacterials
•Enterobacterales (CPEs)
•Pseudomonas
•Actinobacter
Big 5 Carbapenemases of CPEs
•OXA 48 like
•NDM
•KPC
•IMP
•VIM
How to try stop the rise of CPEs
•prevent spread
•antimicrobial stewardship
What is antimicrobial stewardship
Control and correct use of antibiotics
What antibiotics can’t be used for ESPLs
