Resistant Organisms

Question 1

Causes of antibiotic resistance

Answer 1

Over prescribing, incorrect dosing/duration, using broad spectrum agents, non-compliance and agricultural use. Tends to devlop quickly after 1st introduced to market (no new antibiotics really being made)

Question 2

How to bacteria share resistance genes

Answer 2

Transformation, transduction, conjugation and transposition

Question 3

Impact of Antibiotic resistance

Answer 3

Lower bacterial susceptibility, empiric treatment failure, patients experience poorer outcomes and more complications. Increased duration of hospital stays and more expensive medicines needed

Question 4

Key Antibiotic resistant bacteria

Answer 4

penicillin resistant streptococcus pneumoniae, meticillin resistant staph aureus, vancomycin resistant enterococci and extended spectrum beta lactamase resistant enterobacteriaceae

Question 5

Penicillin Resistance Streptococcus Pneumoniae Outline

Answer 5

Modification to penicillin binding proteins in cell wall syntheses. Associated with community acquired pneumonia and blood stream infections (meningitis). Multi-resistant to cephalosporins, clarithromycin, teteracyclines and co-trimoxazole

Question 6

Methicillin Resistant Staphylococcus Aureus

Answer 6

Associated with HCAIs. surgical site, device related and blood stream infections. Target site modification of penicillin binding protein (lower beta lactamase affinity). chromosomally associated mec A gene. Erythromycin, gentamicin and ciprofloxacin. No vancomycin resistance

Question 7

Why may rates of prevalence of infections decrease

Answer 7

Preventative measures put in place or natural cycles of microorganism infection (seasonal infection)

Question 8

Multivalent Vaccine Outline

Answer 8

Preventative against Penicillin resistant and susceptible streptococci. Attacks streptococci capsules

Question 9

How is MRSA Spread prevented

Answer 9

Good hand hygiene, isolating contaminated patients, decolonisation pre-surgery and good antibiotic stewardship

Question 10

VanA+ Outline

Answer 10

VREs that are resistant to both vancomycin and teicoplanin

Question 11

VanB+

Answer 11

VREs that are resistant to vancomycin but not teicoplanin

Question 12

Antibiotics to use in ESBLs

Answer 12

Carbepenems (Imipenem, meropenem, entrapenem)

Question 13

What is the last line treatment in ESLBs

Answer 13

Colistin, highly toxic (nephro and neuro) high chance of drug-drug

Question 14

Enzyme that breaks down the beta lactam ring

Answer 14

beta lactamase

Question 15

Enzyme that breaks down carbapenem ring

Answer 15

carbepenamase