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Bacterial Identification > Sensi Quiz > Flashcards

Sensi Quiz Flashcards

1
Q

What organisms should be screened for vanc resistance?

A

S. aureus and Enterococcus spp

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2
Q

Which bug/drug combinations have ECVs for bacteria?

A

P. acnes and Vanc
Salmonella, Shigella flexneri and sonnei and Azithro
E. coli, K. pneumo, R. orthinolytica, E. cloacae and aerogenes and Colistin
N. gonnorrhoae and Azithro

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3
Q

intrinsic Cephalosporin resistance

A

Enterococcus
Listeria
Bacillus anthracis

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4
Q

resistant to ampicillin

A

HACEK (produce beta-lacatmase, Rx 3rd gen cephalosporin)

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5
Q

What isolates of Staph spp are tested for beta-lactamases?

A

MSSA and MS CoNS

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6
Q

intrinsic novobiocin resistance

A

Staph saprophyticus

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7
Q

(generally) sensitive to bactrim

A

Burkholderia cepacia

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8
Q

What specimen source restrictions are there for daptomycin testing?

A

No respiratory sources

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9
Q

Mechanism of action of echinocandins

A

inhibit 1-3 glucan sythase in glucan sythesis

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10
Q

Ampicillin susceptible

Synercid (Quin/Dalf) resistant

A

E. faecalis

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11
Q

Tiers of Beta-lactamases

A

AmpC (lowest)
ESBL (middle)
Carbapenemases (highest)

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12
Q

Orgs we report as ESBLs

A

Klebsiella pneumoniae
Klebsiella oxytoca
Proteus mirabilis
E. coli

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13
Q

resistant to macrolides and clindamycin

A

Eikenella

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14
Q

What drugs should NOT be reported for Salmonella isolates?

A

1st and 2nd gen cephalosporins and aminoglycosides

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15
Q

intrinsic metronidazole resistance

A

Actinomyces
Proprionibacterium
Lactobacillus

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16
Q

What are the CLSI methods to detect carbapenemases and which bugs can they be used on (per CLSI)?

A

MHT (Enterobacteriaceae)
Carba-NP (Enterobacteriaceae, P. aerug, Acinteo spp)
mCIM (Enterobacteriaceae)
(plus molecular assays for all groups as well)

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17
Q

no AST

A

Legionella

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18
Q

Cefoxitin sensitivity screening

A

Predicts methicillin resistance in Staphylococci

19
Q

Mechanism of action of amphoterecin B

A

Targets ergosterols and inserts into membrane

20
Q

What methods are used to test for high level aminoglycoside resistance?

A

Disk diffusion, broth microdilution, and agar dilution

21
Q

intrinsic vancomycin resistance

A 
Pediococcus (PYR-)
Weisella
Erysipelothrix
Enterococcus casseliflavus
Enterococcus gallinarium
Lactobacillus
Leuconostoc (PYR-)

Clostridum innocuum

22
Q

Definition of extended spectrum beta-lactamase (ESBL)

A

Hydrolyze at least 1 oxy-imino-beta-lactam at a rate of > or = to 10% of that of benzylpenicillin and are inhibited by clavulanic acid

23
Q

What must be added to test fosfomycin AST?

A

Glucose-6-phosphate, this is added to KB disk, but must be added for MIC method (why agar dilution is only approved method)

24
Q

How ESBLs are detected in the lab

A

3 doubling dilution shift in MIC w/ clavulanic acid or >= 5mm change in zone diameter for KB testing

25
Q

What is the acceptable “validation” to go to weekly AST QC?

A

20 or 30 days of consecutive testing of all appropriate QC strains, with no more than 1/20 or 3/30 out of range QCs

26
Q

Which drugs have meningitis and non-meningitis breakpoints for S. penumo?

A 
Penicillin
amoxicillin
Cefepime
Cefotaxime
Ceftriaxone
27
Q

What organisms are tested for high level aminoglycoside resistance?

A

Enterococcus spp

28
Q

intrinsic bactrim resistance

A 
Pseudomonas aeruginosa
Strep Groups (BAD)
 - S.. agalactiae (B)
 - S. pyogenes (A)
 - Enterococcus (D)
29
Q

Ampicillin resistant

Synercid (Quin/Dalf) susceptible

A

E. faecium

30
Q

How is beta-lacatmase detection in Staph spp performed

A

S. aureus and CoNS - cefinase test (red/pink=pos) from zone around cefoxitin disk
S. aureus can also do penn KB - sharp edge=pos, fuzzy edge=neg

31
Q

Which bug/drug combination has the SDD category?

A

Cefepime and Enterobacteriaceae

32
Q

What are appropriate methods to test for methicilin resistance in Staph species?

A

For S. aureus and S. lugdunensis = Oxacillin MIC or cefoxitin disk/MIC
CoNS = Cefoxitin disk or MIC as surrogate for oxacillin
S. pseudintermiedius = Oxacillin disk or MIC

33
Q

Which drugs have different breakpoints for S. aureus and CoNS?

A

Oxacillin (also S. lugdunensis and S. pseudintermedius)

Vancomycin

34
Q

Mechanism of action of azoles

A

inhibit 14-alpha demethlyase in ergosterol sythesis

35
Q

intrinsic colistin resistance

A

Burkholderia
Serratia
Porphyromonas

36
Q

Common orgs with chromosomal AmpC

A 
(SPACE!)
Serratia
Proteus/Pseudomonas*
Acinetobacter/Aeromonas
Citrobacter*
Enterobacter

(plus Provdiencia, Hafnia, Morganella…)

*not all species have chromosomal AmpC

37
Q

How is a vanc resistance screen done?

A

On BHI agar with 6ug/ml vanc, resuspension is inoculated directly on to plate and examined for growth of at least 1 colony, if growth, follow with appropriate vanc MIC method

38
Q

Classic test for ESBLs

A

Double disk synergy test (looks for keyhole structure - where clav. acid inhibits and there is no growth)

39
Q

resistant to all Beta-lactams except imipenem

A

Campylobacter

40
Q

What agents are tested for high level aminoglycoside resistance?

A

Genatmysin, Streptomycin

41
Q

sensitive to colistin

A

Pseudomonas

42
Q

AmpC producers should be reported as “R” to which Abx?

A

1st and 2nd gen cephalosporins, and the cefamycins

43
Q

What drugs should be reported on Slamonella isolates?

A

Intestinal - Amp, Fluoroquinolone, Bactrim (SXT)

Extra-intestinal - Above plus third gen cephalosporin

44
Q

What species should be tested for inducible clindamycin resistance?

A

Staph spp, S. pneumo, and B-heme strep spp that are R to erythro and S or I to clinda

Bacterial Identification (3 decks)

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