Viro antibiotic resistance Flashcards
Antibiotics that can cause cell wall impermeability:
FQ
Macrolides
Tetracyclines
B-lactams
Aminoglycosides
Penicillin binding proteins modifications:
MecA gene confers for MRSA by changing PBP to PBP2A
DNA gyrase conferse for resistance to:
Fluoroquinolones
Levofloxacin (Levaquin)
Ciprofloxacin (Cipro)
Delafloxacin (Baxdela)
Moxifloxacin (Avelox)
30s/50s ribosomal subunits coferse resistance to:
Macrolides (Azithromycin, Clarithromycin)
and
Linezolid
Amber Class A is resistant to which antibiotics?
Most beta lactams:
Penicillins, Cephalosporins and Azactam
If resistance to ceftriaxone –> then is a ESBL Amber class A
Amber Class A is still active to which antibiotics?
Carbapenems
Imipenem (Primaxin)
Meropenem (Merem)
Ertapenem (Invaz)
Which antibiotic is the key to identify Ambler Class A?
Ceftriaxone
How will you treat a patient with ESBL and has a Cystitis (uncomplicated UTI) ?
Can give Nitrofurantoin or Bactrim
2nd line option is:
Amoxicillin-clavunate single dose
Aminoglycosides
Carbapenem
Fosfomycin
Fluoroquinolones
How will you treat a pt with ESBL and has pyelonephritis or complicated cystisis?
Carbapenems or Fluroquinolones or Bactrim
How will you treat a patient with ESBL and has systemic infection non urinary tract?
Carbapenems
–> but once the patient is stable can give Fluoroquinolones or bactrim
What are the organism that cause AmpC (amber class C enzymatic degredation)
thinks: HECK YES
Hafinia alvei
Enterobacter Cloace
Citrobacter Freundi
Klebsiella Areginosa
Yersina enterocolitica
What antibiotics can you use when the patient is Amp C?
Carbapenems
Cefepime and meropenem
And fluroquinolones and bactrim
Carbapenemases Class A, B and D common organism
E.coli
K.pneumonia
P.aeruginosa
Acinetobacter
Carbapenemases Class A
What is the active site?
Serine
Carbapenemases Class A what is the common enzyme?
KPC, IMI
Carbapenemases Class A what are the antibiotics suceptible?
Ceftazidime/avibactam
Imipenem/revebactam
Meropenem/vaborbactam
Cefiderocol
Carbapenemases Clas B
What is the active site?
Zinc
Carbapenemases Class B
What are the enzymes?
NDM, VIM, IMP
Carbapenemases Class B
What are the antibiotics suceptible?
Aztreonam/avibactam
Cefiderocol
Carbapenemases Class D
What is the active site?
Serine
Carbapenemases Class D what are the enzymes?
OXA-48
Carbapenemases Class D
What are the antibiotic suceptible?
Ceftazidime/avibactam
Cefiderocol
