W6- Lecture 27.2- Antibiotic Resistance B

Question 1

do activity sheet part b

Answer 1

well done for that !

Question 2

Antibiotic Prescribing in England
how many prescriptions ?
distribution between animals and humans
primary care setting % of total prescriptions
% hospital prescribing

Answer 2

50 million prescriptions in England every year
50% use in humans (50% use in animals)
Primary care settings accounted for 81.0% of all antibiotics prescribed in 2018. (GP, Community and Dental settings)
Hospital antibiotic prescribing accounted for up to 20% (Inpatients 11% and outpatients 6%)

Question 3

which are the three groups of antibiotics most prescribed in england

Answer 3

penicillins (45.0 %), tetracyclines (22.1%) and macrolides (14.8%.

Question 4

how much did prescribing fall from 2013 to 2017

Answer 4

13.2%

Question 5

how much did prescribing fall from 2016 to 2017

Answer 5

4.5%

Question 6

what percentage of primary care and hospital antibiotic prescriptions are deemed inappropriate (indication/ choice /duration)

Answer 6

primary care - 8.8%

hospitals - 50%

Question 7

name three types of natural/intrinsic bacterial resistance

with examples

Answer 7

Lack of penetration through cell wall

Lack of suitable cell wall target site

Susceptibility of antibiotic to naturally produced enzymes

Gentamicin resistant Strep pyogenes
Polymixin resistant Staph aureus
Cloxacillin resistant Pseudomonas aeruginosa
Penicillin resistant Mycoplasma pneumoniae

Question 8

what are the three types of bacterial resistance (how the resistance was acquired )

Answer 8

natural/intrinsic resistance 
acquired resistance (use of AB)
Emergence (mutation caused)

Question 9

name a describe three ways bacteria transfer genes

Answer 9

a - conjugation
plasmids move from one bacteria to another
b - transduction
bacteriophages or phages move between bacteria sometimes carry genes
c - transformation
take up DNA from solution

Question 10

what is antibiotic inactivation ?

+ examples

Answer 10

Bacteria acquire genes encoding enzymes that inactivate antibiotics

Examples include:
beta-lactamases
aminoglycoside-modifying enzymes

Question 11

name 5 Mechanisms of resistance for bacteria against antibiotics

Answer 11

Inactivation of antibiotic by enzymes produced by bacteria
Alteration of antibiotic (drug) target site
Modification of bacteria well wall protein
Activation of drug efflux pump by bacteria
Transfer of DNA between different species of bacteria

aka
impermeable
inactivation
efflux
hyperproduction (stimulates production of bacter )
byass(e.g bacteria used different metabolic pathway )
altered target

Question 12

Strategies to reduce AMR (antimicrobial resistance )

Answer 12

Prevention of Infection
Better diagnostics
Reduce the use of antibiotics
Development of new classes of antibiotics