Week 9 - Topic 1: MDRO - Overview Flashcards
What is AMR
Antimicrobial resistant
What does MDR/MDRO stand for
Multi-Drug Resistant Organisms
Definition of MDRO
Organism that is resistant to >1 agent in 3+ antimicrobial categories used to treat that bacteria
What does XDR stand for
Extensively drug resistant
Definition of XDR
More dangerous than MDRO
Bacteria susceptible to only 1-2 antimicrobial categories
Resistant to >1 agent in all but <2 antimicrobial categories
What does PDR stand for
Pan Drug Resistant
Definition of PDR
Resistant to all agents in antimicrobial categories
We will therefore use experimental or off the market drugs
What are the most common antibiotic resistant organisms from the ESKAPE soup?
E nterococcus S taphylococcus K lebsiella A cinetobacter P seudomonas E nterobacteriaceae
Give 4 examples on how you can get a hospital acquired infection, especially with MDRO
Central line –> bloodstream infection
Use of catheter –> UTI
Surgical site
Ventilator –> pneumonia
Describe antibiotic development in the last few decades
Less and less new antibiotics are being produced
What is the biggest challenge of modern medicine?
Antibiotic resistance, a ‘silent tsunami’
Causes 700,000 deaths worldwide, and will rise up to 10 million by 2050
A bacteria that has antibacterial resistance will be resistant to what?
Antibiotics and other antibacterial drugs
A parasite that has antiparasitics resistance will be resistant to what?
Anti-malaria medicines
A fungus that has antifungal resistance will be resistant to what?
Medicines used to treat candidiasis
A virus that has antiviral resistance will be resistant to what?
Anti-HIV medicines
Why does WHO do pathogens prioritization?
To develop new antibiotics for drug-resistant bacterial infections, ESPECIALLY for tuberculosis
What is the #1 global infectious disease killer?
Tuberculosis
What is the most lethal airborne drug resistant pathogen? Where is it found?
MDR-TB
Eastern Europe, Asia, Africa
in Asia and Africa it can even be XDR-TB
Identify 3 of the top countries with the highest reported incidence of MDR-TB to WHO as of 2018
India - China - Russia
For which bacteria is it especially hard to find new antibiotics?
Gram - bacteria (they are critical priority!)
What are the 3 critical priority bacteria?
Acetinobacter baumannii
Pseudomonas aeruginosa
Enterobactertaceae
All carbapenem-resistant
What are the 6 high priority bacteria?
Enterococcus faectum Helicobacter pylori Salmonella species Staphylococcus aureus Campylobacter species Neisseria gonorrhoeae
What are the three medium priority bacteria?
Streptococcus pneumoniae
Haemophilus influenzae
Shigella species
First 2 cause pneumonia
What are the 5 reasons to control AMRs?
1) ↓ colonization of host
2) ↓ toxic Ab options
3) Protect the effectiveness of our limited reserve of antimicrobials
4) ↓ circulating pool of resistance genes
5) 30% of ppl colonized will develop an infection in a few years
What are 5 mechanisms of resistance?
1) Acquiring resistance genes via conjugation, transposition or transformation
2) Synthesis of enzymes that break down the drug
3) Chemically ↓ the drug’s function
4) Prevent access of the drug to its target by inhibiting uptake, increasing export or modifying the target receptor size
5) Chromosomal mutations during replications
Where does antibiotic resistance spread?
Hospitals, nursing homes, daycares, abroad (ex: shigella), water, food, gyms, etc.
Give 5 examples of antibiotic classes
1) Penicillin with b-lactam inhibitors
2) 3rd gen cephalosporin
3) Carbapenems
4) Aminoglycosides
5) Fluoroquinolones
What are risk factors for AMR colonization
Staying in: Prolonged hospital stay ICU Close proximity to infected (sharing same bed/household) Foreign hospital stays LTC facilities
Use of: IV Central line Prior antibiotics Ventilators
Why are patients with comorbidities (especially renal/liver disease and transplant) at risk of AMR colonization?
They are more likely to already be on antibiotics
