MICROB Bacteria Integration and antibiotic stewardship Flashcards
4 bacteria that produces exotoxins that increase levels of cAMP?
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4 bacteria that produces exotoxins that increase levels of cAMP?
Bruce the […], Yersin the […], Francis the […], Pasteur the […], Barton the […]
Bruce the Cow/Camel, Yersin the Rat, Francis the Rabbit, Pasteur the bitey cat, Barton the scratchy cat
How does beta-lactamases confer resistance?
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What are ESBLs resistant to?
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What are carbapenemases resistant to?
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How does beta-lactamases confer resistance?
inactivate beta lactam drugs
What are ESBLs resistant to?
“R” to penicillin and cephalosporins
What are carbapenemases resistant to?
“R” to penicillins, cephalosporins and carbapenems
ESBLs and Carbapenemases are commonly seen in enterobacteria
BL inhibitors solves this problem e.g clavulanic acid.
Imagine you are a bacteria….how do you aquire resistance genes???
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Imagine you are a bacteria….how do you aquire resistance genes???
- I can inherit resistance genes (chromosomal, plasmid)
- **I can mutate my existing bacterial gene **
- I can acquire new DNA/gene through transduction, transformation and conjugation (aka bacteria sex)
This one…. was tested in meq also LOL.
Minimum volume of blood to be collected from a patient for culture?
Adult:
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Child:
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Minimum volume of blood to be collected from a patient for culture?
Adult:
2 sets of 2 bottles (min. 8-10ml) = 40ml
Endocarditis - 3 sets of 2 bottles = 60ml
Child:
2 sets of 2 bottles (max. 4ml) = 16ml
Vincent will be sad if u dk this :((
MRSA has the […] gene which codes for […]
Treatment for MRSA is usually with […]
MRSA has the mecA gene which codes for PBP2
Treatment for MRSA is usually with ***Vanco/linezolid/ceftaroline/ceftabiprole
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PBP2 is a type of altered PBP because it doesnt bind to penicillin/cephalosporin (1st - 4th gen)/carbapenems/co-amoxiclav
Name some of the mechanisms that the resistance genes confer resistance to the antibiotics
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Name some of the mechanisms that the resistance genes confer resistance to the antibiotics
- Altered target
- Inactivation of antibiotic
- Decreased permeability
- Active efflux
- Bypass “target” pathway
- Overproduction of target
Or combinations of the above.
OVERVIEW CARD. THE ULTIMATE CHALLENGE.
List every medically important organism under each category.
Gram Positive Cocci
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Gram Positive Rods (Aerobic)
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Gram Positive Rods (Sporing Anaerobic)
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Gram Negative Cocci
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Gram Negative Rods (Enterobacteriae)
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Gram Negative Rods (Fastidious)
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Gram Negative Rods (Pseudomonads)
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Gram Negative Rods (Vibrio)
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Little or no peptidoglycan (atypicals…but not really all)
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Mycobacterium
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Non-Sporing Anaerobic Rods (NSAs) & Exceptions
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Obligate Intracellular Pathogens
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Spiral bacteria
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OVERVIEW CARD. THE ULTIMATE CHALLENGE.
List every medically important organism under each category.
Gram Positive Cocci
Streptococcus pneumoniae + Viridians Streptococcus
Streptococcus pyogenes (GAS)
Streptococcus agalactiae (GBS)
Staphylococcus aureus
Enterococcus
Gram Positive Rods (Aerobic)
Corynebacterium diphtheriae
Listeria monocytogenes
Bacillus anthrax
Bacillus cereus
Nocardia asteroides
Gram Positive Rods (Sporing Anaerobic)
Clostridium botulinum
Clostridium tetani
Clostridium perfringens
Clostridiodes diffucile
Gram Negative Cocci
Neisseria gonorrhoeae
Neiserria meningitidis
Gram Negative Rods (Enterobacteriae)
Escherchia coli
Klebsiella spp.
Proteus spp.
Salmonella spp.
Shigella spp.
Gram Negative Rods (Fastidious)
Acinetobacter mraumannii
Bartonella spp.
Brucella spp.
Bordetella spp.
Haemophilus spp.
Legionella pneumophilia
Pasteurella multocida
Yersinia spp.
Gram Negative Rods (Pseudomonads)
Pseudomonads aeruginosa
Burkholderia spp.
Sternotropomonads maltophilia
Gram Negative Rods (Vibrio)
Vibrio cholerae
Vibrio parahaemolyticus
Vibrio vulnificus
Little or no peptidoglycan (atypicals…but not really all)
Chlamydia trachomatis
Chlamydophilia pneumniae
Chlamydophilia psittaci
Mycoplasma pneumoniae
Mycobacterium
Mycobacterium tuberculosis (MTB)
Mycobacterium leprae
i
Non-Sporing Anaerobic Rods (NSAs) & Exceptions
Non-Sporing Anaerobic Rods (NSAs)
Actinomyces israelii
Fusobacterium necrophorum
Obligate Intracellular Pathogens
Coxiella burnetti
Rickettsia & Orientia spp.
Spiral bacteria
Campylobacter jejuni
Helicobacter pylori
Borrellia spp.
Leptospira interrogans
Treponema pallidum
Congrats you survived!!! :))
Resistance to beta-lactams are usually due to
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Resistance to beta-lactams are usually due to
Beta-lactamase
Altered PBP
or both mechanisms
PBP = Penicillin Binding Protein
T/F?
A beta lactamase confers cloxacillin resistance in MRSA […]
The MecA gene codes for PBP2 […]
Penicillin resistance in gonorrhoea may be due to beta lactamases and/or PBP changes […]
Empirical penicillin is reliable for meningitis due to S. pneumoniae […]
Vancomycin is default drug for suspected MRSA […]
T/F?
A beta lactamase confers cloxacillin resistance in MRSA F
The MecA gene codes for PBP2 T
Penicillin resistance in gonorrhoea may be due to beta lactamases and/or PBP changes T
Empirical penicillin is reliable for meningitis due to S. pneumoniae F
Vancomycin is default drug for suspected MRSA T
MRSA is due to altered PBP, not BL.
Penicillin not reliable for meningitis cuz of BBB
T/F?
Legionella susceptibility testing is a routine test […]
A lower MIC equates with more resistance […]
Bata lactams work on the outer cell membrane […]
Beta lactamases are enzymes that inactivate beta lactam drugs […]
Ceftriaxone contains a beta lactamase inhibitor […]
T/F?
Legionella susceptibility testing is a routine test F
A lower MIC equates with more resistance F
Bata lactams work on the outer cell membrane F
Beta lactamases are enzymes that inactivate beta lactam drugs T
Ceftriaxone contains a beta lactamase inhibitor F
Legionella assumed to be susceptible to erythromycin, rifampicin and quonolones
Lower MIC = less resistance
Beta lactamases works on cell wall
The main drug for MSSA is […]
The main drug for MSSA is cloxacillin
Cloxacillin is almost used exclusively for MSSA.
Staphs have penicillinase so its “R” to penicillin!
Then……what is E test??? What does it test?
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Then……what is E test??? What does it test?
Inoculate plate, apply strip with antibiotic gradient and incubate. Test for MICs (= junction between growth & no growth).
Came out for MEQ CA1 19/20 btw LOL!!! 4 marks. Class of 2023 was tilted as heck.
The moral of the story is that nothing in medicine really surprises us anymore
And also learn to let it go~
Treatment for gonococcus is […]
Treatment for gonococcus is Ceftriaxone AND azithromycin
What are some common reasons for failure of therapy despite sensitive strain?
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What are some common reasons for failure of therapy despite sensitive strain?
resistance, non-compliance, abscess, foreign body, yadayadayada
What are the antibiotics that we assume these microbes are sensitive to?
Legionella spp.
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Chlamydia, Coxiella spp
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Treponema Pallidum
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What are the antibiotics that we assume these microbes are sensitive to?
Legionella spp.
Erythromycin, rifampicin, quinolones
Chlamydia, Coxiella spp
doxycycline, erythromycin (atypical coverage? add quinolones)
Treponema Pallidum
penicillin
We dont test them! All assume.
What is a tell tale sign that these assumed sensitivities may be wrong?
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What is a tell tale sign that these assumed sensitivities may be wrong?
***no/poor clinical response to the assumed sensitive antibiotics
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What is disc sensitivity testing?
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What is disc sensitivity testing?
Spread bacterial suspension over agar plate, apply test antibiotics on paper discs, incubate and measure zone of inhibition
Zone of inhibition size is proportional to MIC!!!
What is MIC?
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What is MIC?
Minimum inhibitory concentration, i.e lowest concentration with no visible growth
Whats the difference btween bactericidal and bacteriostatic?
Bactericidal = […]
Bacteriostatic = […]
Whats the difference btween bactericidal and bacteriostatic?
Bactericidal = kill bacteria
Bacteriostatic = only inhibit growth of bacteria
Which organism may have both BL and altered PBP?
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Which organism may have both BL and altered PBP?
N. gonorrhoeae
