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4.2 Medical Microbiology > Add- Ons > Flashcards

Add- Ons Flashcards

1
Q

Types of care bundles

A
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2
Q

PVC care bundle

A
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3
Q

Vertical vs horizontal ipc programmes

A
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4
Q

Types of esbls

A

TEM and SHV
CTX-Ms
VEB and PER
GES

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5
Q

Endemic CTX

A

CTX-M-15

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6
Q

Endemic KPC CPE strain

A

ST-258

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7
Q

What CPE are we most concerned with

A

ST23-K1 - a hyper virulent and invasive K.pneumonia that’s spreading rapidly

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8
Q

Detection methods for cpes

A

Disks and mic etc
Colorimetric - Blue Carba
MALDI - hydrolysis
Immunochronatography - resist/carba-5
Check Direct CPE
GeneXpert CarbaR
LightMix

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9
Q

Resistance mechanisms in CRAB

A
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10
Q

Detecting CRAB

A

CHROMID-CARBA SMART bi plate
Coris Resist Oxa23
RAPIDEC CARBA NP - culture
RAPIDEC CARBA NP - blood culture
GeneXpert Carba R
Light Mix

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11
Q

Specific Adaptive tolerance of p. aeruginosa biofilm

A
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12
Q

Why three factors determine if a disinfection method might fail to work on biofilm

A

Biofilm thickness
Biofilm maturity
Presence of persister cells

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13
Q

DSB disinfection

A
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14
Q

P. Aeruginosa biofilm disinfection

A
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15
Q

Biofilm ast

A

Biofilm inhibitory concentration

Minimum biofilm eradication concentration

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16
Q

MIC of antimicrobials needed to remove biofilm in a patient

A
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17
Q

Biofilm ast on a surface methof

A

Modified Robbins device/Biofilm device reactor system

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18
Q

Biofilm novel strategies

A
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19
Q

C. Difficile hcai prevalence

A
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20
Q

Zoonotic c. Diff

A

RT 078

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21
Q

C. Difficile carriage

A
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22
Q

C. Difficile associated antibiotics

A
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23
Q

Region of tcd gene frequently mutated

A

CROP binding domain

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24
Q

Common ribotypes/sequence types in Ireland

A

ST11/RT027 predominates at 16%

ST8/RT002 follows at 13%

ST2/RT014 follows at 12%

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25
Changing epidemiology of C.diff
26
Current C.diff treatment
27
Current C.diff treatment
28
New c.diff treatment
Bovine whey protein 'mucomilk' Tolevemer - linear polymer - toxin Bezlotoxumab - MAB Toxoid vaccines Active vaccines
29
Disinfection for CDI
Alcohol rub not affected, soap needed HW decreased from 16.75 to 9.49 ASW reduced c.diff by 32%
30
6 Ds of Antimicrobial Stewardship
31
CDI care bundle
32
MRSA strains
Sporadic: rarely cause infection Epidemic: propensity to spread in HC environment ST 22 predominates in Ireland, 80% of S.aures BSIs Other mrsa infections by ST8, ST5, ST1
33
IPC of MRSA
HH reduces MrSA from 1.88 to 0.91, no affect on MSSA
34
Additional resistance in vre
Linezolid resistance since 2014 Mutation I'm 23S rRna inhibits it's binding
35
Vre carriage study
Cuh study 0% community carriage 19.1% hospital carriage 87% vanA only
36
Vre infection control
37
Vre infection control
38
HCAI intro
39
5 aims of PPS
40
What % of HCA pneumonia was associated with intubation in 2023
8%, rates have halved since 2017
41
What % of HCA uTi was associated with catheterisation in 2023
40% an increase of 10% since 2017
42
What % of HCA BSI was associated with invasive devices in 2023
30%
43
Give percentages for each HCAI group for 2023
Pneumonia at 27% - down from 29 - up rank UTI at 14.5% - no change - up rank SSI at 14% - down from 18 - down rank x2 BSI at 8.6% - down from 10 - no change Gastro at 8.5% - up from 8 - no change
44
Pps common organisms
15% e.coli 15% s.aures 9% covid 9% c.diff 6.0% e.faecium 6% k.pneumonia
45
Pps micro results
46
Types of plasmids
R plasmid Virulence plasmid Degradative plasmid - toluene Conjugative/Fertility plasmids
47
4 types of mutations in vgt
Point -silent/missense/nonsense Frame shift Large scale Spontaneous
48
Hgt methods
Transformation - lysed outside dna Transduction - phages - generalised - specialised Conjugation - Hfr conjugation
49
Pathogenicity islands
50
4 main transposable elements
Insertion sequences Composite transposons Non-composite transposons Retrotransposons
51
Types of transposition
52
Transposons that carries resistance to Beta lactams
Tn3
53
Transposon for virulence
Tn916 in c.diff
54
Transposons for ESBLs
Tn3 ESBL production in e.coli and k.pneumoniae
55
Vre transposon
Tn1546
56
Tn for cre
Tn4401
57
Integrons in resistance
22-59% of GNs had integrons Class 1 integrons in enterobacters carrying resistance to beta lactats, aminoglycosides and sulfonamides, -> e.coli and k.pneumo esbls and aminoglucoside resistance Class 1 in Salmonella against sulfonamides
58
Incidence of tb
8.6 million cases 1.4million deaths
59
Antibiotics have extended human life by how many years
23
60
How long and how much does it take to get an antibiotic to market
15 years 800 million
61
What are our novel antibiotics
62
Two precision antimicrobial strategies
Targeting biofilm using enzymes Upec binding - mannosides fir uti - stop fimH adhesion
63
New antimicrobial strategies
64
New antimicrobial strategies
65
Properties to consider when choosing an antibiotic
66
Bs antibiotic
Norfloxacin
67
An antibiotic that's both bacteriostatic and cidal
Linezolid Static to staph and enterococcus Cidal to strep
68
Examples of toxicity
Aminoglycosides are nephrotoxic Isoniazid is hepatotoxic
69
KADME
kinetics of absorption, distribution, metabolism, excretion
70
Concentration dependent antimicrobials
Aminoglycosides Fluoroquinolones
71
Bactoprenol function
Transports NAM and NAG across cell membrane
72
Peptidoglycan formation
73
Liopoteichoic acid
Bringa about cell suicide - an autolysin Trigger by B lactam antibiotics - bind BPB - NAM/NAGs build up and trigger liopteichoic acid
74
A synthetic Penicillin
Augmentin Amoxicillin + clavulanate for activity against b-lactamase enzymes
75
Synthetic cephalosporin
Ceftazidime/avibactam for beta lactamase gns
76
Synthetic monobactam
Aztreonam/avibactam got resistant gns
77
Glycopeptides examples
78
Antibiotics that target nucleic acids
Fluoroquinolones - dna gyrase + topoisomerase Nitroimidazoles - mtz - ROS damage Nitrofurans - reactive intermediates Novobiocin - dna gyrase - gyrB Rifampicin - binds rna polymerase preventing mrna synthesis
79
Antibiotics targeting protein synthesis
30S: - aminoglycosides (gentamycin, amikacin, tobramycin, streptomycin, neomycin) - tetracyclines (tetracycline, doxyxycline, minocycline) - glycylcyclines - tigecycline 50S: - macrolides - azithreonam - lincosamides - clindamycin - chloramphenicol - oxazolidines - linezolid - streptogranins
80
Mechanisms of aminoglycosides and tetracyclines
Aminoglycosides bind 30s and cause misreading of mRNA Tetracyclines bind 30S and preventing binding of tRNA needed for adding amino acids to the growing protein chain
81
Glycylcyclines such as tigecycline
NB - affective against acinetobacter one of only drugs that is
82
Lunezolid function
Targets 23s rRNA in 59S subunit which prevents the formation of a functional 70S This inhibits protein synthesis
83
Improved linezolid
Tedizolid Extended activity Few gi side effects
84
Antibiotics that affect the cell membrane
85
Polymyxin
86
Polyenes
87
How is daptomycin great
Highly selective as it only targets liposomes containing phosphatidylglycerol which is only found in bacterial membranes - K+ efflux - death Reduces expression of MecA in mrsa (not meC)
88
Competitive inhibitors
89
4 key characteristics of tb cell wall
Acid fast bacilli Low permeability High lipid content Slow growers
90
Tb cell wall
Tripartite complex: - cross linked peptidoglycan - highly branched arabinogalactan polysacchraides - long chain mycolic acids-> free lipids and glycolipids such as PGM and PDIM
91
TB pamps

4.2 Medical Microbiology (20 decks)

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