anti microbial resistance

Question 1

what does HCAI stand for?

Answer 1

healthcare associated infections

Question 2

Some reasons why AMR develops?

Answer 2

occurs naturally through genetic changes, but can be accelerated by misuse and overuse of antimicrobials.

Question 3

4 things that pathogens can change and contribute to AMR

Answer 3

1) efflux pumps (prevents accumulation of drugs to effective levels)
2) cell wall changes (e.g. becomes impermeable to drugs)
3) changes in DNA and polymerases etc.
4) production of inactivating enzymes

Question 4

Two ways resistance can be passed on?

Answer 4

through vertical and horizontal gene transfer.

Question 5

3 different forms of horizontal evolution that allow intra and inter species transfer?

Answer 5

1) conjugation involving the ‘sex’ pilus and plasmid exchange.
2) phage transduction (often with toxins too)
3) taking up genetic material from the environment in transfection.

Question 6

6 examples of key health threats because of AMR?

Answer 6

MRSA, E.coli, TB, C.difficle and neisseria.

Question 7

What kind of infections can (MR) S.aureus cause?

Answer 7

skin infections, soft tissue, muscoskeletal and bloodstream.

Question 8

What gene, which has been independently acquired too, is present in most MRSA?

Answer 8

mecA, which binds beta lactam and methicillin to inhibit their action.

Question 9

How else (apart from mecA activity) is MRSA resistant?

Answer 9

other antibiotic resistance e.g. to quinolones

resistance to antiseptics and desiccation.

Question 10

What are two important Enterobacteriaceae?

Answer 10

E.coli and Klebsiella penuomniae.

Question 11

Where are the Enterobacteriaceae niches?

Answer 11

In the human GI tract, in mammals like on farms and in environment (soil and water).

Question 12

What are most UTIs caused by?

Answer 12

E.coli

Question 13

What pathogens can give UTIs, intra abdominal infections, neonatal meningitis, diarrhoae and hospitalassociated pneumonia?

Answer 13

Enterobacteriacea (E.coli and Klebsiella pneumoniae.

Question 14

E.coli strains are very genetically diverse, what drives the different pathotypes of E.coli in particular?

Answer 14

teh acquisition of an accessory genome.

Question 15

What is the environmental organism that when cultured a green pigment is observed and that forms a good biofilm?

Answer 15

pseudomonas aeruginosa.

Question 16

What kinds of infections are associated with Pseudomonas aeruginosa?

Answer 16

ventilator associated pneumonia, skin infections of burns and wounds.

Question 17

What is pseudomonas aeruginosa intrinsically resistant to?

Answer 17

to borad spectrum anitbiotics co-amoxiclav and B lactams.

Question 18

symtpoms of Neisseria gonorrhoeae in men and women.

Answer 18

men: non-specific urethritis.
woman: vaginal discharge, (if asymptomatic can cause infertility.

Question 19

Symptoms of disseminated N. gonnorrhoeae and in neonates.

Answer 19

skin infections and septic arthritis, and affects eyes in neonates (opthalmia neonatorum)

Question 20

What is N. gonorrhoeae treated with and becoming resistant to?

Answer 20

azithromycin and ceftriaxone.

Question 21

What can increase host vulneratibility to HCAIs?

Answer 21

Age and comorditiy
reduced consciousness and protective airway reflexes (which would prevent secretions passing into lugns)
malnutrition and disturbed microbiome (through antibiotics)
immunosuprression

Question 22

Part of physical treatment options that increse HCAIs

Answer 22

intubation and catheters (bypasses protection direct line)
proximity with healthcare workers and other patients.
lying in bed (respiratory tract infections).

Question 23

What is virulence generally like of HCAIs?

Answer 23

low virulence and opportunistic infections (more likely to be bacteria and fungi)

Question 24

Are the most frequent HCAIs more of less deadly?

Answer 24

Inverse correlationof mortality with HCAI frequency.

Question 25

Big 5 with most issues with resistance.

Answer 25

Eneterobacteriaceae
MRSA
C. difficle
P. aeruginosua
enterococcus (bowel flora)

Question 26

what is the nosocomial infection?

Answer 26

Those occurring within 48 horus of arrival at hospital, 3 days after discharge of 30 days post op.

Question 27

what pathogens are resistant to alcohol gels?

Answer 27

c difficle and norovirus- requires soap and water.

Question 28

what was the outbreak of M chimaera linked to?

Answer 28

patients who had undergo heart bypass, traced back to heater cooler units with pathogen in water that aerosolysed.

Question 29

What was candida auris resistant pathogen outbreak linked to?

Answer 29

difficult to clean, reusable underarm temp probe