antimicrobial bacteria general Flashcards

1
Q

what are the important things to consider when choosing an antimicrobial

A

the organism, the host, the treatment

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2
Q

what is characteristic of gram +

A

they have a much thicker cell wall, explains the retention of gram stain.

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3
Q

what is the gram + wall composed of?

A

peptidoglycan a complex polymer.

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4
Q

what are the three parts of peptidoglycan

A

backbone, tatrapeptide chains, peptide cross bridges.

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5
Q

what is the backbone of the peptidoglycan wall composed of

A

alternating subunits of N-acetylglucosamine NAG and N-acetylmuramic acid NAM connected by beta (1,4) linkages.,

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6
Q

what are the characteristics of the tetrapeptide chains?

A

they are identical and attached to NAM.

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7
Q

what are the characteristics of the cross-bridges

A

they are identical and made of protein.

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8
Q

what is the site of action of the beta-lactams

A

the peptide cross-links. it inhibits the b-lactamase

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9
Q

what is beta-lactamase

A

a penicillin-binding protein that is secreted outside of the cell. performs the cross-linking for the cell wall

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10
Q

gram negative outer membrane

A

semipermeable lipid bilayer composed of phospholipids, lipoproteins, LPS, and proteins. prevents toxic substances from entering the cell.

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11
Q

what is lipopolysaccharide?

A

this is endotoxin and released when the cell is killed.

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12
Q

what are the porins in gram - responsible for?

A

permit the passive diffusion of low-molecular weight hydrophilic compounds accounts for the inability of larger molecules to enter the cell.

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13
Q

what is the periplasmic space

A

gelatinous material between the inner and outer membrane of gram (-) contains the peptidoglycan and beta-lactamase.

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14
Q

what is the purpose of peptidoglycan

A

provides structural stability to prevent osmotic lysis.

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15
Q

gram (+) treat with what?

A

penicillin, antistaph PCN, aminopenicillin, vancomycin, linezolid, daptomycin

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16
Q

what do we use against stenotrophomonas

A

TMP/SMX, quinolones

17
Q

what do we use against gram (-)

A

carbapenems, cefepime, ceftaz, pip/taz, ticar/clav, quinolones, 3rd generation cephs, beta-lactams, 1st generation cephs and aminopenicillin.

18
Q

what are the gram (+) with limited susceptibility

A

MRSA, CA-MRSA, enterococcus, VRE, coagulase (-) staph.

19
Q

what do we use against MRSA

A

vancomycin, linezolid, daptomycin, ceftaroline, tigecycline

20
Q

what do we use against CA-MRSA

A

TMP/SMX, doxycycline/minocycline, clindamycin

21
Q

what do we use against enterococcus

A

ampicillin, vancomycin, daptomycin, linezolid, tedizolid.

22
Q

what do we use against VRE

A

often ampicillin resistant, daptomycin, tedizolid, linezolid, oritavancin, telavancin.

23
Q

what do we use against coagulase-negative staph

A

vancomycin, linezolid, daptomycin.

24
Q

what are the gram (-) with limited susceptibility

A

pseudomonas, enterobacter, stenotrophamonas, acinetobacter

25
Q

what do we use against pseudomonas

A

ceftazidime, cefepime, imipenem-cilastatin, meropenem, doripenem, piperacillin-tazobactem, ticarcillin-clavulanate.

26
Q

what do we use against enterobacter>

A

3rd and 4th gen cephs, ticar/clav, piptaz, carbapenems, aminoglycosides, quinolones, TMP/SMX, tigecyclin.

27
Q

what do we use against stenotrophomonas

A

TMP/SMX, quinolones

28
Q

what do we use against acinetobacter

A

carbapenems (not ertapenem), colistin, amikacin