Antimicrobial Resistance Flashcards

(37 cards)

1
Q

define antimicrobial resistance

A

ability of microbes to resist whatever is trying to kill them

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2
Q

three major purposes of antiicrobial prescription

A

therapeutics – treat sick individual
metaphylactics – treat herd when one sick individual
prophylactics – seasonal treatment
growth promotion – banned in many places

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3
Q

what leads to AMR bacteria spread

A

unregulated use of anitmicrobials
use of contaminated feces or water in fertilizer
contaminated food or water

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4
Q

classical gram positive cell wall architecture

A

several layers of peptidoglycan with lipo/teichoic acid

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5
Q

mycobacterium cell wall architecture

A

peptidoglycan covered by mycolic acids (wax or lipids)

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6
Q

classical gram negative cell wall architecture

A

outer membrane of proteins and lipopolysaccharaides (lipid A and sugar or endotoxin) that hides peptidoglycans
thin layer of peptidoglycans

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7
Q

chlamydia cell wall architecture

A

cell wall without peptidoglycans
outer membrane with proteins and lipopolysaccharides (lipid A and sugar or endotoxin)

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8
Q

mycoplasma cell wall architecture

A

no cell wall
sterols in cell membrane
not stained by gram stain
resistant to antimicrobials acting on cell wall

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9
Q

porins

A

antimicrobials, nutrients, mineral go through these

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10
Q

biofilms

A

dense bacteria community

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11
Q

6 mechanisms of action of antimicrobials

A

-cell wall synthesis – B lactams deactivate cell wall synthesis enzymes
-metabolism – folic acid synthesis
-30S – protein syntehsis
-50S – protein syntehsis
-RNA polymerase – mRNA (RNA synthesis)
-DNA gyrase/topoisomerase (DNA syntehsis)

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12
Q

4 mechanisms of AMR

A

-reduced permeability – constrict porins so antimicrobials can’t enter
-efflux pumping (“vomiting”)
-drug inactivation by enzymes – cut antimicrobials
-target site change, modification, protection

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13
Q

what is an additional mechanism of AMR in addition to main 4

A

biofilm formation

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14
Q

biofilm characteristics

A

-induced extracellular polymer (matrix)
-low nutrient and oxygen supply to center
-dormant spore like cells in center for persistence

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15
Q

acquired resistance

A

-horizontal gene transfer
-free DNA transformation
-plasmid conjugation
-bacteriophage transduction

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16
Q

intrinsic (innate) resistance

A

-vertical gene transfer
-mycoplasma

17
Q

grow fast in 24 hours

A

-enterobactericeae
-gram negative bacilli
-non fastidious gram positive

18
Q

do not grow fast in 24 hours

A

-fastidious organisms
-bioterrorism agents
-anaerobic microbes

19
Q

ESKAPE

A

E – Enterococcus
S – Staphylococcus aureus
K – Klebsiella pneumoniae
A – Acinetobacter baumannii
P – Pseudomonas aeruginosa
E – Enterobacter

20
Q

isolation using bacterial cell culture media

A

-mannitol salt agar – Staphylococcus, Enterococcus, Listeria, Micrococcaceae
-Edward media – Streptococcus, Enterococcus
-Kenner fecal agar – Enterococcus
-MacConkey agar – Enterobacteriaceae, Enterococcus

21
Q

media for anaerobic bacteris

A

-broth – Brucella + hemin, vitamin K, lysed horse blood
-agar – Brucella blood agar + hemin, vitamin K, lysed horse blood

22
Q

media for aerobic bacteria

A

-broth – cation adjusted Mueller Hinton + lysed horse blood
-agar – cation adjusted Mueller Hinton + lysed horse blood

23
Q

disc diffusion for AMR detection

A

-solid media
-qualitative
-one disc represents one drug
-measure diameter of inhibition zone

24
Q

E test AMR detection

A

-solid media
-quantitative
-strip impregnated with drug
-MIC – minimum inhibitory concentration
-determine last concentration that inhibited growth

25
agar dilution AMR detection
-solid media -quantitative -drug added to culture media -between concentrations of 0.12 to 64 ug/mL
26
macrodilution AMR detection
-liquid media -quantitative -determine last dilution that inhibited growth -bacterial growth indicated by cloudiness
27
microdilution AMR detection
-liquid media -quantitative -96 well plate with serially diluted in increased 2 fold concentrations of antimicrobial agents -determine last dilution to inhibit growth -growth indicated by dot of organismal growth
28
what do guidelines instruct to include and why
genetically stable known reference bacteria strains quality control
29
quality control for B lactamase producing bacteria
E coli K pneumoniae A bacumannii
30
quality control for nonfastidious bacteria for agar/broth dilution (MIC)
E coli P aeruginosa E faecalis S aureus
31
quality control for testing bacteria of bioterrorism
E coli S aureus
32
why would testing be invalidated
-no viable or pure growth of quality control strains -cut off value inhibition zone by disc or MIC not within range defined by CLSI, EUCAST, ISO
33
what are MIC cut off values for most antimicrobials
0.5 to 64 ug/mL
34
steps of disc diffusion test protocol
1. McFarland standards = 0.5 2. 1-2x10^8 CFU/mL; rotate and press against glass 3. 4mm thick MH agar 4. rotate in 3-4 directions by swabbing each time 5. rim swab around entire edge of plate 6. 6mm diameter disc; place disc >24 mm from each other 7. incubate 8. measure inhibition zones
35
control of fast spreading AMR
-surveillance -- periodic survey of drug use pattern -educate expertise for reducing drug use -regulate, monitor, and evaluate is frug use is per set priority
36
what can bacteria acquire AMR genes form
plasmid phage free DNA parents
37
AMR can be controlled by what broad interventions
-judicious drug use -surveillance -diagnosis -discoveries -collaborations -policy and practice changes