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PCOL Cumulative Final > Exam II ABX Types > Flashcards

Exam II ABX Types Flashcards

1
Q

What are the Bacteria shapes?

A

Sphere - Cocci

Rod - Baillus

Spirochete - Spirilla

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2
Q

Gram-Negative vs Gram-Positive

A

Gram-Negative - Outer membrane with Lipopolysaccharides

Gram-Positive - Numerous Peptidoglycan as outer layer

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3
Q

Patterns of Gram-Positive organisms.

A

Clusters

Pairs

Chains

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4
Q

Staphylococci w/ positive Coagulase test.

A

Staph Aureus

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5
Q

Gram-Positive Characteristics

A

Gram Stain

Purple

Bacterial Shape

Cocci/Bacili

Bacterial Pattern

Cocci

Chains/Pairs/Clusters

Bacilli

Usually no pattern

Reactive Tests

Cocci - Chains - Hemolysis +/- Lancefield Classification

Cocci - Pairs - Hemolysis +/- Lancefield Classification

Cocci - Clusters - Coagulase Test

Bacilli - Usually no pattern - Other tests

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6
Q

Common Gram-Positive Organisms

A

Cocci

Streptococcus SP

Staphylococcus SP

Enterococcus SP

Peptostreptococcus SP (anaerobic)

Bacilli

Bacillus anthracis

Clostridium SP (anaerobic)

Corynebacterium SP

Listeria SP

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7
Q

Reactive Tests for Gram Negative Rods (GNR)

A

Oxidase Test

Positive = Purple

Lactose Test

Positive = Pink

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8
Q

Gram-Negative Characteristics

A

Gram Stain

Pink

Bacterial Shape

Bacilli/Cocci

Reactive Tests

Bacilli - Lactose Positive

Bacilli - Lactose Negative

Cocci - Nitrate Tests

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9
Q

Common Gram-Negative Organisms

A

Cocci

Neisseria gonorrhoeae

Neisseria meningitides

Moraxella SP

Bacilli

Lactose Fermentation

Citobacter SP (may appear as non-lactose fermenter initially as it is slow)

Escherichia Coli

Enterobacter SP

Klebsiella SP

Serratia SP (may appear as non-lactose fermenter initially as it is slow)

Non-lactose Fermentation

Pseudomonas SP (oxidase +)

Proteus SP

Yersinia SP

Acinetobacter SP

Bacteroides SP

Legionella SP

Campylobacter SP

Salmonella SP

Shigella SP

Stenotrophomonas SP

Escherichia Coli

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10
Q

Encapsulated Organisms

A

Bacteria that have an extra thick layer of Polysaccharide

Unable to undergo phagocytosis

PTs without B-Cells or lack a spleen have high mortality from infections

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11
Q

Types of Encapsulated Organism Bacteria

A

Hemophilus FLU B

Streptococcus Pneumoniae (Pneumococcus)

Neisseria Meningitides (Meningococcus)

Group A & B Streptococcus

Klebsiella Pneumoniae

Salmonella Typhi

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12
Q

Atypical Bacteria

A

Incomplete bacteria

Zoonotic

Lack of a Cellular Wall

Replicate within host cells

Difficult to see on a microscopic or staining properties

Types

Mycoplasma Pneumoniae

Chlamydia Pneumoniae

Rickettsias

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13
Q

Normal Flora and location

A
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14
Q

Why are some infections more severe than others?

A

Genetics

Type of Bacteria

  • Endotoxins* - Part of the outer portion of the cell wall of Gram-Negative bacteria. They are liberated when the bacteria die and the cell wall breaks apart.
  • Exotoxins* - Produced inside mostly Gram-Positive bacteria as part of their growth and metabolism. They are then secreted or released following lysis into the surrounding medium.
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15
Q

Resistance to Antibiotics

A

ESKAPE pathogens

Enterococcus faecium, Staphylococcus aureus, Klebisella. Acinetobacter, Pseudomonas, Enterobacter

Resistance mechanisms: Efflux pumps, Enzymes for antibiotic degredation, Cell wall alteration, protein synthesis variation.

Pass along resistance by exchanging plasmids

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16
Q

Empiric Therapy

A

Antibiotics chosen prior to knowing ID and Sensitivity of pathogens

Important to understand types of bacteria that are known for causing disease

Previous infections

Local Sensitivity

17
Q

De-escalation

A

Narrowing therapy from broad agents

18
Q

Antimicrobial Stewardship

A

Preserving broad-spectrum antibiotics

Limit development of resistance

19
Q

Alpha-Hemolytic

A

Streptococcus Viridans

Streptococcus Pneumoniae (Pneumococcus)

20
Q

Beta-Hemolytic

A

Streptococcus Pyrogenes (Group A)

Streptococcus Agalactiae (Group B)

Streptococcus Equi (Group C)

Streptococcus Bovis (Group D)

Streptococcus Anginosus (Group F)

Streptococcus Dysgalactiae (Group G)

Streptococcus (Group H)

21
Q

Staphylococcus

A

Staph Aureus (MRSA/MSSA)

Coag Positive

Prodices Toxin

Methicillin-Resistant VS Methicillin-Sensitive

Staph Epidermidis

Coag Neg

Common on skin

Not Susceptible to many antibiotics

Usually not virulent

Contaminant in blood cultures

Can cause wound, bone infections

22
Q

Enterococcus

A

E. Faecium

Not Virumlent

Vancomycin resistant (VRE) vs. Susceptible

E. Faecalis

Not Virulent

Problematic for Immunocompromised Patients

Usually susceptible to vancomycin and penicillins

23
Q

HNM

A

Gram-Negative Cocci

Haemophilus (coccobacilli)

Neisseria

Moraxella

Common infections of Haemophilus and Moraxella include upper and lower respiratory tract infections.

Common infections of Neisseria are meningitis and STDs

24
Q

Atypical

A

Rarely grow on gram stain

Mycoplasma Pneumoniae

Chlamydia Pneumoniae

Often treat without knowing bacteria

Common infections: Upper respiratory tract infections, walking pneumonia

25
Q

Enteric Gram Negatives

A

Group includes GNR (Gram Negative Rods), Lactose, and non-Lactose fermenting organisms.

Common Pathogens: E. Coli, Proteus, Serratia, Acinetobacter, Citobacter, Klebsiella, Legionella pneumoniae

Types of infections (community): UTI, Abdominal infections

Types of infections (hospital): Pneumonia, UTI - Tend to be More Drug Resistant.

Many have** **potential** **to develop resistance to antibiotics by plasmid exchange.

26
Q

Anaerobes

A

Rarely anaerobes are virulent by themselves (co-infection)

Worry with abscesses in peritoneal, brain, and lung

Requires incision and drainage

C.diff is an infection on the rise

Associated with Antibiotic use

27
Q

Gram + Anaerobes

A

Clostridium sp (Bacilli)

Actinomyces sp (Bacilli)

Lactobacillus sp (Bacilli)

Propionobacterium sp (Bacilli)

Peptostreptococcus (Cocci)

28
Q

Gram - Anaerobes

A

Bacteroides fragilis (Bacilli)

Fusobacterium sp (Bacilli)

Porphyromonas sp (Bacilli)

Veilonella sp (Cocci)

29
Q

Important Bacteria on the rise

A

MRSA

Increasing infection rates inside and outside of hospital

VRE

Increasing colonization and infections in hospitals

C. diff

Increasing infections post-antibiotic use

MDR GNR

S.P.A.C.E. Organisms - Extended spectrum beta-lactamase inhibitor ESBL

  • Serratia*
  • Pseudomonas*
  • Acinetobacter*
  • Citobacter*
  • Enterobacter*
30
Q

Antibiotic cellular sites of action

A

Cell Wall

Cross-linking of peptidoglycan or membrane depolarization

Protein synthesis

Inhibit ribosomes - 30s and 50s subunit

DNA/RNA synthesis and replication

Inhibit DNA gyrase or RNA

Need to be specific to bacteria so they do not damage human cells

31
Q

Type 1 Pattern of activity

A

Aminoglycosides, Daptomycin, Flouroquinolones

MAximize concentrations

24 Hr AUC/MIC Peak (Cmax/MIC)

32
Q

Type 2 Pattern of Activity

A

B-lactams, Linezolid, Erythromycin

Maximize duration of exposure

T>MIC

33
Q

Type 3 Pattern of Activity

A

Azithromycin, Clindamycin, Tetracyclines, Vancomycin, Metronidazole

Maximize the amount of drug

24 hour AUC/MIC

34
Q

Dose adjustments

A

Many antibiotics require adjustment of renal or liver dysfunction

Still allows for optimization of PK/PD parameters

Lower dose, more frequent admin (continuous or extended infusions)

T>MIC

Same of higher dose decreased frequency

  • Peak (Cmax/MIC)*
  • 24 Hr AUC/MIC*

PCOL Cumulative Final (14 decks)

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