Global Antibiotic Resistance, Causes and Solutions Flashcards Preview

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Flashcards in Global Antibiotic Resistance, Causes and Solutions Deck (12)
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1
Q

What resistance is emerging in pathogens of global interest?

A

MRSA - a pandemic

MDR enterobacteriaceae (multi drug resistant)

VRE national issues (vancomycin resistant enterococci)

Acinetobacter baumannii

Clostridium difficile

2
Q

Why do carbapenem resistant enterobacteriacae differ from other MDR pathogens?

A

Carbapenem resistant Enterobacteriacae (CRE) differ from other MDR pathogens in that there is no reliable treatment

3
Q

How do antibiotics increase disease?

A

With penicilin came staph aureus that was resistant to penicillin

Methicilllin was introduced which led to the birth of MRSA

MRSA outbreak and use of gentamicin

Epidemic strains evolved/spread. Increased use of glycopeptides - vancomycin resistant staph aureus - ‘untreatable MRSA’

4
Q

How can antibiotics increase the pathogenicity of MRSA?

A

Bioilm formation

Hypermutation

Toxin production

5
Q

What factors can increase the chances of MRSA infection?

A

Poor infection control

MRSA colonisation pressure

MRSA in the environment

Length of stay, medical devices

Antimicrobial consumption

Exposure to fluroquinolones, beta lactams, selection, increased adhesion, increased virulence, patient risk factors

6
Q

Paradox 5 states •Antibiotics increase infections……………and mortality in uninfected patients?

A

Evidence suggests that conservative use of antibiotics actually leads to less patient mortality than aggressive use

7
Q

New systemic antibacterial agents approved by the US Food

and Drug Administration per 5-year period, through 2012. Modified from

Spellberg 2004

A

This graph shows that the rate of of new and approved drugs being produced is decreasing

8
Q
A
9
Q

What is the projected number of deaths expected to be caused anually by antimicrobial resistance in 2050?

A

Expected to cause up to 10 million deaths per year

It is currently sitting at around 700000 per year

10
Q

When prescribing antibiotics, what are the main two things you have to balance?

A

The best interests of the individual

The global need for sustainable antibiotic use

11
Q

Conclusions

A

With current trends in antimicrobial use, new resistances and increasing numbers of infections (new clones) will be generated at home and abroad and spread internationally

Current control efforts are “firefighting”

Prevention requires a new attitude to Antibiotic Stewardship, requiring major decline in antibiotic use and “antibiotic holidays”

12
Q

What are the antimicrobial paradoxes?

A

Antibiotics initially led to poorer hygiene

Antibiotics increase infections

Antibiotics can increase the severity of infection

Antibiotics increase infections and mortality in uninfected patients?

Are newer antibiotcs really the answer (can we ever win the ar or would they just feed the cravings of a drug dependant culture)

Antibiotics are too cheap - encourages inappropriate use

Many similarities to global warming

Non-human use is greatest

The global village - resistant bacteria can spread globally