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Y2 MCD Microbiology RI > Hospital Acquired Infections > Flashcards

Flashcards in Hospital Acquired Infections Deck (30)
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1

Define the following:
a. Antimicrobial
b. Antibacterial
c. Antibiotic

a. Antimicrobial
Interferes with growth and reproduction of a microbe

b. Antibacterial
Commonly used to describe agents that reduce or eliminate harmful bacteria

c. Antibiotic
Type of antimicrobial that is used as medicine for humans and animals

2

What is a health-care associated infection?

Infections that occur after exposure to healthcare

Infection starts >48 hours after admission to hospital

3

Why do health-care associated infections cost money to the healthcare system?

They increase the length of stay at hospital

4

List some medical interventions that can increase the risk of infection.

Catheterisation

Intubation

Lines (e.g. central venous lines)

Chemotherapy

Prosthetic material

Prophylactic antibiotics/Inappropriate prescribing

5

State the 3 factors that increase the risk of infection in the hospital setting.

Interventions

Dissemination by healthcare staff

Concentration of ill patients

6

What are the ESCAPE pathogens?

Enterococcus faecium

Staphylococcus aureus

Clostridium difficile

Acinetobacter baumanii

Pseudomonas aeruginosa

Enterobacteriaceae

NOTE:
ESC are Gram-positive
APE are Gram-negative

7

What is the main problem with the escape pathogens?

They are antibiotic resistant

8

What is the most frequent cause of bacteraemia by a Gram-negative bacterium?

E. coli

9

What does E. coli frequently cause?

UTI

10

Which antibiotics is E. coli resistant to in many countries?

Cephalosporins

11

Which antibiotics is E. coli still sensitive to?

Carbapenems

12

What is ESBL encoded on?

Plasmid

13

What are carbapenemases encoded on?

Transposon

14

What types of infections does Klebsiella pneumoniae tend to cause?

UTI
Respiratory tract

15

Which group of patients are at risk of Klebsiella infection?

Immunocompromised

16

Which classes of antibiotics are Klebsiella widely resistant to?

Cephalosporins, fluoroquinolones and aminoglycosides

Carbapenem resistance in the US

17

Which group of patients are at risk of P. aeruginosa infection?

Immunocompromised

18

Which class of antibiotics is P. aeruginosa widely resistant to?

Carbapenems

19

What is the most important cause of antimicrobial resistant infection in the world?

MRSA

20

What is Enterococcus faecium widely resistant to?

Vancomycin

21

What are the most common HAI?

surgical site infections

urinary tract infection

pneumonia

bloodstream infections

gastrointestinal infections

22

What is the class, target pathway and target protein of Cephalosporins?

class of
b-lactam antibiotics

Target pathway:
Inhibit peptidoglycan
synthesis

Target protein:
Inhibit the activity
of penicillin binding
proteins (PBPs)

23

What is the mechanism of resistance to Cephalosporins?

Extended spectrum
b-lactamase (ESBL)

coded on a mobile plasmid

ESBL enzyme cleaves cephalosporin

24

What is the class, target pathway and target protein of Carbapenems?

A class of
b-lactam antibiotics

Target pathway:
Inhibit peptidoglycan
synthesis

Target protein:
Inhibit the activity
of penicillin binding
proteins (PBPs)

25

What is the mechanism of resistance to Carbapenems?

carbapenemase enzyme,
blakpc

encoded on a tranposon
mobile genetic element

enzyme cleaves carbapenem

26

What is the class, target pathway and target protein of Methicillin?

Is a b-lactam antibiotics

Target pathway:
Inhibit peptidoglycan
synthesis

Target protein:
Inhibit the activity
of penicillin binding
proteins (PBPs)

27

What is the mechanism of resistance to Methicillin?

Expression of additional
penicillin binding protein

PBP2A has low affinity for methicillin and can still function in the presence of the antibiotic

MRSA strains can synthesis peptidoglycan and survive in the presence of methicillin

28

What is the target pathway and target protein of Vancomycin?

Target pathway:
Inhibit peptidoglycan
synthesis

Target:
binds to peptidoglycan precursor

29

What is the mechanism of resistance to vancomycin?

multiple proteins
genes encoded on plasmid or transposon

Results in the synthesis of a different PG precursor

30

What does Enterococcus faecium cause?

Blood stream infections