Introduction

Question 1

What is the aim of Antimicrobial stewardship programs?

Answer 1

1. Minimizing the emergence of antimicrobial resistance

Question 2

How do stewardship programs aim to minimsise resistance?

Principles to implement?

Answer 2

1. Judicious
   use of ABx
2. Right dose ABx
3. Right frequency ABx
4. Right duration ABx

Question 3

What is an important antistaphylococcal drug, but must be given IV because oral absorption is negligible?

Answer 3

Vancomycin

Question 4

How long to continue ABx when pt. clinically improved?

Answer 4

1. Can continue ABx for further 72 hours

Question 5

Why switch from IV to oral form of ABx?

Answer 5

1. Reduces impact on native flora
2. Reduces risk of resistance

Question 6

Well known Toxicity of aminoglycosides:

Answer 6

1. Kidney - Nephrotoxic
2. Cranial nerve VIII - Ototoxic

Question 7

Characteristics of gram positive organisms:

Answer 7

1. Thick outer layer of peptidoglycan on cell wall
2. Appear blue

Question 8

Characteristics of Gram negative organisms:

Answer 8

1. Thin layer of peptidoglycan beneath an outer membrane
2. Appear red

Question 9

What is acid fast stain used for?

Answer 9

1. Used to identify bacteria that take up Gram stain poorly
2. E.g., Mycobacterium, Nocardia

Question 10

Colour of organisms on acid fast stain:

Answer 10

1. Acid-fast organisms appear red
2. Non-acid-fast organisms appear blue

Question 11

Use of Wright’s stain:

Answer 11

1. Used for intercellular organisms

Question 12

What is the MIC?

Answer 12

1. The minimal concentration of antibiotic
2. In which visible growth of bacteria is inhibited

Question 13

What is MBC?

Answer 13

1. The lowest antibiotic concentration
2. Which kills all organisms

Question 14

Risk factors for developing MRSA:

Answer 14

1. Recent hospitalization or surgery
2. Nursing home residence
3. Having an indwelling vascular catheter

Question 15

Enterococcus faecium is
notorious for colonizing and / or infecting:

Answer 15

1.Pressure sores

Question 16

How many cases of IE are due to Enterococcus faecium?

Answer 16

10%

Question 17

Enterococcus faecium is now commonly resistant to?

Answer 17

1. Vancomycin (VRE)
2. Ampicillin

Question 18

What is a common nosocomial organism that causes significant VAP (not the most common cause of VAP)?

Answer 18

Acinetobacter baumannii

Question 19

What is the most common cause of VAP?

Answer 19

Pseudomonas aeruginosa

Question 20

Main virulence factors of Pseudomonas aeruginosa:

Answer 20

1. Produce a thick biofilm on ETTs
2. Multidrug-resistant genes
3. Toxins - target immune cells in the lungs

Question 21

Where are Enterobacteriaceae found?

Answer 21

1. Residents of GIT

Question 22

Enterobacteriaceae are responsible for variety of infections including:

Answer 22

1. Wound infections
2. UTIs
3. GIT infections
4. Pneumonia - both CAP & VAP

Question 23

Examples of ESBL-producing Enterobacteriaceae are:

Answer 23

1. Klebsiella pneumoniae
2. E. coli

Question 24

Risk factors for ESBL-producing Enterobacteriaceae:

Answer 24

1. Diabetes mellitus
2. Prior quinolone use
3. Recurrent UTIs
4. Prior hospital admissions
5. Older age

Question 25

Rx of Enterobacteriaceae:

Answer 25

1. Carbapenems