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Infection > Session 4 > Flashcards

Session 4 Flashcards

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1
Q

Which types of bacteria are likely to cause cellulitis? Give an example

A

Bacteria that are part of the skin commensals - e.g. Staph aureus

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2
Q

List some components of the acute inflammatory response that account for the sign you seen in cellulitis (4)

A

Redness (Rubor)
Swelling (Tumour)
Heat (Calor)
Pain (Dolor)

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3
Q

What is commonly the treatment for cellulitis?

A

Flucloxacillin

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4
Q

What type of bacteria are S aureus?

A

Gram positive

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5
Q

What is the common treatment for a urinary tract infection?

A

Trimethoprim

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6
Q

What is the mechanism of action of trimethoprim?

A

Affects nucleic acid synthesis
Inhibitor of bacterial dihydrofolate reductase
Results in a decreased availability of the tetrahydrofolate cofactors required for base and amino acid synthesis

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7
Q

What is the most common cause of bacterial pneumonia? Name two other causes

A

Streptococcus pneumoniae

Haemophilus influenzae
Chlamydia pneumoniae
Mycoplasma pneumoniae

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8
Q

Name two viruses that can cause pneumonia

A

Influenza A

Respiratory Syncytial Virus (RSV)

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9
Q

Is Strep pneumoniae gram positive or gram negative?

Is Haemophilus pneumoniae gram positive or gram negative?

Which antibiotic is commonly prescribed for the treatment of bacterial pneumonia?

A

Positive

Negative

Amoxicillin

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10
Q

What is an antimicrobial?

A

An agent which is acting against a microbe e.g. Antifungal, antiviral etc.

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11
Q

What is an antibiotic?

A

Agent derived from another living creature that works against microbes

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12
Q

What is the largest group of antimicrobials?

A

Antibacterial agents

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13
Q

How are antibacterial agents classified? (4)

A

Either bactericidal or bacteriostatic
Broad or narrow spectrum
Target site
Chemical structure - antibiotic class

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14
Q

What is meant by bactericidal?

What is meant by bacteriostatic?

In relation to antibacterial agents

A

Kills bacteria

Stops the growth of bacteria

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15
Q

State some ideal features of antimicrobials

A

Selectively toxic
Reaches site of infection
Long half-life
No interference with other drugs

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16
Q

Antibacterial agents can be classified by their mechanism of action.

In which 4 ways, can antibacterial agents work to destroy bacteria?

Which is the most uncommon mechanism of action?

A

By affecting…

Cell wall synthesis
Protein synthesis
Nucleic acid synthesis
Cell membrane function (most uncommon)

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17
Q

Give 2 examples of classes of antibacterials that work by disrupting cell wall synthesis

A

Beta-lactams

Glycopeptides

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18
Q

Give 3 examples of classes of antibacterials that work by disrupting protein synthesis

A

Tetracyclines
Aminoglycosides
Macrolides

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19
Q

Give an example of a class of antibacterial agents that work by disrupting cell membrane function

A

Polymixins

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20
Q

Give an example of a polymixin

A

Colistin

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21
Q

Give an example of a class of antibacterial agents that works by disrupting nucleic acid synthesis

A

Quinolones

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22
Q

Penicillin fits into which antibiotic class?

A

Beta-lactam

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23
Q

What is penicillin’s mechanism of action?

A

The cell wall of bacteria consist of peptidoglycans with cross-linking between chains
Penicillin binding protein allows these cross links to be formed
Penicillin binds to penicillin binding protein preventing the formation of cross links

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24
Q

What is the function of penicillin binding protein?

A

Allows cross-links between peptidoglycan chains in the cell wall to be formed

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25
What class of antibiotics does vancomycin belong to?
Glycopeptides
26
How do vancomycin work?
Sits where cross-links are made in the bacterial cell wall, so site for cross-links to be made is already blocked
27
How do fluoroquinolones work as antibacterial agents?
They bind to topoisomerase and DNA gyrase inhibiting DNA replication
28
What is the function of DNA gyrase in cells?
Involved in the super coiling of DNA
29
Which two enzymes are bound by fluoroquinolones to inhibit DNA replication?
DNA gyrase | Topoisomerase
30
Name three types of antibiotic resistance Which types are permanent? Which types are reversible?
Intrinsic - permanent Acquired - permanent Adaptive - reversible
31
Describe intrinsic resistance
Drug doesn't work and never has done | There is no target or access for the drug
32
Describe acquired resistance
Bacteria acquires new genetic material or mutates making it resistant
33
Describe adaptive resistance Give an example of a circumstance that can cause adaptive resistance
The organism (bacteria) responds to a stress making it resistant Prescription of a sub-inhibitory level of an antibiotic
34
Give 3 mechanisms of resistance
Drug inactivating enzymes Altered target for the drug Altered uptake for the drug
35
Describe how drug inactivating enzymes can provide resistance for bacteria against antimicrobial agents Provide an example
Bacteria develop enzymes that inactivate antibacterial drugs Beta-lactamases
36
Describe how an altered target can be a mechanism of antimicrobial resistance
Target enzyme in the bacteria can have a lowered affinity for the antibacterial agent
37
In which two ways can genes for antibiotic resistance be passed onto other bacteria?
Chromosomal gene mutation | Horizontal gene transfer
38
Name two ways in which antibiotic activity can be measured?
Disc sensitivity testing | Measurement of the minimum inhibitory concentration
39
Disc sensitivity testing determines...
Which antibiotic to use
40
What is the minimum inhibitory concentration? How is it measured? What does it provide an indication of?
The minimum concentration which inhibits growth of the bacteria Incubation of test tubes with the microbe and different concentrations of the antibiotic How well an antibiotic works
41
Name 4 classes of beta-lactams
Penicillins Cephalosporins Carbapenems Monobactams
42
Give 3 examples of 'penicillin' class drugs
Penicillin Amoxicillin Flucloxacillin
43
Give an example of a 'combination penicillin' drug
Co-amoxiclav Amoxicillin + clavulanate
44
Give an example of a cephalosporin beta-lactam drug
Ceftriaxone
45
Carbapenems can be described as particularly ___________ drugs Give an example
Potent Meropenem
46
Meropenem is one of the most ________ spectrum drugs available
Broad
47
Penicillin are mainly active against ____________. Amoxicillin also has some activity against ________________. Flucloxacillin is active against ________________ and _______________.
Streptococci Gram-negatives Staphylococci and streptococci
48
Give an example of a beta-lactamase inhibitor combination What bacteria is it active against?
Co-amoxiclav (amoxicillin and clavulanate) Strep, staph, gram-negatives and anaerobes
49
Cephalosporins have increased effectiveness against which type of bacteria? Describe their spectrum/activity against anaerobes
Gram negative over gram positive Broad spectrum No anaerobe activity
50
Ceftriaxone has good activity in the cerebral spinal fluid. What are the implications of this?
Can be used to treat meningitis
51
Give an example of a carbapenem drug Describe its spectrum Carbapenems are usually active against most Gram __________ bacteria
Meropenem Very broad spectrum Gram negative
52
Meropenem can be given in case of penicillin __________
Allergy
53
Give an example of a glycopeptide drug
Vancomycin
54
Vancomycin is active against which bacteria?
Most gram positives (not gram-negatives)
55
Tetracyclines affect bacteria by which mechanism? Give an example of a tetracycline
Disrupt protein synthesis in bacteria Doxycycline
56
When is doxycycline commonly used?
In penicillin allergy
57
Tetracyclines are usually active against...
Gram positives, chlamydia, some protozoa
58
Why should doxycycline be given to children below 12 years of age?
Stains bones and teeth yellow
59
What is the most common aminoglycoside? What are they commonly active against?
Gentamicin Gram negatives
60
Aminoglycosides such as gentamicin are commonly reserved for...
Severe gram negative sepsis
61
Give an example of a macrolide drug
Erythromycin
62
Erythromycin can act as an alternative to...
Penicillin for mild gram positive infections
63
Give an example of a quinolone drug. How does it work? Which bacteria does it work again?
Ciprofloxacin Inhibits DNA gyrase/topoisomerase Gram negatives
64
The use of quinolones such as ciprofloxacin is associated with increased risk of...
C. difficile
65
Which antibiotic is commonly used for treatment of a UTI?
Trimethoprim
66
How do trimethoprim and sulphonamide act against bacteria?
By inhibiting folic acid synthesis
67
Co-trimoxazole is a combination of which two drugs? What is it commonly used to treat?
Trimethoprim and sulphamethoxazole Plasma cell pneumonia
68
Give two classes of antifungals
Azoles | Polyenes
69
Describe the action of azoles as antifungal drugs Give an example of an azole drug and what it is used to treat
Inhibit cell-membrane synthesis Fluconazole to treat Candida
70
Describe the action of polyenes as antifungal drugs Give an example of a polyene drug and what it is used to treat
Inhibit cell membrane function Amphotericin for treatment of systemic fungal infections
71
Give two examples of antiviral drugs
Aciclovir | Oseltamivir
72
How does aciclovir work as an antiviral drug? What can it be used to treat?
When phosphorylated inhibits viral DNA polymerase Herpes simplex
73
How does oseltamivir (tamiflu) work as an antiviral drug? What can it be used to treat?
Inhibits viral neuraminidase Influenza A & B
74
Give an example of a drug that is both an antibacterial and antiprotozoal agent
Metronidazole
75
Metronidazole is active against which type of bacteria?
Anaerobic bacteria
76
Give an example of protozoa that Metronidazole is active against
Amoebae | Giardia
77
What is an antibiotic? How old are antibiotics? When does antibiotic resistance emerge after antibiotic use?
An agent derived from another living creature that works against microbes Ancient - billions years old Very soon and inevitably as a result of antibiotic use
78
All exposure of bacteria to antimicrobials will result in antimicrobial _______________. Is resistance effectively reversible or irreversible?
Resistance Irreversible
79
Give three consequences of antibacterial resistance
Treatment failure Prophylaxis failure Economic costs
80
Define multi-drug resistance (MDR)
Non-susceptibility to at least one agent in three or more antimicrobial categories MDR
81
Define extensive drug resistance (XDR)
Non-susceptibility to at least one agent in all but two or fewer antimicrobial categories
82
Define pan-drug resistance (PDR)
Non-susceptibility to all agents in all antimicrobial categories
83
What does antimicrobial stewardship involve?
A set of measures designed to achieve appropriate use of antimicrobials to achieve optimal clinical outcomes
84
What sort of evidence is there that antibacterials cause resistance? (3)
Laboratory evidence Ecological studies Individual level data
85
How do ecological studies provide evidence that antibacterials cause resistance?
Relates levels of antibiotic use in a population with levels of resistance
86
How does individual level data provide evidence that antibacterials cause resistance?
Relates prior antibacterial use in an individual with the subsequent presence of bacterial resistance in that individual

Infection (10 decks)

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