Antimicrobial Stewardship and Resistance Flashcards Preview

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Flashcards in Antimicrobial Stewardship and Resistance Deck (18)
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1
Q

What is an antibacterial?

A

Something that acts only to kill bacteria but includes all compounds including antibiotics and antibacterial handwash, disinfectant ect.

2
Q

What is antibiotic?

A

Natural and synthetic compounds that are active against bacteria and have been liscenced for use to treat infections

3
Q

What is antibiotic resistance?

A

The ability of bacteria to protect themselves against the effects of an antibiotic.
Laboratory phenomenon- Resistant bacteria will multiply in the presence of antibiotics on a petri dish.

4
Q

What is clinical antibiotic resistance?

A

The baceria can grow in the antibiotic concentrations reached in the body during therapy resulting in treatment failure and an antibiotic resistant infection

5
Q

What is resistant and susceptible bacteria?

A
Resistant = Antibiotic will not inhibit bacterial growth at clinically achievable concentrations
Susceptible  = Antibiotic will inhibit bacterial growth at clinically achievable concentrations.
6
Q

What is MDR?

A

Non susceptibility to at least 1 agent in 3 or more antimicrobial categories.

7
Q

What is XDR?

A

Non susceptibility to at least one agent in all but 2 or fewer antimicrobial categories

8
Q

What is PDR?

A

Pan drug resistance: non susceptibility to all agents in all antimicrobial categories

9
Q

Resistance is either innate or acquired. Which type of resistance can good prescribing reduce?

A

Acquired resistance

10
Q

Is it normal to have resistant bacteria in the gut microbiome?

A

Yes its variation- normally there is no reason for them to replicate or transfer their DNA. Just die

11
Q

How is antibiotic resistance acquired?

A

Vertical transmission (random mutation)
Horizontal transmission. (3 methods)
ALL increases the resistance of the microbiome- only a problem if that infects a sterile site

12
Q

What are the 3 methods of horizontal transmission of resistance?

A

1) Transformation- bacteria scavenge resistance genes form dead bacterial cells and integrate them into their genome
2) Transduction- When resistance genes are transferred by bacteriophages (virus’ that infect bacteria)
3) Conjugation- when genes are htransferred on plasmids between bacterial cells through tubes called pilli.

13
Q

What are the resistance mechanisms which bacteria use?

A

1) Inactivation of antibiotics
2) Impermiability to antibiotics
3) Efflux of antibiotics

14
Q

What percentage of health care associated infections are caused by resistant organisms?

A

25%

15
Q

Where does most antibiotic prescribing occur?

A

Communities.

High income countries still use more antibiotics per capitia than low and middle income countries

16
Q

What is antimicrobial stewardship?

A

An organisational or healthcare system wide approach to promoting and monitoring use of antimicrobials to preserve their future effectiveness.
Right antibiotic, Right dose, Right time, Right patient

17
Q

What are the 4 D’s of antimicrobial stewardship?

A

Drug, Dose, Duration and de-escalation.

18
Q

What is prudent prescribing?

A

Not prescribing as few antibiotics as possible. But IDENTIFY the small group who need an antibiotic and explain, educate and reassure the large group who do not