Principles of Infectious Diseases & Clinical Microbiology Antimicrobial Selection

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35 Terms

1
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What does MIC mean?

lowest concentration of an antibiotic that completely inhibits the growth of a microorganism in vitro; expressed as a concentration

2
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What is a breakpoint?

discriminatory antimicrobial concentrations used in the interpretation of results of susceptibility testing to define isolates as susceptible, intermediate or resistant

3
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What is MBC?

lowest concentration of the antibiotic which results in a 99.9% reduction in colony forming units in a given time

4
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How do you interpret an MIC breakpoint of susceptible?

clinical success can be expected if treated with usual doses

5
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How do you interpret an MIC breakpoint of intermediate?

clinical success may be possible if:

  • high doses of antibiotics are used

  • antibiotic concentrates at the site of infection

    • possible combination agents are used

6
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How do you interpret an MIC breakpoint of resistant?

treatment failure is expected

7
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What is broth microdilution?

a known quantity of bacteria is paced into each tube with an increasing antibiotic concentration, the lowest concentration of an antimicrobial that results in the inhibition of visible growth of a microorganism is the MIC

8
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What is the infectious disease triad?

bacteria, drug, and host

9
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What is the relationship in the infectious disease triad of the drug to the host?

toxicodynamic

10
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What is the relationship in the infectious disease triad of the host to the drug?

pharmacokinetics

11
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What is the relationship in the infectious disease triad of the host to the bacteria?

host defenses

12
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What is the relationship in the infectious disease triad of the bacteria to the host?

infection

13
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What is the relationship in the infectious disease triad of the bacteria to the drug?

resistance

14
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What is the relationship in the infectious disease triad of the drug to the bacteria?

pharmacodynamics and efficacy

15
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What bacteria most commonly causes bacterial meningitis?

streptococcus pneumonia

16
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What bacteria most commonly causes otitis media?

streptococcus pneumoniae

17
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What bacteria most commonly causes community acquired pneumonia?

streptococcus pneumonia

18
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What is the most common bacteria that causes skin infections?

staphylococcus aureus

19
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What bacteria most commonly causes eye infections?

staphylococcus aureus

20
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What bacteria most commonly causes an upper respiratory tract infection?

streptococcus pyogenes

21
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What ranking does infectious and parasitic diseases have in terms of global death burden?

2

22
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True or False: antibiotic resistance is inevitable.

true

23
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Why are we constantly behind the curve of antibiotic resistance?

they evolve fast; bacteria double every 20-40 mins; they have a much shorter lifespan

24
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What patient considerations should be made in infectious diseases?

host, infection (site and severity), MICs, treatment regimens

25
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How do you maximize efficacy in infectious disease treatment?

bacterial killing, positive outcomes in patients

26
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How do you minimize toxicity in infectious disease treatment?

avoid toxicities/ADRs (usually through TDM), minimize resistance

27
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What is the timing/order of information you gain from a bacteria culture?

gram stain → organism identification → organism susceptibilities

28
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How long does it take to figure out the susceptibility of a culture?

72-96 hours

29
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What kind og antibiotics cause collateral damage?

broad spectrum (will kill some good bacteria also)

30
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What does a 100 mean on an antibiogram?

this drug will be effective against those bacteria 100% of the time

31
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What does a 0 mean on an antibiogram?

the medication will be effective 0% of the time on those particular bacteria

32
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What antibiotic on a antibiogram can be used to see % of MRSA?

oxacillin

33
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If imipenem has 100%/high effectiveness on gram-negative bacteria, what kind of antibiotic would it be classified as?

broad spectrum antibiotic

34
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If ampicillin has 0% effectiveness against most gram-negative bacteria except for 1 or 2, what class of antibiotic is this?

narrow spectrum antibiotic

35
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How are breakpoints set?

by the clinical and laboratory standards institute for each medication