ID 1 - the most basic bacteria information

______ combines culture data collected from patients at a single institution over a period of time. shows susceptibility patterns and can be used to monitor resistance trends over time

antibiogram

what kind of organism has a thick cell wall and stains dark purple/blue?

a. gram positive

b. gram negative

c. atypical

a. gram positive

what kind of organism has a thin cell wall and stains pink?

a. gram positive

b. gram negative

c. atypical

b. gram negative

what kind of organism has a NO cell wall and does not stain well?

a. gram positive

b. gram negative

c. atypical

c. atypical

what kind of bacteria is staphylococcus?

a. gram+ cocci in clusters

b. gram+ cocci in pairs/chains

c. gram+ rods

d. atypical

a. gram+ cocci in clusters

what kind of bacteria is streptococcus?

a. gram+ cocci in clusters

b. gram+ cocci in pairs/chains

c. gram+ rods

d. atypical

b. gram+ cocci in pairs/chains

what kind of bacteria is enterococcus?

a. gram+ cocci in clusters

b. gram+ cocci in pairs/chains

c. gram+ rods

d. atypical

b. gram+ cocci in pairs/chains

what kind of bacteria is listeria monocytogenes?

a. gram+ cocci in clusters

b. gram+ cocci in pairs/chains

c. gram+ rods

d. gram- rods

c. gram+ rods

what kind of bacteria is corynebacterium?

a. gram+ anaerobe

b. gram- coccobacilli

c. gram+ rods

d. gram- rods

c. gram+ rods

what kind of bacteria is clostridioides difficile?

a. gram- anaerobe

b. atypical

c. gram+ rods

d. gram+ anaerobe

d. gram+ anaerobe

what kind of bacteria is clostridium?

a. gram- anaerobe

b. atypical

c. gram+ rods

d. gram+ anaerobe

d. gram+ anaerobe

what kind of bacteria is chlamydophila?

a. gram- anaerobe

b. atypical

c. gram+ rods

d. gram+ anaerobe

b. atypical

what kind of bacteria is legionella?

a. gram- anaerobe

b. atypical

c. gram+ rods

d. gram+ anaerobe

b. atypical

what kind of bacteria is mycoplasma?

a. gram- anaerobe

b. atypical

c. gram+ rods

d. gram+ anaerobe

b. atypical

what kind of bacteria is neisseria spp.?

a. gram- cocci

b. gram- curved/spiral rod

c. atypical

d. gram- anaerobe

a. gram- cocci

what kind of bacteria is bacteroides fragilis?

a. gram- cocci

b. gram- curved/spiral rod

c. atypical

d. gram- anaerobe

d. gram- anaerobe

what kind of bacteria is prevotella?

a. gram- cocci

b. gram- curved/spiral rod

c. atypical

d. gram- anaerobe

d. gram- anaerobe

what kind of bacteria is acinetobacter baumannii?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- anaerobe

c. gram- coccobacilli

what kind of bacteria is bordetella pertussis?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- anaerobe

c. gram- coccobacilli

what kind of bacteria is moraxella catarrhalis?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- anaerobe

c. gram- coccobacilli

what kind of bacteria is pseudomonas aeruginosa?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

d. gram- rod (nonenteric)

what kind of bacteria is h. influenzae?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

d. gram- rod (nonenteric)

what kind of bacteria is providencia spp.?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

d. gram- rod (nonenteric)

what kind of bacteria is h. pylori?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

b. gram- curved/spiral rod

what kind of bacteria is campylobacter spp.?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

b. gram- curved/spiral rod

what kind of bacteria is treponema spp.?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

b. gram- curved/spiral rod

what kind of bacteria is proteus mirabilis?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

what kind of bacteria is escherichia coli?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

what kind of bacteria is klebsiella?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

what kind of bacteria is serratia spp.?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

what kind of bacteria is enterobacter cloacae?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

what kind of bacteria is citrobacter spp.?

a. gram- enteric rod

b. gram- curved/spiral rod

c. gram- coccobacilli

d. gram- rod (nonenteric)

a. gram- enteric rod

gram+ cocci in clusters

• staphylococcus spp.

gram+ cocci in pairs and chains

• streptococcus pneumoniae

• streptococcus spp.

• enterococcus spp.

gram+ rods

• listeria monocytogenes

• corynebacterium spp.

gram+ anaerobes

• clostridioides difficile

• clostridium spp.

• peptostreptococcus

• propionibacterium acnes

atypicals

• chlamydophila

• legionella

• mycoplasma

gram- anaerobes

• bacteroides fragilis

• prevotella spp.

gram- coccobacilli

• acinetobacter baumannii

• bordetella pertussis

• moraxella catarrhalis

gram- cocci

• neisseria spp.

gram- enteric rods

• proteus mirabilis

• escherichia coli

• klebsiella spp.

• serratia spp.

• enterobacter cloacae

• citrobacter spp.

gram- rods (nonenteric)

• pseudomonas aeruginosa

• haemophilus influenzae

• providencia spp.

gram- rods (curved/spiral shaped)

• h. pylori

• campylobacter spp.

• treponema spp.

• borrelia spp.

• leptospira spp.

T/F you can compare MICs among different antibiotics

FALSE — specific to each abx and organism

which is coagulase-positive?

a. staphylococcus aureus

b. staphylococcus epidermidis

a. staphylococcus aureus

resistance that is natural to the organism

a. intrinsic resistance

b. selection pressure

c. acquired resistance

d. antibiotic degradation

a. intrinsic resistance

resistance occurs when abx kill susceptible bacteria, leaving behind more resistant strains to multiply

a. intrinsic resistance

b. selection pressure

c. acquired resistance

d. antibiotic degradation

b. selection pressure

bacterial DNA containing resistant genes can be transferred between species and/or picked up from dead bacterial fragments in the environment

a. intrinsic resistance

b. selection pressure

c. acquired resistance

d. antibiotic degradation

c. acquired resistance

bacterial enzymes break down the antibiotic

a. intrinsic resistance

b. selection pressure

c. acquired resistance

d. antibiotic degradation

d. antibiotic degradation

why are clavulanate, sulbactam, tazobactam, and avibactam used?

beta-lactamase inhibitors

preserve/increase beta-lactams spectrum of activity by preventing them from being degraded

what can extended-spectrum beta-lactamases break down?

how do we treat them typically?

ESBLs break down all penicillins and most cephalosporins

treatment: carbapenems or cephalosporin/BLIs

what are carbapenem-resistant enterobacterales (CRE)?

MDR gram- organisms that break down penicillins, most cephalosporins, and carbapenems

• klebsiella

• e coli

treatment: combo of abx, advanced beta-lactam/BLI combos, or polymyxins

common resistant pathogens

Kill Each And Every Strong Pathogen

• Klebsiella pneumoniae

• Escherichia coli

• Acinetobacter baumannii

• Enterococcus faecalis, Enterococcus faecium

• Staphylococcus aureus

• Pseudomonas aeruginosa

bacteria that produce ESBL

• klebsiella pneumoniae

• e. coli

CRE (carbapenem-resistant enterobacterales) organisms

• klebsiella pneumoniae

• escherichia coli

VRE organisms

• enterococcus faecalis

• enterococcus faecium

abx with highest risk of c diff

• broad-spectrum penicillins

• broad-spectrum cephalosporins

• FQs

• carbapenems

• clindamycin

what antibiotic has a boxed warning for c diff?

a. penicillin

b. levofloxacin

c. cephalexin

d. clindamycin

d. clindamycin

example antimicrobial stewardship program interventions

• PK monitoring

• clinical decision support software

• restricted use of select abx

• prospective audit

• IV to PO

DNA/RNA inhibitors

• FQs

• metronidazole, tinidazole

• rifampin

cell membrane inhibitors

• polymyxins

• daptomycin

• telavancin

• oritavancin

protein synthesis inhibitors

• aminoglycosides

• macrolides

• tetracyclines

• clindamycin

• linezolid, tedizolid

cell wall inhibitors

• beta-lactams

• monobactams

• vancomycin, dalbavancin, telavancin, oritavancin

folic acid synthesis inhibitors

• sulfonamides

• trimethoprim

• dapsone

properties of hydrophilic agents

• small Vd —> less tissue penetration

• mostly renally eliminated

• low intracellular concentrations —> not active against atypical pathogens

• poor bioavailability —> IV:PO ratio is not 1:1

properties of lipophilic agents

• large Vd —> better tissue penetration

• mostly hepatically metabolized

• achieve higher intracellular concentrations —> active against atypical pathogens

• excellent bioavailability —> IV:PO ratio is often 1:1

hydrophilic agents

• beta-lactams

• aminoglycosides

• vancomycin

• daptomycin

• polymyxins

lipophilic agents

• FQs

• macrolides

• rifampin

• linezolid

• tetracyclines

features of concentration-dependent (Cmax:MIC) killing abx

goal: high peak, low trough

dosing strategies: large dose, long interval

concentration-dependent (Cmax:MIC) abx

• aminoglycosides

• FQs

• daptomycin

features of exposure-dependent (AUC:MIC) killing abx

goal: exposure over time

dosing strategies: variable

pretty similar to concentration dependent

exposure-dependent (AUC:MIC) abx

• vancomycin

• macrolides

• tetracyclines

• polymyxins

features of time-dependent (time > MIC) killing abx

goal: maintain drug level > MIC for most of the dosing interval

dosing strategies: shorter dosing interval, extended or continuous infusions

time-dependent (time > MIC) abx

beta-lactams