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44 Cards in this Set
- Front
- Back
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What are the 10 steps in selecting optimal antimicrobial therapy?
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1. Predict the infecting organism
2. Consider Host Defense Mechanisms 3. Consider the Age 4. Consider the host factors 5. Perform Diagnostic tests 6. Consider antibiotic susceptibilities of suspected pathogens 7. consider pharmacokinetic/dynamic properties of the drugs 8. target attainment 9. empiric and definitive decisions separately 10. special considerations (cost) |
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Under step 1 of selecting a drug, the type of infection gives us a clue to the ___ __
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probable organism
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What are the 2 types of bacteria?
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-Aerobic
-Anaerobic |
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What are examples of aerobic bacteria?
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strep and staph
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What are the examples of anaerobic bacteria?
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Deep wounds
-characterized by abscess formation, foul-smelling pus and tissue destruction -C. diff -Bacteroides fragilis |
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What are the common illness caused by strep pneumoniae?
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-pneumonia
-meningitis -bacteremia -endocarditis |
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What are the organisms leading to malaria?
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plasmodium species
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An overgrowth of endogenous organisms may become ___
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pathogenic
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ToF: Isolation of bacteria from non-sterile body site is diagnostic of an infection.
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False: only if the organism is pathogenic, or found in a sterile body site
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What are 2 examples of endogenous flora that can be pathogenic if overgrown?
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Bacteroides and staphococcus epidermidis
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An overgrowth by exogenous organisms is also referred to as ___
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colonization
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To F: colonization is transient.
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False, may be transient or persistent
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Nosocomial organisms are important infections because they are often __ to many antibiotics
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resistant
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What is common organism to get nosocomally by children in the hospital>
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Pseudomonas Aeruginosa
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What is a common cause of meningitis in newborns that is not in other age groups?
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Listeria monocytogenes
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What organism often causes meningitis in infants and children but not over age 5
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H. influenza
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What is the leading cause of pneumonia in the newborn period?
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GBS
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What is a gram stain?
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microscopic identification of the organism
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What diagnostic test looks at titers or antibodies measured?
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Serology
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What is meant when an organism is sensitive?
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organism should be eradicated by treatment with the antibiotic at the recommended dosage
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Describe intermediate sensitivity?
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organism may or may not be eradicated dependent on achievable drug concentration and organism MIC
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What is the MIC?
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lowest concentration of antimicrobial that prevents VISIBLE bacterial growth in the specified medium; predicts bacteriological response to therapy
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cultures must be performed in a manner that minimizes the likelihood of ___ with normal ___ while maximizing the yield.
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contamination; flora
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ToF: findings of bram stains are absolute
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false
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What is the most important procedure in all of microbiology?
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Gram stain
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What are the 2 dyes used in gram staining?
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crystal violet and safrinin
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Which organisms retain the crystal violet (purple/blue)?
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Gram +
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What color does gram - organisms retain?
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safrinin dye (pink red)
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What is the reason for the difference in color between gram + and - bacteria?
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Differences in the size of the cell wall of the bacteria
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Sequencing of ___ ___ __ molecules has become the gold standar in bacterial taxonomy
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16S ribosomal RNA
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ToF: DIRECT detection of bacteria without culture is possible in only a few cases.
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True
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What are the ways to directly detect bacteria without culture?
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-antigen detection
-bacterial DNA sequences -Direct microscopic observation -serologic identification of an antibody response |
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How do you know the MIC?
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The ETest meniscus-- THe MIC corresponds to the point where the bacterial growth crosses the numbered strip
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Which types of antimicrobials have a MIC=MBC?
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bacteriocidal
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What are the types of agar plates?
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-ogranisms will thrive
-organismis will die |
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which is more severe, community or nosocomial acquired infections?
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Nosocomial
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What are the 3 functions of antibiotics?
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-destroy microbes
-prevent replication and/or growth -prevent an organism's pathologic action |
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What are the drug classes that inhibit cell wall sythesis?
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-penecillin
-cephalosporins -carbapenems -monobactam (aztreonam) -vancomycin |
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What are the drugs that inhibit protein synthesis?
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-chloramphenicol
-tetracyclines -macrolides -clindamycin -stretogramins -oxazolidnones -aminoglycosides |
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WHich drugs alter nucleic acid metabolism?
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-rifamycins
-quinolones |
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What is the mechanism of trimethoprim and sulfamethoxazole
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Inhibit folate metabolism
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Which antimicrobials need to stay above the MIC in order to work no matter how long?
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concentration dependent
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What is time dependent?
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Relies on amount of time serum concentration remains above the MIC
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What is the post antibiotic effect?
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Delayed regrowth of bacteria following exposure to the antimicrobial
-varies according to drug-bug combination |
