Glossary of weird conditions of antibioitcs
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- 3 reasons why bacterium should be suscept but patient doesnt respond
- -acidic pH at infection site decreases med action.
-vascular occlusion prevents med from reaching site.
-immunological factors require bacteriocidal and you gave a STATIC DUMMY
- 3 REASONS WHY A PATIENT SHOULDNT RESPOND BUT DID!!
- 1. acid pH site increases some activity
2. kidney concentrates antibiot, high enough levl kills bug
3. host defense mechanisms just work
- 6 events that precipitate resistance
- 1. natural selection
2. overuse of antibiots
3. overuse of broadspectrum
4. poor patient compliance
5. international travel, rapid spread of resistance.
6. feeding antimicrobials to livestock
- 2 categories of developing resistance
- a. chromosomal mutation of indiv cell
b. resistance gene trasnfer between cells
- 2 ways to develop chromosomal mutation of individ cell
- -somatic mutation (spontaneous)
-selective pressure (exposing to antibiots pressures them to mutate)
- 4 ways to transfer R genes
- who does conjugation occur in?
- only gram negative bugs
- how is resistance transferred in transduction?
- via a BACTERIOPHAGE in gram positives or negatives. a bacteriophage is a virus that only infects bacteria
- transformation; what is it?
- transfer of bacteria-free genetic material into bacteria; causes resistance
- plasmid transfer
- -non-chromosomal dna
transferred by any of the other three methods of transfer, also
TRANSPOSONS - jumping from one plasmid to another - this is translocation.
- 4 mechanisms of resistance
- -altered antimicrobial target site
-inactivate antibiotic by producing an enzyme
-change cell membrane permeability
- 2 ways to alter permeability
- decrease uptake - porins
efflux - pump antibact out!
- 2 ways to modify antimicrobial's target to resist it:
- -change penicillin binding proteins (PBP) - penicillin can't bind and inhibit bug.
-alter enzyme or ribosome target - new replacement is not susceptible.
- principal of therapeutic drug monitoring
- when amount of drug necess for treatment is considerably high, have to monitor activity so that toxic levels aren't reached.
- multidrug resistance
- resistance of a bacteria to multiple drugs
- how multidrug resistance is caused
- plasmids can have more than one resistance gene, transfers all to bacteria. MDR GNB
multiple r-genes can accumulate on the chromosome. MDR TB
- MDR TB - caused by?
- multi drug resistance - accumulation of r-genes on the chromosomes
- mdr gnb - caused by?
- multidrug resistant gnb
transfer of conjugal plasmid with multiple resistance genes
- extended spectrum betalactamase
-ß-lactamases capable of hydrolysing extended spectrum cephalosporins and penicillins and aztreonam.
-associated with E. coli or Klebsiella pneumoniae
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