ANTIBOTIC SUSCEPTIBILITY I

Yves Laure Pimentel · 70問 · 2年前

通報

問題一覧

– substances obtained and purified from other microbial organisms

ANTIBIOTIC

_________ agents - natural and synthesized substances: antibacterial, antifungal, antiparasitic, or antiviral agents.

ANTIMICROBIAL

_________ - ensured through the pharmacodynamic design of the drug

ACTIVE form

sufficient levels or concentrations at the site of infection - depends on the _________

pharmacoKINETIC

RESPOND OF BODY IN DRUGS

PHARMACODYNAMIC

most targets of antibacterial agents are _________

INTRACELLULAR

- inhibit bacterial growth

bacteriostatic

- kill target organisms

bactericidal

B-lactams - This drug class comprises the _________ group of antibacterial agents bactericidal action and lack of _________ to humans and their molecular structures can be _________

LARGEST; TOXICITY; MANIPULATED

- This drug class comprises the LARGEST group of antibacterial agents bactericidal action and lack of TOXICITY to humans and their molecular structures can be MANIPULATED

B-lactams

The _________ is the key to the mode of action of these drugs

β-lactam RING

Inhibits cell wall synthesis

β-lactam

B-LACTAMASE PRODUCERS

MORAXELLA ACINETOBACTER N. GONORRHOEAE STAPHYLOCOCCI HAEMOPHILUS ENTEROCOCCI ENTEROBACTERIACEAE P. AERUGINOSA

– it is bactericidal

Gram positive – cocci

- bacteriostatic

Enterococci

- refers to changes that result in observably REDUCED susceptibility of an organism to a particular antimicrobial agent

Biologic resistance

- When antimicrobial susceptibility has been lost to such an extent that the drug is no longer effective for CLINICAL use

Clinical Resistance

A NEGATIVE CHARGE ORGANISM

PSEUDOMONAS AURUGINOSA

Environmentally mediated resistance decreased pH

ERYTHROMYCIN

Environmentally mediated resistance increased pH

TETRACYCLINE

are able to use thymine and other exogenous folic acid metabolites to circumvent the activities of the sulfonamides and trimethoprim, which are folic acid pathway

enterococci

-mediated resistance/ Organism-based resistance

Microorganism

results from genetically ENCODED traits of the microorganism

Antimicrobial resistance

resistance- from the NORMAL genetic, structural, or physiologic state of a microorganism

intrinsic or inherent

– from altered cellular physiology and structure caused by CHANGES in a microorganism’s genetic makeup

acquired resistance

The procedures used to produce antimicrobial susceptibility profiles and detect resistance to therapeutic agents

Antimicrobial susceptibility testing (AST)

Standardized Component of AST  Inoculum  Two requirements:

PURE culture and STANDARD inoculum

Standard inoculum = _________ turbidity standards

0.5 MCFARLAND

= 0.5 MCFARLAND turbidity standards

Standard inoculum

Standard inoculum = 0.5 MCFARLAND turbidity standards THE ADDITION OF?

1% sulfuric acid + 1.175% barium chloride

provides an optical density comparable to the density of a bacterial suspension of _____

1.5X10^8 CFU/ML

final standard bacterial concentration in each microtiter well: _________

5X10^5 CFU/mL

Match the turbidity of pure culture to 0.5 McFarland by examining turbidity against a _________background

DARK

Growth Medium  Medium:

Mueller-Hinton (broth and agar)

Growth Medium  Medium: Mueller-Hinton (broth and agar)  pH?

7.2-7.4

Growth Medium Medium: Mueller-Hinton (broth and agar) Incubation atmosphere:

aerobic, no CO2

Growth Medium Medium: Mueller-Hinton (broth and agar) Incubation temp:

35-37 C

Growth Medium Medium: MRSA Incubation temp:

35 C

Growth Medium Medium: MRSA Incubation duration:

16-18 HOURS

_________ – antimicrobial agents chosen for testing against a particular bacterial

antimicrobial BATTERY/PANEL

– the lowest antimicrobial concentration that completely inhibits visible bacterial growth

Minimal Inhibitory Concentration

organism of interest with antimicrobial agents in a liquid environment.

Broth dilution

Mueller-Hinton preparation is the _________ medium used for most broth dilution testing

STANDARD

is the STANDARD medium used for most broth dilution testing

Mueller-Hinton preparation

- total broth volume is 0.05 to 0.1 mL; commonly used

Microdilution test

Microdilution test - total broth volume is mL ?; commonly used

0.05 to 0.1 mL

Microdilution test stored at _________ or lower – prevent the loss of antibiotic _________

-20oC ; POTENCY

Once thawed the panels should never be refrozen

Microdilution test

- 1 mL or greater

Macrodilution

Macrodilution - mL

1 mL or greater

– Indicates that the antimicrobial agent in question may be an appropriate choice for treating the infection

Susceptible

The potential utility of the antimicrobial agent in body sites where it may be concentrated

Intermediate

Possible effectiveness of the antimicrobial agent but possibly less so than against a susceptible isolate

Intermediate

Use as an interpretive safety margin to prevent relatively small changes in test results from leading to major swings in interpretive category

Intermediate

- Indicates that the antimicrobial agent in question may not be an appropriate choice for treatment.

Resistant

_______ - The specific concentrations that separate the different categories (Suscep, Intermediate, or resitant)

BREAKPOINT

panels that only contain these antimicrobial concentrations

breakpoint panels

Many bacteria vs single drug

Agar Dilution

one advantage of this method is that it provides a means for determining MICs for N. gonorrhoeae (fastidious)

Agar Dilution

Agar Dilution, one advantage of this method is that it provides a means for determining MICs for

N. gonorrhoeae (fastidious)

Agar Dilution Inoculum size per plate:

1 X 10^4 CFU/spot

Is still among the most frequently used methods for antimicrobial susceptibility testing

Disk Diffusion/Kirby-Bauer

use of antibiotic-impregnated filter paper disks with MICs using MANY bacterial strains

Disk Diffusion/Kirby-Bauer

Process: Lawn streak the pure bacterial inoculum onto the plate -> place the antibiotic disk on the agar plate -> incubate -> measure the diameter of the zone of inhibition

Disk Diffusion/Kirby-Bauer

Medium  Depth =

4mm

Medium  If the agar is too thick

FALSE RESISTANT/SMALL ZONE OF INHIBITION

Medium FALSE RESISTANT/SMALL ZONE OF INHIBITION

If the agar is too thick

Medium if the agar is too thin

FALSE SUSCEPTIBLE/ LARGER ZONE OF INHIBITION

Medium FALSE SUSCEPTIBLE/ LARGER ZONE OF INHIBITION

if the agar is too thin

Inoculation  0.5 McFarland turbidity standard = equivalent to

1.5 × 10^8 CFU/mL

Inoculation  ? McFarland turbidity standard = equivalent to 1.5 × 108 CFU/mL

0.5

0.5 McFarland turbidity standard = equivalent to 1.5 × 108 CFU/mL

Inoculation

Inoculation ________ pure culture

18-24 HR

Inoculation Swab directions =

3 DIRECTIONS

Inoculation = INCREASE BACTERIA - FALSE RESISTANT- SMALL ZOI

Too heavy

Inoculation = DECREASE BACTERIA - FALSE SUSCEPTIBLE- LARGE ZOI

Too light

Inoculation Within 15 minutes of inoculation, the antimicrobial disks are applied and the plates are _________ for incubation to prevent the accumulation of _________ on the agar surface,

INVERTED; MOISTURE

Inoculation Within ? of inoculation, the antimicrobial disks are applied and the plates are INVERTED for incubation to prevent the accumulation of MOISTURE on the agar surface,

15 minutes

Disk are only held up for _________ week in refrigerator temp

12 antibiotic disks for _________-mm MHA plate

150

HOW MANY antibiotic disks for 150 -mm MHA plate

Antibiotic disk application Disk distance = _________

15 mm

Antibiotic disk application Antibiotic disk = _________ mm

6mm

The highest concentration is _________ to the disk

CLOSEST/CENTER

Incubation  Within _________ min of disk placement

most organisms are incubated at ? in room air -> 16-18 hrs

35oC

most organisms are incubated at 35oC in room air -> FOR HOW MANY HOURS?

16-18 hrs

most organisms are incubated at 35oC in room air -> 16-18 hrs -> Beyond 16hrs is for resistant bacteria (i) <16h =

FALSE SUSCEPTIBLE/LARGE ZOI

most organisms are incubated at 35oC in room air -> 16-18 hrs -> Beyond 16hrs is for resistant bacteria >18h =

FALSE RESISTANT/SMALL ZOI

_______ = require 24h incubation

MRSA

MRSA = require ? incubation

24h

Incubation  not an acceptable method for testing SLOW -growing organisms (eg. ?)

Mycobacteria and anaerobes

>15min before disk application

FALSE SUSCEPTIBLE/SMALL ZOI

Incubation <15min before incubation

FALSE RESISTANT/LARGE ZOI

other names parasitology

other names parasitology

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CSF 1

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CSF 2

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SEMEN 1

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SEMEN 2

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SYNOVIAL FLUID 1

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SYNOVIAL FLUID 2

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SEROUS FLUID

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PLEURAL FLUID

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PERICARDIAL FLUID

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PERITONEAL FLUID/ ASCITIC FLUID

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AMNIOTIC FLUID

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FECALYSIS

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OTHER BODY FLUIDS

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MTLBE- SUHO NOTES

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MTLBE..

MTLBE..

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CC- CHROMATOGRAPHY

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CC-OSMOMETRY

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CC- CARBOHYDRATES

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CC- DIABETES MELLITUS

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MAJOR LIPOPROTEINS

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MINOR LIPOPROTEINS

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PROTEINS

PROTEINS

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PLASMA PROTEINS 1

PLASMA PROTEINS 1

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PLASMA PROTEINS 2 (ALPHA 2 REGION)

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MISCELLANEOUS PROTEINS

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Liver Function Test 1

Liver Function Test 1

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Liver Function Test 2

Liver Function Test 2

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TUMOR MARKERS

TUMOR MARKERS

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GLYCOGEN STORAGE DISEASES

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LIPID STORAGE DISEASES

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PROTEINS

PROTEINS

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QUICK FIRE- ELECTRODES

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ELECTROLYTES

ELECTROLYTES

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DRUGS

DRUGS

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TOXIC AGENTS:

TOXIC AGENTS:

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HEMATOLOGY 1 (HEMATOPOIESIS 1)

HEMATOLOGY 1 (HEMATOPOIESIS 1)

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HEMATOLOGY (HEMATOPOIESIS 2)

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hema diseases

hema diseases

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AML

AML

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GLOBIN SYNTHESIS

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HEMATOLOGY REFERENCE RANGES

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DISORDERS OF PRIMARY HEMOSTASIS

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PLATELET DISORDERS

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CHARACTERISTICS OF CLOTTING FACTORS

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4. CLASSIFICATION OF MACROPHAGE

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3. NATURAL OR INNATE IMMUNITY

3. NATURAL OR INNATE IMMUNITY

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5. INTERNAL DEFENSE:SOLUBLE FACTORS (ACUTE PHASE REACTANTS)

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6. PHAGOCYTOSIS Chemotaxis

6. PHAGOCYTOSIS Chemotaxis

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8. NATURE OF ANTIGEN

8. NATURE OF ANTIGEN

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9. MAJOR HISTOCOMPATIBILITY COMPLEX/HUMAN LEUKOCYTE ANTIGEN

9. MAJOR HISTOCOMPATIBILITY COMPLEX/HUMAN LEUKOCYTE ANTIGEN

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1. HISTORY

1. HISTORY

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2. TYPES OF IMMUNITY

2. TYPES OF IMMUNITY

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7. PHAGOCYTOSIS Engulfment and Digestion

7. PHAGOCYTOSIS Engulfment and Digestion

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8. PHAGOCYTOSIS EXOCYTOSIS

8. PHAGOCYTOSIS EXOCYTOSIS

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10. DISEASE ASSOCIATED TO HUMAN LEUKOCYTE ANTIGEN (henry)

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11. TRANSPLANTATION IMMUNOLOGY

11. TRANSPLANTATION IMMUNOLOGY

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2. LYMPHOID ORGANS

2. LYMPHOID ORGANS

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3. CLUSTER OF DIFFERENTIATION

3. CLUSTER OF DIFFERENTIATION

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4. T-CELL DIFFERENTIATION

4. T-CELL DIFFERENTIATION

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5. T CELL IMMUNODEFICIENCIES

5. T CELL IMMUNODEFICIENCIES

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6. STAGES IN B-CELL DIFFERENTIATION  PROPIMAP

6. STAGES IN B-CELL DIFFERENTIATION  PROPIMAP

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7. B CELL IMMUNODEFICIENCIES

7. B CELL IMMUNODEFICIENCIES

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8. COMBINED T CELL AND B CELL DEFICIENCIES

8. COMBINED T CELL AND B CELL DEFICIENCIES

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9. COMPARISON OF T AND B CELLS

9. COMPARISON OF T AND B CELLS

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10. LABORATORY IDENTIFICATION OF LYMPHOCYTES

10. LABORATORY IDENTIFICATION OF LYMPHOCYTES

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11. NATURAL KILLER CELLS OR THIRD POPULATION CELL

11. NATURAL KILLER CELLS OR THIRD POPULATION CELL

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12. ANTIBODY

12. ANTIBODY

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13. TYPES OF ANTIBODIES

13. TYPES OF ANTIBODIES

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14. MONOCLONAL ANTIBODIES

14. MONOCLONAL ANTIBODIES

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1. INTERLEUKINS

1. INTERLEUKINS

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2. INTERFERONS

2. INTERFERONS

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3. CYTOKINES IN THE INNATE AND ADAPTIVE IMMUNITY

3. CYTOKINES IN THE INNATE AND ADAPTIVE IMMUNITY

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4. COMPLEMENT SYSTEM

4. COMPLEMENT SYSTEM

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15. COMPLEMENT SYSTEM

15. COMPLEMENT SYSTEM

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16. SYSTEM CONTROLS/COMPLEMENT REGULATION

16. SYSTEM CONTROLS/COMPLEMENT REGULATION

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17. COMPLEMENT AND DISEASE STATES

17. COMPLEMENT AND DISEASE STATES

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18. IMMUNOLOGIC ASSAYS OF INDIVIDUAL COMPONENTS (CLASSICAL)

18. IMMUNOLOGIC ASSAYS OF INDIVIDUAL COMPONENTS (CLASSICAL)

19問 • 2年前

Yves Laure Pimentel · 22問 · 2年前

19. CYTOKINES

19. CYTOKINES

22問 • 2年前

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20. INTERLEUKINS

20. INTERLEUKINS

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21. INTERFERONS, TNF, TGF, CHEMOKINE

21. INTERFERONS, TNF, TGF, CHEMOKINE

21問 • 2年前

Yves Laure Pimentel · 54問 · 2年前

1. SERO

1. SERO

54問 • 2年前

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2. PRECIPITATION

2. PRECIPITATION

38問 • 2年前

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3. PASSIVE IMMUNODIFFUSION

3. PASSIVE IMMUNODIFFUSION

17問 • 2年前

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4. OUCHTERLONY

4. OUCHTERLONY

15問 • 2年前

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5. ELECTROPHORETIC TECHNIQUE

5. ELECTROPHORETIC TECHNIQUE

9問 • 2年前

Yves Laure Pimentel · 11問 · 2年前

6. IMMUNOELECTROPHORESIS (DOUBLE DIFFUSION)

6. IMMUNOELECTROPHORESIS (DOUBLE DIFFUSION)

11問 • 2年前

Yves Laure Pimentel · 29問 · 2年前

7. IMMUNOFIXATION ELECTROPHORESIS

7. IMMUNOFIXATION ELECTROPHORESIS

29問 • 2年前