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IOS 10 Exam 2

Resistance

QuestionAnswer
B-lactam resistance most relevant and clinically significant B-lactamase production
All ____ organisms have a high concentrations od B-lactamase Gram -
Most common forms of B-lactamase are TEM, SHV
Constitutive expression Expression of chromosome can be low or high expression
Inducible expression Usually plasmid mediated (SPACE)
SPACE organisms Serratia, pseudomonas, Acintobacter, Citobacter, Enterobacter
SPACE organisms have what enzyme that are highly resistant ampC
Stable derepression Chromosomal carried genes that control repressor genes are mutated and enzyme is always on.
Anaerobic resistance B-lactamase is very common(may produce penicillinase or cephalosporinase) also Metallo-B-lactamase resistant ot carbapenems
Aminoglycosides Aminoglycoside modifying enzymes, actylase can inactivate the antibiotic
Fluoroquinolones resistance Chromosomal mutaion of Topo II (gyrA) and Topo IV (parC) or efflux proteins
Vancomycin resistance Alterations in D-alanyl-D lactate
Stap aures resistance Penicillinase is the most common and relevant, alterations in PBP, Topo IV mutations
Strept pneumoniae resistance Multi resistance: Alterations in PBP (PCN) high or low resistance, Efflux proteins & ribsomal alterations for macrolidesm clindamycin, Topo IV for quinolones, Resistant gene cassette for multi classes
Enterococcus resistance intrinsic B-lactams have altered PBP,and decreased permibility
Enterococcus acquird resistance Further alterations in PBP,and aminoglycodises have enzyme modifications
Gram negative bacilli resistance B-lactamase production most common. Permability, aminoglycoside inactivating enzymes, DNA grA mutations
Created by: liza001
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