MCB4271 AMR EXAM 2 QUESTIONS & ANSWERS
Clinical resistance - Answer -Multiple factors such as type of bacteria, infection site,
antibiotic pharmacokinetics, and the immune response affecting clinical outcomes of
antibiotic treatment.
Minimun inhibitory concentration (MIC) - Answer -A minimum concentration of an
antibiotic required to completely inhibit bacterial growth.
Clinical Resistance: Non-toxic drug concentration - Answer -The most effective
treatment of bacterial infections is when the antibiotic MIC is non-toxic to humans.
Clinical Resistance: Toxic drug concentration - Answer -Administration of toxic
concentration of drugs into patients are made on individual basis and the benefits of the
treatment must outweigh the risk.
The clinical ecosystem has a _____ selection pressure
a. High
b. Medium
c. Low - Answer -A
Environmental ecosystem has a _____ selection pressure
a. High
b. Medium
c. Low - Answer -C
The non-clinical ecosystem has a _______ selection pressure
a. High
b. Medium
c. Low - Answer -B
Chain and Abraham (1940) noticed what? - Answer -B.coli released an anti-antibiotic
enzyme in culture.
T/F Bacteria naturally develop counter-attack mechanisms against other microbes that
are trying to kill them. - Answer -True
____________ ________ ___________ accelerates bacteria to acquire resistance and
lead to life-threatening infections. - Answer -High selective pressure
Intrinsic resistance: - Answer -- Nat'ly occuring resistance to antibiotics
- The outer memb of G(-) bact makes them more resistant to more antibiotics than G(+)
,- Bact that nat'ly produce antibiotics have an intrinsic ability to defend themselves
Acquired resistance: - Answer -- Genetic mutations
- Acquisition of mobile elements carrying antibiotic resistant genes
- Poses highest risk
WHO antibiotic classification Criterion 1 (C1) - Answer -The antimicrobial class is the
sole, or one of limited available therapies, to treat serious bacterial infections in people
WHO antibiotic classification Criterion 2 (C2) - Answer -The antimicrobial class is used
to treat infection in people cause by either:
- bacteria that may be transmitted to humans from nonhuman sources OR
- bacteria that may acquire resistance genes from nonhuman sources
Critically important: - Answer -Antimicrobial classes which meet both C1 and C2 are
termed critically important for human medicine.
Highly important: - Answer -Antimicrobial classes which meet either C1 or C2 are
termed highly important for human medicine.
Important: - Answer -Antimicrobial classes used in humans which meet neither C1 nor
C2 are termed important for human medicine.
WHO antibiotic prioritization: P1 - Answer -High absolute number of people, or high
proportion of use in patients with serious infections in health care settings affected by
bacterial diseases for which the antimicrobial class is the sole or one of few alternatives
to treat serious infection in humans
WHO antibiotic prioritization: P2 - Answer -High frequency of use of the antimicrobial
class for any indication in human medicine, or else high proportion of use in patients
with serious infections in health care settings, since use may favor selection of
resistance in both settings.
WHO antibiotic prioritization: P3 - Answer -The antimicrobial class is used to treat
infections in people for which there is evidence of transmission of resistant bacteria
(e.g., non-typhoidal Salmonella
and Campylobacter spp.) or resistance genes (high for E. coli and Enterococcus spp.)
from non-
human sources.
Highest priority: - Answer -Three out of three Prioritization Criteria (P1, P2, P3)
High priority: - Answer -Two out of three Prioritization Criteria
Critically important antimicrobials: - Answer -- Cephalosporins (3rd, 4th, 5th gen)
- Glycopeptides
, - Macrolides and ketolides
- Polymyxins
- Quinolones
Enzymatic degradation: Linearization - Answer -Cutting
Enzymatic degradation: Hydrolysis - Answer -β-lactamases
Enzymatic modification: Nucleotidylation - Answer -Additional of nucleotides
Enzymatic modification: Phosphorylation - Answer -Phosphate group addition
Enzymatic modification: Glycosylation - Answer -Attachment of a carbohydrate
Enzymatic modification: Acylation - Answer -Addition of the acyl (RCO-) group
Enzymatic modification: Hydroxylation - Answer -Addition of hydroxy (-OH) group
What was the unknown enzyme Chain and Abraham observed to have antibiotic
properties? - Answer -Penicillinase
_________________ are enzymes that hydrolyze β-lactam antibiotics. - Answer -β-
lactamases
Penicillinase (β-lactamases) - Answer -Is an enzyme that facilitates hydrolysis of beta-
lactams rendering them ineffective at killing bacteria
Currently there are over __________ β-lactamases identified. - Answer -1000!
__________ _________ _________ protect the β-lactam ring from β-lactamases. -
Answer -Bulky side groups
Penicillins :PenG --> Amox --> Ticarcillin --> Piperacillin
Cephalosporins: Cefalotin --> Cefuraxime --> Ceftazidime --> Cefepime
How many classes are there of β-lactamases? - Answer -4 (Class A-D)
- Serine β-lactamases
- Metallo-β-lactamases
- Cephalosporinases
- Oxacillinases
In what classes of β-lactamases is serine in the active site? - Answer -Class A, C, and
D
In what class of β-lactamases is metalloenzymes found? - Answer -Class B
(Check out lecture for slides 17-19) - Answer -
Clinical resistance - Answer -Multiple factors such as type of bacteria, infection site,
antibiotic pharmacokinetics, and the immune response affecting clinical outcomes of
antibiotic treatment.
Minimun inhibitory concentration (MIC) - Answer -A minimum concentration of an
antibiotic required to completely inhibit bacterial growth.
Clinical Resistance: Non-toxic drug concentration - Answer -The most effective
treatment of bacterial infections is when the antibiotic MIC is non-toxic to humans.
Clinical Resistance: Toxic drug concentration - Answer -Administration of toxic
concentration of drugs into patients are made on individual basis and the benefits of the
treatment must outweigh the risk.
The clinical ecosystem has a _____ selection pressure
a. High
b. Medium
c. Low - Answer -A
Environmental ecosystem has a _____ selection pressure
a. High
b. Medium
c. Low - Answer -C
The non-clinical ecosystem has a _______ selection pressure
a. High
b. Medium
c. Low - Answer -B
Chain and Abraham (1940) noticed what? - Answer -B.coli released an anti-antibiotic
enzyme in culture.
T/F Bacteria naturally develop counter-attack mechanisms against other microbes that
are trying to kill them. - Answer -True
____________ ________ ___________ accelerates bacteria to acquire resistance and
lead to life-threatening infections. - Answer -High selective pressure
Intrinsic resistance: - Answer -- Nat'ly occuring resistance to antibiotics
- The outer memb of G(-) bact makes them more resistant to more antibiotics than G(+)
,- Bact that nat'ly produce antibiotics have an intrinsic ability to defend themselves
Acquired resistance: - Answer -- Genetic mutations
- Acquisition of mobile elements carrying antibiotic resistant genes
- Poses highest risk
WHO antibiotic classification Criterion 1 (C1) - Answer -The antimicrobial class is the
sole, or one of limited available therapies, to treat serious bacterial infections in people
WHO antibiotic classification Criterion 2 (C2) - Answer -The antimicrobial class is used
to treat infection in people cause by either:
- bacteria that may be transmitted to humans from nonhuman sources OR
- bacteria that may acquire resistance genes from nonhuman sources
Critically important: - Answer -Antimicrobial classes which meet both C1 and C2 are
termed critically important for human medicine.
Highly important: - Answer -Antimicrobial classes which meet either C1 or C2 are
termed highly important for human medicine.
Important: - Answer -Antimicrobial classes used in humans which meet neither C1 nor
C2 are termed important for human medicine.
WHO antibiotic prioritization: P1 - Answer -High absolute number of people, or high
proportion of use in patients with serious infections in health care settings affected by
bacterial diseases for which the antimicrobial class is the sole or one of few alternatives
to treat serious infection in humans
WHO antibiotic prioritization: P2 - Answer -High frequency of use of the antimicrobial
class for any indication in human medicine, or else high proportion of use in patients
with serious infections in health care settings, since use may favor selection of
resistance in both settings.
WHO antibiotic prioritization: P3 - Answer -The antimicrobial class is used to treat
infections in people for which there is evidence of transmission of resistant bacteria
(e.g., non-typhoidal Salmonella
and Campylobacter spp.) or resistance genes (high for E. coli and Enterococcus spp.)
from non-
human sources.
Highest priority: - Answer -Three out of three Prioritization Criteria (P1, P2, P3)
High priority: - Answer -Two out of three Prioritization Criteria
Critically important antimicrobials: - Answer -- Cephalosporins (3rd, 4th, 5th gen)
- Glycopeptides
, - Macrolides and ketolides
- Polymyxins
- Quinolones
Enzymatic degradation: Linearization - Answer -Cutting
Enzymatic degradation: Hydrolysis - Answer -β-lactamases
Enzymatic modification: Nucleotidylation - Answer -Additional of nucleotides
Enzymatic modification: Phosphorylation - Answer -Phosphate group addition
Enzymatic modification: Glycosylation - Answer -Attachment of a carbohydrate
Enzymatic modification: Acylation - Answer -Addition of the acyl (RCO-) group
Enzymatic modification: Hydroxylation - Answer -Addition of hydroxy (-OH) group
What was the unknown enzyme Chain and Abraham observed to have antibiotic
properties? - Answer -Penicillinase
_________________ are enzymes that hydrolyze β-lactam antibiotics. - Answer -β-
lactamases
Penicillinase (β-lactamases) - Answer -Is an enzyme that facilitates hydrolysis of beta-
lactams rendering them ineffective at killing bacteria
Currently there are over __________ β-lactamases identified. - Answer -1000!
__________ _________ _________ protect the β-lactam ring from β-lactamases. -
Answer -Bulky side groups
Penicillins :PenG --> Amox --> Ticarcillin --> Piperacillin
Cephalosporins: Cefalotin --> Cefuraxime --> Ceftazidime --> Cefepime
How many classes are there of β-lactamases? - Answer -4 (Class A-D)
- Serine β-lactamases
- Metallo-β-lactamases
- Cephalosporinases
- Oxacillinases
In what classes of β-lactamases is serine in the active site? - Answer -Class A, C, and
D
In what class of β-lactamases is metalloenzymes found? - Answer -Class B
(Check out lecture for slides 17-19) - Answer -
