MCB4271 EXAM 3 STUDY GUIDE
Surveillance - Answer -Allows us to better understand and respond to AMR patterns
and key drivers, information about incidence, prevalence and trends
Purpose of surveillance - Answer -Determine the scope of the problem, formulate
effective responses to AMR, and monitor effectiveness of response to AMR
Conclusion about surveillance - Answer -There are many gaps in information on
pathogens of major concern, surveillance isn't coordinated or harmonized, many
common treatment options for bacterial infections are becoming ineffective, ABR has
negative impact on outcomes for affected patients and healthcare expenditures, high
levels of resistance have been observed in bacteria that cause common HA and CA
across all WHO regions
Surveillance models - Answer -We can use TB, malaria and HIV as models to
determine disease burdens and interventions
Assessment - Answer -Diagnostic tools that identify resistance mechanisms and
determine sensitivity to antibiotics
Global Antimicrobial Resistance Surveillance System (GLASS) - Answer -Goal is to
enable standardized, comparable and validated data on AMR to be collected, analyzed
and shared with countries in order to inform decision-making, drive local, national and
regional action, and provide evidence for action and advocacy
GLASS Objectives - Answer -Foster national surveillance systems and harmonized
global standards, estimate extent and burden of AMR globally by selected indicators,
analyze and report global data on AMR on a regular basis, detect emerging resistance
and international spread, inform implementation of targeted prevention and control
programs, and assess impacts of interventions
Surveillance Site - Answer -Collect basic demographic, clinical, epidemiological and
microbiological information from patients
National Reference Library - Answer -Promote good lab practices and support labs in
national surveillance system
National Coordinating Center - Answer -Establish and oversee national surveillance
program; gathers national AMR data and communicates with GLASS
GLASS Important Data - Answer -Priority pathogens- E. Coli, K. pneumoniae,
acinetobacter spp., S. aureus, S. pneumoniae, salmonella spp., shigella spp., Neisseria
gonorrhoeae
Specimen types- blood, urine, stool, genital swab
, Global Antimicrobial Resistance Surveillance System - Answer -WHO initiated it; early
implementation stage was 2016-2019 and the majority of countries are still not
registered and many don't report (funding and resources are limited)... surveillance can
even be difficult at the national level
Clinical and Laboratory Standards Institute - Answer -Formerly the National Committee
for Clinical Laboratory Standards and it is a international organization with over 60
countries that does test standardization and monitors test quality
Antibiotic Prescription Numbers - Answer -Out of the 40 Million people annually
prescribed antibiotics, 27 Million get antibiotics unnecessarily
Empirical Diagnosis - Answer -An educated guess that provides a non-specific
antibiotic with high potential for failure or resistance
Traditional diagnostics- take days, non-specific antibiotics, high resistance potential
Rapid diagnostics- immediate results, proper antibiotic, low potential for resistance
Diagnostics Goal - Answer -Determine if it is bacterial or viral, what type of bacteria if
applicable, what it is resistant to, what it is susceptible to; ultimately goal is to give
patients the best care and provide epidemiological data
Growth conditions - Answer -Different media types: basic, enriched, selective,
differential, anaerobic
Morphological Identification - Answer -Microscopy and staining (motility, gram stain)
Biochemical Testing - Answer -Coagulase, oxidase, urease
Antigen Detection - Answer -ELISA, IF, agglutination, EIA
Serological diagnosis - Answer -Antibody titer
Molecular Diagnostics - Answer -FISH, PCR, RT-PCR
Antibiotic Sensitivity Tests - Answer -Diffusion (Kirby-Bauer/disk diffusion, stokes),
dilution (MIC test), diffusion+dillution (E-test)
Kirby-Bauer - Answer -Antibiotic-containing paper disks with standardized quantity of
AB that generates concentration gradient of AB in agar
Stokes - Answer -Variation of KB but uses bacteria with known AB susceptibility as
control for unknown resistance of top and bottom bacteria
Dilution - Answer -MIC, determine minimum concentration of AB in agar to inhibit or kill
bacteria (solid or liquid media)
Surveillance - Answer -Allows us to better understand and respond to AMR patterns
and key drivers, information about incidence, prevalence and trends
Purpose of surveillance - Answer -Determine the scope of the problem, formulate
effective responses to AMR, and monitor effectiveness of response to AMR
Conclusion about surveillance - Answer -There are many gaps in information on
pathogens of major concern, surveillance isn't coordinated or harmonized, many
common treatment options for bacterial infections are becoming ineffective, ABR has
negative impact on outcomes for affected patients and healthcare expenditures, high
levels of resistance have been observed in bacteria that cause common HA and CA
across all WHO regions
Surveillance models - Answer -We can use TB, malaria and HIV as models to
determine disease burdens and interventions
Assessment - Answer -Diagnostic tools that identify resistance mechanisms and
determine sensitivity to antibiotics
Global Antimicrobial Resistance Surveillance System (GLASS) - Answer -Goal is to
enable standardized, comparable and validated data on AMR to be collected, analyzed
and shared with countries in order to inform decision-making, drive local, national and
regional action, and provide evidence for action and advocacy
GLASS Objectives - Answer -Foster national surveillance systems and harmonized
global standards, estimate extent and burden of AMR globally by selected indicators,
analyze and report global data on AMR on a regular basis, detect emerging resistance
and international spread, inform implementation of targeted prevention and control
programs, and assess impacts of interventions
Surveillance Site - Answer -Collect basic demographic, clinical, epidemiological and
microbiological information from patients
National Reference Library - Answer -Promote good lab practices and support labs in
national surveillance system
National Coordinating Center - Answer -Establish and oversee national surveillance
program; gathers national AMR data and communicates with GLASS
GLASS Important Data - Answer -Priority pathogens- E. Coli, K. pneumoniae,
acinetobacter spp., S. aureus, S. pneumoniae, salmonella spp., shigella spp., Neisseria
gonorrhoeae
Specimen types- blood, urine, stool, genital swab
, Global Antimicrobial Resistance Surveillance System - Answer -WHO initiated it; early
implementation stage was 2016-2019 and the majority of countries are still not
registered and many don't report (funding and resources are limited)... surveillance can
even be difficult at the national level
Clinical and Laboratory Standards Institute - Answer -Formerly the National Committee
for Clinical Laboratory Standards and it is a international organization with over 60
countries that does test standardization and monitors test quality
Antibiotic Prescription Numbers - Answer -Out of the 40 Million people annually
prescribed antibiotics, 27 Million get antibiotics unnecessarily
Empirical Diagnosis - Answer -An educated guess that provides a non-specific
antibiotic with high potential for failure or resistance
Traditional diagnostics- take days, non-specific antibiotics, high resistance potential
Rapid diagnostics- immediate results, proper antibiotic, low potential for resistance
Diagnostics Goal - Answer -Determine if it is bacterial or viral, what type of bacteria if
applicable, what it is resistant to, what it is susceptible to; ultimately goal is to give
patients the best care and provide epidemiological data
Growth conditions - Answer -Different media types: basic, enriched, selective,
differential, anaerobic
Morphological Identification - Answer -Microscopy and staining (motility, gram stain)
Biochemical Testing - Answer -Coagulase, oxidase, urease
Antigen Detection - Answer -ELISA, IF, agglutination, EIA
Serological diagnosis - Answer -Antibody titer
Molecular Diagnostics - Answer -FISH, PCR, RT-PCR
Antibiotic Sensitivity Tests - Answer -Diffusion (Kirby-Bauer/disk diffusion, stokes),
dilution (MIC test), diffusion+dillution (E-test)
Kirby-Bauer - Answer -Antibiotic-containing paper disks with standardized quantity of
AB that generates concentration gradient of AB in agar
Stokes - Answer -Variation of KB but uses bacteria with known AB susceptibility as
control for unknown resistance of top and bottom bacteria
Dilution - Answer -MIC, determine minimum concentration of AB in agar to inhibit or kill
bacteria (solid or liquid media)
