Antimicrobial Stewardship

Question 1

Antimicrobial resistance (AMR) is resistance of a microorganism to ____________ to which it was ____________ ____________

Answer 1

an antimicrobial agent

previously sensitive

Question 2

The term _________________ is a subset of AMR, as it applies only to ________ becoming resistant to antibiotics

Can be intrinsic or acquired

Answer 2

antibiotic resistance

bacteria

Question 3

Resistance to antimicrobials is a natural biological phenomenon that can be amplified by a variety of factors such as??

Answer 3

Selection pressure

Question 4

Bacteria double their population every __________ and this rate of division comes with ______ which gets _________ very fast

Therefore, in a colony of organisms there will be some ________ and these will have characteristics different from the mother cell
These characteristics could be, among others, in the form of changes in ______________________

Answer 4

20mins ; error ; replicated

variants

receptors to antibiotics

Question 5

For example, if the variation results in a change to a receptor to which an antibiotic binds, then this variant strain will be at an advantage and survive in the presence of the antibiotic while normal sensitive strains will die; what we call antibiotic ____________________

Answer 5

selection pressure

Question 6

This selection pressure is caused by ?????

Answer 6

sustained use of an antibiotic

Question 7

Bacteria will be killed rather than adapt

T/F

Answer 7

F

Bacteria will adapt rather than be killed
when anti-microbials are used incorrectly.

Question 8

when anti-microbials are used incorrectly:

for _______ a time
at _______ a dose
at inadequate _____
for the ________ disease

The microbes which adapt and survive carry genes for resistance, which can be passed on

Answer 8

too short

too low

potency

wrong

Question 9

underuse through lack of access, inadequate dosing, poor adherence, and substandard anti-microbials does not play as important a role as overuse

T/F

Answer 9

F

Paradoxically, underuse through lack of access, inadequate dosing, poor adherence, and substandard anti-microbials may play as important a role as overuse

Question 10

AMR
• Bacteria are particularly efficient at enhancing the effects of resistance,
• because of their ability to ________________ but also coz they can _____________________ to other
related bacteria through “_________”,
which are passed on when the bacteria replicate.

Answer 10

multiply very rapidly

transfer their resistance genes

conjugation

Question 11

__________ are a critical component of
the antimicrobial resistance problem worldwide

Answer 11

Hospitals

Question 12

_____________ are also the eventual site of treatment for many patients with severe infections due to resistant pathogens acquired in the community

Answer 12

Hospitals

Question 13

Cross-infection result in transmission of ___________ pathogens to highly susceptible patients.

Answer 13

resistant hospital

Question 14

AMR …
• The combination of
• __________________ patients
• ________ and ________ antimicrobial use
• and ________

• results in nosocomial infections with highly resistant bacterial pathogens
•

Answer 14

highly susceptible

intensive ; prolonged

cross-infection

Question 15

Why IPC is important for AMS

_________ Transmission of Resistant organisms
Reduces ________ For Antibiotic Use
Reduces ___________

Answer 15

Interrupts

Need

Selection Pressure

Question 16

Decreasing antimicrobial resistance requires

antimicrobial ____________ + _________________ efforts.

Answer 16

antimicrobial stewardship

infection prevention efforts.

Question 17

_____________________ (ASP) reduce antimicrobial resistance by optimizing antimicrobial therapy.

Answer 17

Antimicrobial Stewardship Programs

Question 18

Solving resistance problems

DETERMINANTS of resistance
Antibiotic ________ /________
Occurrence of ________ genes
Degree of ________ with resistance strains
Environmental ________

Globally, antibiotic resistance is a problem

Answer 18

overuse/misuse

resistance ; cross-infection

Environmental reservoirs

Question 19

Solving resistance problems

Concerted effort
___________ of resistance
Monitoring antibiotic ___________ rates
Antibiotic _________/Antibiotic _______ Preventing __________
___________ environmental reservoirs
ANTIMICROBIAL STEWARDSHIP

Answer 19

Concerted effort
Surveillance of resistance
Monitoring antibiotic consumption rates Antibiotic guidelines/Antibiotic policies Preventing cross-infections
Eliminating environmental reservoirs
ANTIMICROBIAL STEWARDSHIP

Question 20

Stewardship strategies

•Supplemental strategies

___________
Guidelines and clinical pathways Antimicrobial ________-
___________ or ___________
______ optimization
___________ switch
Antimicrobial _______

Answer 20

Education; order forms

Streamlining ; de-escalation

Dose

IV-to-PO

cycling

Question 21

Need to monitor effectiveness of
interventions
Monitor _______ in resistance
Monitor _______ of antibiotic consumption
____________________ (Global-PPS)
__________

Answer 21

trends ; rates

Point prevalence surveys

Audits

Question 22

Point prevalence surveys (Global-PPS),
particularly the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance, are a standardized method for ___________ and __________ antimicrobial _________ and ___________ in hospitals and healthcare centers worldwide.

They provide a tool to assess antimicrobial prescribing practices, identify areas for improvement, and evaluate the effectiveness of interventions.

Answer 22

measuring

monitoring

prescribing

resistance