Antibiotics
A scientist’s vacation led to the discovery of this antibiotic.
This antibiotic is _________
PENICILLIN
Sir Alexander Flemming realized that he had forgotten to place a petri dish in an incubator. As a result, an unusual mold was growing there. It was first used on a policeman who’d contracted a life-threatening infection after being scratched by a rosebush in his garden. The first human subject to use antibiotics!!
You can contribute to your hospital's antimicrobial stewardship efforts by...
a) sending samples for microbiology testing every time an infection is suspected
b) reporting Hospital-Acquired Infection cases to the Infection Control Committee promptly
c) prescribing antibiotics as per the antibiotic policy of the hospital
d) All of the above
d) all of the above
A municipality worker has been asked by the APSI-India team to assist them in collecting sewage water samples from an area in the city. What kind of surveillance is being conducted?
a. Environmental Surveillance
b. Syndromic Surveillance
c. Clinical Surveillance
d. Ad-hoc Surveillance
a. Environmental Surveillance
One Health is a collaborative, multisectoral, and transdisciplinary approach that recognizes the interconnection between people, animals, plants, and their shared environment. One Health inspired environmental surveillance is the preferred tool to monitor human-adjacent environments for known and yet-to-be-discovered superbugs.
The absolute indication for using soap and water for hand hygiene is
a) When touching the personal belongings of the patient
b) When you have to examine the patient
c) When giving care to a patient with diarrhoea
d) When you leave the patient’s room
c) When giving care to a patient with diarrhoea
Stool is a common body excretory product that harbors parasitic agents and its products like eggs, ova, cysts that are resistant to alcoholic agents like isopropyl alcohol; chlorhexidine which are the contents in hand rubs. These are destroyed only by the saponification action of soap.
A 19Y/M came to your OPD with a fever due to sore throat. When is it correct to prescribe antibiotics?
Try to avoid prescribing Antibiotics as pharyngitis is most commonly caused by viruses and viruses are not killed by antibiotics.
It is advised to prescribe antibiotics after 5 days of unresolved fever.
Other auxiliary answers may include any symptomatic management of the case.
Which was the first commercially available antibacterial?
a) Prontocil
b) Penicillin
c) Amoxicillin
d) Clindamycin
a) Prontocil
The first commercially available antibacterial was Prontosil, a sulfonamide developed by the German biochemist Gerhard Domagk in the 1930s
Penicillin is the first mass-produced antibiotic. and was introduced on a large scale as a treatment for bacterial infections in 1945 more than a decade from its first discovery in 1928. This was possible through the work of Florey and Chain who managed to efficiently purify the antibiotic and scale-up production. The introduction of penicillin marked the beginning of the so-called “golden era” of antibiotics
During Antimicrobial Susceptibility Testing, what type of culturing technique is preferred?
Lawn Culture is the most commonly used culture technique for antimicrobial sensitivity testing studies by microbiologists.
Environmental Surveillance can help identify superbug patterns in a region. What makes a pathogen a superbug?
a) More contagious
b) More virulent
c) Resistance to multiple antimicrobials
d) All of the above
c) Resistance to multiple antimicrobials
For example, Neisseria gonorrheae is a superbug because it has developed high-level resistance to the current recommended treatment for gonorrhea (ceftriaxone and azithromycin) as well as antibiotics such as penicillin, sulphonamides, tetracycline, fluoroquinolones and macrolides.
During doffing which PPE is considered most contaminated and during donning which PPE is considered the most sterile.
a) Gloves; Gloves
b) Gloves; mask
c) Gown; glove
d) Mask; face shield
a) Gloves; Gloves
During donning i.e. the wearing of sterile PPE, the most sterile part is glove that is worn at the LAST and doffing the removal procedure, most dirty PPE is removed FIRST i.e. the glove after completion of the procedure.
A 20Y/F came to the ENT OP with an ear ache and discharge.
What is your course of action for antibiotics administration?
Start with a broad spectrum initially. Send discharge for microbiological culture and sensitivity testing following which choose the apt empirical treatment.
(Give pain meds to relieve pain)
What is the first antibiotic discovered?
a) Penicillin
b) Macrolides
c) Arsphenamine
d) Sulfonamides
c) Arsphenamine
In 1909, Paul Ehrlich discovered that a chemical called arsphenamine (or salvarsan) was an effective treatment for syphilis.
Which pathogen is NOT a superbug yet-
a) Bordetella pertussis
b) Acinetobacter baumanii
c) Candida albicans
d) Clostridium botulinum
e) None of the above
e) None of the above
Superbug is a microbe resistant to multiple antibiotics. All four pathogens, Bordetella pertussis, Acinetobacter baumanii, Candida albicans, and Clostridium botulinum, are known to show resistance to multiple antibiotics. This underlines the urgency of the issue of AMR as almost all the pathogens are showing patterns of some form of resistance.
Public health surveillance is crucial to inform action to prevent disease and infections. Which of the following are surveillance activities?
a. Collection and analysis of data once yearly
b. Periodic collection and analysis of data
c. The ongoing, systematic collection and analysis of data
d. Timely dissemination of these data to those responsible for prevention and control
e. Storing data on behalf of public health institutions
f. Help support the evaluation of public health strategies
c. The ongoing, systematic collection and analysis of data
d. Timely dissemination of these data to those responsible for prevention and control
f. Help support the evaluation of public health strategies
These microbes are known to be seen in hanging mask syndrome except:
a) Staphylococcus
b) Roseomonas
c) Bacillus
d) Mycoplasma
d) Mycoplasma
Hanging mask syndrome is caused when masks are left dangling tied around the neck. The inner layer of the generally used triply surgical mask usually gets contaminated with these bugs
A JR prescribed a broad-spectrum antibiotic to an HIV-TB coinfected patient. A few weeks later he developed a white patch over his tongue and Pneumocystis jirovercii infection.
Why did the patient develop these infections?
The white patch over the tongue is called oral thrush or moniliasis.
P. jirovercii and candidiasis are called opportunistic infections.
This occurs due to indiscriminate use of antibiotics by the patient.
An apparent sequale of AMR!!
Which of the following is a possible side effect of antibiotics?
a) Yeast infection
b) A severe diarrheal infection called C. difficile infection
c) Allergic reaction
d) All of the above
The correct answer is (d), all of the above.
Common side effects of antibiotics can include rash, dizziness, nausea, diarrhoea, and yeast infections. More serious side effects include Clostridioides difficile infection (also called C. difficile), which causes diarrhoea that can lead to severe colon damage and death. People can also have severe and life-threatening allergic reactions to antibiotics.
What would you do as a clinician if blood culture results were negative and an ongoing infection was not suspected?
(a)Discontinue antibiotics after 48 hours
(b)Switch to narrow-spectrum antibiotics
(c)Taper doses of antibiotics
(d)Continue the same treatment till the full dose is completed
(a) Discontinue antibiotics after 48 hours
What is genomic surveillance?
A) Monitoring genetic changes linked to the origins or characteristics of a disease over time.
B) The study of genomic sequences to identify the geographical origin of an infectious disease.
C) The use of genomic data to track the personal health history and genetic predispositions of individual patients.
D) The process of sequencing DNA from environmental samples to identify new species.
A) Monitoring genetic changes linked to the origins or characteristics of a disease over time.
Genomic surveillance involves monitoring pathogens and identifying changes linked to the origins or characteristics of a disease. Genomic sequencing is the technique used to sequence the genetic material found in an organism or pathogen.
The air surveillance indications of the CDC include the following Non-microbiological parameters except:
a) Air parameters like velocity, direction, air handling etc
b) Negative pressure in OT
c) Temperature in orthopaedic theatres between 16-20 *C
d) Humidity
b) Negative pressure in OT
There must be a POSTIVE pressure maintained of atleast 22.5 Pa to prevent air entry from outside. A negative pressure sucks air inside the OT, thus breaking the sterility of the theatre.
You are a microbiologist at a tertiary care unit and you are required to culture and check the specimen for sensitivity. Which biosafety cabinet will you use?
Usage of BSC Class 2A.
Early antibiotic exposure is associated with an increased risk of chronic diseases later in life, except
a) allergy
b) atopic dermatitis
c) coeliac disease
d) diabetes
e) obesity
f) heart disease
f) heart disease
Studies show that early antibiotic exposure is associated with an increased risk of chronic diseases later in life, such as allergy, atopic dermatitis, coeliac disease, diabetes, and obesity.
But, studies also show that long-term exposure to antibiotics is associated with heart disease.
Which of the following factors is NOT considered when selecting the right antibiotic for a patient?
a) Serum Albumin
b) Allergies
c) Renal function
d) Liver function
e) Local resistance patterns to antimicrobials
f) Site of infection
g) None of the above
The correct answer is g) None of the above
Patient-specific factors, such as age, allergies, renal function - that includes serum albumin, liver function, site of infection, and local resistance patterns, need to be considered before prescribing an antibiotic!!
According to recent studies, what were the leading causes of death in 2019 in increasing order?
a) HIV<Diabetes<AMR<Heart disease
b) AMR<HIV<Diabetes<Heart disease
c) HIV<AMR<Diabetes<Heart disease
d) HIV<Diabetes<Heart disease<AMR
a) HIV<Diabetes<AMR<Heart disease
Global data show that in 2019, AMR killed more people than HIV and malaria combined (GRAM study 2019)
Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis of AMR
Stroke and heart disease were the only two conditions that killed more people globally than AMR that year.
Spill management includes the following steps. Arrange in order
A. Confine the spill and wipe with an absorbent cloth
B. Mark the spill area
C. Allow to soak in disinfectant
D. Rinse with clean water
E. Clean with 5% hypochlorite solution
CDC recommends use of 1:10 dilution of 5% hypochlorite solution for large spills >10cm and 1:100 for small spills of <10cm with a minimum contact time of 10 mins.
Follow 10,10,10 rule: 10 parts dilution for 10cm spill with 10 mins contact time.
A 2yrs/ M infant from an impoverished locality came to the Paeds OPD with complaints of noisy breathing and breathlessness. After assessing the situation you admit the infant to the PICU and you ask your resident to start on an empirical treatment regimen awaiting the Culture and sensitivity reports. What process is followed for empirical treatment?
1. Suspect the most possible cause based on symptoms
2. Refer to the hospital antibiogram for the most effective antibiotic
3. Work out the pediatric dosage based on the weight
The hospital antibiogram is a locally collected resource compiling the susceptibility of various antibiotics over a period of time and it aids in deciding the correct drug for empirical treatment ONLY.
The drug with relatively high susceptibility rates must be chosen over other drugs for empirical treatment.
K.pneumoniae is the most common agent causing pneumonia in infants till age of 4 yrs (can confirm diagnosis without lab workup in peripheral centres as per IMNCI guidelines).