Bacterias e resistentia
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Questions and Answers

Qual del sequente bacteria pote presentar resistentia a vancomicina per alteration del sito de scopo?

  • Pseudomonas aeruginosa
  • Escherichia coli
  • Klebsiella pneumoniae
  • Enterococcus (correct)

Le antibioticos beta-lactamic agi per ligar se a qual typo de proteina?

  • Ribosomas
  • RNA polimerasa
  • Proteinas de ligação a penicilina (PBP) (correct)
  • DNA girasa

Qual es le rolo del proteinas de ligation a penicilina (PBP) in le cellula bacterian?

  • Synthetisar peptidoglycano pro le pariete cellular (correct)
  • Transportar nutrientes trans le membrana cellular
  • Regular le expression genetic del bacterio
  • Degradar toxinas presente in le citoplasma

Perque le penicillina G es principalmente administrate per via intramuscular o intravenose?

<p>Proque es rapidemente inactivate per le sucos gastric (B)</p> Signup and view all the answers

Qual del sequente organismos es le minus probabilemente sensibile a penicillina G?

<p>Escherichia coli (D)</p> Signup and view all the answers

Qual es un characteristic clave del bacteries multi-resistente (MDR)?

<p>Resistentia a al minus tres classes de antibioticos. (B)</p> Signup and view all the answers

Quales del sequente bacteries es associate specificamente con infectiones del tracto respiratori inferior?

<p>Legionella pneumophila e Mycoplasma. (C)</p> Signup and view all the answers

Qual del sequente bacteries es plus probabilemente associate con infectiones nosocomial?

<p>Pseudomonas aeruginosa. (B)</p> Signup and view all the answers

Qual del sequente es un exemplo de un bacterio gram-positive multi-resistente (MDR)?

<p>Staphylococcus aureus resistente a meticilina (MRSA). (D)</p> Signup and view all the answers

Qual es le definition de un chimiotherapeutic anti-infectiose?

<p>Un gruppo de medicamentos con toxicitate selective, capace de destruer o inhibir le multiplication de microorganismos patogene. (C)</p> Signup and view all the answers

Qual del sequente bacterios es le plus communmente associate con meningite?

<p>Streptococcus pneumoniae. (C)</p> Signup and view all the answers

Quelles bacteries usualmente causa infectiones in le abdomine?

<p>E.coli, Proteus, Klebsiella, Enterococcus, Bacteroides sp. (D)</p> Signup and view all the answers

Quelles del sequente mechanismos de resistentia es communmente associate con Enterobacteriaceae?

<p>Production de beta-lactamases de spectro extendite (ESBL/BLSE). (B)</p> Signup and view all the answers

Qual es le mechanismo de action commun de beta-lactamines?

<p>Ligar se e inhibir le enzimas que catalyza le ligamine in le synthese del perete cellular (D)</p> Signup and view all the answers

Qual affirmation describe le melior ration pro usar piperacilina in loco de ticarcilina?

<p>Piperacilina ha un activitate superior contra <em>Pseudomonas aeruginosa</em>. (C)</p> Signup and view all the answers

Qual es le rolo del usato de inhibitores de beta-lactamase in combination con penicillinas?

<p>Illos contrasta le resistentia bacterial mediate per le production de beta-lactamases. (B)</p> Signup and view all the answers

Quales inter le sequente combinationes de antibioticos e inhibitores de beta-lactamase es active contra Pseudomonas aeruginosa?

<p>Piperacilina-tazobactam (A)</p> Signup and view all the answers

Perque certe stirpes de Enterobacter, Citrobacter, Serratia, Morganella, e Pseudomonas es considerate exceptiones in le therapia con inhibitores de beta-lactamase?

<p>Illos expressa beta-lactamases que non es inhibite per inhibitores commun. (B)</p> Signup and view all the answers

Qual es le consequentia de inhibitor beta-lactamase combinate con penicillina super le cellula bacterial?

<p>Impede le attache de nove subunitates pro elongation de peptidoglycano. (C)</p> Signup and view all the answers

Qual gruppo de antibioticos include aztreonam?

<p>Monobactames (A)</p> Signup and view all the answers

Qual characteristic structural distingue carbapenemes de penicillinas e cephalosporinas?

<p>Le existentia de un atomo de carbonio reimplaciate con un atomo de sulfure in le anello. (B)</p> Signup and view all the answers

Qual es le implication clinic primari del allergia a penicillina G?

<p>Il indica un allergia possibile a altere beta-lactamines, ergo necessita un medication alternative. (B)</p> Signup and view all the answers

Qual gruppo de antibioticos es generalmente associate con colite pseudomembranose como un effecto adverse?

<p>Cephalosporinas (B)</p> Signup and view all the answers

Qual es un mechanismo commun per le qual bacterios deveni resistente a beta-lactamines?

<p>Secretion de beta-lactamases que rumpe le anello beta-lactame. (A)</p> Signup and view all the answers

Qual del sequente infectiones es frequentemente associate con SCN (Staphylococcus coagulase-negative) resistente a methicillina?

<p>Infectiones de catheter (A)</p> Signup and view all the answers

Certe antibioticos ha como scopo le subunitates ribosomic. Qual es le differentia inter le subunitates ribosomic de bacterios e cellulas eukaryotic?

<p>Bacterios ha subunitates plus parve (30S e 50S) que cellulas eukaryotic (40S e 60S). (D)</p> Signup and view all the answers

Considerante le information providite, qual antibiotico es plus appropriate pro le tractamento de infectiones causate per Pseudomonas aeruginosa?

<p>Ceftazidim (B)</p> Signup and view all the answers

Un patiente ha un infection sever e es allergic a penicillina. Qual del sequente antibioticos debe ser administrate con caution extreme a causa del potential pro reactivitate cruciate?

<p>Aztreonam (D)</p> Signup and view all the answers

Qual es le implication de BLSE (beta-lactamases a spectro extendite) essente codificate plasmidicamente e chromozomicamente?

<p>BLSEs pote esser facilemente transmittite inter bacterios, conducente a resistentia accelerate. (B)</p> Signup and view all the answers

Qual es le significantia clinic de nafcilina in le tractamento de infectiones del systema nervose central (SNC)?

<p>Es le agente de prime linea in meningites causate per <em>Staphylococcus aureus</em> sensibile a meticillina (MSSA) e in patientes con function renal compromittite. (D)</p> Signup and view all the answers

Quales inter le sequente organismos es typicamente sensibile a amoxicillina, rendente lo un option de tractamento appropriate pro certe infectiones?

<p><em>Haemophilus influenzae</em> (A)</p> Signup and view all the answers

Quando se considera penicillinas a spectro amplie, qual characteristica face carbenicillina e ticarcillina particularmente utile in contextos clinic?

<p>Lor activitate contra un spectro plus large de bacterios Gram-negative, incluse <em>Pseudomonas aeruginosa</em>. (B)</p> Signup and view all the answers

Qual es un consideration principal quando se usa ureidopenicillinas como piperacillina in le therapia antibiotic?

<p>Lor activitate a spectro amplie contra bacterios Gram-negative, incluse <em>Pseudomonas aeruginosa</em>, les face valorose in certe infectiones. (A)</p> Signup and view all the answers

Quales inter le sequente organismos es min probabilemente tractate con nafcilina?

<p><em>Escherichia coli</em> (B)</p> Signup and view all the answers

Un patiente es diagnosticate con pneumonia communitari. Basate in le information fornite, qual penicillina es plus appropriate pro le tractamento?

<p>Ampicillina (D)</p> Signup and view all the answers

Qual es le implication del resistentia a penicillase in relation a agentes como nafcilina, oxacilina, e cloxacilina?

<p>Illos es resistente al degradation per penicillases bacterial, permettente los de remaner efficace contra certe coci Gram-positive. (A)</p> Signup and view all the answers

Pro un patiente con function renal alterate qui require therapia antibiotic pro un infection de MSSA, qual agente es plus appropriate?

<p>Nafcilina (A)</p> Signup and view all the answers

Qual antibiotico es indicate specialmente pro tractar infectiones causate per bacterios BGN-MDR (multiresistente), incluso illos resistente a carbapenemes?

<p>Cefiderocol (D)</p> Signup and view all the answers

Qual characteristic distingue melior le ceftobiprol ab altere cephalosporinas?

<p>Su activitate forte contra MRSA e Str.pneumoniae penicillino-resistente. (D)</p> Signup and view all the answers

Pro qual conditiones clinic es le combination de ceftazidime-avibactam specificamente recommended?

<p>Infectiones concepientes tulpines BGN-MDR (multiresistente). (D)</p> Signup and view all the answers

Qual es le principal mechanismo de action de cefiderocol que lo differentia de altere antibioticos cephalosporinic?

<p>Utilisation del mechanismo de captation de ferro bacterial pro entrar in le cellula. (B)</p> Signup and view all the answers

In que situationes clinic es indicate le carbapenem meropenem?

<p>Infectiones mixte causate per CGP, BGN, e BGN non-fermentative. (A)</p> Signup and view all the answers

Qual es un avantatge specific del ceftobiprol in comparation con altere cephalosporinas in le contexto del resistentia bacterial?

<p>Es resistente a multiple beta-lactamases, meliorante su efficacia contra tulpines resistente. (B)</p> Signup and view all the answers

Qual es le ration principal pro le administration parenteral de carbapenemes como imipenem e meropenem?

<p>A assecurar concentrationes systemic adequate, specialmente in infectiones severe e in patientes granulocytopenic. (B)</p> Signup and view all the answers

Qual characteristic commun illo ha cephalosporinas nove como ceftobiprol e cefiderocol?

<p>Un spectro plus ample de activitate contra bacterios gram-positive e gram-negative, includente tulpines resistente. (B)</p> Signup and view all the answers

Flashcards

S. aureus

Un bacterio gram-positive que pote causar infectiones del pelle, pneumonia, e septicemia.

UTI

Infection del tracto urinari communmente causate per E. coli, Proteus, Klebsiella, e Enterococcus.

Infectiones Respiratori Inferior

Infectiones que occurre in le vias respiratori inferior, frequentemente causate per S. pneumoniae, H. influenzae, e K. pneumoniae

Pseudomonas aeruginosa

Un typo de bacterio gram-negative associate con infectiones nosocomial e meningitis.

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Bacterias Multi-Resistente (MDR)

Bacterias que ha devenite resistente a tres o plus classes de antibioticos.

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MRSA (SARM)

S. aureus resistente a methicillina, un causa commun de infectiones difficile a tractar.

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VRE

Enterococcus resistente a vancomycina, un altere bacterio difficile a tractar.

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Chemotherapeuticos anti-infectiose

Medicamentos que inhibi le crecimento o occide microorganismos pathogenic con toxicitate selective.

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Resistentia a Bacterias GP

Es relativemente rar, reportate in Enterococcus (VRE), Staphylococcus (VISA), Leuconostoc, Lactobacillus, Pediococcus, e Erysipelothrix.

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Mechanismo de action de antibioticos beta-lactamic

Illes age per ligar se a proteinas appellate penicillin-binding proteins (PBP), que es enzimas in le synthese del componentes del pariete cellular.

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Typos de Penicillinas natural

Inclue Benzyl, Penicillina G potassic, Penicillin V, e formas retardate como Procain e Benzatin penicillinas.

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Administration de Penicillina G

Es inactive per sucos gastric, assi illo es administrate per IM o IV. Peni V es minus susceptibile, ergo administrate oralmente.

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Spectro de Penicillina G

Streptococcus pneumoniae, Neisseria meningitidis, e certe germenes anaerobic (supra le diaphragma).

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Anaerobic Bacterias Gram-Positive

Anaerobic bacterias commun, include Clostridium e Bacteroides.

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Aerobic Bacterias Gram-Positive

Include Actinomyces, Streptococcus pyogenes, e altere streptococcos.

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Penicillinas Anti-Staphylococcal

Penicillinas resistente al penicillase, effective contra MSSA e streptococcos.

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Nafcilina

Usate pro infectiones del SNC (meningitis) causate per MSSA. Option in dysfunction renal.

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Aminopenicillinas

Ampicillina (IV, IM, O) e amoxicilina (O).

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Ampicillina usos

Ampicillina lucta pneumonias communitari e infectiones enterococic, saepe con aminoglycosides.

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Amoxicillina usos

Amoxicillina es usate in otitis medie, sinusitis, exacerbationes de bronchites chronic, e infectiones del tracto urinari.

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Ureidopenicillinas

Piperacillina e mezlocillina es usate pro un spectro plus large de bacterias, include Pseudomonas aeruginosa.

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Anaerobi

Un typo de bacteria que pote viver e crescer in absentia de oxygeno.

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Piperacillin

Un beta-lactamine con activitate anti-Pseudomonas, preferite al ticarcilina.

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Inhibitores del synthese del pariete cellular

Antibioticos que inhibi le synthese del pariete cellular bacteriophage.

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Beta-lactamines

Antibioticos que se liga e inhibi le enzimas que catalysa le ligation in le synthese del peptidoglycano.

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Cephalosporinas

Un classe de antibioticos beta-lactamine, exemplos include cephalexin e cefuroxim.

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Monobactami

Un classe de antibioticos beta-lactamine, exemplo es aztreonam.

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Carbapenemes

Un classe de antibioticos beta-lactamine, exemplo es imipenem.

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Inhibitores de beta-lactamases

Substantias que augmenta le activitate antibacterial de penicillinas quando le resistentia es causate per beta-lactamases.

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Cephalexin

Un cephalosporina de prime generation usate pro tractar infectiones del tracto urinari.

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Cefuroxim

Un cephalosporina usate pro tractar infectiones del tracto urinari e infectiones del tracto respiratori inferior.

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Ceftriaxona

Un cephalosporina de tertie generation usate pro tractar meningitis, infectiones articular, e infectiones del osso.

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Imipenem

Un carbapenem usate contra P. aeruginosa e altere bacillos Gram-negative.

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Modification del sito objectivo (PBP)

Sitios objectivo mutate que impedi le ligage del beta-lactamines, rendente le antibiotico inefficace.

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Inhibitores del Synthese Proteic

Antibioticos que inhibi le synthese de proteina bacterian ligate al subunitates ribosomic 30S e 50S.

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Ceftobiprol

Un nove cephalosporina a spectro large con activitate bactericida forte contra MRSA, SCN, Str.pneumoniae Penicilino-Rezistent, e BGN, inclusivamente Pseudomonas aeruginosa.

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Cefiderocol

Un antibiotic de ultime generation que age como un 'troiano molecular' pro superar le resistentia de BGN-MDR, inclusivemente P.aeruginosa, A.baumannii, e K.pneumoniae.

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Ceftazidime-Avibactam

Combination de ceftazidime con avibactam, usate contra infectiones con tulpini BGN-MDR como infectiones intrabdominal complicate, urinari e pneumonias nosocomial.

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Ceftolozan-Tazobactam

Combination de ceftolozano con tazobactam, un cephalosporina con inhibitor de beta-lactamase, active contra BGN-MDR.

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Spectro de Carbapenemes

Un del agentos antimicrobial con le spectro le plus large, efficace contra un varietate de bacterios, includente CGP, BGN e BGN non-fermentative.

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Bacterios sensibile a carbapenemes

Include Streptococcus spp. (inclusive Str.pneumoniae resistente a penicillina), S.aureus (MSSA), Neisseria spp. H.influenzae e Enterobacteriacee

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P. aeruginosa, S.maltophilia, Acinetobacter spp.

Bacterios gram-negative non-fermentative que pote esser tractate con carbapenemes.

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Study Notes

  • Chimiotherapia antimicrobian

Obiectivos de Curs

  • Familiarisar se con le definitions basic, incluse effectos bactericide e bacteriostatic
  • Comprender le spectro de activitate e le classes principal de antibioticos
  • Illos include le sito de action, spectro de activitate, e le reactiones adverse associate
  • Recognoscer le mechanismos de resistentia a antibioticos

Bacterias Gram-Positive Aerobic

  • Cocos include formationes de cluster associate con Staphylococcus
  • Cataenas de streptococos son un arrangiamento commun
  • Diplococos e formationes de catena se observa in S. pneumoniae e Enterococcus sp.

Bacterias Gram-Negative Aerobic

  • Cocos include Moraxella catarrhalis e Neisseria gonorrhoeae e N. meningitidis
  • Enterobacterales include Escherichia coli, Enterobacter sp., Citrobacter, Klebsiella sp. e Salmonella, Shigella e Yersina
  • Altere bacilos gram-negative aerobic es Acinetobacter, Pseudomonas aeruginosa e Helicobacter

Germines Anaerobic

  • Germines anaerobic supra le diaphragma include Deasupra diafragmului, Peptococcus sp., Peptostreptococcus sp., Prevotella, Veillonella, e Actinomyces
  • Germines anaerobic sub le diaphragmia include Clostridium perfringens, Cl. tetani, Cl. difficile, Bacteroides fragilis, e Fusobacterium

Altere Bacterias

  • Bacterias atypic include Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia pneumoniae, e Rickettsia
  • Spirochetes include Treponema pallidum (syphilis) e Borrelia burgdorferi (Lyme)

Bacterias per Sito de Infection

  • Cavitate oral include Peptococcus, Peptostreptococcus, e Actinomyces
  • Abdomen include E. coli, Proteus, Klebsiella, Enterococcus, e Bacteroides sp
  • Tracto respiratori inferior include S. pneumoniae, H. influenzae, K. pneumoniae, Legionella pneumophila e Mycoplasma, Chlamydia
  • Pelle e tissus subcutanee include S. aureus, Str. pyogenes, S. epidermidis e Pasteurella
  • Tracto urinar include E. coli, Proteus, Klebsiella, Enterococcus, e S. saprophyticus
  • Tracto respiratori inferior nosocomial include K. pneumoniae e Pseudomonas aeruginosa e Enterobacter sp.
  • Systema osteoarticular include S. aureus, S. epidermidis, Streptococos, e N. gonorrhoeae
  • Tracto respiratori superior include S. pneumoniae e H. influenzae e Moraxella catarrhalis e Str. pyogenes
  • Meningites include Streptococcus pneumoniae, Neisseria meningitides, Haemophilus influenzae e Streptococo de gruppo B e Escherichia coli e Listeria

Bacterias Multiresistente (MDR)

  • Bacterias Gram positiva resistenta a plus que tres classes de antibioticos include S. aureus resistente a meticillin (MRSA/SARM) e Enterococcus resistente a vancomycin (VRE)
  • Bacterias Gram negativa resistenta a plus que tres classes de antibioticos include Enterobacterias e non-fermentativos como P. aeruginosa e A. baumannii
  • Le Mechanismos de resistentia includerea beta-lactamases de spectro extense (ESBL/BLSE) e carbapenemases
  • Altere bacterias multiresistente include M. tuberculosis

Chemotherapicas Anti-Infectionose

  • Es un gruppo de medicamentos que ha toxicitate selective pro destruer o inhiber le multiplication de microorganismos pathogenic
  • Initialmente derivate de fontes natural como ascomicetes (Penicillium), actinomicetos (Streptomyces), e le genere Bacillus
  • Illos son etiam producite per synthese

Chemotherapicas Antimicrobie

  • Antibacterial
  • Antiviral
  • Antifungic
  • Antiprotozoa

Principios de Chimotherapia Anti-Infectionose

  • Toxicitate selective usa differentias in structura e metabolismo inter agentes pathogenic e cellulas hospite
  • Attinger le concentration inhibitori al sito de infection es crucial pro efficacia
  • Penetration e ligatura a scopo, evitante inactivation e elimination, es un principio importante

Spectro de Activitate

  • Se le spectro natural refere se a tote le species bacteria que son sensibile a un chimotherapeutic al tempore de su introduction
  • Valor practic per clinicos include iniciation de therapia empiric
  • Valor practic pro bacteriologos include le preparation de medios selective con antibioticos, que es utile por isolar species microbiotic in culturas pur

Lista Nigre

  • Le listas son elaborate mediante le monitorisation stricte de sensibilitate al chimotherapia anti-infectionosa de tote le spissas isolate in hospitales pro 4-6 annos.
  • Antibioticos a quales le spissas es resistente se remove del uso pro un periodo prolongate, durante quale tempo le spissas recuperea su sensibilitate.

Classification Chimotherapeutic Antibacterial: Secundo Origine

  • Antibioticos es productos natural de fungos, actinomicetos, e bacterias que occide o inhiber crecimento microbial, como penicillinas, cephalosporinas, tetracyclina, etc.
  • Compositos synthetic, como trimethoprim, es un altere classe

Classification Chimotherapeutic Antibacterial: Secundo Action Bactericide/Bacteriostatic

  • Bactericidas occide le microorganismos, bacteristaticos stoppar le multiplication bacterial.
  • Un defensa anti-infectiose es plus effective que un population static. (Minus effective al hospites immunocompromettite.)
  • Alcun agentes, p.ex., chloramphenicol, pote esser bactericide pro alcun species (p.ex., H. influenzae) sed solmente bacteristatic pro alteres (p.ex., E. coli).

Mecanismos de Action Antibacterial

  • Synthesis de pariete cellular (absente in cellulas eucariote) es un sito selective, le bacterios perde integritate structura
  • Synthesis de proteina (ribosomas) es un altere scopo pro toxicitate selective; le bacteria non pote crescer o division sin synthese de proteina
  • Synthesis de acidos nucleic blocca processo essential pro superviventia and multiplication
  • Le altere scopi es interferer con membrana cytoplasmic y metabolisma

Structura Chemica Bacterial

  • Structura functional e morphological de bacterias es le cellula procariota que es auto-organisate e interage con su ambiente pro mantener functiones vital.

Syntese de Pariete Cellular

  • Cycloserine, isoniazid, e ethionamide son chemotherapia que functiona inter tanto con le synthese de pete celular

Cycloserine, Isoniazid, Ethionamide

  • Agent es usate in le tractamento de TBC
  • Ethionamida (Nizotin) ha un effecto tuberculostatic e es usate por TBC resistente
  • Reactiones adverse include reactiones allergic, hypoglycemica e hepato e neurotoxicitate

Bacitracina

  • Es un antibiotico polypeptidic usate local pro infectiones cutanee a causa su toxicitate
  • Illo functiona plus effectivemente contra BGP
  • Su mechanismo include: Prohibir le synthese PP, inhibir enzymaticamente e alteration de CM.

Inhibitores de Synthese de Pariete Cellular

  • Glicopeptidos liga se con restos terminal de D-ala-d-ala, prevener le incorporation de sumunitates in le processo de extension de peptidoglican

Glicopeptidos-Vancomycina

  • Vancomycina functiona sur bacterios GP, durante que es inactinive sur Gram negative
  • Llo es obtenite de natura de ressource (actinomycetes) un complex glycpeptidico intertanto con syndese PC intra GP.

Activitate de Glycopeptidos

  • Es polares massive. Se administra iv in un senso general
  • Es actos in le inclussive sur MRSA
  • Per via oral, le vancomycina es a causa de inflammation del C difficile.
  • Un effecto secundario possibile es nephrotoxicitate

Glicopeptidos: Vancomycina

  • Es un antibiotico de reserve in ille administrationes del inflammations:
    • MRSA
    • C difficile,
    • Antibacterii GP es resistente a ẞ-lactamines.
  • Vancomicinas resistente altera le sede de objective.

Antibioticos Beta-Lactamicos

  • Illo agi per connexiones a proteinas nominave connexiones de penicillin (PBPs)
  • Bacterios pote haber varies PBPs.
  • Spissas de action active necessita le connectiones de antibiotic al PBP.

Penicillins Natural

  • include Bezyl, Penicillin, Procain. Su spectro ha Gram positivas, Gram negavita e germine anaerobic
  • Gram negativa ha le include de Neisseria meningitide, Neissewria gonwrrhoeae!!!
  • Per germines ha le include de Clostridium

Penicillinas Resistente a Penicilinase

  • Includes Nafcilina, oxacilina
  • Gram positiva Coci potiva include S. aureus e Streptococcus pneumoniae.

Aminopenicillina

  • Ampicilina es usate in inflammation de pneummonias comunitate et infecstion enterococs
  • Su Gram negativas includere E. coli e Proteus

Penicillinas com amplo spectro: Carboxypenicillina:carbencillina, ticarcillina

  • Gram negativa includer Proteus mirabilis et Salmonella

Inhibiteres de Beta-Lactamases

  • augmenta antibiotics de antibacterial le active ex penicillins, si le resulto es un production de beta-lactamases
  • Inhibitores includee Streptococcus

Cefalosporines

  • Cefalosporines es un classification de agento antibacterial que es de genere es dividie in gruppo

Ceffalosporine Nove

  • Cefftobiprolul il have un amplio spectro pro activitates por MRSA et pneumonia et P se aequginosa non BLSE
  • Le Sederocolo ha por scopos de BNG MDR.

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Explora le mundo del bacterios e lor resistentia al antibioticos. Discopre le mecanismos que illes usa pro eluder le effectos del drogas e le consequentias pro le salute human. Examina le rolo del antibioticos beta-lactamic e le importantia del proteinas de ligation a penicilina (PBP).

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