Drug Penetration and Efflux in Gram-Negative Organisms
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Questions and Answers

What is the major difference between cephalosporins and penicillins in terms of susceptibility?

  • Penicillins are generally more resistant to beta-lactamase destruction.
  • Cephalosporins are generally more resistant to beta-lactamase destruction. (correct)
  • Penicillins are generally more susceptible to beta-lactamase destruction.
  • Cephalosporins are generally more susceptible to beta-lactamase destruction.

How do beta-lactam antimicrobials impair the development of bacterial cell walls?

  • By inhibiting the autolysins responsible for cleaving cell wall lattices.
  • By interfering with transpeptidase enzymes responsible for the formation of cross-links between peptidoglycan strands. (correct)
  • By mimicking the structure of peptidoglycan strands in the bacterial cell wall.
  • By enhancing the synthesis of new strands of bacterial cell walls.

What are the penicillin-binding proteins (PBPs) associated with in bacteria?

  • Development of bacterial cell wall lattices.
  • Formation of cross-links between peptidoglycan strands. (correct)
  • Synthesis of new strands of bacterial cell walls.
  • Formation of bacterial cell wall autolysins.

What balances bacterial growth by continually cleaving cell wall lattices during cell wall synthesis?

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

How do gram-negative beta-lactamases primarily act?

<p>By hydrolysis of the amide bond in the 4-member beta-lactam ring (B)</p> Signup and view all the answers

Which bacterial species is NOT mentioned as capable of resistance due to beta-lactamase production?

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

What is the impact of beta-lactamase protectors such as clavulanic acid on the treatment of gram-negative organisms?

<p>It may not be as positive for treatment compared to gram-positive organisms (C)</p> Signup and view all the answers

What leads to a sizable increase in resistance to beta-lactam antimicrobials?

<p>Decrease in affinity of crucial PBP due to acquired gene mutations (A)</p> Signup and view all the answers

In which environment can L-forms, a phenotypic form of resistance, survive?

<p>A hyperosmotic environment like the renal medulla (B)</p> Signup and view all the answers

What results in resistance to all beta-lactam drugs, including carbapenems and most generations of cephalosporins in Staphylococcus spp?

<p>Acquisition of the mec gene resulting in a mutation in PBP-2 (C)</p> Signup and view all the answers

What is the most important mechanism of bacterial resistance to beta-lactam antimicrobials?

<p>Enzymatic inactivation by beta-lactamases (D)</p> Signup and view all the answers

What do porins in gram-negative organisms do in relation to drugs?

<p>Effectively remove drugs after penetration of the lipopolysaccharide covering (D)</p> Signup and view all the answers

What do second- and third-generation cephalosporins reflect in their modifications?

<p>Larger R groups minimizing beta-lactamase access (B)</p> Signup and view all the answers

Which antimicrobials are not subject to extended-spectrum beta-lactamases (ESBLs)?

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

What do newer beta-lactamases emerging reflect, in part?

<p>Continued manipulation of the drugs in an attempt to circumvent bacterial beta-lactamase production (D)</p> Signup and view all the answers

What renders cephalosporins resistant to penicillinases?

<p>Addition of larger R groups on the beta-lactam structure (C)</p> Signup and view all the answers

What do inhibitors of beta-lactamases such as clavulanic acid and sulbactam aim to do?

<p>Minimize penicillin destruction (C)</p> Signup and view all the answers

What are some gram-positive beta-lactamases unable to initiate?

<p>Self-transmission (B)</p> Signup and view all the answers

In which bacterial species are gram-positive beta-lactamases generally excreted into the external environment as exoenzymes?

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

What is the main resistance mechanism for Staphylococcal strains?

<p>Altered PBP targets (B)</p> Signup and view all the answers

What is a common difference between gram-negative and gram-positive bacteria in terms of beta-lactamase production?

<p>Plasmid-mediated production (A)</p> Signup and view all the answers

What is one of the characteristics of gram-positive beta-lactamases related to their self-transmission?

<p>Inducible production (C)</p> Signup and view all the answers

At subinhibitory concentrations, what effects do beta-lactam antimicrobials have on bacterial structure and function?

<p>They promote host-mediated cell death (A)</p> Signup and view all the answers

In the context of beta-lactam antimicrobials, what is the significance of the log phase of bacterial growth?

<p>Susceptible organisms must be actively multiplying or growing (C)</p> Signup and view all the answers

What is a contributing factor to the development of resistance to beta-lactam antimicrobials?

<p>Increased expression of efflux pumps (D)</p> Signup and view all the answers

Which type of organisms are susceptible to the action of beta-lactam antimicrobials?

<p>Organisms that have cell walls (A)</p> Signup and view all the answers

In the context of gram-negative bacteria, what hinders access to the cytoplasmic membrane?

<p>Capsular materials (C)</p> Signup and view all the answers

Which bacteria present a greater obstacle to beta-lactam antimicrobials due to their outer membranes?

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

What is a characteristic feature of beta-lactam antimicrobials' activity in a slightly acidic environment?

<p>Increased membrane penetration (A)</p> Signup and view all the answers

What is the primary factor related to the efficacy of beta-lactam antimicrobials?

<p>Time that plasma or tissue drug concentrations exceed the MIC (D)</p> Signup and view all the answers

What is a common mechanism of antimicrobial resistance to beta-lactam antimicrobials in bacteria?

<p>Downregulation of porins (B)</p> Signup and view all the answers

What is a characteristic feature of carbapenems in relation to time-dependent antimicrobials?

<p>Concentrations should remain above the MIC for approximately 25% of the dosing interval (B)</p> Signup and view all the answers

What type of bacteria have a restricting sieving mechanism (porins) in their outer membranes?

<p>Gram-negative bacteria (D)</p> Signup and view all the answers

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