Practice Test Geeks(SM) Specialist in Microbiology Practice Test
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SM Antimicrobial Resistance & Stewardship Flashcards

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  1. Which international surveillance network monitors global antimicrobial resistance trends in clinically important bacteria?

    Answer: GLASS (Global Antimicrobial Resistance and Use Surveillance System) by WHO

    WHO's GLASS is the primary global surveillance system for standardized AMR monitoring across countries, providing data to guide global health policy.

  2. Colistin resistance in Gram-negative bacteria has emerged globally via a plasmid-mediated gene. What is this gene called?

    Answer: mcr-1

    The mcr-1 gene (mobile colistin resistance) encodes a phosphoethanolamine transferase that modifies lipid A, reducing colistin binding and conferring transferable resistance.

  3. In the context of antibiotic stewardship, 'de-escalation' refers to:

    Answer: Narrowing antibiotic spectrum based on culture and susceptibility results

    De-escalation means transitioning from broad-spectrum empiric therapy to a narrower agent once culture results identify the pathogen and its susceptibilities.

  4. Which of the following beta-lactamase classes, per the Ambler classification, includes the metallo-beta-lactamases (MBLs)?

    Answer: Class B

    Ambler Class B beta-lactamases are metallo-enzymes that require zinc ions for catalysis and can hydrolyze carbapenems; they include NDM, VIM, and IMP enzymes.

  5. A specimen shows Pseudomonas aeruginosa resistant to all beta-lactams, fluoroquinolones, and aminoglycosides. This is classified as:

    Answer: Extensively drug-resistant (XDR)

    XDR is defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories, leaving only one or two categories potentially active.

  6. Which mechanism primarily accounts for high-level aminoglycoside resistance in Enterococcus faecalis?

    Answer: Aminoglycoside-modifying enzymes (AMEs) encoded by transferable genes

    High-level aminoglycoside resistance (HLAR) in enterococci is primarily mediated by aminoglycoside-modifying enzymes (acetyltransferases, nucleotidyltransferases, phosphotransferases) encoded on plasmids.

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