Course Outline
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- Introduction
- Methicillin-Resistant Staphylococcus aureus
- Vancomycin-Resistant Enterococci
- Clostridioides difficile
- Carbapenem-resistant Enterobacterales
- MRSA is only a problem for patients who are hospitalized.
- Staphylococcus aureus
- Staphylococcus aureus
- S. aureus Virulence Factors
- The pathogenicity of S. aureus, as well as the frequency with which this organism produces infections, can be attributed to:
- Clinical significance of S. aureus
- Beta-lactam antibiotics and S. aureus
- Which of these describes the mode of action of the beta-lactam class of antibiotics?
- Beta-lactam antibiotics interfere with cell wall synthesis by:
- MRSA
- Beta-lactams and Methicillin-Resistant Staphylococcus aureus
- Healthcare (Hospital)-Associated MRSA (HA-MRSA) versus Community-Associated MRSA (CA-MRSA)
- Risk Factors
- The increased resistance of MRSA strains to beta-lactam antibiotics is due to production of which of the following penicillin binding proteins (PBPs)?
- Which are true statements regarding HA-MRSA and CA-MRSA?
- Laboratory Diagnosis of MRSA
- Laboratory Identification of S. aureus
- Screening Cultures for MRSA
- Assume you perform microbiology for an institution submitting surveillance cultures for MRSA. Which isolate should receive further workup to rule out ...
- Susceptibility Testing of Isolates
- Susceptibility Testing
- Selection of Drugs for Testing
- Interpretation of Oxacillin Broth Dilution Tests
- Interpretation of Oxacillin and Cefoxitin Disk Diffusion Tests
- Detection of Oxacillin Resistance
- Which of the following scenarios represents appropriate detection of MRSA by the Kirby Bauer method?
- A laboratory performs MIC tests, in addition to Kirby Bauer, and a PBP 2a assay on blood culture isolates. Which of the following isolates should be r...
- MRSA Treatment/Vancomycin Resistance in S. aureus
- Testing for Vancomycin Susceptibility
- Testing for Vancomycin Susceptibility
- A laboratory's primary susceptibility testing method is disk diffusion. The cefoxitin disc has a zone size of 19 mm and the vancomycin disc has a zone...
- Future Perspectives: MRSA
- Future Perspectives
- Future Perspectives, continued
- Future Perspectives, continued
- Moving forward, important strategies for dealing with MRSA strains will include which of the following?
- Enterococcus
- Enterococci
- Risk Factors and Resistance
- Enterococci can possess both intrinsic and acquired resistance. Which of the following represents the intrinsic resistance of a typical enterococcal s...
- Vancomycin-resistant Enterococci
- Laboratory Diagnosis of VRE
- Treatment of Resistant Enterococci
- Clostridium Species
- Clostridioides difficile
- Laboratory Diagnosis of CDAD
- Laboratory Detection of C. difficile
- Stool Culture
- Cell Cytotoxicity Neutralization Assay (CCNA)
- Enzyme Immunoassay Methods
- Various methods have been employed for detection of C. difficile disease: cultivation of the organism, cell cytotoxin neutralization assays, and enzym...
- Glutamate Dehydrogenase (GDH) Antigen Assays
- Molecular Methods
- Which of the following approaches for diagnostic testing have been indicated by recent literature?
- Treatment of C. difficile Infection
- Future perspectives
- Future Perspectives: CDI/CDAD
- Carbapenem-resistant Enterobacterales
- Enterobacterales and Spectrum of Disease
- CRE Defined and Risk Factors
- Mechanisms of Resistance
- Carbapenemase-producing Enterobacterales
- What carbapenemase is produced most commonly by CRE encountered in the United States?
- Laboratory Diagnosis of CRE
- Detection, Identification, and Susceptibility Testing of CRE
- Summary: CRE Versus CP-CRE
- When using current antimicrobial susceptibility testing (AST) breakpoints, it is recommended by CLSI that laboratories should also routinely implement...
- Treatment and Control of CRE
- Future Perspective: CRE
- References
Additional Information
Level of instruction: Intermediate
Intended audience: Medical laboratory scientists, medical technologists, and technicians, This course is also appropriate for clinical laboratory science students and pathology residents.
Author information: Carolyn M. Law, PhD, MT(AMT) is the CEO of Celtic Labs Diagnostic Microbiology Services in Trinidad. She holds a PhD in Microbiology from National University of Ireland, Maynooth.
Author information: Catherine Dragoni, MT(ASCP)SM received her BS degree in medical technology from the State University of New York, Upstate Medical Center, Syracuse. She began her career as a bench microbiologist at Maine Medical Center, Portland, Maine. Currently she is the Assistant Chief Technologist of Microbiology and Molecular Pathology at NorDx Laboratories, Scarborough, Maine.
Co-author information: Judi Bennett, MT, BSM is currently a Program Director for MediaLab, Inc. in Lawrenceville, Georgia. She has over 30 years of medical laboratory experience in an acute care hospital setting as a laboratory manager, senior clinical applications specialist, point-of-care coordinator, microbiology supervisor, and generalist technologist. Judi has experience speaking at various professional conferences and is the author of numerous peer-reviewed publications.
Reviewer Information: Julie Ann West, PhD, is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). She has earned a PhD in Public Health - Infectious Disease Epidemiology - and is Certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a Technical Specialist, Safety Officer, Educator, and Lead in the Veterans Administration Healthcare System, and has prior experience as an Administrative Laboratory Director.