Antibiotic Resistance In Clinical Practice – Problems and solutions (A problem and case-based course)

Data

Official data in SubjectManager for the following academic year: 2023-2024

Topic

Resistance to antibiotics, i.e. to “miracle drugs” once thought to solve the problem of bacterial infections forever is the most serious challenge medicine and public health is facing now and most likely also in the foreseeable future, as well. Due to this problem, we are making steps backwards, i.e. infections once easily treatable may not respond to our current therapies. Practically all bacterial species and every drug can be affected. Nevertheless, there are some “key problems”, i.e. resistant pathogen groups that, either due to their frequency or to the severity of infection they cause represent particularly serious and/or common challenges. In this problem-driven course the most important pathogen groups and resistance types will be covered by discussing specific cases, clinical and epidemiological scenarios.
For each cases the characteristics of the pathogens, drugs in question and possible resistance mechanisms will be discussed, all from the clinician’s perspective: How the problem can be recognised, what are the remaining treatment options, how the problem can be prevented and controlled

Lectures

• 1. The history of antibiotics and antibiotic resistance - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 2. Spread of antibiotic resistance bacteria and resistance genes - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 3. When cell wall synthesis inhibitors fail: MRSA bloodstream infection - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 4. When cell wall synthesis inhibitors fail: hospital acquired MRSA respiratory tract infection - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 5. When cell wall synthesis inhibitors fail: vancomycin resistant enterococcus - Dr. Pál Tibor
• 6. When cell wall synthesis inhibitors fail: penicillin resistant pneumococcus - Dr. Pál Tibor
• 7. When cell wall synthesis inhibitors fail: ESBL bacteraemia - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 8. When cell wall synthesis inhibitors fail: ESBL in the NICU - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 9. When cell wall synthesis inhibitors fail: carbapenem resistant Enterobacteriaceae (CRE) - Dr. Pál Tibor
• 10. When cell wall synthesis inhibitors fail: carbapenem resistant Pseudomonas - Dr. Pál Tibor
• 11. When cell wall synthesis inhibitors fail in community acquired infections: cefalosporine resistant gonorrhea - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 12. When cell wall synthesis inhibitors fail in community acquired infections: community acquired MRSA soft tissue infection - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 13. Folic acid inhibitors: trimetoprime-sulfamethoxazole resistant Stenotrophomonas - Dr. Pál Tibor
• 14. Protein synthesis inhibitors: emergence of tigecycline resistance during therapy - Dr. Pál Tibor
• 15. Protein synthesis inhibitors: aminoglycoside resistance of Enterobacteriaceae - Dr. Pál Tibor
• 16. Protein synthesis inhibitors: highly aminoglycoside resistant Enterococcus - Dr. Pál Tibor
• 17. Protein synthesis inhibitors: macrolide resistant Helicobacter pylori - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 18. Protein synthesis inhibitors: macrolide resistance in pneumococcus - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 19. Nucleic acid synthesis inhibitors: quinolone resistant enteric infection - Dr. Pál Tibor
• 20. Nucleic acid synthesis inhibitors: quinolone resistant bacteria in urinary tract infections - Dr. Pál Tibor
• 21. Membrane active agents: colistin resistance in hospital acquired infections - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 22. Membrane active agents: the danger of plasmid mediated colistin resistance - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 23. The solution – infection control - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)
• 24. The solution – antimicrobial stewardship - Dr. Pál Ágnes (Dr. Sonnevend Ágnes Mária)

Practices

Seminars

Reading material

Obligatory literature

Literature developed by the Department

Notes

Recommended literature

Mims' Medical Microbiology 6th ed. by Richard Goering, Hazel Dockrell, Mark Zuckerman, Ivan Roitt, Peter L. Chiodini ISBN-13: 978-0702071546
Medical Microbiology, 9th edition by Patrick R. Murray, Ken S. Rosenthal, Michael A. Pfaller

Conditions for acceptance of the semester

Maximum of 25 % absence allowed

Mid-term exams

Based on individual agreement.

Making up for missed classes

Based on individual agreement

Exam topics/questions

-

Examiners

Instructor / tutor of practices and seminars