Questions for Superbugs – Desperately Seeking Superdrugs:
1. All of the following are considered superbugs except:
a. MRSA
b. VRE
c. S. Pneumoniae
d. ESBL
2. Which of the following agents is the mainstay (1st line) treatment for healthcare acquired MRSA
infection?
a. Metronidazole
b. Ceftriaxone
c. Bactrim
d. Vancomycin
3. Community acquired MRSA differs from Healthcare acquired MRSA in all of the following ways
except:
a. Mec gene type
b. Type of bacteria
c. Source of infection
d. Pattern of resistance
4. Treatment of ESBL’s (Extended Spectrum Beta-Lactamases) include which of the following
medications?
a. Imipenem
b. Meropenem
c. Cefepime
d. All of the above
5. C. difficile reoccurrence should be treated with which of the following?
a. Metronidazole (flagyl)
b. Vancomycin taper
c. Fidaxomicin (Dificid)
d. B and C are both good choices
Answers:
1. C. MRSA, VRE, ESBL, C. difficile and KPC’s are all examples of superbugs. Strep. Pneumoniae
has shown resistance to penicillins rarely but has not reached epidemic proportions as see with
these other “superbugs”.
2. D Vancomycin is the mainstay of treatment for healthcare acquired MRSA. Bactrim is used for
community acquired infections but does not have the extended coverage for the healthcare
associated version.
3. B – type of bacteria. Community acquired and healthcare acquired MRSA are both Staph Aureus
strains but they are distinguished from one another by MEC gene type, source of infection, and
patterns of antibiotic resistance.
4. D – all of the above. Carbapenems such as imipenem, meropenem, ertapenem and doripenem
can be used to treat ESBL infections. Cefipime is the 4th generation cephalosporin with ESBL
activity.
5. D – both B and C are good choices. Current recommendations for reoccurrence treatment
include a vancomycin taper or fidaxomicin. Fidaxomicin has shown a slightly better prevention
of reoccurrence profile than vancomycin in certain strains of C. difficile but in all studies both
showed a similar cure rate.