MCQs on ESKAPE pathogens (antibiotic resistance bacterial pathogens)

ESKAPE: Group of antibiotic resistant pathogens.

Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.

1. A 75-year-old female patient, was admitted to the intensive care unit (ICU) following a severe slip and fall accident in the bathroom. She sustained multiple fractures, required mechanical ventilation, and underwent several surgical procedures. During her ICU stay, she developed a fever and signs of sepsis.

On Day 1, the patient was stable post-surgery but developed a fever of 39°C (102.2°F) and a leukocytosis with a white blood cell count of 18,000/µL.

Blood cultures were taken, and empiric broad-spectrum antibiotics (piperacillin/tazobactam and vancomycin) were initiated.

On third day, the patient's condition worsened with increased respiratory distress, and new infiltrates were noted on chest X-ray.

Blood culture results returned positive for Klebsiella pneumoniae, and additional cultures were taken from the endotracheal tube, urine, and surgical wounds.

Laboratory Results

Blood Culture: Klebsiella pneumoniae

Endotracheal Culture: Pseudomonas aeruginosa

Urine Culture: Enterococcus faecium.

Surgical Wound Culture: Staphylococcus aureus.

The patient's respiratory status began to stabilize with improved oxygenation.

Repeat cultures showed no growth of Klebsiella pneumoniae and reduced colony counts of Pseudomonas aeruginosa and MRSA.

The patient was transferred to a step-down unit with a tailored antibiotic regimen and close monitoring for potential relapse or secondary infections.

Which of the following antibiotic is a common initial empiric antibiotic therapy given to the patient? 

A. Colistin and meropenem

B. Meropenem and vancomycin

C. Piperacillin/tazobactam and vancomycin

D. Piperacillin/tazobactam and linezolid

2. MRSA stands for:
A. Methicillin-resistant Staphylococcus aureus   
B. Multidrug-resistant Staphylococcus aureus
C. Methicillin-resistant Streptococcus aureus
D. Multidrug-resistant Streptococcus aureus

3. Which pathogen among the ESKAPE group is known for its intrinsic resistance to many antibiotics and ability to acquire additional resistance mechanisms?
A. Acinetobacter baumannii
B. Enterococcus faecium
C. Klebsiella pneumoniae
D. Pseudomonas aeruginosa   

4. Carbapenem-resistant Enterobacteriaceae (CRE) refers to:
A. Acinetobacter baumannii
B. Klebsiella pneumoniae and Enterobacter species   
C. Pseudomonas aeruginosa
D. Staphylococcus aureus

5. Which pathogen is associated with vancomycin resistance?
A. Acinetobacter baumannii

B. Enterococcus faecium    

C. Pseudomonas aeruginosa

D. Staphylococcus aureus


6. The primary concern with Klebsiella pneumoniae as an ESKAPE pathogen is its resistance to:
A. Penicillin
B. Vancomycin
C. Carbapenems    
D. Tetracycline

7. What type of enzyme do Enterobacter species often produce that confers resistance to beta-lactam antibiotics?
A. Beta-lactamase
B. Carbapenemase    
C. Extended-spectrum beta-lactamase (ESBL)   
D. Both B and C   

8. Which of the following is NOT a characteristic of Acinetobacter baumannii as an ESKAPE pathogen?
A. Association with severe infections in hospitalized patients

B. Ability to survive on surfaces for long periods
C. Multidrug resistance 

D. Resistance primarily to vancomycin   

9. Which infection control measure is crucial in preventing the spread of ESKAPE pathogens in healthcare settings?
A. Frequent hand washing
B. Use of broad-spectrum antibiotics
C. Isolation of infected patients
D. Both A and C  

10. Which of the following pathogen is commonly found to be resistant to multiple antibiotics including ciprofloxacin and ceftazidime?

A. Enterococcus faecium

B. Klebsiella pneumoniae

C. Pseudomonas aeruginosa

D. Staphylococcus aureus 

11. Acinetobacter baumannii is most commonly associated with infections in which of the following settings?

A. Community settings

B. Dental offices

C. Hospital ICUs

D. Outpatient clinics

Answers:

1. C. Piperacillin/tazobactam and vancomycin

2. A. Methicillin-resistant Staphylococcus aureus

3. D. Pseudomonas aeruginosa

4. B. Klebsiella pneumoniae and Enterobacter species

5. B. Enterococcus faecium

6. C. Carbapenems

7. D. Both B and C

8. D. Resistance primarily to vancomycin

9. D. Both A and C
10. C. Pseudomonas aeruginosa
11. C. Hospital ICUs