15 Bordetella/Haemophilus

Question 1

what anatomical location are bordetella, haemophilus, and moraxells typically found?

Answer 1

upper airway

Question 2

bordetella grows on what agar? Has what shape?

Answer 2

• bordet-gengou or regan-lowe

- coccobacillus

Question 3

T/F B. pertussis is aerobic? Non-fastidious?

Answer 3

• T

- F

Question 4

what is infection rate of whooping cough?

Answer 4

100% in unvaccinated (but may not show symptoms)

Question 5

what 2 organisms cause whooping cough?

Answer 5

B. pertussis, parapertussis

Question 6

pertussis is common in what age group?

Answer 6

less than 5 yrs

Question 7

when did vaccination start for pertussis? before that, what was mortality rate?

Answer 7

1940’s

1%

Question 8

T/F recently there is an increase in pertussis?

Answer 8

T (non-vaccinaters)

Question 9

T/F pertussis vaccination is world-wide?

Answer 9

F

Question 10

Catarrhal stage pertussis how many weeks?

Answer 10

1-2 wks

Question 11

paroxysmal stage pertussis how many weeks?

Answer 11

2-8

Question 12

convalescent stage pertussis is what?

Answer 12

symptoms get better (after paroxysmal stage)

Question 13

Which pertussis stage is most contagious?

Answer 13

catarrhal

Question 14

List B. pertussis MAIN virulence factors? (3)

Answer 14

• filamentous hemagglutinin (adhere to glycolipids in CILIATED epithelium)
• pertussis toxin (also an adhesion)
• pertactin (adhere to cells)

Question 15

what type of toxin is pertussis toxin? What’s its mechanism?

Answer 15

• A-B toxin, ADP-ribosylating

- up Gs ->up adenylate cyclase ->up cAMP -> ions are expelled from cell ->paralyzes cell (up respiratory mucus)

Question 16

List B. pertussis additional toxins? (4)

Answer 16

• cya toxin (anti-inflamm, anti-phagocytic)
• dermonecrotic toxin
• tracheal toxin (cilia paralysis)
• endotoxin

Question 17

pneumonia, otitis media, seizures, encephalopathy, death are complications of what disease?

Answer 17

pertussis [of these pneumonia is the MOST common. death is rare.]

Question 18

What symptoms when a vaccinated individual gets pertussis?

Answer 18

90-day cough can be only symptom, or sometimes also scratchy throat, episodes of sweating, post-tussive vomiting

Question 19

how do we vaccinate for pertussis?

Answer 19

purified B. pertussis components w/ D and T toxoids (DTaP for “acellular”)

Question 20

what are the components of “aP” in pertussis vaccination/

Answer 20

pertussis toxoid, two colonization antigens and NO endotoxin

Question 21

pertussis immunization schedule?

Answer 21

2,4,6,15-18 months, 4-6 yrs

Question 22

T/F prophylactic antibiotics are provided to ALL close contacts of a pertussis case?

Answer 22

T

Question 23

Haemophilus is coccus/Bacilli? anaerobe/aerobe? Transformable/not? Fastidious/not?

Answer 23

• coccobacilli
• facultative anaerobe
• NATURALLY transformable
• Fastidious

Question 24

T/F non-encapsulated Haemophilus influenza is found in human oral cavity and mucosal surfaces of upper resp. tract normally?

Answer 24

T. (80% of humans!) [occasionally healthy people also harbor encapsulated Hib]

Question 25

Type-able strains of H. influenza have what serotype?

Answer 25

a-f (b most prevalent. This is the vaccinated strain!)

Question 26

Non-typeable strains of H. influenza have capsule or not? cause disease or not?

Answer 26

-no, yes occasionally

Question 27

When it comes to the disease it causes, how is H. parainfluenzae different than H. influenza?

Answer 27

same, but lower incidence

Question 28

what strain of H. influenza is known for pink eye which can progress to Brazilian purpuric fever?

Answer 28

aegypticus

Question 29

what strain of H. influenza causes "soft chancre/chancroid"?

Answer 29

H. ducreyi [mostly tropical, may not even be a real haemophilus!]

Question 30

What diseases can H. influenza cause? (3 categories) [global card, review rather than memorize]

Answer 30

``` occasionally: -meningitis, epiglottitis Rarely: -pneumonia, cellulitis, bacteremia Local: -otitis media, sinusitis, conjunctivitis ```

Question 31

COPD is commonly exacerbated by what organism?

Answer 31

H. influenzae

Question 32

Hib no longer causes what childhood problem post-CONJUGATE vaccination?

Answer 32

meningitis is kids under 5 yrs

Question 33

What are Haemophilus Influenzae B. virulence factors?

Answer 33

- NO exotoxin! - anti-phagocytic + adhesin capsule in Hib only - LOS - neuraminidase & IgA protease (role in invasion unproven)

Question 34

For non-type-B H. influenza, what are virulence factors?

Answer 34

unknown (NO exotoxin!)

Question 35

growing H. influenze requires?

Answer 35

choc agar /w X (hemin) and V (NAD) at 37 degrees in CO2-enriched environment

Question 36

besides growing, how can we diagnose H. influenza?

Answer 36

type b capsular antigen detection

Question 37

Treat H. influenza with what? What is key to treatment?

Answer 37

- cefuroxime since it crosses Blood-Brain-Barrier (and since Beta-lactamases are common) - Prompt! (epiglottitis/meningitis 99% mortality)

Question 38

Moraxella is similar to what pathogen?

Answer 38

Haemophilus

Question 39

T/F 50% healthy kids and some adults have Moraxella flora?

Answer 39

T

Question 40

Moraxella usually causes what diseases?

Answer 40

- otitis media in kids - sinusitis in adults - COPD exacerbations (like Haemophilus)

Question 41

If Moraxella progresses to bacteremia what does this mean?

Answer 41

patient has other serious disease. (don't usually progress)

Question 42

Virulence factors of Moraxella?

Answer 42

- adhesins | - LOS

Question 43

How is Moraxella different from Haemophilus?

Answer 43

- diplococcus | - grow on most agars!

Question 44

How do we treat Moraxella?

Answer 44

-Beta-lactam plus B-lactamase inhibitor (like augmentin), or 2 or 3 gen. cephalosporins

Question 45

How is Moraxella similar to Haemophilus?

Answer 45

- most things - oxidase positive - gram neg.