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MicroBiology Exam 2 > 3/6: Legionella, Coxiella, Plague, Zoonotic Diseases > Flashcards

3/6: Legionella, Coxiella, Plague, Zoonotic Diseases Flashcards

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1
Q

Legionella Pneumophila: general

A

gram negative, aerobic, plemorphic bacilli, no capsule

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2
Q

Legionella Pneumophila are found ____

A

primarily waterbound

also found in soil

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3
Q

Legionella Pneumophila are ___ pathogens. Meaning they only infect ____

A

opportunistic pathogens

only infect smokers, immune-compromised hosts

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4
Q

T/F: Legionella pneumophila are facultative intracellular bacteria

A

TRUE

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5
Q

Legionella pneumophila have 4 virulence factors. What are they?

A
  1. PAMPS
  2. Type IV Secretion System
  3. Legionella-containing vacuole (LCV)
  4. Low metabolic state
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6
Q

T/F Legionella Pneumophila causes typical pneumonia

A

false

causes a-typical pneumonia

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7
Q

Describe the PAMP virulence factors of legionella pneumophila

A

pili/fimbriae, flagella, LPS

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8
Q

Describe the LPS of legionella pneumophila

A

LPS of legionella pneumophila is less toxic than other LPS of gran neg strains

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9
Q

What is legionella-containing vacuole (LCV)_

A

replication vacuole INSIDE of a macrophage

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10
Q

Why is the low metabolic state of legionella pneumophila a virulence factor?

A

creates a resistance to essentially any form of killing (heat, chlorination)

cells are embedded in biofilm

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11
Q

Infection of legionella pneumophila begins when ______

A

aerosolized droplets of contaminated water are breathed into lunchs

legionella begins to grow inside of alveolar macrophages in the lungs

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12
Q

Once legionella begins to grow inside of alveolar macrophages in lungs, this causes ____

A

inflammation

causing NECROTIZING MULTIFOCAL PNEUMONIA

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13
Q

What type of pneumonia does legionella pneumophila cause?

A

a-typical

necrotizing multifocal pneumonia

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14
Q

Describe LCV (legionella-containing vacuole) once legionella is inside the macrophage of a phagosome

A

LCV - legionella-containing vacuole

bacteria surrounds itself with a membrane bound vacuole that blocks the fusion of a lysosome to it’s resident phagosome

bacteria recruits ER proteins, ribosomes, mitochondria

Bacteria replicates inside of vacuole leading to cell lysis and inflammation due to DAMPS

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15
Q

Type IV secretion system aka ____

A

Icm/Dot

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16
Q

Describe Type IV secretion system (aka Icm/Dot)

A

secretes over 300 proteins into the host cell

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17
Q

Legionella pneumophila virulence requires intracellular replication. This activates ____ response

A

TH1 adaptive immune response

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18
Q

What recognizes legionella LPS?

A

TLRs on macrophages and dendritic cells

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19
Q

Legionellosis is linked to ____

A

large, complex manmade water systems in hotels, hospitals, nursing homes

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20
Q

What are the 2 forms of legionelllosis?

A

Legionnaires’ Disease

Pontiac fever

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21
Q

Which of the 2 forms of legionellosis is the severe form? Which is the milder form?

A

legionnaire’s disease = severe

pontiac fever = mild

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22
Q

Legionnaire’s Disease affects what target population?

A

middle age-elderly smokers or those with chronic diseases

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23
Q

What is the mortality rate of those with legionnaire’s disease?

How does this change in a health-care establishment?

A

15% mortality rate of legionnaire’s disease

Higher mortality in health-care establishments because of population in this setting (they’re sick…)

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24
Q

What are the symptoms of legionnaire’s disease?

A

myalgia/headache, rapidly rising fever, dry cough and chest pain, chills, vomitting, diarrhea, confusion delirium, hepatic dysfunction common

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25
Q

Diagnosis of legionnaire’s disease is via ___

A

patient history intake + DIRECT FLUORESCENT ANTIBODY mixed with cultured infected tissue

(this tissue has to be very high quality so this works 25% of time)

Or can use PCR or special media (buffered charcoal yeast extract)

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26
Q

T/F: Penecillin is the treatment for legionnaire’s disease

A

FALSE

treatment = fluoroquinoline, azithromycin, erythromycin

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27
Q

Prevention of legionnaire’s disease can be by minimizing _____

A

aerosols in public places from contaminated water

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28
Q

Prevention of legionnaire’s disease can be by minimizing aerosoles in public places from contaminated water.

Why is this complicated?

A

because once legionella is inside the water, it forms a biofilm and has a LOW METABOLIC STATE

= resistance to chlorine and heat killing.

hard to get rid of once it’s in the water

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29
Q

Pontiac fever is the milder version of ____

A

legionnaire’s disease

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30
Q

Pontiac fever causes ___ symptoms

A

flu-like

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31
Q

Both pontiac fever and legionnaire’s disease are caused by ____.

Only pontiac fever is caused also by _____

A

both - contaminated water droplets

only pontiac fever - contaminated soil

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32
Q

Define zoonotic infections

A

humans acquire infections by direct or indirect contact with animals

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33
Q

Coxiella Burnetti general

A

gram negative

small coccobacilli

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34
Q

T/F Coxiella Burnetti are facultative intracellular pathogens

A

FALSE

they are OBLIGATE intracellular pathogens

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35
Q

Because coxiella burnetti are obligate intracellular pathogens, this means that they prefer ____

A

macrophages and phagocytic cells

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36
Q

Coxiella burnetti can grow well in ___

A

placental tissue

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37
Q

What is the infection dose of coxiella burnetti?

A

LOW INFECTIOUS DOSE

ID50 = 1

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38
Q

Coxiella burnetti causes ____ in those who are around animals a lot

A

q-fever

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39
Q

Coxiella burnetti has 5 virulence factors. What are they?

A
  1. PAMPS (LPS)
  2. Type IV secretion system (lcm/Dot)
  3. Resistance to low pH/enzymes of phagolysosomes
  4. Coxiella containing vacuole (CCV)
  5. Biphasic life cycle
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40
Q

Describe the biphasic life cycle of coxiella burnetti

A
  1. small cell variant (SCV) = NOT metabolically active. infectious phase (survive standard disinfection)

–>

  1. large cell variant (LCV) = metabolically active, only acts once inside the cell
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41
Q

Coxiella burnetti is inhaled via ___

A

aerosole transmission

dust on the farm is stirred up and inhaled by farmer

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42
Q

Once in the lungs, coxiella burnetti binds to ____ (describe in detail)

A

phagocytic cells - alveolar macrophages (passively taken up through phagocytosis) and monocytes.
*both of these are in reticuloendothelial system

nonphagocytic cells - like epithelium and endothelium

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43
Q

Once inside the phagosome, coxiella burnetti forms their CCV (coxiella containing vacuole).

Describe this.

A

coxiella containing vacuole is formed once inside the phagosome

this ALLOWS LYSOSOME TO FUSE

The lowered pH in CCV stimualtes coxiella to expand the size of the vacuole.

44
Q

Once the CCV is formed, what happens in terms of the biphasic life cycle of coxiella burnetti?

How long does this take

A

Inside the CCV vacuole, coxiella transitions from SCV (small cell variant) –> LCV (large cell variant) and REPLICATES

this takes about 6 days

45
Q

Coxiella burnetti causes ___ (disease)

A

q-fever

46
Q

What are the symptoms of q-fever

What are the symptoms of severe cases….

A

flu-like symptoms begin about 20 days

can have stomach pain, nausea, diarrhea, vomiting, LIVER ISSUES ARE COMMON

severe cases…
pneumonia and hepatitis can occur, chronic infections are rare and are associated with endocarditis

47
Q

What is the treatment for q-fever

A

doxycycline for 2 weeks

48
Q

Doxycycline is used to treat many ____ infections

A

obligate intracellular

49
Q

Yersina Pestis general info

A

gram negative, pleomorphic bacillus

50
Q

Yersina pestis caused ____ in the late 19th-early 20th century

A

black plague

51
Q

Describe the epidemiology of the black plague

A

(YERSINA PESTIS)

rats entered city to find food.
high # of non-immune rats lead to bacteremia and high rat mortality rates
fleas fed on rates = infected with yersina pestis
bacteria multiplies inside fleas = blocks GI system = throw up into human bite wound

52
Q

Transmission of yersina pestis (during black plagiue) was highest when ____

A

there was high rat population and high rates of rat mortality

(duh. think about it.)

53
Q

What are the 2 diseases associated with yersina pestis?

A
  1. bubonic plague (w/ sylvatic plague and urban plague)

2. pneumonic plague

54
Q

Describe bubonic plague transmission

A

(yersina pestis)
bacteria infects rats, causing BACTEREMIA and is transmitted to other rat fleas. has 2 cycles:

  1. SYLVATIC CYCLE: infected fleas leave rt and go to other rats to infect them. rarely transmits to humans
  2. URBAN CYCLE: when many infected rats/fleas are in close contact with humans. infected fleas bite humans.
55
Q

Describe pneumonic plague transmission

A

(yersina pestis)

humans are infected with yersina pestis that develops into BACTEREMIA infecting LUNGS

this can spread from HUMAN TO HUMAN

56
Q

Yersina pestis have many regulatory systems for their virulence factors. What does that mean?

A

Regulatory systems sense environment and turn on/off virulence factors

57
Q

What are the 2 virulence factors of yersina pestis when in the flea gut?

A
  1. phospholipase D

2. coagulase and polysaccharide biofilm

58
Q

Describe how phospholipase D is a virulence factor for yersina pestis

A

yersina pestis multiplies easily in the foregut of the flea due to low temperature that activates phospholipase D (virulence factor)

this resists anti-bacterial factors in the flea gut

59
Q

Describe how coagulase and polysaccharide biofilm are virulence factors for yersina pestis

A

As yersina pestis sits in the flea gut, this starves the fleas, blocking the digestion of blood, causing vomitting of bacteria into wound of feed

60
Q

When yersina pestis is transferred to humans, what happens to the temperatuer?

A

temperature in flea foregut = low

temperature in humans = high

61
Q

When yersina pestis is transferred to humans, increased temperature creates regulatory systems to turn “on” 4 new virulence factors.

What are they?

A
  1. different LPS (not recognzied by TLR)
  2. antiphagocytic F1 capsule
  3. Pla (plasminogen activator allows spread to tissues)
  4. Yops (protein that destroys/disrupts host cell)
62
Q

Once yersina pestis is inside human phagocytes, what happens?

A

Yops disrupt and destroy host cell
bacteria enter blood stream (bacteremia)
travels to lymph nodes where lyse host cells (multiply rapidly to produce BUBO)

63
Q

Define bubo

What bacteria is it associated with?

A

hermorrhagic suppurative lymphadenitis

associated w/ yersina pestis

64
Q

Bubonic plague symptoms present ___ after flea bite.

What are the symptoms?

A

(yersina pestis)

2-7 days after flea bite

fever, painful bubo in groin/axilla
50% = progress to BACTEREMIA without treatment and die
5% = develop into pneuonomic plague

65
Q

Pneumonic plague symptoms present ___ after exposure.

What are the symptoms?

A

(yersina pestis)

2-3 days after exposure

fever, malaise, toght chest, later cough, sputum, trouble breathing, blue lips occur

Death after 2-3 days, NO SURVIVORS W/O TREATMENT

66
Q

How do you diagnose patients with yersina pestis-associated diseases?

A

patient history + gran-stain aspirate of bubo or immunofluorescence techniques

67
Q

What is the treatemnt of yersina pestis-associated diseases?

A

gentamycin or streptomycin

68
Q

Of meningitis is present with yersina pestis-associated diseases, what is the treatment?

A

ciprofloxacin or chloramphenocol

69
Q

Brucella abortus general info

A

gran negative
small coccobacilli
aerobic
non-motile

70
Q

Brucella abortus have an unusual envelope made of ____

why is this beneficial

A

phosphatidylcholine

this makes them resemble eukaryotic cells (beneficial)

71
Q

Describe the growth rate of brucella abortus

A

slow

72
Q

Brucella abortus causes brucellosis.

Describe this.

A

chronic infection that persists for life in animals within their reproductive organs (male and female)

causes spontaneous abortions, sterility, descreased milk production in pregnant cattle, goats, hogs.

73
Q

How is brucellosis spread to animals?

A

(brucella abortus)

spread via DIRECT contact with infected tissue or INGESTING contaminated feed

74
Q

How do we systeamically control brucellosis in animals?

A

vaccination of animals

and euthanizing infected animals

75
Q

Higher cases of brucellosis are found in ___

A

mexico or states close to mexico

76
Q

Humans can become infected with brucellosis when ____

A

they consume unpasteurized dairy products

or if they work around animals (vets, lifestock owners, slaughter workers)

are infected via ingestion, inhalation, cuts in skin or mucous membranes

77
Q

Why does brucella abortus grow in placental tissues of aniamls but not humans?

A

animals placenta have ERYTHRITOL present. huamns do not.

78
Q

Brucella abortus is a ____ intracellular parasite

A

facultative intracellular parasite of epithelial cells and phagocytes

79
Q

Why do TLRs not recognize brucella abortus?

A

because brucella abortus has a phosphatidylcholine envelope (making it look like a eukaryotic cell)

so TLRs cannot recognize this envelope

80
Q

Brucella abortus multiples and forms ____ in liver, spleen, bone marrow, reticuloendothelial systems

A

granulomas

81
Q

Brucall abortus must inhibit ____ to survive

A

must inhibit phagosome-lysosome fusion and apoptosis of host cell

82
Q

T/F Brucella abortus uses type IV sercretion system

A

true

83
Q

What are the 2 immune responses to brucella abortus?

How affective are they?

A
  1. antibodies are formed (not protective)

2. Th1 response is critical to control the disease by clearing brucella from macrophages

84
Q

Brucellosis is also called ____

A

undulant fever

85
Q

Brucellosis symptoms present ___ after infection.

What are the symptoms?

A

7-21 days after infection

headache, chills, fever, periodic drenching night sweats which can continue for weeks, months, or years.

because generic symtpoms - hard to tell if someone has this.

86
Q

Only 25% of patients with brucellosis have ____

A

enlarged lymph nodes or enlargement of lymphatic organs like spleen/liver

87
Q

Describe the diagnosis of brucellosis

A

isolation via biopsy

bc it’s slow growing this requires long incubation period

serological tests available

88
Q

What is the treatment of brucellosis of humans

what is the recovery like

A

doxycycline + rifampin

could be 2-7 days before fever breaks
10% of patients will relapse within 3 months of taking antibiotics

no vaccine

89
Q

Francisella Tularensis general info

A

gram negative, small coccobacilli, aerobic, requires CYSTEINE

non-motile

90
Q

Fansicella Tularensis is a ___ intracellular parasite of macrophages

A

facultative

91
Q

Francisella tularensis causes ____ (disease)

A

tularemia

92
Q

Which bacteria is considered a tier 1 agent by the US government? why?

A

francisella tularensis

because of low ID, ease of spread, high virulence

93
Q

What are the 2 virulence factors of fransciella tularensis?

A
  1. Lipid rich capsule

2. unusual LPS (isn’t recognized by TLR but does induce protective antibodies)

94
Q

Francisella tularensis is spread by ____

ID =

A

contact with infected mammal or arthropod (these can be infected w/o symptoms)

Many routes of infection

Low ID (less than 100)

95
Q

Infection of francisella tularensis can be via ___

A

minor abrasions, insect bites, inhalation

96
Q

Why can francisella tularensis multiply so much?

Where does it multiply?

A

LPS is not recognized, so bacteria can multiply until they are detected by phagocytes

they will multiply in many cell types, especially alveolar epithelial cells and reticuloendothelial organs forming GRANULOMAS

97
Q

A ____ often develops at the site of infection from francisella tularensis

A

ulcerated lesion

98
Q

Once fracisella tularensis is ingested into the phagosome, it blocks ____ and escapes into ____

A

blocks fusion of lysosome to phagosome

escapes into HOST CYTOPLASM

99
Q

Tularemia has an incubation period of ____

A

2-5 days

francisella tularensis

100
Q

Tularemia has various symptoms. The type of disease depends on _____

All cases begin with ____

Most common form is ____ due to ____

A

(francisella tularensis)

type of disease depends on site of inoculation and extent of spread

all cases begin with acute onset of high fever

most common = ULCEROGLANDULAR FORM due to tick bite or handling infected animals (produces ulcer and swollen lymph notes)

101
Q

How do we diagnose tularemia?

A

(francisella tularensis)

patient history is important bc symptoms so similar to other more common illnesses

hard to culture

SEROLOGIC TESTS are commonly used

102
Q

What is the treatment for tularemia?

A

(fracisella tularensis)

gentamycin or streptomycin

high risk populations can receive a live attenuated vaccine

103
Q

Pasturella multocida general info

A

Gram negative, small coccobacilli, facultative anaerobe

104
Q

T/F Pastuerella multocida is susceptible to penicillin

A

true
surprising
unlike most other gram negative rods

105
Q

Pasturella multocida is part of ____

A

normal flora of most domestic animals

106
Q

What is the general pathogenesis of pasturella multocida?

A

most common cause is infected cat/dog bite

develops within 24 hours after bite/scratch

causes diffuse CELLULITIS with well-defined border

MicroBiology Exam 2 (8 decks)

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