50. Yersinia, Campylobacter, Helicobacter Flashcards

1
Q

Yersinia microbiology?

A
  • GN
  • enterobacteriaciae
  • flagella
  • motility at colder than body temp – refrigerated foods susceptible
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2
Q

yersinia pathogenesis?

A
  • tropism for lymphoid tissue (invades and replicates within macrophages and travels to mesenteric lymph nodes where they form micro-colonies)
  • virulence plasmid
  • evade host immune response
  • differences among species thanks to chromosomal islands and additional plasmids
  • highly regulated by temperature
  • colonization of distal small intestine, proximal colon
  • penetrates M cells and epithelial cells
  • replicate extracellularly in MLN in micro-abscesses and resist phagocytosis
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3
Q

yersinia virulence?

A
  • cross epithelial barrier via adhesins
  • inject efectors (Yops) via T3SS (resists phagocytosis, down regulates inflamm, cytokine suppression, apoptosis of macrophages)
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4
Q

yersinia disease?

A
  • abdominal pain
  • fever, vomiting
  • sepsis is rare (immunocompromised or iron-overloaded individuals)

Y.entercolitica: - inflammatory diarrhea +/- watery diarrhea

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5
Q

yersinia dx?

A
- often mistaken for appendicitis – thanks to acute terminal ileitis and mesenteric lymphadinitis
Stool culture
- slow lactose fermenter
 (McConkey)
- selective agar
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6
Q

yersinia tx?

A
  • Abx likely not beneficial
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7
Q

yersinia common orgs?

A

Y. entercolitica:

  • multiple serotypes
  • common flora of farm animals
  • foodborne gastroenteritis (pork, beef)

Y. pseudotuberculosis:

  • zoonotic
  • least common
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8
Q

campylobacter microbiology?

A
  • curved GN rods
  • microaerophilic
  • flagella
  • extensive genetic variation b/w strains esp in genes for LOS, capsule, and flagellin…also may play a role in immune evasion
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9
Q

campylobacter Epi?

A
  • major cause of foodborne bacterial infection
  • commensal flora of birds
  • colonizes avian GI mucosa at high numbers
  • pathogen in human GI tract
  • consumption of contaminated foods
  • esp concern for military personnel
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10
Q

campylobacter pathogenesis?

A
  • infectious dose is low
  • guillian-barre syndrome: infection induces production of cross reacting antibodies to gangliosides tha tare damaging to peripheral nerve tissue Specific types of campylobacter LOS from the antiens that mimic gangliosides and induce Abs = molecular mimicry (RARE)
  • flagella
  • cytolethal distending toxin (CDT) causes disruption of host cell cycle and IL-8 secretion
  • avoids innate immune response: altered flagellin structure unrecognizable by TLR-5
  • curved shape for penetration, uses MT (not actin)
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11
Q

campylobacter disease?

A
  • bacterial gastroenteritis: stool w/blood and mucus, abd cramps/pain
  • fever
  • traveler’s diarrhea
  • systemic infections in immunocompromised
  • can cause Guillian Barre syndrome (ascending paralysis) 1-3 weeks post infec.
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12
Q

campylobacter dx and tx?

A
  • culture organism on special agar from stool sample
  • Abx only if given early: macrolides and FQ
  • oral replacement of fluids and electrolytes
  • protective immunity
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13
Q

H.pylori microbiology?

A
  • GN
  • microaerophilic
  • requires specialized growth media
  • flagella
  • genetic heterogeneity
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14
Q

H pylori epi?

A
  • huge problem worldwide
  • we don’t know transmission
  • most common infection in man (90% of pop in some areas)
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15
Q

H.pylori pathogenesis?

A
  • flagella allows penetration of mucous layer
  • urease
  • inflammatory response
  • pyloric region gastritis -> excessive acid -> duodenal ulcer
  • pangastritis -> atrophic gastritis -> inflammation-> hypochlorhydria -> gastric ulcer ->cancer
  • promote robust immune response without clearing infec
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16
Q

H.pylori virulence?

A
  • flagella, urease
  • modified LPS not recog by TLR4
  • VacA gene – variation in activity b/w strains thnx to heterogeneity (form pores in epith cell membs)
  • Cag island – chrom. Gene cluster in virulent strains – CagA transported by T4SS
17
Q

H.pylori disease?

A
  • chronic gastritis
  • duodenal ulcer disease
  • gastric carcinoma
  • lymphoma
  • mostly asymptomatic
18
Q

H,pylori Dx and tx?

A
  • serology
  • urea breath test
  • biopsy
  • cx
  • super prevalent – but treat anyone + re: risk of gastric carcinoma
  • combo: amoxicillin, clarithromyin, metronidaxole