9-3 Niesseria/Hemophillus/Bordetella

Question 1

What 3 things does the [Polysaccharide capsule] likely provide for Neisseria?

Answer 1

1. bloodstream invasion
2. survival
3. possibly CNS penetration

Question 2

A: What 2 components of Neisseria generate CNS inflammation/Local Inflammation?

B: What 2 HOST chemicals mediate this?

Answer 2

CNS/Local inflammation generated by

1. [cell wall peptidoglycan]
2. LPS

B: mediated by IL-1 and TNF

Question 3

4 Clinical Manifestations of [Neisseria MENINGITIDIS]

Answer 3

1. Respiratory colonization followed by overt disease or transient carrier state
2. Meningitis
3. Skin: petechiae → purpura
4. Meningococcemia: shock, hemorrhage and purpura,
   destruction of adrenals

Question 4

A: Describe the [Neisseria Meningitidis] Vaccine

A2: What part of the immune system does it stimulate

B: Who is it for? (3)

Answer 4

A: Polysaccharides from Group A, C, Y , W-135 conjugated to conjugated to either diphtheria toxoid, [N. meningitides OMP] or [tetanus toxoid]

A2: T-cell dependent antigens

B:

• Starts at 2 months y/o
• [all adolescents age 11-12]
• [at risk adults]

Question 5

Define these [NEISSERIA GONORRHEAE] structures:

A: PorB

B: Opa

C: Rmp

Answer 5

A: PorB - Outer membrane protein 1 (Porin) that acts as a channel and facilitates epithelial cell invasion

B: Opa - adherence protein tht confer OPAQUE appearance to colony

4. Rmp (Reduction Modifiable Protein) – stimulates [blocking antibodies] to literally block the good antibodies

Question 6

What is the difference between NEISSERIA GONORRHEAE [Antigenic variation] vs. [Phase variation]

Answer 6

1. Pili - Antigenic variation
   a. recombination by transfer of pilS to the expression locus, pilE

vs.

2. Opa – Phase variation
   a. Can switch on and off as many as 11 different Opa
   genes throughout the genome

Question 7

A: List the attachment sites for
*Pilli (5)

*Opa (2)

B: How does [Neisseria Gonorrhea] obtain iron

Answer 7

1. Pilli attach to
   - urethra
   - [vaginal epithelium]
   - [nonciliated fallopian tube epithelium]
   - neutrophils
   - sperm
2. Opa attach to
   - urethra
   - [cervical epithelium]

B: Has ability to bind to host cell transferrin and obtain iron

Question 8

A: Disseminated [Neisseria gonococcal] infection can lead to what 3 things?

B: Incubation time for [Neisseria gonococcal]

C: Who is [Gram Stain] testing more sensitive for? [Male vs. Female]

Answer 8

Disseminated gonococcal infection – 1-3% women>men

a. Arthritis
b. Dermatitis
c. Endocarditis, meningitis – rare

B: 2-5 Days

C: MALES have more sensitive/accurate [Gram Stain Test]

Question 9

What are the two Penicillin resistance types

Answer 9

Penicillin resistance - two types

a. decreased affinity for penicillin of penicillin-binding proteins
b. Plasmid mediated TEM-type β-lactamase (PPNG)

Question 10

Which [Haemophilus Influenzae] biogroup causes [Brazilian Purpuric Fever]?

B: Describe [Brazilian Purpuric Fever] (4)

Answer 10

H. influenzae biogroup AEGYPTIUS causes Brazilian purpuric fever

B: HIGHLY LETHAL Conjunctivitis which may progress to

• fever,
• petechiae,
• purpura
• shock

Question 11

Major virulence factor for [Haemophilus Influenzae]

Answer 11

TYPE B - polyribitol phosphate (PRP)

-Also contained in Vaccines to DEC childhood invasive infection and meningitis

Question 12

NON-encapsulated [Haemophilus influenzae] commonly colonize the _______, rarely cause _______, but are common causes of ____(3)

Answer 12

Unencapsulated H. influenzae commonly colonize the upper airway, rarely cause invasive disease, but are common causes of

• sinusitis,
• otitis media
• exacerbations of chronic bronchitis

Question 13

A: Explain Cellulitis caused by [Haemophilus influenzae]

B: What age group does it occur in

Answer 13

A: Purplish, erythematous swelling involving cheek, periorbital area

B:children 2-4 years

Question 14

A: Which [Haemophilus Influenzae] causes an [STD Chancroid]?

B: What is the main sx

C: Why is this a problem for future Dz?

D: Which Factor does this strain need to grow in Chocolate Agar?

Answer 14

A: [STD Chancroid] - [Haemophilus ducreyi] .

B: painful genital ulcer w/ lymphadenopathy.

C: Open sores enhance risk of transmission of HIV

D: Factor 5

Question 15

A: How does the [A subunit] of [Pertussis Toxin] work molecularly?

B: What are the 3 results of this

C: How does the [B subunit] of [Pertussis Toxin] work molecularly

Answer 15

A: [A subunit] catalyzes the ADP ribosylation of a
cellular regulatory protein (G- protein) —> prevents inactivation of the [adenylate cyclase]—> INC cAMP

B:
ºIncreased respiratory secretions –> Cough
ºmucus production –> Cough
ºlymphocytosis

C: [B subunits] bind to receptors on ciliated respiratory cells and phagocytic cells

Question 16

What 2 things does the [Adenylate cyclase PERTUSSIS TOXIN] do?

Answer 16

Adenylate cyclase toxin
a) Causes increased cAMP levels in host cells
b) Interferes with chemotaxis and superoxide production
of leukocytes

Question 17

List the 5 [Bordatella Pertussis] Toxins

B: Which one causes IL1 release and fever?

Answer 17

1. Pertussis Toxin
2. [Adenylate cyclase] Toxin
3. Tracheal cytotoxin = causes extrusion of [ciliated rep epithelial cells] AND [IL1 release / Fever]
4. Dermonecrotic Toxin
5. Endotoxin (AKA LPS)

Question 18

1. Incubation time for [Bordatella Pertussis]
2. What sx are in the Catarrhal Stage? (4)
3. describe the Cough (5)
4. What is the [Convalescent stage]

Answer 18

1. Incubation 7-10 days
2. Catarrhal stage - rhinorrhea, fever, sneezing, anorexia
3. Paroxysmal cough:
   - up to 50 times a day for 2-4 weeks.
   - Inspiratory whoop,
   - vomiting,
   - mucoid secretions,
   - [marked lymphocytosis]
4. Convalescent stage - COUGH gradually fades but can last for 100 days

Question 19

A: Recommended [Bordatella Pertussis] Vaccine Regimen for Adults

B: What 3 components is the [acellular Bordatella Pertussis Vaccine] composed of?

Answer 19

A: TDaP, is recommended for all adults (every 10 years)

B:

1. detoxified pertussis toxin (PT),
2. filamentous hemagglutinin (Fha),
3. Pertactin (Pn)