9-4 Pseudomonas & Gram negative bacteria Flashcards
A:L What type of pts acquire [Pseudomonas Aeruginosa] (4)?
B: How is it incorporated into the normal flora
C: Where do [Pseudomonas Aeruginosa] typically occur?
- Burn patients
- Cystic fibrosis patients
- Patients with hematologic malignancies
- Immunocompromised patients
B: Can be part of the microbial flora in
hospitalized patients and ambulatory,
immunocompromised hosts
C: Infections occur at any site where moisture tends to accumulate (external ear or indwelling catheters)
Most common cause of VAP (Ventilator Associated PNA)
[PseudoMONAs Aeruginosa]
Describe [Pseudomonas Aeruginosa] EXOTOXIN A (3)
Exotoxin A
– Blocks protein synthesis like the [diphtheria toxin]
– Wound dermatonecrosis
–Lung Tissue Damage
Describe [Pseudomonas Aeruginosa] EXOTOXIN S (2)
Exoenzyme S (S for Spreading)
– ADP-ribosylating toxin
– Epithelial cell damage facilitates bacterial spread, tissue invasion and necrosis
Describe [Pseudomonas Aeruginosa]
ELASTASE (3)
Elastase:
– Results in tissue destruction and [erythematous hemorrhagic lesions]—-> [ecthyma gangrenosum]
– 2 enzymes: Las A and Las B act synergistically to degrade elastin
– Degrades compliment components and inhibits neutrophil chemotaxis/function
A: What bacteria causes Melioidosis ?
B: What is the habitat for this bacteria
C: Is this a Biothreat agent?
A: Burkholderia Pseudomallei
B: Soil and Water 20º north and south of equator (SE Asia)
C: CATEGORY B BIOTHREAT AGENT
Describe the 3 Different Types of Burkholderia ________ Melioidosis
[Burkholderia pseudomallei] Melioidosis:
- Acute Disease: septicemia with metastatic lesions. 95% mortality if untreated
- SubAcute Disease: MOST COMMON. TB like pneumonia with cellulitis and lymphangitis
- Chronic Disease: localized cellulitis. Treat with antibiotics BEFORE DRAINING otherwise pt will become bacteremic
What’s the most common autosomal recessive genetic dz in Caucasians?
CYSTIC FIBROSIS
(Requires TWO DYSFUNCTIONAL ALLELES to have Dz)
A: Etiology for Cystic Fibrosis
B: Symptoms (5)
C: What is [Pulmonary Exacerbation] (2)
A: Gene mutation in CFTR (cystic fibrosis transmembrane regulator
B: “Cystic Fibrosis can cause PIINE and is associated with Serious Bronchial Problems”
º Pulmonary Exacerbation
ºInternalization of bronchial bacteria FAILS
ºINC inflammation
° Electrolyte transport abnormality—> [thick/sticky mucus accumulation]—> PERFECT NICHE for chronic lung infection
C: Pulmonary Exacerbation =
- neutrophil recruitment with inappropriate elastase activity
- cytokine release
3 Main bacteria implicated in Cystic Fibrosis Infections
“Cystic Fibrosis can cause PIINE and is associated with Serious Bronchial Problems”
- Staph aureus
- Burkholderia Cepacia complex
- Psuedomonas aeruginosa
3 Lab Characteristics of [Burkholderia Cepacia]
- Glucose NON-FERMENTER
- Yellow pigmented
- SLOW oxidase-positive
[Stenotrophomonas maltophilia]
A: [Community Acquired] or [Hospital Acquired]
B: What’s this bacteria 2nd leading cause of?
C: What’s the Hallmark for [Stenotrophomonas maltophilia]
disease
D: Natural Habitat (3)
Stenotrophomonas maltophilia :
A: [hospital acquired]
B: 2nd leading cause of [gram-negative nonfermentative bacillary infections]
C: Hallmark = life- threatening systemic infections in debilitated patients
D:
ºWorldwide Distribution but is NOT APART OF OUR EXTERNAL FLORA
ºClinical sites
° Respiratory Tract
A: List the Opportunistic Infections [Stenotrophomonas maltophilia] can cause (5)
B: Oxidase negative or positive
C: Color?
“Steno Maltophilia can cause a Wound BUMP”
- Wound Infection
- Bacteremia
- UTI
- Meningitis
- PNA
B: OXIDASE NEGATIVE and some strains have yellow pigment
Tx for [Stenotrophomonas maltophilia]
- Inherently resistant to ______ agents including ______ and ______
- Drug of Choice
- Alternates if someone is allergic (5)
[Stenotrophomonas maltophilia]
- Inherently RESISTANT to [beta lactam] and aminoglycoside agents
- ►USE BACTRIM for Tx***
- Alternate: [ticarcillin/clavulanate], ceftazidime, Levofloxacin, Minocycline, tigecycline
_“_Use LMT-CT if BACTRIM isn’t avail”
[Elizabethkingia meningoseptica]
A: Disease (3)
B: Tx (4)
C: Oxidase negative or positive
D: + or - growth on MacConkey Agar
“Queen Elizabeth Probably BreastFed Neonates!”
A:
- Potential PNA in [intensive care adults]
- Breast Pumps are common cause of Nosocomial Outbreaks in hospital nurseries
- ## Neonatal meningitisB: Tx= (It is VERY RESISTANT to [beta lactam agents]) So you have to use a QBRIM for Tx:
º Quinolones
º Bactrim
ºRifampin
° Minocycline
C: OXIDASE PoSitive
D: NO GROWTH on MacConkey Agar
