An Introduction to the Microbiology of the Skin Flashcards
• What skin microenvironments are created?
Elevated temperature with humidity, occluded sites (digital webs) & other factors (exposure to UV light, diet & hormonal changes)
• What skin factors effect microbiology?
Skin mostly dry – affects ability to adhere, pH, salinity, nature of lipids and immune response, antimicrobial peptides in sweat, transferrin
• What factors predispose niches to colonisation?
Local secretions, local pH, contamination from local structures, moisture
• What are resident and transient organisms?
Resident – can replicate on the skin and can persist
Transient – cannot replicate so stay for a short time
• What is the most common yeast commensal?
Malassezia pachydermatitis
• What approach would you take to concurrent Malassezia and Staphylococcus pseudintermedius samples being found on a swab?
Treat
• What type of bacteria would you not expect to find on a routine swab?
Gram –ve & rods
• What are the common features of the Staphylococcus species?
Gram +ve, catalase positive, facultative anaerobes, oxidase negative, non-motile, four types of haemolysis
• How do you distinguish between S. aureus & S. pseudintermedius?
S. aureus can ferment maltose, S. pseudintermedius cannot
• What virulence factors to Staphylococcus species possess?
Coagulase, lipases, elastase, protein A inhibits opsonisation & a range of toxins
• With regards to treatment, what do most staphylococcus species produce?
β-lactamase enzyme which inactivates penicillin
• What do MRSP and MRSA stand for?
MRSP – methicillin resistant staphylococcus pseudintermedius
MRSA – methicillin resistant staphylococcus aureus
• What are pseudomonas?
Rod shaped, gram –ve, aerobic, non-spore forming bacteria, associated with a wide range of opportunistic infections
• What are the naturally occurring defences by the skin?
Secretory immunoglobulin A, cell-mediated immunity, physical barrier, desquamination (constant flow of cells), poor conditions – dry & low pH, competition by normal flora
• What barriers help provide innate immunity?
Physical barrier, antimicrobial peptides, mucus, complement, phagocytic cells, lymphocytes and NK cells, mast cells, cytokines and chemokines, the development of inflammation
• What are the mechanisms by which microbes can avoid host detection?
Antigen variation, inhibition of antigen processing, inhibition of complement activation, resistance to phagocytosis, inactivation of reactive oxygen species, escape from phagolysosome, production of cytokine receptor homologues
• What is the result of superantigens?
Superantigens over active T lymphocyte by passing the normal process, activation by binding MHC and lymphocytes but not through the peptide binding cleft, this can lead to cytokine production and an inflammatory response
• What factors impact on the cutaneous environment?
Moisture/humidity, damage, normal tissue maintenance, washing, behaviour, health & physical breaches of the barrier
• What are the usual primary causes that result in proliferation of commensals?
Hypersensitivity, systemic disease, damage compromise of defences
• What may skin disease be due to?
A virulent pathogen, proliferation of normal commensals, penetration through damage of skin by commensals or pathogens, disruption of the normal skin biology allowing secondary infection