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Pathology And Pharamcology > Anaerobic Bacteria > Flashcards

Anaerobic Bacteria Flashcards

1
Q

Four main toxins produced by C. perfringens

A
  • Alpha
  • Beta
  • Epsilon
  • Iota

From 5 toxintypes (A,B,C,D,E)

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2
Q

Which C. perfringens toxin causes the gas gangrene?

A

Alpha toxin - lecithinase C / Phospholipase C
Theta toxin - Cytolysin

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3
Q

Risk factors for C.perfringens?

A

Trauma to host tissue (puncture/gunshot wounds)
Surgical incisions
diabetic ulcers
Septic abortions

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4
Q

Symptoms of gas gangrene ?

A
  • fever and pain in the infected tissue.;
    –more local tissue necrosis and systemic toxemia.
    –Infected muscle is discolored (purple mottling) and edematous
    –produces a foul-smelling exudate;
    –gas bubbles form from the products of anaerobic fermentation
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5
Q

Which strain of C.perfringens causes food poisoning ?

A

Enterotoxin producing strains

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6
Q

How many bacteria species of c perfringens is required to causes food poisoning ?
What happens once they are ingested?

A
  • More than 108 vegetative cells
  • They sporulate in the gut once they are ingested
  • Hypersecretion of toxins in the jejunum and ileum.
  • Diarrhea develops after like 6-18hours
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7
Q

C. perfringens is found where ?

A
  • In mammalian feces and soil
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8
Q

What bacteria and toxin causes pig bel?

A
  • C. perfringens
  • B-Toxin
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9
Q

Another name of pig bel and characteristic of the disease ?

A

Necrotizing enteritis
Enteritis necroticans

  • Causes acute necrosis in the jejunum
  • Seen in children in New Guinea - Type C strain
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10
Q

What kind of spores does C. botulinum produce?

A

Sub-terminal spores which are highly heat resistant

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11
Q

How many toxigenic subtypes in C. botulinum ?
Most potent toxin?

A

7 (A, B,C,D,E,F,G)

Toxin A is the most potent

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12
Q

Where can you find Clostridium botulinum?

A
  • Canned food: Hams, sausage, Fish, liver paste, honey, home preserved meat products and vegetables
  • intestinal tract of birds, mammals, fish
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13
Q

Symptoms of botulism

A

Block the release of ACH neurotransmitter
Symptoms
- double vision
- inability to swallow
- speech difficulty
- bulbar paralysis
- constipation
- Bilateral descending weakness of peripheral muscle
- Death occurs from respiratory paralysis or cardiac arrest
•Mortality is high

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14
Q

When and why does Infantile botulism occur?

A
  • Occurs in the first month of life
  • Caused by ingestion of the bacteria or spores
  • Feeding of honey has been implicated as a possible cause

Symptoms
- Weakness and signs of paralysis,
- C. botulinum and its toxin are found in faeces
- Patients recover with supportive therapy alone

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15
Q

What pattern of spore forming does C. tetani exhibit?

A

Terminal sporulation

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16
Q

Types of clostridium tetani toxin ?

A
  • Tetanolysin; no determined function
  • Tetanospasmin: polypeptide, MW of 160,000, produced during lysis of bacteria.
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17
Q

Symtoms of tetanus ?

A

Tetanospasmin blocks the release of inhibitory neurotransmitters

  • muscle spasm (spontaneous or initiated by environmental stimulus)
  • lock jaw (trismus)
  • risus sardonicus (Devil’s Smile)
  • dysphagia
  • opisthotonus
  • laryngospasm can lead to serious respiratory distress
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18
Q

Clostridium deficile

A
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19
Q

Hehehe

A
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20
Q

Sheheh

A
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21
Q

What’s the catalyst and indicator in an anaerobic Jar?

A

Gaspak - Catalyst
Methylene blue - indicator (blue in the presence of origin

22
Q

Principles for optimal recovery of anaerobes?

A
  • Proper collection and transport of specimens
  • Processing specimens with minimal exposure to atmospheric oxygen
  • Use of fresh or pre-reduced media
    –Proper use of anaerobic system
23
Q

Media to be used for Anaerobic organism identification?

A
  • Anaerobe blood agar
  • Kanamycin-vancomycin agar
  • Anaerobe paramomycin-vancomycin laked blood agar
  • Cycloserine-cefoxitin fructose agar
  • Enriched thioglycolate medium
24
Q

Which agar for C.difficile ?

A

Cycloserine-cefoxitin fructose agar

25
Q

Which agar for Bacteriodes fragilis ?

A

Anaerobe paramomycin-vancomycin laked blood agar

26
Q

Agar for Bacteroides and pigmented anaerobes?

A

Kanamycin-vancomycin agar

27
Q

Blood culture medium for Anaerobes ?

A
  • Thioglycolate medium
  • Trypticase-soy broth
  • Supplemented peptone broth
  • Brain-heart infusion broth
  • Brucella broth
  • Columbia broth
28
Q

Precautions to take when sampling for Anaerobic bacteria?

A
  • AVOID throat swabs, sputum, gastric contents, skin surfaces, voided urine, vaginal swabs
  • Go for exudates from deep abscesses, tissue biopsies, aspirates
  • Need to decontaminate skin well
  • Use of a reducing media like Robertson cook meat medium to inoculate from site of collection to transport
29
Q

C. botulism causes what type of paralysis in infant ?

A

Baby flaccid paralysis
Floppy baby syndrome

30
Q

In the soil and intestinal tract of human, clostridia live as ?

A

saprophytes.

31
Q

Toxin A of C. Perfringens

A

lethal action is proportionate to the rate at which it splits lecithin into phosphorylcholine and diglyceride.

32
Q

action of C perfringens enterotoxin

A

involves marked hypersecretion in the jejunum and ileum, with loss of fluids and electrolytes in diarrhea.

33
Q

Pathogenesis of C. Perfringens infection

A
  • spores reach tissue through contamination if traumatized tissue

The spores germinate at low oxidation-reduction potential; vegetative cells multiply, ferment carbohydrates present in tissue, and produce gas.

  • The distention of tissue and interference with blood supply, together with the secretion of necrotizing toxin and hyaluronidase, favor the spread of infection.
  • Tissue necrosis extends, providing an opportunity for increased bacterial growth, hemolytic anemia, and, ultimately, severe toxemia and death.
34
Q

What favour the the spread of C. Perfringens?

A
  • The distention of tissue and interference with blood supply, together with the
  • secretion of necrotizing toxin and hyaluronidase
35
Q

Gas gangrene also called? And what causes it ?

A

gas gangrene (clostridial myonecrosis),

  • a mixed infection is the rule.
  • toxigenic clostridia
  • proteolytic clostridia
  • various cocci and gram-negative organisms are also usually present.
36
Q

What species of Clostridium causes Toxic shock systole

A

C sordellii has been reported to cause a toxic shock syndrome after medical abortion

37
Q

How to prevent Pig bel ?

A

Immunization with type C toxoid appears to have preventive value.

38
Q

The most common cause of Pseudomembrane colitis are?

A

Ampicillin and clindamycin.
- The disease is treated by discontinuing offending antibiotic
- severe cases (metronidazole or vancomycin)

39
Q

How is pseudomembranous colitis diagnosed ?

A
  • detection of one or both C difficile toxins in stool
  • endoscopic observation of pseudomembranes or microabscesses in patients who have diarrhea and have been given antibiotics.

Diarrhea may be watery or bloody, and the patient frequently has associated abdominal cramps, leukocytosis, and fever.

40
Q

The term “Tetanus” is derived from the ancient Greek words ?

A

tetanos and teinein, meaning taut and stretched

  • which **describes the condition of the muscles affected by the toxin”
41
Q

How is tetanus acquired?

A
  • Tetanus spores are found throughout the environment, usually in soil, dust, and animal waste.
  • The usual locations for the bacteria to enter the body are puncture wounds, Burns or any break in the skin
  • Tetanus is acquired through contact with the environment; it is not transmitted from person to person.
42
Q

The majority of new cases worldwide are in?

A

in neonates in third-world countries.

43
Q

What are the different forms of Tetanus

A

The disease can manifest in 4 ways:
Generalized tetanus: most common and most severe.
Local tetanus: muscle spasms at or near the site of wound
Cephalic tetanus: usually involve 1 or 2 muscles of the face; trismus (Lock jaw) may occur, and usually progressing to generalized tetanus.
Neonatal tetanus: generalised tetanus occuring in neonates.

44
Q

risus sardonicus – is characteristi of ?

A

facial muscle spasms.

45
Q

Muscle spasms are progressive and may include a characteristic arching of the back known as ?

A

opisthotonus

Muscle spasms may result in fracture and dislocation..

46
Q

The diagnosis of generalized tetanus is usually made by observing the clinical presentation and a combination of the following:

A
  • history of a recent wounds in about 70% of cases
  • Incomplete tetanus immunizations
  • Progressive tonic muscle spasms starting the facial region, especially lockjaw to include all muscles of the body
  • Spasms can be precipitated by external stimuli
  • Neonates show signs of being generally irritable, muscle spasms, and poor ability to take in liquids (poor sucking response), usually seen in neonates about 7-10 days old.

-

47
Q

Laboratory diagnosis of tetanus?

A

Laboratory tests are rarely used to diagnose tetanus by taking sample from site of injury and culture on Kanamycin blood agar under anaerobic condition.

  • Toxins production and neutralization by specific antitoxin is an important proof of isolation of C tetani
  • Serum antitoxin levels if detected to be high are protective suggesting that the diagnosis of tetanus is unlikely.
48
Q

Treatment of tetanus

A
  • Prevent toxin production: Debridement of wound site, wound cleasing, oxidative wound treatment.
    **Neutralize unbound toxins with large doses of Anti Tetanus Serum (ATS): 3,000-10,000units of anti-tetanus immunoglobulin can be given.
  • Penicillins strongly inhibit clostridium and stop elaboration of toxin.
    other agents of pyogenic infections are treated also need to be taken care of hence triple therapy is commenced while awaiting M/C/S result.
  • Muscle relaxants and sedation is required
  • Ventilatory support: in spasms of the vocal cords or the respiratory muscles.
  • Rehydration because, muscles spasm increases metabolic demand and fluid loss on the individual
49
Q

Prognosis of tetanus

A
  • 25%-50% of people with generalized tetanus will die.
  • The disease is more serious when the symptoms come on quickly.
  • Older people and very young children tend to have more severe cases
  • Intensive medical care improves the prognosis in severe cases.
  • Death is usually due to respiratory failure or disturbance of heart rhythm
  • Neonatal mortality rates range from about 60-80%.
50
Q

Prevention of tetanus ?

A
  • Tetanus toxoid to prospective mothers at least 2x during pregnancy.
  • Immunization: DPT at 6th, 10th and 14th of life,
  • booster dose may be give one year later then every ten years.
  • Proper wound clean before suturing.
  • Give tetanus toxoid (T.T) to patients with injury on contact.
  • ATS can also be given in Effective treatment of patient with puncture wounds and immunization with T.T
  • Proper handling of neonatal umbilical cord

Pathology And Pharamcology (7 decks)

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