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Anaerobic bacteriology Flashcards

1
Q

Concepts in Anaerobic Bacteriology

Normal Air = about ___% O2 and ____% CO2

CO2 Incubator = about _____% O2 and ___%- ___% CO2

Microaerophilic System = ___% CO2

Anaerobic System – __% O2

A

21; 0.03

15; 5-10

5

0

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2
Q

Obligate anaerobes

-they undergo no ___________
-they can do _____
-are killed by ____
lack certain enzymes such as :
____
_____
____

A

oxidative phosphorylation

fermentation; oxygen

superoxide dismutase

catalase

peroxidase

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3
Q

Obligate anaerobes grow ONLY in the absence of _______ but vary in their _______ and can be classified as _____ anaerobes or ______ anaerobes

A

molecular oxygen

sensitivity to oxygen

moderate; strict

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4
Q

Moderate anaerobes can ________ exposure to air for _______ but cannot _______

A

Tolerate ; several hours; multiply

multiply

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5
Q

Strict anaerobes are _____ by only a _______’ exposure to air

A

killed; few minutes

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6
Q

Fortunately ____ anaerobes are seldom associated with human infections

A

strict

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7
Q

Anaerobes

Bacteria that require anaerobic conditions to _____ and ______

A

initiate and sustain growth

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8
Q

Strict (obligate) anaerobe

Unable to grow if there is > than ____% oxygen

A

0.5

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9
Q

Moderate anaerobes
Capable of growing between ____% oxygen

A

2-8

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10
Q

Microaerophillic bacteria doesn’t grow in air

T/F

A

F

It just Grows poorly in air, but better in anaerobic conditions

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11
Q

Facultative bacteria (facultative anaerobes)

Grows only in the presence of air

T/F

A

F

both in presence and absence

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12
Q

Anaerobes do not have enzymes for __________________________________, so oxygen can have a _________ or even ________ effect on them

A

protection against the toxic effects of molecular oxygen

bacteriostatic; bactericidal

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13
Q

Anaerobes require environments with (low or high?) oxidation- reduction potential (redox), so they must live in areas where the redox potential is ( low or high?)

A

Low

Low

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14
Q

Anaerobes are thought to be the second earliest forms of life

T/F

A

F

Earliest

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15
Q

All life on earth was (aerobic or anaerobic?) for hundreds of millions of years

A

Anaerobic

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16
Q

Today anaerobes are found in soil, fresh and salt water, and in ______ of humans and animals

A

normal flora

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17
Q

Problems in identification of anaerobic infections

1)______ during sampling or transportation leads to no growth

2)identification takes _______ or longer therefore limiting usefulness

3) often derived from ______ , therefor sample contamination can confuse

A

air in sample

several days

normal flora

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18
Q

Anaerobes that live outside the body are called “ _________ anaerobes” (Example: ________ species)

Anaerobes that live inside the body are called “ _________ anaerobes”

A

exogenous ; Clostridium

endogenous

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19
Q

Most anaerobic infections are from ( endogenous or exogenous ?) sources

A

endogenous

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20
Q

Classification of Medically Important Anaerobes

Gram positive cocci
-___________________
Gram negative cocci
–______________

A

Peptostreptococcus

Veilonella

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21
Q

Classification of Medically Important Anaerobes

Gram positive bacilli
•__________________________________
•______________
•_____________
•___________
•__________

A

Clostridium perfringens, tetani, botulinum, difficile

Propionibacterium

Actinomyces; Lactobacillus; Mobiluncus

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22
Q

Classification of Medically Important Anaerobes

Gram negative bacilli

————-
—————
—————
——————

A

Bacteroides fragilis, thetaiotaomicron
Fusobacterium
Prevotella
Porphyromonas

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23
Q

Epidemiology
–Endogenous infections

•Indigenous microflora
Skin: _________, _________

Upper respiratory: __________

Mouth:_____,________

Intestines:_____,_____,________

Vagina: _________

A

Propionibacterium; Peptostreptococcus

Propionibacterium

Fusobacterium, Actinomyces

Clostridium, Bacteroides, Fusobacterium

Lactobacillus

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24
Q

Epidemiology
–Endogenous infections

•Profound modification of flora in pathophysiologic states such as:

______________(PPI, antacids)
__________(____)
_________

A

Antimicrobials and other medications

Surgery (blind loops)

Cancers

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25
Q

Epidemiology of anaerobes
–Endogenous infections

Exogenous infections

A

T

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26
Q

Indigenous microflora of the skin:

Prevalence in areas exposed to air explained by (1) ____________ (2) ______________ of the microhabitats

A

oxygen consumption by aerobes

low oxidation-reduction potential

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27
Q

Role of Anaerobes

Role in normal host physiology
– Prevent _________ and ______ by ____

– Contributes to _________

A

colonization & infection by pathogens

host physiology

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28
Q

Role of Anaerobes
Role in normal host physiology
•– Prevent colonization & infection by pathogens

Bacterial interference through _____,_____,_______

Also by Interference with _______

•– Contributes to host physiology
E.g _________ synthesizes ________ and __________________

A

elaboration of toxic metabolites, low pH, depletion of nutrients

adhesion

B. fragilis; vitamin K ; deconjugates bile acids

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29
Q

Anaerobic Anatomical Sites for Endogenous Anaerobes
anaerobes often cause infection in the urinary tract

T/F

A

F

Rarely

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30
Q

Anaerobic Anatomical Sites for Endogenous Anaerobes
–GU Tract – cervical and vaginal areas have ____% anaerobes

–GI Tract – Approximately 2/3’s of all bacteria are in the ____; only cultured anaerobically if ___________ is suspected

A

50

stool

Clostridium difficle

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31
Q

Indications of Anaerobic Infections

Usually _______ ( ____ -producing)

Close proximity to a _____ surface

Infection persists despite _________

A

purulent; pus

mucosal

antibiotic therapy

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32
Q

Indications of Anaerobic Infections

Presence of ____ odor

Presence of large quantities of _____ (______ or ______ sound when tissue is pushed)

Presence of ____ color or ____ fluorescence

A

foul

gas; bubbling or cracking

black; brick-red

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33
Q

Indications of Anaerobic Infections

Presence of “ ______ granules”

Distinct morphologic characteristics in ________ preparation

A

sulfur

gram-stained

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34
Q

Virulence factors

•Lipopolysaccharide - promotes _______, enhanced _________

•Polysaccharide capsule - correlated with _______ production

•Enzymes a. ______ b. ________ which can lead to development of _______ and _____ emboli

A

abscess formation; coagulation

abscess

Collagenase; Heparinase

thrombophlebitis & septic emboli.

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35
Q

Virulence factors

____ chained fatty acids a. Butyrate- seen in ________ b. succinic acid – reduces _____

A

Short

dental plaque

phagocytic killing

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36
Q

Virulence factors

•Attachment and adhesion
______ and _______

•Invasion

________ in host tissue (trauma, disease)
________ of the organism

A

Polysaccharide capsules and pili

Alteration; Aerotolerance

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37
Q

Virulence factors

•Establishment of infection

_________ (B. fragilis)
_________ (Clostridium)
Maintenance of ________ environment

•Tissue damage
___________

A

Polysaccharide capsule

Spore formation

reduced oxygen

Elaboration of toxins

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38
Q

Clinical features of anaerobic infections

The source of infecting micro-organism is the ____________ of host

________ of host’s tissues provide suitable conditions for development of __________ infections

_______ formation
________ formation

A

endogenous flora

Alterations; opportunist anaerobic

Abscess; Exotoxin

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39
Q

Anaerobic infections are generally polymicrobial

T/F

A

T

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40
Q

Specimens for Anaerobic Culture

Tissue – must be placed in _______ transport bag or vial

Blood – ________________________ bottles are collected for most blood culture requests

A

an oxygen-free

aerobic AND anaerobic

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41
Q

Typical Anaerobic Media
_______________ agar (BRU/BA)

__________________ agar (BBE)

________________________ agar (KVLB)

_____________ agar (PEA)

Anaerobic broth, such as ______,________, or ________ agar

A

Anaerobic blood

Bacteroides bile esculin

Kanamycin-vancomycin-laked blood

Phenylethyl alcohol

thioglycollate (THIO) , brain heart infusion or chopped meat

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42
Q

Anaerobic Incubation
•Anaerobic ________ (p. 581)

•Anaerobic jars
________________ generate _____ and ____ , which combines with ____

•Anaerobic ______ or _____

A

chambers

Gas-Pak envelopes

CO2 and H2; O2

bags or pouches

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43
Q

Warning!:
_____ is explosive; _____ catalyst MUST be used with the anaerobic jars

A

H2; palladium

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44
Q

All anaerobic incubation systems must have ____________ system in place

A

an oxygen indicator

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45
Q

Definitive Identification of Anaerobes

_______ and ________ biochemical test media

Biochemical-based and preexisting enzyme-based minisystems

______ chromatographic analysis of metabolic end products

_________ analysis by GLC

A

PRAS (Pre-reduced Anaerobic System) and non-PRAS

Gas-liquid

Cellular fatty acid

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46
Q

Frequently Encountered Anaerobes
Gram-positive spore-forming anaerobic bacilli
– _________

A

Clostridium

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47
Q

Frequently Encountered Anaerobes
Gram-positive spore-forming anaerobic bacilli
– Clostridium
Most from (endo or exo?) genous sources

Examples:_____,______,_______,______,________

A

Exo

tetanus, gas gangrene, botulism, food poisoning, pseudomembranous colitis (C. difficle)

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48
Q

Clostridium difficle is most often detected via _______________ detection

A

direct stool antigen

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49
Q

Frequently Encountered Anaerobes (cont’d)
Gram-positive non-spore-forming anaerobic bacilli

–PALMEB(________________________________)

– Most are from (Endo or Exo?) genous sources and are therefore ______

A

Actinomyces, Bifidobacterium, Eubacterium, Mobiluncus, Lactobacillus, and Propionibacterium

Endo

opportunists

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50
Q

Frequently Encountered Anaerobes (cont’d)

Anaerobic gram-negative bacilli
– (endo or exo?) genous

– Include _____ group, ______,_____, and ______

A

Endo

Bacteroides fragilis

Porphyromonas spp., Prevotella spp., and Fusobacterium spp.

51
Q

Frequently Encountered Anaerobes (cont’d)

Anaerobic cocci
-usually (endo or exo?) genous

-Gram-positive –__________
– Gram-negative – _______ spp.

A

endo

Peptostreptococcus

Veillonella

52
Q

Source of spore-formers and non- spore formers

•Spore-formers (______)
– (presence or absence?) of exotoxins
– common in the _______
– also found in ______

•Non - spore-formers
- (presence or absence?) of exotoxins
– mostly _______

A

clostridia; presence; environment; normal flora

absence; normal flora

53
Q

Anaerobic cocci

Normal flora of _____,_____,______, and ____

A

skin, mouth, intestinal and genitourinary tracts

54
Q

Anaerobic cocci

Pathogenesis

-they are _______ pathogens
-often involved in _______ infections
-can cause Brain ____, ______ disease, _____, skin and soft tissue infections, _______ infections

A

Opportunistic

polymicrobial

abscesses; periodontal; pneumonias; intra-abdominal

55
Q

Virulence factors of anaerobic cocci are well characterized

A

F

not as well characterized

56
Q

Anaerobic cocci

Peptostreptococcus
P. _____
P. _____
P. _______

A

magnus

prevotti

anaerobius

57
Q

Anaerobic cocci

Peptostreptococcus

P. magnus: ____________ infections, especially ______ joints

P. prevotti and P. anaerobius: _________ and ———— infections

A

chronic bone and joint ; prosthetic

female genital tract and intra- abdominal

58
Q

Anaerobic cocci

Veillonella

Found in Normal ____ flora

isolated from ________ infections

A

oral

infected human bites

59
Q

Anaerobic gram positive bacilli

No Spore Formation
•Propionibacterium
-P.______

•Actinomyces
A. _______

•_______

•_______

A

Acnes

Israeli

Lactobacillus

Mobiluncus

60
Q

Anaerobic gram positive bacilli

• SporeFormation
– Clostridium
• C._______
•C. _______
•C. ______
•C. ______

A

perfringens

difficile

tetani

botulinum

61
Q

Propionobacterium

-Anaerobic or _____, produces ______ as major byproduct of fermentation

-Colonize ____,_____,______,____,______

A

aerotolerant; propionic acid

skin, conjunctiva, external ear, oropharynx, female GU tract

62
Q

P. acnes

•Acne

–Resides in ________ , releases _____ peptide, stimulates _______ response

•Opportunistic infections
–________ devices (_______,———)

A

sebaceous follicles; LMW; an inflammatory

Prosthetic; heart valves, CSF shunts

63
Q

Actinomyces

-Could be _____ or ______ anaerobes

-Colonize _____,———-, and _____

-(Low or High?) virulence

-development of disease when ______ are disrupted

A

Facultative or strict

upper respiratory tract, GI, female GU tract

Low; normal mucosal barriers

64
Q

Actinomyces

Diagnosis:

-_____scopic colonies of organisms resembling ________(____)

–Culture

A

Macro

grains of sand (sulfur granules)

65
Q

Actinomycosis

_________ Actinomycosis

•Can be caused by __________, ___ trauma

• (Rapidly or Slowly?) evolving, (painful or painless?) process

•_________ lesions that become ______ and form ________

Treatment: __________ and ________

A

Cervicofacial

Poor oral hygiene; oral

Slowly, painless

Chronic granulomatous; suppurative; sinus tracts

surgical debridement and prolonged penicillin

66
Q

Lactobacillus

-is a ________ or ________ anaerobes

-it Colonizes ____ and _____ tract

-it Produces _____ which is bactericidal to _____________

A

Facultative or strict

GI and GU

H2O2; Gardnerella vaginalis

67
Q

Lactobacillus

Clinical disease

Transient _______ from ____ source

Endocarditis

_________ in immunocompromized host

A

bacteremia; GU

Bacteremia

68
Q

Vagina heavily colonized (105/ml) by Lactobacillus ______ and ——-

A

crispatus & jensonii

69
Q

Mobiluncus

-are ———— anaerobes

-Gram _____ or gram ________

  • Colonize ______ in (low or high?) numbers

-Associated with bacterial ______

A

Obligate

negative; variable

GU tract; low

vaginosis

70
Q

Mobiluncus is Detected in vagina of ___% of controls and As many as ____% of women with bacterial vaginosis

A

6

97

71
Q

Clostridium

Epidemiology

Ubiquitous:
•present in _______
• also present in ________

Pathogenesis
___________ that are resistant to ____,___,______ and can survive for years in adverse environments

A

Soil, water, sewage
Normal flora in GI Tracts of human and animals

Spore formation; heat, dessication, and disinfectants

72
Q

Clostridium

Rapid growth in _______, oxygen deprived environment

Toxin elaboration (_______ toxins, ______toxins, ______toxins)

A

nutritionally enriched

histolytic; entero; neuro

73
Q

Clostridium perfringens

Epidemiology
•found in ____ of humans and animals
•Type __ responsible for most human infections

A

GI tract

A

74
Q

Clostridium perfringens

Pathogenesis
•α-toxin: _____ (phospholipase C) that lyses ______,______, and ______ cells

•ß-toxin:_______ activity

•θ-toxin:________

•Enterotoxin: binds to ______ and disrupts small intestinal transport

A

lecithinase; erythrocytes,platelets and endothelial

necrotizing; hemolysin

brush borders

75
Q

Clostridium perfringens

Clinical manifestations

•Self-limited _______

•Soft tissue infections: ______, _______ or ________ (_____ gangrene)

A

gastroenteritis

cellulitis

fascitis or Myonecrosis

Gas

76
Q

Clostridial myonecrosis

Clinical course:
-less than _____ hours incubation
-local area marked with ____,———-,_______ discharge, bullae, slight _____
-May be associated with increased _____

A

48

Pain, swelling , serosanguinous, crepitance

CPK

77
Q

Clostridial myonecrosis

– Treatment

_________
___________
_______

A

Surgical debridement
Antibiotics
Hyperbaric oxygen

78
Q

Clostridium difficile

Epidemiology

•Colonizes _____ of ___% healthy individuals

•Endogenous infection after _____ exposure associated with overgrowth of C. difficile

•Exogenous infection from _____ detected in _______ of infected patients

A

GI tract; 5

antibiotic; spores; hospital rooms

79
Q

______ _____ can lead to pseudomembanous colitis

: after _______, the intestinal normal flora is _______ and ______ occurs

A

Clostridium difficile

antibiotic use

greatly decreased; colonization

80
Q

C.Difficile pathogenesis

•Enterotoxin (toxin ___)
–produces _____, induces ______ production and ______ of fluid, development of ___________

•Cytotoxin (toxin __)

Induces __________ with loss of cellular _______

A

A; chemotaxis; cytokine; hypersecretion

hemorrhagic necrosis

B; polymerization of actin ; cytoskeleton

81
Q

Which exotoxin of Clostridium difficile is more potent

A or B

A

A

82
Q

C. difficile

exotoxin A (____,_____)

exotoxin B
- (also a _____)

A

enterotoxin, cytoxin

cytoxin

83
Q

C. difficile colitis

Clinical syndromes
•Asymptomatic _______
•Antibiotic-associated ______
•_________ colitis

A

colonization; diarrhea

Pseudomembranous

84
Q

C. difficile colitis

Diagnosis

Isolation of the _____ or ______

A

cytotoxin or enterotoxin

85
Q

C. difficile colitis

Treatment

• ____________
•________ or ______
•Relapse in __-__% (spores are resistant)

A

Discontinue antibiotics

Metronidazole or vancomycin

20-30

86
Q

Clostridium tetani

Epidemiology
•Spores found in _____
•is a Disease in _________ or _____

A

most soils

un-vaccinated or inadequately immunized

87
Q

Clostridium tetani infection induces immunity

T/F

A

F

Disease does not induce immunity

88
Q

Clostridium tetani

Pathogenesis
•Spores gets inoculated into ____

A

wound

89
Q

Clostridium tetani

Tetanospasmin
•Heat-(labile or stable ?) ____toxin

•(Antero or Retro?) grade axonal transport to ___

•Blocks ________________________ resulting in ________ paralysis

Binding is (reversible or irreversible ?)

A

labile; neuro

Retro; CNS

release of inhibitory neurotransmitters (GABA)

spastic; irreversible

90
Q

Clostridium tetani

Tetanolysin

•Oxygen (labile or stable ?) __________

A

Labile

hemolysin

91
Q

What is the clinical significance of clostridium tetani

A

unclear clinical significance

92
Q

Clostridium tetani spore is : sub terminal or terminal?

A

Terminal

93
Q

Clostridium Tetanus

Clinical manifestations

•Generalized–
Involvement of _____ and ——— muscles
–______involvement

•Cephalic
–Involvement of _____ nerves only

• Localized
–Involvement of muscles in _____

• Neonatal
–(localized or generalized?) in neonates; infected ________

A

bulbar and paraspinal

Autonomic

cranial

primary area of injury

Generalized; umbilical stump

94
Q

Clostridium Tetanus

Treatment
–______ of wound
–_______
– Tetanus ______
– Vaccination with _______

Prevention
– Vaccination with a series of ________
– Booster dose every ___ years

A

Debridement
Metronidazole
immunoglobulin
tetanus toxoid

3 tetanus toxoid; 10

95
Q

Clostridium botulinum

Epidemiology
– Commonly isolated in _________
– Human disease associated with __,___,__,__

A

soil and water
A, B, E, F

96
Q

Clostridium botulinum

Pathogenesis
– Botulinum toxin targets __________
– Prevents release of _______
– Recovery depends upon ______________

A

cholinergic nerves

acetylcholine

regeneration of nerve endings

97
Q

Clostridium botulinum

food poisoning is (common or rare?) ,(fatal or non-fatal?)
germination of spore

Can come from _____________ food
home

A

Rare

fatal

inadequately sterilized canned

98
Q

Botulism is an infection

T/F

A

F

not an infection

99
Q

Clostridium botulinum

It binds peripheral nerve receptors - acetylcholine neurotransmitter, and inhibits nerve impulses leading to _____ paralysis

•death as a result of
–_______ and ______ failure

A

flaccid

respiratory and cardiac

100
Q

Botulinum toxin can be used for ____

resembles a _______

A

Bioterrorism

Chemical attack

101
Q

Botulism

Clinical Syndromes

______ botulism

______ botulism

______ botulism

A

Food borne

Wound

Infant

102
Q

Clinical Syndromes of botulism

Foodborne botulism

•Mostly associated with _____ foods and preformed ____

•Onset of symptoms _____ days

•_____ vision, ______ pupils, ____ mouth, constipation

•Bilateral (ascending or descending?) weakness of _______ muscles

•death related to ______ failure

A

home-canned ; toxin

1-2; blurred; dilated; dry

Descending; peripheral

respiratory failure

103
Q

Clinical syndromes of botulism

Infant botulism

•Consumption of foods contaminated with ______

•Disease associated with ____toxin produced in ____

A

botulinum spores

neuro; vivo

104
Q

Bacteroides fragilis

(major or minor?) component of gut flora

A

Minor

105
Q

most common (strict) anaerobic infection after abdominal surgery is ????

A

Bacteriodes fragilis

106
Q

Anaerobic gram negative bacilli

Epidemiology
– Colonize human body in (minute or great?) numbers
- they ______ resident bacterial flora
- they Prevent ______ by pathogens

A

Great; Stabilize; colonization

107
Q

(Aerobes or Anaerobes?) are predominant bacteria in upper respiratory tract, GI and GU tract

They Outnumber the other type of bacterias by _________ fold

(Little or Many?) species, (many or few?) pathogens

A

Anaerobes

Aerobes

10-100

Many; few

108
Q

Bacteroides

Epidemiology
It is associated with ____% of intra-abd infx

A

80

109
Q

Pathogenesis of Bacteriodes fragilis

•________ capsule
•________ and ______
•Elaborate a variety of enzymes

A

Polysaccharide

Superoxide dismutase and catalase

110
Q

Pathogenesis of Bacteriodes

•Polysaccharide capsule
–Increases _______ to peritoneal surfaces (along with fimbriae)
-Protection against ________

A

adhesion; phagocytosis

111
Q

Polysaccharide capsule of anaerobic GNR Differs from LPS of aerobic GNB

T/F

How?

A

T

Less fatty acids linked to Lipid A component
Less pyrogenic activity

112
Q

Bacteroides fragilis
Major disease causing strict anaerobic non-spore-former

T/F

A

T

Note the strict

113
Q

Bacteriodes fragilis

(Endo or Exo?) toxin
(low or high?) toxicity
structure (the same or different ?) than other lipolysaccharide

A

Endo

Low

Different

114
Q

Bacteriodes fragilis

Presence of beta lactamase

T/F

A

T

115
Q

Bacteroides

Infections
–_________ infections (peritonitis, ______); _______; decubitus and ____ ulcers

Treatment
–______ of abscess and ______ of necrotic tissue
– ________

A

Intra-abdominal; abscess

bacteremias; diabetic

Drainage; debridement

Antibiotics

116
Q

Specimens for Anaerobic Culture

Aspirates
– Should be collected with _________
– Specimen injected into _______ transport ______ or ____

Swabs
– if collected, must be transported in
_________ system

A

needle and syringe

oxygen-free ; tube or vial

An anaerobic

117
Q

Collection, Transport and Processing Specimens for Anaerobic Culture

Any specimen collected on a swab is usually not acceptable because _____________________

A

of the possibility of having normal anaerobic organisms

118
Q

Compare bacterial growth of obligate aerobe, Microaerophilic, facultative anaerobe, and obligate anaerobe

A

Aerobe- at the top top surface
Micro- below the surface but still top
Facultative- the entire thing
Anaerobe- the bottom

119
Q

What disease can u find
Risus sardonicus

A

Tetanus

120
Q

Risus sardonicus

Aka

A

Evil grin

121
Q

Second symptom of tetanus?

A

First is Risus sardonicus

Second is opisthotonos

122
Q

Colitis caused by C.difficile must not be given IV vancomycin
T or F

A

T

Must be given oral vancomycin because we want the slow absorption

123
Q

The presence of sulphur granules suggest what bacteria

A

Actinomycetes

House Microbiology (93 decks)

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