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Micro Q3 > Anaerobic Infection & Normal Flora > Flashcards

Anaerobic Infection & Normal Flora Flashcards

0
Q

Abscess formation, foul discharge, gas formation, necrosis, and predisposing conditions such as pulmonary aspiration, bowel surg, bad dental hygiene, bites, and trauma are all common features of:

A

Anaerobic infection

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1
Q

T/F: most anaerobic infections are caused by a single species

A

FALSE; most anaerobic infections are mixed with multiple anaerobes or facultative aerobes.

Most aerobic infections are due to a single organism.

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2
Q

Most anaerobic infections are caused by/from:

A

The patient’s endogenous flora!

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3
Q

Bacteroides Fragilis infections (are/are not) penicillin resistant and are found (above/below) the diaphragm.

A

B. Fragilis infections are penicillin resistant and are found below diaphragm.

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4
Q

Bacteroides Fragilis are what shape

A

PLEOMORPHIC, but most commonly GM - rods

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5
Q

T/F: Bacteroides Fragilis are found in small numbers within the human large intestine

A

FALSE: THEY ARE FOUND IN LARGE-ASS NUMBERS 10^11 CFU per gram of poo

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6
Q

T/F: B. Fragilis can resist the bactericidal action of bile

A

TRUE

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7
Q

B. Fragilis and C. Perfringens together acccount for ___% of anerobic septicemias; ___% of all septicemias are anaerobic.

A

80%

10%

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8
Q

Extraintestinal infection by B fragilis may result in septicemia as a result of:

A

Bowel rupture, female genital infections -> abscess following birth, induced abortion, infected IUD

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9
Q

Name the most important anaerobe that is PENICILLIN RESISTANT:

A

B. Fragilis <- memorize this as penicillin resistant

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10
Q

The majo virulence factor for B. Fragilis is:

A

Its Capsule. Only encapsulated strains produce abcesses

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11
Q

Prevotella Melaninogenicus is a GM (+/-) ______

A

GM - rod

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12
Q

This bacterium along with other anaerobes, is a serious cause of periodontal dissease, sometime found in genital infections. Many strains are penicillin sensitive. Its name derives from ‘black pigment’ - hemin, that is required for its growth.

A

Prevotella melaninogenicus

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13
Q

This gram - rod species has TAPERED ENDS and are VERY THIN, they are penicillin and oxygen sensitive, and important causes of oral infection, lung abcess and abdominal infections

A

Fusobacterium

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14
Q

This gramm + rod is normal flora in the intestine + vagina, and important for maintaining low pH and preventing growth of pathogens by converting sugar to lactate. It is a non-pathogen. Some strains are used to make yogurt milk etc.

A

Lactobacillus

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15
Q

An infection by this GM positive branching rod species might be involved in cervico-facial, lung, or abdominal infections with SINUS TRACTS. Its microcolonies would be characterized by yellow SULFUR GRANULES

A

ACTINOMYCES

16
Q

This GM + coccus anaerobe grows in chains and is part of normal mouth gut and urogenital flora. It may be found in pleuro-pulmonary, brain abcess, or OBGYN infections.

A

Peptostreptococcus

17
Q

Treatment hierarchy for anaerobic infections (7)

A
  1. Penicillin! (EXCEPT FOR B. FRAGILIS -> don’t use alone for infection below diaphragm!!!)
  2. Clindamycin
  3. new cephalosporins (EFFECTIVE FOR B. FRAGILIS)
  4. chloramphenicol
  5. Metronidazole
  6. Gentamicin+ cefoxitin or + clindamycin for MIXED aerobe/anaerobe infection
  7. Surgical drainage for any acesses
18
Q

Bacterial overgrowth in the small bowel can lead to: (2)

A
  1. Fat malabsorption

2. Vitamin B12 deficiency

19
Q

Normal mouth flora:(5)

A 
Viridans Streptococci
Neisseria Species
Diptheriods
Staphlococcus epidermidis
Eiknella corrodens
20
Q

Viridans Streptococci

A

GM+ cocci in chains. Large numbers - PREDOMINANT organisms of MOUTH. Common cause of SUBACUTE ENDOCARDITIS. Highly adherent to valves and teeth. Turnn sucrose into plaque + make lactate -> cavities.

21
Q

Diptheroids

A

Corynebacterium species other than c. diptheriae that are NON PATHOGENIC PLEOMORPHOC GM + rods. found in mouth. Also, MOST COMMON CAUSE OF BLOOD CULTURE CONTAMINATION because they also colonize skin

22
Q

Staphlococci epidermidisare the major species of ________ negative staphlococci in the oral flora. They appear as GM ____ ____________

A

Coagulase negative

Appear as GM + cocci in grape like clusters. Along with diptheriods, they are the most common causes of blood culture contamination.

23
Q

Common anaerobes in oral cavity & sensitivity (4)

A
  1. Fusobacterium, penicillin sensitive
  2. Prevotella, penicillin sensitive
  3. Streptococci such as petptostreptococcus, penicillin sensitive
  4. Actinomyces
24
Q

T/F: anaerobes of the oral cavity (fuso, prevotella, etc) do NOT extend into the lower trachea in healthy individuals.

A

True!

25
Q

Gastric achlorhydria

A

abnormality with no stomach acid -> bacteria CAN proliferate in stomach. Normally bacteria CANNOT be cultured due to the acid.

26
Q

T/F: the upper small bowel is generally sterile

A

TRUE. sterility due to rapid movement and peristalsis and unconjugated bile acids. Bacteria may increase here in the event of obstruction.

27
Q

T/F: the terminal ileum is sterile

A

False. Normally houses about 10^6 bacteria due to stasis

28
Q

In the colon there is marked bacterial proliferation; metabolic activity of bacteria results in ammonia, acid, and gas production. HOW IS THE AMMONIA FORMED?

A

the bacteria split UREA to form protein

29
Q

Patient ruptures a bowel, what bacteria is a frequent cause of the following intrabadominal infection? What drug should you use?

A

BACTEROIDES FRAGILLIS is the MOST COMMON species in STOOL.

it is penicillin RESISTANT
USE CLINDAMYCIN, CEFOXITIN, OR METRONIDAZOLE for BELOW THE DIAPHRAGM infections

30
Q

Establishing flora:

  1. Fetal
  2. Born
  3. And then…
A

Fetal intestine is sterile
very very very few bacteria @ birth, but intestine is colonized within hours
Flora of breast fed infants = BIFIDOBACTERIUM
Weaning->-> adult like flora

31
Q

Regarding bile acid, what is the consequence of abnormal bacterial growth in the upper small intestine?

A

BILE ACID DECONJUGATION: Bacterial growth will convert more conjugated bile acid into FREE BILE ACID, causing fat malabsorption.

32
Q

What is a hepatic coma and how is it treated

A

if liver fxn is imparied, blood ammonia levels rise.
Treatment = reducing the normal intestinal flora, because their conversion of protein is a major source of ammonia to the blood.

33
Q

Intestinal flora are responsible for converting bilirubin to ____ & ______

A

Urobilin and sterobilin

34
Q

What is the fate/significance of carbs that are not absorbed by the host?

A

The carbs are FERMMENTED by intestinal flora, causing a drop in pH; the low pH helps maintain the gut flora.

35
Q

Normal flora of skin is ~_____ CFU per cm^2 of skin

A

10^3 - 10^4

36
Q

What are the 3/4 major normal flora of the skin?

A

Staph Epidermidis - Predominant, normally non-pathogenic
Staph Aureus skin + nares
Diptheriods
#4 - other anaerobes like proprionibacterium in deep follicles (acnes)

37
Q

Normal flora of GU tract

A

Lactobacillus -> responsible for pH in vagina
E. Coli from colon
20% women have Group B streptococcus in vagina too -> newborn sepsis.

Micro Q3 (5 decks)

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