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Bloc G - Infection > Apr24 M1,2-Introduction to Basic Medical Bacteriology > Flashcards

Apr24 M1,2-Introduction to Basic Medical Bacteriology Flashcards

1
Q

taxonomy of bacteria

A

genus with capital letter + species in lower case, all in italic. Mendelian structure

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2
Q

keys ways to identify bacteria

A
  • morphology (microscopy)
  • organization (microscopy)
  • gram stain (microscopy)
  • colony appearance
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3
Q

key test to identify bacteria (molecular profiles and genetics)

A

MS-MALDI-TOF (Mass Spectrometry -Matrix Assisted Laser Desorption Ionisation - Time of Flight)

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4
Q

what an MS-MALDI-TOF does

A
  • cristallize colony
  • zap it with laser
  • vaporize specimen into electrically charged particles with a mass to charge ratio
  • plot particles obtained
  • determine corresponds to which bacteria
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5
Q

what is the scheme of identification of bacteria that is the most ACCURATE

A

Amplification and sequencing of 16S rRNA genes

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6
Q

what is the scheme of identification of bacteria that is the MOST COMMONLY USED

A

culture and biochemical analysis

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7
Q

To guide the appropriate EMPIRIC Abx) treatment, what is the scheme of identification of bacteria that is SUFFICIENT IN MOST CASES?

A

gram stain

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8
Q

gram + external structure

A

in to out

  • single lipid bilayer
  • thick murein or peptidoglycan cell wall for rigidity
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9
Q

gram - external structure

A

in to out

  • lipid bilayer
  • periplasmic space with thin peptidoglycan (murein) layer
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10
Q

resistance mechanisms present in periplasmic space in gram - bacteria

A
  • enzymatic degradation of Abx (so enzymes that degrade Abx are there)
  • porins
  • pumps
  • manipulation
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11
Q

2 most important bacteria categories

A
  1. gram positive cocci (staph spp, strep spp, enterococcus spp)
  2. gram negative bacilli (enterobacteriaceae, haemophilus spp., e.coli)
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12
Q

some gram + bacilli

A
  • cornybacteria spp
  • bacillus spp.
  • listeria monocytogenes (important in neonatal sepsis)
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13
Q

some gram - cocci

A
  • neisseria
  • moraxella
  • acinetobacter spp
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14
Q

some gram + anaerobes

A
  • peptostreptococcus (coccus)
  • clostridium spp (bacillus)
  • nocardia (branching)
  • actinomyces (branching)
  • mycobacteria (branching)
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15
Q

some gram negative anaerobes

A 
bacilli = bacteroides, prevotella, fusobacterium
spiral = helicobacte, treponema, leptospira, borrelia
curved = vibrio, campylobacter
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16
Q

(imp?) most common bacterium in the gut

A

bacteroides spp (gram negative anaerobic bacilli)

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17
Q

exceptions to the gram + and gram - separation

A

atypical bacteria

  • the IC organisms
  • ones with few or no cell wall
  • ones with bizarre morphology
  • ones difficult to culture
  • ones difficult to stain (chalmydia, chlamydophila, coxiella, rickettsiae, mycoplasma, ureaplasma)
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18
Q

chlamydia vs chlamydophila

A 
chlamydia = infection below the belt
chlamydophila = infection above the belt
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19
Q

coxiella causes what

A

Q fever

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20
Q

mycoplasma bacteria cause what

A
  • respiratory or immune diseases

- are agents of STDs

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21
Q

most dangerous gram + bacterium

A

staph aureus

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22
Q

how to differentiate staph aureus from other staff

A

coagulase test in rabbit serum

  • put colony in rabbit serum
  • if contains coagulase (staph aureus does), serum will coagulate
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23
Q

other test to check for staph aureus

A

agglutination test with a bench top test

  • look for clamping
  • involves an enzyme other than coagulase
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24
Q

alpha vs beta vs gamma hemolysis

A

some gram+ can hemolyze RBCs in sheep blood agar

  • alpha = partial hemolysis (greeny hue)
  • beta = complete hemolysis (see through): like staph that has clumps of round cells + coagulase positive
  • gamma = 0
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25
Q

Strep pyogenes is what type of bacteria specifically

A

gram positive, beta hemolytic group A strep

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26
Q

subdivisions of gram positive COCCI

A
  1. tetrads and clusters (catalase +) VS pairs and chains (catalase -)
  2. in tetrads and clusters, are coagulase + or -
  3. in pairs and chains, are beta or alpha or gamma hemolytic
  4. in beta hemolytic, have a specific Lancefield grouping (A, B, G, G)
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27
Q

alpha hemolytic cocci examples

A
  • Strep pneumoniae

- Viridans strep family (CAUSES CARIES)

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28
Q

gamma AND alpha hemolytic cocci examples

A

enterococci

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29
Q

staph aureus vs strep skin infection

A
  • staph is pyogenic (purulent infection)

- strep = red dry skin

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30
Q

how staph aureus colonizes

A
  • surface proteins that bind fibronectin

- surface targetting molecules like MSCRAMMs

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31
Q

pyogenic (pus forming, infection and inflammation) effects of staph aureus (types of infection you get)

A
  • cellulitis
  • abscesses
  • osteomyelitis
  • endocarditis
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32
Q

toxin mediated effects of staph aureus

A

released locally but can have systemic effects

  • food poisoning
  • toxic shock syndrome (overwhelming sepsis)
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33
Q

how staph interacts with the immune systems and the WBCs

A
  • uses coagulase to form clots to escape immune system
  • causes hemolysis
  • targets leukocytes with leukocidin
  • using its protein A, it binds Igs in inverse sense to disrupt opsonization
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34
Q

late visible sign of toxic shock syndrome

A

palmar erythema with desquamation

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35
Q

cause of toxin shock syndrome

A

a toxin that is a superantigen

  • cross-links MHC2 (of APCs) and TCRs (of T cells) non specifically and outside of binding cleft
  • get uncontrolled immune response (fever, cytokine prod, shock)
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36
Q

MRSA, VRSA and VISA are what

A 
MRSA = methicillin resistant staph aureus  (very common) (use vanco)
VISA = vancomycin intermediate staph aureus  (vanco works)
VRSA = vanco resistant staph aureus (has the vanA gene). rare and very bad scenario
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37
Q

MSSA means what

A

methicillin sensitive staph aureus (it expresses a penicilinase so we point out that it is therefore sensitive to methicillin)

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38
Q

characteristics of resistance in hospital acquired bugs

A
  • more virulent
  • multi-drug resistant
  • *resistant to everything except vancomycin and daptomycin**
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39
Q

charact of resistance in community acquired bugs

A

-more sensitie (less resistance)
-MORE aggressive
bc have PVL (Penton Valentin Leukocidin) = cutaneous and deep abscesses, tissue destruction

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40
Q

3 coagulase negative staphylococci and characteristics

A
  • staph epidermidis (common in skin flora and is opportunistic)
  • staph saprophyticus (common in UTIs)
  • staph lugdunensis and staph schleiferi (aggressive disease, endocarditis)
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41
Q

beta hemolytic group A strep causes what types of infections

A
  • tonsilitis, skin infections, soft tissue infections
  • toxic shock syndrome
  • scarlet fever
  • necrotizing fasciitis (flesh eating disease), myositis, meningitis
  • acute post-strep GN
  • acute rheumative fever (carditis, polyarthritis)
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42
Q

(imp?) primary reason to treat group A strep PHARYNGITIS

A

prevention of rheumatic heart disease

acute post strep GN will happen no matter what if right host + right strain

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43
Q

(IMP) important protein for adhesion and other things in group A strep

A

M protein

  • adhesion
  • anti-complement
  • responsible for molecular mimicry (our Ags attack heart valves instead of M protein)
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44
Q

most common group B strep organism

A

streptococcus agalactiae

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45
Q

what streptococcus agalactiae gives (what problems) (group B strep)

A
  • neonatal sepsis* (prenatal screening programs. if infected start Abx at delivery)
  • neonatal meningitis
  • diabetic wound infections
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46
Q

streptococcus pneumoniae on CXR (alpha hemolytic) + symptoms of that + pther diseases it can cause

A

LOBAR pneumonia
symptoms = chest pain, cough, rusty sputum
(strep pneumo also causes meningitis, bacteremia, acute otitis media)

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47
Q

strep pneumo cell shape

A

edges and internal aspects caved on itself, bc created an autolysin so self destructed with time forming doughnut shape

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48
Q

PRSP stands for what

A

penicillin resistant strep pneumo

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49
Q

19A is what

A

a strain of strep pneumo found to be resistant (now covered in Prevnar vaccine)

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50
Q

what organisms cause dental caries

A

the Viridans Streptococcus species

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51
Q

viridans species charact and cause what

A
  • alpha hemolytic, less virulent member of the normal flora

- dental caries, bacteremia, endocarditis, abscesses

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52
Q

two viridans strep species and what they do

A
  • Strep mutans, Strep sanguis = dental plaque and carries

- S anginosus (deep tissue abscesses)

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53
Q

enterocccus species charact

A
  • gram + cocci
  • non hemolytic (gamma), but group with Lancefield group D
  • in normal biliary tract and GIT flora (are bile resistant and like high Na content)
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54
Q

2 enterococcus species

A

E faecalis = less resistant to penicillin and ampicillin

E faecium = penicillin and ampicillin resistant

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55
Q

diseases enterococci cause

A
  • abdomen abscesses
  • is a bystander in infections (treat the rest = entero goes away)
  • bacteremia, endocarditis
  • UTIs
56
Q

tx of enterococcus infection

A
  • limited options (less and less things are working) + use combinations
  • vancomycin if not VRE
57
Q

VRE is what

A

vancomycin resistant enterococcus

  • has vanA gene on plasmid that mediates that
  • VRE tends to colonize rather than infect (but nocosomial careful in central lines, wounds, etc.)
  • VRE more frequent than VRSA
58
Q

how gram positive BACILLI are classified

A
  1. spore forming (large rods) or not
  2. in spore forming = large rods, either aerobic catalase + (bacillus) or not (clostridium)
  3. in non spore forming, either small irregular rods, regular rods or branching rods
59
Q

listeria spp (gram+ small irregular rods) charact

A
  • major foodborne illness

- virulence factors = listerolysin, ActA (for IC parasitism immune evasion)

60
Q

2 types of diseases with listeria spp

A
  1. invasive (meningitis, chorioamnionitis, granulomatous infantiseptica, bacteremia, endocarditis)
  2. non invasive (febrile diarrhea syndrome, where cultures are negative)
61
Q

listeria often confused with what bacteria

A

corynebacteria (are gram + rods, also smaller irregular rods) in palisades or chains

62
Q

cornybacteria (smaller irregular rods) give some species

A
  • C.diphtheriae (toxin mediated URTI, multiorgan involvement)
  • C. urealyticum (renal disease calculus)
  • C jeikeium (multiresistant, bacteremia)
63
Q

bacillus (large rods) main diseases (say the species)

A
  • bacillus cereus = toxin mediated food poisoning and immunocompromised infections
  • Bacillus anthracis = acquired from animals (zoonoses), bio weapon, non motile white colonies that stick to plates and form medusa heads (projections)
64
Q

enterobacteriaceae (gram NEGATIVE rods) main charact

A
  • *ferment glucose**
  • in the gut
  • usually commensals
65
Q

diseases with enterobacteriaceae

A

(some opportunistic and some virulent)

  • enteric pathogens
  • urinary pathogens
  • bacteremia
66
Q

5 most important enterobacteriaceae and 2 very common in them

A
  • escherichia coli
  • klebsiella pneumoniae
  • salmonella enterica
  • shigella
  • yersinia
67
Q

lactose fermenting enterobacteriaceae some examples

A

-klebsiella spp
-e.coli
-enterobacter
-serratia
(kees)

68
Q

lactose non-fermenters in enterobacteriaceae family some examples

A
  • salmonella spp
  • shigella spp
  • yersinia enterocolitica
69
Q

prototype gram negative rod and definition of a coliform

A
  • e.coli = prototype
  • coliform = gram negative rod that ferments lactose
  • e.coli is a coliform
  • a coliform will appear like e.coli
70
Q

goal of Macconkey plate and charact

A

check if organisms are lactose fermenting (coliforms) + select for gram negative rods

  • pH indicator, bile salts, chemicals selecting for gram negative
  • grow on plate
  • if ferment lactose, pH change. colour = pink (otherwise stays translucent)
71
Q

which is more dangerous lactose fermenting or lactose non fermenting enterobacteriaceae

A

lactose non-fermenting (salmonella, shigella, yersinia)

72
Q

what’s common to all coliforms (enterobacteriaceae)

A

ferment glucose

73
Q

how macconkey plate can help identify salmonella and shigella

A

you have to workup the translucent colonies more

74
Q

main UTI causing organism

A

e.coli

75
Q

what e.coli causes

A
  • UTIs
  • intra-abdominal infection
  • bacteremia
  • seeds
76
Q

two types of e.coli

A

ETEC (enterotoxic) and EHEC (enterohemorrhagic)

77
Q

e.coli outbreak associated with vegetables was what

A

a shigatoxin producing e.coli

78
Q

E coli O157:H7 charact

A
  • zoonosis
  • an EHEC strain
  • hamburger disease
79
Q

E coli O157:H7 pathophysiology

A

shigatoxin like toxin is produced

  • damage to endothelium, glomerulus, CNS endothelium
  • TTP in adults
  • HUS in children
80
Q

how bacteriophages influence E coli O157:H7

A

a specific lytic phage (virus for bacteria) can convert a non hemorrhagic strain to a hemorrhagic strain

81
Q

how most E coli O157:H7 are found in stools

A

stool culture using a special sorbitol MacConkey plate. E coli O157:H7 doesn’t ferment sorbitol (sorbitol non-fermenting): you then investigate further the translucent colonies

82
Q

diseases salmonella causes

A
  • gastroenteritis
  • typhoid fever (name it like that for shigella)
  • infection of vascular endothelium
  • infection of organ systems (osteomyelitis)
83
Q

disease shigella causes

A
  • mucosal endothelium damage

- shigatoxin causes direct invasion (apoptosis of cells) leading to Na and water accum in the lumen

84
Q

vibrio cholerae type of bacteria and problems causes

A
  • curved gram negative rod
  • toxin mediated disease
  • profuse diarrhea
85
Q

tx of cholera (vibrio cholerae infection)

A

most important thing is rehydration

2nd most important is Abx

86
Q

cholera dx

A

gram stain of stool smear

87
Q

other diseases of fibrio species

A

vibrio vulnificus = bullae on skin + liver disease association (hemochromatosis and cirrhosis)
typical scenario = large yosters meal then 3 days of purpura then 3 days of bullae

88
Q

pseudomonas spp type of bacteria and charact

A
  • gram negative bacilli (rods)
  • forms a biofilm** (harder for Abx to get to it)
  • NOT an enterobacteriaceae
89
Q

most common non glucose fermenter gram negative bacteria

A

pseudomonas

90
Q

pseudomonas species to be concerned about + its charact

A

Pseudomonas aeruginosa

  • green apperance
  • bc of 2 pigments: pyocyanin, pyoverdin
91
Q

pseudomonas implications and disease

A
  • important nocosomial pathogen
  • problematic in immunosuppressed (FEBNEUT**, burns, CF pts)
  • complicated UTIs**
  • ventilator associated PNEUMONIAS**
  • line associated infections
  • bacteremia, endocarditis, septic arthritis
92
Q

pseudomonas: what’s quorum sensing

A
  • express molecules between individual cells to make cells act in a community fashion and use autoinducers to upregulate each other’s specific genes
  • some gram negative NON fermenters do that
93
Q

key issue with pseudomonas

A
  • multi drug resistant (MDR) pseudomonas aeruginosa

- alteration of outer membrane permeability. limited therapy options

94
Q

virulence factors of pseudomonas spp

A
  • pili
  • flagella
  • LPS
  • exotoxin A
  • proteases
  • phospholipases
  • etc
95
Q

3 main gram negative non fermenter rods

A

-pseudomonas aeruginosa
-stenotrophomonas maltophilia
-acinetobacter baumanii
(2 other than pseudomonas = ventilator, ICU issues)

96
Q

Neisseria charact

A
  • gram negative diploCOCCUS (pairs)

- higher susceptibility in C5-C8 deficient and Ab deficient people

97
Q

main concern with Neisseria spp infections (species we worry about)

A
  • Neisseria meningitidis
  • agent of meningitis
  • sepsis, shock, DIC, necrosis, purpura fulminans
  • most worrysome form is encapsulated
98
Q

Neisseria gonorrhoeae diseases it causes

A

causes gonorrhea, PID (pelvic inflammatory disease), epididymitis

99
Q

Neisseria gonorrhoeae 2 ways it evades the immune system

A
  • phase variation (ctly switching virulence factors on-off)

- antigenic variation (program diff pili by genetic recombination so are not recognized)

100
Q

dx of Neisseria gonorrhoeae done how

A

cervix swab, gram negative diplococci with WBCs

101
Q

Haemophilus spp charact

A
  • coccoid-rods gram negative
  • opportunistic
  • serotypes a to f are encapsulated
102
Q

diseases caused by haemophilus

A
  • haemophilus influenza type B associated with epiglotitis
  • all types cause pneumonias, otitis media, etc.
  • encapsulated cause septicemia, meningitis
103
Q

examples of encapsulated organisms + how this helps

A
  • neisseria meningitidis (gram-)
  • haemophilus influenzae (gram-)
  • streptococcus pneumoniae (gram+)
  • capsule helps evade immune system and Abs*
104
Q

fastidious gram negative bacilli 5 classical ones and cause what

A

HACEK agents of endocarditis

  • haemophilus (aggrigatibacter) aphrophilus
  • aggrigatibacter actino…
  • cardiobacterium hominis
  • eikenella corodens
  • kingella kingae
105
Q

dog, cat and human bite organisms and problems

A 
cat bite = pasteurella multocida (cellulitis)
dog bite (have cleanest mouth) = capnocytophyga canimorsus and cynodegnmi (if immunocompromised: shock, DIC)
human bite = eikenella corrodens (HACEK list + suppurative infection, septic arthritis**** bc bites near joints)
106
Q

bordetella pertussis disease caused and virulence factors

A
  • whooping cough that has 3 sages (catarrhal, paroxysmal, recovery) or chronic cough
  • virulence factors = pertussis toxin (cAMP modulator), tracheal cytotoxin, LPS, pili, etc.
107
Q

example of organisms that mediate disease by toxins and that are NOT invasive

A
  • B pertussis
  • C diphtheriae
  • V cholarae
  • C diff
108
Q

anaerobes (don’t like cold and oxygen) typical diseases

A

polymicrobial infections (pulmonary abscess, abd abscess, pelvic infection, UTI)

109
Q

anaerobe that is very important and charact

A

C.difficile

-spore forming gram+ bacillus

110
Q

risk factors for c diff

A
  • Abx use
  • immunocompromised pt
  • PPI use
  • NG tube use
111
Q

C diff toxin, strains and tx

A
  • 2 toxins - TcdA and TcdB
  • NAP1 strain is important (hypervirulent and fluoroquinolone resistant)
  • Tx = vancomycin, metronidazole, etc.
  • note: pathophgy = pseudomembranous colitis
112
Q

diarrhea after Abx exposure approach to that

A

consider c diff until proven otherwise

113
Q

c diff usual course of illness

A
  • 50% = mild version
  • 50% serious
  • recurs if proper tx BUT have risk factors
114
Q

most prevalent organisms in the colonic flora

A
  • bacteroides (gram neg anaerobic bacilli)

- opportunistic

115
Q

bacteroides how resistance spreads and tx now

A
  • transmission of resistance elements by conjugative transposons
  • metronidazole = tx (clindamycin less good now)
116
Q

anaerobes in places other than colon

A
  • oral spirochetes like fusobacterium necrophorum

- aspiration can lead to lung abscesses and empyema

117
Q

atypical pneumonia on CXR

A

diffuse interstitial pattern

note: walk in pneumonia

118
Q

how atypical pneumonias are diagnosed

A

serology (serovar Ag detection)

119
Q

standard set of organism called atypical pneumonias some examples (are called WALKING pneumonias)

A
  • chlamydophila pneumoniae and psitacci
  • coxiella burnetti
  • mycoplasma pneumoniae
  • legionella pneumophilia
  • mycobacterium TB
120
Q

charact of chalmydia

A
  • pelvic infections, peri-hepatic inflammation
  • STIs
  • ocular disease
  • asymptomatic carriage
121
Q

2 variants of chlamydia that cause genital disease

A
  • LGV (lymphogranuloma venerum): much worse

- cervicitis

122
Q

tx of chalmydia

A

azythromycin

123
Q

legionella charact

A
  • gram negative atypical rod
  • survives after phagocytosed and evades immune system
  • replicates
124
Q

legionella main symptom

A

pontiac fever (name specific for legionella spp. non fatal resp prob + fever)

125
Q

legionella main virulence factor causing the signs and symptoms

A

flagellin

126
Q

some mycoplasma organisms (are atypical organisms) and critical one

A 
**M pneumoniae** (resp tract)
M genitalium (UTI)
M hominis (UTI)
U urealyticum (UTI)
127
Q

how to stain mycoplasma organisms

A

use acridine orange (bc otherwise stain badly)

128
Q

mycoplasma pneumoniae diseases

A
  • adhere to resp epithelium. resp problems
  • extra pulm infections that are immune mediated (hemolytic anemia, inflam disorders, rashes, arthritis, pericarditis, endocarditis)
129
Q

rickettsiae charact

A
  • small gram - rod atypical (rarely stain)
  • IC pathogen
  • independent metabolism and very adapted to their environment
  • transmitted through insect bites
130
Q

2 main groups of rickettsiae

A
  • spotted fever group

- typhus group

131
Q

prototypical rickettsiae organism

A

rickettsiae rickettsii

-rocky mountain spotted fever dog tic

132
Q

spirochettes (spirally bacteria) some examples

A
  • H pylori
  • Leptospira interrogans
  • Treponema spp
  • Borrelia spp
133
Q

agent of syphilis

A

treponema pallidum

134
Q

agent of lime disease, fever, borreliosis

A

borrelia (curved)

135
Q

leptospira causes what

A

liver, lungs, CNS problems

136
Q

borrelia recurrentis causes what

A

relapsing fever

Bloc G - Infection (39 decks)

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