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BACILLUS AND CLOSTRIDIA Flashcards

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1
Q

gram positive spore forming rods

Spore forming bacteria of the family …

two clinically important genera:

Number of species of Bacillus and is what types of pathogen with names

A

Bacillaceae

Bacillus

Clostridia

51 species of which only one is a strict pathogen. B anthracis

B,cereus is an opportunistic

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2
Q

Bacillus sp.

Respires in what ways

Most species are what 2 things

Soil ….

spore formation in…..

A

aerobic of facultatively anaerobic

  • varied motitily
  • catalase positive

oragnisms

B.anthracis
B.cereus

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3
Q

B.anthracis

charcoal …..

large organisms of what size

motile?

A

Charcoal carbuncle

1x3-5um.

non motile

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4
Q

B.anthracis.

single or paired…. bacilli in …. specimens

A

Single or paired bacilli in clinical specimens.

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5
Q

B.anthracis

Long serpentine chains in culture

  • gluta……
  • poly….
  • a to….
A

Glutamic acid capsule
Polysaccharide cell wall antigen
A toxin.

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6
Q

B.anthracis

Anthrax….

3 antigenically distinct, heat labile components:

The combination of protective antigen and either of the other two is

A

anthrax toxin

  • protective antigen
  • lethal factor
  • oedema factor

the combination of protective antigen and either of the other two is toxic.

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7
Q

B. anthracis

Virulence factors:

toxin can be

Anthrax is primarily an

Human disease occurs through exposure to

Causes serious problems in countries without

A

Virulence factors:
Toxin
Capsule.

Toxin can be lethal.

Anthrax is primarily an animal disease.

contaminated animals or their products.

vaccination

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8
Q

anthrax in humans

Inoculation

what percentage of infection in humans

spores enter …

spores germinate and cause

A

Cause of 95% human infection

Spores enter exposed skin from soil or infected animal products eg.
Hides
Goat hair
Wool.

Spores germinate and cause cutaneous anthrax

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9
Q

Anthrax in Humans.

Inhalation

name of disease

bacterial growth in the lung leads to

now very rare in

Inhalation of spores which enter …. and ……

A

Wool-sorters disease

Bacterial growth in the lung leads to:
Pulmonary oedema
Bacteraemia
Death.

Now very rare in developed countries

Inhalation of spores which enter alveolar macrophages and germinate.

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10
Q

Anthrax in Humans.

Ingestion

Gastrointestinal disease is …… in humans

common in …..

bacilli excreted in what 3 things

A

Gastrointestinal disease is rare in humans

Common in herbivores.

Bacilli excreted in faeces urine and saliva.

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11
Q

Bacillus cereus

what type of pathogen

what coloured

what 3 causes

  • gastroenteritis
  • eye infections
  • IV catheter related sepsis

Gastroenteritis mediated by one of two enterotoxins:

  • ….. toxin
  • …. toxin
A

Opportunist pathogen.

‘cereus’ wax coloured.

Causes:
Gastroenteritis
Eye infections
IV catheter related sepsis.

Gastroenteritis mediated by one of two enterotoxins :
Emetic toxin.
Diarrhoeal toxin

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12
Q

Bacillus cereus food poisoning

Emetic form

  • caused by … toxin
  • caused by reheating … and how

how many hrs incubation period after ingestion and the symptoms

duration

A

Caused by heat stable toxin.

Caused by eating reheated contaminated rice.
When heat resistant spores survive and germinate if the rice is not refrigerated.

1-6 hrs incubation period after ingestion of rice.
Vomiting
Nausea
Abdominal cramps.

Short duration, < 24 hours.

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13
Q

Diarrhoeal form

heat labile toxin similar to … and ….

stimulates …. cyclase - ….. system in intestinal …. cells

consumption of ….., …… or …..

longer …. period

dia. ..
nau. ..
adom. …

lasts ….

A

Diarrhoeal form.
Heat labile toxin similar to E.coli and V.cholera.

Stimulates adenylate cyclase -cyclic AMP system in intestinal epithelial cells.

Consumption of contaminated meat, vegetables or sauces. 
Longer incubation period. 
Diarrhoea
Nausea 
Abdominal cramps

Lasts >24 hours.

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14
Q

other infections caused by bacillus cereus

eye infections

  • penetration by objects …
  • 3 toxins implicated are:

IV …. infections

bacteraemia and me…
- immun….

Endocarditis
- IV drug ….

A

penetration of objects contaminated by soil

3 toxins implicated

  • a heat labile entertoxin
  • a haemolysin (Cereolysin)
  • phopholipase C

IV catheter infection

bactermia and meningitis
- immunocomprimised

Endocarditis
- IV drug abusers

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15
Q

Clostridium

Anaerobic or aerobic?

  • …. forming
  • gram…. bacilli

what natural and in living things are they in

Many are harmless …..

others are the caused of human disease, name 6

A 
Anaerobic
Spore forming
Gram positive bacilli.
Found in soil, water, sewage and intestinal tract of humans and animals.
Many are harmless saprophytes
Others  are the cause of human disease, e.g.
C.tetani
C.botulinum, C.butyricum
C.perfringens,C.septicum, C.novyi
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16
Q

Clostridium

The range and success of pathogens is achieved by what 3 things

A
  1. The ability to survive in adverse
    environments by spore formation.
    1. The ability for rapid growth in nutritionally enriched environment in anaerobic conditions.
    2. Production of a range of toxins including enterotoxins and neurotoxins
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17
Q

C.perfringens

is large …. Gram …. bacillus

Motile?

  • has characteristic spreading…. on media
  • haemolytic

Grows rapidly in … and in culture

Produces 4 lethal toxins 
-
-
-
-

Isolates of 5 types A to …
Type A causes most ….

A 
Large rectangular Gram positive bacillus.
Non-motile
Has characteristic spreading growth on media.
Haemolytic.
Grows rapidly in tissue and in culture.
Produces 4 lethal toxins
Alpha
Beta
Epsilon
Iota. 
Isolates of 5 types, A-E.
Type A causes most human infection.
18
Q

C. perfringens

Alpha

Alpha produced by

Is a lect,,,,

lyses …. cells. white cells platelets ,,,,, cells

Causes …., ….. and /….destruction

A

Produced by all types

Is a lecithinase (phospholipase C)

lyses red cells white cells platelets endothelial cells,

Causes haemolysis, bleeding and tissue destruction

19
Q

C. perfingens

Beta

Causes ….. lesions in necrotising ….

Induces ….

A

Causes necrotic lesions in necrotising enteritis

induces hypertension

20
Q

C, perfringens

Epsilon

Protoxin activated by …

Increases the permeability of

A

Protoxin activated by trypsin

Increases the permeability of the gastrointestinal wall

21
Q

C. perfringens
Lota

…. activity

increases ,,,,

A

necrotic activity

increases vascular permeability

22
Q

c. perfringens

enterotoxin

Heat labile … produced in the ….

Released during …. formation

Produced by type … but also …. and ….

Alters membrane …..

A

Heat labile toxin produced in the colon

Released during spore formation

Produced by Type A but also C and D

Alters membrane permeability

23
Q

Disease caused by C.perfringens

Type A causes:

  • Gas….
  • Soft ti..
  • Food ….

Gas gangrene (myonecrosis)

  • full potential of …
  • clostridia introduced by …. or …..
A 
Type A causes:
Gas gangrene
Soft tissue infections
Food poisoning.
Gas gangrene (myonecrosis) 
Full potential of virulence factors.
Clostridia introduced by trauma or surgery.
Extensive:
Muscle necrosis
Shock renal failure
Death within 2 days. 
Gas in tissues.
24
Q

Disease caused by C. perfringens

The bacteria can also colonise …

may caused …. and ….

If found in blood cultures:

  • Transient ….
  • Contam…
  • Must be interpreted in ….

Necrotising enteritis

  • Rare disease of the ….
  • Caused by Beta toxin producing ……
A 
The bacteria can also colonise wounds.
May cause cellulitis and fasciitis.
If found in blood cultures:
Transient bacteraemia
Contamination. 
Must be interpreted in relation to clinical findings.
Necrotising enteritis 
Rare disease of the jejunum. 
Caused by Beta toxin producing Type C.
25
Q

Disease caused by C.perfringens

Food Poisoning.
- Short incubation and lasts less than..

  • Ingestion of meat contaminated (10^8- 10^9) Type A

Enterotoxin acts as ..

prevented by ……. of food after cooking and ….. reheating

A

Food poisoning.
Short incubation and lasts less than 24 hours.
Ingestion of meat contaminated (108 -109) Type A.
Enterotoxin acts as superantigen.
Prevented by refrigeration of food after cooking and adequate reheating.

26
Q

Clostridium Difficile.

toxin producing C.difficile
- Now known to cause ,,, antibioic associated diarrhoe

self limiting diarrhoea to life
threatening

May be part of normal bowel … and is present in

A

Toxin producing C. difficile
Now known to cause antibiotic associated diarrhoea.
Self-limiting diarrhoea to life-threatening pseudomembranous colitis.
May be part of normal bowel flora and is present in soil, water and sewage.

27
Q

Clostridium Difficile

Proliferates when normal balance of bacteria is disturbed
by….

Important pathogen in hospital associated diarrhoea.
- Spores survive ….

Virulence factors:
_ toxin...
- toxin ...
adhes....
spore....
A

Proliferates when normal balance of bowel bacteria is disturbed
By antibiotics.
Important pathogen in hospital associated diarrhoea.
Spores survive easily in the environment.
Virulence factors:
Toxin a (enterotoxin)
Toxin B (cytotoxin)
Adhesion factor and hyaluronidase
Spore formation.

28
Q

Clostridium Difficile

both toxins procuced in the ….

Induce:
what 4 things

Pseudomembrane consists of …., ……, and ….. cells

A

Infiltration of neutrophils into the ileum
Cytokine release
Haemorrhagic necrosis.
Destroy cellular cytoskeleton.

Pseudomembrane consists of mucus, fibrin and inflammatory cells.

29
Q

Clostridium Difficile : Treatment and diagnosis.

Treatment what 2 things:

Diagnosis by detection of …. by …..

A

Treatment:
Stop antibiotics
Treat if necessary with oral vancomycin or metronidazole.

Diagnosis by detection of the toxins by EIA.

Careful cleaning of the affected rooms.

30
Q

C. Botulinum

Fastidious heterogenouse group of ….

Found in …. and ….

divided into 4 groups. most human diseases caused by type … and … strains

7 distince toxins from

Usually only one toxin per

A

Latin ‘botulus’ sausage.

Fastidious heterogenous group of spore forming anaerobic bacteria.

Found in soil and water.

Divided into 4 groups. Most human disease caused by Types I and II strains.

7 distinct toxins A-G.

Usually only one toxin per type.

31
Q

C. Botulinum

disease caused by the …… toxin
- A powerful …..

150-165 kda progenitor complex with …..

  • Consisting of ….
  • Non-toxic B or …..

Proteolytic cleaving makes the ….

cleaved by clostridial ….. or ….. proteases

A

Disease caused by the botulinum toxin

A powerful neurotoxin.
150 -165 Kda progenitor complex with derivative toxin (A-B toxin)

Consisting of neurotoxin subunit (light or A chain)

Non-toxic B or heavy chain subunit.

Proteolytic cleaving makes the toxin active.

Cleaved by clostridial proteases or gastric proteases

32
Q

C. Botulinum

Toxins … and …. are also found in some strains
- Their function is …

Botulinum toxin blocks ….. at peripheral cholinergic synapses by preventing …..

3 types of clinical syndromes:
- food borne ….
infant ….
.wound ….

A

Toxins C2 and C3 are also found in some strains
Their function is unclear.
Botulinum toxin blocks neurotransmission at peripheral cholinergic synapses by preventing release of acetylcholine.
3 types of clinical syndromes:
Foodborne botulism
Infant botulism
Wound botulism.

33
Q

Food borne botulism

associated with consumption of ……. particularly

1-2 days incubation follwed by :
-
-
-
-
-

Muscle weakness and flaccid …. Binding of toxin is …..

A

Associated with the consumption of contaminated food
- Particularly canned food

1-2days incubation followed by:
Dizziness
blurred vision
abdominal pain 
dilated pupils 
Dry mouth

muscle weakness and flaccid paralysis, Binding of toxin is irreversible

34
Q

Infant botulism

Most common form of botulism in the USA

Colonisation of the G.I
tract of young….

Neuro…. producing C.botulinum

Non-specific symptoms in <1 year olds

Mortality is low (1-2%)

Associated with spores in

A

Colonisation of the G.I tract of young infants

Neurotoxin producing c.botulism

associated with spores in honey

35
Q

Wound botulism

In ….. production of toxin in wounds

Similar symptoms to … disease:

Longer …..

Less …… involvement

Botulinal toxin can be used to treat disabling muscle spasms (dystonias) which can me

A

In vitro production of toxin in wounds

Similar symptoms to foodborne disease:

Longer incubation period

Less gastrointestinal involvement

Botulinal toxin can be used to treat disabling muscle spams (dystonias). Cross eyes, face and neck spams

36
Q

C.tetani

Rare in developed countries because ….

Organism has terminal spores

susceptible to oxygen …. so …. and live in soil and GI tract of animals.

Often stains …. negative

Motile or non motile?

A

Rare in developed countries because of vaccination but still causes a million deaths per year worldwide.
Organism has terminal spores.
Susceptible to oxygen toxicity so sporulate and live in soil and GI tract of animals.
Often stains Gram negative.
Motile.

37
Q

Tetanus

symptoms caused by ….
- 4 clinical ….

Toxins:
Tetanolysin is ,,,,

Tetanospasmin is a plas….

A

symptoms caused by toxin
- 4 clinical manifestations

Toxins:
Tetanolysis is an oxygen labile haemolysis

  • Related to other clostridal haemolysis and Streptolysin 0)

Tetanspasmin is a plasmid encoded, heat labile neurotoxin

38
Q

Tetanus

teanospasmin synthesised as…

light chain, like botulinum toxin is a

Neurotoxin- blocks release of

Spastic ….

A

Tetanospasmin synthesised as 151 Kda peptide cleaved by protease.
Light chain, like botulinum toxin is a zinc endopeptidase.
Neurotoxin - blocks release of gamma-aminobutyric acid (GABA).
Spastic paralysis.

39
Q

Tetanus

-

Cephalic tetanus if wound on head or ear =

Localised infection of muscle in….

neonatal infection associated with

A

Wound infection leads to generalised tetanus including:
Lockjaw
Back spasms etc.

Cephalic tetanus if wound on head or ear - poor prognosis.

Localised infection of muscles in area of injury.

Neonatal infection associated with infected umbilical stump.

40
Q

Diagnosis, treatment and control of tetanus

treatment involves:

  • debri…
  • treatment with metro….
  • human tet…
  • v….
A

Diagnosis by clinical presentation.

Treatment involves:
Debridement of wound
Treatment with metronidazole
Human tetanus immunoglobulin
Vaccination.

Microbiology (13 decks)

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