Bact PNA (lec 12) Flashcards
Cause of PNA: Φ predisposing factors?
pneumoniae:
Mycoplasma (no wall)
Strep (+)
Chlamy (-)
Cause of PNA: alcoholics/homeless/DM?
pneumoniae:
Strep (+)
Kleb (-)
Cause of PNA: underlying dz?
Strep pneumo (+)
H. flu (-)
P. aerug (-)
Staph aureus (+)
Cause of PNA: vent pts?
K. pneumo (-)
P. aerug (-)
Cause of PNA: travel/occupational?
Legion pneumo (-)
Cause of PNA: Community Acquired?
S. pneumo (+)
K. pneumo (-)
H. flu (-)
S. aureus (+)
Atypical PNA: zoonotic pathogens?
Chlam psittaci Fran tularensis (-) Cox burnetii (-)
Atypical PNA: non-zoo pathogens?
Chlam pneumo (-)
M. pneumo (no wall)
Leg. pneumo (-)
Atypical PNA presentation:
Onset/Appearance?
Temp?
Chills/Shakes?
Cough?
Pleurisy?
CXR?
Other sxs?
Onset: gradual, Appearance: well
Temp: < 103
Chills/Shakes: rare
Cough: dry
Pleurisy: rare
CXR: patchy, undefined infiltrate
Other sxs: GI, aches
Atypical PNA resistant to what drugs?
β-lactams
Typical PNA presentation:
Onset/Appearance?
Temp?
Chills/Shakes?
Cough?
Pleurisy?
CXR?
Other sxs?
Onset: sudden, Appearance: sick
Temp: >103
Chills/Shakes: common
Cough: productive
Pleurisy: frequent
CXR: consolidation
Other sxs: chest pain, SOB
Strep pneumo microbe characteristics?
G+ diplococcus lances
⍺-hemolytic (green colonies)
Optochin sensitive (clearance around op disk)
Bile will lyse
Strep pneumo epidemiology?
young/old
cold/wet months
reservoir: asympt carriers
Strep pneumo Virulence Factor result of?
CAPSULE:
Φ phagocytosis
Φ complement
Φ opsonization by C3b
S. pneumo protection factors?
IgA protease: Φ host IgA
H2O2 prodxn: lyse host, kill competition
S. pneumo binding factors?
Pili: activate TNF
Surface proteins: bind choline on epi cells
S. pneumo Pneumolysin is?
cytotoxin that forms pores in host membrane ->
lyse host,
activate complement
S. pneumo Autolysin is?
enzyme produced in response to abx:
lyses host and pneumococcus ->
release pneumolysin,
↓ host immune response
S. pneumo action?
causes immune response, allows replication of micorbe
fluid fills alveoli -> RBC/WBC -> consolidation
S. pneumo resolution?
fluid reab and phago of bacteria
S. pneumo diagnostic tests?
Aggultination = capsular polysacc
Genetic Probe = s. pneumo rRNA
S. pneumo tx?
PCN G
Klebsiella pneumoniae microbe characteristics?
G- bacillus
Slime capsule
K. pneumo epidemiology?
Normal intest flora, aspirated
Nosocomal
K. pneumo Virulence Factors?
POLYSACC CAPSULE:
Φ phagocytosis
Φ MAC lysis
Adhesion
K. pneumo action?
Causes typical CAP/Nosocom:
necrosis of alv spaces, up lobes ->
inflamm and hemorr
(C) fatal
K. pneumo presentation?
acute onset high fever
hemoptysis (currant jelly sputum)
abscess, cavitation
K. pneumo diagnostic tests?
Cx = mucoid capsule CXR = cavitation
K. pneumo tx?
aminoglyco + 3rd gen cephalo + fluoro
Mycoplasma pneumo microbe characteristics?
Φ cell wall
“Fried egg” in culture
Sterols in plasma memb
M. pneumo action?
Adhesion to epith -> release H2O2,
Φ airway clearance,
hides w/i host memb
M. pneumo causes what infections?
Atyp PNA
otitis
rhinitis
pharyngitis
tracheobronch
M. pneumo epidemiology?
(U) 5-20yo
Reservoir: p-to-p resp droplets
M. pneumo diagnostic tests?
CXR = patchy infilt
Cx = mulberry colonies
Cold Agg = IgM’s bind I antigen of RBC
M. pneumo DOC?
Azith/TCN
Chlamydophila pneumo microbe characteristics?
G- cocci
Obligate INTRACELLULAR parasite
2 Forms: Elementary Bodies (infectious) Retic Bodies (intracellular)
C. pneumo action?
Inflamm response,
Tissue destruction by bact replication
C. pneumo epidemiology?
> 60yo
Reservoir: p-to-p resp droplets
C. pneumo DOC?
TCN/Erythro
