د.الهام Bacteria Flashcards
The staphylococci are gram- positive spherical cells, usually arranged in …..
They grow readily on many types of media and are active metabolically, …… and producing …… that vary from white to deep yellow (golden) as a result of …..during growth.
.
grape-like irregular clusters,
fermenting carbohydrates
pigments
carotenoid pigment
Some of staphylococci are members of the …. of the skin and mucous membranes; others are …., causing …..
Normal flora
pathogenic
suppuration, abscess formation, a variety of pyogenic infection and even fatal septicemia.
Staphylococcus aureus
Non-motile, no spore forming, facultative anaerobic
Catalase positive.
Hardy organisms surviving many non-physiologic conditions.
*Hemolysis blood, coagulates plasma, and produces a variety of extracellular enzymes and toxins.
Rapidly develop resistance to many antimicrobial agents.
. …. is carries by 20-50% of healthy individuals on nasal mucosa & on the skin.
S.aureu
CLASSIFICATION of staphylococcus
Based on coagulase production:
1. Coagulase positive: (e.g. S.aureus)
2. Coagulase negative :( e.g. S. epidermidis) & (S. saprophyticus).
B) Based on pathogenicity:
1. Common pathogen :( e.g.-S. aureus)
2. Opportunistic pathogens: (e.g.-S. epidermidis)
(S.saprophyticus)
Virulence factors & diseases of staphylococcus
Cell associated factors
1Capsule: slim layer of polysaccharide protect bacteria from PMN leukocytic phagocytosis.
2Cell wall: rigid peptidoglycan layers, stimulates the production of endogenous pyrogens, IL-1 &PMN activate (abscess formation).
3Protein A: linked to cell wall, preventing the antibody mediating immune clearance and complement consumption.
4Teichoic acid: linked to the peptidoglycan & can be antigenic, it’s also mediating the attachment of staphylococci on mucosal surfaces.
EXTRACELLULAR FACTORS
A Enzymes:
1Catalase; convert H2O2→H2O +O2.
(The catalase test differentiate staphylococci (+ve catalase) from other strain (-ve catalase streptococci).
2Coagulase; Convert fibrinogen→ insoluble fibrin.
3Hyaluronidase ; hydrolyze hyaluronic acid that found in cellular matrix of the connective tissues.
3 Lipase; hydrolyze lipid to ensure the staph survival in sebaceous area of the body.
4Other enzymes which have role in diseases such as kinase nuclease and pinicillinase.
B Toxins:
Exotoxins
1. Cytolytic toxins
i) Hemolysins
Alpha hemolysin; potent hemolysis toxin.
Beta hemolysin; degrades sphingomyelin & therefore is toxic for many kinds of cells.
Gamma hemolysin; lyse erythrocytes from humans & animals.
Delta hemolysin; disrupt biologic membrane.
ii) Leukocidin; toxin, kill human leukocytes.
2Exfolitative toxin, (epidermolytic toxin), causing staphylococcal scalded skin syndrome (SSSS).
3) Toxic shock syndrome toxin- 1 (TSST-1),
Superantigen binds to MHC class II molecules,T cell stimulation.
Also associated with fever, multisystem involvement shock & desquamated skin rash.
4Enterotoxins: Five serologically toxins (A-E) which are superantigens, an important cause of food poisoning.
Pathogenicity: of staphylococcus
The pathogenic capacity of staphylococcus species is combined effect of extracellular factors and toxins together with the invasive properties of the strain in the host tissue.
Staphylococcus infections
Local lesions of skin:
….. (is inflammation at the base of the eyelashes, The first sign of a stye is a small, yellowish spot),
….. (infection of hair follicle resulting in localized accumulation of pus and dead tissue often on back or neck), …. (infection of several hair follicles), …… (progressive appearance of swelling and pain in a surgical wound after about 2 days from the surgery).
…. (skin lesion with blisters that break and become covered with crusting exudate).
Systemic infections (endocarditis, osteomyelitis &septic arthritis.
Styes
Furuncles or Boils
Carbuncles
Woundinfections
Impetigo
Staphylococcal food poisoning:
Enterotoxin is responsible for manifestations of staphylococcal food poisoning.
Five types of enterotoxin are currently known, named A, B, C, D and E.
It usually occurs when preformed toxin is ingested with contaminated food
The toxin acts directly on the autonomic nervous system to cause the illness, rather than gut mucosa.
The common food items responsible are - milk and milk products, meat, fish and ice cream.
Source of infection- food handler who is a carrier.
Incubation period- 2 to 6 hours.
Clinical symptoms- fever, nausea, vomiting and watery diarrhea.
The illness is usually self-limited, with recovery in days.
- Staphylococcal Toxic shock syndrome (STSS):
The disease initiated with localized growth of toxin-producing S.aureus in vagina or a wound.
It is fatal multisystem disease presenting with fever, hypotension, myalgia, vomiting, diarrhea, mucosal hyperemia and erythematous rash which desquamates subsequently.
Types of STSS known:
Menstrual associated STSS: Here colonization of S.aureus occurs in the vagina of menstruating woman who uses highly absorbent vaginal tampons.
Non menstrual associated STSS: Here colonization of S. aureus occurs in other sites like surgical wound.
Staphylococcal scalded skin syndrome (SSSS):
-Exfoliative toxin produced by S.aureus is responsible for this.Also known as Ritter’s disease.
-It is a skin disease in which outer layer of epidermis gets separated from the underlying tissues.
-Disease of young children.
-Mediated through minor Staphylococcal infection by epidermolytic toxin’ producing strains
-Mild erythema (redness and inflammation around the mouth) and blistering of skin followed by desquamation of epidermis.
-Bullous impetigo (superficial infection affecting mostly young children, on face and limbs) is a localized form of SSSS.
-Children are otherwise healthy and most eventually recover as a result of antibodies formation.
Staphylococcus culture
Culturing in blood(β- hemolytic) and Mannitol agar.
.. is the antibiotic of choice in the treatment of staphylococcal diseases.
Vancomycin
Stapylococcus saprophyticus:
.
Skin commensal.
.Important Cause of UTI in sexually active young women.
.Infected women have dysuria (pain in urination) &pyuria(pus in urine).
.Usually sensitive to wide range of antibiotic.
Staphylococcus epidermidis:
..
Coagulase negative staphylococci.
.Skin commensal.
.Has predilection for plastic material.
.Associated with infection of IV lines, prosthetic heart valves, shunts.
.Causes urinary tract infection in catheterized patients
.Has variable ABS pattern
.Important Cause of UTI in sexually active young women.
.
Stapylococcus saprophyticus:
Aerobic non-spore forming bacilli:
Corynebacterium diphtheriae.
Listeria monocytogenes.
spore- forming bacilli:
Bacillus anthracis (Aerobic).
Clostridium species (Anaerobic).
Corynebacterium diphtheria
Is a Gram-positive rod, 0.5-1µm in diameter.
Arranged as ….
The cells are …. , often with …
They also contain ….. that stain differently from the other cell materials.
irregular aggregations looking like (Chinese letters).
pleomorphic
bulging at one end that gives a club appearance (Greek coryne= club)
accumulations of phosphates (metachromatic granules)
Corynebacteria normally colonize the ….
The most virulence strain is …
Greek, diphtheriae ‟ leathery skin” referring to the ….
skin, upper respiratory tract, gastrointestinal tract, and urogenital tract of human.
C. diphteriae .
pseudomembrane that initially forms on the pharynx.
Corynebacterium diphtheria
This disease results when the organism produces a …… that absorbed by various tissues within the body.
The toxin acts by …..
powerful exotoxin
inhibiting the translation step during eukaryotic protein synthesis.
1-Corynebacterium diphtheria
The ability to produce the exotoxin is associated with infection of bacterium with ….
bacteriophage
lysogenic activation
The ability of bacteriophage to insert their DNA into bacterium DNA
Corynebacterium diphtheria
However, not all strains are . …
.
A non-toxigenic strain can become toxigenic by the infection of such a ….
toxigenic
bacteriophage
Diphtheria It is transmitted from …. by …. especially in ..
person to person
respiratory droplets or skin contact,
crowded and unsanitary living conditions.
Diphtheria is primarily a …. disease, caused death among children.
childhood
Today diphtheria is rare due to ….
widespread vaccination
The clinical presentation of diphtheria is determined by the
site of infection, the immune status, and the virulence of the organism.
Respiratory diphtheria:
The symptoms develop after…
Organisms multiply …
Onset malaise, sore throat, exudative pharyngitis and low grade fever.
The exudate evolves into ….
This membrane (marker of diphtheria) covers the …
2-6 days incubation period.
locally on epithelial cells in the pharynx and initially cause localized damage as a result of exotoxin activity.
thick, gray pseudomembrane (composed of bacteria, lymphocytes, plasma cells, fibrin, and dead cells).
tonsils and extends up into the nasopharynx or down into the larynx causing breathing difficulties and painful swallowing.
marker of diphtheria)
thick, gray pseudomembrane
Respiratory diphtheria
Swollen lymph nodes of neck causing ….
Complications in patients with severe disease include …
bull neck appearance.
breathing obstruction, cardiac arrhythmia and coma.
Clinical picture of Respiratory diphtheria
Bull neck diphtheria pseudomembrane
Cutaneous diphtheria
The organism colonizes the …
… is first develop and then evolves into a … covered with a ..
skin and gain entry into subcutaneous tissue through breaks in the skin.
A papule
chronic ulcer
grayish membrane.
Cultivation on … (selective differential medium for C.diphtheriae) , which grow and give … appearance.
cultivation on ..which give. gray to black colonies.
Loffler’s serum
poached egg
Tellurite medium
Laboratory diagnosis: diphtheria
Toxigenicity test to detect exotoxin production:
This can be done by an in vitro .. using .specific antitoxin .
In vivo, using … injected subcutaneously.
immunodiffusion assay (Elek test),
guinea pigs
Symptomatic diphtheria can be prevented by …. and with …
Initially, children are given monthly injections of …
actively immunizing people with diphtheria toxoid during childhood
booster doses every 10 years throughout life.
diphtheria toxoid, pertussis and tetanus antigen (DPT) vaccine.
Listeria
……
The organisms are …..
Small, gram- positive, non-spore forming, facultative anaerobic bacillus.
motile at room temperature with tumbling motion by means of 4 flagella.
Listeria organisms are widely distributed in nature, but the more susceptible people to listeria diseases are …..
neonates, elderly, pregnant women and immunocompromised patients.
Listeria causing …..
meningitis and bacteremia.
L . monocytogenes is a facultative intracellular pathogen, can grow in ..
macrophages, epithelial cells.
Listeria monocytogenes
The virulent strain produce: …..
Hemolysin, which help the bacteria to released after phagocytosis and intracellular growth.
Listeriolysin O; which are genetically related to streptolysin O and pneumolysin , degrade the cell membrane.
Virulence factor of listeria monocytogenes
Hemolysin
Listeriolysin O
Human listeriosis is a … disease seen throughout the year, especially in the warmer months.
The disease is ….., associated with …..
This organism can grow in …… Thus it can multiplication in ….
sporadic
foodborne
consumption of contaminated milk, soft cheese, undercooked meat, unwashed raw vegetables .
a wide PH ranges and in cold temperatures
refrigerated contaminated food.
Neonatal disease
Surviving neonates of fetomaternal listeriosis may suffer ….. unless it is promptly treated.
………. occurs 2-3 weeks after birth.
granulomatosis infantiseptica — pyogenic granulomas distributed over the whole body
Meningitis or meningoencephalitis with septicemia
Adult diseases:
Manifestation of adult listeriosis especially in immunocompromized adult with renal transplantation includes …..
Infections in pregnant women may lead to ….
meningitis, septicemia, endocarditis, and corneal ulcer.
abortion or premature delivery and the infected mothers has an influenza-like illness.
Cultivation of listeria on …
blood media ( small, gray, β hemolytic colonies).
Listeria Invasive disease is treated by a combined therapy of
ampicillin and gentamicin
Bacillus anthracis
Gram positive rod, normally resides as …
spores in the soil.
B. anthracis possesses an antigenic ……
Anthrax are different diseases caused by B. anthracis and is Greek means …..
unique capsule composed of D- glutamic acid (retards phagocytosis by host cells).
coal
Transmission of anthrax among animals (. ……) usually through …..
It infects humans upon contact …..
Exposure to spores and infected with them through a …..
No spread from one person to another.
sheep, horse, and cattle
ingestion of spore-contaminated feed.
with infected animals.
skin wound, ingestion, or by inhalation.
PATHOGENESIS of B. anthracis
B. anthracis possesses a capsule that is antiphagocytic and is essential for full virulence.
The organism also produces three plasmid-coded exotoxins:
Edema factor.
Protective antigen(PA).
( both a and b responsible for the severe edema usually seen in B. anthracis infections)
Lethal toxin is responsible for tissue necrosis.
: the most common form of anthrax
Cutaneous anthrax
Clinical picture of Cutaneous anthrax
eschar
Cutaneous anthrax: the most common form (95%), causes….. , results when the spores enters the tissues through abrasions or lesions.
a localized, inflammatory, black, necrotic lesion (eschar)
Pulmonary anthrax: the highly fatal form, is characterized by …’..
sudden, fever, pneumonia , massive chest edema followed by cardiovascular shock.
Gastrointestinal anthrax: a rare but also fatal (causes …..
death to 25%) type, severe enteritis results from ingestion of spores.
B. anthracis Cultured on … to confirm the presence of bacteria.
nutrient agar and blood agar
Cloudy appearance
B. anthracis
Several antibiotics are effective including ….
… are available to control the disease in animals and humans.
penicillin, doxycycline and ciprofloxacin.
Vaccines
Bacillus cereus
Morphologically …. to B. anthracis
It is present in …….
It produces ….. that cause ……
Food poisoning results from the ingestion of preformed enterotoxins, producing …..
similar
soil, contaminating agricultural products
enterotoxins
food poisoning.
vomiting and diarrhea.
Type of Bacillus cereus enterotoxin
heat stable toxin
heat labile toxin
The vomiting form:
Is most often associated with …… from …..
This toxin is similar to …
The symptoms include ….
ingestion of heat stable toxin
contaminated rice.
S. aureus toxin.
vomiting, nausea, abdominal pain beings after 2 hr of ingestion.
The diarrheal form:
Is most associated with ……
…..occurs within 9 hr of ingestion.
Treatment in both forms is …
ingestion of heat labile toxin in contaminated meat, sausage or vegetables.
Watery, non-bloody diarrhea
only symptomatic.
Aerobic spore forming bacilli
1) - Bacillus anthracis
- Bacillus cereus