Bacteria Flashcards
Staphylococcal species is gram___ and____
gram positive and aerobic
Streptococcal species is gram ___ and ____
gram positive and aerobic
Enterococcal species is gram___ and ____
gram positive and aerobic
What is the most virulent of the staph species?
staph aureus
staph aureus is coagulase ____
positive
Most staph aureus produce _____, mediated by plasmids
penicillinase (beta-lactamase)
What is affective against staph aureus?
penicillinase-resistant penicillin (methicillin) and cephalosporins
What is methicillin-resistant, cephalosporin resistant, but vancomycin sensitive?
MRSA - chromosomally encoded PBP (penicillin binding protein)
VISA stands for
vancomycin intermediately susceptable
GISA stands for
glycopeptide intermediately susceptable
Staph aureus is a true _____
pathogen
Staph aureus is gram ____
positive
Staph epidermidis is gram ____
positive
Which staph is part of the normal skin flora?
staph epidermidis
staph epi. is coagulase ____
negative
Which staph is usually a colonizer?
staph epi
Diseases from staph ____ are usually associated with immunocompromised, violation of natural barriers, implantation of foreign devices (biofilms)
staph epi
Coagulase positive test means it is ___ form
gel
coagulase negative test means it is ____ form
liquid
Staph saprophyticus is gram ___
positive
staph sapro is coagulase ___
negative
Which staph species rarely causes infection in healthy individuals, but is most noted for UTI’s in women?
staph saprophyticus
Pyogenic supprative lesions, infection of the hair follicle or sweat gland, acne vulgaris, or a stye are all considered
furunculosis (“boil”)
infection of the base of the eyelash
stye
Spreading lesions of subq tissue, very serious, can lead to bloodstream infection is known as
carbuncle
Highly communicable, superficial skin infection, large blisters containing viable staph, seen mostly in infants and children under conditions where infections can easily be spread through touch contamination is known as
bullous impetigo
infection of soft tissue around the nails is known as
paronychia
tissue destruction with abscess formation in deep tissues is known as
deep lesions
Examples of deep tissue infections are:
osteomyelitis, septic arthritis, cerebral, pulmonary and renal abscesses, breast abscesses, bacterial pneumonia, endocarditis, entercolitis
In individuals with diabetes, alcoholism, malignancy, old age, steroid or cytotoxic therapy have an increased risk to having
deep lesions
when bacteria gets in the blood causing severe infections it is known as
septicemia
Gangrene is a type of
staph septicemia
Diseases can be caused by staphylococcal ____
toxins
Staphylococal toxins can cause diseases such as:
scalded skin syndrome (Ritter’s Disease)
Toxic Shock Syndrome
Staphylococcal food poisioning
streptococcus is gram ___
positive
Streptococcus is ____ or ___ shaped
spherical or oval
Streptococcus is usually found in ____ or ___
chains or pairs
Which bacteria comprise significant portion of the indigenous microflora of humans and animals (mostly GI tract; some respiratory tract)?
streptococcus (rarely cause disease)
Streptococcus has 3 impt human pathogens, they are:
strep pyogenes
strep pneumoniae
strep agalactiae
A further classification of the streptococcus species is
Lancefield groups
Lancefield groups are based on
antigenic characteristics of the outer membrane
There are ___ common groups designated by the letters of the alphabet (A-R) for Lancefield groups
14
Another classification of strep species is ____
brown groups
For brown group classification, streptococci are grown on sheep’s blood agar producing 3 pathogens of _____ around the colonies
hemolysis
A green zone is ___ hemolysis and is indicative of _____ hemolysis
alpha, incomplete
What are the two strep species that have alpha hemolysis?
S. pneumoniae, s. viridans
A clear zone is ___ hemolysis and is indicative of ____ hemolysis
beta, complete
What are two strep species that have beta hemolysis?
s. pyogenes, s. agalactiae
No zone is ___ hemolysis and is indicative of _______
gamma, non-hemolytic
What group of streptococci are non-hemolytic?
most Group D
Clinical classification combines ___ and ___ groupings and disease producing characterisitcs
Lancefield and Brown
An example of clinical classification for s. pyogenes would be
Group A, beta hemolytic Strep
Enterococcal and Non-enterococcal species are both
Group D Streptococci
A sore throat is
pharyngitis
Pharyngitis accounts for ___ million MD office visits yearly
40
Of all the sore throats presented, many of them are actually caused by
viruses
Only ___ of sore throats are caused from Group __ Streptococcus
15%, group A
Pharyngitis can also be caused by:
Arcanobacterium hemolyticum, neisseria gonorrhea, chlamydia pneumoniae, epstein-barr virus (mononucleosis), & other viruses
When a patient presents with pharyngitis, the diagnostic focus is to rule in or out ____
group A strep
First test to perform in a patient with pharyngitis is
rapid strep test
In a rapid strep test, good specificity (90%), means if the test is positive, ___ chance that a strep infection __ occuring
90% chance it IS occuring
In a rapid strep test, fair specificity (60%), means if the test is negative, ____ chance that you ____a strep infection
40% chance you MISSED a strep infection
What is the gold standard for someone with pharyngitis?
Culture and susceptibility of throat swab
If the rapid strep test is negative, the next step is to
perform a throat culture
Pharyngitis is usually indistinguishable from
viral infections
If a patient with pharyngitis turns out to have group ___, ____-hemolytic strep, concern arises over immunological sequella (disease that can result from pharyngitis)
group A, beta-hemolytic
Sequellas that can arise from group A, beta-hemolytic strep are:
Rheumatic fever (heart valve disease) - more common with strep pharyngitis Acute glomerulnephritis (chronic renal failure) - more common with strep impetigo
Another strep disease causing a localized infection of healthy skin is
impetigo
Impetigo usually affects kids ___ years old
2-5
Vesicles associated with impetigo are ____, but lesions do not usually result in ____
contagious, scarring
In a patient with impetigo, staph ___ sometimes becomes a secondary invader
staph aureus
Nephritogenic strains of imetigo cause immunogloblins to
attack the kidneys
Another strep disease that causes strep infection of the skin and subcutaneous tissues (dermis) is
erysipelas
Spreading areas of erythema and pain with systemic manifestations of fever and lymphadenopathy is associated with
erysipelas
Patients with erysipelas usually have a history of a ____ and the infection is usually on the ___
sore throat, face
Serious infection of ____ can require ____ (PCN)
erysipelas, antibiotics (penicillin)
Cellulitis, necrotizing fasciitis (“flesh-eating strep”), would and burn infections, puerperal infection, scarlet fever, immunologic sequelae (rheumatic fever, acute glomerulonephritis) are all examples of
streptococcal diseases
Strep agalactiae is classified as a group ___ strep
B
The species responsible for the leading cause of pneumonia, sepsis and meningitis during the first 2 mos of life is
strep agalactiae
strep agalactiae has an incidence of ___ cases per ____ births
1-3/1000 births
Mortality rates from strep agalactiae ___ to __
30-60%
immediate perinatal period infections caused by contamination of infant with birth canal is from
strep agalactiae
_____ is a late onset disease (3-8 wks post-partum lower mortality rate (not enough maternal IgG)
strep agalactiae
Treatment for step agalactiae is
penicillin and aminoglycoside
Streptococcus pneumoniae aka “pneumococcus” or “diplococcus” has no
Lancefield classification
strep pneumoniae has a unique ____ which inhibits ____
polysaccharide capsule, phagocytosis
-at least 80 antigenically distinct types
Many strains of strep pneumoniae are sensitive to ___ but growing numbers are becoming resistant
penicillin
Strep pneumoniae is responsible for causing
community acquired pneumonia
The most common cause of bacterial pneumonia is
pneumococcal pneumonia
Mortality from pneumococcal pneumonia increases dramatically after ___ yrs of age
50
alcoholism, diabetes mellitus, chronic renal disease, some malignancies, transplantation all increase mortality from
pneumonia
Treatment for ___ is getting more complicated
pneumococcal pneumonia
pneumococcal meningitis is caused by the bacteria
strep pneumoniae
strep pneumonia is one of the “big three” causes of ___ and the most common
bacterial meningitis
Neisseria meningiditis causes
meningococcal meningitis
H. influenzae is caused by the bacteria
haemophilus influenzae
common cause of sinusitis and otitis media is
upper respiratory infection (URI)
Other infections caused by _____ include: endocarditis, arthritis and peritonitis usually following bloodstream infections
strep pneumoniae
when treating a patient with strep pneumoniae you must consider
site of infection
meningitis vs. pneumonia vs. bacteremia vs. URI
For CNS infections,
Drug-susceptible strep pneumoniae (DSSP)
-penicillin G (MIC is less/equal to ___mcg/mL)
Drug-intermediate susceptible strep pneumoniae
-MIC greater/equal to ___
DSSP 0.06mcg/mL
DISSP 0.12
DRSP 2.0
For lung and intestinal fluid,
susceptible less/equal to
intermediate equal
resistant greater than
2
4
8
High risk patients for strep pneumoniae are elderly older than ___ and those with ____ affecting immune status
65, underlying diseases
2 vacinne types for strep pneumoniae
pneumococcal conjugate vaccine, 7 valent
pneumococcal polysaccharide vaccine, 23 valent
7 valent vaccine covers ____ of disease causing strains.
80%
23 valent vaccine covers ____ of disease causing strains
98%
Prevnar (7 valent) is for children less than ___ yrs of age
2
pneumovax 23, pneu-imune 23 are for children older than ___ yrs of age and
2 and high risk adults
The spleen is composed of ___ pulp, ___ pulp, ___follicles, and ____sheaths
red, white, lymphoid, periarteriolar lymphoid
mechanical filtration of the red blood cells
red pulp
provides active immune response through humoral and cell-mediated pathways
white pulp
rich in B-lymphocytes
lymphoid follicles
rich in t-lymphocytes
periarteriolar lymphoid sheaths
A large group of streptococci with no ____ designation but with ___ hemolytic characteristic and are major constituents of the mouth and nasopharnyx are Viridans
lancefield, alpha
subacute bacterial endocarditis is caused by
viridans group A strep
Enterococcus is ___ hemolysis
gamma
Normal inhabitants of GI tract and able to survive harsh condition are
enterococcus
enterococcus can spread through
touch contamination
enterococcus can be very resistant to
penicillin and others
Many times, this bacteria must be treated with a combination of antibiotics (synergy)
enterococcus
Enterococcus does NOT cause
pneumonia
Opportunistic organisms capable of causing UTI’s, wound infections, endocarditis in damaged heart valves are
enterococcus species
One of the most highly resistant organisms today
enterococcus
synergistic combos are losing effectiveness
VRE stands for
Vancomycin resistant entercoccus
enterococcus faecium
There is some evidence that the resistance factors can be passed on to more virulent organisms such as
staph aureus
Molecular _____ is very reactive and toxic
oxygen
what are the 3 forms of molecular oxygen?
H2O2 (peroxide)
O2- (superoxide radicals)
OH- (hydroxyl radicals)
____ pour oxygen radicals over bacteria
macrophages
There are ___ bacterial enzymes that break down oxygen radicals. What are they?
3
Catalase
peroxidase
superoxidase dismutase
catalase reaction
2(H2O2) –> 2(H2O) + O2
peroxidase reaction
2(H2O2) –> 2(H2O) + O2
superoxidase reaction
(O2-) + (O2-) + (2H+) –> (H2O2) + (O2)
There are four main classifications of growth for bacteria, what are they?
obligate aerobes
facultative anaerobes
microaerophilic bacteria (aerotolerant anaerobes)
obligate anaerobes
In obligate aerobes, energy is derived from ______ and the ______
glycolysis (important) and Krebs Cycle
humans are obligate aerobes
In obligate aerobes, ____ is the final electron acceptor in the ETC
oxygen
_____ have all the protective enzymes, O2 isn’t toxic
Obligate aerobes
Bacteria in facultative anaerobes are (aerobic/anaerobic)?
aerobic
In facultative aerobes, ____ is the electron acceptor
oxygen
Facultative anaerobes have _____ & _____ but not superoxidase mudismutase
catalase & peroxidase
_____ can grow in the absence of oxygen through fermentation derived energy
facultative anaerobes
facultative anaerobes prefer ___ but have the “faculty” to grow in _____ conditions
O2, can grow in anaerobic conditions (fermentation)
Microaerophilic bacteria use ____ for energy
fermentation
Microaerophilic bacteria (MAB) do not have an
electron transport system
MAB are also known as
aerotolerant anaerobes
MAB can “tolerate” low amounts of ____ because they have _____
oxygen
superoxidase dismutase
MAB do not have ____ or ____
catalase of peroxidase
____ cannot thrive in the presence of oxygen because there are no enzymes available to defend against it
obligate anaerobes
Blood cultures for obligate anaerobes are put into special bottles that are free of _____
oxygen
Clostridia is an _____ and gram ____
obligate anaerobe and gram positive
C. botulinum causes ____ because neurotoxins cause “flaccid” paralysis
Botulism
Flaccid = lose total control of skeletal muscle (like breathing)
C. tetani causes ___ because neurotoxins cause “rigid” paralysis
Tetanus (Lock jaw)
Rigid = causes muscles to lock up (can’t breathe if the muscles lock up)
C. perfringens causes _____ because exotoxins destroy skin, soft tissue and muscle
gas gangrene
gas produced under skin ends up killing tissue
C. difficile causes ____ (CDD)
Clostridium difficile disease (CDD)
-can be a side effect to taking antibiotics bc they would wipe out normal GI flora and allow this to grow)
In CDD, exotoxin A causes _____, exotoxin B is _____
diarrhea (annoying), cytotoxic (attack mucosal cells of GI tract)
_____ causes superinfection of the intestines caused by antibiotics which wipe out the normal GI flora
C. difficile
_____ also causes pseudomembranous enterocolitis (Colon reabsorbs water, in this disease prevents water reabsorption, causing diarrhea, bleeding, NASTY)
C. difficile
Strep species is _____ and gram ___
microaerophilic and gram positive
What does SRGPC stand for?
streptococcus-related gram-positive cocci
Peptostreptococcus is another name for
anaerobic strep
______ is the most significant pathogen recovered in clinical specimens and recovered as often as Bacteroides fragilis
Peptostreptococcus
Peptostreptococcus has been recovered in _____ cavities of the body
abscessed
Bacteroides are classified as _____ and gram ___
obligate anaerobes and gram negative
_____ is the most abundant bacteria of the lower GI tract (colon), outnumbering E. Coli 1000 to 1
Bacteroides fragilis
Bacteroides fragilis produces
beta-lactamase
_____ is instrumental in the development of intraabdominal abscesses
bacteroides fragilis
_____ has been a target organism in the development of broad-spectrum antibiotics
bacteroides fragilis
_____ is found in the oral cavity and upper respiratory tract. Dental, sinus, pulmonary infections, abscesses and human bites
bacteroides melaninogenicus
Some _____ are beta-lactamase producers
bacteroides melaninogenicus
Neisseria species are _____ and gram ____
obligate aerobes and gram negative
Neisseria species are gram negative _____
diplococci
What are the two pathogenic strains of Neisseria species?
Neisseria meningiditis (meningococcus) Neisseria gonorrhea (gonorrhea)
N. meningiditis is the main cause of ____, exclusively affecting humans
meningitis
____ can be a harmless member of the normal flora
N. meningiditis
in N. meningiditis, serogroups A,B,C,Y, and W135 are most commonly associated with
disease
in N. meningiditis, serogroups __ and ___ account for 75% of outbreaks
B & C
peak incidence of N. meningiditis, occurs btw ___ mo and ___ years. Can also occur in populations that live close together (military)
6 mo to 5 yrs
Transmission of N. meningiditis is by
droplet nuclei
Last epidemic of ____ was 1971 in Brazil and 1946 in USA
N. meningiditis
in N. meningiditis, encpsulated bacteria resists ____, contributing to virulence, and also a need for vaccine protection
phagocytosis
Mortality from N. meningiditis if untreated is ___, ___ if treated appropriately
100%, 15%
meningitis and sepsis caused from ______ can cause coagulopathy which detroys major organs and also can cause adrenal gland destruction (waterhouse-friderichsen Syndrome)
N. meningiditis
what is the treatment for N. meningiditis?
high dose of penicillin G, alternative 3rd generation cephalosporins, chloramphenicol
Prevention of N. meningiditis, although controversial is
rifampin 600mg bid x2 days for adults
N. gonorrhea is an ____ and gram ____
obligate aerobe and gram negative
Transmission of N. gonorrhea is by
sexual contact, major reservoir in asymptomatic infected persons
1 mil new cases estimated each yr of ___ is probably a sever underestimate
N. gonorrhea
Highest incidence occurs btw ____ years of age
20-24
____ of women are infected after single exposure
50%
____ of women are asymptomatic, 15% may develop PID, fallopian scarring, sterility, ectopic pregnancies
50%
___ of men are infected after single exposure
20%
___ of men are asymptomatic, <1% developing complications: prostatitis, uretheral stricture, epidimitis
10%
along with N. gonorrhea, ____ can also be present as a co-infection and should also be treated
chlamydia trachomatis
N. gonorrhea produces ____ which complicates treatment
beta-lactamase,
ideal treatment of N. gonorrhea involves >___% erradication rate with a single dose
95%
Regimen for _____depends on site of infection and whether infection is complicated or not
N. gonorrhea
What drugs are effective against N. gonorrhea?
selected 2nd or 3rd generation cephalosporins, fluoroquinolones, spectinomycin
Ophthalmia neonatorium is caused by
N. gonorrhea
Prophylaxis of Ophthalmia neonatorium is
silver nitrate solution 1%
treatment of Ophthalmia neonatorium is
ceftriaxone 25-50 mg/kg single dose
Moraxella catarrhalis is an ___ and gram ____
aerobe and gram negative
Moraxella catarrhalis is also known as
Branhamella catarrhalis
Moraxella catarrhalis is aerobic, gram negative ____
diplococci
Moraxella catarrhalis resembles ____ species
Neisseria
_____ has low pathogenicity, but increasing concern in ____ and ____ especially in patients with chronic bronchitis
Moraxella catarrhalis
URI’s & pneumonias
The ___ ___ is a natural reservoir for Moraxella catarrhalis
nasal cavity
COPD, CAP, acute otitis media, sinusitis, urethritis, invasive diseases in immunosuppressed patients are caused by
Moraxella catarrhalis
___ in Moraxella catarrhalis contributes to virulence but is different in structure from lipopolysaccharide of the enteric gram-negative bacilli (enterobacteriaceae)
lipo-polysaccharide
Moraxella catarrhalis usesd to be sensitive to ____
penicillin
In the 1980’s Moraxella catarrhalis became ___ producers (chromosomally and plasmid mediated)
beta-lactamase
Most Moraxella catarrhalis remain sensitive to
erythromycin, tetracycline, amoxicilin/clavulanic acid (augmentin), and cephalosporins
Most Moraxella catarrhalis infections involve oral mucosa, oral antibiotics are (okay/not okay)
usually okay
Pneumonia/ bacteremia caused by Moraxella catarrhalis, antibiotics should be given ____
parenteral
___ in Moraxella catarrhalis contributes to virulence but is different in structure from lipopolysaccharide of the enteric gram-negative bacilli (enterobacteriaceae)
lipo-polysaccharide
Moraxella catarrhalis usesd to be sensitive to ____
penicillin
In the 1980’s Moraxella catarrhalis became ___ producers (chromosomally and plasmid mediated)
beta-lactamase
Most Moraxella catarrhalis remain sensitive to
erythromycin, tetracycline, amoxicilin/clavulanic acid (augmentin), and cephalosporins
Most Moraxella catarrhalis infections involve oral mucosa, oral antibiotics are (okay/not okay)
usually okay
Pneumonia/ bacteremia caused by Moraxella catarrhalis, antibiotics should be given ____
parenteral
Enterococcus is resistant to ___
vancomycin
The most prominent species of enterococcus is
E. faecalis
The second most prominent species of enterococcus is
E. faecium
We try to limit our use of _____ because of resistant factors
vancomycin
Enterobacteriaceae are also known as
enteric bacilli
enteric bacilli are gram ____ and ____
gram negative and aerobic
_____ are a large, diverse group of gram negative ____ found in nature and as part of the normal flora of man and animals
enteric bacilli, rods
most _____ are opportunistic pathogens but some strains are highly and specifically pathogenic (E. coli)
enteric bacilli
_____ is the most abundant organism found in normal flora followed by Klebsiella species, Proteus species, and Enterobacter species
Escherichia coli
Enterobacteriaceae are also known as
enteric bacteria
These four species are truly pathogenic
Salmonella, Shigella, E. coli, and Yersinia
enteric bacilli are also known as
“gram-negative rods” (coliforms)
____ is the causative organism of gram-negative sepsis
enteric bacilli
In the development of gram-negative sepsis, the lip-polysaccharide _____ is contained in the cell wall and is the initiating _____ factor
endotoxin, virulence
“enteric common antigen” is
enteric bacilli
in ____ chromosomal and plasmid-mediated resistance to antibiotics is common and treatment is guided by results of cultures and sensitivities
enteric bacilli
E. coli (___) is a type of enter bacilli.
non-diarrheagenic
E. coli (___) is typical or common, its part of the normal flora, most common cause of UTI’s, causes opportunistic infections (breach of natural barriers pathologically of iatrogenically), some quite severe (septic shock - lipopolysaccharide)
non-diarrheagenic
What were the first organisms identified in producing extended-spectrum beta-lactamases?
E. coli (non-diarrheagenic)
there are __ E. coli (diarrheagenic) causing enteric infections
5
ETEC is
enterotoxogenic
EPEC is
enteropathogenic
EIEC is
enteroinvasive
EHEC is
enterohemorrhagic
EAggEC is
enteroaggregtive
Klebsiella-Enterbacter-Serratia group is gram ____ and _____
negative and aerobic
the Klebsiella-Enterbacter-Serratia group is part of the ____ _____
enteric bacilli (enterobacteriaceae)
there are ___ bacteria classified under the Klebsiella-Enterbacter-Serratia group. what are they?
3
Klebsiella pneumoniae
Enterobacter cloacae
Serratia marcescens
_____ & _____ contribute to the virulence of Klebsiella pneumoniae
endotoxin and capsule (inhibit macrophage but not WBC - used for protection)
Klebsiella pneumoniae is _____ producer, resulting in antimicrobial resistance
beta-lactamase
Klebsiella pneumoniae is in GI tract, causes mainly _____ diseases including pneumonia (lobar & bronchopneumonia), UTI’s (common cause but E. coli most frequent), bacteremia (6th leading cause of nosocomial infection), klebsiella can also be present in alcoholics
nosocomial (hospital acquired)
when patients aspirate, it can cause pnuemonia
_____ is the main virulence factor for enterobacter cloacae. It is enteric, gram negative and aerobic.
endotoxin (lipopolysaccharide - causes problem)
_______ is also a beta-lactamase producer contributing to antibiotic resistance (along with others)
enterobacter cloacae
UTI’s (pyelonephritis - deep infection of kidney and cystitis-infection of bladder) and nosocomial pneumonia’s (people on ventilator) and bacteremia are all caused by
enterobacter cloacae
In Serratia marcescens, and _____ is the main virulence factor. Note: main pigment strains may be more virulent
endotoxin
Serratia marcescens is another _____ producer contributing to antibiotic resistance (along with multiple other mechanisms)
beta-lactamase
______ is the cause of diseases such as UTI’s (pyelonephritis and cystitis), nosocomial pneumonia and bacteremia, and infective arthritis - from intra-auricular injections (needle to joint, contaminated needle)
Serratia marcescens
Proteus mirabilis is classified as ___ ____
enteric bacilli
Proteus mirabilis is gram ____ and ______
negative and aerobic
Proteus mirabilis is indole ___
positive
endotoxin, flagella producing “swarming appearance” under microscope, and urease production are all virulence factors for
Proteus mirabilis
Proteus mirabilis has SOME ______ production
beta-lactamase
susceptible to most antibiotics
UTI’s (pyelonephritis and cystitis), and urolithiasis (struvite stones), staghorn calculi and nosocomial infections are caused by ___
proteus mirabilis
all ____ species produce urease which breaks down urea, generates ammonia, alkalinizes the urine, precipitation of magnesium and ammonium phosphate (due to precipitation, causes struvite stones - develop staghorn calculi)
proteus
Proteus vulgaris, morganella morganii, providentia rettgeri, and providentia stuartii are all indole ___. Note: all used to be called proteus
negative
these organisms are harder to treat with antibiotics
Salmonella typhi is a true
pathogen (not normally present)
Salmonella typhi is gram _____ and _____
negative and aerobic
______ has a endotoxin, capsule that resists antibodies and complement, and survives within macrophages but not neutrophils
Salmonella typhi
____ has multiple mechanisms of drug resistance
Salmonella typhi
Salmonella typhi invades the ____ layer of intestines and epithelial cells of ____
mucus layer and cells of intestines
enteric fever (Typhoid fever) - steady invasion of GI tract to lymphatic system to bacteremia is caused by
Salmonella typhi - starts as gastrointestinal disease but can get bad very quick
Salmonella typhi is highly fatal if
untreated
in the Salmonella typhi there is a “carrier state” known as
Typhoid Mary
Salmonella enteriditis is gram ____ and _____
negative and aerobic
Salmonella enteriditis and Salmonella typhi are both true
pathogens
______ has an endotoxin, invasion properties, and the ability of survive macrophages but not neutraphils
Salmonella enteriditis
Salmonella enteriditis has _____ _____ resistance
multiple drug
Salmonella enteriditis usually causes watery diarrhea with fever, n&v, and is usually ____-____
self-limiting (will be sick, but will get better, we need to let it run its course - don’t take meds to prevent body from normal response)
Salmonella enteriditis can occasionally cause
bacteremia
transmission of Salmonella enteriditis is through
fecal/oral, contaminated foods - eggs, milk, poultry, kitchen sponges/towels/utensils
Shigella dysenteriae is a true
pathogen
Shigella dysenteriae produces ______ - Shiga A and B that contribute to virulence
enterotoxins (specifically attacks the intestine)
Shigella dysenteriae also has endotoxins, invasion properties and the ability to resist ____ that contributes to virulence
stomach acid (makes it extremely contagious)
Shigella dysenteriae causes _______ (Shigellosis) - watery diarrhea, fever, n&v. Can be fatal to small children
Dysentery (diarrhea containing blood - fever, abdominal pain)
Transmission of Shigella dysenteriae is by
fecal/oral - extremely contagious requiring very small amounts of bacteria
Yersinia pestis is another true
pathogen
Shigella dysenteriae is gram ____ and ____
negative and aerobic
Yersinia pestis is gram ____ and _____
negative and aerobic
Yersinia pestis is classified as
coccobacilli
Yersinia enterocolitica does NOT cause
plague
what 4 factors of Yersinia pestis contribute to virulence?
exotoxin, endotoxin, capsule (resists phagocytosis), and enzymes (coagulase and fibrinolysin)
Bubonic plague (black plague, pneumonic plague) is causes by
Yersinia pestis
Yersinia pestis is a ____ fatal disease, associated with fever, chills, ____ onset, ____ and sepsis, vasculitis and _____ (black death)
rapidly fatal, sudden onset, bacteremia and sepsis, gangrene
Transmission of Yersinia pestis is through
infected fleas
Haemophilus influenza is gram ____ and aerobic
negative
Haemophilus influenza is non-
enterobacteriaceae
Haemophilus influenza is gram negative and cocco____
coccobacilli
what are the 3 virulence factors for Haemophilus influenza?
endotoxin, capsule (only on the type B strain) and surface enxymes
Haemophilus influenza is a _____ producer
beta-lactamase
Haemophilus influenza occurs in ____ and the ____
young children and elderly
Haemophilus influenza is the #1 cause of _____ in children 6mo to 6yrs (mostly associated with type b strain)
meningitis
Antibiotics used to treat meningitis from Haemophilus influenza will reduce _____ but not ____ (neurologic deficits)
reduces mortality but not morbidity
Haemophilus influenza is the #1 cause of ___ in young children
epiglotitis
_______ is also known to cause sinusitis and otitis media and purulent conjunctivitis
Haemophilus influenza
There is a vaccine to prevent disease and prevents mortality and morbidity against type b strain of _____. The vaccine is polysaccharide with conjugated protein carrier
Haemophilus influenza
Pseudomonas aeruginosa and Burkholderia are gram ____ and _____
gram negative and aerobic
what 3 virulence factors are associated with Pseudomonas aeruginosa and Burkholderia?
exotoxins, endotoxins, proteolytic enzymes (elastase)
Pseudomonas aeruginosa and Burkholderia have multiple ___ ___ mechaniams, therefore they are extremely challenging to kill
antibiotic resistance
Pseudomonas aeruginosa and Burkholderia are harbored in
moist environments (hot tubs, swimming pools (swimmer’s ear)
Pseudomonas aeruginosa and Burkholderia are also associated with
cystic fibrosis
pneumonia (necrotizing and bronchopneumonia), burn wound infections - black of green discoloration, endocarditis - IV drug abusers, UTI’s - cystitis and pyelonephritis, bacteremia - especially in immunocompromised patients, external otitis, corneal keratitis, hot tub folliculitis, osteomyelitis are diseases caused by
Pseudomonas aeruginosa and Burkholderia
treatment of Pseudomonas aeruginosa and Burkholderia requires ____ ______ because no single agent covers more than 80% of isolates
multiple antibiotics
Stenotrophomonas and Acinetobacter are gram ____ and ____
negative and aerobic
What is the virulence factor for Stenotrophomonas and Acinetobacter?
endotoxin
Stenotrophomonas and Acinetobacter have ___ ___ ____
multiple drug resistance
Stenotrophomonas and Acinetobacter are often seen in _____ patients who have undergone courses of ____
hospitalized, and antibiotics
nosocomial pneumonia and bacteremia are diseases caused by
Stenotrophomonas and Acinetobacter
Legionella pneumophilia is gram ____ and ____
negative and aerobic
Endotoxin, exotoxin (cytotoxin - impairs phagocytes), enzymes (proteolytic - lyse macrophages and monocytes), survives inside alveolar macrophages are virulence factors for
Legionella pneumophilia
Legionella pneumophilia is a _____ producer
beta-lactamase (no beta-lactam antibiotics)
Legionella pneumophilia causes _____ pneumonia, can be fatal in immunocompromised and elderly
atypical
Legionella pneumophilia is susceptible to 3 drugs, what are they?
macrolides, tetracyclines, and fluoroquinolones
Transmission of Legionella pneumophilia is by
water contamination (air conditioners, cruise ship water supplies, hospital water supplies, hot tubs)
Helicobacter pylori is gram ____ and _____ but considered an ____ organism
negative and aerobic, considered atypical
virulence factors for Helicobacter pylori include endotoxin, and production of ____ - enables survival in stomach by neutralizing acid with ammonia
urease
the human GI tract is the only known reservoir for
Helicobacter pylori
transmission of Helicobacter pylori is by
fecal/oral
chronic gastritis (superficial mucosal inflammaiton - 100% of patients have infection), duodenal/peptic ulcer (occurs as an extension of chronic gastritis - 90-100% have infection), gastric peptic ulcer (similar to duodenal - 50-80% have infection), gastric carcinoma (may be an association with chronic gastritis) are all diseases caused by
Helicobacter pylori
what is the treatment of Helicobacter pylori?
clarithromycin +amoxacillin+ PPI
PESKY MESS
Proteus mirabilis Enterobacter cloacae Serratia marcescens Klebsiella pneumoniae Yersinia
M ??
E. Coli
Salmonella
Shigella
