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Practice topics Exam 1 > Bacteria 3 > Flashcards

Bacteria 3 Flashcards

1
Q

Involvement of pores invovles

A

Folliculitis
Furuncles
Carbuncles

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2
Q

Infection of superficial skin layers (epidermis) include what

A

impetigo

erysipelas

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3
Q

Deeper involvement of dermis and/or subcutaneous tissue includes what

A

cellulitis

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4
Q

Involvement of deeper skin structures and muscle includes what

A

fasciitis, myositis

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5
Q

SSTI is what

A

skin and soft tissue infections

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6
Q

SSTI involve microbial invasion of what

A

layers of the skin

underlying soft tissues

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7
Q

What is responsible for many of the SSTIs

A

S aureus and GAS, S pyogenes

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8
Q

Minimum diagnostic criteria for SSTIs

A

Erythema, edema, warmth, and pain/tenderness

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9
Q

Impetigo is what

A

Most superficial of bacterial skin infections
Causes honeycrusts, bullae (blisters) and erosions
Often around the mouth
Small vesicles lead to pustules which crust over

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10
Q

Impetigo is the ____ common bacterial skin infection in ____

A

MOST common bacterial skin infection in CHILDREN

most frequent in children ages 2 to 6 yrs, but can be seen in patients of any age

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11
Q

Impetigo - which organism is most common

A

Streptococcus pyogenes is more common than staphylococus

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12
Q

Folliculitis is what

A

an infection of the hair follicle

Multiple species of bacteria have been implicated as well as fungal organisms

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13
Q

Furuncle/Boil is what

A

S aureus

Deep seated infection (abscess) involving the entire hair follicle and adjacent subcutaneous tissue

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14
Q

Carbuncle is what

A

S aureus

Multiple furuncles/boils can coalesce and extend into deeper subcutaneous tissue

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15
Q

Carbuncle - pt will present how

A

Chills and fever

Often leads to systematic spread of infection

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16
Q

Erysipelas is what

A

Acute infection of superficial skin layers (epidermis) of the skin

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17
Q

Erysipelas - pt presents how

A

Inflammation (warmth)
Lymph node enlargement
Chills, fever

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18
Q

Erysipelas - distinguishing factors

A

Invovled skin is distinct from uninvolved skin - there are distinct borders
Usually preceded by respiratory or skin streptococcus pyogenes infection

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19
Q

Cellulitis is what

A

Involves skin and deeper subcutaneous tissue

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20
Q

Cellulitis - pt presents how

A

local inflammation and systemic symptoms (fever)

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21
Q

Cellulitis - unique factors

A

involved versus uninvolved tissue is unclear
Precise identification of microbe is necessary for tx because many microbes cause cellulitis (often caused by strep or staph)

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22
Q

Necrotizing fasciitis: debridement is what

A

acute infection of subcutaneous tissues

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23
Q

Necrotizing fasciitis: debridement is often caused by what

A

Streptococcus pyogens, staphylococcus aureus (including MRSA), clostridium perfringens

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24
Q

Necrotizing fasciitis: debridement - pt will present with

A

diffuse redness due to deep tissue involvement
Destruction of muscle and fat
Cellulitis, gangrene, blisters
Can lead to toxicity, multi organ failure, and death!!!

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25
Necrotizing fasciitis: debridement - treatment
Antibiotic cocktails and surgical debridement
26
Differentiation between Staphylococcus and Streptococcus
Both are gram positive cocci Use hydrogen peroxide on a slide and mix it with the bacteria Staphylococcus will break down the hydrogen peroxide making it catalase positive
27
Differentiation between Staphylococcus and Streptococcus - Staph
Responsible for a wide variety of clinical diseases Catalase positive Clusters
28
Differentiation between Staphylococcus and Streptococcus - Strep
Responsible for a wide variety of clinical diseases Catalase negative Pairs or chains
29
Staphylococci
``` Gram pos Facultative anaerobe Form grape like clusters White of golden colonies Catalase pos (breaks down H2O2) ```
30
Staphylocccci - found in
skin and mucus membranes of humans
31
Staphylococci how spread
person to person spread through direct contact or exposure to contaminated formites (bed linenes, clothing)
32
Staphyloccci - virulence factors
numerous - toxins, capsules...
33
S aureus virulence factors - structural
Capsule, biofilm, peptidoglycan, teichoic acid | PROTEIN A - binds to Fc domain of IgG
34
S aureus virulence factors - toxins
Cytotoxins, exfoliative toxins, enterotoxins, toxic shock syndrome toxin
35
S aureus diseases can be __ or ___
toxin mediated or suppurative
36
S aureus diseases - Toxin mediated examples
Scalded skin syndrome Food poisoning Toxic shock
37
S aureus diseases - suppurative examples
``` Impetigo Folliculitis Furuncles or boils Carbuncles Bacteremia and endocarditis Pneumonia and empyema Osteomyelitis Septic arthritis ```
38
Staphylococcal scalded skin syndrome (SSSS) is most common in who
neonates less than 5 yrs of age has a high recovery If immune compromised though has high lethality
39
Staphylococcal scalded skin syndrome is what
Exfollative toxin cause exfoliation of superficial layers of skin (no scarring)
40
Staphylococcal scalded skin syndrome - symptoms
first appears as localized perioral erythema (red/inflamed around mouth) spreads over body in 2 days cutaneous blisters containing clear fluid and desquamation
41
Staph culturable from skin?
NO because it is a toxin mediated disease
42
S aureus clinical manifestations
``` Impetigo Folliculitis Foruncles or boils Carbuncles These you can culture! Localized cutaneous pyogenic staphylococcal infections ```
43
Methicillin resistant staphylococcus aureus (MRSA) is what
resistant to beta lactams including methicillin and other or more common antibiotics such as oxicillan, penicillan, and amoxicillan High % of nosocomial infections and community acquired infections
44
MRSA tx
Tx with vancomycin
45
S aureus presentation
multiple presentations - cutaneous, systemic, staph food poisoning, scalded skin syndrome, and toxic shock syndrome
46
S aureus diagnosis made how
Gram pos stain Culture on blood apgar aerobically (white/gold colonies, hemolytic) Catalase pos, coagulase pos Blood cultures pos in acute s aureus, osteomyelitis, and endocarditis TOXIN mediated disease will not always yield cultured microbes
47
S aureus treatment
Superficial lesions will resolve | MRSA is a problem though because it is resistance to all beta lactams
48
Streptococcus pyogens - can transiently colonize where
in the oropharynx of healthy children and young adults in the absence of clinical disease
49
Streptococcus pyogens is spread how
person to person through respiratory droplets (pharyngitis) or breaks in the skin (soft tissue infections)
50
GAS infection - suppurative diseases include what
``` Pyoderma (impetigo) Erysipelas Cellulitis (inflammation) Necrotizing fasciitis Streptococcal toxic shock syndrome ```
51
GAS infection - Necrotizing fasciitis occurs where
deep in the subcutaneous tissue | extensive destruction of muscle and fat
52
GAS infection - necrotizing fasciitis - AKA
streptococcal gangrene | flesh eating bacteria
53
GAS in implicated in what percent of cases of necrotizing fasciitis
60 percent
54
GAS - necrotizing fasciitis - physical findings
early on may not be striking - minimal erythema overlying the skin Pain and tenderness are usually severe!!! As infection progresses, severity and extent of s/s worsens and skin changes become more evident with appearance of dusky or mottled erythema and edema
55
Streptococcal toxic shock syndrome
Associated with cutaneous forms of GAS infections | Similar to staph toxic shock BUT here bacteremia and NF are distinctive factors
56
Streptococcal toxic shock syndrome - presents how
Soft tissue inflammation at the site of the infection pain, fever, chils, malaise, nausea, vomiting, diarrhea production of streptococcal pyrogenic exotoxins SPEs Shock and organ failure
57
In contrast with staphylococcal disease, most patients with sreptococcal disease are
Bacteremic and many have necrotizing fasciitis
58
Streptococcal toxic shock syndrome - diagnosis and tx
culture followed by lancefield grouping group A is susceptible to bacitracin so can kill group A with bacitracin can also diagnose with a swab but may be inaccurate PCR detection is also possible TX with antibiotics
59
Clostridium - describe
gram positive spore forming rod anaerobic
60
Clostridium spores are
resistant to hear, desiccation and disinfectants can last for years rarely seen in clinical specimens
61
Clostridium - ubiquitous to
soil, water, sewage, GI commensal
62
Clostridium - 4 major species of clinical interest
C perfringens - gangrene, diarrhea/colitis C difficile - diarrhea/colitis C tetani - tetanus C botulinum - botulinism
63
C perfringens - describe
large gram pos rods non motile! multiply rapidly
64
C perfringens - found in
soil contaminated water and normal GI tract
65
C perfringens - growth is accompanied by
production of large amounts of hydrogen and carbon gas
66
C perfringens - unique factors
anaerobic B hemolytic produces many toxins! spectrum of diseases
67
C perfringens - soft tissue infections (wide range) - includes what
cellulitis - of the CT fasciitis - of the CT surrounding mm suppurative myositis - inflam and pus forming in mm Myonecrosis AKA gas gangrene
68
C perfringens disease also includes what (besides soft tissue infections)
food poisoning necrotizing enteritis septicemia
69
C perfringens - gas gangrene - what is susceptible
traumatic wounds and surgical wounds are susceptible
70
C perfringens - gas gangrene - clostridia can come from
GI or environmental spores
71
C perfringens - gas gangrene - begins as
wound infection accompanied by gas production (crepitations)
72
C pergringens - gas gangrene - starts as cellulitis and then
``` suppurative myositis (pus in mm layer) and then myonecrosis (painful, rapid destruction of mm tissue, systemic spread with high mortality) Discoloration of wound (reddish/brown), foul smelling discharge (anaerobic infection) ```
73
C perfringens - gas gangrene - increased vascular permeability can lead to
death without bacteremia (toxin induced shock)
74
C perfringens treatment
Clinical observations are key Isolation is secondary since it is a common contaminant of samples TX NEEDS TO BE IMMEDIATE, can be fatal (40-100%) Surgical debridement with high dose antibiotic therapy for soft tissue infection Proper wound care and use of prophylactic antibiotics can prevent
75
Osteomyelitis is what
infection of bone
76
Osteomyelitis s/s
bone pain, fever, swelling, malaise
77
Osteomyelitis is almost always associated with
a bacterial infection
78
Osteomyelitis is obtained through
bacteremia injury (exposure of bone of foreign body penetration) surgical procedures involving bony areas untreated infections of tissue near a bone
79
Osteomyelitis - when occur
at any age
80
Osteomyelitis - risk factors
sickle cell anemia diabetes kidney dialysis
81
Osteomyelitis - tx
antibiotics and sometimes surgery
82
Septic arthritis - characterized by what
painful, erythematous joint with purulent material obtained on aspiration
83
Septic arthritis - usually occurs where
in large joints
84
Septic arthritis - primary cause (which organism) in children and adults receiving intra articular injections
s aureus
85
Septic arthritis - most common cause is sexually active individuals
Neiserria gonorrhoeae
86
Septic arthritis - tx
antibiotics

Practice topics Exam 1 (15 decks)

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