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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
Q

Necrotizing fasciitis: debridement - treatment

A

Antibiotic cocktails and surgical debridement

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26
Q

Differentiation between Staphylococcus and Streptococcus

A

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

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27
Q

Differentiation between Staphylococcus and Streptococcus - Staph

A

Responsible for a wide variety of clinical diseases
Catalase positive
Clusters

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28
Q

Differentiation between Staphylococcus and Streptococcus - Strep

A

Responsible for a wide variety of clinical diseases
Catalase negative
Pairs or chains

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29
Q

Staphylococci

A 
Gram pos
Facultative anaerobe 
Form grape like clusters 
White of golden colonies 
Catalase pos (breaks down H2O2)
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30
Q

Staphylocccci - found in

A

skin and mucus membranes of humans

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31
Q

Staphylococci how spread

A

person to person spread through direct contact or exposure to contaminated formites (bed linenes, clothing)

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32
Q

Staphyloccci - virulence factors

A

numerous - toxins, capsules…

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33
Q

S aureus virulence factors - structural

A

Capsule, biofilm, peptidoglycan, teichoic acid

PROTEIN A - binds to Fc domain of IgG

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34
Q

S aureus virulence factors - toxins

A

Cytotoxins, exfoliative toxins, enterotoxins, toxic shock syndrome toxin

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35
Q

S aureus diseases can be __ or ___

A

toxin mediated or suppurative

36
Q

S aureus diseases - Toxin mediated examples

A

Scalded skin syndrome
Food poisoning
Toxic shock

37
Q

S aureus diseases - suppurative examples

A 
Impetigo
Folliculitis 
Furuncles or boils
Carbuncles
Bacteremia and endocarditis
Pneumonia and empyema
Osteomyelitis 
Septic arthritis
38
Q

Staphylococcal scalded skin syndrome (SSSS) is most common in who

A

neonates
less than 5 yrs of age has a high recovery
If immune compromised though has high lethality

39
Q

Staphylococcal scalded skin syndrome is what

A

Exfollative toxin cause exfoliation of superficial layers of skin (no scarring)

40
Q

Staphylococcal scalded skin syndrome - symptoms

A

first appears as localized perioral erythema (red/inflamed around mouth)
spreads over body in 2 days
cutaneous blisters containing clear fluid and desquamation

41
Q

Staph culturable from skin?

A

NO because it is a toxin mediated disease

42
Q

S aureus clinical manifestations

A 
Impetigo
Folliculitis 
Foruncles or boils
Carbuncles 
These you can culture! Localized cutaneous pyogenic staphylococcal infections
43
Q

Methicillin resistant staphylococcus aureus (MRSA) is what

A

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
Q

MRSA tx

A

Tx with vancomycin

45
Q

S aureus presentation

A

multiple presentations - cutaneous, systemic, staph food poisoning, scalded skin syndrome, and toxic shock syndrome

46
Q

S aureus diagnosis made how

A

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
Q

S aureus treatment

A

Superficial lesions will resolve

MRSA is a problem though because it is resistance to all beta lactams

48
Q

Streptococcus pyogens - can transiently colonize where

A

in the oropharynx of healthy children and young adults in the absence of clinical disease

49
Q

Streptococcus pyogens is spread how

A

person to person through respiratory droplets (pharyngitis) or breaks in the skin (soft tissue infections)

50
Q

GAS infection - suppurative diseases include what

A 
Pyoderma (impetigo)
Erysipelas 
Cellulitis (inflammation) 
Necrotizing fasciitis 
Streptococcal toxic shock syndrome
51
Q

GAS infection - Necrotizing fasciitis occurs where

A

deep in the subcutaneous tissue

extensive destruction of muscle and fat

52
Q

GAS infection - necrotizing fasciitis - AKA

A

streptococcal gangrene

flesh eating bacteria

53
Q

GAS in implicated in what percent of cases of necrotizing fasciitis

A

60 percent

54
Q

GAS - necrotizing fasciitis - physical findings

A

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
Q

Streptococcal toxic shock syndrome

A

Associated with cutaneous forms of GAS infections

Similar to staph toxic shock BUT here bacteremia and NF are distinctive factors

56
Q

Streptococcal toxic shock syndrome - presents how

A

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
Q

In contrast with staphylococcal disease, most patients with sreptococcal disease are

A

Bacteremic and many have necrotizing fasciitis

58
Q

Streptococcal toxic shock syndrome - diagnosis and tx

A

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
Q

Clostridium - describe

A

gram positive
spore forming rod
anaerobic

60
Q

Clostridium spores are

A

resistant to hear, desiccation and disinfectants
can last for years
rarely seen in clinical specimens

61
Q

Clostridium - ubiquitous to

A

soil, water, sewage, GI commensal

62
Q

Clostridium - 4 major species of clinical interest

A

C perfringens - gangrene, diarrhea/colitis
C difficile - diarrhea/colitis
C tetani - tetanus
C botulinum - botulinism

63
Q

C perfringens - describe

A

large gram pos rods
non motile!
multiply rapidly

64
Q

C perfringens - found in

A

soil
contaminated water
and normal GI tract

65
Q

C perfringens - growth is accompanied by

A

production of large amounts of hydrogen and carbon gas

66
Q

C perfringens - unique factors

A

anaerobic
B hemolytic
produces many toxins!
spectrum of diseases

67
Q

C perfringens - soft tissue infections (wide range) - includes what

A

cellulitis - of the CT
fasciitis - of the CT surrounding mm
suppurative myositis - inflam and pus forming in mm
Myonecrosis AKA gas gangrene

68
Q

C perfringens disease also includes what (besides soft tissue infections)

A

food poisoning
necrotizing enteritis
septicemia

69
Q

C perfringens - gas gangrene - what is susceptible

A

traumatic wounds and surgical wounds are susceptible

70
Q

C perfringens - gas gangrene - clostridia can come from

A

GI or environmental spores

71
Q

C perfringens - gas gangrene - begins as

A

wound infection accompanied by gas production (crepitations)

72
Q

C pergringens - gas gangrene - starts as cellulitis and then

A 
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
Q

C perfringens - gas gangrene - increased vascular permeability can lead to

A

death without bacteremia (toxin induced shock)

74
Q

C perfringens treatment

A

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
Q

Osteomyelitis is what

A

infection of bone

76
Q

Osteomyelitis s/s

A

bone pain, fever, swelling, malaise

77
Q

Osteomyelitis is almost always associated with

A

a bacterial infection

78
Q

Osteomyelitis is obtained through

A

bacteremia
injury (exposure of bone of foreign body penetration)
surgical procedures involving bony areas
untreated infections of tissue near a bone

79
Q

Osteomyelitis - when occur

A

at any age

80
Q

Osteomyelitis - risk factors

A

sickle cell anemia
diabetes
kidney dialysis

81
Q

Osteomyelitis - tx

A

antibiotics and sometimes surgery

82
Q

Septic arthritis - characterized by what

A

painful, erythematous joint with purulent material obtained on aspiration

83
Q

Septic arthritis - usually occurs where

A

in large joints

84
Q

Septic arthritis - primary cause (which organism) in children and adults receiving intra articular injections

A

s aureus

85
Q

Septic arthritis - most common cause is sexually active individuals

A

Neiserria gonorrhoeae

86
Q

Septic arthritis - tx

A

antibiotics

Practice topics Exam 1 (15 decks)

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