BACTERIA OF KEY PUBLIC HEALTH IMPORTANCE Flashcards
WHAT DOES IT MEAN IF AN ORGANISM IS ‘FACULTATIVE ANAEROBIC’?
THAT IT CAN FUNCTION WITH OR WITHOUT OXYGEN
HOW ARE BACTERIA COMMONLY GROUPED BASED ON THEIR ABILITY TO CAUSE DISEASE?
TO PATHOGENIC (CAUSES DISEASE) AND COMMENSAL (LIVES ON HOST WITHOUT CAUSING HARM)
WHAT ARE COMMENSAL BACTERIA?
BACTERIA WHO LIVE ON A HOST BUT DON’T CAUSE ANY HARM
BASED ON WHICH FEATURES DO WE USUALLY DESCRIBE BACTERIA?
GRAM STAIN, SHAPE, O2 USE, DRUG RESISTANCE, TOXINS, POTENTIAL TO CAUSE DISEASE
WHAT IS THE DIFFERENCE BETWEEN GRAM POSITIVE AND GRAM NEGATIVE BACTERIA?
Gram-negative bacteria are surrounded by a thin peptidoglycan cell wall, which itself is surrounded by an outer membrane containing lipopolysaccharide. Gram-positive bacteria lack an outer membrane but are surrounded by layers of peptidoglycan many times thicker than is found in the Gram-negatives.
WHAT IS GRAM STAINING?
Gram stain or Gram staining, also called Gram’s method, is a method of staining used to classify bacterial species into two large groups: gram-positive bacteria and gram-negative bacteria.
Gram staining differentiates bacteria by the chemical and physical properties of their cell walls. Gram-positive cells have a thick layer of peptidoglycan in the cell wall that retains the primary stain, crystal violet. Gram-negative cells have a thinner peptidoglycan layer that allows the crystal violet to wash out on addition of ethanol. They are stained pink or red
COLOUR OF GRAM POSITIVE VS GRAM NEGATIVE BACTERIA UPON STAINING?
POSITIVE: VIOLET
NEGATIVE: RED OR PINK
WHAT IS A NATURAL HISTORY OF A DISEASE?
IT DESCRIBES THE DISEASE’S EXPECTED PROGRESSION OVER TIME, FROM WHEN A PERSON IS FIRST INFECTED ONWARDS; THIS WOULD INCLUDE WHICH SYMPTOMS TYPICALLY APPEAR AND IN WHAT ORDER
WHAT IS THE INCUBATION PERIOD?
THE TIME BETWEEN A PERSON BEING INFECTED AND WHEN THEY START TO SHOW SYMTPOMS
WHAT IS THE LATENT PERIOD?
THE TIME BETWEEN A PERSON BEING INFECTED AND WHEN THEY START BEING INFECTIOUS TO OTHERS
WHAT IS THE INFECTIOUS PERIOD?
THE PERIOD OF TIME A PERSON IS INFECTIOUS
EXPLAIN THE COMMON EPIDEMIOLOGICAL FRAMEWORK FOR DESCRIBING PATTERNS OF DISEASE?
TIME-PLACE-PERSON
TIME: IS THE DISEASE SEASONAL?, HAS THE PATTERN OF DISEASE BEEN CHANGING OVER TIME?
PLACE: DOES THE PATTERN OF DISEASE VARY BY PLACE?
PERSON: WHO IS AT RISK? WHO IS AT RISK OF SEVERE DISEASE?
TYPES OF PREVENTION STRATEGIES; EXPLAIN:
PRIMARY: AIMS TO PREVENT A CONDITION FROM OCCURRING
SECONDARY: AIMS TO LIMIT DISEASE PROGRESSION AND MODIFY THE DISEASE BY EARLY INTERVENTION ONCE IT HAS ALREADY OCCURRED
TERTIARY: AIMS TO PREVENT COMPLICATIONS OF THE DISEASE
EXAMPLES OF PRIMARY, SECONDARY AND TERTIARY PREVENTION?
PRIMARY: VACCINATION, HAND WASHING, PROGRAMMES ENCOURAGING HEALTHY LIFESTYLES
SECONDARY: BREAST CANCER SCREENING
TERTIARY: DIABETIC EYE SCREENING
DESCRIBE THE NEISSERIA MENINGITIDIS PATHOGEN?
- GRAM NEGATIVE
- AEROBIC
- DIPLOCOCCAL BACTERIUM (OCCURS AS PAIRS OF COCCI, CIRCULAR)
SOME NEISSERIA SPECIES EXCEPT FOR N. MENINGITIDIS?
N. GONORRHOEAE (CAUSES THE STI GONORRHOEA)
N. LACTAMICA (COMMENSAL)
1 IN HOW MANY PEOPLE HAVE N. MENINGITIDIS LIVING HARMLESSLY IN THEIR THROATS AND NOSES?
1/10
UP TO 1/4 IN ADOLESCENTS
WHAT DOES THE TERM MENINGOCOCCAL DISEASE OR INVASIVE MENINGOCOCCAL DISEASE (IMD) REFER TO?
DISEASES CAUSED BY N. MENINGITIDIS;
A) MENINGITIS
B) SEPTICAEMIA
WHAT IS MENINGITIS?
INFLAMMATION OF THE MENINGES - THE MEMBRANES COVERING THE BRAIN AND SPINAL CORD
WHAT IS SEPTICAEMIA?
BLOODSTREAM INFECTION
HOW MANY SEROGROUPS DOES N. MENINGITIDIS HAVE? WHICH ONES ACCOUNT FOR MOST CASES OF INVASIVE DISEASE?
13 SEROGROUPS
6 ACCOUNT FOR MOST CASES OF INVASIVE DISEASE:
A, B, C, W-135, X, Y
WHAT ARE THE 2 MAIN STRAINS OF N. MENINGITIDIS?
ENCAPSULATED AND UNENCAPSULATED
FEATURES OF N. MENINGITIDIS THAT MAKE IT MORE DIFFICULT FOR THE IMMUNE SYSTEM TO FIGHT IT?
THE CAPSULES (IN THE CAPSULATED FORMS WHICH MORE COMMONLY CAUSE INVASIVE DISEASE) CONTAIN A TYPE OF SIALIC ACID THAT IS SIMILAR TO THOSE FOUND IN THE HUMAN BODY, AND THIS ACTS AS A PARTIAL CAMOUFLAGE TO THE IMMUNE RESPONSE
N. MENINGITIDIS ALSO CONTAINS PILI (HAIR LIKE STRANDS) WHICH HELP THE BACTERIA STICK TO THE CELLS ON THE INSIDE OF THE THROAT/NOSE
WHICH CAPSULATED GROUP OF N. MENINGITIDIS DOES NOT CONTAIN SIALIC ACID?
GROUP A
WHAT IS LESS SEVERE, VIRAL OR BACTERIAL MENINGITIS?
VIRAL
OTHER CAUSES OF MENINGITIS APART FROM N. MENINGITIDIS?
VIRUSES
FUNGAL OR PARASITIC MENINGITIS IS POSSIBLE BUT RARE
OTHER BACTERIA (TUBERCULOSIS, HAEMOPHILUS INFLUENZAE AND STREPTOCOCCUS AGALACTIAE)
MOD OF TRANSMISSION FOR N. MENINGITIDIS?
PERSON-TO-PERSON
ESPECIALLY WHERE INDIVIDUALS ARE LIKELY TO COME INTO CLOSE CONTACT WITH THE NASO-PHARYNGEAL SECRETIONS OR RESPIRATORY DROPLETS OF OTHERS (E.G. HOUSEHOLD CONTACTS OR KISSING CONTACTS)
!!!! HOWEVER, EVEN IN A HOUSEHOLD SETTING, THE RISK OF A SECOND CASE OF MENINGOCOCCAL DISEASE IS LOW !!!!!
FATALITY RATE OF MENINGOCOCCAL DISEASE?
CCA 10%
ARE SURVIVAL RATES HIGHER IN PATIENTS WITH MENINGITIS OR SEPTICAEMIA?
MENINGITIS
INCUBATION PERIOD FOR N. MENINGITIDIS?
3-5 DAYS
SYMPTOMS OF MENINGITIS?
Sudden high fever Stiff neck Severe headache that seems different from normal Headache with nausea or vomiting Confusion or difficulty concentrating Seizures Sleepiness or difficulty waking Sensitivity to light No appetite or thirst Skin rash (sometimes, such as in meningococcal meningitis)
PERMANENT COMPLICATIONS ARE PRESENT IN WHAT PERCENTAGE OF PEOPLE WHO SURVIVE MENINGOCOCCAL DISEASE, AND WHAT DO THEY INCLUDE?
15%
LOSS OF LIMBS, HEARING LOSS, SEIZURES AND COGNITIVE IMPAIRMENTS
WHEN WAS MENC VACCINE INTRODUCED IN ENGLAND?
1999
WHEN IS MENINGOCOCCAL DISEASE MORE COMMON?
IT IS SEASONAL AND MORE COMMON IN WINTER
WHEN WAS MENB VACCINE INTRODUCED IN ENGLAND? DID THE DECLINE IN INCIDENCE OCCUR BEFORE OR AFTER THIS?
2015
BEFORE
EPIDEMIOLOGICAL YEARS IN CASE OF MENINGOCOCCAL DISEASE RUN DURING WHICH PERIOD?
JULY TO JUNE TO ENSURE THE ENTIRE WINTER PERIOD IS CAPTURED WITHIN ONE YEAR
WHAT IS THE ‘MENINGITIS BELT’?
AREA OF HIGHER INCIDENCE OF MENINGOCOCCAL DISEASE; A GROUP OF COUNTRIES SPANNING THE WIDEST PART OF AFRICA
SOME RISK FACTORS FOR DEVELOPING INVASIVE MENINGOCOCCAL DISEASE?
BEING AROUND OTHERS WHO SMOKE, OVERCROWDING, HAVING RECENTLY HAD THE FLU, HAVING SOME CONDITIONS AFFECTING IMMUNITY (E.G. NO SPLEEN)
THE AGE GROUP WITH THE HIGHEST INCIDENCE OF MENINGOCOCCAL DISEASE?
INFANTS
WHICH GROUP OF N. MENINGITIDIS IS THE MOST COMMON IN THOSE UNDER 25 AND WHICH IS MORE COMMON IN OLDER PEOPLE WITH COMORBIDITIES?
UNDER 25: MENB
ELDERLY: GROUP Y
AGE GROUPS WITH THE HIGHEST RISK OF MENINGOCOCCAL DISEASE?
INFANTS HAVE THE HIGHEST RISK, THEN AGES 1-5, THEN TEENAGERS
WHY IS THE ABSOLUTE NUMBER OF CASES OF MENINGOCOCCAL DISEASE HIGHER IN ADULTS ALTHOUGH THE RISK IS LOWER?
BECAUSE THE ADULT POPULATION IS LARGER
VACCINES AGAINST MENINGOCOCCAL DISEASE ARE AVAILABLE FOR WHICH SUBGROUPS?
A, B, C, W, Y
WHEN SHOULD CHILDREN IN THE UK RECEIVE THE VACCINES MENB, MENC AND MENACWY?
MENB: 16 WEEKS AND 12 MONTHS
MENC: 12 MONTHS
MENACWY: 14 YEARS
INTRODUCTION OF MENC VACCINE REDUCED THE INCIDENCE OF MENINGOCOCCAL DISEASE GROUP C CASES BY HOW MUCH?
96%
AWARENESS CAMPAIGNS REGARDING MENINGITIS ARE OFTEN CARRIED OUT AT WHICH PLACE AND WHY? WHAT KIND OF PREVENTION IS THIS?
AT UNIVERSITIES, AS YOUNG PEOPLE ARE A RISK GROUP AND MANY OF THEM ARE LIVING AWAY FROM THEIR FAMILIES FOR THE FIRST TIME AND IN COMMUNITY SETTINGS
ROLE IS TO ENSURE STUDENTS KNOW THE SYMPTOMS, KEEP AN EYE ON THEIR FRIENDS AND SEEK HELP IF MENINGITIS IS SUSPECTED
TYPE OF SECONDARY PREVENTION
TERTIARY PREVENTION/TREATMENT FOR N. MENINGITIDIS?
ANTIBIOTICS ARE EFFECTIVE
IN CASES OF INVASIVE MENINGOCOCCAL DISEASE, INTRAMUSCULAR OR INTRAVENOUS BENZYLPENICILIN SHOULD BE GIVEN ASAP
SPECIFIC DEFINITION USED FOR CLOSE CONTACT OF CASES OF N. MENINGITIDIS:
A PROLONGED CLOSE CONTACT WITH THE CASE IN A HOUSEHOLD TYPE SETTING DURING THE SEVEN DAYS BEFORE THE ONSET OF ILLNESS.
EXAMPLES OF SUCH CONTACTS WOULD BE: THOSE LIVING OR SLEEPING IN THE SAME HOUSEHOLD, PUPILS IN THE SAME DORMITORY, BF OR GF, UNIVERSITY STUDENTS SHARING A KITCHEN..
WHAT IS GUIDANCE FOR PEOPLE WHO HAVE CASES OF N. MENINGITIDIS BEEN IN CLOSE CONTACT WITH IN THE LAST 7 DAYS?
THEY WILL BE OFFERED CHEMOPROPHYLAXIS; ANTIBIOTICS TO PREVENT THEM FROM PASSING THE BACTERIA ONTO OTHERS
IF THEY HAVEN’T RECEIVED IT IN THE LAST YEAR, THEY WILL ALSO BE OFFERED THE MENACWY VACCINE
WHAT IS CONSIDERED A CLUSTER WHEN IT COMES TO N. MENINGITIDIS?
2 OR MORE CASES WITHIN 28 DAYS IN THE SAME HOUSEHOLD OR EDUCATIONAL/RESIDENTIAL SETTING
WHAT IS THE GUIDANCE WHEN IT COMES TO N. MENINGITIDIS CLUSTERS?
- THE CASE AND CLOSE CONTACTS ARE ADVISED TO HAVE THE RELEVANT VACCINE (MENB/MENACWY) UNLESS THEY HAVE ALREADY BEEN VACCINATED IN THE LAST YEAR
- THEY SHOULD ALSO BE OFFERED CHEMOPROPHYLAXIS, WITH A DIFFERENT ANTIBIOTIC TO THE ONE THEY HAD BEFORE IF THEY HAD CHEMOPROPHYLAXIS IN THE LAST 28 DAYS
WHICH VACCINE IS ADVISED FOR CONTACTS IF THERE IS A CLUSTER OF N. MENINGITIDIS, BUT NOT IF IT IS JUST A SINGULAR CASE?
MENB
IS CHLAMYDIA TRACHOMATIS GRAM POSITIVE OR GRAM NEGATIVE?
IT IS A GRAM NEGATIVE BACTERIUM
NAME SOME SPECIES WITHIN THE CHLAMYDIA GENUS (APART FROM CHLAMYDIA TRACHOMATIS) AND WHAT DO THEY CAUSE?
C. PNEUMONIAE (CAN CAUSE PNEUMONIA IN HUMANS)
C. PSITTACI (AFFECTS BIRDS, BUT CAN BE PASSED ON TO HUMANS)
WHICH TYPE OF CHLAMYDIA AFFECTS BIRDS BUT CAN BE PASSED ON TO HUMANS?
C. PSITTACI
C. TRACHOMATIS IS AN OBLIGATE INTRACELLULAR BACTERIUM. WHAT DOES THAT MEAN?
IT CAN ONLY REPRODUCE WITHIN ITS HOST’S CELLS
HOW IS C. TRACHOMATIS SUBDIVIDED?
IT IS SUBDIVIDED INTO 3 BIOVARS BASED ON THE DISEASE THEY CAUSE: TRACHOMA, CHLAMYDIA OR LYMPHOGRANULOMA VENEREUM (LGV)
WHAT IS A SEROVAR/SEROTYPE?
A serotype or serovar is a distinct variation within a species of bacteria or virus
WHAT IS A SEROGROUP?
A group of serovars with common antigens is called a serogroup or sometimes serocomplex. Serotyping often plays an essential role in determining species and subspecies.
HOW CAN CHLAMYDIA BE TRANSMITTED?
- UNPROTECTED VAGINAL, ANAL OR ORAL SEX
- SHARING SEX TOYS WHICH AREN’T WASHED/ COVERED BY CONDOM
- PEOPLE’S GENITALS COMING INTO DIRECT CONTACT (EVEN IF THERE IS NO ORGASM, EJACULATION OR PENETRATION)
- INFECTED SEMEN OR VAGINAL FLUID GETTING INTO ONE’S EYE
- CAN BE PASSED BY A PREGNANT WOMEN TO HER BABY
CANNOT BE PASSED THROUGH CASUAL CONTACT (E.G. KISSING, HUGGING, SHARING BATHS, TOWELS, CUTLERY…)
CHILDREN BORN TO MOTHERS WITH CHLAMYDIA ARE AT RISK OF WHICH MEDICAL COMPLICATION?
NEONATAL CONJUCTIVITIS
WHAT IS TRACHOMA?
EYE INFECTION THAT CAN LEAD TO BLINDNESS, CAUSED BY C. TRACHOMATIS
WHAT IS LYMPHOGRANULOMA VENEREUM?
AN STI WHICH USUALLY CAUSES INFECTION IN THE RECTUM, CAUSED BY C. TRACHOMATIS
WHY DO WE CONSIDER ‘DETECTION RATE’ (RATE OF NEW CASES DETECTED) INSTEAD OF ‘INCIDENCE RATE’ (RATE OF NEW CASES) WHEN IT COMES TO CHLAMYDIA?
BECAUSE MANY PEOPLE DO NOT HAVE SYMPTOMS OR DO NOT GET TESTED (ACTUAL INFECTION RATE MOST LIKELY HIGHER THAN NUMBER OF KNOWN CASES)