Bacteria Pt 2 Flashcards
What are general characteristics of Staphylococci bugs?
- Gram positive cocci
- produce catalase
- S aureus is coagulase positive, the rest of Staph are not
- tend to appear in grape like clusters
What are tests that can be done to differentiate S aureus (3)? What color are the colonies of S. aureus?
Coagulase positive (S. epidermididis is coagulase negative)
produces clumping factor
contains protein A (an IgG binding protein)
S epidermidis is negative for these three
Gold
What are the characteristics of Staphylococcus epidermidis?
Classification: Coagulase -, Clumping F-, Protein A-, White colonies
Transmission: colonized on skin (part of skin flora)
Pathogenesis: produces exopolysaccharides (slime)
Defense: Antibacterial resistance (plasmid DNA contains resistance genes), Catalase, Slime makes adherance to foregin bodies easier
Clinical: UTI, Nosocomial Bacteremia, Endocarditis of native OR prosthetic valve, Osteomyelitis, Infections of prosthetic devices, bladder infections in sexual active women
How is S. aureus transmitted?
Encounter: 25% of normal healthy people are carriers
Transmission: Risk of Invasive disease increases in:
- Carriers
- Post-Influenza A
- Chemotactic defects in WBC, Phagocytic Cells
- Patients with other immune defects (complement deficiency- gamma globulin deficiency)
Colonization:
Anterior nares
Axilla, grown
How does S. aureus pathogenesis occur?
Virulence factors in cell wall include peptidoglycan, teichoic acids, protein A
Superantigens- activate up to 20% of immunity non-specifically (similar to Strep toxins)
- overwhelming inflammatory response including fever, shock, endothelial leakage, multiorgan failure, and sometimes death
What are some specific toxin causing diseases associated with S aureus?
- Epidermolytic Toxins- Staph scaled skin syndrome (SSSS) causing exfoliation, ET-A and ET-B responsible for manifestation
- Enterotoxin- Toxic Shock Syndrome- leads to desquamation, hypotension, and diarrhea
- sustained release of inflammatory cytokines, non-specific T cell mitogens interact with Class II MHC, stimulate CD4 cells to produce IFN-gamma
- other enterotoxins are major source of food born illness producing vomitting and diarrhea, these toxins are heat stable
What are defense mechanisms/virulence factors for S. aureus?
Catalase- inactivates bactericidal hydrogen peroxidase
Coagulase- converts fibrinogen to fibrin which decreases WBC accumulation by creating a barrier clot
B-lactamase- hydrolyses active binding site on penicillin (resistance)
Secreates hyaluronidases, DNAses, and Lipases
What is the clinical presentation of S aureus?
Localized infection: folliculitis, carbuncles, impetigo, cellulitis, wound infections
PUS PUS PUS
Deep infection:
- abscesses (brain abscess, endopthalmitis, renal carbuncle, splenic abscess
- bacteremia
- infection (bursitis, myositis, osteomyelitis, pneumonia, septic arthritis)
Endocarditis (tx 4-6 weeks IV Abs)
How does S. aureus design it’s resistance? What can treat it?
Produce beta-lacatamase which hydrolyzes binding site of PCN
MRSA- alter the Penicillin Binding Protein 2 to PBP2a
Treat with vancomycin (recently S aureus has become resistant to this, received resistance to vancomycin from enterococcus)
How is S. epidimis treated?
Vancomycin plus rifampin (80% are methicillin resistant)
Name 3 factors that enable S aureus to damage host tissue and form pus?
Coagulase
Catalase
Hyaluronidase
What are two examples of toxin mediated disease in the Staph family?
Staph scaled skin syndrome
toxic shock syndrome
Why are S coagulase negative staphylocci able to survive and avoid host defenses in patients with prosthetic devices?
Production of exopolysaccharides or slime which helps adhere to foregin bodies and prevents binding of immune cells
What are general characteristics of spirochetes?
Dark field microscopy needed to visualize
Outer and Inner membrane like Gram-, but no LPS, dont gram stain well
Difficult/impossible to grow in vitro
HIGHLY MOTILE due to endoflagella
What are diseases caused by different spirochete bugs?
Syphilis- Treponema pallidum
Lyme disease- Borrelia burgdorferi
What are the general characteristics of Borrelia burgdorferi?
Classification: Highly motile, endoflagella between membranes increases risk for systemic infection
Encounter: Deer tick (ixodes) in NE and Great Lakes
Colonization: Arterial blood, vessels, CT, skin
Pathogenesis: Binds decorin protein on collagen to adhere to host cells
- coats itself with host protease (plasminogen- just like Yersinia pestis) and may produce systemic infection
- Few antigenic target: OspA- displayed when in tick, not once in human, OspC once in human, and prevents complement binding–> antigenic diversity (like Nisseriae)
- Tissue damage is secondary to intense inflammatory response
What is the clinical presentation of Lyme Disease and what is the treatment?
Primary Local Spread
- Days to weeks
- expanding skin lesion, erythema migrans
Secondary Infection
- weeks to months
- 2nd erythema migrans, heart block, arthalgia, shooting pain, Bells palsy, meningitis, eye findings
Chronic Infection
- acrodermatitis atrophicans, chronic inflammatory arthritis with autoimmune etiology, difficulties with memory/concentration
Prevention/Treatment
- protective clothing/insect repellant
- antibiotics (early to prevent chronic infection)
- OspA Vaccine
What are the characteristics of traponema pallidum?
Classification: Highly motile
Encounter: Human muccous membranes, small skin abrasions
Transmission: Sexual Contact, can cross placenta
Important points: Can cross placenta and cause multi-systemic infection, difficult to diagnose because organism cannot be cultured and serology is critical for diagnosis
Pathogenesis: Lipoproteins induce cytokines, Similar to B. burgdorderi, few antigenic targets, no known endo/exo toxins
What is the clinical presentation and treatment of Traponema pallidum?
Sexually Acquired Syphilis
Primary- Chancre- painless ulcer which heals in two to six weeks
Secondary- invasion and systemic illness, flu like Sx’s, lymphadenopathy
Tertiary- Great immitator, gummus, vasculitis, chronic inflammation of bone, CNS, sensory loss, personality changes
Congenitally Acquired Syphilis
- prematurity, diminished growth
- facial, tooth, bone deformities, deafness
- arthritis
Prevention and Treatment
- PCN very effective, difficulty in reaching high risk communities, no vaccine 2nd to lack of antigenic targets
What are some similarities between Lyme and Syphilis?
- Infections occur in stages
- Periods of remission followed by relapse, with a variety of disease manifestations
- Low bacterial load
- Tissue destruction triggered in part by lipoproteins
- Vigorous immune response is not able to clear organism
What host protease does Lyme disease spirochete coat itself with? What function might this serve in the mammalian host? What function might this serve in the tick vector?
Plasminogen
Promote systemic infection in both the mammal, and tick
What major pathogenic strategies contribute for Lyme disease and syphilis spirochetes to cause chronic infection?
motile
few antigenic targets
antigenic variation
major inflammatory response
How does Lyme and syphilis produce an inflammatory response?
Produce a cytokine leading to an inflammatory response, no toxin!
What is the syphilitic equivalent to erythema migrans? Are both lyme and syphilis potentially spread congenitally?
painless ulcer
no, only syphilis
What are characteristics of Vibrio, Campylobacter, and Helicobacter species? How do they differ?
curved, microaerophilic, gram negative associated with human disease
differ in their environmental niches and disease manifestations
What are key concepts of Vibrio species?
- environmental organisms
- toxin mediated diarrheal disease
- wound infections
- systemic infections- compromised host