Bacterial Infections Flashcards
What factors play a role in the development of a bacterial disease?
not an inevitable consequence of the pathogenic bacteria on body surface
related to many factors including:
response of the host
presence of damaged tissue
location of the bacteria
bacterial virulence
What are some of the basic functions of virulence factors?
penetrate the epithelium
bind to cell surfaces
acquire iron
evade immune responses
hide within cells
promote transmission to another host
What does IFN-a/b do during bacterial invasion?
boosts macrophage response and enhances their production of IFN-y, nitric oxide, and TNF-a
What is the role of vitamin D in immunity against Mycobacterium in diurnal animals?
Mycobacteria interact with TLR 1/2 –>
activates a gene encoding a Vit D receptor –>
receptor is upregulated on macrophages –>
binding of Vit D to receptor upregulates expression of cathelicidin –>
can kill intracellular mycobacteria
*serum Vit D levels are linked to resistance against mycobacteria
How can platelets aid in bacterial resistance when activated?
release AMPs and nitric oxide, bind to neutrophils and enhance activity
What are the 5 mechanisms by which the adaptive immune responses combat bacterial infections?
1) neutralize toxins or enzymes with antibodies
2) kill bacteria by activating classical complement pathway
3) opsonize bacteria
4) destroy intracellular bacteria with activated macrophages
5) kill bacteria with CD8+ T cells
(relative importance of each depends on the bacteria)
What is the heat-shock protein (HSP) response?
low levels of HSPs are present in bacteria at normal temp
mild stress like low fever induces HSP production
when bacteria is phagocytized even more HSP is produced
HSP 60 is predominant one in mycobacteria infections
HSPs are highly antigenic and activate the immune system
What happens if an animal mounts an inappropriate Th2 instead of Th1 response to invading bacteria?
M2 but not M1 macrophages may be activated
least to chronic progressive disease
can have disorganized granulomas and bacteria-laden macrophages
(tuberculosis infections will often swing between Th1 and Th2 responses)
How do bacteria evade innate immunity by interfering with TLR signaling and inflammasome activation?
- production of modified PAMPs
- masking of PAMPs
- blockage of TLR signaling pathways
- destruction of signaling molecules
- destruction of NFkB
- misdirection of signaling pathways towards anti-inflammatory
How do bacteria evade innate immunity by resisting AMPs?
- staphylokinase can bind and neutralize defensins
- aureolysin destroys cathelicidin
- change the negative charge and fluidity of cell membrane to decrease defensin binding
How do bacteria evade innate immunity by blocking phagocytosis?
- binds Fc region of IgG
- encapsulated bacteria have hydrophilic capsules
- evade opsonization
- switching from planktonic growth to biofilm production
- avoid being phagocytized by killing phagocytes
- resistance against lysosomal enzymes
- resistance against respiratory burst
- interfere with phagosomal maturation
- break down NETs and METs
What does staphylococcus Protein A do?
binds Fc region of IgG
- antibodies can’t bind to phagocytic cells or activate complement
upregulates keratinocyte adhesion molecules
What does staphylococcus Protein M do?
prevents opsonization by binding fibrin and masking C3b-binding sites
What does staphylococcus Factor H do?
prevents opsonization by inactivating bound C3b
What does streptolysin O do?
on Strep canis
lyses neutrophil cell membranes
What does the specialized peptidoglycan in the S. aureus cell wall do?
resist lysozyme
What do endonucleases secreted by S. aureus do?
degrade DNA NETs
further dephosphorylated to trigger apoptosis in nearby macrophages
How do bacteria evade innate immunity by avoiding metabolic privation?
- activate their own tryptophan synthesis
- produce siderophores to capture available iron
How do bacteria evade adaptive immunity?
- changing surface coat
- secrete proteases to destroy immunoglobulins or cytokines
- live within macrophages (pathogenic mycobacteria)
–> either alive (virulent) or as “cellular corpses” (avirulent) - interfere with macrophage polarization by switching to M2 and IL-10
Why do pigs with Erysipelothrix get arthritis?
Type III hypersensitivity
Why do horses get purpura hemorrhagica?
Type III hypersensitivity to Strep equi equi (causative agent of strangles)
may also be associated with Rhodococcus equi, equine influenza virus, or equine herpesvirus type 1
Do antibiotics “cause” resistance?
not technically
typical infection consists of wild-type and resistant strains
antibiotic exposure can select for resistant bacteria, which multiply because the competition from more susceptible bacteria is reduced during antibiotic administration
What are the most common bacteria producing resistant infections in small animals?
Escherichia coli
Pseudomonas aeruginosa
methicillin-resistant Staphylococcus species
Enterococcus species
What virulence factors does Staphylococcus pseudintermedius have?
cytotoxins
exfoliative toxins
superantigens
cell wall–associated (CWA) proteins
ability to form biofilms
accessory gene regulator (agr) quorum-sensing system
potentially Staph ammonification
(includes things like proteases, thermonucleases, coagulases, DNAase, lipase, hemolysin, clumping factor, leukotoxin, enterotoxin, protein A, and exfoliative toxin)
What are staphlococcal superantigens?
a family of potent immunostimulatory exotoxins
more than 20 distinct superantigens from S. aureus
classically associated with food poisoning and toxic shock syndrome
- causative agents (enterotoxins and toxic shock syndrome toxins)
- 6 serotypes of enterotoxins (A-G)
heat-stable proteins that exhibit pyrogenicity, superantigenicity and capacity to induce lethal hypersensitivity
What are staphylococcal leukotoxins?
pore-forming toxin that targets immune system cells such as neutrophils and monocytes
What are staphylococcal phenol-soluble modulins?
family of peptides that have cytolytic activity against a variety of cells including neutrophils and erythrocytes
What do staphylococcal exfoliative toxins do within the skin?
digest desmoglein (Dsg) 1
causes intraepidermal splitting
involved in bullous impetigo, staphylococcal scalded skin syndrome and swine exudative epidermitis
What do staphylococcal hemolysins do?
are pore forming toxins that target a variety of cells including RBCs
What gives S. aureus its golden color?
Staphyloxanthin which is an antioxidant to protect the cell from ROS produced by host immune cells
What do pathogenic staph species due to the pH of the skin?
neutralize it by down-regulates organic acid production and up-regulates purine biosynthesis and ammonia production, increasing urease and arginine deiminase activity
What is associated with dogs having a significantly higher risk of
carrying ESBL- and/or AmpC-resistant E. coli?
history of antibiotic treatment in the past year
dogs from shelters/breeders
feeding of diets that contain raw meat
Which drugs are most often cited for driving MRSA acquisition and
transmission in humans?
cephalosporins and fluoroquinolones
What does clavulanic acid do when combined with amoxicillin?
is a a β-lactamase inhibitor to help overcome β-lactamase resistance
What is the mecA gene?
in staphylococcal species
encodes an altered penicillin-binding protein (PBP-2a)
- a transpeptidase that helps form the bacterial cell wall
- has a lower affinity for β-lactam antibiotics
- don’t bind to the ringlike structure of penicillin-like antibiotics
- enables transpeptidase activity in the presence of β-lactams
- prevents β-lactams from inhibiting cell wall synthesis
spread through the staphylococcal chromosome cassette (SCCmec)
phenotypic expression of methicillin resistance is variable
What is the mecC gene?
in staphylococcal species
shares only 70% similarity to mecA
encodes resistance to β-lactam antibiotics and some non-β-lactams
What mobile genetic element type accounts for the greatest portion of resistance spread between organisms?
Plasmid-induced resistance
What are the mechanisms of horizontal gene transfer between bacterial cells?
1) transformation (DNA fragments are released and taken up)
2) transduction (uses bacteriophages)
3) conjugation (bacteria dock together and share gene)
4) transfection (disruption of the cell wall, happens in experimental settings)
What are transposons?
responsible for the microbial genome flexibility
are capable of changing their position within the same DNA molecule or jump between diverse DNA molecules, including plasmids
What are integrons?
associated with great benefits for bacterial fitness and robustness
provide “tools” that enable survival under varying environments
can be mobilized both by the bacterial chromosome and plasmids
can be propagated and integrated far from their original site
What are some non-mobilizable non-heritable contributors of bacterial resistance?
growing in biofilm
swarming adaptation
persister cells
What is phenotypic persistence?
the condition where bacterial cells are not killed by the dose/type of antibiotic administered but are in a quiescent status (persister cells) that is reversed once the stressor is removed
(but the antibiotic susceptibility is reverted along with the bacterial growth and second exposure to the antibiotic results in the bactericidal or bacteriostatic effect)
How does biofilm growth preserve bacterial cells from antibiotic treatment?
are fixed microbial communities in extracellular polymeric substances
- stick to each other and surfaces (irreversible attachment)
- may be a single organism or a mixture
provide an excellent and stable homeostasis environment
matrix might reduce antibiotic efficacy by diminishing its diffusion
- and host immune response
matrix may neutralize antimicrobial agents
matrix may seize antibiotic molecules through its complex structure
- different regions of the biofilms are featured by subpopulations
- may have bacterial populations with dynamic susceptibility to antibiotics
have a communication mechanism, called the quorum sensing system
What is swarming movement of bacteria?
strategy to shield themselves from antibiotic treatments
complex physiological adaptation processes
- increased codification for porins and efflux pumps
several proteases affecting swarming are relevant for forming biofilms
What is penicillinase?
produced by more than 90% of staphylococcal isolates
directly inactivates penicillin and penicillin-derived antibiotics
What is blaZ?
gene that encodes β-lactamase in Staphylococcal species
What is β-lactamase?
encoded by blaZ in Staph species
predominantly extracellular enzyme
synthesized when staph are exposed to β-lactam antibiotics
hydrolyzes the β-lactam ring, rendering the β-lactam inactive
How does fluoroquinolone resistance develop?
spontaneous chromosomal mutations in the target of the antibiotic
- topoisomerase IV - gyrA/gyrB
- DNA gyrase (topoisomerase II) - parC and parE
or by the induction of a multidrug efflux pump
What happens after exposure of a quinolone-resistant isolate to a quinolone?
increases the organism’s expression of fibronectin-binding protein, a surface protein that mediates adherence to tissue surfaces
Does susceptibility testing always match with clinical outcomes of use?
there is potential disparity between in vitro susceptibility testing and in vivo therapeutic efficacy
What are the mechanisms of Staph resistance to macrolide antibiotics?
modification of the target site for the antibiotic (most common)
- carried out by methyltransferase Erm
- coded by erm gene (usually ermA or ermC)
- may be expressed in a constitutive manner = inducible resistance
- D-test
Synthesis of efflux pumps proteins such as ABC proteins
Synthesis of MLS-B-inactivating enzymes
mutations in chromosomal genes encoding ribosomal proteins
What is a D-test?
test for inducible resistance in clindamycin
disks for erythromycin and clindamycin are placed on a plate
- plate is coated with bacteria
incubated overnight
should make a perfect circle around clindamycin if not present
positive D-test has blunting of the growth by the erythromycin side
What is the most common mechanism of resistance to aminoglycosides in S. aureus?
synthesis of enzymes of the transferase group that modify the aminoglycoside molecule
What is the most common mechanisms of resistance to tetracyclines in staph species?
Active removal of the antibiotic from the bacterial cell
- membrane protein Tet(K): resistance except to minocycline
- membrane protein Tet(M): resistance including minocycline
Ribosomal protection
What is the cause of chloramphenicol resistance in staph species?
synthesis of chloramphenicol acetyltransferases (CATA7, CATA8, CATA9)
removal of chloramphenicol by membrane proteins (MFS superfamily)
may also result from mutations in genes encoding ribosomal proteins
What is the cause of trimethoprim resistance in staph species?
synthesis of dihydrofolate reductase
Why do Mycolicibacterium spp. (former Mycobacterium spp.) tend to cause panniculitis?
they are attracted by lipid-rich environments
Which types of bacterial infections are considered epidermal disease on histopathology?
Dermatophilosis
Exudative epidermitis
Superficial pyoderma
Surface pyoderma
Impetigo
Which types of bacterial infections are considered hair follicle diseases on histopathology?
Deep pyoderma
Post-grooming furunculosis
Interdigital furunculosis
Canine acne
GSD pyoderma
Which types of bacterial infections are considered dermal and pannicular diseases on histopathology?
Botryomycosis
Nocardiosis
Actinomycosis
Mycobacteriosis
Glanders
Necrotizing faciitis
Which drug is associated with increased risk of toxic shock syndrome in dogs?
enrofloxacin can cause a bacteriophage induced lysis of S.canis and superantigen expression (via the SOS response)
Which dog breeds are at most risk of toxic shock syndrome?
Shar Pei, racing greyhounds, Great Dane
Which bacteria is most commonly associated with toxic shock syndrome in dogs?
Streptococci (same for people)
but genes coding for TSS toxins have been demonstrated in canine S. pseudintermedius
Which types of bacterial infections are considered vascular diseases on histopathology?
Erysipelas
Rocky mountain spotted fever
Lyme disease
Purpura hemorrhagica
Porcine ear necrosis syndrome
What is the relative diversity of the animal microbiota compared to humans?
animals have a higher diversity of their microbiota
What is an individual’s microbiota primarily influenced by?
In general: host taxonomic order and geographical location
Canine: mainly by individual variability and body site
Horse: body site
What are the most common bacterial phyla found on dog skin?
Proteobacteria
Actinobacteria
Firmicutes
Bacteroidetes
Fusobacteria
What are the most common bacterial phyla found on cat skin?
similar bacterial phyla as dogs
- Proteobacteria
- Actinobacteria
- Firmicutes
- Bacteroidetes (one of most prevalent, from mouth, related to grooming)
- Fusobacteria
What are the most common bacterial genera on equine skin?
Psychrobacter
Macrococcus
Pseudomonas
Acinetobacter
Planomicrobium
Arthrobacter
Carnobacterium
Desemzia
Corynebacterium
What do commensal species such as Cutibacterium acnes (formerly Propionibacterium acnes) and Staphylococcus epidermidis do to the pH of the skin?
metabolize lipids, leading to the production of antimicrobial metabolites and decreased cutaneous pH –> hostile environment for pathogenic organisms
What do S. epidermidis, S. hominis, and S. felis have to do with production of AMPs?
they directly produce AMPs that inhibit the growth of Staphylococcus aureus and S. pseudintermedius
S. epidermidis can also induce the production of AMPs by the host
What are the two models that explain why dysbiosis could occur?
(1) dysbiosis driven by microbial communities
- a shift in microbial composition alters the immune response
(2) dysbiosis driven by host biology/pathology
What are the primary pathogens associated with superficial pyoderma in dogs?
Staphylococcus spp. (primarily S. pseudintermedius)
S. delphini
S. schleiferi
S. coagulans
What are some characteristics of the canine stratum corneum that make them more susceptible to superficial pyodermas?
it is thinner and more compact than in other species
they lack a lipid follicular plug
it has decreased intercellular lipids
it has a higher pH (more neutral than humans)
What is impetigo?
a superficial pustular dermatitis
commonly caused by coagulase-positive staphylococci
- S. pseudintermedius in dogs
- S. aureus in other species
Which non-human animal species are most likely to be affected by impetigo?
Dogs, cats, cattle, goats, and sheep
What are the lesions of classical impetigo like?
small, papules and pustules affecting the interfollicular epidermis
- frequently rupture
usually occur at the time of puberty
- can also happen in some lactating females
nonpruritic, nonpainful, and frequently heal spontaneously
What are predisposing factors for classical impetigo?
moist environment, skin abrasions, parasitism, stress, or poor nutrition
Milking equipment and lack of sanitization
Where do lesions associated with classical impetigo occur most frequently in dogs?
axillary and inguinal regions
Where do lesions associated with classical impetigo occur most frequently in cats?
areas that are in contact with the mouth of the queen
Where do lesions associated with classical impetigo occur most frequently in cows, does, and ewes?
base of the teats and intermammary sulcus of the udder, ventral abdomen, perineum, vulva, medial thighs, and ventral tail
What is bullous impetigo?
more severe form of impetigo
can also affect adult dogs
results in larger, pan-follicular pustules
often have underlying conditions (ex. endocrinopathies)
What is the primary histopathologic change associated with impetigo?
subcorneal pustules with neutrophils, not associated with hair follicles
cocci are seen within pustules
- can be highlighted with Gram stain or GMS
may have acantholytic keratinocytes
- due to exfoliative toxins cleaving Dsg 1
What is dermatophilosis?
rain rot/rain scald
caused by Dermatophilus congolensis
- gram-positive facultative anaerobic bacterium
What type of bacteria are Staph species?
gram-positive, catalase-positive facultative anaerobic organisms
- primarily considered aerobic
can be coagulase positive or negative
What does coagulase positive mean?
has an enzyme that enables the conversion of fibrinogen to fibrin
usually associated with pathogenic species
“clumping factor” can be detected by carrying out a slide coagulase test
free coagulase can be detected using a tube coagulase test
- uses rabbit plasma
Where is dermatophilosis most common?
tropical and subtropical climates
- especially in these climates it may be generalized/cause systemic illness
What are the two staph species that are considered normal skin flora in most food animals?
S. aureus
S. hyicus
What animals are most often affected with dermatophilosis?
Cattle
temperate climates, goats and sheep
occasionally horses and camels
zoonotic and reported in a bearded dragon