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Micro Post Midterm > Bacterial, Viral, Fungal, Infection III > Flashcards

Bacterial, Viral, Fungal, Infection III Flashcards

1
Q

causes of skin, soft tissue, blood and bone infection

A

gram negative aerobic and facultative rods

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2
Q

environment where these gram neg aerobic and facultative rods flourish

A

– Pseudomonas spp.
– Stenotrophomonas maltophilia
– Tap water, hospital flowers, moist lettuce, soil

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3
Q

what can enterobacteriaceae GNR infect

A

all tissues

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4
Q

resistance that is common in enterobacteriaceae

A

antibiotic resistance

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5
Q

order of the enterobacteriaceae GNR group and the most pathogenic

A
  1. E. coli
  2. klebsiella (most pathogenic)
  3. enterobacter spp
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6
Q

feature that klebsiella and enterobacter spp share

A

Mucoid capsular antigens antiphagocytic

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7
Q

what are the non enterobacteriaceae GNR

A

pseudomonas aureginosa and acinetobacter baumannii

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8
Q

features of acinetobacter baumannii

A
  • high resistant and originated in iraq
  • endotoxin
  • wound and blood stream infections
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9
Q

what is pseudomonas toxin similar to

A

diphtheria toxin

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10
Q

features of pseudomonas

A

– Naturally resistant to many antibiotics
• metallo-carbapenemase similar to KPC.
– Ability to adapt to almost any growth opportunity.
– Mucoid strains block WBC, & enhance survival
– Can infect skin, soft tissue, bone, blood

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11
Q

exception to requesting specially an anaerobic culture to recover anaerobes

A

blood cultures which come with both aerobics and anaerobic bottles

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12
Q

what type of infections do anaerobes usually cause

A

mixed organism infections (mixed with other anaerobes or facultative organisms)

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13
Q

where do anaerobe dominate

A

in stool of colon

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14
Q

Opportunistic Anaerobic Conditions that Allow Infection

A 
• Tissues devitalized by: 
–Trauma
– Malignancy
– Inflammation 
–Impaired blood supply 
– Surgery
–Foreign body
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15
Q

acceptable specimens for anaerobic cultures

A
  • Abscess fluid aspirates
  • Surgically removed tissue
  • Blood cultures
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16
Q

how does one get anaerobic cellulitis and what does it contain

A

dog bite

mixed anaerobic flora including clostridium –> clostridium infection of wounds and surrounding subcutaneous tissue

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17
Q

what is formed in anaerobic cellulitis and what is absent

A

-marked gas formation but absence of toxicity of gas gangrene

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18
Q

most common Gram-negative rods causing anaerobic infections and second common

A

Bacteroides fragilis group is most common

fusobacterium sp is second common

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19
Q

what does bacteriodes fragillis have

A

capsule with antiphagocytic function

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20
Q

more pathogenic non spore forming gram positive anaerobic rods

A

actinomyces and proprionibacterium

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21
Q

less pathogenic non spore forming gram positive anaerobic rods

A

– Mobiluncus (may help cause vaginitis)
– Lactobacillus : Normal flora
– Eubacterium
– Rothia

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22
Q

describes actinomyces

A

long gram pos rods that are often branching (no spores, no acid fast); anaerobes but some are aerotolerant

23
Q

most common pathogen in serious infection with actinomycetes sp

A

a. israelii

24
Q

morphology of a. israelii and how long it takes to grow

A

molar tooth colony morphology

4-10 days to grow

25
Q

places other than the oral cavity where actinomyces can cause serious chronic infection

A
  • uterus with contaminated IUD
  • thoracic due to aspiration pneumonia
  • abscess in neck or head
26
Q

classic finding seen with pus in actinomyces

A

sulphur granules - colonies of actinomyces

27
Q

what are propionibacterium acnes

A

anaerobic coryneform which grows in hair follicle

28
Q

what are infections of propionibacterium acnes

A

– Acne
– Opportunistic infection of prosthetic devices.
– Mixed anaerobic infection
– Can be common blood culture contaminant

29
Q

laboratory support for diagnosis of gas gangrene

A

culture and gram stain

tissue biopsy

30
Q

organism in gas gangrene

A

clostridium perfringes

31
Q

characteristics of clostridium perfringes

A

– Gram positive spore forming rod.
• No spores are seen in stains of tissue.
– Fast growing anaerobic fermenter
• Generates large amounts of H2 & CO2
– Encapsulated and non-motile.
– Found in colon and soil

32
Q

main pathogenic factor in clostridium perfringes

A

alpha toxin

33
Q

what does the alpha toxin in clostridium perfringes do

A

Diffuses through tissue killing cells thus producing more necrotic growth areas for organism

34
Q

what are the other toxins of clostridium perfringes

A

theta toxin and enterotoxin

35
Q

what does enterotoxin of clostridium perfringes cause

A

food poisoning

36
Q

what are importance of theta toxins of clostridium perfringes

A

– Toxic for heart muscle & capillaries.

– Similar to Streptolysin O in beta strep

37
Q

other mechanism of pathogenesis of c. perfringes

A
  • fermentation of muscle carbs (produces crepitation which are palpable gas)
  • destructive extracelllular enzymes: collagenases, hyaluronidase, DNAse, and protease
38
Q

when does one get gas gangrene

A

in severe traumatic wounds

39
Q

why can’t clinicians wait on lab cultures to diagnose gas gangrene

A

it is rapidly life threatening so a clinical diagnosis must be made by detecting gas in infected tissue

40
Q

treatment of gas gangrene

A

remove infected tissue immediately by surgical debridement and placing drain in wound

41
Q

what are secondary treatments for gas gangrene

A

placing patients in hyperbaric oxygen chamber

treat with penicillin

42
Q

how do neonates acquire strep agalactiae

A

through passage of the birth canal because about 30% of women have it as part of their normal vagina flora

43
Q

clinical manifestation of strep agalactiae in neonates

A

Lethargy, fever, sepsis, meningitis, respiratory distress

44
Q

clinical manifestation of strep agalactiae in older children and adults

A

– Puerperal fever at delivery
– Gynecologic surgery infections
– Skin and soft tissue infections

45
Q

what pyogenic bacteria can cause pharyngitis without any post infection sequelae

A

beta strep group C and G

46
Q

results of getting beta strep C and G

A

skin and soft tissue infections

  • infections of wounds
  • occasional bacteremia
47
Q

secondary to some other insult to the lung such as influenza or aspiration

A

staph pneumonia

48
Q

types of bacteremia

A
  • transient
  • intermittent
  • continuous (infective endocarditis, typhoid fever, brucellos and etc)
49
Q

classification of infective endocarditis

A

acute, subacute, chronic

50
Q

signs and symptoms associated with infective endocarditis

A

• Local infection of valve & tissue damage
• Septic embolization of valvular vegetations
• Continuous bacteriemia
• Cytokine release
• Circulation of immune complexes to distant organs
– Glomerulonephritis

51
Q

5 major viridian strep group that causes endocarditis

A
  • S. mutans group
  • S. salivarius group
  • S. anginosus group
  • S. mitis group
  • S. sanguinis group

viridian mmass

52
Q

microbes that causes endocarditis

A

staph aureus, virdians, enterococci, coag neg staph, strep bovis, enterobacteriaceae plus pseudomonas gram neg rods, fungi (candida), and hacek

53
Q

how to diagnose infective endocarditis

A
  • 2 positive blood cultures before first administration of antibiotics
  • on ECG: oscillating intracardiac mass
  • petechiae, fever
54
Q

what do rare causes of endocarditis require for diagnosis

A

infectious disease consult to identify hard to grow organisms: mycobacterium, rickettsia, fungi

Micro Post Midterm (31 decks)

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