Bacteriology 13- strict anaerobes Flashcards

1
Q

Clinical case: Buddy Plott dog came for
Dyspnea
Anorexia
Collapse
PLEURAL EFFUSION

A

Using VINDICATE:

I= chylothorax
N= Lymphosarcoma, hemangiosarcoma
T= trauma, lung torsion

Bacterial pleuritis:
-E.coli/kelbsiella
-ancitnbacillus
-paseurella multicoda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnostic test for the Plott hound who seems to have a pleural effusion would be?

A

CBC/Chem
-mod. leucocytosis, Left shift and tox changes to the PMNs; mod. thrombocytopenia
-decrease in GLucose– increase liver enzymes and BUN/creatine
-hypotensice

Thoracocentesis

Cytology of Pleural Fluid
-lysed PMNs, some RBS
-Many different kind of bacteria

Culture of Pleural Fluid
-NO normal flora
-culture both aerobically and anaerobically
–> yo found bacteria in both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In buddy’s case you would culture all bacteria?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

You diagnosis for Buddy is Pleuritis why?

A

Mixed bacterial infection incl. anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why was buddy hypotensive and had hematological &biochemical changes?

A

Endotoximia
-vasodilation, vascular damage, thrombosis, and consumptive coagulopathy (DIC) resulting in organ disfunction

DIC=low platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is an obligate anaerobes?

A

BActeria that does NOT like oxygen ( or not in high quantities)– but most oxygen is LETHAL to the them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anaerobic bacteria require the Eh (oxidation-reduction potential to be less than -100mV

A

In normal (oxygenated) tissue the Eh is positive

In necrotic tissue (e.g., abscesses, areas of trauma etc) the Eh is often -250mV to –150mV and therefore favors the growth of anaerobes

Areas where there is a low pH are also usually anaerobic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the NSF Anaerobes?

A

Large group of morphologically diverse bacteria
Some are Gram-
others are Gram +
Some are cocci, rods, branching rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where do NSF come from?

A

Normal flora:
skin
mucus membrane: URT, GIT, LGT

major shareholders within the normal flora

they outnumber the facultative anaerobes 5:1 on mucocutaneous surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do anaerobes grow in areas
where oxygen is present?

A

vary in oxygen tolerance

ecological niche

presence of physical factors e.g., mucus, tartar, skin folds

synergy with aerobes and facultative anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the role of the normal
flora?

A

Normal flora (including anaerobes) play
an important role in maintaining our
health

Act as “security bouncers” by limiting
attachment and growth of dangerous
newcomers (other bacteria!)

so problems if you get rid of them!

BUT - they can take their job too
seriously by:

overgrowing

moving out of their usual location into
nearby sterile areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What needs to happen for disease to
occur with the NSF Anaerobes?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NSF anaerobes infection are always ____________

A

OPPOTUNISTIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What factors predispose to the infections?

A

Breakdown of normal host defences
- e.g., penetrating F.B.

Change in association between normal flora

Overgrowth of some bacteria

Poor blood supply and tissue necrosis

Trauma, tumors, GI obstruction or stasis, hypotension

Decreased host resistance
- e.g., chemotherapy, disease (Cushing’s),
immunodeficient (e.g., FIV +)

Prior use of antibiotics
-especially narrow spectrum; directed at
aerobic

Overwhelming contamination of
normally sterile area
-e.g., aspiration pneumonia, GIT rupture causing peritonitis

Current infection with aerobes/facultative anaerobes
-Create sufficient tissue damage to allow
anaerobes to invade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do NSFAs cause Disease?

A

At/near sites where these bacteria are part of the normal flora –> they gain access in these areas
- Do they survive if it is HEALTHY, NORMAL TISSUES???

AND these sites have necrotic tissue
- these niches protect them from oxygen and provides them with nutrients
- e.g., abscesses, areas of trauma, periodontal pockets, necrotic bite wounds, necrotic lung etc., etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do NSF produce disease? (virulence
factors)

A

Tolerance of oxygen in more virulent species
of bacteria

Extracellular or cell bound enzymes

Endotoxin (gram -)

Capsule

Synergy between community members

Work as a TEAM to produce disease

17
Q

When should I suspect anaerobes as
the culprits of disease?

A

Foul smell***

Production of gas***

Black discolouration at the site***

Location of infection
- Near where they live

History e.g. Bites wound

Mixed/filamentous organisms on smear

Failure to culture

18
Q

Cat fight abscess?

A

MOST common infectious diseases

Organisms (normal flora of the mouth) are
inoculated into a traumatized area (bite wound = has necrosis)’

cat bites close and so don’t allow aeration and
drainage

Both facultative anaerobes and strict anaerobes (NSFA) there

FA multiply first then when O2 runs out (~2 days) NSFA go wild

Important principle: NSFA are involved 2° and
LATER in the disease process (can “date” an
infection by presence of NSFAs)!

19
Q

What are the other diseases that NFA infection cause?

A

Periodontal diseae
-many species
-2º to other disease
-can progress root abscesses

Pleuropneumonia/pyothorax

Pyometra

Peritonitis

20
Q

What are some examples of diseases they RARELY cause (NSF)

A

Otitis externa
Cystitis
Superficial
Pyoderma
Endometritis
in horses
but can be involved
in PYOMETRA in dogs

21
Q

How do you diagnosis infections

A

Collect sample into
blood culture bottle
place into vacutainer

ALWAYS MAKE A SMEAR AT THE TIME
don NOT refridgerate
submit within 6 hours

22
Q

How do you treat infections?

A

General:
Drainage of any fluid

Debridement of necrotic tissue
–>MUST DO OR DON’T BOTH WITH ANTIBIOTICS

Copious lavage

Empirical principles
-commonly used
- metronidazole
- clindamicin (NOT horse)
- penicillin + beta-lactamase inhibitor
-do NOT use aminoglycosides or old generation quiolones
-Need to also address FA bacteria

Nursing support as needed