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Micro Exam #2 > Bordetella pertussis, Haemophilus influenzae, Legionella pneumophila > Flashcards

Bordetella pertussis, Haemophilus influenzae, Legionella pneumophila Flashcards

1
Q

Describe the structure of Bordetella pertussis.

A

Small, G- Coccobacillus
Encapsulated
Non-motile

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2
Q

Bordetella pertussis is associated with _______ in virulent strains.

A

Hemolysis

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3
Q

Incubation time of Bordetella pertussis?

A

1-2 weeks

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4
Q

Three stages of Bordetella pertussis?

A

Catarrhal stage
Paroxysmal Stage
Convalescent Stage

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5
Q

Describe symptoms in the catarrhal stage of Bordetella pertussis infection.

A

Low grade fever, runny nose, worsening cough

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6
Q

Describe the clinical presentation of the paroxysmal stage of Bordetella pertussis infection.

A

Severe Cough – So prolonged/irritated that inhalazion is wheezy and vomiting occurs

Lymphotoxicity results in leukocyte prolif

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7
Q

Common name of Bordetella pertussis?

A

Whooping Cough

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8
Q

Describe the Bordetella pertussis convalescent stage.

A

Cough becomes less severe for about 45 days

“The Cough of 100 days”

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9
Q

Complications of Bordetella pertussis?

A

Bronchopneumonia

Encephalitis

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10
Q

How is Bordetella pertussis spread?

A

Respiratory droplets

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11
Q

Why is Bordetella pertussis so prone to spread?

A

It is highly contagious

It is rarely detected before spread

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12
Q

In what stage is Bordetella pertussis most contagious?

A

Catarrhal stage

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13
Q

Who is most prone to get Bordetella pertussis? Who is it most dangerous in?

A

Small Children

Most dangerous in small airway

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14
Q

Four causes of Bordetella pertussis?

A

Increased Surveillance
Increased Toxin Production
Vaccine targets few antigens
Low coverage of booster vaccine

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15
Q

Six virulence factors of Bordetella pertussis

A 
Filamentus hemagglutinin
Pertussis toxin
Calmodulin-dependent adenyl cyclase
Dermonecrotic Toxin
Tracheal Cytotoxin
LPS
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16
Q

What is the activity of filamentous hemagglutinin?

A
  • Allows Bordetella pertussis to bind specifically to glycoprotein receptor on ciliated epithelial cells
  • Aided by pertactin surface protein, pili, pertussis toxin
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17
Q

What is the clinical significance of filamentous hemagglutinin?

A

Ciliary stasis of mucociliary escalator

can’t sweep bacteria out of resp. tract

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18
Q

Describe the six parts of pertussis toxin.

A

5 B parts bind to ganglioside for ciliated cells

A part - ADP ribosylates an inhibitory G ptorein

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19
Q

What does ribosylating the inhibitory G protein in Bordetella pertussis cause problems

A

Prevents inactivation of adenyl cyclase (inc. cAMP)

Increases H2O secretion in respiratory tract

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20
Q

Difference between pertussis toxin and cholera toxin.

A

Pertussis locks in stimulated/active form

Cholera blocks the inhibitory form

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21
Q

Effect of calmodulin-dependent adenyl cyclase.

A

Additional ACase, only active in eukaryotic cells

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22
Q

Role of dermonecrotic toxin? Who secretes it?

A

Role Uncertain

Secreted by T3SS

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23
Q

What is tracheal cytotoxin? What does it do?

A

Soluble peptidoglycan residue

Kills ciliated epithelial cells

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24
Q

What two lipids are contained in LPS?

A

Lipid A and Lipid X (half of A)

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25
Q

How is Bordetella pertussis controlled?

A

DTap Vaccine 3 times before 1st birthday, boosters

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26
Q

How can Bordetella pertussis be treated? What stage must a patient be in?

A

Erythromycin/Azithromycin

Catarrhal Stage

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27
Q

Describe Bordetella parapertussis

A

Similar to whooping cough, less severe

Have cryptic ptx operon

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28
Q

Describe the physical structure ofHaemophilus influenzae

A

G- coccobacillus

Some have capsule

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29
Q

Difference between typable and non-typable Haemophilus influenzae?

A

Typable have capsule, non-typable do not

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30
Q

Why to culture and make apparent Haemophilus influenzae?

A

Capsulated forms irridescent on BHI agar

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31
Q

Two factors required for Haemophilus influenzae growth in culture?

A

Heme (Factor X)

NAD (Factor V)

32
Q

What happens to Haemophilus influenzae grown on “chocolate” blood agar?

A

“Satellite” colones will develop

33
Q

How are Haemophilus influenzae typed?

A

Quellung reaction into type a-f

Add Ab that recognize, capsule gets bigger under microscope

34
Q

What type are most infectious strains of Haemophilus influenzae?

A

B

35
Q

How is Haemophilus influenzae spread?

A

Enters via URT mucosa

36
Q

Effect of Haemophilus influenzae infection in utero before 24 weeks

A

Stillbirth

37
Q

Effect of Haemophilus influenzae in children?

A

Meningitis

Acute otitis media

38
Q

Frequency of bacterial meningitis in the US? % fatal?

A

4500

15%

39
Q

Top Five Overall Causes on Meningitis?

A 
S. pneumoniae - 58%
Group B Strep - 18%
N. miningitidis - 14%
H. influenzae - 7%
Listeria monocytogenes - 4%
40
Q

Most common cause of meningitis in newborns?

A

GBS

41
Q

Top three causes of meningitis in kids?

A

S. pneumoniae
N. miningitidis
H. influenzae

42
Q

Most common cause of meningitis in teens?

A

N meningitidis

43
Q

Most common cause of meningitis in adults?

A

S. pneumoniae

44
Q

Most common cause of meningitis in elderly?

A

S. pneumoniae

45
Q

What three bacterial strains are most prone to cause acute otitis media?

A

Haemophilus influenzae
Strep pneumoniae
Moraxella catarrhalis

46
Q

How does Haemophilus influenzae tend to present in adults?

A

Pneumonia, Sinusitis, Epiglottitis

47
Q

Sign seen in radiograph of a Haemophilus influenzae patient?

A

Thumb sign of the epiglottis

48
Q

Top two causes of bacterial pneumonia?

A

Streptococcus pneumoniae

Haemophilus influenzae

49
Q

How is Haemophilus influenzae spread?

A

via droplets

Especially common in daycare centers

50
Q

Untreated Haemophilus influenzae meningitis is ___% fatal

A

90

51
Q

Why is Haemophilus influenzae typically not a huge problem for adults?

A

They’re probably already immune

52
Q

Describe Haemophilus influenzae pathogenesis

A
  • Adhesion pili allow uptake and intracellular growth
  • IgA protease prevents IgA detection
  • LOS makes less immunogenic/easily killed
  • T cell activation by soluble PG
53
Q

What is the main virulence factor of Haemophilus influenzae (seen in Type B)

A

poly-ribosylribitol phosphate (PRP) capsule

it allows capillary/CNS invasion

54
Q

What is the Haemophilus influenzae vaccine made of?

A

PRP conjugated to diptheria toxoid

55
Q

Why might you avoid antibiotics for Haemophilus influenzae?

A

80% of the time, resolves on its own in 3 days

92% success with amoxycilin, but 3rd gen

56
Q

What other drug can you use to treat Haemophilus influenzae? Why wouldn’t you?

A

Caohalosporins

Diarrhea as side effects

57
Q

Describe the presentation of Haemophilus ducreyi.

A

Ragged soft ulcer on genitals

58
Q

How is Haemophilus ducreyi spread?

A

STD

59
Q

Haemophilus ducreyi requires what to grow?

A

Factor V

60
Q

Where is Haemophilus ducreyi most prevalent? How is it treated?

A

Africa

SxT or Macrolides

61
Q

Describe the physical structure of Legionella pneumophila?

A

G- Rods

Variable Length, Pleomorphic

62
Q

Things required for the growth of Legionella pneumophila

A

Fe, Cysteine

High Humidity

63
Q

How is Legionella pneumophila plated?

A

Buffered charcoal yeast extract agar

64
Q

Three ways in which Legionella pneumophila manifests?

A

Asymptomatic
Pontiac Fever
Legionnaire’s Disease

65
Q

Describe Pontiac Fever seen in Legionella pneumophila.

A

Highly infectious

Mild flu-like malaise that runs its course in a day or 2

66
Q

Describe Legionnaires’ Disease in Legionella pneumophila?

A

Acute pneumonia with high fever
Consolidation and fibrin deposition in multiple foci
(usually lower parts of lungs)

67
Q

Most likely group to contract Legionnaire’s Disease?

A

Elderly men over 55

68
Q

Risk factors for Legionnaire’s Disease (3)?

A

Smoking, Emphysema, Lung Cancer
Bronchitis
Immunosuppressant Drugs

69
Q

Top 5 most common pathogens to cause community-acquired Pneumonia.

A 
Streptococcus pneumoniae
Hemophilus influenzae
Staphylococcus aureus
Gram-negative bacilli
Legionella bacilli
70
Q

Most likely place to find Legionella pneumophila?

A

Fresh water and Soil
58% of outbreaks in city tap water
Form films in continually standing water

71
Q

Legionella pneumophila survive in….

A

Amoeba

72
Q

How does Legionella pneumophila tend to be spread?

A

mechanically aerosolized droplets inhaled

NOT transmissable person-to-person

73
Q

Describe the pathogenesis of Legionella pneumophila.

A
  • Macrophage-specific adhesion pili
  • Type II and Type IV (Dot/Icm) (4 secretes AnkB - stops lysosome fusion to phagosome)
  • Pathogen mediated endocytosis (coiling phagocytosis)
  • Grow in macrophages by preventing fusion
  • Can release PS blebs from outer membrane
74
Q

What does AnkB do?

A

Stops Lysosome fusion to phagosome

75
Q

How to detect Legionella pneumophila?

A

Urine Antigen Test

76
Q

How to decontaminate Legionella pneumophila?

A

Bleach + Superheating

77
Q

How to treat Legionella pneumophila?

A

Macrolides: erythromycin/azithromycin

Micro Exam #2 (15 decks)

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