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I & I Part III > Bordetellae & Mycolasmae > Flashcards

Bordetellae & Mycolasmae Flashcards

1
Q

Bordatellae genus

A
  • Gram -
  • coccobacilli
  • obligate aerobe
  • fastidious
  • B. pertussis
  • B. parapertussis
  • B. bronchseptica
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2
Q

B. pertussis

A
  • Encapsulated coccobacillus
  • Motile (due to flagella)
  • Slow growing on special selective medium
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3
Q

B. pertussis Virulence Factors

A
  • Pertussis toxin
  • Adenylate cyclase toxin
  • Tracheal cytotoxin
  • Pertactin
  • Fimbria
  • Filamentous hemagluttinin
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4
Q

B. pertussis Epidemiology

A
  • Strict human pathogen
  • Highly contagious
  • Classically toddlers & young children

– Now >70% of deaths < 1 year

• Partially immune adolescents & adults are primary reservoir

– Milder symptoms mask disease

– “Just a cold”

•Resurgence in last 2 decades

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5
Q

B. pertussis Pathogenesis: Attachment

A

• Primarily cilia of bronchial epithelium:

-Pili, fimbriae, filamentous hemagglutinin

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6
Q

B. pertussis Pathogenesis: Virulence Factor Production

A
  • Pertussis Toxin
  • Adenylate cyclase
  • Tracheal cytotoxin
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7
Q

B. pertussis Pathogenesis: Alteration of Host Cell Dynamics

A
  • Ciliary dysfunction
  • Non-ciliary impacts
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8
Q

B. pertussis Pertussis Toxin

A
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9
Q

B. pertussis Pertussis Toxin Effects

A
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10
Q

B. pertussis Adeylate Cyclase

A
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11
Q

B. pertussis Tracheal Cytotoxin

A
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12
Q

Bordetella Virulence Gene Regulation

A
  • Expression is modulated in a two-component system by changes in specific environmental parameters, including temperature.
  • The induction of virulence factors in B. pertussis is sequential, with adhesin expression (FHA and pili) preceding expression of factors involved in tissue injury (PT, AC).
  • Multiple virulence genes respond to temperature and ionic changes.
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13
Q

B. pertussis Clinical Aspects

A
  • 7-10 days incubation
  • 3 Stages
  1. catarrhal
  2. paroxysmal
  3. convalescent
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14
Q

B. pertussis Catarrhal Stage

A

•In the catarrhal stage, the primary feature is a profuse, mucoid rhinorrhea, which persists for 1 to 2 weeks. The disease is most communicable at this stage, because large numbers of organisms are present in the nasopharynx and the mucoid secretions

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15
Q

B. pertussis Paroxysmal Stage

A
  • The appearance of a persistent cough marks the transition from the catarrhal to the paroxysmal coughing stage. At this time, episodes of paroxysmal coughing occur up to 50 times a day for 2 to 4 weeks. The characteristic inspiratory whoop follows a series of coughs as air is rapidly drawn through the narrowed glottis.
  • Vomiting frequently follows the whoop. Apnea may follow such episodes, particularly in infants. Marked lymphocytosis reaches its peak at this time, with absolute lymphocyte counts of up to 40,000/mm3
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16
Q

B. pertussis Convalescent Stage

A

•During the 3- to 4-week convalescent stage, the frequency and severity of paroxysmal coughing and other features of the disease gradually fade.

17
Q

B. pertussis Complications

A
  • The most common complication of pertussis is pneumonia caused by a superinfecting organism such as Streptococcus pneumoniae.
  • Atelectasis is also common but may be recognized only by radiologic examination.
  • Other complications are related to the venous pressure effects of the paroxysmal coughing and the anoxia produced by inadequate ventilation and apneic spells.
18
Q

B. pertussis Diagnosis

A
19
Q

B. pertussis Treatment

A
  • Antimicrobial agents have little effect once coughing stage is reached (damage is done)
  • Erythromycin in prodromal or catarrhal stage
20
Q

B. pertussis Prevention

A
  • Chemoprophylaxis – erythromycin for close contacts
  • Immunization
  • DTap for ypung children
  • TDap for adults
21
Q

Mycoplasma genus

A
  • small, no cell wall
  • M. pneumoniae
  • M. genitalium
  • M. ureaplasma
22
Q

M. pneumoniae pneumonia

A

•Respiratory symptoms mild enough to function, but usually not severe enough for hospitalization

-Pharyngitis, sinus congestion, incubation period up to 3 weeks

23
Q

M. pneumoniae pneumonia Diagnosis

A
  • Culture: Eaton’s agar or similar complex medium; 7-12 days; “fried-egg” colonies
  • Serology
  • PCR
24
Q

M. pneumoniae pneumonia Treatment

A

• Macrolides, Doxycycline

25
Q

M. genitalium

A

I & I Part III (26 decks)

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