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House Microbiology > Brucellosis, Meloidisis, Whooping Cough, Legionnaires > Flashcards

Brucellosis, Meloidisis, Whooping Cough, Legionnaires Flashcards

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Biology 101 flashcards
1
Q

Brucellosis is a bacterial disease caused by various Brucella species, which mainly infect ________________________

A

cattle, swine, goats, sheep and dogs.

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2
Q

Brucellosis

Humans generally acquire the disease through _______ with _______, by ________ or ______ contaminated animal products, or by ___________

A

direct contact

infected animals

eating or drinking

inhaling airborne agents.

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3
Q

Brucellosis

The majority of cases are caused by _______________________________

A

ingesting unpasteurized milk or cheese from infected goats or sheep.

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4
Q

Brucellosis

Person-to-person transmission is (common or rare?) .

A

Rare

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5
Q

Brucellosis

The disease causes _____-like symptoms, including ______,_______,______, and ________

A

flu

fever, weakness, malaise and weight loss.

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6
Q

brucellosis

__________ the bacteria that causes brucellosis may also lead to infection.

This risk is generally greater for people in _______ that _____ with the bacteria.

A

Breathing in

laboratories

work

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7
Q

brucellosis

In addition, slaughterhouse and meat- packing employees have also been known to be exposed to the bacteria and ultimately become infected.

T/F

A

T

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8
Q

brucellosis

Inoculation injuries have been implicated

T/F

A

T

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9
Q

Brucella spp.

Gram (positive or negative?) (cocci or bacilli?)

Facultative, _____cellular organism

A

Negative ; coccobacillus

intra

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10
Q

Brucella spp.

Multiple species
– Associated with certain hosts

Environmental persistence – Withstands ______
– Temperature, pH, humidity
– ______ and _______ materials, dust, soil

A

drying

Frozen and aborted

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11
Q

Brucellosis Clinical presentation
fever
sweats
malaise
anorexia
headache
pain in muscles, joint, and/or back fatigue
Some signs and symptoms may ________________. Others may ________ or _______

A

persist for longer periods of time

never go away or reoccur.

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12
Q

•Disease in Humans

•Incubation period
– Variable; _______ to _______

•Multisystemic
– Any organ or organ system
–_______ fever

•Flu-like illness
– May ____ and ______
– Chronic illness possible

A

5 days to three months

Cyclical; wax and wane

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13
Q

Diagnosis in Humans(Brucellosis)

Isolation of organism
–_____,______, other tissues
Serum agglutination test
–____________ or _________
– Samples ________ apart
Immunofluorescence
– Organism in clinical specimens
• •
PCR

A

Blood, bone marrow

Four-fold or greater rise in titer

2 weeks

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14
Q

Treatment of Choice for brucellosis

Combination therapy
–________ for ____ weeks + _______ for ____ wk or ________ for __ wk
– In pregnancy: ______ +_________

CNS cases treat for _________
– Same for ________ cases plus surgical _______

A

Doxycycline; 6

streptomycin; 2

rifampicin; 6

rifadin; co-trimoxazole

6-9 months; endocarditis ; replacement of valves

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15
Q

Prognosis of brucellosis

(Commonly or Rarely?) fatal if treated

Case-fatality rate _____% (untreated)

–________ are necessary

Death usually caused by _______,______

A

Rarely

<2

Antibiotics

endocarditis, meningitis

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16
Q

Prognosis of brucellosis

About _____% of treated cases relapse due to _________________ or Infections requiring ___________

A

5

Failure to complete treatment

surgical intervention

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17
Q

Prevention and Control of brucellosis

________ about risk of transmission

__________ if dealing with infected animals/ tissues

Avoid ________________

A

Education

Wear proper attire

consumption of raw dairy products

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18
Q

Prevention and control of brucellosis

_________ in areas of high prevalence

Eradicate _______

A

Immunize

reservoir

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19
Q

There’s No human vaccine for brucellosis

T/F

A

T

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20
Q

Meliodosis

Background
Causatitive organism - _________ _______

Prevalent in __________

A

Burkholderia pseudomallei

south-east Asia

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21
Q

Meliodosis

Background

Gram-_________ (cocci or bacillus?)

A potential _________

A

Negative ; bacillus

bioterror terrò threat

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22
Q

Meliodosis

Background

characterized by ______ ,________

Mortality of up to _____%

A

sepsis, abscess formation

40

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23
Q

Meliodosis

Background

Melioidosis mainly affects individuals who are in regular contact with ______ and _____

A

soil and water.

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24
Q

Meliodosis
Early detection and adequate treatment of melioidosis can reduce morbidity and mortality significantly1

T/F

A

T

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25
Q

Meliodosis

It is a predominantly seasonal disease with three-quarter of cases present during the ______ season.

A

rainy

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26
Q

Meliodosis

The known hot spots of melioidois are located in _________ in ________ and _______, where annual incidence is up to ___ cases per 100,000 persons

A

Northern Territory in Australia and northeast Thailand

50

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27
Q

Meliodosis

Other foci however have been identified recently – most importantly the well documented emergence of melioidosis in ________.

A

Brazil5

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28
Q

Meliodosis

The global burden of melioidosis is estimated to be around ________ human melioidosis cases per year worldwide, from which _________ people die

A

165,000

89,000

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29
Q

Meliodosis in Africa

Reported patients with melioidosis in Africa are (numerous or few?) and _______

Due to _________ and _________

However, the isolated case reports on the presence of B. pseudomallei in the soil and animals in East and West Africa (amongst others in ______, The Gambia, Kenya, Uganda, and Gabon)

A

Few; isolated

Under recognition and under reporting.

Nigeria

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30
Q

Meliodosis: Laboratory diagnosis

oxidase-(positive or negative?) , Gram-(positive or negative?) bacteria that are not __________ are further tested to determine whether they are B. pseudomallei by using ______ and identification methods.

A

positive; negative

Pseudomonas aeruginosa

subculture

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31
Q

Meliodosis: Laboratory diagnosis

B. pseudomallei will be identified by colony morphology (_______), ________ oxidase test result, inability to assimilate __________, antimicrobial drug susceptibility

A

metallic sheen

positive; arabinose

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32
Q

Meliodosis: Laboratory diagnosis

antimicrobial drug susceptibility:

resistant to ________ and ______ and susceptible to _________

B. pseudomallei–specific ____________ which is (slow or rapid?)c (simple or complex?) to learn and (expensive or inexpensive?)
indirect haemagglutination assay (IHA),

A

gentamicin and colistin

amoxicillin-clavulanic acid

latex-agglutination.; rapid; simple

Inexpensive

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33
Q

Pertussis

Pertussis is a (mildly or highly?) contagious respiratory infection commonly known as ‘______________’.

A

highly

whooping cough

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34
Q

Pertussis (whooping cough)

It is caused by the bacterium- ________

It was one of the most common ______ disease world wide before
_______ became widely available

A

Bordetella pertussis

Childhood ; vaccines

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35
Q

Pertussis (whooping cough)

In developing countries, the average case fatality rate (CFR) for pertussis has been estimated at almost ___% in infants aged <1 year and at ____% in children aged 1–4 years

A

4

1

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36
Q

Large scale vaccination programmes were associated with a steep decline in the number of pertussis cases and deaths in children

T/F

A

T

37
Q

Pertussis (whooping cough)

Despite high vaccination coverage (in 2014, 86% coverage with ___ doses of a pertussis containing vaccine), pertussis remains ________________ and continues to be a public health concern

A

3

endemic in all countries

38
Q

Epidemiology of Pertussis Mode of transmission

Person to person via
–___________ from ____ or ______

– Direct contact with ________ from ________ of infectious person

A

Aerosolized droplets from cough or sneeze

secretions from respiratory tract

39
Q

Epidemiology of Pertussis

____% - secondary attack rate

A

80

40
Q

Epidemiology of Pertussis

________ and ______ are important sources of disease for _______ and ———

A

Older children and adults

infants and young children

41
Q

Epidemiology of Pertussis

Infants <_________ of age greatest risk for complications and death

A

12 months

42
Q

Clinical presentation of pertussis

Mostly _____hood disease

Incubation period of ______ day

Patients develop ______ symptoms, including _____ with characteristic “ ______ ”

A

child; 9–10

catarrhal; cough; whoop

43
Q

Clinical presentation of pertussis

Cough is particularly severe at (day or night?) and frequently followed by ______

In very young infants, pertussis may initially present as ______ and _____

In previously immunized adolescents and adults, a ___________ may be the only manifestation, without the characteristic “whoop”

A

night; vomiting

apnea and cyanosis

persistent cough

44
Q

Clinical presentation of pertussis

Pertussis is a ____-week disease divided into ______,_______, and ______ stages, each lasting from _____ weeks.

A

6

catarrhal, paroxysmal, and convalescent

1-2

45
Q

Clinical presentation of pertussis

Older children, adolescents, and adults may not exhibit distinct stages.

Symptoms in these patients include ___________, feelings of ______ or _______, and ________

A

uninterrupted coughing

suffocation or strangulation, and headaches

46
Q

Clinical presentation of pertussis

The cough can last for __________.

It has been called the “______ day cough.”

A

6-10 weeks

100

47
Q

Clinical presentation of pertussis

How long a person is ill depends on _____, other health conditions, and whether ___________ is given in the _____ stage of illness.

A

age

antibiotic treatment

early

48
Q

Gold standard for testing for pertussis in the laboratory is by??

A

Culture

49
Q

Laboratory Criteria for Diagnosis of Pertussis

 Isolation of Bordetella pertussis from a clinical specimen (_____)
 Positive polymerase chain reaction (PCR) assay for B. pertussis DNA

A

Culture

50
Q

Pertussis Complications
________
 _____ disturbance
___________
_________

 Complications among infants

 Death

A

Syncope

Sleep

Incontinence

Rib fractures

51
Q

Pertussis Complications

Complications among infants

________ (22%)
________(2%)
__________________(<0.5%)

A

Pneumonia

Seizures

Encephalopathy

52
Q

Pertussis Complications

Death

_______, particularly those who _____________________, are at risk for complications and mortality.

A

Infants

have not received a primary vaccination series

53
Q

Treatment of pertussis

Aim is to eradicate ________

Treatment duration usually _____ with _________ (EES), newer Macrolides _____ days

A

nasopharyngeal carriage

14 days; erythromycin sulfate

5-7

54
Q

Macrolides-______ ,______,________

_________ eradicates naso-pharyngeal carriage in pertussis the fastest

A

erythromycin, azithromycin, and clarithromycin

Azithromycin

55
Q

Treatment of pertussis

______________ has been reported with oral EES in infants younger than 6 weeks

______________ is an alternative to erythromycin-resistant strain, or for intolerance to macrolides

A

Hypertrophic pyloric stenosis

Trimethoprim-sulfamethoxazole

56
Q

Penicillins, first and second generation cephalosporins are effective against pertussis

T/F

A

F

Penicillins, first and second generation cephalosporins are not effective

57
Q

Two types of pertussis vaccines are available:
–_____________ vaccines
– _____________ vaccines

A

Whole-cell (wP)

Acellular (aP)

58
Q

Two types of pertussis vaccines are available:

– Whole-cell (wP) vaccines based on ______________

– Acellular (aP) vaccines based on ____________________

A

killed B. pertussis organisms

one or more highly purified individual pertussis antigens

59
Q

Pertussis

Many high-income countries have replaced _____ with _____ vaccines as a means of decreasing the _______ of the vaccine

A

wP

aP

reactogenicity

60
Q

Pertussis vaccines are produced as ————————

A

combinations with other antigens

61
Q

How many stand-alone pertussis vaccines are currently available

??

A

no stand-alone pertussis vaccines are currently available

62
Q

PERTUSSIS: WHO

WHO recommends a ___-dose primary series

with the first dose administered at _______ of age;; subsequent doses should be given ________ apart
The series should be completed by ___________ of age

A

3

6 weeks

4–8 weeks

6 months

63
Q

PERTUSSIS: WHO

for those who have not completed the schedule, vaccine may be given later than 6 months of age

T/F

A

T

at the earliest opportunity

64
Q

PERTUSSIS: WHO

For children whose vaccination series has been interrupted, the series should be resumed by repeating previous doses

T/F

A

F

the series should be resumed without repeating previous doses

65
Q

PERTUSSIS: WHO

A booster dose is recommended for children aged _________, preferably during the ______ year of life

A

1–6 years

second

66
Q

Legionella pneumophilia causes ________ pneumonia

A

Atypical

67
Q

Legionella pneumophila

(Small or large?), gram- ________ (cocci or bacillus?)

• Beta-________ producer

• Enters and replicates inside ________

A

Small; negative ; bacillus

lactamase

macrophages

68
Q

Legionella pneumophila

• Causative agent of “________ disease”

•causes ________ pneumonia syndrome

A

Legionnaire’s

Fulminant

69
Q

Legionella pneumophila

• Historically associated with __________ in air-conditioning systems

•_________ test for diagnosis

A

contaminated water

Urinary antigen

70
Q

The most common form of transmission of Legionella is _________ of __________ produced in conjunction with water sprays, jets or mists

Infection can also occur by ________ of contaminated _________, particularly in __________- patients.

A

inhalation of contaminated aerosols

aspiration

water or ice

susceptible hospital

71
Q

Legionnaires’ disease has an incubation period of _________ days (but up to 16 days has been recorded in some outbreaks).

A

2 to 10

72
Q

Legionnaires’ disease

Death occurs through ________ with _______ failure and/or shock and ________ failure.

A

progressive pneumonia

respiratory

multi-organ

73
Q

Legionnaires’ disease

Untreated Legionnaires’ disease usually worsens during the ________

A

first week.

74
Q

Legionnaires’ disease

Of the reported cases 75–80% are over _____ years and 60–70% are (male or female?) .

A

50

Male

75
Q

Legionellosis varies in severity from a ________ illness to a serious and sometimes fatal form of _______ and is caused by exposure to Legionella species found in ______ and ______

A

mild febrile

pneumonia

water, and soil

76
Q

Legionellosis

It is often categorized as being ______,______, or _______ acquired based on the type of exposure

A

community, travel or hospital

77
Q

Legionellosis

_________ Legionella pneumophila is the most common cause of cases including outbreaks

A

Waterborne

78
Q

Legionella pneumophila and related species are commonly found in __________________________

Other species including L. __________ can be found in _____

A

lakes, rivers, creeks, hot springs and other bodies of water

longbeachae; soil

79
Q

Legionella can survive and grow as parasites within free- living _______ and within ________ which develop in water systems

A

protozoa

biofilms

80
Q

Symptoms of legionellosis

The non-pneumonic form (______ disease) is a/an (acute or chronic?) , self-limiting _____-like illness usually lasting _____ days. The incubation period is from a few and up to ______

Characterized by fever, chills, headache, malaise and muscle pain (myalgia)

A

Pontiac
Acute ; influenza

2–5 ; 48 hours

81
Q

Symptoms of legionellosis

_________ disease, the pneumonic form, has an incubation period of __________

symptoms are fever, loss of appetite, headache, malaise and lethargy
Some patients may also have mild cough, muscle pain, diarrhoea and confusion.

_______ phlegm or ______ occurs in about one-third of the patients

A

Legionnaires’

2 to 10 days

Blood-streaked ; hemoptysis

82
Q

Symptoms of legionellosis

Legionnaires’ disease, the pneumonic form

The severity of disease ranges from a _______ to a (slowly or rapidly?) fatal _______.

A

mild cough

Rapidly

pneumonia

83
Q

Symptoms of legionellosis

Legionnaires’ disease

Death occurs through ______________ with ________ failure and/or shock and ______ failure

A

progressive pneumonia

Respiratory

Multi-organ

84
Q

Laboratory diagnosis of legionella

______ of lower respiratory secretions (e.g., sputum, bronchoalveolar lavage) on selective media and the _________ test

A

Legionellaurinary antigen

85
Q

Laboratory diagnosis of legionella

___________ [BCYE] agar) is confirmatory and an important method for diagnosis

Isolation of Legionella can come from lower respiratory secretions, lung tissue, pleural fluid, or a normally sterile site

Culturing specimens can detect Legionella species and serogroups that the __________ does not.

A

Buffered Charcoal Yeast Extract

urinary antigen test

86
Q

Which is a more specific method of diagnosis of legionella

Culture or urinary antigen test

A

urinary antigen test

87
Q

Which is a more sensitive method of diagnosis of legionella

Culture or urinary antigen test

A

Culture

88
Q

The ________________ can detect Legionella infections in some cases for days to weeks after treatment

A

urinary antigen test

House Microbiology (93 decks)

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