Clostridia Flashcards
shape
gram + rods
oxygen requirement
strict anaerobe
spore formation?
yes
list the species of clostridium
dificile
perfringens
botulinum
tetani
how does clostridium cause disease symptoms?
produce and release proteinaceous toxin
what induces spore formation?
unfavorable conditions (ie nutrient depletion)
when do spores germinate?
when conditions become favorable for vegetative growth
Pseudomembranous colitis (PMC) is caused by what strain of clostridium?
C. diff
PMC is characterized by:
yellow plaques filled with fibrin and cellular debris in ulcers of colonic mucosa
what is leading cause of nosocomial diarrhea?
C. diff
C. dificile mode of transmission
endospore (hands of healthcare workers)
disease state of C. diff is usually associated with:
use of antimicrobial drugs (cephalosporins, ampicillin, clindamycin)
true or false? C. diff is harbored in a dormant state in the small intestine of a small % of healthy people
false; harbored in large intestine
how do C. diff spores react to antibiotics?
resistant ; antibiotics kill the normal flora
what causes diarrhea in C. diff?
vegetative spores begin to produce toxin = diarrhea
does C. diff invade the bowel wall?
no, just like E. coli and V. cholera
what are the toxins of C. diff?
Toxin A
Toxin B
which C. diff toxin is the enterotoxin?
Toxin A
what damage does an enterotoxin do?
fluid production and damage to mucosa
which C. diff toxin is the cytotoxin?
Toxin B
what does a cytotoxin do?
rounding of tissue-culture cells
where do C. diff toxins act?
cytoplasm of host cell
how do C. diff toxins act?
glycosylate GTP-binding proteins (Rho, Rac)
what happens when GTP-binding proteins are glycosylated by C. diff toxins?
cells lose cytoskeletal structure and die
what is standard diagnostic for toxin A of C. diff?
ELISA
Where is C. perfringens found?
soil and intestinal tract of animals
where is C. perfringens NOT found?
Sahara desert sand
what is the major pathogen of wound infections, especially war wounds?
C. perfringens
true or false? C. perfringens causes local damage only
false, causes local AND systemic damage because of its invasive properties and toxin production
true or false? C. perfringens produces a toxin?
true
C. perfringens tissue infections caused when:
severe trauma introduces spores from environment
in C. perfringens, after a severe trauma, environmental spores germinate under what conditions:
anaerobic
compromised blood supply
Ca++ ions
Availability of peptides and AAs
C. perfringens toxins typically cause:
cellulitis
cellulitis caused by C. perfringens toxins can lead to:
gas gangrene
what is gas gangrene:
necrotizing
gas-forming
systemic signs of shock
how many toxins does C. perfringens produce?
12 toxins
C. perfringens Alpha-toxin (lecithinase) does what?
damages cell membranes
causes gas gangrene
how does C. perfringens Alpha-toxin cause its damage?
Phospholipase Type C
What is Phospholipase Type C and what does it do?
produced by Alpha-toxin of C. perfringens
Hydrolyzes phosphatidylcholine and sphingomyelin = cell death
what is myonecrosis? symptoms?
destruction of muscle tissue
reddish-blue to black in color
gas bubbles present
How do you treat a C. perfringens infection?
surgery to remove infected muscle
antibiotics for control but still amputation
Antitoxin from horses
High O2
Prompt care to restore arterial blood supply
C. perfringens food poisoning results when:
sporulating C. perfringens produces enterotoxin in intestine after eating contaminated food
At what point is diarrhea is typically seen in C. perfringens food poisoning?
12-24 hours
True or false? C. perfringens food poisoning is self limiting:
true - disappears on its own in 1-3 days
C. botulinum is found where?
soil and marine sediments
C. botulinum spores are unique because they:
heat resistant - survive food processing
germinate and grow under anaerobic conditions (cans)
causative agent of botulism
intoxication by ingestion of preformed toxin
*organism does not need to be present
C. botulinum produces how many toxins and what kind?
8 neurotoxin (BoNT) serotypes A-G
among most poisonous substances known
pose a bioweapon and bioterrorism threat
what are most common BoNT serotypes in humans?
A, B, E
Purified BoNT is produced as a:
900 kDa protein complex with a 150-750 kDa toxic/nontoxic ration
connected by disulfide bridge
What is the MOA of C. botulinum neurotoxin?
prevents release of acetylcholine NT
zinc metalloprotease
C. botulinum neurotoxin prevents release of ACh which leads to:
impaired neurotransmission at peripheral cholinergic synapses
zinc metalloprotease does what?
cleaves proteins involved in NT vesicle docking
Symptoms of C. botulinum toxin poisoing
Flaccid paralysis in 12-36 hours
Cranial nerves affected first - double vision, difficulty swalling
Paralysis descends = respiratory failure
What are the 3 types of botulism?
Food-borne
Infant
Wound
what causes infant botulism
intestinal colonization of organisms in babies <1
honey
is infant botulism slow or fast onset?
slow
infant botulism is characterized by:
hypotonic (floppy) baby
wound botulism
most rare
systemic spread of toxin produced by organisms in wound
causes of wound botulism
trauma, surgery
subQ heroin injection
sinusitis caused by intranasal cocaine
what should be administered immediately to treat C. botulinum?
trivalent antitoxin isolated from horses
C. tetani is found where?
ubiquitous in human and animal GI tracts
soil samples
True or false? C. tetani spores are susceptible to the environment
false- they are resistant to the environment
C. tetani infection is usually associated with:
traumatic wounds
what is the major toxin of C. tetani:
tetanospasmin - responsible for all symptoms
size of tetanospasmin:
150 kDa
Describe makeup of tetanospasmin
150 kDa protein
Heavy and light chain (A-B) connected by disulfide bridge)
True or false? Individual chains of tetanospasmin are extremely toxic
false, individual chains are not toxic
tetanospasmin MOA
attached to peripheral nerves near wound, transmitted to cranial nerve nuclei
inhibits GABA release and normal inhibitory input
result of tetanospasmin actions
reflex spasms and spastic paralysis
What is trismus?
lockjaw
tetanic spasm of masseter mm. that prevent open mouth
effects of generalized tetanus
trismus (lockjaw)
descends to neck & back = rigid abdomen & stiff extremities
tonic seizures
respiratory failure (chest mm. paralysis)
how to prevent tetanus?
DPT vaccine tetanus toxoid (inactivated antigenic toxin)
treatment of tetanus?
human globulin as passive immunization in tetanus prone wounds
immediate antitoxin administration + penicillin G to prevent further paralysis
surgical wound debridement