E1- Bacterial Pneumonia II Flashcards

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1
Q

What are the most common pathogens of HAP?

A

Pseudomonas aeruginosa*
Stapholococcus aureus
Klebsiella pneumoniae

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2
Q

Is Pseudomonas aeruginosa gram positive or gram negative? What shape?

A

Gram negative bacillus

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3
Q

What type of environments does Pseudomonas aeruginosa like?

A

Wet envrionements (cut flowers, food, sinks, toilets, dialysis equipment, disinfectants)

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4
Q

What color is Pseudomonas aeruginosa?

A

Blue-green

Pyoverdin, pyocyanin

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5
Q

What is unique about Pseudomonas aeruginosa?

A

Non-fermenting

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6
Q

What can Pseudomonas aeruginosa use as a terminal electron acceptor?

A

Nitrate

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7
Q

What kind of pathogen is Pseudomonas aeruginosa?

A

Opportunistic, rarely infects healthy individuals

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8
Q

What are the five virulence factors of Pseudomonas aeruginosa?

A
Adhesins
Alginate capsule
Pyocyanin
Exotoxin A
Elastases
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9
Q

What virulence factors of Pseudomonas aeruginosa is important for cyclic fibrosis patients?

A

Alginate capsule

Inhibits mucocilary escalator

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10
Q

How does pyocyanin act as a virulence factor in Pseudomonas aeruginosa?

A

Catalyze ROS and causes tissue damage

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11
Q

What elastases does Pseudomonas aeruginosa have? How do they work?

A

LasA and LasB

Work synergistically to degrade elastin (30% of the lung tissue is elastin)

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12
Q

What diseases can Pseudomonas aeruginosa cause?

A

Pneumonia (HAP)*
Urinary tract
Eye, ear, skin
Second leading cause of infection in burn pts
Common cause of death in cystic fibrosis pts
Sepsis

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13
Q

What population commonly gets chronic and recurrent Pseudomonas aeruginosa infections in the respiratory tract?

A

Cystic fibrosis pts

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14
Q

How is Pseudomonas aeruginosa pneumonia (HAP) dx?

A

Gram stain

Culture

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15
Q

Why is treatment of Pseudomonas aeruginosa pneumoniae (HAP) difficult?

A

Notoriously resistant to abx (capsule)
Pts are typically immunocompromised
Acquisition of resistance mediators

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16
Q

Can you prevent a Pseudomonas aeruginosa infection?

A

No, you can only hope to contain it
Prevent contamination of sterile equipment
Prevent pt to pt spread

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17
Q

What are the common pathogens that cause atypical pneumoniae?

A

Legionella pneumoniae
Mycoplasma pneumoniae
Chlamydophila pneumoniae

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18
Q

What disease can mycoplasma pneumoniae cause?

A

Atypical CAP

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19
Q

What is unique about mycoplasma pneumoniae?

A

No cell wall/peptidoglycan

20
Q

What abx can you not use to tx mycoplasma pneumoniae? Why?

A

Beta lactams

They do not have a cell wall

21
Q

How does atypical CAP caused by mycoplasma pneumoniae present?

A
Non productive cough that lasts 1-2 months
Fever (not usually in children <5)
Crackles
Headache
Chest pain
Non specific rash
22
Q

Does mycoplasma pneumoniae infection lead to long lasting immunity?

A

No, relapses are common

23
Q

How is mycoplasma pneumoniae transmitted?

A

Person to person via respiratory droplets

24
Q

How does mycoplasma pneumoniae attach to the respiratory epithelium?

A

Via attachment organelle leading to the development of ciliostasis, allowing the bacteria to colonize

25
Q

What does Mycoplasma pneumoniae release that damages the epithelial layer?

A

H2O2

26
Q

What is ciliostasis and how does it work?

A

Damage to the ciliated epithelium (paralysis)
Halts the mucociliary escalator, preventing the host from clearing the bacterium from the airway
Bacterium colonized

27
Q

How is mycoplasma pneumoniae atypical pneumoniae dx?

A

CXR, culture, serological testing

28
Q

Is Chlamydia pneumoniae gram positive or negative? What shape?

A

Gram negative

Coccus

29
Q

What type of pathogen is Chlamydia pneumoniae?

A

Obligate intracellular parasite

30
Q

What is the infectious stage of Chlamydia pneumoniae called?

A

Elementary bodies

31
Q

What is the intracellular stage of Chlamydia pneumoniae called?

A

Reticulate bodies

32
Q

How does atypical pneumoniae caused by Chlamydia pneumoniae present?

A

Generally asymptomatic or mild illness in adults

Persistent non productive cough and malaise for weeks to months

33
Q

How is Chlamydia pneumoniae transmitted?

A

Person to person via respiratory droplets

34
Q

What causes illness from a Chlamydia pneumoniae infection?

A

Tissue destruction during bacterial replication and the associated inflammatory response

35
Q

Does infection with Chlamydia pneumoniae provide long lasting immunity?

A

No

36
Q

What is the most effective tool for dx Chlamydia pneumoniae?

A

Serology

MIF test looks for IgM and IgG

37
Q

Is Legionella pneumoniae gram positive or negative? What shape?

A

Gram negative bacillus

38
Q

What species of Legionella pneumoniae causes majority of human infections?

A

L. Pneumohila serotype 1

39
Q

What diseases can Legionella pneumoniae cause?

A

Pontiac fever

Legionnaires disease

40
Q

How does Pontiac fever present?

A

Fever, chills, malaise, myalgia, headache, NO sign of pneumonia

Self limited illness
Sxs last for 2-5 days
Resolved without tx

41
Q

How does legionnaires disease present?

A

Fever, chills, non productive cough, headache, GI/neuro sxs

Severe, acute atypical pneumonia with a high mortality rate

42
Q

What causes death in legionnaires disease?

A

Shock or respiratory failure

43
Q

Where does Legionella pneumoniae grow?

A

Aquatic environments

44
Q

What does Legionella pneumoniae use as hosts?

A

Amoeba

45
Q

How is Legionella pneumoniae transmitted?

A

Aerosolized biofilms (no person to person transmission)

46
Q

Where does growth of Legionella pneumoniae occur in humans?

A

Alveolar macrophages

47
Q

How is Legionella pneumoniae dx?

A

Culture is gold standard (buffered charcoal yeast extract)

Rapid test for antigen in the urine (only detects serotype 1)