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Microbiology Exam 5 > Etiologic agents predominately seen neonate > Flashcards

Etiologic agents predominately seen neonate Flashcards

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1
Q

what is the gram staining of s. agalactiae?

A

gram-postive cocci in chains or pairs

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2
Q

what is the hemolytic status of s. agalactiae on sheep blood agar?

A

beta-hemolytic

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3
Q

what is the status of s. agalactiae when exposed to bacitracin and how does it differ from GAS

A

bacitracin resistant unlike GAS which is sensitive

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4
Q

s. agalactiae serologically is based on what

A

capsular polysaccharide

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5
Q

what is s. agalactiae virulence factor

A

capsular polysaccharide- antiphagocytic

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6
Q

for neonates and young infants what is the leading cause of bactermia alone or with meningitis with first 3 months

A

s. agalactiae

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7
Q

what ratio of pregnant women in counter invasive GBS

A

1/3

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8
Q

what other populations are effected by GBS

A

people >60yo and

diabetics, cirrhosis , malignancy and AIDS

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9
Q

in what tissues can GBS syndromes occur?

A

virtually all

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10
Q

how can GBS be transmitted

A

vertically during birth or horizontally from mother after birth

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11
Q

where does GBS colonize

A

mothers pharynx, vagina, and skin via rectal colonization

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12
Q

what is age and gender is most affected by GBS meningitis

A

neonates

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13
Q

what is the seasonality of GBS

A

none

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14
Q

what are the RF for GBS

A

LBW and material related events( I.E infections)

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15
Q

what two GBS forms of disease are recognized in neonatal infections

A

Early onset sepsis (bacteremia)

late onset sepsis (bacteremia and focal event)

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16
Q

how is acute onset GBS sepsis decribed

A

occurs within 6 days of birth

mother is source occurs in utero

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17
Q

how is late onset GBS sepsis defined

A

occurs week to 3 months after birth

source: postpartum in nursery, community or mother

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18
Q

what are focal infections in late onset GBS sepsis

A

meningitis
cellulitis
osteomyelitis
septic arthritis

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19
Q

what is more common early or late onset GBS sepsis

A

early

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20
Q

meningitis occurs more commonly in early or late onset GBS sepsis

A

late

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21
Q

How to diagnose GBS

A

isolate from neonate (CSF, Blood, Lungs)
isolate from mother (vagina, pharynx, GI, skin)
do a rapid slide agglutination or PCR

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22
Q

what is the treatment for GBS

A

Penicillin G

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23
Q

what is the prevention for early onset GBS infection

A
  1. screen mother
  2. IV AB to mother preterm and at labor
  3. AB to mothers who have RF for GBS (premature membrane rupture)
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24
Q

what is the prevention for late onset GBS infection

A

NONE

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25
Q

what effect on etiology can intrapartum AB have on neonate

A

cause of infections switches from GBS to E.Coli

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26
Q

what is the gram staining of listeria monocytogenes

A

gram positive coccobacilli, motile and cornyeform

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27
Q

is listeria monocytogenes fastidious?

A

NO

28
Q

what type of pathogen is listeria monocytogenes?

A

facultative intracellular pathogen

29
Q

what two ways does listeria monocytogenes invade

A
  1. invade and multiply in non-professional macrophages (epithelial and endothelial)
  2. survive and multiply with phagocytic cells
30
Q

what re the two virulence factors for listeria monocytogenes

A

lipoteichic acids- endotoxin

proteins- organism-directed phagocytosis and cell to cell spead

31
Q

what is the incidence of listeria monocytogenes

A

sporadic and food-borne epidemics

32
Q

how is listeria monocytogenes transmitted

A
  1. food-borne: rare but high mortality
  2. human to human: in utero or parturition
  3. zoonosis
33
Q

what is the reservoir for listeria monocytogenes

A

soil, water, fecal flora, food

34
Q

what is the age and gender associated with listeria monocytogenes disease

A

pregnant women are are increase risk

35
Q

what is the seasonality of listeria monocytogenes

A

summer

36
Q

what are the RF for listeria monocytogenes

A

T cell suppression

37
Q

what is the simple pathogenesis of listeria monocytogenes

A

Organism ingested -> pases through intestinal epithelium -> bacteremia

38
Q

what is the POE for listeria monocytogenes

A

GIT

39
Q

what is the purpose of listeriolysin O?

A

disrupts phagosome membrane allowing listeria cells to escape

40
Q

what is the incubation time for listeria monocytogenes

A

~30 days

41
Q

What possible immunity is there to listeria monocytogenes

A

primarily t-dependent immunity

42
Q

what is the clinical syndrome of listeria monocytogenes in pregnancy

A

illness usually occurs at 3rd trimester

mother has flu-like symptoms rarely any CNS

43
Q

what is the clinical syndrome of listeria monocytogenes in utero

A
  1. early onset sepsis
  2. spontaneous abortion
  3. still born
  4. premature births
    mortality is high
44
Q

what two organs has the most concentration listeria in early onset sepsis found?

A

LUNG and GUT

45
Q

what is granulomatosis infantisepticum

A

rare condition of disseminated abscess or granulomas in multiple organs with papules in throat and skin
mortality is high!

46
Q

what is the clinical syndrome of listeria monocytogenes in late onset sepsis

A

occurs during or after birth
symptoms start 1-2 weeks after birth
mortality is moderate
mother is asymptomatic

47
Q

how is listeria monocytogenes diagnosed

A

Culture, Gram stain, CSF

48
Q

what environment is best to culture listeria monocytogenes

A

cold-enrichment

49
Q

what limitations are there to gram stain listeria monocytogenes

A

similar to corneybacterium, easily decolorized, small number

50
Q

what is seen in CSF of listeria monocytogenes

A

monocyte predominante
glucose normal
low probability of visualizing listeria so leads to misdiagnosis

51
Q

what is the treatment of listeria monocytogenes

A

ampicillin and gentamycin alternative is tmp-smx

52
Q

what is the gram staining of e.coli

A

gram negative rod enteric and a coliform

53
Q

is e- coli oxidase positive or negative

A

oxidase negative

54
Q

which strain of e.coli causes the majority of UTI in humans

A

Extraintestinal pathogenic e. coli (ExPEC)

55
Q

what is the most important virulance factor of e. coli in meningitis cases

A

K1

56
Q

what does K1 in e.coli strains refer to

A

capsular serotype

57
Q

what is the K1 serotype in e.coli responsible for

A

anti-phagocytic to neutophils

58
Q

What type of pathogen is e.coli

A

facultative intracellular pathogen of macrophages and monocytes

59
Q

what is the incidence level of e. coli

A

HIGH
2nd most common cause of invasive disease in neonate
most common gram-negative agent in neonatal meningitis
there is a

60
Q

what affect can e.coli k1 vaginal colonization have on a pregnant female

A

increases chances of preterm

61
Q

what is the source of e.coli k1 infection

A

mother’s colon

62
Q

how do you diagnose E.coli k1

A

culture and ID

63
Q

what other gram negative agents can cause systemic infections in neonate

A

klebsiella pneumoniae and pseudomonas aeruginosa

64
Q

klebsiella pneumoniae and pseudomonas aeruginosa occurs in what type of neonate

A

VLBW

65
Q

what other Gram Positive agents that can cause systemic infections in neonates

A

staphlococcus epidermidis (CoNS) which causes early onset sepsis and meningitis

66
Q

what neonate diseases can klebsiella pneumoniae cause

A

early and late onset sepsis. easy to culure and ID

67
Q

what viruses can cause infection and morbidity in neonates

A 
CMV
HSV 1/2
HHV 6/7
non-polio enterovirus - neonatal sepsis
HMV and laryngeal warts
LCMV

Microbiology Exam 5 (7 decks)

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