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Pathogenic Microbiology > Exam 2 Study Deck > Flashcards

Exam 2 Study Deck Flashcards

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1
Q

what is included in the upper urinary tract

A

kidneys
adrenals
ureters

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2
Q

what is included in the lower urinary tract

A

bladder
urethra

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3
Q

who, men or women, are more susceptible to urinary tract infections

A

women - they have a shorter urethra

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4
Q

why are urinary tract infections more common in older men than younger men

A

older men (60+) experience benign hyperplasia of the prostate which can obstruct urine flow

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5
Q

what is pyelonephritis

A

kidney infection most commonly caused by E. coli
symptoms include: fever, flank pain, frequency, urgency, dysuria (pain), and systemic signs like vomitting and diarrhea

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6
Q

what is cystitis

A

bladder infection most commonly caused by E. coli
symptoms include: dysuria (pain), frequency, urgency, and bloody/cloudy urine

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7
Q

what is urethritis

A

urethral infection most commonly caused by a sexually transmitted organism (chlamydia or gonorrhea)
symptoms include: dysuria (pain) and frequency

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8
Q

what is prostatitis

A

inflammation of the prostate gland most commonly caused by E. coli

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9
Q

name five normal organisms of the flora of the urinary system

A

staphylococcus
streptococci
lactobacilli
diptheroids
neisseria

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10
Q

what is the most common organism to be community acquired

A

E. coli

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11
Q

what is important about hospital acquired UTI’s

A

common due to catheterization procedures
often very antibiotic resistant making them hard to treat

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12
Q

what are the five main complicated community acquired organisms

A

proteus
pseudomonas
klebsiella
enterobacter
serratia

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13
Q

what is an ascending infection

A

most common type of infection route
infection that travels superiorly within the urinary tract
most commonly caused by colonization of GI bacteria in the vaginal canal or periurethral area

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14
Q

what is hematogenous spread

A

blood borne route of spread to the urinary tract

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15
Q

kidney infections caused by which three organisms most often indicate hematogenous spread

A

yeast - Candida albicans
TB
staph. aureus

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16
Q

what is lymphatic spread

A

least common route
bacterial spread to the urinary tract from the lymphatics
originating from retroperitoneal abscesses and severe rectal infections

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17
Q

describe this host defense against UTI’s: urine

A

its conditions inhibit growth or organisms
low pH
high urea

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18
Q

describe this host defense against UTI’s: flushing

A

we are constantly peeing which flushes out organisms before they can cause infection

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19
Q

describe this host defense against UTI’s: bladder mucosa

A

has antibacterial properties to prevent infection

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20
Q

describe this host defense against UTI’s: valve mechanism

A

junction of ureter and bladder acts like a valve to prevent reflux of urine back into the ureter which can cause infection

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21
Q

describe this host defense against UTI’s: host immune response

A

urothelial cells that come into contact with bacteria trigger an immune response
cytokines are released which activate the complement pathway

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22
Q

what are the 5 main host defenses against UTI’s

A

urine environment
flushing
bladder mucosal surface
valve mechanism
host immune response

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23
Q

what are the 5 main microorganism virulence factors for urinary tract infections

A

pathogenicity islands
adherence factors
urease
motility
K antigen production

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24
Q

describe this microorganism virulence factor: pathogenicity islands

A

genome sequences in organisms associated with virulence

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25
Q

describe this microorganism virulence factor: adherence factors

A

organisms have things like pili and can make adhesins which allow them to stick better to the host

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26
Q

describe this microorganism virulence factor: urease

A

certain organisms can make urease
urease will hydrolyze urea which increases pH level and stimulates growth of kidney stones

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27
Q

describe this microorganism virulence factor: motility

A

motility of microorganism thanks to things like flagella allow it to more easily ascend the urinary tract and cause infection

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28
Q

describe this microorganism virulence factor: K antigen production

A

microorganism’s production of K antigen can protect them from being phagocytized

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29
Q

what are 6 things in urine that can help diagnose a UTI

A

leukocyte esterase
nitrites
WBC
WBC casts
RBC
physical bacteria

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30
Q

what are the three main groups of organisms found in urine samples

A

E. coli
enterobacter
KES group (klebsiella enterobacter serratia)

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31
Q

what is the clean-catch midstream specimen collection method

A

most common method
urine is collected by the patient mid stream to prevent contamination with normal flora

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32
Q

what is the straight catheterized urine collection method

A

urine is collected from the bladder through a catheter
less contamination, assuming catheterization is done in a sterile manner

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33
Q

what is the suprapubic bladder aspiration collection method

A

urine is withdrawn from the bladder into a syringe through a percutaneous needle
full bladder is needed
usually done on infants or those hard to collect a sample from
less contamination, assuming done in a sterile manner

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34
Q

what is the indwelling catheter collection method

A

urine is retrieved from long term catheterized patients
catheter port is washed with 70% alcohol before procedure
urine should not be taken from the collection bag as this could skew results

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35
Q

how is a gram stain used in the detection of a UTI

A

gives the clinician a preliminary to help them decide which antibiotic to start the patient on

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36
Q

how are urine cultures processed

A

pre-calibrated loop (1:1000 - very small) is used to place the cultures on Maconkey, 5% sheep blood, or CNA agar
plates are incubated for 2 days at 35 degrees centigrade

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37
Q

what bacteria count is considered a true UTI

A

> 10^5 CFU/ml

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38
Q

what do urine collection tubes contain

A

preservatives like boric acid which will stabilize the urine for 48 hours and prevent contamination

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39
Q

are anerobes or aerobes more common in the normal adult GI flora

A

anaerobes

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40
Q

what are the 6 host factors that help prevent GI infections

A

acidity of stomach
peristalsis
mucous
normal flora
follicles (peyer’s patches)
cells that destroy bacteria

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41
Q

describe this host factor that prevents GI infections: follicles

A

specialized cells in the GI tract that make up Peyer’s patches when clumped together
cell types include: M, B, and T cells and macrophages
when microorganisms interact with these cells, IgA is released which will destroy them

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42
Q

describe this host factor that prevents GI infections: cells

A

3 main cell types that help destroy bacteria:
phagocytic cells
IgA
eosinophilic cells

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43
Q

describe esophagitis

A

infection of the esophagus, usually associated with an underlying illness (HIV)
symptoms: painful swallowing

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44
Q

what are the three organisms that can cause esophagitis

A

candida albicans
herpes simplex (HSV)
cytomegalovirus

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45
Q

describe gastritis

A

inflammation of the gastric mucosa
symptoms: nausea, pain, vomiting, burping, and fever

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46
Q

which organism causes gastritis

A

helicobacter pylori

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47
Q

describe proctitis

A

inflammation of the rectum
symptoms: itching and mucoid discharge

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48
Q

which four organisms can cause proctitis

A

STI’s:
chlamydia
herpes simplex (HSV)
syphillus
gonorrhea

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49
Q

which organism can cause Crohn’s disease

A

mycobacteria

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50
Q

what are the three main symptoms of Crohn’s disease

A

diarrhea
pain
cramping

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51
Q

what are three microbial factors that allow organisms to cause disease within the GI tract

A

1.) enterotoxin production changes the balance of water and electrolytes leading to massive fluid secretion in the small bowel

2.) invasion and destruction of host cells in colon

3.) penetrate of intestinal mucosa and spreading which can cause systemic infections

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52
Q

what are the five pathogenic mechanisms that bacteria employ to cause GI infections

A

enterotoxin
cytotoxin
neurotoxin
attachment
invasion

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53
Q

describe this pathogenic mechanism that causes GI infections: enterotoxins

A

production of enterotoxins causes release of electrolytes and fluid into the lumen of the small bowel
symptoms: watery diarrhea
organisms: vibrio cholerae + salmonella

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54
Q

which organism produces the most potent enterotoxin

A

vibrio cholerae - causes watery diarrhea

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55
Q

describe this pathogenic mechanism that causes GI infection: cytotoxins

A

production of cytotoxins causes damage to intestinal cells and causes them to slough away, thus leaving unprotected areas
symptoms: dysentery, pain, cramps, and tenesmus (painful straining)
organisms: clostridium difficile + shigella

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56
Q

describe this pathogenic mechanism that causes GI infection: neurotoxins

A

production of neurotoxins causes food poisoning
symptoms: vomitting and diarrhea
organisms: bacillus cereus + clostridium botulinum

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57
Q

what is the epidemiology of E. coli

A

traveler’s diarrhea
food and waterborne illnesses

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58
Q

what is the epidemiology of salmonella

A

traveler’s diarrhea
food and water borne outbreaks
immunocompromised hosts

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59
Q

what is the epidemiology of shigella

A

institutional setting
food and water born outbreaks
immunocompromised hosts

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60
Q

what is the epidemiology of campylobacter

A

institutional setting
traveler’s diarrhea
food and waterborne outbreaks
immunocompromised hosts

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61
Q

what is the epidemiology of noroviris and rotavirus

A

institutional setting
traveler’s diarrhea (rotavirus)

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62
Q

what is the epidemiology of vibrio cholerae

A

traveler’s diarrhea

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63
Q

what is the epidemiology of clostridium difficile

A

institutional setting

64
Q

what is the epidemiology of cryptosporidium

A

institutional setting
food and water born outbreaks
immunocompromised host

65
Q

what is the epidemiology of Giardia

A

institutional setting
food and water borne outbreaks
immunocompromised hosts

66
Q

what are some features of clostridium difficile

A

gram stain: gram positive
tests: PCR or EIA
epidemiology: antibiotics killing good bacteria
symptoms: watery diarrhea

67
Q

what are some features of shigella and salmonella

A

gram stain: gram negative
tests: culture
epidemiology: contaminated food
symptoms: shigella: dysentery; salmonella: diarrhea, enteric fever, and bacteremia

68
Q

what are some features of campylobacter

A

gram stain: gram negative
tests: culture
epidemiology: undercooked chicken
symptoms: blood, gastritis, and septicemia

69
Q

what are some features of vibrio parahemolyticus

A

gram stain: gram negative
tests: hard to culture - with salt
epidemiology: contaminated water or seafood
symptoms: gastroenteritis

70
Q

what are some features of yersinia enterocolitica

A

gram stain: gram negative
tests: hard to culture - bullseye on plate
epidemiology: undercooked pork
symptoms: presents as appendicitis

71
Q

what are some features of norovirus and rotavirus

A

tests: PCA or EIA
epidemiology: contaminated food and water
symptoms: vomitting, nausea, and diarrhea
incubation period: 2 days (rotavirus)

72
Q

what are some features of Giardia (parasite)

A

tests: staining, PCR, and EIA
epidemiology: fecal contamination
symptoms: diarrhea and cysts

73
Q

what are the 4 routes of infection transmission to the brain

A

hematogenous
direct spread
anatomic defect
direct intraneural

74
Q

what is hematogenous spread to the brain

A

most common route of infection
bacteria enters the subarachnoid space through the choroid plexus
ex. purulent meningitis caused by hematogenous spread of staph. aureus

75
Q

what is direct spread to the brain

A

extension of an infection of close proximity to the CNS
ex. middle ear infection (otitis media) can spread to the brain because it’s so close

76
Q

what is the anatomic defect route of spread to the brain

A

defects within CNS structures due to things like surgery can allow organisms to reach the brain and cause infection
ex. encephalocele

77
Q

what is direct intraneural spread to the brain

A

infections travel along the nerves to get to the brain
ex. rabies and herpes virus

78
Q

what is purulent meningitis

A

bacterial caused, acute inflammatory exudate with lots of polymorphonuclear cells
mostly affects the ventricles

79
Q

what is aseptic meningitis

A

increase in lymphocytes or mononuclear cells in the CSF that is usually caused by viruses

80
Q

what are two host defenses against purulent meningitis

A

blood brain barrier
age of patient

81
Q

what is the blood brain barrier

A

choroid plexus arachnoid membrane and the cerebral microvascular endothelium prevent the passage of infectious agents into the CSF

82
Q

which age of patient is at most risk for developing purulent meningitis

A

neonates because they are immunocompromised
they can get infections like strep. and E. coli while being delivered

83
Q

what are the three virulence factors that allow microbes to enter the CNS and cause purulent meningitis

A

secretion of IgA proteases - destroy host’s IgA allowing them to attach to the epithelium

antiphagocytic capsule helps them evade destruction by the host immune system

breaking down microvascular endothelial cells of blood brain barrier, allowing them to penetrate the CSF

84
Q

what are the 6 main symptoms of purulent meningitis

A

stiff neck
fever
headache
nausea
vomitting
altered mental status

85
Q

what are the three clinical factors used to diagnose purulent meningitis

A

CSF: lots of polymorphonuclear cells (neutrophils)
decreased glucose
increase protein

86
Q

what are the 5 main symptoms of aseptic meningitis

A

stiff neck
fever
headache
nausea
vomitting

87
Q

what are the two factors used to diagnose aseptic meningitis

A

increase in lymphocytes/mononuclear cells
negative bacteria/fungi cultures

88
Q

which organism causes purulent meningitis in young adults

A

neisseria meningitis - acquired from communal areas like jails and dormitories

89
Q

which 4 organisms can cause purulent meningitis in adults

A

neisseria meningitis
strep. pneumo
listeria
staph. aureus

90
Q

which underlying condition can cause chronic meningitis

A

HIV

91
Q

which two non viral organisms can cause aseptic meningitis

A

syphilis
spirochetes

92
Q

give five examples of organisms that can cause chronic meningitis

A

TB
cryptococcus
candida
actinomyces
brucella
mostly fungi

93
Q

what is encephalitis

A

inflammation of the brain parenchyma usually due to a virus

94
Q

what is meningoencephalitis

A

meningitis (inflammation of the meninges) that occurs with encephalitis (inflammation of brain parenchyma)

95
Q

what are the two most common organisms that cause encephalitis

A

enteroviruses - coxsackievirus and echoviruses

96
Q

what are two organisms that can cause meningoencephalitis

A

amoebae - naegleria fowleri and acanthomoeba

97
Q

how is CSF collected

A

through lumbar puncture
10-15 ml of CSF is placed into 4 sterile tubes
specimen is brought immediately to the lab and kept at room temperature

98
Q

what tests are done on a CSF culture

A

cell count, glucose, and protein levels
cytospun for 15 minutes
gram stained
plated on chocolate media, BAP, and thioglycolate broth

99
Q

how are the results reported for a CSF culture

A

gram stain results read and reported immediately
bacterial cultures are help for 3 days
positive cultures called immediately

100
Q

what are wet preps used for

A

used to detect amoebas in the case of naeglaria fowleri

101
Q

what is India ink and latex tests used for

A

India ink: stain that will show cryptococcus neoformans and its capsule
latex test: detects polysaccharide capsular antigen in crypto coccus neoformans

102
Q

why are molecular methods involving PCR so good to use for CSF specimens

A

rapid and have excellent specificity and sensitivity
they can also detect multiple different types of organisms at once

103
Q

what is bacteremia

A

bacteria in the bloodstream, usually due to a wound or infection
produces mild symptoms and usually requires no treatment

104
Q

what is septicemia/sepsis

A

organ injury or damage in reponse to a bacterial infection

105
Q

what is septic shock

A

when sepsis leads to dangerously low blood pressure and abnormalities in cellular metabolism

106
Q

why is it important to be urgent when working up a positive culture

A

timely identification of the organism and its susceptibility provides information to the clinician that will help them administer appropriate antimicrobial therapy

107
Q

what are the results of inappropriate antibiotic use

A

antibiotic won’t kill the organism
they develop resistance
using a more expensive one when you don’t need to
using an antibiotic that is more toxic to the patient than necessary

108
Q

what are the three types of bacteremia

A

transient
consistent
intermittent

109
Q

what is transient bacteremia

A

bacteria are introduced spontaneously or due to minor events like brushing the teeth

110
Q

what is continuous bacteremia

A

organisms are released into bloodstream at a constant rate
ex. septic shock and endocarditis

111
Q

what is intermittent bacteremia

A

organisms are released into the bloodstream at an intermittent rate
ex. meningitis and pneumonia

112
Q

what are the two types of blood stream infections

A

intravascular and extravascular

113
Q

what is the origin of intravascular blood stream infections

A

cardiovascular system

114
Q

what are four examples of intravascular blood stream infections

A

infective endocarditis
mycotic aneurysm
suppurative thrombophlebitis
catheter-associated bacteremia

115
Q

what is the most common organism to cause infective endocarditis

A

viridan streptococcus

116
Q

what is a mycotic aneurysm

A

typically a bacterial infection that damages that aortic endothelium leading it to bulge and burst

117
Q

what is suppurative thrombophlebitis

A

inflammation of the wall of a vein which allows a clot to form

118
Q

which organism most commonly causes catheter-associated bacteremia

A

staph. epidermis (catalase+, coagulase-)

119
Q

what is an extravascular blood stream infection

A

bacteria gets to the circulation through the lymphatic system
most common cause for bacteremia

120
Q

what are the three most common extravascular portals of entry which lead to extravascular blood stream infections

A

genitourinary tract
respiratory tract
abscesses

121
Q

what are the two main GI tract organisms to cause extravascular blood stream infections

A

E. coli
enterococcus

122
Q

what are the three main organisms that cause intravenous catheter-associated bacteremia

A

staph. epidermidis
staph. aureus
mallazezia furfur

123
Q

how do bacteria cause intravenous catheter-associated bacteremia

A

they enter the catheter from the skin and get to the blood
they migrate from the inside of the catheter into the blood

124
Q

how is intravenous catheter-associated bacteremia diagnosed and treated

A

most commonly, patients will have a fever or redness at the site
treatment is to removed the catheter and replace with a new one - antibiotics can be given if infection is severe

125
Q

what is unique about malazessia furfur

A

it is a yeast that is normally found on the skin
it is lipophilic so it flourishes at the parenteral nutrition (intravenous nutrition) site
it’s hard to grow because of it’s strict lipid requirement - use olive oil to grow
helmet shaped

126
Q

which 5 organisms in the blood can indicate a neoplasm

A

clostridium septicum
strep. bovis
pleisiomonas shigelloides
aeromonas hydrophila
campylobacter

127
Q

what is often used when taking blood cultures for bacteria and how are they used

A

blood bottles - they are loaded into an instrument that will monitor the presence of bacterial growth for 5 days at 10 minute intervals

128
Q

how does the Bactec blood instrument detect bacterial growth in blood bottles

A

detected of CO2 production using a CO2 sensitive membrane at the bottom of the bottle

-organism releases CO2 which reacts with dye in vial sensor
-LED activates fluorescent material in sensor
-photo detector reads fluorescence
-data from detector is analyzed by row board and positivity analysis is performed
-positive vial is announced in multiple ways

129
Q

what are two instruments that can perform identifications straight from the blood bottles

A

MALDI-TOF and PCR

more timely than the Bactec blood instrument

130
Q

if you have a gram positive cocci in clusters, what should you suspect

A

staphylococcus

131
Q

if you have a gram negative rod, what should you suspect

A

enterobacteriacea

132
Q

if you have gram positive large cells, what should you suspect

A

yeast

133
Q

if you have gram positive cocci in chains, what should you suspect

A

streptococci

134
Q

if you have gram positive rods in palisading form, what should you suspect

A

corynebacterium

135
Q

if you have gram negative cocci in pairs, what should you suspect

A

neisseria

136
Q

if you have large gram positive rods, what should you suspect

A

bacillus or clostridium

137
Q

what are the four criteria for a systemic inflammatory response syndrome (SIRS) diagnosis

A

fever (between 36 and 38 C)
elevated heart rate (over 90 beats/min)
elevated respiratory rate (over 30 breaths/min)
elevated white blood cell count (over 12,000)

138
Q

what are the criteria important for a sepsis diagnosis

A

you must have all four criteria of SIRS as well as a documented or suspected infection
may also have elevations in procalcitonin, C-reative protein, hyperglycemia, and altered mental status

139
Q

what are the criteria important for a severe sepsis diagnosis

A

SIRS along with organ dysfunction marked by:
acute oliguria (decreased urine output)
increase in creatinine
hepatic dysfunction
paralytic ileus

140
Q

what are the criteria important for a septic shock diagnosis

A

SIRS, organ dysfunction, and hypotension refractory to fluid resuscitation or hypercalacemia

141
Q

what are some characteristics of strep. pneumoniae

A

can cause sepsis
found on the mucosal surfaces of upper respiratory tract
gram positive
arranged in pairs
capsule
grows on blood agar - anaerobic surrounded by alpha-hemolysis

142
Q

what are some characteristics of staph. aureus

A

can cause sepsis
found in nose and skin
gram positive
form in clusters
anaerobic, catalase positive
cause toxic shock syndrome

143
Q

which organism is known to cause toxic shock syndrome (TSS)

A

staph. aureus

144
Q

what are some characteristics of listeria monocytogenes

A

can cause sepsis
gram positive
rod shaped
anaerobic, beta hemolytic
has umbrella motility
can affect pregnant and immunocompromised patients

145
Q

what are some characteristics of strep. agalactiae

A

can cause sepsis
gram positive
pairs of chains
anaerobic, beta-hemolytic on blood agar
CAMP positive, catalase negative
most commonly affects neonates

146
Q

what are some characteristics of step. pyogenes

A

can cause sepsis
gram positive
chains and large colonies
aerobic, beta-hemolytic, catalase negative, PYR positive on blood agar
can cause scarlet fever and impetigo

147
Q

what are some characteristics of enterococcus

A

can cause sepsis
gram positive - cocci in pairs or short chains
PYR positive

148
Q

what are some characteristics of neisseria meningitis

A

can cause sepsis
gram negative
encapsulated
diplococci - kidney bean shaped
needs blood for growth
oxidase and catalase positive

149
Q

what are some characteristics of clostridium perfringes

A

can cause sepsis
anaerobic
encapsulated
rod shaped, pleomorphic cells in pairs or short chains
catalase and SOD negative
double zones of hemolysis (target)
can cause food poisoning

150
Q

in which organism would you see double zone of hemolysis (target)

A

clostridium perfringes

151
Q

what are some characteristics of bacteroides

A

can cause sepsis
gram negative
found in the intestinal tract of humans
important factor in abscess formation

152
Q

what are some characteristics of candida

A

can cause sepsis
encapsulated
cells much bigger than normal gram positive cocci

153
Q

what is the most common organisms to cause disease in humans

A

Candida albicans

154
Q

what are some characteristics of cryptococcus neoformans

A

can cause spesis
spherical yeast that has a GXM capsule
india ink and urea positive
growth on bird seed agar is black
can cause respiratory and cutaneous infections most commonly

155
Q

bird seed agar is most commonly used to isolate which organism

A

cryptococcus neoformans

Pathogenic Microbiology (3 decks)

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