Exam 3 Flashcards
_____ after birth we develop our own human microbiome and resident flora stabilizes by _____
3 hours, 3-4 years of age
transient microbes attempt to displace resident microbes, which can take residence due to _____, _____, and _____
environmental changes, geographic location, diet
greatest variety of microbes in ____ and _____ (__ types)
mouth and gut (700 types)
_______ stimulate resistance factors
non-pathogenic flora
non-pathogenic flora provide competitive exclusion with _____
colicin production
non-pathogenic flora provide vitamins (__, __, and ____)
(k, b, and folic acid)
non-pathogenic flora helps in removal of toxins (_____)
heterocyclic amines
aerobes coexist with anaerobes or microaerophiles in ____ and ____
gums and intestines
human microflora is mostly
bacteria
human microflora has some ___ and a few ____
some yeasts and a few protozoa
mycoplasma (in ___ and ____)
urinary tract and intestines
viruses in tissues in latent forms (____ and ____)
adenoviruses and herpes
____ in eyelashes
mites
skin is protected by protected by _______ (____ and ____)
inhibitory chemicals (fatty acids, lysozyme)
on the skin the population is mainly ___ (_______)
gram + (staphylococcus)
staphylococcus is mostly in heat and moisture pockets (___ and ____)
armpit and groin
on the skin ____ found in moist areas
yeast
_____ (______) in follicles (acne)
diphtheroids (propionibacterium)
180 different microbes on the ____
skin
_____ is protected by flow of saliva, with lysozyme, mucus, stomach acid, bile
GI tract
in the GI tract ____ predominates but anaerobes and ____ may be found and fusiforms too
in the GI tract STREP predominates but anaerobes and SPIROCHETES may be found and fusiforms too
____ and ____ contribute to gingivitis
prevotella and treponema
pharynx has ____ and _____
neisseria and haemophilus
stomach may harbor _____ (25% of people)
helicobacter
____ types in gut (__% have archae)
750 types in gut (50% have archae)
small intestines: ____ in low levels and ____
cocci in low levels and lactobacilli
large intestines: _____ of organisms
billions
large intestines are __% anaerobes: ____ and _____
90% anaerobes: clostridium and bacteroides
predominant type in large intestines, ______ , determines type of gas produced
enterotype
breast fed infants have more _____ and bottle fed infants have more _____ in large intestines until solid food when ______ replaces both
breast fed infants have more BIFIDO BACTERIA and bottle fed infants have more LACTOBACILLUS in large intestines until solid food when BACTEROIDES replaces both
700 types in ____ (about __ fungi)
oral area, about 80 fungi
in the GU tract the upper regions are ___
sterile
urethra has ____ and some ____
urethra has STREP and some MYCOPLASMA
______ in vagina after birth, disappear until after puberty where they set up an acid condition, during menopause they are replaced by ___ and ____
LACTOBACILLI in vagina after birth, disappear until after puberty where they set up an acid condition, during menopause they are replaced by STREP and STAPH
yeast is found in __-___% of women
10-30%
respiratory tract is protected by ____, _____and ____
mucus, cilia, and bony barriers
staph and strep in _____ of respiratory system
upper regions
no organisms below ____
larynx
lung may contain ____ and _____ in dormancy
aspergillus and mycobacterium
there is also ____ and _____ in the lungs
chlamydia and pneumocystis
eye/ear are protected by ___ and ___
tearing and wax
___ and ____ may reside temporarily in the eye/ear
cocci and bacilli
____, ____ and ____ are always sterile
deep organs, blood, and CSF
infections may be ___/acute
chronic/acute
infections may be local/____ (_____)
local/general (systemic)
infections may be primary or ____
secondary
infections may be covert (______) or overt (______)
infections may be covert (subclinical) or overt (symptomatic)
infections may be pyogenic/______ (___ , ____)
pyogenic/pyrogenic (pus, fever)
infections may be ____/iatrogenic
nosocomial/iatrogenic
40% of nosocomials due to ____
enterics
10% of nosocomials due to ____, ____, ____
staph auerus, enterococcus, psedomonas
15% of nosocomials due to ___
c. difficile
most often nosocomial is ___
UTI
____ due to catheters
septicemia
highest fatality rate with _____ (______)
ventilators (pneumonia)
health care facilities have similar ____ rate as hospitals but higher __________ rate
health care facilities have similar STAPH rate as hospitals but higher PSEUDOMONAS-PNEUMONIAE rate
viral infections can exacerbate ____ and _____ in a synergism
allergies and asthma
______ infections involve more than one infectious agent acting together
polymicrobial
examples of polymicrobial infections: ____, _____, ____
GI infections, otitis media, vaginal infections
GI infections (____ and ____)
bacteria and viruses
vaginal infections due to ____ and ____
bacteria and yeast
____ and ____ build biofilms (employ ____)
pseudomonas and staph build biofilms (employ quorum sensing)
infection process steps (4):
- encounter with agent involves an ID 50
- pathogen acquired endogenously or exogenously
- entry via a portal
- dissemination
ID 50 = size of ___ needed to cause ____ in ____
size of inoculums needed to cause fatal infection in mice
ID50 for TB is
10
ID 50 for shigella is
100
ID50 for salmonella is
1000s
______: some infections are congenital or transplacental
endogenously
examples of ____ acquired infections:
treponema, herpes, HIV, hepatitis, rubella, toxoplasma, CMV (TORCH), listeria, ednovirus, borrelia, plasmodium
endogenously
____ - leads to encephalitis (heart, brain, liver damage)
borrelia
plasmodium is a ____
teratogen
opportunistic infections arise from _____
our own microflora
opportunistic infections post surgery or intestinal trauma (____) or following burns or skin lesions (_____)
opportunistic infections post surgery or intestinal trauma (bacteroides) or following burns or skin lesions (acinetobacter)
exogenous/enternal transmssion routes (5)
- body contact:
- fomites
- microdroplets and particles
- food and liquids: contaminated
- animals
body contact: contagious, such as transmission of STDs or through ___ and ____
blood and semen
___ and ___ most frequent STDs
chlamydia and gonorrhea
spirochetes in blood can be killed by _____
refrigeration
____ are objects that harbor infectious agents (clothing, bedding, utensils)
fomites
____ carry lowest amount while ___ and ____ are high carriers
metal carry lowest amount while wood and natural fabrics are high carriers
____ on any surface can encourage the growth of microbes
organic residues
microdroplets or particles: spread by ____, ____, ____, and ____
sneeze, cough, dust, skin shedding
___ stay suspended for months
spores
___ and ____ are good aerosoles
snow and humidifiers
cooling towers may aerosolize ____ or _____
legionella or acanthamoeba
dust can carry _____ for extensive distances (miles)
fungal agents
contaminated foods and liquids are called
vehicles
campylobacter ID50 =
10^3
campylobacter is present in milk or meat of poultry (especially if ____), cattle, sheep
especially if frozen
onset of food poisoning from campylobacter is
onset = 3 days
clostridium botulinum causes ___ from improperly ____
botulism from improperly canned foods
onset = ___-___ hrs for food poisoning from clostridium botulinum
4-36 hrs
e coli carried in ___ and _______
water, raw/undercooked meat
food poisoning from e coli onset = __-__ hours
onset = 10-72 hours
listeria ID50 =
10^8
___ found in soft cheese, raw milk, meat, ice cream, seafood
listeria
onset of food poisoning from listeria is __-__ days
onset = 3-5 days
salmonella ID50 = ___
10^7
____ is in raw/undercooked meat, poultry, eggs
salmonella
onset of salmonellosis __-__ hours
onset = 6-48 hrs
shigella ID50 =
10^2
____ can be in potato, chicken, tuna salads, raw foods
shigella
shigella food poisoning onset ___-__ hours
onset = 24-48 hrs
____ present in foods left at room temp, can grow well in foods high in sugar/salt
staph aureus
onset of food poisoning from staph aureus is __ hours
6 hrs
vibrio ID50 =
10^9
___ present in oysters, clams, muscles
vibrio
vibrio onset = __-__ hrs
1-8 hrs
____ from improper food handling and seafood from polluted waters
hepatitis a
onset of hepatitis a from food is __-__ days
onset = 15-50 days
bacillus cereus ID50 = 10^5
10^5
____ rice, sauces, beef
bacillus cereus
bacillus cereus onset = __-__ hours
5-6 hours
likely contamination sources _____, _____, ______
food handlers, wash water, slaughter splash
____ carry fewest pathogens
reptiles
entry via a portal requires a _____ at the site
receptor
____ may protect receptors like linkage site for hormones or nutrients
mucus
Dissemination: attachment via ____
adhesions
proteins, polysaccharides, and ____ assist in adhesions
fimbriae
strep has ___ proteins
strep has M proteins
microbes produce ____ like:
capsules, siderophores, enzymes,toxins
virulence factors
enzymes produced by microbes: _____, _____, ____, _____
proteases, catalase, coagulase, hemolysins
invasion may also employ _____ (ruffling) where host cell cytoskeleton fibers move bacteria
actin modulation
______ : groups of virulence genes that can be transmitted as a cluster
pathogenicity islands
example of pathogenicity islands ____ of helicobacter and ____ of staph
cag genes of helicobacter and SCC genes of staph
tissue damage may be CPEs (______)
cytopathogenic effects
tissue damage may involve obstruction (_____)
clotting
tissue damage may involve cell lysis (____)
necrosis
tissue damage may result in ____, ____, ____
metabolic change, edema, fever
in ____ infections, person may act as a carrier with no symptoms (ex is typhoid, hepatitis)
latent
_____: genetic shifts leading to new antigens, can also lead to reinfection
phase variation
TNF (______, a ____) blocks appetite (____)
TNF (tumor necrosis factor, a cytokine) blocks appetite (catchectic)
____ accelerate tissue destruction
toxins
_____: produced outside the organism, proteins, elicit antibody response, more neuro or cytotoxic, are heat sensitive
exotoxins
_____: lipopolysaccharides, fever inducing, less heat sensitive, part of sepsis
endotoxins
enzymatic toxin ____
hemolysins
pore forming toxin ____
RTX
toxins that inhibit protein synthesis ____,____
cytotoxins, diphtheria
toxins that disrupt immunity (____ or ____ such as ____)
superantigens or immunotoxins such as TSS
_____ toxins that disturb cAMP levels, causing leakage
enterotoxins
neurotoxins ______ (botulism)
block transmission
staph aureus is coagulase ___
positive
___ is resistant to salt/drying and likes oils and lower temp
s. aureus
s. aureus on ____ can cause:
abscess, carbuncle, impetigo, decubitus ulcer, furuncles (boils), sties, SSS
skin
intestinal s. aureus causes
enterocolitis
s. aureus skin infection seeding blood stream can cause:
____, ____, _____
osteomyelitis, cellulitis, endocarditis
s. aureus in GU tract causes
TSS
staph epidermidis is coagulase ____
negative
staph epidermidis is most prevalent on ___
skin
staph epidermidis causes endocarditis from ____ and _____
prosthetics and venous catheters
staph saprophyticus is coagulase ____
negative
staph saprophyticus is in the ____ and causes
____ in women (UTIs)
staph saprophyticus is in the urinary tract and causes
cystitis in women (UTIs)
staph virulence factors: ___, ____, ____, _____
protein a, FBP, biofilms, necrotic enzymes
____: ties up Ig
protein a
fibronectin binding protein (FBP): _______
promotes adhesion
______ hyaluronidase, lipase, protease, DNAse, hemolysins
necrotic enzymes
______ (breaks down hyaluronic acid which is a glue in CT)
hyaluronidase
virulent strain of staph is ____ hemolytic
beta hemolytic
toxins of ____: enterotoxin, exfoliative toxin, alpha toxin, TSS-1
staph
enterotoxin in involved in ___ toxemia
food
exfoliative toxin is a ____ of the skin that kills the ____ layer of the skin
exfoliative toxin is a CYTOTOXIN of the skin that kills the germinal layer of the skin
alpha toxin is a _____ that is _____ forming
alpha toxin is a leukocidin that is pore forming
strep pyogenes is serotype __
A
strep pyogenes is ___ hemolytic
beta
strep pyogenes is found in the ____ and ____
throat and skin
strep pyogenes PYR3 test ____
positive
strep pyogenes is inhibited by _____
bacitracin
PANDAS is involved with
strep pyogenes
____ diseases: pharyngitis, impetigo, rheumatic fever, erysipelas, glomerulonephritis, fasciitis
strep pyogenes
strep pyogenes may initiate _______ (rheumatic fever, glomerulonephritis) as well as scarlet fever and ______ (endometriosis)
strep pyogenes may initiate AUTOIMMUNE DISEASES (rheumatic fever, glomerulonephritis) as well as scarlet fever and PLEURPERAL FEVER (endometriosis)
strep agalactiae is serotype _
B
strep agalactiae is ___ hemolytic
beta
strep agalactiae is found in the _____
female genital tract
mother screened vaginally for _____ at 35 weeks gestation
strep agalactiae
strep agalactiae causes _____ and meningitis (1 week after birth)
neonatal sepsis
enterococcus faecalis is serotype __
D
enterococcus faecalis common in the ___
ICU
enterococcus faecalis has ___ and ____ hemolysis
none and alpha
enterococcus is found in the ___
colon
enterococcus faecalis shows growth in presence of ____ and hydrolyze esculin
bile
enteroccocus faecalis grows in 6.5% ___
NaCl
enteroccocus faecalis diseases: _____, ____, ____
abdominal abscess, UTI, endocarditis
streptococcus bovis is serotype ___
D
streptococcus bovis shows growth in presence of ___ and will hydrolyze esculin
bile and will hydroyze esculin
strep bovis shows _____ in 6.5% NaCl and degrades ___
strep bovis shows no growth in 6.5% NaCl and degrades starch
___ causes endocarditis and is a common isolate in colon cancer
strep bovis
strep bovis has ___ hemolysis
no
streptococcus equi: serotype __,__,__ and ____
C, F, G and untypable
strep equi is ___ hemolytic
beta
strep equi is found in the ___, ____, and ____
throat, colon, and female gentical tract
strep equi is ___ resistant and PYR ___
bacitracin resistant and PYR negative
_____: s. mitis, s. salivarius, s. mutans
viridans streptococci
viridians streptococci serotype =
untypable
virians streptococci are ___ and ___ hemolysis
alpha and no
viridians streptococci are found in the _____, ____, ____, and _____
ORAL CAVITY, throat, colon, female genital tract
viridians streptococci are ____ resistant and soluble in ___
opochtin resistant and soluble in bile
___ cause dental caries
s. mutans
endocarditis and abscesses caused by
viridians streptococci
_______ typed by capsule antigens
streptococcus pneumoniae
strep pneumoniae are ____ hemolytic
alpha
strep pneumoniae are found in the ____ and are susceptible to _____
strep pneumoniae are found in the throat and are susceptible to optochin
strep pneumoniae colonies soluble in ___
bile
strep pneumoniae are quellung reaction ___
positive
strep pneumoniare cause deadly ____, ____, _____
deadly pneumoniae, meningitis, endocarditis
virulence factors of ____: m-protein, hyaluronic capsule, protein g, protein f, hemolysins, streptokinase, C5 peptidase, erythrogenic toxins, cytotoxins, superantigens, TSST-A
strep
m-protein (____) for _____
(group a) for colonization
protein g - _____
ties up Ig
protein f - for _____
adhesion
hemolysins - __ and ___
O and S
_______ diseases: meningitis in children under 4, otitis media in children
H. influenzae type b
virulence of _____: capsule, IgA protease, cytolethal toxin (CDT)
H. influenza type b
transmission of H. influenza type b:
inhalation of respiratory droplets
H. influenzae are _____
nonencapsulated
diseases of H. influenzae: ____ in children, ____ in elderly
otitis media in children, pneumonia in elderly
H. influenzae transmission: ______ or ______
inhalation of respiratory droplets or mother to newborn
h. ducreyi causes ___ in men and is transmitted by ___
chancroid in men and is transmitted by STD
bordetella causes ____/______
pertussis/whooping cough
whooping cough _____stage (cold) and _____ stage (cough)
whooping cough catarrhal stage (cold) and paroxysmal stage (cough)
virulence factors of ____: filamentous, hemagglutinin, pertussis toxin, cAMP, adenylate, cyclase, tracheal cytotoxin
bordetella
bordetella transmission: inhalation of _____ generated by _____
inhalation of aerosols generated by infected individuals
bordetella has only ___ carriers
human carriers
_____ is encapsulated, aerobic, and a gram + rod
anthrax
anthrax produces highly resistant
spores
_____ anthrax is the most common
cutaneous
with cutaneous anthrax ___ forms and turns into a ____ in 7-10 days
with cutaneous anthrax PAPULAR LESION forms and turns into a BLACK ESCHAR in 7-10 days
____ anthrax is not lethal
cutaneous
___ anthrax occurs after eating undercooked meat or dairy products from infected animals
GI
GI anthrax incubation period is __-__ days
1-7 days
____/____ anthrax is the rarest and most deadly form
inhalation/respiratory
respiratory/inhalation anthrax incubation period is ___ week to __ months
one week- 2 months
with respiratory/inhalation anthrax you first develop ____ and ____ and death occurs within __-__ hours
nonspecific signs and symptoms and death occurs within 24-36 hours
virulence of respiratory/inhalation anthrax virulence:
____ and __ toxins
protein capsule and 3 toxins
list the three respiratory/inhalation anthrax toxins
PA - attachment
EF
LF - cell destruction
virulence of _____: Fra in capsule, V and W factors , exotoxins, coagulase, Pla protease, siderophores, type III secretion, Yop gene products, 3 virulence plasmids
yersinia pestis
Fra in capsule is _____
antiphagocytic
exotoxins shut down ___
TNF
Pla protease - degrades __
c3
type III secretion that disrupts ____ and ____ of ____ and induces type III secretion that disrupts actin and induces _____ in macrophages
type III secretion that disrupts actin and proteins of phagocytosis and induces apoptosis in macrophages
3 virulence plasmids of yersinia pestis:
capsule, Pla, L cr V
____ induces IL and binds to TLR2 to downregulate immunity
L cr V
urban cycle, _____ , 7 day incubation
cutaneous route
_____ has droplet spread and a 3 day incubation
secondary pneumonic plague
secondry pneumonic plague has ___% fatality
75%
_____ 5% of the world’s population infected with it and it causes 2-3 million deaths per year
mycobacterium
virulence of ____: mycolic acids, glycolipids of wall, sulfolipid, proteins in wall (PPD)
mycobacterium
sulfolipid that inhibits
phagocytosis
proteins in wall (PPD) used for
tuberculin mantoux test
m. tb infects ___ and ____
humans and elephants
m. avian complex (MAC) from ____ infects _______
from water ingfects immunocompromised
langerhans cells from TB are _____
fused macrophages
___ killing of infected phagocytes, stops infection in about 1 month
CD8
_____: walled off area with mycobacteria (in people with OK defenses)
tubercles
granulomas: _____
encapsulated
_____: hardened tubercle, calcification
ghon complex
91% have ____ TB
latent
_____ - organism into lung tissue
caseation
______ (in immunocompromised), rip up lungs
tuberculous cavities
tuberculous cavities become
disseminated TB (miliary)
enterotoxigenic (____): causes diarrhea and infants are very susceptible
ETEC
ETEC colonizes _____
proximal small intestine
ETEC virulence:
- heat labile (__) _____
- heat stable (__) _____
- CFA - ________
- heat labile (LT) cholera toxin
- heat stable (ST) enterotoxin
- CFA - fimbrial adhesin colonization factor
enteropathogenic (____): has distinctive lesions
and colonizes the proximal intestine
EPEC
EPEC virulence:
- _____ like shiga toxin
- ____ (cling to intestine)
- ___ like virulence proteins
- cytotoxin like shiga toxin
- intimin (cling to intestine)
- YOP like virulence proteins
enteroinvasive (___): causes severe abdominal cramps and gross dysentery with bloody stools and mucus
EIEC
EIEC has a predilection for ____ of ____
mucosa of colon
EIEC virulence: ____ toxin
shiga like
enterohemorrhagic (___): originated in cattle
EHEC
EHEC ID50 = __
50
EHEC is also known as the _____ strain which causes HUS
O157:H7
EHEC colonizes in the
proximal intestine
EHEC virulence: is a ______ (____ and ____) related to shiga toxin
verotoxin (STX1 and STX2)
enteroaggregative (____): colonizes the small intestine
EAEC
EAEC virulence: is _____/”____”
intimin/”stacked bricks”
0104:H4 new strain,____, has shiga toxins
STEC
salmonella ____ causes typhoid fever
s. typhi
virulence of ____: type III secretion, CDT toxin, OxyR, AB exotoxin
salmonella
type III secretion (___)
sips
OxyR - _____ so it can travel in WBC
neutralizes peroxides
AB exotoxin (___) - is a ____
AB exotoxin (STX) - is a cytotoxin
Shigella: occupies the ______ and causes _____
large intestine, bacillary dysentery
Shigella virulence:
- type III secretion system (_____)
- macrophage ____
- type III secretion system (IPA protein)
- macrophage apoptosis
Vibrio cholerae: _____, produces hemolysin
El Tor biotype
Vibrio cholerae increase levels of cAMP and results in _______ of water and electrolytes
hypersecretion
Pseudomonas: cause ___ and ___ infection
ear and eye
Pseudomonas have _____ enzymes
extracellular
Extracellular enzymes of pseudomonas include: ____, phospholipase __, heat stable _____, _____ - tissue necrosis
proteases, phospholipase C, heat stable glycolipid, exotoxin A - tissue necrosis
Neisseria have _____ and ____
gonococci and meningococci
Neisseria have ___/___ that enhance attachment and resistance to phagocytosis
fimbriae/pili
_____: por extends through gonococcal cell membrane enhances survival in leukocytes (in neisseria)
por/protein 1
_____: adhesion of gonococci within colonies and in attachment (tan adhesin)
Opa/protein 2
lipooligosaccharide is associated with
neisseria
neisseria produces ___ protease (in mucosal Ig of humans)
IgA1 protease
neisseria attack mucus membranes of ____, ____, ____, and ___
GU tract, eye, rectum, throat
Neisseria causes ______ (infection of eye in newborn)
gonococcal ophthalmia neonatorum
______ is responsible for many of the toxic effects found in meningococcal disease
meningococcal LPS
_____ is encountered in nosocomial pneumonias (originates in water of humidifiers or vaporizers)
acinetobacter
acinetobacter bacteremia results from ______
IV catheters
____ is an opportunistic pathogen with burns, can produce sepsis
acinetobacter
