Fastidious Gram Negative Rods Flashcards

1
Q

How could you identify a culture of Haemophilus influenzae?

gram stain?

motility?

growth requirements?

What cultures do they grow on?

where do they typically colonize?

mode of transmission?

A
  • gram stain?
    • gram negative coccobacilli (pleomorphic)
  • motility?
    • non-motile
  • growth requirements?
    • fastidious
    • facultative
    • X+V growth factors (hemin & NAD)
  • Cultures grow on?
    • Grow on chocolate agar
    • do NOT grow on blood agar
      • can grow on blood agar as satellite colonies around S. aureus (bc it excretes NAD & yields hemin from degradign RBC)
  • where do they typically colonize?
    • nasopharynx
    • sample from CSF in patient with meningitis
  • airborne transmission
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2
Q

What are the major virulence factors of Haemophilus influensae?

A
  • pili and non-pilus structures (help w/ adherence)
  • type b capsules contain ribose, ribitol, phosphate
    • responsible for >95% invasive infections
    • rare b/c Hib vaccine
  • invasive disease in vaccinated ‘A’
  • polyribitol phosphate (PRP) is a major virulence factor
  • antiphagocytic, role in immune evasion & systemic disease
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3
Q

What disease is characterized by the following symptoms?

  • initially mild URT disease (fever & systemic signs); headache; confusion
  • high level bacteremia (in CSF & blood)
  • patients is not immunized

What is the likely bacterial source?

A

meningitis

H. influenzae (serotype B)

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4
Q

What disease is characterized by the following symptoms?

  • patient is 2-4 years old
  • swollen epiglottis & aryepiglottic folds
  • patients appear restless, pale, or cyanotic, tachycardiv

What is the probable bacterial cause?

A

Epiglottitis

H. influenzae (serotype b)

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5
Q

What disease is characterized by the following symptoms?

Problems with a single large, weight bearing joints in children

(was a most common cause in chldren younger than 2 before vaccine)

What is the probable bacterial cause?

A

Septic arthritis

H. influenzae

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6
Q

What disease can un-encapsulated (non-typeables) H. influenzae cause?

A
  • pneumonia
  • otitis media
  • conjunctivitis
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7
Q

What are the 5 bacteria that are most likely to cause otitis media?

A
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8
Q

What disease is characterized byt the following symptoms?

initially conjuctivitis

days to weeks later – high fever, vomiting, abdominal pain

In 12-48 hrs - petechiae, purpura, shock–> death

What bacteria is the likely cause?

A

Brazilian purpuric fever

H. influenzae aegyptius

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9
Q

How could you identify a disease caused by H. ducreyi?

How well does it culture?

gram stain?

A
  • Does not culture well
  • gram stain of lesion maerial
    • grma negative coccobacilli w/ PMN
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10
Q

What disease is characterized by the following symptoms?

4-7 days after sex papule w/ edema; then 2-3 days later it ruptures

painful genital ulcers and inguinal lymphadenitis in men

asymptomatic in women

A

Chancroid

Haemophilus ducreyi

susceptible to drying out

STD

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11
Q

What are the species members of the HAECK group?

A
  • H. parainfluenzae
  • H. aphrophilus
  • H. paraphrophilus
  • Aggregatibacter actinomycetemcomitans
  • Cardiobacterium hominis
  • Eikenella corrodens
  • Kingella kingae
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12
Q

How could you identify culture containing one of the HAECK bacteria?

Gram stain?

Growth requirements?

Where are they naturally located?

A
  • gram (-) small rods
  • growth requirement
    • fastidious – can grow slowly on blood agar
  • Location
    • URT & oral cavity
    • 10% saliva bacteria
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13
Q

What are the major diseases caused by HAECK species?

A
  • S/A endocarditis
    • infection of the inner lining of the heart
    • nonspecific symptoms (fever, malaise, shortness of breath)
    • diagnosed by culture, echocardiography, history and symptoms
  • Septic arthritis
  • bite wound
  • periodontal diseases
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14
Q

How could you identify a culture of Bordetella?

Gram stain?

growth requirement?

preferred agar?

How is it transmitted?

What disease does it cause?

If suspected, how should you take a sample?

A
  • Gram stain
    • gram (-) cocobacillus
  • Requires X & V factors & enriched mediumm
    • Regan-Lowe charcoal agar preferred over Bordet-Gengou
  • Transmitted via aerosolized droplets
  • Pertussis (whooping cough)
  • use dacron or rayon swabs (not cotton)
    • sensitive to FA (cotton swabs rich in FA)
    • from posterior nasopharynx
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15
Q

What are the major virulence virulence factors employed by B/ pertussis?

A
  • Adhesins
    • Fha & Pertactin: agglutinates RBC
    • Pertussis Toxin
  • Toxins
    • Pertussis Toxin: increases cAMP
    • Adenylate cyclase: increases cAMP
    • Trachael cytotoxin: kills ciliated cells
    • LPS: lipid A or lipid X
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16
Q

What is the pathogenesis a pertussis infection?

Describe the progression of symptoms.

A
  • Pathogenesis
    • bacterial adhesion attach to ciliated cells
    • They replicate at the site of attachment & persis intra-cellularly
    • toxins produced are responsible for effects (lymphocytosis)
  • Disease Progression
    1. Catarrhal stage: 7-10 days post exposure & lasts 1-2 weeks
      • coryza, lacrimation, mild cough, low fever, and malaise
    2. Paryoxysmal phase:
      • cough more frequent & spasmodic
      • repetition >10 cough
      • vomiting is frequent - ends with a whoop
    3. Convalescent stage: in 2-4 weeks; may last 1-3 months
      1. cough less frequent & severe
      2. can result in seizure & encephalopathy
        1. may be do to hypoxia
        2. or specific bacterial product
17
Q

What are they symptoms of pertussis in infants?

A
18
Q

What are the 4 genera included in Legionellaceae?

Which species causes 90% of all infections

A
  • 4 genera
    • Legionella, Fluoribacter, Tatlockia, Sarcobium
  • L. pneumophila (serotypes 1 & 6)
19
Q

How could you identify a sample of Legionellaceae pneumophila?

Gram stain?

growth requirement?

Agar?

mode of transmission?

natural location?

A
  • Gram stain
    • gram negative, pleomorphic (stain poorly)
  • Growth requirement
    • slow growth (3-5d)
    • FA intolerant
    • require cysteine
  • Agar
    • buffered charcoal yeast extract (BCYE) agar
  • Transmitted through inhalatin of aerosols
  • Found in freshwater environment
20
Q

What is the pathogenisis of a Legionella infection?

A
  • enters lungs through aspiration/inhalation
  • OMPs help binding to alveolar macrophages & induce phagocytosis
  • blocks acidification (prevents lysosome-phagosome fusion)
  • remains intracellular (proliferates until cell ruptures)
  • Severe disease in CMI defect 40+
21
Q

What disease is characterized by the following symptoms?

self-limitin flue-like illness after 24-48 hrs (no pneumonia)

malaise, fatigue, myalgia and fever

What is the likely bacterial cause?

A

Pontiac fever

Legionella

22
Q

What disease is characterized by the following symptoms?

cough, shortness of breath, high fever, muscle ache, headache

multi-organ involvement: GI symptoms (nausea, vomiting)

alveolar infiltrates

What is the likely bacterial cause?

A

Legionnaires’ disease (Pneumonia)

Legionella