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PHD-2 Micro > Gram Positive Bacteria > Flashcards

Gram Positive Bacteria Flashcards

1
Q

Streptococcus pyogenes / Grp A Strep – micro ID

A

Gram positive chain cocci
Catalase neg
Beta hemolytic
Bacitracin disk sensitive

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2
Q

Streptococcus pyogenes / Grp A Strep – Epidemiology

A

young children

skin colonizer

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3
Q

Streptococcus pyogenes / Grp A Strep – pathogenesis / virulence factor

A
  1. antiphagocytic M protein and polysaccharide capsule
  2. pyogenic invasion via hyaluronidase, streptolysis/hemolysins, DNase
  3. Exotoxins as Super-Ag for T cell stimulation
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4
Q

Streptococcus pyogenes / Grp A Strep – clinical presentation

A
  1. pyogenic – pharyngitis, skin infection (cellulitis, necrotizing fasciitis)
  2. exotoxin mediated: TSS
  3. Immunologic: rheumatic fever, post-strep glomerulonephritis
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5
Q

Streptococcus pyogenes / Grp A Strep – tx

A

penicillin

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6
Q

Streptococcus pyogenes / Grp A Strep – prevention

A

no vaccine

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7
Q

Streptococcus agalactiae / Grp B Strep – micro ID

A 
gram positive chain cocci
catalase negative
beta hemolytic
Bacitracin disk resistant
Hippurate hydrolysis
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8
Q

Streptococcus agalactiae / Grp B Strep – epidemiology

A

neonates

Colonizes female genital tract and normal GI flora

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9
Q

Streptococcus agalactiae / Grp B Strep – Clinical

A
  1. maternal-neonate infections (neonatal sepsis & meningitis)
  2. Skin & soft tissue infxns (cellulitis)
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10
Q

Streptococcus agalactiae / Grp B Strep – tx

A

penicillin

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11
Q

Streptococcus agalactiae / Grp B Strep – prevention

A

screen pregnant women for Grp B strep carriage

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12
Q

Streptococcus pneumoniae —micro ID

A

gram positive diplococci
catalase negative
alpha hemolytic
optochin disc sensitive

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13
Q

Streptococcus pneumoniae — epi

A

young, old, IC

Nasopharynx colonizer

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14
Q

Streptococcus pneumoniae — pathogenesis

A
  1. colonizes oropharynx with surface adhesion proteins

2. immune evasion via IgA protease and polysacc capsule

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15
Q

Streptococcus pneumoniae — – clinical

A
  1. community acquired pneumonia
  2. bacterial meningitis
  3. otitis media
  4. bacterial sinusitis
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16
Q

Streptococcus pneumoniae — tx

A

pen/amox for otitis or sinusitis

Ceftriaxone (IV) for meningitis or pneumonia

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17
Q

Streptococcus pneumoniae — prevention

A
  1. conjugate vacccine for infants, IC, >65yo

2. polysacch vaccine for adults >65

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18
Q

Viridans group streptococcus – ID

A

gram positive diplococci and short chain cocci
catalase negative
alpha hemolytic
optochin disk resistant

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19
Q

Viridans group streptococcus – epi

A

normal oral flora

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20
Q

Viridans group streptococcus – clinical

A

endocarditis

dental caries

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21
Q

Viridans group streptococcus – tx

A

penicillin

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22
Q

Viridans group streptococcus – prevention

A

abx prophylaxis only for high risk persons around dental surgery

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23
Q

Enterococcus – ID

A

Gram positive cocci
catalase negative
gamma hemolytic

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24
Q

Enterococcus – epi

A

normal GI flora

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25
Q

Enterococcus – pathogenesis

A

resistant to many abx

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26
Q

Enterococcus – clinical

A
  1. intra-abdominal infxn
  2. endocarditis
  3. line (catheter) infxn
  4. UTI
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27
Q

Enterococcus – tx

A
  1. drain abscess

2. amp/vanco

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28
Q

Staphylococcus aureus: direct invasion – micro ID

A

gram positive cocci clusters
catalase positive
beta hemolytic
coagulase positive

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29
Q

Staphylococcus aureus: direct invasion – epi

A
  • nasopharynx colonizer

- @ risk: ppl with genetic susceptibility, live in heavily contaminated environment, IVDU, IC

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30
Q

Staphylococcus aureus: direct invasion – pathogenesis

A
  1. colonization via techoic acid
  2. entry via skin defect
  3. hematogenous spread via protein A and polysach capsule
  4. metastatic infxn
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31
Q

Staphylococcus aureus: direct invasion – clinical

A
  1. skin abscess
  2. psoas abscess
  3. pyomyositis
  4. epidural abscess
  5. endocarditis
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32
Q

Staphylococcus aureus: direct invasion – tx

A

Nafcillin
Cefazolin
Vancomycin

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33
Q

Staphylococcus aureus: direct invasion – prevention

A

no vaccine
wash hands
chemoprophylaxis

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34
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – ID

A 
same as staph aureus direct invasion: 
gram positive cocci clusters
catalase positive
beta hemolytic
coagulase positive
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35
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – epi

A
  • nasopharynx colonizer **STAPH LIVES IN THE NOSE

* *same as staph aureus direct invasion

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36
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – pathogenesis

A

TOXIN-mediated
toxin (TSsT) released from staph in tampons, nasal packing, or skin infxns –> toxin is superantigen that activates T cells without needing MHC presentation

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37
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – clinical

A
  1. septic shock
  2. diffuse erythrodermic rash
  3. multi-organ dysfxn
    * *Dx: culture is usually negative b/c it’s a toxin mediated dz
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38
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – tx

A

remove packing

supportive tx

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39
Q

Staphylococcus aureus: toxic shock syndrome (TSS) – prevention

A

reduce time of packing

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40
Q

Staphylococcus aureus: scalded skin syndrome (SSS) – ID

A 
same as staph aureus direct invasion: 
gram positive cocci clusters
catalase positive
beta hemolytic
coagulase positive
41
Q

Staphylococcus aureus: scalded skin syndrome (SSS) – epi

A

neonates

42
Q

Staphylococcus aureus: scalded skin syndrome (SSS) – pathogenesis

A

TOXIN MEDIATED: exfoliative toxin –> protease cleaves desmosomes –> stratum corneum splits from stratus granulosum –> separation of epidermis

43
Q

Staphylococcus aureus: scalded skin syndrome (SSS) – clinical

A

blisters

skin sluffing

44
Q

Staphylococcus aureus: scalded skin syndrome (SSS) – tx

A

antibacterial creams/lotions

supportive tx

45
Q

Staphylococcus aureus: food poisoning – ID

A 
same as staph aureus direct invasion
gram positive cocci clusters
catalase positive
beta hemolytic
coagulase positive
46
Q

Staphylococcus aureus: food poisoning – epi

A

food is left out

47
Q

Staphylococcus aureus: food poisoning – pathogenesis

A

TOXIN MEDIATED DZ: preformed enterotoxin on food –> acts as super-ag that activates T cells –> massive cytokine release –> rapid onset

48
Q

Staphylococcus aureus: food poisoning – clinical

A

vomiting and watery diarrhea

49
Q

Staphylococcus aureus: food poisoning – tx

A

supportive

50
Q

Staphylococcus aureus: food poisoning – prevention

A

refrigeration

wash hands

51
Q

Staphylococcus epidermidis –ID

A

gram positive cocci clusters
catalase positive
non-hemolytic
coagulase negative

52
Q

Staphylococcus epidermidis – epi

A

ppl with catheters, prosthetic implants, DEVICES DEVICES DEVICES
**if found on culture of someone without device, it’s a contaminant from normal skin/mucus colonizer

53
Q

Staphylococcus epidermidis – pathogensis

A

sticky: more adherent to devices if produces glycocalyx –> biofilm

54
Q

Staphylococcus epidermidis – clinical

A
  1. catheter infection
  2. prosthetic heart valve –> endocarditis
  3. vascular graft infection
  4. prosthetic joints –> osteomyelitis
55
Q

Staphylococcus epidermidis – tx

A

remove device

abx

56
Q

Staphylococcus epidermidis – prevention

A

catheter insertion protocol

57
Q

Staphylococcus saprophyticus – ID

A

gram positive cocci clusters
catalase positive
nonhemolytic
coagulase negative

58
Q

Staphylococcus saprophyticus – epi

A

sexually active women

59
Q

Staphylococcus saprophyticus – clinical

A

UTI

60
Q

Staphylococcus saprophyticus – tx

A

antibiotics

61
Q

Staphylococcus saprophyticus – prevention

A

post coital voiding

62
Q

Diphtheria (corynebacterium diphtheria) – ID

A

gram positive rods

aerobe

63
Q

Diphtheria (corynebacterium diphtheria) – epi

A

respiratory droplets

@risk - unvaccinated kids

64
Q

Diphtheria (corynebacterium diphtheria) – pathogenesis

A

exotoxin – diphtheria exotoxin acquired via bacteriophage with toxin gene –> inhibits protein synthesis via ADP ribosylation of elongation factor –> cell death

65
Q

Diphtheria (corynebacterium diphtheria) – clinical

A

fever
pharyngitis
respiratory compromise – GREY FILM IN THROAT
systemic sx if toxin reaches blood

66
Q

Diphtheria (corynebacterium diphtheria) – tx

A

abx + anti-toxin

67
Q

Diphtheria (corynebacterium diphtheria) – prevention

A

toxoid vaccine

68
Q

Listeria – ID

A

gram positive rod

aerobe

69
Q

Listeria – epi

A

lives in soil & decaying vegetable matter

  • outbreaks in deli meats and cantaloupe
  • *immune response against listeria is cell mediated, so IC pts are at risk for infnx
70
Q

Listeria – pathogenesis

A
  1. invasion: internalin binds E-cadherin –> allows entry into placenta and across BBB
  2. survival: listeriolysin –> escapes phagosomes
  3. spread: actin rockets
71
Q

Listeria – clinical

A
  1. immunocompromised/elderly/neonates – MENINGITIS
  2. maternal-fetal infxn: mother with febrile illness, fetal death or newborn illness
  3. normal host: febrile GI illness
72
Q

Listeria – tx

A

ampicillin

73
Q

Listeria – prevention

A

avoid high risk foods for pregnant and IC pts (no deli meats)

74
Q

Anthrax – ID

A

gram positive rods in boxcar chains

aerobe

75
Q

Anthrax – epi

A
  • normal host is cattle/animals
  • spore forming bacteria dormant for years
  • @risk if exposure to areas of infected animals or bioterrorism
76
Q

Anthrax – pathogenesis

A

anthrax TOXINS:

  1. protective Ag – forms pore in cell
  2. Edema factor – adenlyate cyclase that inc cAMP in cell –> fluid comes out –> edema
  3. lethal factor – protease that inhibits cell growth
77
Q

Anthrax – clinical

A
  1. cutaneous: necrotic ulcer, local inflammation
  2. inhalation: mediastinal LAD –> hemorrhagic mediastinitis
  3. GI: intestinal ulceration and edema
78
Q

Anthrax – tx

A

antibacterials

79
Q

Anthrax – prevention

A

post exposure – antibacterials, monoclonal ab

Pre-exposure – vaccine

80
Q

Nocardia – ID

A

gram positive rod in branched chains
aerobe
weakly acid fast

81
Q

Nocardia – epi

A

soil

opportunistic infxn, so IC pts at risk

82
Q

Nocardia – pathogenesis

A

inhaled

-need T cells to kill it, so IC pts at risk

83
Q

Nocardia – clinical

A

lung nodules to brain

84
Q

Nocardia – tx

A

TMP-SMX to inhibit folid acid synthesis

85
Q

Nocardia – prevention

A

avoid immunosuppressants if possible

86
Q

Actinomyces – ID

A

gram positive rod in branched chains

Anaerobe

87
Q

Actinomyces – epi

A

normal oral flora

88
Q

Actinomyces – clinical

A

path slides show “sulfur granules”

-sinus tracts in jaw (cervicofacial dz when ppl have poor dentition and bacteria grows)

89
Q

Actinomyces – tx

A

penicilin

90
Q

Actinomyces – prevention

A

dental hygeine

91
Q

How to tell Actinomyces from Nocardia, since both are gram positive branching rods

A
  1. N = aerobic ; A = anaerobic
  2. Dx N by weakly acid fast; Dx A by pathology slide of “sulfur granules”
  3. Dz in N is pulm and CNS in IS hosts; Dz in A is sinus tracts in jaw
92
Q

propionibacterium acnes – ID

A

gram positive rod

anaerobe

93
Q

propionibacterium acnes – epi

A

normal skin flora

94
Q

propionibacterium acnes – pathogenesis

A

often just a contaminant associated with acne but can also grow on prosthetics

95
Q

propionibacterium acnes – clinical

A

acne (rarely pathogenic)

96
Q

Lactobacillus sp – ID

A

gram positive rod

anaerobe

97
Q

Lactobacillus sp – epi

A

normal vaginal flora

98
Q

Lactobacillus sp – clinical

A

loss/disruption of nromal vaginal –> bacterial vaginosis/UTIs (rare)

PHD-2 Micro (2 decks)

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