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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
Enterococcus -- pathogenesis
resistant to many abx
26
Enterococcus -- clinical
1. intra-abdominal infxn 2. endocarditis 3. line (catheter) infxn 4. UTI
27
Enterococcus -- tx
1. drain abscess | 2. amp/vanco
28
Staphylococcus aureus: direct invasion -- micro ID
gram positive cocci clusters catalase positive beta hemolytic coagulase positive
29
Staphylococcus aureus: direct invasion -- epi
- nasopharynx colonizer | - @ risk: ppl with genetic susceptibility, live in heavily contaminated environment, IVDU, IC
30
Staphylococcus aureus: direct invasion -- pathogenesis
1. colonization via techoic acid 2. entry via skin defect 3. hematogenous spread via protein A and polysach capsule 4. metastatic infxn
31
Staphylococcus aureus: direct invasion -- clinical
1. skin abscess 2. psoas abscess 3. pyomyositis 4. epidural abscess 5. endocarditis
32
Staphylococcus aureus: direct invasion -- tx
Nafcillin Cefazolin Vancomycin
33
Staphylococcus aureus: direct invasion -- prevention
no vaccine wash hands chemoprophylaxis
34
Staphylococcus aureus: toxic shock syndrome (TSS) -- ID
``` same as staph aureus direct invasion: gram positive cocci clusters catalase positive beta hemolytic coagulase positive ```
35
Staphylococcus aureus: toxic shock syndrome (TSS) -- epi
- nasopharynx colonizer **STAPH LIVES IN THE NOSE | * *same as staph aureus direct invasion
36
Staphylococcus aureus: toxic shock syndrome (TSS) -- pathogenesis
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
37
Staphylococcus aureus: toxic shock syndrome (TSS) -- clinical
1. septic shock 2. diffuse erythrodermic rash 3. multi-organ dysfxn * *Dx: culture is usually negative b/c it's a toxin mediated dz
38
Staphylococcus aureus: toxic shock syndrome (TSS) -- tx
remove packing | supportive tx
39
Staphylococcus aureus: toxic shock syndrome (TSS) -- prevention
reduce time of packing
40
Staphylococcus aureus: scalded skin syndrome (SSS) -- ID
``` same as staph aureus direct invasion: gram positive cocci clusters catalase positive beta hemolytic coagulase positive ```
41
Staphylococcus aureus: scalded skin syndrome (SSS) -- epi
neonates
42
Staphylococcus aureus: scalded skin syndrome (SSS) -- pathogenesis
TOXIN MEDIATED: exfoliative toxin --> protease cleaves desmosomes --> stratum corneum splits from stratus granulosum --> separation of epidermis
43
Staphylococcus aureus: scalded skin syndrome (SSS) -- clinical
blisters | skin sluffing
44
Staphylococcus aureus: scalded skin syndrome (SSS) -- tx
antibacterial creams/lotions | supportive tx
45
Staphylococcus aureus: food poisoning -- ID
``` same as staph aureus direct invasion gram positive cocci clusters catalase positive beta hemolytic coagulase positive ```
46
Staphylococcus aureus: food poisoning -- epi
food is left out
47
Staphylococcus aureus: food poisoning -- pathogenesis
TOXIN MEDIATED DZ: preformed enterotoxin on food --> acts as super-ag that activates T cells --> massive cytokine release --> rapid onset
48
Staphylococcus aureus: food poisoning -- clinical
vomiting and watery diarrhea
49
Staphylococcus aureus: food poisoning -- tx
supportive
50
Staphylococcus aureus: food poisoning -- prevention
refrigeration | wash hands
51
Staphylococcus epidermidis --ID
gram positive cocci clusters catalase positive non-hemolytic coagulase negative
52
Staphylococcus epidermidis -- epi
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
Staphylococcus epidermidis -- pathogensis
sticky: more adherent to devices if produces glycocalyx --> biofilm
54
Staphylococcus epidermidis -- clinical
1. catheter infection 2. prosthetic heart valve --> endocarditis 3. vascular graft infection 4. prosthetic joints --> osteomyelitis
55
Staphylococcus epidermidis -- tx
remove device | abx
56
Staphylococcus epidermidis -- prevention
catheter insertion protocol
57
Staphylococcus saprophyticus -- ID
gram positive cocci clusters catalase positive nonhemolytic coagulase negative
58
Staphylococcus saprophyticus -- epi
sexually active women
59
Staphylococcus saprophyticus -- clinical
UTI
60
Staphylococcus saprophyticus -- tx
antibiotics
61
Staphylococcus saprophyticus -- prevention
post coital voiding
62
Diphtheria (corynebacterium diphtheria) -- ID
gram positive rods | aerobe
63
Diphtheria (corynebacterium diphtheria) -- epi
respiratory droplets | @risk - unvaccinated kids
64
Diphtheria (corynebacterium diphtheria) -- pathogenesis
exotoxin -- diphtheria exotoxin acquired via bacteriophage with toxin gene --> inhibits protein synthesis via ADP ribosylation of elongation factor --> cell death
65
Diphtheria (corynebacterium diphtheria) -- clinical
fever pharyngitis respiratory compromise -- GREY FILM IN THROAT systemic sx if toxin reaches blood
66
Diphtheria (corynebacterium diphtheria) -- tx
abx + anti-toxin
67
Diphtheria (corynebacterium diphtheria) -- prevention
toxoid vaccine
68
Listeria -- ID
gram positive rod | aerobe
69
Listeria -- epi
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
Listeria -- pathogenesis
1. invasion: internalin binds E-cadherin --> allows entry into placenta and across BBB 2. survival: listeriolysin --> escapes phagosomes 3. spread: actin rockets
71
Listeria -- clinical
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
Listeria -- tx
ampicillin
73
Listeria -- prevention
avoid high risk foods for pregnant and IC pts (no deli meats)
74
Anthrax -- ID
gram positive rods in boxcar chains | aerobe
75
Anthrax -- epi
- normal host is cattle/animals - spore forming bacteria dormant for years - @risk if exposure to areas of infected animals or bioterrorism
76
Anthrax -- pathogenesis
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
Anthrax -- clinical
1. cutaneous: necrotic ulcer, local inflammation 2. inhalation: mediastinal LAD --> hemorrhagic mediastinitis 3. GI: intestinal ulceration and edema
78
Anthrax -- tx
antibacterials
79
Anthrax -- prevention
post exposure -- antibacterials, monoclonal ab | Pre-exposure -- vaccine
80
Nocardia -- ID
gram positive rod in branched chains aerobe weakly acid fast
81
Nocardia -- epi
soil | opportunistic infxn, so IC pts at risk
82
Nocardia -- pathogenesis
inhaled | -need T cells to kill it, so IC pts at risk
83
Nocardia -- clinical
lung nodules to brain
84
Nocardia -- tx
TMP-SMX to inhibit folid acid synthesis
85
Nocardia -- prevention
avoid immunosuppressants if possible
86
Actinomyces -- ID
gram positive rod in branched chains | Anaerobe
87
Actinomyces -- epi
normal oral flora
88
Actinomyces -- clinical
path slides show "sulfur granules" | -sinus tracts in jaw (cervicofacial dz when ppl have poor dentition and bacteria grows)
89
Actinomyces -- tx
penicilin
90
Actinomyces -- prevention
dental hygeine
91
How to tell Actinomyces from Nocardia, since both are gram positive branching rods
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
propionibacterium acnes -- ID
gram positive rod | anaerobe
93
propionibacterium acnes -- epi
normal skin flora
94
propionibacterium acnes -- pathogenesis
often just a contaminant associated with acne but can also grow on prosthetics
95
propionibacterium acnes -- clinical
acne (rarely pathogenic)
96
Lactobacillus sp -- ID
gram positive rod | anaerobe
97
Lactobacillus sp -- epi
normal vaginal flora
98
Lactobacillus sp -- clinical
loss/disruption of nromal vaginal --> bacterial vaginosis/UTIs (rare)

PHD-2 Micro (2 decks)

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