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DMD 5245 > Gram positive pathogens (complete) > Flashcards

Gram positive pathogens (complete) Flashcards

1
Q

Are Staphylococcus normal flora

A

yes, but they can be opportunistic pathogens

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2
Q

What are the nine groups of Gram positive pathogens we study

A
  1. Staphylococcus Aureus
  2. Streptococcus Pyogenes (A)
  3. Streptococcus pneumoniae
  4. Bacillus Anthracis
  5. Clostridium (perfringins, dificile, tetani, and botulinum)
  6. Listeria monocytogenes
  7. Corynebacterium diptheriae
  8. propionibacterium acnes
  9. Actinomyces species
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3
Q

Staphylococcus is motile or nonmotile?

A

non-motile

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4
Q

how does Staphylococcus interact with oxygen (anarobe, aerobe)

A

facultative aerobe

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5
Q

What does Staphylococcus look like under a microscope

A

cocci in irregular clusters (grapes)

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6
Q

What is the most common organism found on the skin

A

Staphylococcus epidermis

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7
Q

Where is Staphylococcus aureus typically carried in 30-50% of the healthy population

A

nose and perineum

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8
Q

How can you tell between Staphylococcus aureus and Staphylococcus epidermis

A

Staphylococcus Areus is
coagulase positive, mannitol positive
Staphylococcus Epidermis
coagulase negative, mannitol negative

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9
Q

which is more virulent Staphylococcus Aureus or Staphylococcus epidermis

A

Staphylococcus Aureus

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10
Q

How many bacteria are required for disease to result from a staph infection

A

only a few hundred bacteria

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11
Q

what are the three things about Staphylococcus that cause pathogenicity

A
  1. It’s ability to evade phagocytosis
  2. Production of enzymes
  3. production of toxins
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12
Q

What are the three categories of Staphylococcus diseases

A

Noninvasive disease
Cutaneous disease
Systemic disease

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13
Q

What is a non-invasive Staphylococcus disease

A

food poisoning that results from ingested food contaminated with enterotoxin

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14
Q

What are examples of cutaneous Staphylococcus disease

A

scalded skin syndrome
impetigo
folliculitis
furuncles

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15
Q

How does Staphylococcus defend itself against phagocytosis

A

Protein A

Bound Coagulase:

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16
Q

how does Protein A help Staphylococcus defend against phagocytosis

A

Protein A onthe bacterial surface binds antibodies by the Fc end. This inhibits opsonization and complement

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17
Q

how does bound coagulase help Staphylococcus defend against phagocytosis

A

converts blood protein fibrinogen into fibrin molecules, which make blood clots, the Staphylococcus hides from the phagocytes in the clots

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18
Q

What are the 5 enzymes created by Staphylococcus that attribute to its virulence

A 
Cell-free coagulase
hyaluronidase
staphylokinase
lipases
B-lactamase
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19
Q

What does Cell-free coagulase do for Staphylococcus

A

triggers fibrin formation, which helps the Staphylococcus hide from phagocytes

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20
Q

What does hyaluronidase do for Staphylococcus

A

breaks down hyaluronic acid, which allows the bacteria to spread between cells

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21
Q

what does staphylokinase do for Staphylococcus

A

dissolves fibrin threads in blood clots, which allows Staphylococcus aureus to free itself from clots

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22
Q

what do lipases do for Staphylococcus

A

digests lipids, allows Staphylococcus to grow on the skins surface and in oil glands

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23
Q

what do B-lactamases do for Staphylococcus

A

Breaks down penicilins, makes them resistant to beta-lactams

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24
Q

What are the 4 toxins produced by Staphylococcus

A

Cytolytic toxins
exfoliative toxins
Toxic shock syndrome toxins
Enterotoxins

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25
Q

What are the two cytolytic toxins created by Staphylococcus and what do they do

A

alpha-toxins- pore forming toxins

PVL - beta pore forming toxin that lyses leukocytes

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26
Q

What do the exfoliative toxins of Staphylococcus cause

A

they cause the patients skin cells to separate from each other and slough off the body

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27
Q

What does the toxic shock syndrome toxin of Staphylococcus cause

A

it causes toxic shock syndrome, which is caused by the creation of a superantigen

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28
Q

What do enterotoxins of Staphylococcus cause

A

they stimulate intestinal muscle crampings, naseua, and intense vomiting (staph food poisoning)

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29
Q

Does Staphylococcus aureus cause food poisoning

A

yes

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30
Q

Does Staphylococcus cause colitis

A

yes

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31
Q

what is colitis (caused by Staphylococcus )

A

overgrown Staphylococcus aureus in the bowels (caused by broad-spectrum antibiotic treatment), when they produce enterotoxin B you get damage to intestinal mucosa, cramps, pain, diarrhea, and fever

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32
Q

What are the 4 skin diseases caused by Staphylococcus aureus

A

impetigo
furuncles (boils) (infected hair follicle)
Carbuncler (many boils)
Scalded skin syndrome

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33
Q

What are the 5 systemic diseases caused by Staphylococcus

A 
Toxic shock syndrome
Bacteremia
Endocarditis
Pneumonia
Osteomyelitis
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34
Q

What causes Toxic shock syndrome

A

the TSS toxin (from Staphylococcus ) being absorbed into the blood, and being used as a superantigen, which causes T-cells to produce far too many cytokines

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35
Q

what are the symptoms of toxic shock syndrome

A

high fever, rash, vomiting, diarrhea

renal, liver, and blood involvement

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36
Q

What is bacteremia

A

bacteria in the blood

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37
Q

What is endocarditis

A

when bacteria attack the lining of the heart

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38
Q

what is pneumonia

A

inflammation of the lungs in which the alveoli and bronchioles become filled with water

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39
Q

what is osteomyelitis

A

inflammation of the bone marrow and surrounding bone

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40
Q

What is the drug of choice to treat staph infections

A

Methicilins

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41
Q

Are any Staphylococcus organisms resistant to methicilins? what are they called

A

yes, MRSA (methicilin resistant staph. aureus)

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42
Q

What is the drug used for MRSA

A

vancomycin

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43
Q

how are staph infections prevented

A
  1. proper food prep and storage
  2. hand antisepsis
  3. proper cleansing of wounds, catheters, and needles
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44
Q

Which type of bacteria is tracked by phage typing

A

Staphylococcus

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45
Q

What is the arrangement of cocci in streptococcus

A

cocci arranged in pairs or chains

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46
Q

how does streptococcus interact with oxygen

A

aerotolerant anaerobes

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47
Q

What is the system of classification often used for streptococcus

A

lancefield classification

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48
Q

What are the two groups of streptococcus that are common pathogens of humans

A

Group A and Group B strep

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49
Q

What is used to determine the group of streptococcus organisms

A

the bacterias C antigens

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50
Q

What is the name for the only organism in Group A strep

A

streptococcus pyogenes

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51
Q

what does strep pyogenes cause on blood agar plates

A

it forms white colonies surrounded by beta-hemolysis on blood agar

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52
Q

What does strep pneumoniae cause on blood agar plates

A

it does alpha hemolysis

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53
Q

do pathogenic strains of streptococcus pyogenes often form capsules

A

yes

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54
Q

When do Group A strep generally cause disease

A
  1. normal microbiota are depleted
  2. large inoculum enable strep to establish themselves before antibodies are formed against them
  3. specific immunity is impaired
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55
Q

What does protein M of streptococcus pyogenes do

A

it interferes with opsonization and lysis of the bacteria, and helps the bacteria attach to keratinocytes of the host

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56
Q

What does a hyaluronic acid capsule do for streptococcus pyogenes

A

it camoflages the bacteria

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57
Q

What are the enzymes produced by streptococcus pyogenes, and what do they do?

A

Streptokinases
Deoxynucleases
C5a
They facilitate the spreading of streptococcus through the tissues

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58
Q

What are the toxins released by streptococcus pyogenes and what do they do

A

they are pyrogenic toxins, and they induce macrophages and T-helper cells to release cytokines

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59
Q

What do streptolysins do

A

they lyse RBCs, WBCs and platelets

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60
Q

What are the 6 diseases caused by group A strep

A
  1. Pharyngitis (strep throat)
  2. Scarlet fever
  3. Pyoderma (impetigo)
  4. Erysipelas
  5. streptococcal Toxic Shock syndrome
  6. Necrotizing Fasciitis
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61
Q

Scarlet fever is caused by a toxin of streptococcus pyogenes, what else is caused by that toxin

A

puerperal sepsis (an infection of the uterus)

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62
Q

What is scarlet fever

A

a rash that begins on the chest and spreads across the body, it is caused by erythrogenic toxin

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63
Q

What is pyoderma (impetigo)

A

confined, pus-producing lesions, usually on the face, arms or legs

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64
Q

What is erysipelas

A

lymph node involvement with pain and inflammation (bright red face-mask shaped inflammation)

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65
Q

What is streptococcal toxic shock syndrome

A

bacteremia and severe multisystem infections

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66
Q

What is necrotizing fasciitis

A

Flesh eating strep

strep that spreads in the deep tissues along fascia, it destroys tissues including fat and muscle. 50% mortality

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67
Q

What are two post-streptococcal diseases? (poststreptococcal sequelae) and what cause them

A

Rheumatic fever and glomerulonephritis

cross reactive antibodies

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68
Q

Which age group is the most common carrier and infected by streptococcus pyogenes

A

Children 1-15

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69
Q

How is Group A strep transmitted

A

by respiratory droplets, direct and indirect contact

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70
Q

How is Group A strep diagnosed

A

hemolysis, bacitracin sensitivity, gram morphology, catalase tests

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71
Q

What is used to treat Group A Strep

A

penicilliin G

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72
Q

how is group A strep prevented and controlled

A

isolation, early and complete treatment

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73
Q

What is the other name for the alpha-hemolytic streptococci

A

the viridans group

74
Q

Where are the viridans group of streptococci normally found

A

the mouth, pharynx, GI tract, genital tract, and urinary tract

75
Q

Which group of strep play a significant role in dental caries, and dental plaque production

A

Alpha-hemolytic Streptococci (The viridans group)

76
Q

What can the alpha-hemolytic strep (viridans group) cause when they enter the blood

A

meningitis, and endocarditis

77
Q

Which group of Strep mostly forms pairs of cocci

A

streptococcus pneumoniae

78
Q

What happens when streptococcus pneumoniae is grown on blood agar? and then on blood agar in anaerobic conditions

A

it forms alpha-hemolytic colonies, then in anaerobic conditions it produces beta-hemolytic colonies

79
Q

Where does streptococcus pneumoniae normally colonize

A

the mouoth and pharynx (pathogenic in the lungs)

80
Q

What was the leading cause of human death before antibiotics

A

streptococcus pneumoniae

81
Q

What percent of bacterial pneumonia is caused by streptococcus pneumoniae

82
Q

Which bacteria causes the majority of otitis media

A

streptococcus pneumoniae

83
Q

in streptococcus pneumoniae, pathogenesis is tied to what

A

a large polysaccharide capsule

84
Q

how does the polysaccharide capsule of streptococcus pneumoniae’s polysaccharide capsule aid in pathogenicity

A

it binds factor H which inhibits the alternative complement pathway, and protects the bacteria from phagocytosis

85
Q

What does the protein adhesin of streptococcus pneumoniae aid in its pathogenicity

A

it helps the cells bind to epithelial cells of the pharynx

86
Q

What type of protease does streptococcus pneumoniae release

A

secretory IgA protease (destroys IgA)

87
Q

What does the streptococcus pneumoniae toxin, pneumolysin do

A

a toxin released when the bacteria is lysed the lyses epithelial cells and suppresses digestion of the phagocytized bacteria

88
Q

What are the 6 diseases caused by streptococcus pneumoniae

A 
pneumococcal pneumonia
sinusitis
otitis media
bacteremia
endocarditis
pneumococcal meningitis
89
Q

What is pneumococcal pneumonia

A

bacteria multiply in the alveoli, damaging it, and causing an inflammatory response

90
Q

What is sinusits

A

streptococcus pneumoniae bacteria in the sinuses

91
Q

what is otitis media

A

streptococcus pneumoniae bacteria in the middle ear

92
Q

What is pneumococcal meningitis

A

when streptococcus pneumoniae bacteria spread to the meninges of the CNS

93
Q

how is streptococcus pneumoniae diagnosed

A

gram stain of sputum smears, growth, optochin sensitivity, and bile solubility

94
Q

How is streptococcus pneumoniae treated

A

penicillin or cephalosporins

95
Q

how is streptococcus pneumoniae prevented

A 
pneumovax 23 (adults)
pneumococcal conjugate vaccine (PCV) 7-valent
96
Q

What is the structure of enterococcus

A

short chains or pairs without a capsule

97
Q

where is enterococcus normally found

A

the human colon, rarely pathogenic here (pathogenic in the lungs, urinary tract, and blood)

98
Q

What is enterococcus resistant against

A

B-lactams, sulfonamides, aminoglycosides, tetracyclines, and erthyromycins (some are even resistant to vancomycin)

99
Q

What is VRE

A

Vancomycin resistant enterococcus

100
Q

what is the structure of Bacillus

A

Bacilli that can occur singly, in pairs, or in chains

101
Q

What makes bacillus particularly difficult to get rid of

A

it forms endospores

102
Q

What is bacillus anthracis

A

Anthrax, a strict pathogen of humans and animals

103
Q

How do humans contract bacillus anthracis

A
  1. inhalation of spores
  2. ingestion of spores
  3. inoculation of spores into the body via a break in the skin
104
Q

how long can anthrax spores survive

A

decades, possibly centuries

105
Q

What is responsible for the virulence of anthrax

A

a 3 component toxin and a protein capsule

106
Q

What are the two plasmids which house the virulence factors of anthrax

A

pXO1 and pXO2

107
Q

What are the three forms of anthrax disease in humans

A

inhalation (pulmonary)
Gastrointestinal
Cutaneus

108
Q

What is woolsorters disease

A

a pulmonary anthrax infection, induces capillary thrombosis and cardiovascular shock

109
Q

How does one get gastrointestinal anthrax

A

ingestion of spore contaminated meat

110
Q

What is a sign of cutaneus anthrax infections

A

Echar lesions (black, necrotic skin lesions)

111
Q

how fatal are cutaneus anthrax infections

A

usually not fatal

112
Q

how is bacilli diagnosed

A

large, non-motile, bacilli in the lungs or skin

113
Q

how is bacilli anthracis treated

A

with ciproflaxin, penicilin, or tetracycline

114
Q

how is bacilli anthracis prevented

A

control the disease in animals

vaccination (requires multiple doses and boosters)

115
Q

besides bacilli anthracis, what are other important bacilli

A

bacilli cereus - food poisoning in rice, beans, and potatoes

Bacili subtilis - produces bacitracin

116
Q

what produces bacitracin

A

bacilli subtilis

117
Q

are clostridium bacteria aerobic or anaerobic

118
Q

do clostridium bacteria produce endospores like bacillus

119
Q

Where are clostridium found

A

soil, water, and the GI tract of humans

120
Q

What are the 4 different types of clostridium

A

clostridium perfringins
clostridium dificile
clostridium tetani
clostridium botulinum

121
Q

what are the two main diseases caused by clostridium perfringins

A 
food poisoning (enterotoxin)
Gas gangrene
122
Q

how is gas gangrene caused by clostridium perfringins

A

endospores enter the tissues in a traumatic event, they germinate and cause necrosis,

123
Q

what are the two toxins of clostridium perfringins that cause gas gangrene

A

lecithinase and pore-forming toxin

it is when there is necrosis that is accompanied by gas build up in the tissues

124
Q

how is gas gangrene diagnosed

A

easily, just by its symptoms

125
Q

how is gas gangrene treated

A

removing dead tissue, large doses of penicillin, and hyperbaric chamber

126
Q

how is gas gangrene prevented

A

proper cleaning of wounds, but it is difficult to prevent because clostridium perfringins is so common in the environment

127
Q

Where is clostridium dificile normally found

A

part of the intestinal microbiota

128
Q

What leads to an infection of clostridium dificile

A

when patients are treated with broad spectrum antibiotic drugs

129
Q

what are the two degrees of infections of clostridium dificile

A 
minor = self-limiting explosive diarrhea
major = pseudomembranous colitis
130
Q

what is pseudomembranous colitis

A

swollen colon that can perforate, leading to massive internal infection by fecal bacteria and death

131
Q

how is a clostridium dificile infection treated

A

discontinuing antimicrobials, and restoring normal bowerl flora (fecal transplants)

132
Q

What is botulism, and what bacteria is it caused by

A

botulism is flaccid paralysis, it is caused by clostridium botulinum

133
Q

how does one contract botulism

A

by ingesting toxin from clostridium butulinum

134
Q

why shoudn’t infants younger than one consume honey

A

because it could contain the botulism toxin

135
Q

What is the most potent poison known to man

A

botulism toxin

136
Q

how is botulism treated

A

administration of the polyvalent antitoxin

137
Q

how is botulism prevented

A

proper food preparation and storage (botulism toxin is destroyed by heat)

138
Q

how does botulism cause flaccid paralysis

A

the toxin enters into a motor nerve terminus, and cleaves the SNARE proteins responsible for fusing the vesicle (containing ACH) with the terminal membrane. (doesn’t allow the muscle to receive the neurotransmitter from the nerve)

139
Q

What are the 3 forms of butulism

A

food-borne botulism
infant botulism
wound botulism

140
Q

how is food borne botulism usually contracted

A

in home-canned food, or preserved fish

141
Q

is infant botulism usually fatal

142
Q

how do the symptoms of wound botulism differ from that of food-borne botulism

A

they don’t just the means of contraction

143
Q

How is botulism diagnosed

A

the symptoms are diagnostic, confirmed by culturing the organism from food, feces or the wound

144
Q

how is botulism treated

A

antibodies against the botulism toxin

antimicrobial drugs to kill clostridia in infant botulism

145
Q

how is botulism prevented

A

proper canning of food

infants under 1 shouldn’t have honey

146
Q

how does clostridium tetani interact with air

A

it is an obligate anaerobe

147
Q

where can clostridium tetani be found

A

soil, dust, GI tract of humans

148
Q

When does tetanus result

A

when the bacterial endospores germinate and produce toxin

149
Q

what are the symptoms of tetanus

A

spasms and contractions, death due to inability to exhale

150
Q

Which bacteria causes lockjaw (spastic paralysis)

A

clostridium tetani

151
Q

how is tetanus treated

A

cleaning of the wound to remove endospores, administration of antitoxin and antibiotics

152
Q

how is tetanus prevented

A

vaccination TDaP, or Td

153
Q

How does tetanus cause spastic paralysis

A

the tetanus toxin blocks the release of glycine, making it so the muscles can’t relax

154
Q

What is the hallmark of an anaerobic infection

155
Q

What is deceiving about the name of the anerobe bacteroides fragilis

A

it is actually one of the easiest anaerobes to grow

156
Q

What is the most commonly isolated anaerobic bacterium, especially from the blood

A

bacteroides fragilis

157
Q

What are the virulent features of bacteroides fragilis

A
  • attachment pili
  • polysaccharide capsule
  • modified or absent lipid A
  • enzymes
158
Q

What makes listeria monocytogenes problematic

A

its ability to live within cells

159
Q

What are the toxins and enzymes of listeria monocytogenes like

A

it doesn’t produce any toxins or enzymes

160
Q

Does listeria monocytogenes produce endospores

161
Q

how is listeria monocytogenes able to live inside cells, and move from one to another

A

it’s able to live inside cells by its ability to escape from phagocytic vessicles. Then once inside cells it builds an actin tail (actin polymerization) which helps it propel itself through that cell and into others.

162
Q

What is the thing that helps listeria monocytogenes escape from vesicles

A

LLO listeriolysin O - it is pore forming

163
Q

What about the conditions that listeria monocytogenes can grow in is different from many other bacteria

A

it can grow at refrigerator temperatures

164
Q

where do most infections of listeria monocytogenes in humans come from

A

contaminated milk or meat

165
Q

What is the problem with a pregnant woman being infected with listeria monocytogenes

A

it can be transferred to the baby prenatally or postnatally, which can cause meningitis, and still-births

166
Q

How is listeria monocytogenes treated, and prevented

A

it is treated with ampicillin, and it is prevented with pasteurization and proper cooking

167
Q

how is a listeria monocytogenes infection diagnosed

A

presence of the bacteria in the blood or cerebrospinal fluid (gram staining isn’t effective because so few cells are required to cause disease)

168
Q

What is the name of the bacteria that causes diptheria

A

cornyebacterium diptheriae

169
Q

how is diphtheria transmitted from person to person

A

respiratory droplets or skin contact

170
Q

What are the signs and symptoms of diptheria

A
  • pseudomembrane (dead cells and fluid that accumulates) in the respiratory tract, or on the skin (in the case of cutaneous diptheria)
  • Bull neck (swelling in cervical lymph nodes)
171
Q

Which bacteria can often be seen on a micrograph in V-shapes

A

cornyebacterium diptheriae

172
Q

besides the respiratory tract, what else can diptheria toxin harm

A

the heart and CNS

173
Q

how is diptheria diagnosed

A

clinical and serological tests

174
Q

how is diptheria treated

A

antitoxin, then penicillin or erythromycin

175
Q

how is diptheria prevented

A

toxoid vaccination

176
Q

What is the bacteria that causes most of our acne

A

propionibacterium acnes

177
Q

can propionibacterium acnes cause more than just acne

A

yes, it can also be an opportunistic pathogen

178
Q

Why is actinomyces an important bacteria to study

A

because it is a major component of dental plaque and is associated with gingivitis and root caries

179
Q

how is antinomyces treated

A

with amoxicillin

180
Q

What is nocardia

A

a soil saprophyte that cause nocardiosis

181
Q

what is nocardiosis

A

a TB-like pulmonary disease that can progress to form abscesses and can show on the back of the patient

182
Q

What is streptomyces

A

a non-pathogenic bacteria that produces most of our antibiotics

DMD 5245 (15 decks)

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