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Micro U4 > Haemophilus and Bordetella > Flashcards

Haemophilus and Bordetella Flashcards

1
Q

What is the gram stain for H. influenzae?

A

Gram (-) pleomorphic rod

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2
Q

What are the two things needed to grow H. influenzae on lab media?

A

Factors X (heme) and V (NAD)

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3
Q

How is H. influenzae transmitted?

A

By respiratory droplets or direct contact

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4
Q

What do the high-pathogenicity strains of H. influenzae have?

A

polysaccharid capsule

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5
Q

What serotypes of the capsule types causes the most severe disease?

A

Type B (Hib)–causes meningitis, pneumonia, spetic arthritis

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6
Q

What is the target for the H. influenzae vaccine?

A

Hib capsule of polyribosyl ribitol phosphate (PRP)

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7
Q

What is the unencapsulated strain of H. influenzae called and what does it cause?

A

NTHi–may cause local mucosal infections, can spread if untreated, and is NOT covered by the vaccine

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8
Q

What does the Hib serotype of the H. influenzae have in order to colonize the respiratory epithelium?

A

IgA protease–clears IgA from respiratory mucosa

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9
Q

What are the possible outcomes when pts develop meningitis from H. influenzae?

A

unvaccinated untreated mortality–90%

50% of survivors have neurological sequalae–deafness, developmental delay

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10
Q

What can the NTHi strain of the H. influenzae causes –the unencapsulated strain?

A

Pneumonia with biofilm formation in CF pts

Pneumonia, septic arthritis after untreated mucosal infection

Neonatal sepsis, maternal sepsis after vaginal delivery if NTHi is normal flora

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11
Q

What are the major complications caused by Hib strain of H. influenzae?

A

Meningitis–rapid onset

Cellulitis–usually on head or neck–may affect eyes

Otitis media, sinusitis–pain and swelling tympanic membrane

Epiglottitis–swollen cherry-red epiglottis, progressive respiratory difficulty

Septic arthritis–single large joints

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12
Q

What are the complications of NTHi–biotype 4?

A

Neonates–associated with prematurity, premature rupture of membranes, low birth weight, maternal chorioamniotis

-vertically acquired

Postpartum–sepsis with endometritis, turbo-ovarian abscess, chronic salpingitis

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13
Q

What is the tx for meningitis caused by H. influenzae?

A

Ceftriaxone

Meningitis in children >2 mo: add dexamethasone

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14
Q

What is the tx of upper-respiratory infection caused by H. influenzae?

A

Amoxicillin+clavulanate
OR
Trimethoprim+sulfamethoxazole

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15
Q

What its the tx for cellulitis, pericarditis, and septic arthritis caused by H. influenzae?

A

Surgical drainage in addition to:

Trimethoprim-sulfamethoxazole, cefuroxime axetil, cefixime, clarithromycin, azithromycin, or fluoroquinolones

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16
Q

What is the tx for otitis media caused by H. influenzae?

A

Amoxicillin

17
Q

What type of vaccine is given for H. influenzae?

A

Capsular polysaccharide of type B conjugated to diphtheria toxoid or other carrier protein (Hib)

18
Q

What is the gram stain of B. Pertussis?

A

Gram (-) rod

19
Q

How is B. pertussis transmitted?

A

Respiratory droplets

20
Q

What does B. pertussis cause?

A

Whooping cough–primarily in infants

21
Q

What is related to the B. pertussis infection but has milder syms?

A

B. parapertussis

22
Q

What attaches B. pertussis to cilia of epithelial cells lining the respiratory tract?

A

Filamentous hemagglutinin pilus

23
Q

What does the pertussis toxin, an A-B subunit ADP-ribosylator cause?

A

Secondary attachment factor
Ciliostasis –kills ciliated cells–> less resistance to bacterial growth, cough
Inhibits chemokine signal transduction–Lymphocytosis

24
Q

What does the tracheal cytotoxin from B. pertussis cause?

A

kills ciliated cells-ciliostasis

25
Q

B. pertussis causes damaged cells and then the bacteria grows and produces what?

A

Mucopurulosanguineous exudate–compromises small airways

26
Q

What are the risk factors for the development of an infection from B. pertussis?

A 
Incomplete or absent vaccination
Prematurity
Underlying cardiac, pulmonary, neuromuscular, neurologic dz
Asthma
Obesity
Pregnancy
27
Q

What are the 3 stages of B. pertussis infection?

A

Stage 1: catarrhal–2 wks
Stage 2: Paroxysmal–2wks
Stage 3: Convalescence–2 months

28
Q

What occurs during the 1st stage of B. pertussis infection?

A

Catarrhal stage 2 wks:

Nonspecific upper respiratory syms–congestion, sneezing, rhinorrea

Maximally contagious

29
Q

What occurs during the 2nd stage of B. pertussis infection?

A

Paroxysmal stage 2 wks:

Intense coughing
–characteristic pattern–Series of hacking coughs, copious mucus production, inspiratory “whoop” as air rushes in past narrowed glottis

Infants turn blue
Children may turn red and vomit

30
Q

What occurs during stage 3 of B. pertussis infection?

A

Convalescence stage 2 months:

Fatigue and chronic cough

31
Q

What is seen when adults get B. pertussis infection?

A

Primary symtom is extremely prolonged upper respiratory infection with 110-day cough

Whoop and leukocytosis absent

32
Q

What is seen on the bloodwork of children who have the B. pertussis infection?

A

Pronounced leukocytosis

33
Q

What are the agar used to grow fastidious B. pertussis?

A

Regan-Lowe or Bordet-Gengou agar

May be negative if pt is immunized or already on antibiotics

34
Q

What is given to prevent B. pertussis from progressing and transmitting?

A

Macrolides

35
Q

What are the 2 vaccines available for B. pertussis?

A

Acellular vaccine–inactivated toxoid

Killed vaccine–whole heat-killed bacterium –> much longer-lived protection, but more pain and fever on vaccination – used outside US

36
Q

What should be used for prophylactics if unimmunized pts are exposed to B. pertussis?

A

Erythromycin

37
Q

What is needed every 10yrs for the B. pertussis vaccine to be effective?

A

Booster

Micro U4 (9 decks)

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