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micro unit 6 > hemophilus and bordetella > Flashcards

hemophilus and bordetella Flashcards

1
Q

H. influenza stain and morphology

A

gram negative coccus-to-rod (coccobacillus)

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2
Q

H. influenza special features

A

small pleomorphic.

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3
Q

how many serotypes of H. influenza

A
  1. type b causes the most severe disease consisting on meningitis and sepsis.
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4
Q

what characterizes the most pathogenic strains of H. influenza

A

capsule

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5
Q

what is important about the NTHi strains of H. influenza

A

they are not encapsulated and thus not covered by the vaccine. they are of lower pathogenicity

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6
Q

how do we grow H. influenza

A

lab media with addition of factors X (heme) and V (NAD)

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7
Q

what organisms does H. influenza infect

A

human restricted

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8
Q

how is H. influenza transmitted

A

through respiratory droplets. colonization maybe asymptomatic or cause respiratory illness

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9
Q

what respiratory illnesses are characteristic of H. influenza

A

otitis media, sinusitis, pneumonia

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10
Q

what virulence factors for H. influenza aid int he pathogenicity

A

IgA protease for the mucus membranes.

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11
Q

does H. influenza have an exotoxin/

A

NO. only capsule and endotoxin.

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12
Q

who is most often affected by H. influenza

A

children 6months-6 years. peak 6 months to 1 year. this is due to the maternal antibody waning and the lack of response from the child.

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13
Q

can H. influenza be normal flora

A

yes. can spread this way

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14
Q

can H. influenza cause complications of birth

A

postpartum sepsis, abscess, early-onset meningitis, sepsis.

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15
Q

what local infections are caused by H. influenza

A

otitis media, conjunctivitis, sinusitis. also can cause septic arthritis, cellulitis, sepsis, pneumonia.

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16
Q

what illnesses predispose patients to H. influenza

A

asthma, malignancy, CF, advanced age, other immune suppression. not covered by vaccine

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17
Q

diagnosis of H. influenza meningitis

A

rapid onset fever, HA, stiff neck. typical of HiB

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18
Q

diagnosis of H. influenza otitis media/sinusitis

A

pain and swelling in the area, bulging of the tympanic membrane usually NTHi

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19
Q

H. influenza epiglottis

A

swollen, cherry red epiglottis that can block the airway. classic of HiB

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20
Q

labs for H. influenza

A

isolate on chocolate agar with and without factors. growth with only factors is usually sufficient for diagnosis. biochemical and immunological tests can be done.

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21
Q

treatment for H. influenza meningitis/other serious

A

ceftriaxone

22
Q

treatment of H. influenza URI

A

amoxicillin + clavulanate or sulfa-trimeth

23
Q

how to treat local NTHi

A

seldom spread, so let patient decide unless there is a predisposition

24
Q

prevention of H. influenza

A

vaccine. made of capsular polysaccharide of B. and conjugated to diptheroid toxoid. made of polyribosyl ribitol phosphate PRP

25
Q

who gets the H. influenza vaccine routinely

A

2-15 month olds.

26
Q

what do close contacts of H. influenza patients receive

A

prophylactic rifampin

27
Q

bordetella pertusis stain and morphology

A

gram negative rod (coccobacillus)

28
Q

is bordetella pertusis encapsulated

A

yes.

29
Q

is bordetella pertusis human-restricted

A

yes

30
Q

how contagious if bordetella pertusis

A

very contagious

31
Q

who gets infected with bordetella pertusis

A

historically infants and children, but now its reaching adolescents and adults in areas with low vaccine coverage. can also be seen in children that have not completed the vaccine

32
Q

what is the virulence factor of bordetella pertusis

A

filamentous hemagluttinin pilus. attaches the bacteria to cilia of epithelial cells lining the respiratory tract. pertussis toxin tracheal cytotoxin,

33
Q

what kind of toxin is bordetella pertusis pertussis toxin and what does it do?

A

A-B subunit ADP-ribosylator. kills ciliated cells giving the bacteria resistance against coughing. also inhibits chemokine signal transduction and thus lymphocytosis.

34
Q

what does bordetella pertusis tracheal cytotoxin do?

A

kills ciliated cells.

35
Q

what disease does bordetella pertusis cause

A

whooping cough

36
Q

clinical features of bordetella pertusis whooping cough

A

acute tracheobronchitis progressing into severe paroxysmal cough. characteristic pattern of cough. infants turn blue and children turn red and vomit. lasts 1-4 weeks.

37
Q

what is the characteristic pattern in whooping cough caused by bordetella pertusis

A

there is series of hacking coughs, copius mucous production, inspiratory whoop as air rushes in past the narrowed epiglottis.

38
Q

does bordetella pertusis become septic.

A

no. it usually sticks to the respiratory system.

39
Q

what is a common non lethal complication of bordetella pertusis

A

CNS anoxia and exhaustion.

40
Q

can bordetella pertusis be fatal?

A

yes. in predisposed patients from pneumonia.

41
Q

what does bordetella pertusis look like in adults?

A

there is usaully no whooping cough, but instead there is a prolonged 100-day cough. URI.

42
Q

labs for bordetella pertusis

A

pronounced leukocytosis 70% lymphocytes, need to culture swabs (slow). samples or cultures tested for ab’s. PCR is available.

43
Q

how do we culture bordetella pertusis

A

on bordet-gengoiu agar. but grows slowly

44
Q

treatment for bordetella pertusis

A

macrolides kill bacteria, but do not heal the respiratory lining. can be coughing for 3 months.
infants and children will need supplemental O2 and mucous suctioning during the paroxysmal stage. if the baby turns blue admit.

45
Q

prevention of bordetella pertusis

A

acellular vaccine and killed vaccine.

46
Q

acellular vaccine for bordetella pertusis

A

genetically inactivated pertussis toxoid filamentous hemaglutinin, pertactin and fimbriae types 2 and 3. raises a good protective response safely.

47
Q

killed vaccine for bordetella pertusis

A

heat-killed bordetella pertusis linked to a small risk of encephalopathy.

48
Q

what is the effectiveness of the bordetella pertusis vaccine

A

neither are 100% sporadic cases still occur. 10 year boosters are needed and is part of the recent resurgence of the disease.

49
Q

what do we give to children at risk for bordetella pertusis

A

erythromycin

50
Q

should we vaccinate or boost nearby contacts of newborn babies>

A

yes. strongly recommended

51
Q

should we vaccinate during pregnancy,

A

no. afterward.

micro unit 6 (7 decks)

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