II-A. Systemic bacteriology | 16. Haemophilus, Legionella, Bordetella Flashcards

1
Q

I. Haemophilus genus
1. What is the morphology of Haemophilus genus?

A

Gram-negative coccobacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

I. Haemophilus genus
2. What are the important species of Haemophilus genus?

A
  1. H. influenzae (H. influenzae (type B))
  2. H. parainfluenzae
  3. H. ducreyi
  4. H. haemolyticus (see later, at HACEK-group)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

I. Haemophilus genus - Haemophilus influenzae
3. What are the features of Haemophilus influenzae?

A

fastidious bacterium
- requires factor X and V for growth (hem and NAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

I. Haemophilus genus - Haemophilus influenzae
4. What are the virulence factors of Haemophilus influenzae? (CAI)

A
  1. capsule (A-F serotypes)
    - B-capsule serotype is the most important
    - usually causes invasive infections
  2. adhesive pili
  3. IgA-protease (neutralizes mucosal immunity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

I. Haemophilus genus - Haemophilus influenzae
5. What are the diseases caused by Haemophilus influenzae?

A
  • otitis media, sinusitis
  • bronchitis, laryngitis, pneumonia
  • blood stream infection, meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

I. Haemophilus genus - Haemophilus influenzae
6. How do we diagnose Haemophilus influenzae?

A
  1. based on clinical signs and symptoms
  2. sampling: based on the clinical disease
  3. laboratory: culturing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

I. Haemophilus genus - Haemophilus influenzae
7. How do we cultivate Haemophilus influenzae for diagnosis?

A

laboratory: culturing
* on factor X and factor V supplemented chocolate agar
* satellitism on blood agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

I. Haemophilus genus - Haemophilus influenzae
8. What is empirical therapy for Haemophilus influenzae?

A
  • beta-lactamase production might occur
  • amoxicillin-clavulanic acid, or cephalosporins ( for e.g. ceftriaxon)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

I. Haemophilus genus - Haemophilus influenzae
9. What is prevention for Haemophilus influenzae?

A

MANDATORY B-serotype polysaccharide capsule vaccine (Hib) for the
prevention of invasive diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

I. Haemophilus genus
10. What are the features of H. parainfluenzae?

A
  • only requires factor V for growth (NAD)
  • less virulent than H. influenzae, otherwise disease are similar
  • might cause endocarditis, prostatitis / orchitis as well!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

I. Haemophilus genus
11. What are the features of Haemophilus ducreyi?

A
  • only requires factor X for growth (hem)
  • sexually transmitted infection (STI)
    +) soft, painful ulceration (chancroid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

II. Legionella genus
1 What is the important species of Legionella genus?

A
  • Legionella pneumophila
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

II. Legionella genus
2. What are the features of Legionella pneumophila?

A
  • most important species→ famous case: Philadelphia, 1976
  • Gram-negative short rods or coccobacilli, form filaments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

II. Legionella genus
3. What is the source of infection of Legionella pneumophila?

A

environment (rivers, ponds, humidifier, shower, AC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

II. Legionella genus
4. What is the transmission route of Legionella pneumophila?

A

via aerosols

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

II. Legionella genus
5. What are the virulence factors of Legionella pneumophila?

A
  • haemolysin
  • listeria-coagulase
  • endotoxin (LPS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

II. Legionella genus
6. What are the diseases caused by Legionella pneumophila?

A
  1. mild form: Pontiac-fever
    - fever, muscle ache, headache, → AB therapy is not necessary
  2. severe form: legionellosis
    - atypical pneumonia, fever, confusion, kidney failure
    - high mortality (15-30%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

II. Legionella genus
7. How do we diagnose Legionella pneumophila?

A
  1. based on clinical signs and symptoms
  2. imaging (chest X-ray)
  3. Sampling
  4. laboratory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

II. Legionella genus
8. How do we sample Legionella pneumophila?

A

BAL (bronchoalveolar lavage), urine

21
Q

II. Legionella genus
8. How do we use laboratory to diagnose Legionella pneumophila?

A
  • culturing of BAL on BCYE-agar
  • rapid antigen test from urine (antigens show up in the kidney in pneumonia)
  • ELISA, IF
21
Q

II. Legionella genus
9. What is the empirical therapy for Legionella genus

A
  • macrolides (azythromycin)
  • fluoroquinolons (moxifloxacin)
  • rifampicin
22
Q

III. Bordetella genus
1. What are the features of Bordetella genus?

A
  • Gram negative (-) rod
  • Encapsulated
  • Strict aerobe
23
Q

III. Bordetella genus
2. What are the important species of Bordetella genus

A
  • Bordetella pertussis
  • B. parapertussis
  • B. bronchiseptica
24
Q

III. Bordetella genus
3. What is the morphology of Bordetella pertussis, B. parapertussis?

A

Gram-negative coccobacilli

25
Q

III. Bordetella genus
4. What are the virulence factors of Bordetella pertussis, B. parapertussis?
(AFPFT)

A
  1. adhesins
  2. filamentous hemagglutinin
  3. pertactin
  4. fimbriae
  5. toxins
26
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
5. What are the toxin produced by Bordetella pertussis, B. parapertussis?

A
  • pertussis-toxin (ADP-ribosilase) → mucus secretion
  • tracheal cytotoxin, dermonecrotic toxin
27
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
6. What is the route of transmission of Bordetella pertussis, B. parapertussis?

A

via respiratory droplets

28
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
7A. What is the disease caused by Bordetella pertussis, B. parapertussis?

A

diseases: pertussis (whooping cough)

28
Q

III. Bordetella genus
7B. What are the 3 phases of pertussis?

A
29
Q

III. Bordetella genus
7C. What happen in incubation phase of pertussis (whooping cough)?

A
  • lasts for 1-2 weeks
  • mild, upper respiratory tract symptoms
30
Q

III. Bordetella genus
7D. What happen in paroxismal phase of pertussis (whooping cough)?

A
  • usually lasts for more than a month
  • typical cough (wet cough)
  • sequelae: subconjunctival, intracranial haemorrhage
31
Q

III. Bordetella genus
7E. What happen in reconvalescent phase of pertussis (whooping cough)?

A

lasts for a few weeks (easing symptoms)

32
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
8A. How should we diagnose Bordetella pertussis, B. parapertussis?

A
33
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
8B. How should we do sampling for Bordetella pertussis, B. parapertussis?

A
  • coughing directly to the agar plate (rarely performed)
  • Ca-alginate or Dacron-tupfer (the use ofcotton swabs is not recommended!)
34
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
8C. How should we do laboratory for Bordetella pertussis, B. parapertussis?

A
  1. culturing on Bordet-Gengou agar
    - selective agar maded of potato, glycerol, blood and penicillin
  2. PCR from sputum / throat swab
35
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
9. What is the therapy for Bordetella pertussis, B. parapertussis?

A

macrolides (such as azithromycin)

36
Q

III. Bordetella genus - Bordetella pertussis, B. parapertussis
10. How should we prevent Bordetella pertussis, B. parapertussis

A

mandatory diphteria-tetanus-pertussis (DTPa) vaccine
* pertussis component: antigens of the bacterium (ain’t the toxin!)

37
Q

III. Bordetella genus
11. What are the features of B. bronchiseptica?

A
  • mainly an animal pathogen (bronchitis, pneumonia)
  • might cause aspecific caughing, pneumonia in humans (rare)
  • might cause a whooping cough-like disease in immunosuppressed patients
38
Q

III. Bordetella genus
12. How can we diagnose B. bronchiseptica?

A
  • clinical signs and symptoms, patient history
  • sampling: sputum, throat swab
  • laboratory: culturing
39
Q

III. Bordetella genus
13. What is the therapy for B. bronchiseptica?

A

macrolides

40
Q

IV. HACEK-group
1. What are the features of HACEK-group?

A

Gram-negative coccobacilli, which are part of the normal throat microbiota

41
Q

IV. HACEK-group
2. What does HACEK-group include?

A
42
Q

IV. HACEK-group
3. What is the disease caused by HACEK-group?

A

subacute endocarditis

43
Q

IV. HACEK-group
4. How to diagnose HACEK-group?

A
44
Q

IV. HACEK-group
5. What is the therapy for HACEK-group?

A

They are usually sensitive to beta-lactams
* we usually combine beta-lactams with aminoglycosides (to achieve synergy)
* therapy is usually 4-6 weeks long