Infection Model and Infections on Surfaces Flashcards

1
Q

What is an opportunist

A

A pathogen that invades a host when they are immunosuppressed

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2
Q

What patient factors influence infection

A

Patient

  • Age
  • Gender
  • Physiological state
  • Pathological state (co-morbidities)
  • Social factors

Time

  • Calender time
  • Relative time- incubation time

Place

  • Current
  • Recent
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3
Q

What are the types of pathogens

A

Virus

Bacterium

Fungus- Yeast and Mould

Parasite- Protozoa and Helminth

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4
Q

Name the mechanisms of infection

A

Contiguous spread

Inoculation

Haematogenous

Ingestion

Inhalation

Vector

Vertical transmission

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5
Q

Describe the process of managment

A

Diagnosis- history, examination, investigations

Treatment- specific or supportive

Infection prevention- hospital and/or community

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6
Q

Describe the two types of treatment briefly

A

Specific treatment- using antimicrobials or surgery to target the infection directly. Surgery can be via three ways: drainage, debridement or dead space removal

Supportive treatment- giving symptom relief and physiological restoration. Supportive treatment aims to reduce the pain while figuring out the causative pathogen or disease

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7
Q

What surfaces can pathogens colonise on

A

Skin - epithelium, hair, nails

Mucosal surfaces - conjuctival, gastrointestinal, respiratory, genitourinary

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8
Q

Why do new strains of the same bacteria cause disease

A

Because the body cannot produce antibodies fast enough against the new strain of bacteria

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9
Q

What are the four ways patients get surface infections

A

Invasion

Migration

Innoculation

Haematogenous

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10
Q

Describe how endocarditis originates

A

Turbulent blood flow damages endothelium in the heart, causing sub-endothelial damage

This exposes fibronectin which bacteria can then bind to and colonise, eventually forming a vegitiation

This then results in endocarditis from the resulting immune response and inflammation

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11
Q

Why are artificial surfaces at risk of infection

A

They are avascular so are not protected by the immune system

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12
Q

Why is staph aureus different from other bacteria in relation to endocarditis

A

Staph aureus does not need any pre-existing valve damage to cause endocarditis unlike other bacteria

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13
Q

How are prosthetic joint infections treated

A

Joint is removed and there can then be: joint replacement, spaces in the joint or fusion of the joint

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14
Q

What is the process of infection on a surface and what is the hosts response

A

Adherence to host cells/surface - using pili or fimbriae

Biofilm formation

Invasion and multiplication

Response is either: pyogenic or granulomatous

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15
Q

What is a biofilm

A

A microbial community attached to a surface, encased in an extracellular matrix of microbial origin

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16
Q

What two bacteria are responsible for frequent nosocomial infections

A

Staphylococci

Enterococci

17
Q

What are the stages in biofilm formation

A

Surface attachment

  • Either reversible or irreversible

Microcolonies

  • Cell proliferation
  • Coaggregation

Macrocolonies

  • Mushroom and tower-like structures
  • Cell detachment
18
Q

Why is it difficult to remove bacteria in biofilms by the immune system

A

The bacteria aggregate together making it harder for opsonisation and phagocytosis

19
Q

What mechanism does a biofilm have against antibiotics

A

Matrix restricts penetration and diffusion of some antimicrobials

B-lactamase secretion

Expression of multi-drug resistance efflux pumps

Quorum-sensing systems and different concentrations of nutrients and waste contribute to resistance

20
Q

What does quorum sensing control

A

Sporulation

Biofilm formation

Virulence factor secretion

21
Q

What principles are involved in quorum sensing

A

Signalling molecules - autoinducers (AI)

Cell surface/cytoplasmic receptors

Gene expression - co-operative behaviour and more AI production

22
Q

What is differential time positivity

A

The time for a blood culture to grow will depend on where the microbe was taken from as some areas will take a longer time to produce a culture than others

23
Q

Give some examples of external natural surface infections

A

Cellulitis

Pharyngitis

Conjuctivitis

Gastroenteritis

UTI

Pneumonia

24
Q

Give some examples of internal natural surface infections

A

Endovascular - endocarditis and vasculitis

Septic arthritis

Osteomyelitis

Empyema

25
Q

Give some examples of prosthetic surface infections

A

Intravascular lines

Peritoneal dialysis catheters

Prosthetic joints

Cardiac valves

Pacing wires

Endovascular grafts

Ventriculo-peritoneal shunts

26
Q

What are some causative organisms of prosthetic valve endocarditis, group the organisms

A

Native valve and >1 year prosthetic valve - viridans strep, enterococcus faecalis, staph aureus, candida, HACEK group

<1 year prosthetic valve - coagulase negative staph

27
Q

Name some causative organisms of prosthetic joint infections

A

Coagulase negative staph

Staph aureus

28
Q

Name some organisms which cause cardiac pacing wire endocarditis

A

Coagulase negative staph

Staph aureus