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Pharmacotherapeutics I > Introduction to Infectious Disease > Flashcards

Introduction to Infectious Disease Flashcards

1
Q

Host flora

A

Occupy space and compete for nutrients
Stimulate cross-protective antibodies
Suppress growth of potentially pathogenic bacteria and fungi

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2
Q

Can normal flora become pathogenic

A

Yes

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3
Q

Colonization vs Infection

A

Colonization- organism present
Infection- organism present, organ damage, and inflammation.
Autoimmune disease- organ damage and inflammation

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4
Q

Monitoring Parameters

A 
Fever- >37 C (98.6 F) in adults
Erythema- redness of the skin
Purulence- discharge of pus
Swelling
Leukocytosis- elevated WBC
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5
Q

WBC- Leukocytes

A

1% of blood volume
Carry out immune system functions and recognize self from non-self.
Average life span 13-20 days

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6
Q

Differential WBCs

A 
Neutrophils- 50-70%
Lymphocytes 25-35%
Monocytes- 2-6%
Eosinophils- 0-6%
BBasophils- 0-3%
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7
Q

Granlocytes

A

Neutrophils, eosinophils, and basophils

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8
Q

Neutrophils mechanism

A

Prevent microorganism invasion, kill invading organisms
Attracted to site of infection by chemotactic factors. Then Phagocytize the microorganisms. Release toxic substances from granules within cell into vacuole containing organism.

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9
Q

Neutrophils

A

Contain multi-lobed nuclie (segs)
Production stimulated by interleukins and other colony stimulating factors (CSF)
Increased bands in circulation causing left shift

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10
Q

Segs

A

Term used to describe a mature working neutrophil, if found then you know they are actively trying to prevent infection

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11
Q

Bands

A

Immature neutrophil, increased means that more immature cells are being pushed out of the marrow (eukemia)

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12
Q

Absolute Neutrophil Count (ANC)

A

The lower the value the higher the risk of infection

WBC # x (%segs+%bands)

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13
Q

Neutropenia

A 
Not enough neutrophils
Mild= ANC 1000-1500/mm3
Moderate= ANC 500-1000mm3
Severe= ANC <500mm3
This gives an idea of how a pt can handle an infection process on their own.
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14
Q

Lymphocytes

A

Effector cells of immune system, recognize invaders, tag them for removal and kill them.
Make antibodies- Tcells 80% and B cells 20%

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15
Q

WBC-Monocytes

A

Serve to replenish tissue with macrophages prior to and during immune response

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16
Q

WBC- Eosinophils

A

Responsible for immuner processes against helminths and parasites (also involved in allergic rxn)

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17
Q

WBC- Basophils

A

Mediate inflammatory response

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18
Q

Gram stain- Gram (+) Cocci

A

chains- streptococcus pyrogens, viridans streptococcus
Pairs- streptococcus pneumoniae and enterococcus spp.
Clusters- coagulase-positive staphylococcus (S. aureus) Coagulase -negative Staphylococcus (S. epidermis)

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19
Q

Gram stain- Gram (+) Bacilli

A

Listeria and lactobacillus

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20
Q

Gram stain- Gram (-) Cocci

A

Neisseria menigitidis and Neisseria gonorrhoeae

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21
Q

Gram stain- Gram (-) Bacilli

A 
Escherichia Coli
Klebsiella Spp
Enterobacter spp
Proteus spp
serratia marcescens
Pseudomonas spp
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22
Q

Gram stain- Gram (-) Coccobaccili

A

Haemophilus influenzae

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23
Q

Cell wall- Gram Positive

A

Rigid, thick
Made up of mostly peptidoglycan (50-60%)
A series of cross-linking (transpeptidases) help to create the building blocks of the cell wall

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24
Q

Cell wall- Gram Negative

A

Cell wall thin layer-one or two glycan chains
Cell wall protected by lipoprotein outerlayer- which functions as a penetration barrier.
Lipopolysaccharide (LPS)
Matrix protein (porin)- important for regulating the influx of molecules
Phospholipids

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25
Q

Cell walls- Walls of mycobacteria (Acid fast bacteria)

A

Contains peptidoglycan w/ polysaccharide and glycolipids

Associated with staining characteristics

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26
Q

Cell Walls- Cytoplasmic membrane

A

Osmotic barrier
Energy production (electron transport-energy grandient- ATPases)
Biosynthesis transport (nutrient uptake, enzyme secretion)
Protein and lipid- lacks sterols

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27
Q

Antimicrobial Susceptibility- MIC

A

Minimun inhibitory concentration (MIC) lowest concentration of antibiotic that inhibits visible growth of bacteria. Want to shoot for 2-4x above this in treatment.

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28
Q

Antimicrobial Susceptibility- Breakpoints

A

Susceptible- isolates may be appropriately treated with the recommended doses
Intermediate- isolates may be appropriately treated in body sites where the drug is physiologically concentrated or when a high dosage of a drug can be used
Resistant- isolates are not inhibited by the achievable concentrations of a normal dose

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29
Q

Gram Positive cocci (Aerobic)- Staphylococcus

A 
Staphylococcus aureus (Coag+)- MSSA, hospital or community acquired MRSA.
Staphylococcus epidemidis(Coag -)
Staphylococcus saprophyticus (Coag -)
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30
Q

Gram Positive cocci (Aerobic)- Enterococcus

A

Enterococcus Faecalis
Enterococcus faecium
Enterococcus durans

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31
Q

Gram Positive cocci (Aerobic)- B hemolytic

A 
Streptococcus pyogenes (Grp A)
Streptococcus agalactiae (Group B)
Streptococcus bovis (nonenterococci, grp D)
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32
Q

Gram Positive cocci (Aerobic)- Viridans streptococci- alpha hemolytic

A

Streptococcus sanguis
Streptococcus salivarius
Streptococcus mitis
Streptococcus mutans

33
Q

Gram Positive cocci (Aerobic)- Streptococcus pneumoniae

A

Pneumococcus

34
Q

Staphylococci- colinzation

A

Skin and nose

35
Q

Staphylococci- Infections caused

A 
Cellulitis, wounds, trauma
Bacteremia/endocarditis
Pneumonia
Osteomyelitis
UTI
36
Q

Staphylococci- post surgery

A

Major players in post surgical infections.

Adhere to foreign material and catheters

37
Q

Staphylococcal Resistance

A

Penicillin resistant- beta-lactamase production
Methicillin resistant- MecA gene codes for Novel PBP2a (50% S. aureus and 70% CoNS are resistant)
Methicilin-suspectible isolates are also susceptible to cephalosporins and carbapenems.

38
Q

Streptococcus- Colinzation

A

Skin- grou A- S. pyogenes
Mouth- viridans streptococcus, anaerobes (e.g. peptostreptococcuss)
Nasopharynx- group A S. pyogenes
Lower GI- group D- S. bovis, viridans streptococcus and anaerobes
Female Genital tract- Group B- Agalactiae

39
Q

Streptococcus- infections caused- cellulitis

A

Group A- S. pyogenes may result in Nec fascitis

40
Q

Streptococcus- infections caused- Dental carries

A

Viridans Streptococcus

41
Q

Streptococcus- infections caused- pharyngitis (Strep throat)

A

Group A- S. Pyogenes

42
Q

Streptococcus- infections caused- bacteremia/endocarditis

A

Viridans Streptococcus

43
Q

Streptococcus- infections caused- neonatal meningitis

A

Group B- S. Agalactiae

44
Q

Streptococcus treatement

A

Penicillin

More resistance seen with alpha-hemolytic strep, specifically S. Mitis

45
Q

Pneumococci

A

Alpha hemolytic

46
Q

Pneumococci- colonization

A

Oropharynx and nasopharynx

47
Q

Pneumococci- infections caused

A

Otitis media, sinusitis, bronchitis, Pneumoni (CAP Community required pneumonia), and meningitis

48
Q

Pneumococci- Asplenia

A

Without the spleen patients are at risk for fulminant sepsis syndrome.
Lack filtration mechanism of spleen macrophages
Cannot clear encapsulated organisms- S. pneumoniae, H. influenzae, and N. menigitidis

49
Q

Pneumococci- treatment

A

Penicillin resistant strains due to PBP alterations
3rd generation cephalosporins (ceftriaxone)
May de-escalate with cultures and sensitivities

50
Q

Enterococci- colonization

A

Gastrointestinal tract and female genital tract

Resistance is the best defence

51
Q

Enterococci- infection

A

Opportunistic
UTI
Bacteremia/Endocarditis
Intra-abdominal infections

52
Q

Gram Negative (aerobic)

A

Rods- Enterobacter spp, escherichia coli, klebsiella pneumoniae, proteus vulgaris, proteus mirabilis, serratia marcenena, pseudonomas aeruginosa, cocc/coccobaccilli

53
Q

Enterobacteraciae

A

GI tract colonization
Exposure comes from soil, water, vegetation
LPS cell wall component and endotoxin.

54
Q

Enterobacteraciae- infections

A 
UTI
Intra-abdominal infections
Bacteremia
Nosocomial pneumonia
Diabetic foot infections
55
Q

Enterobacteraciae- resistance

A

Prevalent
More common in hospital-acquired infections
Tx guided by in vitro susceptibility

56
Q

Pseudomonas aeruginosa

A

Not considered normal flora (sold, water, vegetation)
Can colonize upper respiratory tract of immunocompromised patients- cystic fibrosis, COPD
Opportunistic- immunocompromised pt, broad spectrum ABX, ventilation equiptment

57
Q

Pseudomonas- infections

A 
Nosocomial infections
Hospital acquired pneumonia (HAP)
Febrile neutropenia
Skin and soft tissue infections (burns, trauma, post-surgical)
UTI
58
Q

SPACE Organisms- double covering

A 
Double covering- Tx w/ 2 ABX
Serratia
Psuedomonas
Acinetobacter
Citrobacter
Enterobacter
More adverse effects, no more resistance
59
Q

Gram (-) Cocci/Coccobacilli- Haemophilus Influenzae

A

Encapsulated- more virulent, not regular colonizer, causes meningitis
No capsule- Colonizes upper respiratory tract, causes otitis media, sinusitis, CAP

60
Q

Gram (-) Cocci/Coccobacilli- Neisseria Menigitidis

A

Humans only nature host
Colonizes oro/nasopharynx
Encapsulated
Causes meningitis and less commonly pneumonia

61
Q

Polysaccharide capsule (PS)

A

Eludes immune system
Requires speen for elimination
PS capsule is target for vaccines- Hib vaccine and meningococcal vaccine

62
Q

Anaerobes- above diaphragm

A 
Petpstreptococcus spp (gram + cocci)
Actinomyces spp (gram + rod)
Fusobacterium (gram - rod)
63
Q

Anaerobes- below diaphragm

A 
Bacteroides fragilis (gram - rod)
Lactobacillus (gram + rod)
Clostridium spp (gram + rod)
64
Q

Gram negative isolates

A

Usually penicillinase prodcuers

65
Q

Anaerobes- colinization

A

Upper and lower Gi and vagnial colonizers.

66
Q

Anaerobes- infection

A

Intra-abdominal infection, aspiration pneumonia, endometritis, PID, diabetic lower extremity infections, dental carries, head and neck.

67
Q

Atypicals

A

Not normal colonizers
Not able to gram stain
Mutiply intracellularly
Result in CAP

68
Q

Atypicals- organisms

A

Mycoplasma pneumonia
Legionella pneumophilia
Chlamydophila pneumoniae

69
Q

Atypicals

A 
Even Some Super Killers Have Pretty Nice Capsules
Escherichia Coli
Streptococcus Pneumoniae
Salmonella
Klebsiella pneumoniae
Haemophilus influenzae
Pseudomonas geruginosa
Neisseria meningitidis
Cryptococcuss neofromans (yeast)
70
Q

9 classes of bacterial pathogens- Streptococci

A

Group A strep, viridans strep

71
Q

9 classes of bacterial pathogens- Streptococcus pneumoniae

A

Streptococcuss pneumoniae

72
Q

9 classes of bacterial pathogens- Enterococcuss

A

usually faecalis

73
Q

9 classes of bacterial pathogens- Staphylococci

A

S. aureus, coagulase-negative

74
Q

9 classes of bacterial pathogens- atypical bacteria

A

Mycoplasma, chlamydia, legionella

75
Q

9 classes of bacterial pathogens- Haemophilus influenzae

A

haemophilus influenzae

76
Q

9 classes of bacterial pathogens- Gram negative rods

A

E. coli, Klebsiella, Proteus, ect

77
Q

9 classes of bacterial pathogens- Pseudomonas aeruginosa

A

Psuedomonas aeruginosa

78
Q

9 classes of bacterial pathogens- Anaerobes

A

Bacteriodes, clostridia, pervotella

79
Q

Nine Important “Classes” of Bacterial Pathogens

A 
Streptococci
Streptococcus Pneumoniae
Enterococcus
Staphylococci
Atypical bacteria
Haemophilus Influenzae
Gram negative rods
Peudomonas Aeruginosa
Anaerobes

Pharmacotherapeutics I (23 decks)

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