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MHD 1 > L24 Neisseria, Haemophilus, and Bordetella > Flashcards

L24 Neisseria, Haemophilus, and Bordetella Flashcards

1
Q

Bacteria in the Neisseria genus are Gram ___ (+/-) ___ (shape).

A

Negative; diplococci

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2
Q

Bacteria in the Haemophilus genus are Gram ___ (+/-) ___ (shape).

A

Negative; coccobacilli

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3
Q

Bacteria in the Bordetella genus are Gram ___ (+/-) ___ (shape).

A

Negative; coccobacilli

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4
Q

Neisseria, Haemophilus, and Bordetella contain ___ in the outer membrane; these are also known as ___.

A

Lipopolysaccharides (LPS); endotoxin

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5
Q

Describe the process of culturing Neisseria.

A
  1. Difficult to grow - require enriched media enhanced by CO2
  2. Chocolate agar that contains antibiotics
  3. Oxidase positive
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6
Q

What are the 2 species of Neisseria that cause disease?

A
  1. Meningitidis

2. Gonorrhoeae

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7
Q

An immune response to Neisseria requires an intact ___ system.

A

Complement

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8
Q

What are the virulence factors of N. meiningitidis?

A
  1. Polysaccharide capsule
  2. LPS/LOS
  3. Type IV pilus
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9
Q

What are the 6 serogroups of polysaccharide capsule that are associated with disease in N. meningitidis?

A

A, B, C, W135, X, Y

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10
Q

N. meningitidis attaches selectively to ___ cells of the ___. What happens next?

A

Columnar; nasopharynx; bacteria multiply and form large aggregates. Within a few hours, pili undergo post-translational modification, which leads to destabilization of the aggregates. Bacteria penetrate into the host cells and are released into the airways.

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11
Q

How is N. meningitidis transmitted?

A

Respiratory droplets

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12
Q

Which serogroups of the capsule are seen in N. meningitidis cases in the developed world?

A

B, C, Y

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13
Q

Which serogroups of the capsule are seen in N. meningitidis cases in the developing world?

A

A, W135

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14
Q

Which age group is most affected by meningococcal disease?

A

Infants and young children to ~9 years old; there is a secondary peak in adolescents and young adults

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15
Q

What are the two possible outcomes of colonization by N. meningitidis?

A
  1. Progress to overt clinical disease

2. Become an asymptomatic carrier

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16
Q

What are the two major clinical manifestations of N. meningitidis?

A
  1. Meningococcemia

2. Meningitis

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17
Q

What are the three less common clinical manifestations of N. meningitidis?

A
  1. Pneumonia
  2. Arthritis
  3. Urethritis
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18
Q

What are the symptoms of meningococcemia?

A

Septic shock, petechical and purpuric rash with bullae, hemorrhage and disseminated intravascular coagulation

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19
Q

What are the symptoms of meningitis?

A

Can occur with or without meningococcemia;

severe headache, neck stiffness, confusion, fever, neurologic deficits

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20
Q

What can be cultured to test for N. meningitidis?

A

Blood, CSF, respiratory secretions

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21
Q

What is the treatment for N. meningitidis?

A

Ceftriaxone, Pencillin G if bacteria are susceptible

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22
Q

How can the close contacts of people with N. meningitids be treated?

A

Prophylaxis with rifampin, ciprofloxacin, ceftriaxone

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23
Q

What are the two types of vaccinations for N. meningitidis?

A
  1. Serogroups A, C, Y, W135 (conjugated polysaccharide vaccine)
  2. Serogroup B (newer recombinant protein vaccines)
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24
Q

What are the recommendations for the Serogroups A, C, Y, W135 vaccination?

A
  1. Adolescents: everyone age 11-12, booster at age 16
  2. Adults: complement deficiency, functional or anatomic asplenia, microbiologists, outbreak, military recruit, HIV, travel
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25
Q

What are the recommendations for Serogroup B vaccination?

A
  1. Adolescents: not required, but can be given for age 16-18

2. Adults: complement deficiency, functional or anatomic asplenia, microbiologists, outbreak

26
Q

What are the virulence factors of N. gonorrhoeae?

A
  1. No capsule
  2. Outer membrane proteins: Pilin (attachment), Opa (attachment), Rmp (protects other OMPs), PorB (prevents phagolysozyme fusion), Transferrin (bacterial iron metabolism)
27
Q

What is antigenically varied in N. gonorrhoeae to promote evasion?

A

Pili

28
Q

How is N. gonorrhoeae transmitted?

A

Across mucosal surfaces by direct contact (anogenital tract most common, also oropharyngeal)

29
Q

___% of women are asymptomatic with N. gonorrhoaea, compared with ___% of men.

A

50; 5-10

30
Q

Women have a ___% risk of acquiring N. gonorrhoeae after exposure, compared with ___% risk for men.

A

50; 20

31
Q

What are the 5 primary clinical manifestations of N. gonorrhoeae?

A
  1. Urethritis
  2. Cervicitis
  3. Proctitis
  4. Pharyngitis
  5. Neonatal conjunctivitis
32
Q

What are the 4 secondary clinical manifestations of N. gonorrhoeae?

A
  1. Epididymitis/prostatitis
  2. Endometritis/salpingitis (pelvic inflammatory disease)
  3. Gonococcemia and septic arthritis
  4. Dermatitis
33
Q

What can be tested to culture N. gonorrhoeae?

A

Urethra, cervix, joint fluid

34
Q

What is required to culture N. gonorrhoeae?

A

Chocolate agar and CO2

35
Q

What are the 5 types of Haemophilus species?

A
  1. H. influenzae
  2. H. parainfluenzae
  3. H. aphrophilus
  4. H. ducreyi
  5. H. aegyptius
36
Q

What does H. parainfluenzae cause?

A

Bacteremia, endocarditis

37
Q

What does H. aphrophilus cause?

A

Endocarditis

38
Q

What does H. ducreyi cause?

A

Chancroid (STI)

39
Q

What does H. aegyptius cause?

A

Conjunctivitis

40
Q

Which Haemophilus species are + for X growth factor?

A

Influenzae and ducreyi

41
Q

Which Haemophilus species are + for V growth factor?

A

Influenzae and parainfluenzae

42
Q

Which Haemophilus species is + for CO2 growth requirement?

A

Aphrophilus

43
Q

How is H. influenzae transmitted?

A

Respiratory droplets

44
Q

H. influenzae type ___ was responsible for > 95% of all invasive infections until 1990 when the vaccination was introduced. Now, more than half of all disease is caused by ___ strains.

A

B; non-encapsulated

45
Q

What diseases are caused by H. influenzae type B?

A
  1. Meningitis
  2. Epiglottitis
  3. Septic arthritis
  4. Pneumonia
  5. Bacteremia
  6. Cellulitis
  7. Osteomyelitis
46
Q

What diseases are caused by non-encapsulated strains of H. influenzae (type a, d, e)?

A
  1. Otitis media
  2. Sinusitis
  3. Pneumonia
  4. Conjunctivitis
47
Q

What age group is primarily affected by H. influenzae type B? By the non-encapsulated strains?

A

6 months - 2 years; children and adults

48
Q

Which type of H. influenzae has a vaccination?

A

Type B

49
Q

What can be cultured to look for H. influenzae?

A

CSF, blood, lower respiratory tract, joint fluid

50
Q

What is used to treat severe, invasive disease caused by H. influenzae?

A

2nd and 3rd generation cephalosporins

51
Q

What is used to treat less severe, non-invasive disease caused by H. influenzae?

A

Amoxicillin/clavulanate, macrolides, fluoroquinolones, trimethoprim/sulfamethoxazole

52
Q

Describe culture and growth of bordetella pertussis.

A
  1. Strict aerobe, non-motile, non-spore forming
  2. Catalase +
  3. Difficult to grow (sensitive to drying, susceptible to toxic substances, metabolites, agar supplemented with charcoal, starch, blood, albumin)
53
Q

What are the virulence factors of B. pertussis?

A
  1. Filamentous hemagglutinin
  2. LPS/LOS
  3. Pertussis toxin (PT)
  4. Tracheal cytotoxin
  5. Adenylate cyclase toxin
54
Q

What does adenylate cyclase toxin do?

A

Increase cAMP levels in cells

55
Q

What does pertussis toxin do?

A

Inactivates the protein controlling adenylate cyclase, leading to higher cAMP levels

56
Q

How is B. pertussis spread?

A

Respiratory droplets

57
Q

B. pertussis is most common and severe in what population?

A

Infants from birth-2 years

58
Q

What are the 4 stages of B. pertussis and how long are they?

A
  1. Incubation (7-10 days)
  2. Catarrhal (1-2 weeks)
  3. Paroxysmal (2-4 weeks)
  4. Convalescent (3-4 weeks)
59
Q

What symptoms are seen in each stage ofB. pertussis?

A
  1. Incubation - none
  2. Cararrhal - rhinorrhea, malaise, fever, sneezing anorexia
  3. Paroxysmal - repetitive cough with whoops, vomiting, leukocytosis
  4. Convalescent - diminished paroxysmal couch, development of secondary complications
60
Q

When will bacteria be present in culture of B. pertussis?

A

Highest in catarrhal, increases during end of incubation and decreases during paroxysmal

61
Q

What is the treatment for B. pertussis and when is it effective?

A

Macrolide; only in the catarrhal stage

62
Q

How can B. pertussis be prevented?

A
  1. Acellular vaccines
  2. DTaP (all infants receive)
  3. Tdap (adults receive in place of one Td booster given every 10 years)

MHD 1 (58 decks)

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