L28 The Gram Positive Rods and Aerobic Actinomycetes Flashcards
What are the major Gram Positive rods?
- Bacillus
- Listeria
- Erysipelothrix
- Corynebacteria
- Arcanobacterium
- Lactobacillus
- Nocardia
What are the general characteristics of Bacillus?
- Spore-forming Gram positive rod
- Widespread in nature
- Prefers aerobic conditions
- Motile (Except anthracis)
Bacillus anthracis is a category ___ biothreat agents.
A
What disease is caused by B. anthracis?
Anthrax
What are the three routes of entry for B. anthracis and which is most common?
- Inoculation (95%) - contaminated soil or infected animal products
- Ingestion
- Inhalation - wool sorter’s disease, processing goat hair, biological weapons
Inhalation anthrax has a prolonged ___ period.
Latent (2+ months)
What are the initial symptoms of inhalation anthrax?
Non-specific fever, shortness of breath, cough, headache, vomiting, chills, chest and abdominal pain
Describe the second stage of inhalation anthrax.
Rapidly worsening fever, edema, enlargement of mediastinal lymph nodes
What is a class imaging finding in inhalation anthrax?
Widening of the mediastinum
___ symptoms occur in 50% of inhalation anthrax patients.
Meningeal
What occurs within 3 days of the second stage of inhalation anthrax if treatment is not initiated?
Shock and death
What is caused by inoculation of B. anthracis?
Cutaneous anthrax
What are the symptoms of cutaneous anthrax and what is the mortality rate?
Painless papules that progress to ulcers surrounded by vesicles, and finally to nectrotic eschar; 20%
What is caused by ingestion of B. anthracis?
GI anthrax
What are the symptoms of GI anthrax and what is the mortality rate?
Ulcers in mouth and esophagus (upper GI), necrosis of the terminal ileum, nausea, vomiting, malaise, bloody diarrhea (lower GI); 100%
What are the virulence factors associated with anthrax and how do they contribute to the pathogenesis?
- Capsule: inhibits phagocytosis of replicating cells
- Edema toxin: causes fluid accumulation
- Lethal toxin: stimulates macrophages to release tumor necrosis factor and IL-1-beta
- Protective AG: binds specific cell surface receptors that enable ET and LT to enter the cell.
Both edema factor and lethal factor require translocation into the host cells by ___.
The protective antigen
How is anthrax diagnosed?
Culture (skin, blood, sputum, CSF) Gram + box car-shaped bacilli Non-motile Non-hemolytic Penicillin susceptible
How is anthrax treated?
Penicillin, ciprofloxacin, or doxycycline
How is B. anthracis ruled out?
Motility (it is non-motile) and hemolysis (it is non-hemolytic)
What diseases are caused by B. cereus?
Food poisoning (exotoxins), ocular infections, central line infections, opportunistic infections
What is cultured when B. cereus is suspected?
- Eye
- Wound infection
- Implicated food product
What are the general characteristics of Listeria?
Non-spore forming, Gram-positive rod
What is the habitat of Listeria?
Animals, environment, refrigerated foods
Where is L. monocytogenes found?
Soil, stream water, fecal flora of many animals, contaminated food, undercooked and unpasteurized foods
What types of food become contaminated with L. monocytogenes?
Soft cheeses, veggies, cold cuts, ready to eat foods, smoked seafood
What is the pathogenesis of Listeria?
Bacteria invade epithelial cells, M cells, and macrophages by an internalin protein. Bacteria are engulfed in a vacuole, where they produce listeriolysin and phospholipases to excape from the phagosome. Host cell actin is utilized to move bacteria into adjacent cells with exposure to the immune system.
What encodes the host cell actin utilized by Listeria?
ActA gene
Why will patients with defects in cellular immunity but not humoral immunity be susceptible to severe infections by Listeria?
Humoral immunity is relatively unimportant because bacteria move within cells and avoid antibody-mediated clearance