L46: Medically Important Gram -ve Bacilli Flashcards

1
Q

LPS structure

A
  1. Lipid A: endotoxaemia
    - septic shock (20-40%), mortality rate (20-50%)
    - activate cytokine cascade
  2. O-antigen
  3. Core oligosaccharide
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2
Q

3 important groups of gram -ve bacilli

A
  1. Enterobacteriaceae: Facultative anaerobes, oxidase -, glucose fermentation +
    - Escherichia coli
    - Salmonella
    - Shigella
    - Klebsiella
    - Proteus, Providencia, Morganella
    - Citrobacter, Enterobacter, Serratia
  2. Vibrionaceae: Facultative anaerobes, oxidative +, glucose fermentation +
    - Vibrio cholerae
    - non-cholera vibrio (V. parahaemolyticus, V. vulnificus)
  3. Pseudomonas aeruginosa: Strictly aerobic, oxidase +, glucose fermentation -
    - Other non-fermenters (Acinetobacter baumannii, Stenotrophomonas maltophilia)
  4. Others
    - Bordetella pertussis
    - Campylobacter
    - Helicobacter pylori
    - Haemophilus
    - Brucella
    - Legionella
    - Spirochaetes
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3
Q

Common clinical diseases of gram -ve bacteria

A
  1. UTI
  2. GI infection
  3. Intra-abdominal infection
  4. Hospital-acquired infection
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4
Q

Characteristics of Enterobacteriaceae (big family) (ESSK: E. coli, Salmonella, Shigella, Klebsiella)

A
  • large bowel (coliforms)
  • O antigen (LPS)
  • H antigen (flagella)
  • K antigen (capsule)
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5
Q

Escherichia coli

A
  • Commonest gram -ve bacteria
  • Intestinal: traveller’s diarrhoea, haemorrhagic colitis
  • Extraintestinal: UTI, intra-abdominal
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6
Q

Salmonella enterica

A
  • > 2500 serotypes
  • different O and H antigen
  • Typhoidal (Typhi, Paratyphi) vs Nontyphoidal
  • food and water
  • Salmonellosis:
    —> Gastroenteritis
    —> Typhoid / Paratyphoid fever (systemic infection in human only)
    —> Disseminated/focal infection (osteomyelitis, meningitis)
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7
Q

Shigella

A
  • e.g. Shigella dysenteriae
  • causes bacillary dysentery
  • contaminated food/water, faecal-oral route
  • Shiga toxin
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8
Q

Klebsiella pneumoniae

A
  • pneumonia, UTI, abscess

- Mucoid colony

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9
Q

Proteus, Providencia, Morganella

A
  • Urease positive

- UTI, hospital-acquired infection

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10
Q

Citrobacter, Enterobacter, Serratia

A
  • hospital-acquired infections
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11
Q

Vibrionaceae (big family), Aeromonas, Plesiomonas (under Enterobacteriaceae)

A
  • curved
  • oxidase +ve, glucose fermentation +ve
  • fresh water
  • GI infection, systemic infection
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12
Q

Vibrio Cholerae

A
  • Cholera, gastroenteritis
  • profuse watery diarrhoea
  • O antigen: O1, O139, non-O1-non-O139
  • Cholera toxin: increase cAMP, inhibit NaCl reabsorption, increase water secretion
  • Other non-cholera vibrio: V. parahaemolyticus (bacterial gastroenteritis) + V. Vulnificus (necrotising fasciitis)
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13
Q

Pseudomonas aeruginosa

A
  • Strictly aerobic
  • Oxidase +ve, glucose fermentation -ve
  • Saprophytes in soil, moist environment, skin
  • Green pigment, fruity odour
  • resistant to antibiotics and disinfectants
  • IMPORTANT cause of Hospital-acquired infections
  • Other non-fermenters: Acinetobacter baumannii, Stenotrophomonas maltophilia
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14
Q

Bordetella pertussis

A

Whooping cough

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15
Q

Campylobacter

A
  • Microaerophilic
  • Spiral
  • Contamined animal products (nature in animals)
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16
Q

Helicobacter pylori

A

Gastric ulcer, gastric cancer, gastric lymphoma

17
Q

Haemophilus influenzae

A
  • Coccobacilli
  • Facultative anaerobe
  • Require blood: both X (haemin) and V factor (NAD/NADP)
  • Only grow on chocolate agar (lysed blood cell) but not on blood agar (only X factor); may grow near S. Aureus on blood agar (satellite growth) since S. Aureus is haemolytic
  • Pneumonia, meningitis
  • polysaccharide capsule a-f, non-typeable
  • Type b vaccine available (invasive disease in children/infants)
18
Q

Legionella pneumophila

A
  • aerobic
  • fresh water (cooling tower)
  • Pontiac fever (flu-like illness)
  • Legionnaire’s disease (pneumonia)
20
Q

Spirochaetes

A
  • Spiral
  • not readily visualised in light microscopy
  • Treponema pallidum: ***not cultivable in-vitro, Syphilis, persist in body
  • Leptospira interrogans: Corkscrew-shaped with end hooks, zoonosis, urine of animals, tropical and subtropical area
  • Borrelia
21
Q

Brucella

A
  • Coccobacilli
  • non-motile
  • non-sporting
  • Brucellosis: zoonosis by ingestion
  • Sheep, goat, cattle, pig