M5 PART 1-3 Flashcards
1
Q
gram-positive spore-forming bacilli
A
Bacillus
Clostridium
2
Q
gram-positive spore-forming bacilli
aerobes
A
Bacillus
3
Q
gram-positive spore-forming bacilli
anaerobes
A
Clostridium
4
Q
- resting cells
- dormant
- highly resistant
- are formed when their environment is depleted
- resistant to heat so kahit lutuin buhay pa rin
A
ENDOSPORES
5
Q
- a classical disease in the history of microbiology that is caused by Bacillus anthracis
- important disease of animals & occasionaly humans
- has potent toxins and is a major potential agent of bioterrorism & biologic warfare
A
ANTHRAX
6
Q
causes food poisoning & occasionally eye or other localized infections
A
Bacillus cereus
7
Q
Bacillus species
Large, ____, Gram-positive rods in chains
A
aerobic
8
Q
Bacillus species
Possess virulence ____
A
PLASMIDS
9
Q
Bacillus species
- most of this genus are ____, prevalent in soil, water, and air, and on vegetation
- they feed on decaying matter
A
SAPROPHYTIC
10
Q
Bacillus species
Forms nonhemolytic gray to white colonies
(____)
A
MEDUSA HAIR, CURLED HAIR
11
Q
Bacillus species
Spores are located ___
A
CENTRALLY
12
Q
Bacillus anthracis
Cell wall is made up of amino acid: ______
A
poly-γ-D-glutamic acid
13
Q
Bacillus anthracis
Disease: ____
A
ANTHRAX
14
Q
- commonly found in animals (herbivores)
- has capsule
- non motile
- antiphagocytic
A
Bacillus anthracis
15
Q
a disease of the herbivores
* ex. cow when eating grass can acquire from soil & can hawa from animal to humans
A
ANTHRAX
16
Q
Bacillus anthracis
Pathogensis: based primarily on the production of ____
A
ANTHRAX TOXIN
17
Q
Bacillus anthracis | ANTHRAX TOXIN
causes edema (swelling)
A
EDEMA FACTOR (EF)
18
Q
Bacillus anthracis | ANTHRAX TOXIN
causes death of the cell by necrosis o hypoxia
A
LETHAL FACTOR (LF)
19
Q
Bacillus anthracis | ANTHRAX TOXIN
- a protein that binds to specific cell receptors
- forms a membrance channel so that EF & LF can enter the cell
A
PROTECTIVE ANTIGEN (PA)
20
Q
cell death
A
NECROSIS
21
Q
cell does not have oxygen
A
HYPOXIA
22
Q
Bacillus anthracis
- is usually acquired by the entry of spores through the injured skin
- form accounts for over 95% of anthrax cases
- forms black eschar
- A pruritic papule develops 1-7 days after entry of the spores
A
CUTANEOUS ANTHRAX
23
Q
Bacillus anthracis
- rare case of anthrax in humans
- can be accumulated from food contaminated by anthrax
- abdominal pain, vomiting, diarrhea
A
GASTROINTESTINAL ANTHRAX
24
Q
- Wool sorter’s disease: from wool of sheep
- severe case of anthrax
- 5% of anthrax cases
- once inhaled, mapunta sa alveoli of lungs, then papasok sa blood and then kakalat infection can be systemic
- mediastinal widening: important diagnostic criterion (by xray)
A
INHALATION ANTHRAX
25
# **Bacillus anthracis**
* among persons who **inject heroin** contaminated with anthrax spores
* **resembles** cutaneous anthrax
* characterized by extensive, painless subcutaneous edema and the **notable absence** of the eschar
INJECTION ANTHRAX
25
# **Bacillus anthracis**
Drug of Choice
Ciprofloxacin
26
27
# **Bacillus anthracis**
Vaccine
AVA Biothrax Vaccine
28
# **Bacillus anthracis**
Prophylaxis (prevention)
**3 doses** of **biothrax** vaccine
**ciprofloxacin** or **doxycycline** for **60 days**
29
***Bacillus cereus*** is also known as
FRIED RICE BACILLI
30
# BACILLUS SPECIES
* causes **food poisoning**
* 2 distinct forms: **emetic** & **diarrheal**
* **1-5 hours** incubation period
* **hemolytic** (destroys RBC)
* **motile**
BACILLUS CEREUS
31
incubation period of ***Bacillus cereus***
1-5 hours
32
# **Bacillus cereus**
* seen in **fried rice**, **pasta**, **milk**
* nausea, vomiting, abdominal cramps
EMETIC TYPE
33
# **Bacillus cereus**
* **meat dishes** & **sauces**
* profuse diarrhea with abdominal pain & cramps
DIARRHEAL TYPE
34
B. cereus produce **toxins** that cause disease that is more of ____ **than a food-borne infection**
INTOXICATION
35
# **Bacillus cereus**
EYE INFECTIONS
**severe keratitis**
**endophthalmitis**
36
# **Bacillus cereus**
other clinical findings
ENDOCARDITIS
OSTEOMYELITIS
PNUEMONIA
CNS INFECTIONS
37
# **Bacillus cereus**
catheter-associated ____
| CLINICAL FINDINGS
BACTEREMIA
38
# **Bacillus cereus** | TREATMENT
**Foodborne** infection
* self limiting
* stay hydrated -- drink ORS
39
how to make ORS oral rehydration salts
6 tsp sugar, half level tsp salt, 1L water
40
# **Bacillus cereus** | TREATMENT
**Non-foodborne** infection:
▪ ____ or ____ with or
without an aminoglycoside
Vancomycin
Clindamycin
41
# **Bacillus cereus** | TREATMENT
**Non-foodborne** infection:
▪ ____ - **wound infections**
Ciprofloxacin
42
* large, **anaerobic**, gram +
* **saprophytes**
* spore is placed **centrally**, **subterminal** (gitna ng dulo at central), or **terminally** (dulo)
* can **ferment** variety of **sugars** & **digest proteins**
CLOSTRIDIUM SPECIES
43
# **Clostridium species**
Large, ____, Gram-positive ____rods
**Anaerobic**, **motile**
44
# **Clostridium species**
Spore is placed
| 3
centrally, subterminally, terminally
45
# **Clostridium species**
can ____ variety of ____ and ____
ferment variety of sugars & digest proteins
46
* causes **botulism**
* produce **7** antigenic varieties of toxin
* toxin is **potent**
* found in **soil**, occasionally in animal feces
* highly resistant to **heat**, withstanding **100ºC** for several hours
CLOSTRIDIUM BOTULINUM
47
# **Clostridium botulinum**
Disease:
BOTULISM
48
# **Clostridium botulinum**
Antigenic varieties **affecting humans**:
types **A,B,E** & **F**
49
# **Clostridium botulinum**
Botulinum toxin **blocks** the **release** of
____ resulting to _____
ACETYLCHOLINE, FLACCID PARALYSIS
50
**clostiridia** grow well on what **culture media**
BLOOD-ENRICHED MEDIA
51
**some** clostiridia form colonies that ____ on the **agar surface**
spread or swarm
52
**many** clostiridia produce a zone of ____ on **blood agar**
β-hemolysis
53
characteritically produces a **double zone** of β-hemolysis around colonies
Clostiridium perfringens
54
# **Clostridium botulinum**
types that have been associated with **variety of foods**
A & B
55
# **Clostridium botulinum**
types that have been predominantly associated with **fish products**
E
56
# **Clostridium botulinum**
type that produces **limberneck** in **birds**
C
57
# **Clostridium botulinum**
type that causes **botulism** in **mammals**
D
58
# **Clostridium botulinum**
type that is **not associated** with disease
G
59
# **Clostridium botulinum**
once acquired -> go blood -> go brain (**which part of the brain?**)
presynapse, presynaptic membranes
60
# **Clostridium botulinum**
* **inhibits** the **release** of **acetylcholine** at the synapse
* resulting in **lack of muscle contraction** & **paralysis**
* by the **L chain** of botulinum toxin
**PROTEOLYSIS** of the target SNARE proteins
61
# **Clostridium botulinum**
SNAP PROTEINS
synaptobrevin
SNAP 25
syntaxin
62
**most toxic** substances known
C. botulinum toxins
63
# **Clostridium botulinum**
what is **needed** to release acetylcholine
FUSION (snare proteins)
64
# **Clostridium botulinum**
* **canned good bacilli**
* commonly seen in **spiced**, **smoked**, **vacuum packed** (because it has **anaerobic** environment)
* Botulism characterized by **weakness** of the **eye muscles**, **drooping eyelids**
* usual cause of death is **respiratory related**
* the effect is from **head to toe** (ulo muna pababa)
FOOD BOTULISM
65
# **Clostridium botulinum**
* most frequent **vehicle** is **honey**
* the infant develops **FLOPPY BABY SYNDROME**
* **Adults** with **gastrointestinal anatomical abnormalities** or **functional disorders** may develop this
INFANT BOTULISM
66
# **Clostridium botulinum**
* result of **tissue contamination** with spores
* seen primarily in **injection drug users**
WOUND BOTULISM
67
# **Clostridium botulinum**
TREATMENT & PREVENTION
* Respiratory support
* Trivalent antitoxin (ABE)
68
# **Clostridium botulinum**
TREATMENT & PREVENTION:
for **infants**
botulinum immune globulin (BIG)
69
* causes **tetani**
* **Non communicable**
* all share a **common O antigen**
* all produce the **same type** of antigenic type of neurotoxin
* **uncontrollable** muscle spasms
CLOSTRIDIUM TETANI
70
# **Clostridium tetani**
Disease
TETANUS
71
# **Clostridium tetani**
**Neurotoxin** produced:
TETANOSPASMIN
72
# **Clostridium tetani**
**blocks** the **release** of inhibitory mediators resulting to hyperreflexia, muscle
spasms
TETANUS TOXIN
73
# **Clostridium tetani**
tetanus toxin blocks the release of ____ resulting to _____
inhibitory mediators
hyperreflexia, muscle spasms
74
# **Clostridium tetani**
forced **grin**
Risus sardonicus
75
# **Clostridium tetani**
**lock jaw**
Trismus
76
# **Clostridium tetani**
**severe case** of tetanus
OPSITHOTONOS
77
# **Clostridium tetani**
tetanus **vaccine**
DPT
78
# **Clostridium tetani**
TREATMENT
muscle relaxants, sedation & assisted ventilation
IV tetanus antitoxin
79
# **Clostridium tetani**
ANTIBIOTIC
PENICILLIN
80
# **Clostridium tetani**
PREVENTION
* wound cleaning & debridement
* Tetanus antitoxins & toxoid booster w penicillin (passive-active immunity)
81
# **Clostridium perfringens**
Diseases
Gas gangrene
Food poisoning
82
# **Clostridium perfringens**
Toxins porduced
* Alpha toxin
* Theta toxin
* Epsilon
* DNase and hyaluronidase
* Enterotoxin
83
# **Clostridium perfringens** | TOXINS
**hemolytic** & **necrotizing** effect
ALPHA TOXIN (lecithinase)
84
# **Clostridium perfringens** | TOXINS
the **alpha toxin** is a
lecithinase
85
# **Clostridium perfringens** | TOXINS
**forms pores** in cell membranes
theta toxin
86
# **Clostridium perfringens** | TOXINS
edema & hemorrhage
Epsilon toxin
87
# **Clostridium perfringens** | TOXINS
causes the **spread** of bacteria
DNase & hyaluronidase
88
# **Clostridium perfringens** | TOXINS
* **food poisoning**
* meat dishes
Enterotoxin
89
# **Clostridium perfringens**
* spores reach the **traumatized tissue** or from the intestinal tract
* **necrosis**
* in **large wounds** cause by accidents
* vegetative cells multiply, ferments carbohydrates, and produce **gas**
GAS GANGRENE
90
# **Clostridium perfringens**
Gas gangrene is also known as
Clostridial myonecrosis
90
# **Clostridium perfringens**
* **diarrhea** & **cramps**
* source: **poultry** products
* **enterotoxin** (targets GI tract)
FOOD POISONING
91
# **Clostridium perfringens**
TREATMENT
* surgical debridement
* hyperbaric oxygen
* penicillin G antibiotics
* polyvalent toxin
91
all that can cause **food poisoning** has
ENTEROTOXIN
92
# **Clostridium perfringens**
TREATMENT:
food poisoning
symtpomatic treatment
93
common cause of **nosicomial infection** (hospital acquired)
CLOSTRIDIUM DIFFICILE
94
# **Clostridium difficile**
* seen in **patients w diarrhea** & **have been giving antibiotics**
* produces **potent enterotoxins** (A & B)
* once produce enterotoxin, causes **pseuodmembrane** (inflammation of the membrane)
PSEUDOMEMBRANOUS COLITIS
95
# **Clostridium difficile**
* characetrized by **mild to moderate diarrhea **
* **less severe** than Pseudomembranous colitis
ANTIBIOTIC-ASSOCIATED DIARRHEA
96
in **Clostridium difficile**, diarrhea may be
WATERY or BLOODY
97
# **Clostridium difficile**
the **very first** antibiotics that has been found to cause Psuedomembranous colitis
CLINDAMYCIN
98
# **Clostridium difficile** | TREATMENT
____ offending antibiotics
discontinue
99
# **Clostridium difficile** | TREATMENT
**new antibiotics** that can be administered:
Metronidazole, ____, or
vancomycin
fidaxomicin
100
# **Clostridium difficile**
a **succesful** & **routine method** for the treatment of Pseudomembranus colitis
FECAL TRANSPLANT
101
* **club shaped** rods that form **metachromatic granules** — can store phosphate
* arranged in **palusades** or in **V** or **L** shaped
* forms **black colonies** on **tellurite media**
* **chinese-letter** arrangement of cells **Loffler’s serum medium**
* **4** biotypes
* **aerobic**, **pleomorphic** (shape can vary)
* **non motile**
Corynebacterium diphtheriae
102
# **Corynebacterium diphtheriae**
Shape:
club-shaped rods
103
# **Corynebacterium diphtheriae**
Arrangement:
**palusades** or in **V** or **L** shaped
104
# **Corynebacterium diphtheriae**
Forms **black colonies** on what media
tellurite media
105
# **Corynebacterium diphtheriae**
**Chinese-letter** arrangement of cells what media
Loffler’s serum medium
106
# **Corynebacterium diphtheriae**
how many biotypes
4
107
# **Corynebacterium diphtheriae**
* is a **polypeptide** with **2 fragments**
* **heat-labile**, single chain
* **inhibits protein synthesis** by ADP-ribosylation of elongation factor-2 (EF-2)
diphtheria toxin
108
# **Corynebacterium diphtheriae**
**2 fragments** of diptheria toxin
fragment A & B
109
# **Corynebacterium diphtheriae**
diphtheria toxin **inhibits protein synthesis** by ADP-ribosylation of ____
elongation factor-2 (EF-2)
110
# **Corynebacterium diphtheriae**
* what fragment **allows** the **entry of toxin**
* for **binding**
fragment B
111
# **Corynebacterium diphtheriae** | TRUE OR FALSE
**all** diphtheria had toxin
FALSE
| some diphtheria are non toxinogenic
112
# **Corynebacterium diphtheriae**
where does the diphtheria toxin **reside**
upper respiratory tract
113
# **Corynebacterium diphtheriae**
Role of **bacteriophage**
**carries the code** for diphtheria toxin
114
# **Corynebacterium diphtheriae**
**acquisition** happens in the presence of
bacteriophage
115
virus-infecting bacteria
bacteriophage
116
# **Corynebacterium diphtheriae**
* acquired through **airborne droplet**
* has a chance to be a **systemic infection**
* a **pseudomembrane** is formed (commonly over **tonsils down to the larynx**)
* **enlargement** of regional lymph node & marked edema in the neck can cause a **bull neck** appearance
* **Mycoarditis** (necrosis in heart muscle) accompanied by arrhythmias & circulatory collapse
* **nerve weakness** or **paralysis** of the soft palate, eye muscles, or etremities
Respiratory diphtheria
117
# **Corynebacterium diphtheriae**
Respiratory diphtheria can be acquired through
airborne droplet
118
# **Corynebacterium diphtheriae**
what is formed in **respiratory diphtheria**
psueudomembrane
119
# **Corynebacterium diphtheriae**
common **location** of pseudomembrane
| RESPIRATORY DIPHTHERIA
over **tonsils** down to the **larynx**
120
# **Corynebacterium diphtheriae**
**enlargement** of regional lymph node & marked **edema in the neck** can cause what appearance
| RESPIRATORY DIPHTHERIA
bull neck appearance
121
# **Corynebacterium diphtheriae**
* **wound** or **skin diptheria**
* a membrane may be formed on an infected wound that **fails to heal**
* **localized** infection
* occurs chiefly in **tropics**
* **absorption of toxin** is usually **slight** and the **systemic effects** are **negligible**
* **matagal mag heal**
* does **not** typically **invade deep tissues** & practically **never enters the bloodstream**
CUTANEOUS DIPHTHERIA
122
# **Corynebacterium diphtheriae**
diphtheria **occurs** only in persons who **possess NO** ____
antitoxin antibodis (IgG)
123
# **Corynebacterium diphtheriae**
antitoxin
Diphtheria antitoix (IM or IV)
124
# **Corynebacterium diphtheriae**
ANTIMICROBIAL DRUGS
Penicillin
Macrolides
125
# **Corynebacterium diphtheriae**
Vaccine
Diphtheria toxoid (DPT)
126
# **Corynebacterium diphtheriae**
Diphtheria toxoid is produced in what **animal**
horse
127
# **Corynebacterium diphtheriae**
**test** that **detects** the **immunity** to diphtheria
Schick test
128
# **Corynebacterium diphtheriae**
**Schick test**:
check for reaction after how many days
4 - 7 days
129
# **Corynebacterium diphtheriae**
**Schick test**:
if there is **NO immunity**, there will be ____
inflammation
130
# **Corynebacterium diphtheriae**
**Schick test**:
if **there is immunity**, what will be observed
no inflammation
131
**Corynebacterium** species are typically ____ (motility) and ____ (catalase)
nonmotile
catalase +
132
# **Corynebacterium**
grow **slowly** on **sheep** blood agar
lipophilic corynebacteria
133
* a **psychotroph**
* most common cause of **food spoilage** in **refrigerated** environments
* exhibits **tumbling end-over-end motility** but is **temperature dependent** (22-28C)
* **motile**
* **β-hemolysis** on a **blood agar plate**
* **facultative anaerobe** & **catalase positive** (kaya mag produce ng catalase enzyme)
* had **13 **serovars based on **O** (seen in cell wall) & **H** (in flagella) antigens
Listeria monocytogenes
134
# **Listeria monocytogenes**
Pyschrophile or Psychrotoph?
psychrotoph
135
# **Listeria monocytogenes**
Motility
tumbling end-over-end motility
136
# **Listeria monocytogenes**
oxygen requirement
facultative anaerobe
137
# **Listeria monocytogenes**
catalase
positive
138
# **Listeria monocytogenes**
temperature needed
22 - 28°C
139
# **Listeria monocytogenes**
type of hemolysis
β-hemolysis
140
# **Listeria monocytogenes**
produce **β-hemolysis** on what type of culture media
blood agar plate
141
# **Listeria monocytogenes**
how many **serovars**
13
142
# **Listeria monocytogenes**
Virulence factors
* Internalins A and B
* Listeriolysin O
* Act A
* Filopods
* Siderophores
| I Am Bad Like Omg, Acting lang Filipino kaSi
143
# **Listeria monocytogenes** | VIRULENCE FACTORS
* has **cell wall surface proteins** called
* these interact with E-cadherin, a receptor on epithelial cells, **promoting phagocytosis into the epitheial cells**
internalins A & B
144
# **Listeria monocytogenes** | VIRULENCE FACTORS
after phagocytosis, the bacterium is **enclosed** in a **phagolysosome**, where the **low pH activated the bacterium** to produce ____
Listeriolysin O
145
# **Listeria monocytogenes** | VIRULENCE FACTORS
* a **listerial surface protein**
* **induces** host cell actin **polymerization**, which **propels** them to the **cell membrane**
Act A
146
# **Listeria monocytogenes** | VIRULENCE FACTORS
**elongated protrusions**
Filopods
147
# **Listeria monocytogenes** | VIRULENCE FACTORS
allows the **adherence** and **entrance** of bacteria & will be phagocytized by the phagolysosome
Internalins A & B
148
# **Listeria monocytogenes** | VIRULENCE FACTORS
environment **inside** phagolysosome is **acidic**, allowing the **secretion** of ____ which **punctured** the phagolysosome releasing back the bacteria to the cytoplasm & replicated
| (cannot be digested anymore kz sira na un phagolysosome)
Listeriolysin O
149
# **Listeria monocytogenes** | VIRULENCE FACTORS
will **propell** the organism so that it would **move** & **infect another cell**
| (itulak sa ibang cell na pede i-infect)
Act A protein
150
# **Listeria monocytogenes** | VIRULENCE FACTORS
the panunulak of **Act A** protein will cause the formation of a **bubble** called
Filopod
151
# **Listeria monocytogenes** | VIRULENCE FACTORS
**steal iron** from the cell
Siderophores
152
# **Listeria monocytogenes**
Transmission
Vertical transmission
| across the placenta to the fetus or during dlivery
153
# **Listeria monocytogenes**
two forms of **perinatal human listeriosis**
early-onset
late-onset
154
# **Listeria monocytogenes** | PERINATAL HUMAN LISTERIOSIS
**early-onset** is also called
garnulomatosis infantseptica
155
# **Listeria monocytogenes** | PERINATAL HUMAN LISTERIOSIS
* the result of infection in **uterus**
* a disseminated form of the disease
* characterized by **neonatal sepsis** (death, overreaction of cells), **pustular lesions**, and **granulomas** (nagkakabukol ang organs)
Early-onset syndrome
granulomatosis infantseptica
156
# **Listeria monocytogenes** | PERINATAL HUMAN LISTERIOSIS
* development of **meningitis** between **birth** and the **third week** of life
* nahawa ang baby **during delivery**
* **mother** is **asymptomatic** or mild **influenza-like** symptoms
Late-onset syndrome
157
# **Listeria monocytogenes** | CLINICAL FINDINGS
* **mild**
* **self-limiting**; lasting **1-3 days**
* incubation period: **6 - 48 hours**
* fever, chills, headache, myalgias, abdominal pain, & diarrhea
Gastroenteritis
158
# **Listeria monocytogenes**
* can develop **Listeria meningoencephalitis**
* more on **brain infections**
IMMUNOCOMPROMISED
159
# **Listeria monocytogenes**
Vaccine
**NO** vaccine available
160
# **Listeria monocytogenes**
**Antibiotics**:
for meningitis & sepsis
Ampicillin w/ or w/o gentamicin
161
# **Listeria monocytogenes**
**Antibiotics**:
**CNS infections** for patients **allergic to penicillin**
trimethoprim-sulfamethoxazole
162
* **short chains** or **nonbranching filaments**
* disease of **animals** → **erysipelas**
* disease of **humans** → **erysipeloid**
* madalas nakukuha sa **SWINE**
* **α-hemolytic** on **blood agar**
* **catalase negative**
* distributed in **land** & **sea animals**
Erysipelothrix rhusiopathiae
163
# **Erysipelothrix rhusiopathiae**
may be **α-hemolytic** on what type of culture media
blood agar
164
what is **produced** when ***Erysipelothrix*** is grown on **triple sugar iron agar (TSI)**
hydrigen sulfide
H2S
165
what will be the **color** of TSI when H2S is produced
butt black
166
***Erysipelothrix rhusiopathiae*** is resistant to what drug
vancomycin
167
# **Erysipelothrix rhusiopathiae**
* most common E. rhusiopathiae infection in **humans**
* usually occurs in **fingers** by **direct inoculation** at the site of a **cut** or **abrasion**
* called as **seal finger** or **whale finger**
* incubation: **2-7 days**
* **lesion** is **raised**, well circumcised, **violaceous** in **color**
* **pus** is **not** present
* persons with greatest risk: **fishermen**, **fish handlers**, **bucthers**
ERYSIPELOID
168
# Erysipelothrix rhusiopathiae
Treatment of **erysipeloid**
can resolve without treatment
169
# **Erysipelothrix rhusiopathiae**
**erysipeloid** is **acquired** by
direct inoculation from animals or animal products
170
# **Erysipelothrix rhusiopathiae**
Rare infections
diffuse cutaneous form
bacteremia w/ or w/o endocarditis
171
# Erysipelothrix rhusiopathiae
drug of choice for erysipeloid
Penicillin G
172
* **coccoid** organisms that are **modified acid-fast**
* **salmon pink** smooth colonies
* common cause of **necrotizing pneumonia**
* present in **soil** & **dung of herbivores**
* cause disease in **cattle**, **sheep**, and **swine**
* can cause **severe pulmonar**y & **extrapulmonary infections** in **foals**
Rhodococcus equi
173
# **Rhodococcus equi**
modified ____ when **stained** by **Kinyoun method**
acid-fast positive
174
* thin, branching, **beaded** aerobic bacteria
* filamentous organisms with **hyphae-like branching**
* **weakly acid fast**
* **opportunistic** pathogens
* found in **soil** & **water**
* initiated by **inhalation**
* **catalase positive**
* produce **urease**
* cause **systemic disease** primarily in **immunocompromised patients**
Nocardia
175
# **Nocardia**
oxygen requirement
aerobic
176
# **Nocardia**
component of **cell wall**
mycolic acid
177
# **Nocardia**
what type of pathogen
opportunistic
178
# **Nocardia**
main clinical presentation
Pulmonary nocardiosis
179
# **Nocardia**
primary **route** of **bacterial exposure**
inhalation
180
# **Nocardia**
associated with most primary **cutaneous infections** that usually **result from trauma**
***Nocardia brasiliensis***
181
# **Nocardia**
drug of choice
trimethoprim-sulfamethoxazole
182
# **Nocardia**
species are **best identified** after recovery on routine media by ____
molecular methods
183
# **Nocardia**
usual **pathologic process**
abscess formation
184
* short or **club shaped**, long thin, **beaded** filaments
* **branched** or **unbranched**
* **aerotolerant**
* produce colonies on agar that resemble **molar teeth**
Actinomyces
185
# **Actinomyces**
disease
Actinomycosis
186
# **Actinomyces**
shape
club-shaped
187
# **Actinomyces**
* a **chronic suppurative** and **granulomatous** infection
* produces **pyogenic lesions**
* inititated by **trauma**
* causes **swelling** and may **spread** to **neighboring organs**, including bones
Actinomycosis
188
# **Actinomyces**
* presents as **swollen**, **erythematosus** prcoess in the **jaw** area
* known as **lumpy jaw**
* mas becomes **fluctuant**, producing **draining fistulas**
* disease will **extend** to contiguous tissue, bone, and lymph nodes of the head & neck
Cervicofacial actinomycosis
189
# **Actinomyces**
**Cervicofacial actinomycosis** is also known as
lump jaw
190
# **Actinomyces**
* symptoms resemble those of a subacute **pulmonary infection**
* mild fever, cough, and **purulent sputum**
* lung tissue is destroyed, sinus tracts may erupt, invasion of ribs
Thoracic actinomycosis
191
# **Actinomyces**
* often follows a **ruptured appendix** or an **ulcer**
Abdominal actinomycosis
192
# **Actinomyces**
* **rare** occurenece in **women**
* results from colonization of an **intrauterine device** with subsequent invasion
Genital actinomycosis
193
# **Actinomyces**
Treatment
administration of **Penicillin** for **6-12mos**
194
# **Actinomyces**
drug alternatives
Clindamycin
Erythromycin
195
* members of **normal microbiota**
* metabolic products include **propionic acid**
* **highly pleomorphic**
* curved, clubbed, or pointed ends; long forms with beaded uneven staining
Cutibacterium
196
* **opportunistic** pathogens
* cause the disease **acne vulgaris**
* produces **lipase** that split free fatty acids off from skin lipids
* **fatty acids** can produce **tissue inflammation** that contributes to **acne formation**
* cause of **postsurgical wounds**, particularly those that involve **insertion of devices**
Cutibacterium acnes
197
# **Cutibacterium acnes**
disease
acne vulgaris
198
# **Cutibacterium acnes**
causes acne vulgaris by producing ____
lipases
199
**Cutibacterium acnes** is **formerly** known as
Propionibacterium acnes
200
# **Staphylococcus**
catalase, coagulase
catalase **+,** coagulase **-**
201
# **staphylococcus coagulase test**
only ____ is **positive** in the test
S. aureus
202
**only** staphyloccocus that is coagulase **positive**
S. aureus
203
**test** for S. epidermidis & S. saprophyticus
novobiocin
204
# **STAPHYLOCOCCUS**
has **resistance** in novobiocin
S. saprophyticus
205
# **STAPHYLOCOCCUS**
**susceptible** in novobiocin
S. epidermidis
206
* **catalase positive**; **coagulase negative**
* **nonmotile**
* do **not** form spores
* **grapelike** irregular clusters
* slowly **ferment carbohydrates**, produce **lactic acid** but **not gas**
* rapidly develop **resistance** to any antimicrobial agents
* produce **catalase**
* resistant to **drying** & **heat**
STAPHYLOCCOCI
207
* **major pathogen** for **humans**
* forms **golden yellow colonies**
* ferments **mannitol**
* **hemolyzes RBC**
* **halotolerant**
Staphylococcus aureus
208
only staphyloccoci that **ferments mannitol**
Staphylococcus aureus
209
# **Staphylococcus aureus** | MECHANISMS OF RESISTANCE
responsible for **resistance** to many **penicillins**
β-lactamase
210
# **Staphylococcus aureus** | MECHANISMS OF RESISTANCE
what **causes** **resistance** to **penicillins**
β-lactam ring
211
# **Staphylococcus aureus** | MECHANISMS OF RESISTANCE
what causes **resistance** to **nafcillin**, **methocillin**, **oxacillin**
mecA & mecC genes
212
# **Staphylococcus aureus** | MECHANISMS OF RESISTANCE
how many types of SCCmec
12
213
# **Staphylococcus aureus**
**HA**-MRSA (**hospital** acquired)
Types I, II III, VI & VIII
214
# **Staphylococcus aureus** | MECHANISMS OF RESISTANCE
* **CA**-MRSA (**community** acquired)
* **less resistant**, **more transmissible**
type IV
215
# **Staphylococcus aureus** | MECGANISMS OF RESISTANCE
**partially** resistance
Vancomycin-Intermediate S. aureus (**VISA**)
216
# **Staphylococcus aureus** | MECGANISMS OF RESISTANCE
**completely** resistant; encoded by **vanA** gene
Vancomycin-Resistant S. aureus (**VRSA**)
217
# **Staphylococcus aureus** | ANTIGENIC STRUCTURE
* thick polysaccharide polymer
* has **endotoxin-like** activities
* produce **IL-1**
* can be a **chemoattractant**
* can **activate complement**
PEPTIDOGLYCAN
218
# **Staphylococcus aureus** | ANTIGENIC STRUCTURE
* polymers of **ribotol phosphate**
* mediate **adherence**
* important in cell wall metabolism
* can be antigenic
TEICHOIC ACID
219
# **Staphylococcus aureus** | ANTIGENIC STRUCTURE
* found in the **cell wall** of S. aureus
* belongs to group of **adhesins** called **microbial surface components recognizing adhesive matrix molecules (MSCRAMMs)**
* binds to **Fc** fragment of **IgG** preventing complement activation
PROTEIN A
220
# **Staphylococcus aureus** | ENZYMES & TOXINS
* **produced** by staphylococci
* converts **hydrogen peroxide** into **water** & **oxygen**
* **positive** for **staphylococci**, **negative** for **streptococci**
CATALASE
221
# **Staphylococcus aureus** | ENZYMES & TOXINS
* an **enzyme-like protein** that **clots** oxalated or citrated plasma
* activate **prothrombin** to form enzyme thrombin
* considered synonymous with **invasive pathogenic potential**
COAGULASE
222
# **Staphylococcus aureus** | ENZYMES & TOXINS
* an **MSCRAMM**
* responsible for the **adherence** of microorganisms to **fibrinogen** and **fibrin**
* induces a **strong immunogenic response** in the host
CLUMPING FACTOR
223
# **Staphylococcus aureus** | ENZYMES & TOXINS
regulated by ***agr***
HEMOLYSIN
224
# **Staphylococcus aureus** | ENZYMES & TOXINS
Hemolysin:
acts on a broad spectrum of **eukaryotic cell membranes**
α-hemolysin
225
# **Staphylococcus aureus** | ENZYMES & TOXINS
Hemolysins:
**degrades sphingomyelin** and therefore is **toxic to many kinds of cells** including **human red blood cells**
β-hemolysin
226
# **Staphylococcus aureus** | ENZYMES & TOXINS
Hemolysins:
* **dissociates** into subunits in **nonionic detergents**
* it **disrupts biologic mmebranes** and may have a role in **S. aureus diarrheal diseases**
δ-hemolysin
227
# **Staphylococcus aureus** | ENZYMES & TOXINS
Hemolysins:
* a **leukocidin**
* **lyses white blood cells**
γ-hemolysin
228
# **Staphylococcus aureus** | ENZYMES & TOXINS
* **kills WBCs**
* important **virulence factor** in **CA**-MRSA
Panton-Valentine Leukocidin
229
# **Staphylococcus aureus** | ENZYMES & TOXINS
* **epidermolytic toxin**
* dissolve **mucopolysaccharide** matrix of the epidermis
* toxins are **superantigens**
EXFOLIATIVE TOXINS
230
# **Staphylococcus aureus** | ENZYMES & TOXINS
Exfoliative toxin:
* encoded by *eta*
* located on a phage
* **heat stable**
* resists **boiling** for **20 mins**
Exfoliative toxin A
231
# **Staphylococcus aureus** | ENZYMES & TOXINS
Exfoliative toxin:
* **plasmid** mediated
* heat **labile**
Exfoliative toxin B
232
# **Staphylococcus aureus** | ENZYMES & TOXINS
* heat **stable**
* **resistant** ot the action of **gut enzymes**
* cause of **food poisoning**
* produced when S. aureus grows in carbohydrate & protein foods
* vomiting & diarrhea
ENTEROTOXIN
233
# **Staphylococcus aureus** | ENZYMES & TOXINS
**spreading** factor
Hyaluronidase
234
# **Staphylococcus aureus** | ENZYMES & TOXINS
**formation** of enzymes
Kinase
235
S. areus can **destroy** **penicillin** through formation of ____
biofilms
236
# **Staphylococcus aureus**
Clinical findings
nose
skin
vagina
237
# **Staphylococcus aureus**
Infection from S areus can be
pyogenic
toxin-mediated
238
# **Staphylococcus aureus** | CLINICAL FINDINGS
* **Abscess** on foot
* **Impetigo**
* **Folliculitis**
* **Carbuncle**
Skin & soft tissue infections
239
# **Staphylococcus aureus** | CLINICAL FINDINGS
Skin & soft tissue infections:
* **vesicles** w/ **honey-colored crust**
* usually **around** **nose**, **lips**
IMPETIGO
240
# **Staphylococcus aureus** | CLINICAL FINDINGS
Skin & soft tissue infections:
* multiheaded **abscess** at the **back of the neck**
* **worst**
CARBUNCLE
241
# **Staphylococcus aureus** | CLINICAL FINDINGS
**post-operative** wound infections or infections after a **trauma** (osteomyelitis & meningitis)
Infection from direct contamination of the wound
242
# **Staphylococcus aureus** | CLINICAL FINDINGS
* Incubation period : **1-8 hours**
* nausea, vomiting, diarrhea
* **rapid recovery** & **no fever**; **no antibiotic needed**
Food poisoning (Gastroenteritis)
243
# **Staphylococcus aureus** | CLINICAL FINDINGS
* vomiting, diarrhea, myalgiad, hypotension w cardiac & renal failure
* often occurs within **5 days** after the onset of the **menses** in young women
* **toxin production** happens **during menstruation**
TOXIC SHOCK SYNDROME
244
245
# **Staphylococcus aureus** | CLINICAL FINDINGS
* Exofoliative toxin A - heat stable
* B - heat liable
* common in **children** (esp **infants**)
scalded skin syndrome
246
* **coagulase negative**
* novobocin-**sensitive**
* **pyogenic**
* major cause of **sepsis**
* part of the **normal flora** of the **skin** & **mucous membrane**
* commonly infects **IV catheters** & **prosthetic implants**
Staphylococcus epidermidis
247
# **Staphylococcus epidermidis**
part of the normal flora of the ____ & ____
skin & mucous membrane
248
# **Staphylococcus epidermidis**
commonly infects ____ & ____
IV catheters & prosthetic implants
249
* coagulase **negative**
* causes **UTI**, particularly in **sexually active women**
* novobocin-**resistance**
* **pyogenic**
* common cause of UTI (1st E. coli, 2nd ____)
Staphylococcus saprophyticus
250
# **Staphylococcus saprophyticus**
causes ____ particularly in **sexually active women**
UTI
251
top 2 common causes of UTI
1. E. coli
2. S. saphrophyticus
252
# **Staphylococcus aureus** | TREATMENT
Drug
Penicillin G
253
# **Staphylococcus aureus** | TREATMENT
**Skin** infections
Mupurocin
254
# **Staphylococcus aureus** | TREATMENT
**multiple** skin infections
Tetracycline
255
# **Staphylococcus aureus** | TREATMENT
MRSA / NRSA:
drug of choice
Vancomycin
256
# **Staphylococcus aureus** | TREATMENT
**severe** infections
Nafcillin
Cloxacillin
257
# **Staphylococcus epidermidis** | TREATMENT
drug of choice
Dalbavancin
Tedizolid phosphate
Oritavancin
258
# **Staphylococcus epidermidis** | TREATMENT
* **long half life**, **300 hours** half life
* dosing: **once a week** (same with dalba)
ORITAVANCIN
259
# **Staphylococcus saprophyticus** | TREATMENT
drug of choice
trimethoprim-sulfamethoxazole
fluoroquinolone (ciprofloxacin)
| both are for UTI
260
261
* in **chains** or in **pairs**
* **widely distributed**
* catalase **negative**
STREPTOCOCCI
262
# **STREPTOCOCCI**
* **partial** hemolysis
* **Strep pnuemoniae**
* **Viridans**
α-hemolytic
263
# **STREPTOCOCCI**
* **complete** hemolysis
* **Strep pyogenes**
* **Agalactiae**
β-hemolytic
264
# **STREPTOCOCCI**
* **no** hemolysis
* **enterococcus**
γ-hemolytic
265
# **STREPTOCOCCI**
GROUP **A**
Strep. pyogenes
266
# **STREPTOCOCCI**
Group **B**
Strep. agalactiae
267
# **STREPTOCOCCI**
Group **A, C, G**
Strep. dysgalactiae
268
# **STREPTOCOCCI**
Group **D**
Strep. bovis
269
# **STREPTOCOCCI**
Group **F**
Strep. anginosus
270
# **STREPTOCOCCI** | α-hemolytic
* optochin **sensitive**
* bile **soluble**
* **has** capsule
* **quellung +** (test)
Strep pneumoniae
271
# **STREPTOCOCCI** | α-hemolytic
* optochin **resistance**
* bile **insoluble**
* **no** capsule
Viridans
272
# **STREPTOCOCCI** | β-hemolytic
bacitracin **sensitive**
Strep pyogenes
273
# **STREPTOCOCCI** | β-hemolytic
bacitracin **resistant**
Strep agalactiae
274
* **produce** capsules
* composed of **hyaluronic acid**
* **cell wall** contains **proteins**
* **hairlike pili**
Streptococcus pyogenes
275
# **Streptococcus pyogenes**
**capsule** is composed of ____
hyaluronic acid
276
# **Streptococcus pyogenes**
cell wall **proteins**
M protein
277
# **Streptococcus pyogenes**
* **main virulence factor**
* if **wala** ito, S. pyogenes **cannot** cause a disease
M PROTEIN
278
# **Streptococcus pyogenes** | ENZYMES
* **dissolves** blood clot
* transforms the **plasminogen** of **human plasma** into **plasmin**
STREPTOKINASE
279
# **Streptococcus pyogenes** | ENZYMES
degrades DNA
DEOXYRIBONUCLEASE
280
# **Streptococcus pyogenes** | ENZYMES
* **spreading** factor
* allows the bacteria to spread
HYALURONIDASE
281
# **Streptococcus pyogenes** | ENZYMES
toxic shock syndrome & scarlet fever
Streptococcal Pyrogenic Exotoxins
**SpeA**
282
# **Streptococcus pyogenes** | ENZYMES
Streptolysin O & S
Hemolysin
283
# **Streptococcus pyogenes** | ENZYMES
* oxygen **labile** (**sensitive** to oxygen)
* can **trigger antibody production**
* colonies grow **under** the agar
Streptolysin O
284
# **Streptococcus pyogenes** | ENZYMES
* **stable**
* **not** antigenic
* colonies grow on **surface** of agar
Streptolysin S
285
# **Streptococcus pyogenes** | PATHOGENESIS
* lesions are **raised**
* POE: **skin**
* has **well-demarcated line** or **margin of infection**
ERYSIPELAS
286
# **Streptococcus pyogenes** | PATHOGENESIS
* **not** raised
* can abot to **subcutaneous tissue**
* **rapidly** spreading
* line is **indistinct**
CELLULITIS
287
# **Streptococcus pyogenes** | PATHOGENESIS
* **flesh eating bacteria**
* **extensive** & **very rapidly spreading** necrosis
NECROTIZING FASCIITIS
288
# **Streptococcus pyogenes** | PATHOGENESIS
strep **enters** the **uterus** after delivery
PUERPERAL FEVER
289
# **Streptococcus pyogenes** | PATHOGENESIS
infection of **traumatic** or **surgical wounds**
BACTEREMIA or SEPSIS
290
# **Streptococcus pyogenes** | DISEASES
* **most common infection**
* caused by **β-hemolytic** pyogenes
* thin serous **discharge** & little fever
* cervical lymph nodes are usually **enlarged**
PHARYNGITIS
291
# **Streptococcus pyogenes** | DISEASES
* local infection of **superficial layers of skin**, especially in **children**
* consists of **superficial vesicles** that break down and **eroded areas** whose denuded surface is covered with pus and **later is encrusted**
* **spreads** by **continuity**
* **highly communicable**, especially in **hot**, **humid** climates
IMPETIGO
292
# **Poststreptococcal Diseases**
* **most serious sequela** of S. pyogenes
* results in **damage** to **heart muscle** & **valve**
Rheumatic Fever
293
**All** S. pyogenes are uniformly **susceptible** with
Penicillin G
294
# **S. pyogenes**
**alternative** drugs for **penicillin-allergic** patients
Macrolides (Erythromycin& Clindamycin)
295
* **β-hemolytic**
* produce **zones of hemolysis**
* **positive** to CAMP
* part of the **normal vaginal flora** and **lower gastrointestinal tract** of women
* may cause ????
Streptococcus agalactiae
296
# **Streptococcus agalactiae**
positive for
CAMP test
297
# **Streptococcus agalactiae**
part of normal ____ in **women**
vaginal flora
298
# **Streptococcus agalactiae**
Prevention
IV ampicillin
299
* **α-hemolytic** but can also be **nonhemolytic**
* growth is **not inhibited** by **optochin**
* colonies are **not soluble in bile**
* **most prevalent** members of the normal microbiota of the **upper respiratory tract**
* important for the healthy state of mucous membrane in URT
* principal cause of **endocarditis** on abnormal heart valves
Viridans Streptococci
300
# **Viridans Streptococci agalactiae**
part of the normal microbiota of ____
upper respiratory tract
301
# **Viridans Streptococci agalactiae**
may cause ____
endocarditis
302
# **Streptococcus pneumoniae**
shape
lancet shaped
303
# **Streptococcus pneumoniae**
positive for
capsule swelling test
quellung reaction
304
# **Streptococcus pneumoniae**
TYPES OF PNEUMOCOCCI:
**adults**
type 1 - 8
305
# **Streptococcus pneumoniae**
TYPES OF PNEUMOCOCCI:
**children**
types 6, 14, 19, 23
306
# **Streptococcus pneumoniae**
**production** of disease
ability to multiply in the tissues
307
# **Streptococcus pneumoniae**
what drug sila **resistant**
Penicillin G
308
# **Streptococcus pneumoniae** | PREVENTION
Children **younger** than 24 mos
complete series of PCV 7 to PCV 13
309
# **Streptococcus pneumoniae** | PREVENTION
**Older** children & those with **underlying medical conditions**
PCV 7 & single dose of PCV 13
310
# **Streptococcus pneumoniae** | PREVENTION
**Adults 19 y/o or older** that are **immunocompromised** and **65 y/o**
PPSV23
PCV13
311
# **Enterococci**
part of the normal ____ microbiota
enteric
312
# **Enterococci**
grow in the **presence** of ____
BILE
313
# **Enterococci**
hydrolyze ____
esculin
314
# **Enterococci**
grows in ____ NaCl
6.5%
315
# **Enterococci**
* **most commonly** isolated species
* causing **85 - 90%** of enterococcal infections
E. faecalis
316
# **Enterococci**
causes **5 - 10%** of entercoccal infections
E. faecium
317
# **Enterococci**
most common **form** of enterococcal infection
UTI
318
# **Enterococci** | INFECTIONS
* often **polymicrobial**
intraabdominal & pelvic infections
319
# **Enterococci** | INFECTIONS
frequently associated with **metastatic abscess** and **high mortality rates**
bacteremia & endocarditis
320
# **Enterococci** | INFECTIONS
infections of the **respiratory tract**
pneumonia, otitis, sinusitis
321
# **Enterococci** | INFECTIONS
infection of the **central nervous system**
meningitis
322
# **Enterococci** | INFECTIONS
can be acquired during **vaginal delivery**
neonatal infections
323
# **Enterococci** | TREATMENT
drug of choice
penicillin or vancomycin plus
