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MICROPARA > M5 PART 4 > Flashcards

M5 PART 4 Flashcards

1
Q
  • the most common form of enterococcal infections
  • frequently associated with indwelling catheters, instrumentation, or structural abnormalities of the genitourinary tract
A

UTI

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2
Q

Enterobacteriaceae

MOTILITY

A

motile w/ peritrichous flagella or nonmotile

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3
Q

Enterobacteriaceae

oxygen requirement

A

facultative anaerobes

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4
Q

Enterobacteriaceae

grow well on what medium

A

MacConkey agar

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5
Q

Enterobacteriaceae

____ fermenters, often with gas production

A

glucose

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6
Q

Enterobacteriaceae

reduce ____ to ____

A

nitrate to nitrite

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7
Q

Enterobacteriaceae

catalase ____
oxidase ____

A

catalase positive
oxidase negative

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7
Q
  • Gram-negative rods
  • Either motile with peritrichous flagella or nonmotile
  • Grow on peptone or meat extract media without the addition of sodium chloride or other supplements;
  • Grow well on MacConkey agar;
  • Grow aerobically and anaerobically (are facultative anaerobes);
  • Ferment rather than oxidize glucose, often with gas production
  • Are catalase positive, oxidase negative
  • Reduce nitrate to nitrite
A

Enterobacteriaceae

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8
Q

Enterobacteriaceae

LACTOSE FERMENTED RAPIDLY

A

Klebsiella
Escherichia coli
Enterobacter aerogenes & cloacae

KEE

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9
Q
A
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10
Q

Enterobacteriaceae | ANTIGENIC STRUCTURE

most external part of the CELL WALL lipopolysaccharide and consist of repeating units of polysaccharide, resistant to heat and alcohol and usually are detected by bacterial agglutination

A

O antigen

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11
Q

Enterobacteriaceae | ANTIGENIC STRUCTURE

  • external to O antigens on some but not all Enterobacteriaceae, “Kapsule”
  • may be associated with virulencce
A

K antigens

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12
Q

Enterobacteriaceae | ANTIGENIC STRUCTURE

located on flagella and are denatured or removed by heat or alcohol

A

H antigens

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13
Q

The most frequent sites of clinically important infection are the urinary tract, biliary tract, and other sites in the abdominal cavity, but any anatomic site (e.g., bloodstream, prostate gland, lung, bone, and meninges) can be the site of disease.

A

Escherichia coli

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14
Q
A
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15
Q

Escherichia coli

____ inhibits adhesion of E. coli to the urothelium

A

cranberry juice

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16
Q
A
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17
Q

Escherichia coli

Infection in kidney

A

cystitis

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18
Q
  • the most common cause of UTI
  • accounts for 90% of first UTI in young women
A

Escherichia coli

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19
Q

Escherichia coli

____ may be highly susceptible to E. coli sepsis because they lack IgM antibodies

A

newborns

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20
Q

Escherichia coli

Newborns may be highly susceptible to E. coli sepsis because they lack ____ antibodies

A

IgM

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21
Q

Escherichia coli

Sepsis may occur ____ to urinary tract infection

A

secondary

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22
Q

Escherichia coli

E. coli and group B streptococci are the leading causes of ____ in infants.

A

meningitis

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23
Q

Escherichia coli

Approximately 80% of E. coli from meningitis cases have the ____

A

K1 antigen

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24
Q

E. COLI ASSOCIATED DIARRHEAL DISEASES

  • EPEC adhesion factor (EAF) and chromosomal locus of enterocyte effacement (LEC) promote tight adherence to the intestine
  • Severe, watery diarrhea, vomiting and fever in infants
A

Enteropathogenic
E. coli

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25
Q

E. COLI ASSOCIATED DIARRHEAL DISEASES

  • ETEC colonization factors (pili known as colonization factor antigens [CFA]) that allows attachment to small intestine
  • Traveler’s disease, diarrhea in children
A

Enterotoxigenic
E. coli

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26
Q

E. COLI ASSOCIATED DIARRHEAL DISEASES

  • Produces two antigenic forms of toxins: Shiga-like toxin 1 and 2
  • Mild non-bloody diarrhea, hemorrhagic colitis (bloody diarrhea), severe form of diarrhea, hemolytic uremic syndrome (a disease resulting to acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia)
A

Shiga toxin-producing
E. coli

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27
Q

E. COLI ASSOCIATED DIARRHEAL DISEASES

  • Invades and destroy the mucosal cells of the colon
  • Shigellosis-like, occurs in children in developing countries and in travelers to these countries
A

Enteroinvasive
E. coli

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28
Q

E. COLI ASSOCIATED DIARRHEAL DISEASES

  • They are characterized by their specific patterns of adherence to human cells. This group of diarrheagenic E. coli is quite heterogeneous, and the exact pathogenic mechanisms are still not completely elucidated.
  • Acute and chronic diarrhea (>14 days in duration) in persons in developing countries, cause of foodborne illnesses in industrialized countries and have been associated with traveler’s diarrhea and persistent diarrhea in patients with HIV
A

Enteroaggregative
E. coli

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29
Q
A
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30
Q

Escherichia coli | TREATMENT

CYSTITIS

A

TMP-SMZ or nitrofurantoin

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31
Q

Escherichia coli | TREATMENT

PYELONEPHRITIS

A

ciprofloxacin or ceftriaxone

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32
Q

Escherichia coli | TREATMENT

SEPSIS

A

3rd gen cephalosporins with or without aminoglycosides

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33
Q

Escherichia coli | TREATMENT

NEONATAL MENINGITIS

A

ampicillin and cefotaxime

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34
Q
A
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35
Q
A
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35
Q
A
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36
Q

Klebsiella pneumoniae

Has a very large polysaccharide ____

A

capsule

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37
Q

Klebsiella pneumoniae

Produce a lobar ____ with thick, mucoid, blood sputum

A

pneumonia

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38
Q

Klebsiella pneumoniae

mucoid sputum is also called

A

currant jelly

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39
Q
  • found outside the enetric rod
  • has K1 antigen (K - kapsular antigen)
  • rapid lactose former
  • produce lobar pneumonia
  • produce mucoid sputum (currant jelly)
A

KLEBSIELLA PNEUMONIAE

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40
Q

ENTEROBACTER

may cause ____ infections

A

nosocomial

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41
Q
  • E. cloacae complex and E. aerogenes
  • found in soil, water, sewage system
  • common cause of nosocomial infections (hospital acquired infections)
  • known to be resistance because of the** β-lactamase** called ampC
  • rapid lactose former
A

ENTEROBACTER

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41
Q

ENTEROBACTER

known to be resistant to ampicillin first- and 2nd gen cephalosporins because of the ____

A

β-lactamase called ampC

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41
Q

Serratia marcescens

produce a red pigment called

A

PRODIGIOSIN

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41
Q

Serratia marcescens

site of infection

A

urinary tract

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42
Q

Serratia marcescens

drug resistant because of

A

ampC β-lactamase

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43
Q
  • produce a characteristic red pigment (prodigiosin)
  • Most common sites of infection include the urinary tract
  • resistant to penicillin, ampicillin, and first-generation cephalosporins because it harbors an inducible, chromosomal AmpC ß-lactamase
A

SERRATIA MARCESCENS

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43
Q

Proteus

motility

A

swarming motility

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44
Q
  • Exhibit swarming motility
  • Urease positive → stone formation (struvite)
  • P. mirabilis & P. vulgaris
A

PROTEUS

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44
Q

Proteus

  • urinary tract infections
  • bloodstream infection (frequently secondary due to a UTI)
  • respiratory tract infections
A

P. mirabilis

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44
Q

Proteus

urease ____

A

positive

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45
Q

Proteus

  • wound and soft tissue infections
A

P. vulgaris

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45
Q

Morganella morganii

typically resistant to ____

A

penicillin

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46
Q
  • Cause of UTI and wound infections in the hospital
  • Drug-resistant (penicillin, cephalosporins)
A

Morganella morganii

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47
Q

Providencia

associated with ____

A

UTI

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48
Q
  • can cause urinary tract infections, sepsis, respiratory tract infections, intraabdominal infections, and wound infections, principally among immunocompromised and/or debilitated hospitalized patients
  • Citrate test: Citrate positive
A

CITROBACTER

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49
Q

CITROBACTER

can cause urinary tract infections, sepsis, respiratory tract infections, intraabdominal infections, and wound infections, principally among ____ and/or debilitated hospitalized patients

A

immunocompromised

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50
Q

Enterobacteriaceae species TREATMENT

A

No single therapy is available
Sulfonamides, ampicillin, cephalosporins, fluroquinolones, and aminoglycosides

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51
Q

Shigellae

antigen present

A

somatic O antigen

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52
Q

Shigellae

can cause the most severe human infection

A

Shigella dysenteriae

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53
Q

Shigellae

have a very low ____

A

infective dose

highly communicable

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54
Q

Shigellae

incubation period

A

1 - 4 days

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55
Q

Shigellae

infections are almost always limited to ____

A

gastrointestinal tract

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56
Q

Shigellae

toxin produced

A

shiga toxin

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56
Q

Shigellae

mode of transmission

A

food, fingers, feces, flies
person - person

56
Q

Shigellae

reservoir

A

humans

only reservoir

57
Q

Shigellae

can only ferment

A

glucose

non lactose fermenter

58
Q

Shigellae

bloody diarrhea

A

Shigellosis / Bacillary dysentery

58
Q

Shigellae

only lactose fermenter but SLOW lactose fermenter

A

Shigella sonnei

59
Q

Shigellae

positive result in TSI

A

whole agar is yellow

60
Q

Shigellae

type 1 hemolytic uremic syndrome

A

S. dysenteriae

61
Q

Shigellae

Reiter’s chronic arthritis syndrome

A

S. flexneri

62
Q

Shigellae

disease

A

Shigellosis or Bacillary dysentry

63
Q

Shigellae

treatment for severe infections

A

ciprofloxacin

64
Q

SALMONELLA

antigens

A

cell wall O, flagellar H, capsular Vi

65
Q

SALMONELLA

TYPHOIDAL

A

S. Typhi
S. Parathypi A

66
Q

SALMONELLA

  • severe, systemic illness, caused by Salmonella Typhi (most common) or Salmonella Paratyphi
  • The fever rises to a high plateau (39°C to 40°C)
  • from food or water
  • fever, malaise, headache, constipation, bradycardia, and myalgia
A

ENTERIC FEVER / TYPHOID FEVER

66
Q

SALMONELLA

ENTERIC / THYPOID FEVER:
incubation period

A

10 - 14 days

67
Q

SALMONELLA

enlargement of ____

A

spleen & liver

68
Q

SALMONELLA

spots observed on the chest and abdomen

A

ROSE SPOTS

69
Q

SALMONELLA | TREATMENT

uncomplicated

A

oral azithromycin

70
Q

SALMONELLA | TREATMENT

complicated

A

parenteral
3rd gen cephalosporion or fluoroquinolone

71
Q

SALMONELLA | PREVENTION

oral

A

live attenuated vaccine

72
Q

SALMONELLA | PREVENTION

intramascular

A

Vi capsular polysaccharide vaccine (Typbar)

73
Q

Bacteriologic Methods for Isolation of Salmonellae

  • The specimen (usually stool) can also be placed into selenite F or tetrathionate broth, both of which inhibit replication of normal intestinal bacteria and permit multiplication of salmonellae.
  • After incubation for 1-2 days, an aliquot from this broth is plated on differential and selective media.
A

ENRICHMENT CULTURE

74
Q

SALMONELLA

  • most common manifestation of Salmonella infection
  • severe diarrhea
A

ENTEROCOLITIS

74
Q

SALMONELLA

complicating Salmonella bacteremia usually involves the aorta, often associated with atherosclerotic plaques or aneurysms; people older than 50 years have a higher risk of developing such complications

A

endovascular infection

75
Q

Bacteriologic Methods for Isolation of Salmonellae

  • EMB, MacConkey, or deoxycholate medium permits rapid detection of lactose nonfermenters (not only salmonellae and shigellae but also Proteus, Pseudomonas, etc.).
  • Gram-positive organisms are somewhat inhibited.
  • Bismuth sulfite medium permits rapid detection of salmonellae, which form black colonies because of HS production.
  • Most salmonellae produce H2S.
A

DIFFERENTIAL MEDIUM

76
Q

SALMONELLA | Serologic Methods

known sera + unknown culture

A

AGGLITINATION TEST

76
Q

SALMONELLA

more common among patients with comorbidities (e.g., immunosuppression), as well as infants and the elderly

esp those kids with sickle cell anema

A

BACTEREMIA

76
Q

Bacteriologic Methods for Isolation of Salmonellae

  • The specimen may also be plated on salmonella-shigella (SS) agar, Hektoen enteric (HE) agar, xylose-lysine desoxycholate (XLD) agar, or desoxycholate-citrate agar, all of which favor growth of salmonellae and shigellae over other Enterobacteriaceae.
  • Chromogenic agars specifically for salmonella recovery are also available.
A

SELECTIVE MEDIUM

77
Q

SALMONELLA | Serologic Methods

serum agglutinins rise sharply during the second and third weeks of S serotype Typhi infection.

A

Tube Dilution Agglutination Test (Widal Test)

78
Q

SALMONELLA | Epiemiology

sources of infection

A

poultry products, food & drinks

78
Q

SALMONELLA | Epiemiology

Three percent of survivors of typhoid fever become ____

gallbladder, biliary tract, or rarely, the intestine or urinary tract

A

permanent carriers

78
Q

PSEUDOMONAS AERUGINOSA

oxygen requirement

A

obligate aerobe

78
Q

PSEUDOMONAS AERUGINOSA

Produces a non-fluorescent bluish pigment, ____, which diffuses into the agar

78
Q

PSEUDOMONAS AERUGINOSA

Produces the fluorescent pigment ____, which gives a greenish color to the agar when combined with pyocyanin

A

pyoverdine

78
Q

PSEUDOMONAS AERUGINOSA

dark red pigment

78
Q

PSEUDOMONAS AERUGINOSA

brown-black pigment

A

pyomelanin

78
Q
  • gram negative
  • obligate aerobe
  • motile & rod shaped
  • produces a blue pigment called pyocyanin
  • commonly present in moist environments in hospitals
A

PSEUDOMONAS AERUGINOSA

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

extend from the cell surface and promote attachment to host epithelial cells

A

PILI (FIMBRIAE)

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

an exopolysaccharide is responsible for the mucoid colonies seen in cultures from patients with CF

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

responsible for many of the endotoxic properties of the organism

A

LIPOPOLYSACCHARIDE

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

elastases, proteases, and two hemolysins (a heat-labile phospholipase C and a heat-stable glycolipid)

A

EXTRACELLULAR ENZYMES

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

responsible for the production of hydrogen peroxide and superoxide, and stimulates the release of interleukin (IL)-8

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

serves as a siderophore, that is, binds iron

A

PYOVERDINE

78
Q

PSEUDOMONAS AERUGINOSA | ANTIGENIC STRUCTURES

blocks protein synthesis, causes tissue necrosis and is lethal for animals when injected in purified form.

78
Q

PSEUDOMONAS AERUGINOSA

bifunctional enzymes with GTPase and ADP-ribosyl transferase activity

A

EXOENZYME S & T

78
Q

PSEUDOMONAS AERUGINOSA

phospholipase

A

EXOENZYME U

78
Q

PSEUDOMONAS AERUGINOSA

an adenylyl cyclase

A

EXOENZYME Y

78
Q

PSEUDOMONAS AERUGINOSA

produces what type of odor

A

grape-like or corn taco-like

78
Q
  • not part of normal human microbiota but is capable of colonization of various body sites
  • known to cause disease in humans, especially in people with altered and decreased host defenses
A

PSEUDOMONAS AERUGINOSA

79
Q

PSEUDOMONAS AERUGINOSA

acquisition of the organism can be either ____ or ____

A

endogenous or exogenous

79
Q

PSEUDOMONAS AERUGINOSA

occurs after colonization

A

endogenous infection

79
Q

PSEUDOMONAS AERUGINOSA

occurs from an environmental reservoir via susceptible portal of entry

A

exogenous infection

79
Q

PSEUDOMONAS AERUGINOSA

grows well at what temp

80
Q
  • Comma-shaped, curved, and sometimes straight
  • facultatively anaerobe
  • catalase and oxidase-positive
  • Motile (monotrichous or multitrichous polar flagella)
  • Halophilic
81
Q

VIBRIOS

shape

A

comma-shaped, curved

82
Q

VIBRIOS

catalase & oxidase

83
Q

VIBRIO CHOLERAE

transmission

A

contaminated water & food

84
Q

VIBRIO CHOLERAE

Many vibrios share a single heat-labile ____ antigen

A

flagellar H

85
Q

VIBRIO CHOLERAE

has ____ found on the cell wall

A

O lipopolysaccharides

86
Q

VIBRIO CHOLERAE

can cause epidemic and pandemic cholera

A

O1 and O139

87
Q

VIBRIO CHOLERAE

associated with cholera-like diarrheal diseases

A

non-O1 and non-O139

88
Q

VIBRIO CHOLERAE

50% of the infections with classic vibrio Cholera are ____

A

ASYMPTOMATIC

89
Q

VIBRIO CHOLERAE

75% of the infections are associated with ____

A

El Tor biotype

90
Q

VIBRIO CHOLERAE

medium

A

thiosulfate-citrate-bile salts-sucrose (TCBS) agar

91
Q

VIBRIO CHOLERAE

secretes an enterotoxin called ____ (cholera toxin)

A

choleragen

92
Q

VIBRIO CHOLERAE | ENTEROTOXIN

enters, closed in an endosome, reaching the cytoplasm; catalyze the addition of ADP ribose to the G protein; G protein will cause the persistent stimulation of this enzyme called the adenylate cyclase and the adenylate cyclase will result to the increase of cyclic AMP – prolonged hypersecretion of water and electrolytes

93
Q

VIBRIO CHOLERAE | ENTEROTOXIN

binding to the GM1 receptor (ganglioside receptor)

94
Q

VIBRIO CHOLERAE | CLINICAL FINDINGS

spectrum of disease

A

asymptomatic to mild, moderate, or severe diarrhea

95
Q

VIBRIO CHOLERAE | CLINICAL FINDINGS

incubation period

A

12 hrs - 3 days

96
Q

VIBRIO CHOLERAE | CLINICAL FINDINGS

stools resemble

A

rice water

97
Q

VIBRIO CHOLERAE | TREATMENT

most important treatment

A

water & electrolyte replacement

98
Q

VIBRIO CHOLERAE | TREATMENT

DOC

A

tetracycline

99
Q

VIBRIO CHOLERAE | TREATMENT

children and in pregnant women

A

erythromycin / azithromycin

100
Q
  • Transmitted by contaminated seafood (raw fish or shellfish)
  • The enteritis ranges from mild watery diarrhea to a dysentery-like syndrome (bloody)
A

Vibrio parahaemolyticus

101
Q

Vibrio parahaemolyticus | TREATMENT

DOC

A

doxycycline / fluoroquinolone

102
Q
  • Severe wound and soft tissue infections - Can lead to necrosis
  • Bacteremia/sepsis (rather than gastroenteritis)
  • Chronic liver diseases, such as liver cirrhosis
  • Can invade the bloodstream even without causing GI symptoms
A

Vibrio vulnificus

103
Q

Vibrio vulnificus | TREATMENT

DOC

A

fluoroquinolones, doxycycline, 3rd gen cephalosporins

104
Q

CAMPYLOBACTER JEJUNI

shape

A

curved, comma, S-shaped, SEA GULL WING shaped

105
Q

CAMPYLOBACTER JEJUNI

oxygen requirement

A

macroaerophilic

106
Q

CAMPYLOBACTER JEJUNI

selective media

A

camply blood agar, skirrow’s media

107
Q

CAMPYLOBACTER JEJUNI

grows better at ____C than 37C

108
Q

CAMPYLOBACTER JEJUNI

catalase & oxidase

109
Q
  • A small motile, Gram-negative rod that appears as curved, comma-, or S-shaped organisms
  • “Sea gull wing” shape
  • Microaerophilic (5-7% O2, 10% CO₂)
  • Selective media – Campy blood agar, Skirrow’s media
  • Grows better at 42°C than 37°C
  • Catalase and oxidase-positive
A

CAMPYLOBACTER JEJUNI

110
Q

CAMPYLOBACTER JEJUNI

transmission

A

contaminated food & water
contact w infected animals / animal products

111
Q

CAMPYLOBACTER JEJUNI | ANTIGENIC STRUCTURE

have ____ with endotoxic activity

A

lipopolysaccharide

112
Q

CAMPYLOBACTER JEJUNI | CLINICAL FINDINGS

  • Characterized by abdominal cramps, diarrhea (bloody), HA, malaise, and fever.
  • Self-limiting
  • The organism can occasionally invade the bloodstream.
  • May resemble enteric fever
  • Susceptible in macrolides (e.g., erythromycin)
A

GASTROENTERITIS

113
Q

CAMPYLOBACTER JEJUNI | CLINICAL FINDINGS

A form of ascending paralytic disease.

A

Guillain-Barré syndrome

114
Q
  • A Gram-negative curved rod
  • spiral, curved, or fusiform rod-shaped
  • Motile (single and/or multiple monopolar flagella)
  • Catalase and oxidase-positive; urease-positive
  • Microaerophile
A

HELICOBACTER PYLORI

115
Q

HELICOBACTER PYLORI

catalase & oxidase

116
Q

HELICOBACTER PYLORI

urease

117
Q

HELICOBACTER PYLORI

oxygen requirement

A

microaerophile

118
Q

HELICOBACTER PYLORI

transmission

A

person - person

via fecal-oral route

119
Q
  • survives in the acidic environment of the stomach and ultimately establish lifelong colonization of the gastric mucosa through urease activity.
  • does not appear to invade the gastric mucosa, but rather release various toxins
  • infection is a known independent risk factor for the development of:
    o Atrophic gastritis
    o Gastric ulcer disease
    o Gastric adenocarcinomas
    o Gastric mucosa associated lymphoid tissue
    (MALT) lymphomas
A

HELICOBACTER PYLORI

120
Q

HELICOBACTER PYLORI

reservoir

121
Q

HELICOBACTER PYLORI

grows optimally at pH of

122
Q

HELICOBACTER PYLORI | CLINICAL FINDINGS

Acute infection typically yields an upper gastrointestinal illness called

A

food poisoning

123
Q

HELICOBACTER PYLORI | CLINICAL FINDINGS

colonization with H. pylori

A

chronic gastritis

124
Q

HELICOBACTER PYLORI | TREATMENT

triple therapy

A

7 - 14 days

125
Q

HELICOBACTER PYLORI | TREATMENT

quadruple therapy

A

10 - 14 days

MICROPARA (37 decks)

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