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Abbey MSII Unit 4 > Micro Bacterial pneumonia 1 > Flashcards

Micro Bacterial pneumonia 1 Flashcards

1
Q

P. aeruginosa bacteriology

A

gram -, aerobe, nonfermenter, oxidase +, produces pyocyanin&pyoverdin, glycocalyx, normal flora or opportunistic pathogen,extremely Ab resistant, minimal growth requirements

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2
Q

when does p. aeruginosa appear as an opportunistic pathogen?

A

burns, CF patients, immunocompromised, catheters, IVs, neonates

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3
Q

when does p. aeruginosa appear as a community acquired pathogen?

A

endocarditis (IV drug user)
folliculitis (underchlorinated hot tubs)
osteocohondritis (punctures through sneakers)
corneal infection (contacts)

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4
Q

virulence factors for p. aeruginosa

A
  1. endotoxin (cell wall component)
  2. exotoxin (ExoA like diphtheria released into tissue) and (type III secretion system ExoS that damages cytoskeleton)
  3. enzymes (elastase, protease which is histotoxic and facilitates invasion of bloodstream, collapse of alveolie, and rupture of BV)
  4. pyocyanin
  5. glycocalyx
  6. efflux pumps
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5
Q

what is the exotoxin produced by p. aeruginosa called?

A

pyocyanin

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6
Q

glycocalyx

A

slime layer that makes p. aeruginosa anti-phagocytic

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7
Q

what makes p. aeruginosa pathogenic?

A

environmentall ubiquitous - grows easily in IV fluid, irrigation solutions

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8
Q

when/in who is p. aeruginosa MC?

A
  1. nosocomial UTI
  2. CF pneumonia
  3. burns
  4. neonate/immunocompromised: sepsis, pneumonia, endocarditis, meningitis
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9
Q

how is p. aeruginosa diagnosed?

A
  • grows only on aerobic culture (try both)
  • nonfermenting, oxidase +
  • green color on nutrient agar
  • fruity aroma
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10
Q

what does pyocyanin cause for p. aeruginosa?

A

green color

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11
Q

what does p. aeruginosa non bacteremic pneumonia resemble on chest xray?

A

S. aureus: diffuse bronchopneumonia - bilateral with distinctive nodular infitrates

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12
Q

what does p. aeruginosa bacteremic pneumonia resemble on chest xray?

A

progresses rapidly - has poorly-defined, hemorrhagic, often subpleural nodular areas with a small central area of necrosis and multiple necrotic umbilicated nodules with hemorrhagic parenchyma

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13
Q

treatment for p. aeruginosa

A

Ab treatment without delay, remove/change catheters/IV, Ab sensitivity testing

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14
Q

b. cepacia bacteriology

A

similary to p. aeruginosa

  • less able to infect previously-healthy patients
  • NO pyocyanin (not green)
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15
Q

who does b. cepacia infect?

A
  1. cystic fibrosis pneumonia
  2. IV-associated septicemia
  3. wound infections
  4. catheter-associated UTIs
  5. foot rot in swamp-deployed military
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16
Q

treatment for b. cepacia

A
  • none if previously-healthy

- CF, cancer, HIV require exotic antibiotics

17
Q

b. pseudomallei bacteriology

A

similary to p. aeruginosa

18
Q

which bacterial pneumonias have the potential to be used as bio warfare?

A

b. pseudomallei and b. mallei

19
Q

how is b. pseudomallei transmitted?

A
  • developing nation veterinary disease (meliodosis)

- transmitted by contact with contaminated water, soil

20
Q

b. pseudomallei symptoms

A

flulike symptoms PLUS muscle tightness and light sensitivity

21
Q

complications of b. pseudomallei

A
  • can progress from acute local infection to septicemia with abscesses in all organs (fatal in 7-10 days)
  • also: can have reactivation (vietnam vets)
22
Q

diagnosis b. pseudomallei

A

culture and gram stain - has “wrinkled” colony morphology

-lungs and liver both affected

23
Q

treatment for b. pseudomallei

A

long-term ceftazidine

24
Q

what is similar between P. aeruginosa and B. cepacia infections?

A

extreme antibiotic resistance and dangerous to CF patients

25
Q

what is similar between B. cepacia and B. pseudomallei?

A

normally freeliving water microbes

26
Q

b. mallei bacteriology

A

similar to p. aeruginosa except nonmotile and maintained in animal reservoirs

27
Q

b. mallei symptoms and complications

A

symptoms: flulike
complications: acute localized (nodule at infection site); acute pulmonary (bronchitis ->pneumonia); acute septicemic (fulminant, multiorgan)

28
Q

Farcy

A

milder, chronic form of b. mallei

29
Q

b. mallei diagnosis and treatment

A

patient history, culture, gram stain, urine, skin lesions

treatment: long term antibiotics

30
Q

what are the 3 chlamydia bugs? what differentiates between them and the other bacterial pneumonias?

A

c. pneumoniae (human-borne community acquired), psittaci (bird-borne), trachomatis (STI)
- hard to gram stain becuase not gram -

31
Q

c. pneumoniae history/presentation

A

-incubation period 3-4 weeks - usually asymptomatic
-rhonchi and rales in mild disease
headache, sinus percussion tenderness
-symptoms may be prolonged

32
Q

c. psittaci history/presentation

A
  • exposure to birds (esp sick ones)
  • incubation period 5-14 days
  • nonproductive cough, chest pain, splenomegaly, high fever (MC)
  • horder spots (erythematous, blanching, maculopapular rash)
  • can become severe with meningitis, encephalitis, endocarditis
33
Q

c. trachomatis history/presenation

A

nasal obstruction and discharge, cough, tachypnea, inclusion conjunctivitis, middle ear abnormalities, scattered crackles with good breathing sounds
-most patients are afebrile (moderately ill)

34
Q

treatment for c. pneumoniae and c. psittaci

A

doxycycline

35
Q

treatment for c. trachomatis

A

erythromycin (topical)

36
Q

why does p. aeruginosa have extreme antibiotic resistance?

A

low-permeability outer membrane and efflux pump

37
Q

which bacterial pneumonias have minimal growth requirements?

A

p. aeruginosa and b. cepacia

38
Q

chlamydia bacteriology

A

small, obligate intracellular bacterium (reticulate bodies in cells, elementary bodies that unpack extracellularly)

39
Q

chlamydia virulence factor

A

T3SS used for entry and establishing inclusion body

Abbey MSII Unit 4 (7 decks)

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