Micro - Gram Positive Bacteria IV Flashcards by Matt Stanton

6 medically important gram positive

streptococcus
staphylococcus
bacillus
clostridium
corynebacterium diptheriae
listeria monocytogenes

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gram positive rods spore formers

bacillus and clostridium

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aerobic spore form gram positive rods

bacillus

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bacillus

aerobic spore forming gram positive

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anaerobic spore form gram positive rods

clostridium

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clostridium

anaerobic spore forming gram positive

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anthrax

bacillus anthracis

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food poisoning

bacillus cereus

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protein capsule

bacillus anthracis

prevents phagocytosis

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pX01 and pX02

plasmid with virulence factors in bacillus anthracis

pX01 - exotoxins

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most common route for bacillus anthracis

cutaneous infection

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painless black lesion with a rim of edema

aka malignant pustule
-caused by bacillus anthracis

usually resolves spontaneously

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woolsorters disease

pulmonary anthrax

-mediastinal widening - on chest radiograph and CT - enlarged area above heart

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anthrax exotoxins

edema factor (EF) - increased cAMP - impairs neutrophils and causes massive edema

protective antigen (PA) - promotes entry of EF into cells

lethal factor (LF) - zinc metalloprotease - increase TNF and IL-1 from macrophages - death

encoded on pX01

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pX02

plasmid in bacillus anthracis
-encodes genes for poly-glutamyl capsule

inhibits phagocytosis

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bacillus cereus enterotoxins

heat labile

heat stable

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heat labile toxin

enterotoxin in bacillus cereus
-nausea, abdomen pain, diarrhea

similar to cholera and E. coli

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heat stable toxin

enterotoxin in bacillus cereus
-nausea and vomiting with limited diarrhea

similar to staph aureus

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anaerobic gram positive spore forming rods

clostridium

differentiate clostridium from bacillus?

both gram positive spore forming rods

however - bacillus - aerobic
clostridium - anaerobic

do in anaerobic culture

botulism

clostridium botulinum

flaccid muscle paralysis

botulisum

clostridium botulinum

eating smoked fish or home-canned vegatable

transmission of botulism

bilateral cranial nerve palsies with double vision, dysphagia, general muscle weakness, respiratory paralysis, death

botulism in adults

fresh honey ingestion

botulism in infants

constipated infant for 2-3 days, followed by muscle weakness or dysphagia

floppy baby | -botulism

wound botulism

no prodromal GI symptoms and longer incubation | -have associated fever

tetanus

clostridium tetanus

puncture by a nail

tetanus | -caused by clostridium tetanus

exotin of clostridium tetanus

tetanospasmin - taken up at NMJ - inhibits inhibitory neurons (GABA release) - sustained contraction

sustained contraction

tetanus

severe muscle spasm, lockjaw, grinning expression

tetanus

trismus

lockjaw

risus sardonicus

grinning expression in tetanus

gas gangrene

clostridium perfringes cellulitis/wound infection - with crepitus myonecrosis diarrhea - watery

pseudomembranous enterocolitis

clostridium dificile -severe diarrhea, abdominal cramping, fever

necrotic skin with crepitus and thin blackish fluid leaving skin

clostridium perfringes | -gas gangrene

diarrhea while on antibiotics or within month of using them

clostridium dificile

diagnosis for c. dificile

PCR testing for tixin A and toxin B - quick turn around - results within an hour EIA also - but only 75% sensitive

Tx for c. dificile

vancomycin

colonoscopy of red inflamed mucosa with white exudate

pseudomembranes | -c. dificile infection

gram positive rodes with drumstick shape on gram stain

clostridium tetani | -endospore on one end

PCR for toxin A and toxin B

for clostridium difficile

toxin A

c dif | -diarrhea

toxin B

c dif | -cytotoxic to colonic epithelial cells