Microbiology Flashcards

1
Q

What is the difference I cell biology of gram +ve be gram -ve bacteria.

A

Gram +ve bacteria have thicker peptidoglycan layer and lack outer lipopolysaccharide layer.

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2
Q

How does gram staining differentiate between gram +ve and gram -ve bateria

A

After staining with Crystal violet and fixation with iodine, a third decolouriser is added, this remove the stain from gram -ve bacteria but not gram +ve (remains purple).

A final stain is added (pink safranin) which is taken up by gram -ve

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3
Q

What other characteristic are used to classify bacteria?

A

Shape:
Cocci vs bacilli

Oxygen requirement:
Aerobes:
- oblique arobes
- faculatative aerobes

Anaerobes

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4
Q

List differences between exotoxins and endotoxins

A
Exotoxins:
Gram +ve organisms
Proteins 
Heat labile and denatures by formaldehyde 
Neutralised by specific antibodies 

Endotoxins
Gram -ve organisms
Lipopolysaccaride
Heat stable and not denatured by formaldehyde
Poorly antigenic (partially denaturalised by antibodies)

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5
Q

What group of bacteria is streptococcaeae?

What is the 2 main pathogens in this genera?

A

Gram +ve, facultative anaerobes that grow in pairs or chains, negative catalase test.

Streptococcus
Enterococcus

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6
Q

If diagnosed with skin infection cause by streptococcus pyogenes what should happen?

A

Highly infectious and virulent.

Isolated until 48 hours of IV Abx

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7
Q

Explains the causative agents of the types of necrotising fasciitis

A

NF type 1: poly microbial: anaerobes, gram negative, strep, staph

NF type 2: group A strep (+/- concomitant staph)

NB: group A: streptococcus pyogenes (Lancefield group A)

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8
Q

What complication can arise by invasive streptococcal disease if exotoxins are release?

A

Streptococcal pyogenic exotoxins A and C can result in toxic shock syndrome - systemic inflammation response + shock - few superficial signs

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9
Q

Group B strep is what bacteria!

Where is it’s normal habitat?

A

Streptococcus agalactiae (lancefield group B)

Normal flora of lower GI, throat and female genital tract.

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10
Q

What % of woman have GBS in pregnancy

What % of babies born to mothers colonised with GBS will become colonised through the passage of the vagina?

A

30% but may be intermittent

60%

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11
Q

What are the risk factors for the baby accruing GBS

A
Preterm <37/40
PROM (more than 18 hours)
Intrapartun fever >38
Precious infant GBS
Heavy maternal carriage of GBS
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12
Q

How can GBS present in the infant?

A

Early (hours to days): bacteraemia, meningitis, pneumonia
Significant morbidity neurological sequela (blindness, mental retardation)

Late (not a quite during del): meningitis with bacreraemia

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13
Q

Incidence of neonatal GBS disease in UK

A

0.5/1000

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14
Q

Which mother receive prophylactic Abx intrapartun?

A

Previous GBS disease in baby or pregnancy
GBS found in vagina or urine during pregnancy
PROM (18 hours)
Preterm rupture of membrane in labour (<37/40)
Preterm rupture of membrane with known GBS (whether in labour or not)
Intrapartun temp

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15
Q

What is the Abx regime to prevent GBS in labour + if pen allergic

A

IV benpen 3g at onset of labour, 1.5G every 4 hours until delivary

IV clinda 900mg every 8 hours

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16
Q

Despite the gram stain and morphology of staphylococceae .

Result of catalase test

A

Gram +ve, facultative anaerobes in clusters (like grapes)

Catalase test +ve (note streptococci is negative)

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17
Q

How is the presence of extra cellular enzyme coagulate used to classify staph

A

The prsescence of coagulase allows the ability to clot plasma

S.aureus: coagulse +ve
Coag negative: S.epidermidis, s.haemolyticus

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18
Q

How to decolonisw those identified with MRSA

A

Chlorexidine gluconate: shampoo, body wash and mouthwash

Nasal mupirocin

19
Q

Do coagulase negative staphylococci cause serious infections

A

Mostly low pathogenicity,

Often contaminants of microbiological specimens

20
Q

What gram stain and morphology is listeria monocytogenes (most significant form of listeria)

A

Gram +ve, rod, facultative anaerobes

Beta haemolytic on blood agar

21
Q

Where is Listeria monocytogenes often found in the environment, how can it be contracted by humans?

A

Soil, water, faeces of many animals,
Can multiply in foods that have been refrigerated for long periods of time,

Food borne outbreaks: contaminated milk, soft cheese, undercooked meat, unwashed or uncooked vegetables

22
Q

What is the effect of listeria monocytogenes in pregnancy on the mother + baby

A

Mother: asymptotic or mild febrile illness with conjunctive, headache sore throat

Fetal infection can occur at any gestation
Early: spont abortion
Late: Preterm, stillbirth
Infant: neonatal listeriosis (less than 2 days), mortality 60%

23
Q

How if it Dx in mothers?

A

HVS, MSU, stool sample

AF may be discoloured or contain meconium

24
Q

If late neonatal listeriosis - where has the baby likely contracted the infection

A

Either during labour/passage through the birth canal or hospital cross infection

Mortality 10%

25
Tx listeriosis
High dose IV Amox +/- gent - which dose not cross BBB Resistant to ceph
26
Gram stain and morphology of enterobacteriaceae
Gram -ve rods that ferment glucose
27
2 main groups of enterobacteriaceae
Commensalism bacteria (e coil, klebsiella, enterobacter) Overt pathogens produce virulence factors (Salmonella typhi (typhoid), shigella, campylobacter)
28
What is the incidence of asymptotic bacteriuria in pregnancy? What is it associated with?
2-5% | May progress to pyelonephritis, increases risk of preterm birth
29
E. Coli is common in which infections
``` UTI Biliary tract infection Neonatal sepsis and meningitis Wound infection Septicaemia - Abx should always cover gram -ves eg co amox or 3rd gen cephalosporin like ceftriaxone ``` If gram negative resistance suspected - gent or carbapenems
30
What is the gram stain and morphology of neisseria. Name 2 significant pathogens
Gram -ve, diplococus Positive catalase and oxidase test Neisseria meningitis and neisseria gonorrhoea
31
CSF for nesiera meningitis
High protein Low gluclose High WBC predominant neutrophil
32
Tx of Meningococcal infection
In community: IM benpen Hospital: IV benpen or ceftriaxone Contacts: ciprofloxaxine or rifampicin
33
What bacteria cause syphilis and what it gram stain and morphology
Treponema pallium No gram stain Spiral rod shape
34
Incidence of TB in UK and London
15/100,000 UK 50/100,000 London 3 x higher not born in UK
35
Lab Dx of TB Histology findings
Fluorochrome stain and confirmed Ziehl-Belsen stain (pink) Caseating granulomas with multinucleate giant cells
36
Tx of Tb and associates side effects of the drugs
Rifampicin: orange body secretion + hepatoxicity Isoniazid: peripheral neuropathy, hepatoxicity Pyrazinamide: arthralgia, raised Utica acid/gout Ethambutol hydrochloride: renal inpairment
37
What is a common predisposing factor for abdominal actinomyocosis
``` Perforated appendicitis (65%) Intrauterine device (30%) ```
38
What are the 4 species of Protozoa which cause malaria. Which causes the majority of deaths
P. Falciparum, P vivax, P ovale, P malariae p falciparum
39
What complications can be seen in severe malaria
``` Severe anaemia Acute pulmonary oedema hypogylcaemia cerebral malaria consciousness and seizure DIC acute renal failure ```
40
which Tx for malaria are CI in pregnancy?
Primaquine Tetracycline Doxycycline
41
How long should women of childbearing age been advise to wait before seeking to conceive
mefloquine 3 months doxycycline 1 week atovaquone/proguanil hydrochloride 2 weel
42
advise to pregnant women traveling to malra zones
Avoid if unavidoabl clothing precautions, DEET >50% Chloroquine and proguanil hydrochloride (need high dose folic acid) safe but not good at prevent p falciparum If high p falciparumarea consider mefloquine in 2nd/3rd trimester
43
In wound infection if patient is colonised with MRSA what Abx should be used?
Teicoplanin or doxycycline
44
When should intraopertive prophylactic abx be given
At time of aeanaethetic age, no more than 30 mins prior to skin incision