Microbiology Flashcards
Define a pathogen
Organism that causes or is capable of causing disease
Define a commensal
organism that colonises the host but causes no disease in normal circumstances
Define an opportunist pathogen
microbe that only causes disease if host defences are compromised
Define virulence/ pathogenicity
degree to which an organism is pathogenic
Define asymptomatic carriage
When a pathogen is carried harmlessly at a tissue site where it causes no disease
Describe how to apply the gram stain
Apply crystal violet to heat fixed bacteria
Treat with iodine
Decolourise sample with alcohol
Counterstain with safranin
Describe the characteristics of gram positive bacteria
Single membrane
Large peptidoglycan ares
Describe the characteristic features of gram negative bacteria
Double membrane
Small peptidoglycan area
Endotoxins (LPS)
Describe endotoxins
component of the outer membrane of bacteria. They are heat stable and non-specific
Describe exotoxins
Proteins secreted from gram positive and negative bacteria. They’re specific and heat labile
Give 2 examples of gram positive cocci
Staphylococcus and streptococcus
What test can be done to distinguish between staphylococcus and streptococcus
Catalase test; detects presence of catalase enzyme using hydrogen peroxide
Staph = catalase +ve
Strep = catalase -ve
How would you describe the arrangement of Staph
Clusters of cocci
How would you describe the arrangement of Strep
Chains of cocci
What test could be done to distinguish between staph bacteria
Coagulase test: looks at whether a fibrin clot is formed
What bacteria would be coagulase positive
Staphylococci aureus
What bacteria would be coagulase negative
Staphylococci epidermis
What test could be done to distinguish between different streptococci
Haemolysis on blood agar; uses hydrogen peroxide o test reaction with Hb
What would you see on the agar plate in alpha haemolysis and give an example of a bacteria in this group
a-haemolysis is partial erythrocyte lysis (green colour visible)
S. pneumoniae
What would you see on the agar plate in ß haemolysis and give an example of a bacteria in this group
Complete erythrocyte lysis: you see a clear area
S. pyogenes
S. agalactiae
What would you see on the agar plate in gamma haemolysis and give an example of bacteria in this group
No haemolysis
E.g., Strep. bovis
Describe the appearance of bacilli
Rods
What type of organism would you stain with Ziehl Neelsen
Mycobacteria
What further test can be done for streptococci in the alpha haemolysis group?
Optochin test
S.pneumoniae is optochin sensitive
Virdans Strep is optochin resistant
Give examples of gram positive bacilli
Bacillus
Cornyebacterium
Listeria
What is MacConkey agar
Selective agar containing bile salts and crystal violet. If an organism ferments lactose, lactic acid will be produced and the agar will appear a pink/red colour
What kind of bacteria is MacConkey agar used with
Gram negative bacilli
Name 2 gram negative bacilli that will give a positive result with MacConkey agar
Escherichia coli
Klebsiella pneumoniae
(pink)
Where in the body might you find Staphylococci
Nose and skin
Name 2 gram negative bacilli that will give a negative result with MacConkey agar
Shigella
Salmonella
(white)
How does serology aid to distinguish between gram negative bacilli
Detects the presence of the H antigen (flagella)
Salmonella is motile and have flagellum (+ve)
Shigella is non motile and doesn’t have flagellum (-ve)
Name 2 infections associated with E. coli
UTIs
Traveller’s diarrhoea
What type of bacteria are neisseria
Gram negative diplococci
What are mycobacteria
Aerobic
Non-motile
Non spore forming
Bacilli
Give 2 example of mycobacteria
M. tuberculosis (TB)
M.leprae (leprosy)
What colour do s. aureus colonies appear on blood agar
Creamy/ yellow
What is XLD agar used for
It is a selective growth medium used to isolate salmonella and shigella
Salmonella shows black dots
Define antibiotics
Agents produced by microorganisms that kill or inhibit the growth of other microorganisms
Name the 3 main types of beta lactams
Penicillin
Cephalosporins
Carbapenems
Apart from beta lactams, what other type of antibiotic inhibits cell wall synthesis
Give examples
Glycopeptides
Vancomycin
Teicoplanin
How do beta lactams inhibit cell wall synthesis
Disrupt peptidoglycan production by binding covalently and irreversibly to the penicillin binding site
Cell wall is disrupted and lysis occurs
What type of bacteria are beta lactams particularly effective against and why
gram positive bacteria as they have thick cell walls which makes them more susceptible to ß-lactams
Name 3 penicillin’s
Amoxicillin
Flucloxacillin
Benzylpenicillin
Name 3 cephalosporins
Cefotaxime
Ceftriaxone
Cefuroxime
Name 2 carbapenems
Meropenem
Imipenem
Give 3 ways antibiotics inhibit nucleic acid synthesis and give examples in each group
Break DNA strand: Metronidazole
Bind to RNA polymerase: Rifampicin
Inhibit DNA gyrase: Quinolones (Ciprofloxacin)
Give 2 examples of antibiotics that inhibit folate synthesis
Trimethoprim
Co-trimoxazole
Why shouldn’t trimethoprim be given to pregnant women
Folate is important during pregnancy to prevent spina bifida
What type of antibiotic is usually used for those with a penicillin allergy
Macrolides
Name 2 types of antibiotics that prevent protein synthesis by binding to the 50S unit
Give examples for each
Macrolides e.g., Clarithromycin
Lincosamides e.g., Clindamycin
What 2 types of antibiotics inhibit protein synthesis by binding to the 30S subunit. Give examples for each
Tetracyclines - doxycycline
Aminoglycosides - gentamicin
What are bactericidal antibiotics
Antibiotics that inhibit cell wall synthesis
Define minimum inhibitory concentration (MIC)
The lowest concentration of a chemical that prevents the growth of a bacterium
What are bacteriostatic antibiotics
Inhibit protein synthesis, DNA replication or metabolism
What does a drug need to ensure it inhibits metabolic processes
Concentration: occupy an adequate n.o binding sites
Time: occupy these binding sites for a sufficient period of time
What is concentration dependent killing
Antibiotics that eradicate pathogenic bacteria by achieving high concentrations at the site of binding
Key: how high the [ ] is above MIC. [Peak] / MIC ratio
What is time dependent killing
Time that [serum] remain above the MIC during the dosing period
t > MIC
Give an example of a class of antibiotics that use [dependent] killing
Aminoglycosides
Quinolones
Give examples of a class of antibiotics that uses time dependent killing
Beta lactams
Macrolides
What are the 4 mechanisms of antibiotic resistance
Antibiotic resistance
Destroy antiobiotic
What are the 4 mechanisms of antibiotic resistance
Change antibiotic target
Destroy antibiotic
Prevent antibiotic access
Remove antibiotic from bacteria
How can the antibiotic target change
Bacteria change the molecular configuration of antibiotic binding site or masks it
Give an example of a change in antibiotic target
Flucloxacillin is no longer able to bind to PBP of Staph
Give an example of how an antibiotic is destroyed
Beta lactam ring of penicillins and cephalosporins hydrolysed by bacterial enzymes
Beta lactamase now unable to bind to PBP
How can access to antibiotics be prevented
Modification of bacterial membrane porin channel, size, number and selectivity
How can antibiotics be removed from bacteria
Proteins in bacterial membrane act as an export or efflux pump
How does resistance develop
- Intrinsic: natural resistance
- Acquired:
- spontaneous mutation
- Horizontal gene transfer
Give 3 methods of horizontal gene transfer
Conjugation
Transduction
Transformation
What is a clinically important gram positive resistant bacteria
MRSA (methicillin resistant Staph. aureus)
Plasmid transfer resistance
What is a clinically important gram negative bacteria
ESBL (extended spectrum beta lactamase)
Mutation at active site
Give an example of a drug that can be used to inhibit beta lactamase in ESBL
Amoxicillin + Clavulanate = Co-Amoxiclav
What types of bacteria does vancomycin work against
Gram positive only
Good for MRSA treatment
What antibiotic might be used for s.pneumoniae
amoxicillin
What antibiotic might be used for s.aureus (MSSA)
Flucloxacillin