microbiology Flashcards
Give 3 bacterial features
- No membrane bound organelles
- Haploid
- May have flagella
- Very small and unicellular
What are the forms of bacteria
Cocci, Bacili, Spinilli
Describe the grams stain process
Add violet dye
iodine
rinse with alcohol
Red dye
Why do bacteria have difference results from gram stain
Gram negative bacteria have two membranes so the violet dye is lost to one of them and the red counterstain is absorbed instead -> pink colour
Which type of bacteria cannot use a gram stain
Mycobacterium
What stain must be used for mycobacterium
Acid-fast as they do not decolourise
Give 2 examples of gram -ve bacteria
Shigella, Salmonella, E.Coli etc.
Give 2 examples of gram +ve bacteria
Streptococcus pneumoniae
Staphylocuccus Aureus
What do bacterial pathogens do
Colonise Persist Replicate Disseminate Cause disease
Give examples of extracellular bacteria
Staphylococcus Aureus
Streptococcus Pneumoniae
Neisseria
Give examples of Intracellular bacteria
Shigella Salmonella E. Coli Chlamydia Coxiella Mycobacteria
How do chlamydia, mycobacteria and Shigella survive
Inhibit fusion of the lysosome with the phagosome
How does coxiella survive
Survives in the phagosome
How do listeria and shigella survive
Escapes the phagosome
What is the purpose of the flagella and give an example of a bacteria that uses it
Movement and salmonella
What is the injectisome and give an example of a bacteria that uses it
manipulates the host actin cytoskeleton so that the bacteria can enter and move. Salmonella and Listeria
What are the three mechanisms of horizontal gene transfer
Transformation
Confugation
Transuction
Describe transformation and give bacterial examples
Uptake of naked DNA and integration into the host genome. Neisseria and streptococcus
Describe conjugation and give bacterial examples
Transferring a plasmid that gives antibiotic resistance. The plasmid is OriT which transfers via a mating bridge. The new plasmid is produced via semi-conservative replication. Gram -ve and +ve
Describe transduction and give bacterial examples
Bacteriophages insert DNA and cleave the bacterial DNA, packaging it into bacteriophages which then travel to other bacterium to inject material.
What contributes to evolution of bacteria
Pathogenicity island, horizontal gene transmission, selection pressure, rapid replication, genetic variation
What is a pathogenicity island
Pathogenicity Isalnds are a class of non-core genomes that are acquired by HORIZONTAL TRANSMISSION; they can be revealed by aligning pathogenic genomic DNA and a closely-relate non-pathogen.
Compare intrinsic sources to extrinsic sources
Intrinsic = non-sterile sites e.g. mouth, respiratory tract, sinus, lower genital tract, stomach etc. Extrinsic = other people or living things e.g. animals, food, water
Compare routes of bacterial transmission
expected = maternal microbiota to the newborn Unexpected = surgery
How may upper respiratory tract affect other organs
Spread to adjacent tissue (ear, brain)
Spread to the blood stream (bacteraemia)
Spread to the lower respiratory tract (bronchitis, pneumonia)
Give an example of an upper respiratory bacteria
neisseria meningiditis
What kind of bacteria infect the urogenital tract. Give an extrinsic and intrinsic route
intrinsic bacteria (E. coli). Ex- catheter, In- Bacteria
How may bacteria enter through skin
Wounds
Skin diseases
Insect bites
I.V.
What kind of diseases may entry through skin diseases cause
Gangrene
Cellulitis
Bacteraemia
What bacteria causes tonsilitis
Streptococcus Pyogenes
Give an example of a bacteria that enters the GI tract
E. coli, Sigella spp., Vibrio Cholerae, Salmonella, Listeria
Give an example of a bacteria that enters the faeco-oral route
Cholera, E. Coli
What does Neisseria Meningiditis do
Releases respiratory endotoxin, damages RBCs, causes shock.
What does E. coli do
Caused by food/ water contamination, Toxins released into the blood stream via the large intestine. Causes kidney failure
What does staphylococcus aureus do
Releases toxins and enzymes
What is the infective dose and how is it measured
Minimum amount of pathogen required establish disease. Measured in colony-forming units
Define infectivity
The ability of a pathogen to establish an infection
Define virulence
Ability of a pathogen to cause disease
What feature contribute to infectivity
Transmission to host Colonisation Tropism (final niche and motility) Replication speed Evasion of the immune system
What features contribute to virulence
Toxin production
Degrading enzymes
Interruption of host cell processes
Immune evasion
What is the process of shock
SIRS - Sepsis - Severe sepsis/shock - MODS
Describe SIRS
Severe Inflammatory Response Syndrome. Features include a temp. above 38 or below 36, respiratory rate above 20, heart rate above 90, WBC count above 10,000 or below 4000
Describe sepsis
SIRS and an infection . An overreaction and dysregulation. Includes skin warmth, decrease in mental ability, pain and breathing difficulty
Describe severe sepsis/ shock
Poor tissue diffusion. sepsis = Sepsis + lactic acidosis. Shock = sepsis +hypotension (increase in permeability and vasodilation)
Describe MODS
Multiple Organ dysfunction syndrome.
What is the treatment for sepsis
Antibiotic
Blood Products
Fluids and vasopressors to increase blood pressure
What are the sepsis risk factors
Genetic Microbiome Nutrition Stress Immunosuppression
What are the hospital-acquired diseases therapies
Antibiotics, bactericidal, bacteriostatic, anti-septic
What is the minimal inhibitory concentrations
Lowest concentration of antibiotic required to inhibit growth
What is the breakpoint
Breakpoint is the clinically achievable MIC
Why are hospital acquired diseases transmissible
High density of ill people - lots of pathogens
People moving - spread
Open wounds - easy portal of entry
Insertion of devices e.g. catheter, cannulas
Antibiotic therapy - antibiotic resistance
What are antimicrobials
Any substance or chemical that kills a microbe or inhibits its growth
What are the classes of antimicrobials and what do they do
Beta-lactams - inhibits cell- wall synthesis
Tetracyclines - efflux/membrane pumps
Chloramphenicols- inhibits protein synthesis
Quinolones - target site modification
Sulphanamides - blocking uptake or influx
Aminoglycosides - inhibits protein synthesis
Macrolides - inhibits protein synthesis
What are the pathways of resistance
Altered target sites
Antibiotic inactivation
Altered metabolism
Decreases drug accumulation
What is the basic resistance mechanism
Colony of bacteria present, some are resistant Antibiotic kills bacteria Resistant ones remain No competition for resources Resistant strain replicates
how does morbidity, mortality, length of stay and cost relate to resistance
More exposure to hospital pathogens, more illness, more drugs, cost of a bed
Which pathogens are multi-drug resistant
Gram -ve = E. Coli, Salmonella Neisseria Gonorrhoeae
Gram +ve = Staphylococcus Aureus, S. Pneumoniae, clostridium dificcile
Mycobacterium = M. Tuberculosis
Treatment of multi-drug resistant pathogens
Temporarily withdraw certain antibiotics Only use them for dangerous infections Reduce broad-spectrum antibiotics Identify resistant strains Combination therapy Adjust current antibiotics
What is the size of a virus
20-100nm
Compare enveloped to non-enveloped viruses
Enveloped = lipid=envelope from the host cell e.g. measles, ebola Non-enveloped = adenovirus, calcivirus
What are the features of a DNA virus
Segmented genomes
Reassortment of 2 viruses
Half of the DNA codes immune resistant proteins
What is the basic viral life cycle
Virus locates target cell Binding to receptors Nucleocapsid enters Formation go early (regulation) then late (structural) proteins Replication of the viral genome Assembly of new virus Release
What is the HIV life cycle
HIV binds to CCR5/ CXCR4
Viral proteins and mRNA released
Host proteases hydrolyse the protein capsid
Reverse transcriptase generates DNA from RNA
Integrase integrates the DNA into host genome
Host cell produces proteins
Proteases cleave into constituent proteins
Host membrane used as the lipid envelope
How are viruses detected
Using the cytopathic effect = effect of the virus lysing the cell (could be due to shut down of protein synthesis or viral protein accumulation)
How can viruses be analysed
Viruses will form plaques in monolayers - Assay
Some viruses (HIV) do not form plaques but fuse = Syncytia
Antibody generation
How are viral infection diagnosed
Amplify genomes using PCR Detect using IDA or ELISA Look for viral particles Cytopathic effect Antibodies (Serology) High density fluorescent markers
Consideration for viral testing
Who will use it and where
Source of the specimen
Test purpose
Stage of disease
Describe propagation
Continuous lines of viral growth leads to mutation and therefore evolution. If the genome is small, it can be synthesised and mutation can be added for vaccinations.
What is attenuation
The virus becomes so different that it is unable to grow as well in humans. Can be used for vaccines
What are the viral routes
Latrogenic - HCW e.g. contaminated needles Nosocomial - hospital acquired Vertical - Parent to offspring Horizontal - All other forms Germ- line - part of host cell genome
Describe viral transmission in terms of viraemia
Site of entry - blood (primary viraemia) - organ - Amplification - main organ through blood (secondary viraemia)
What is tropism
The place where the virus replicated. May be determined by expression of the host cell receptor e.g. T cells and HIV, Ability to replicate in one cell type e.g. polio, extracellular factors e.g. influenza and proteases
What are the modes of transmission for HIV
T cells - CD4, CCR5, CXCR4 (GP120)
What are the modes of transmission for Measles
Dendritic cells- CD155, SLAM, Neetin 4
What are the modes of transmission for influenza
endosomes, receptors found everywhere (ubiquitous). Low pH means HA fuses, Clara secrete, cleavage protein
What does counteraction of the host defence involve
Effects of replication
Strength of the host immune system
Ability of the virus to spread
What is pathogenicity
Ability to infect
Describe an acute infection and give examples
Infection followed by viral clearance. Smallpox, dengue, polio
Describe persistant infection
Latent, slow, transforming infection that is not cleared by adaptive immunity. Chronic or lifelong. HIV, varicella zoster
What gives acute infection epidemic potential
Transmission before the symptoms arise
How can polio strains vary in virulence
A single mutation can cause it to be live or to cause flaccid paralysis
What is the relationship between siblings and varicella zoster
1st child is milder while second is much worse
What is prophylaxis
Preventing the disease before the etiologic agent is acquired by vaccination or giving a drug before infection
What is therapy
Treating the disease after host infection
Compare vaccines and antivirals
prophylactic vs therapeutic
Herd immunity or target group vs defined target group - very sick or over the counter
government vs individuals
Compare the different types of vaccines
Attenuated - rapid, broad, long-lived, but may revert, Adenovirus, influenza, measles
Inactivation - Safe, may be from wild-type, frequent and will need boosts, Hep A, polio
Purified subunit - influenza
Cloned subunit - hep B, HPV
Smallpox
success of the cowpox vaccination other strains grown on animals skin Sporadic flare of epidemics WHO invested $2.5 million 1977- last case in Somalia (endgame) - ring vaccination of everyone in the area
Why was smallpox eradicated
No animal reservoir
100% penetrance
Obvious symptoms
Modern aims
eliminate polio and measles
Polio has two versions: live (Sabin) and inactive (Salk)
Describe selective drugs
Drugs are very specific to their viruses
An accurate diagnosis is required to inform correct drug choice
Why is combination therapy used
High mutation rate causes resistance development
What is genomics
Identifying host cell genes that viruses need
Give examples of successful viral therapy
Acyclovir for herpes which is a nucleoside analogue for deoxyguanosine without a3’ OH. It must be thymidine kinase which is only present in viruses.
Zidovudine AZT for HIV. It is a nucleoside and used in HAART
What are the features of influenza
Infects water fowl and mutation meant it infected humans. Changes in epitope means it can escape immunity.
What is reassortment
Combination of 2 viruses that infect the same cells
Define antigenic shift
When mutation adapt a virus for replication and transmission in humans and on its spread it displaces the previous strain
how was HIV introduced to humans
From simian virus - bushmeat trade. Quasispecies
How was west nile virus, norovirus and SARS introduced
WNV- Mosquitos and birds from Asia to USA
Norovirus - small RNA
SARS - bats
Why may new viruses emerge
Zoonosis
Genetic variation
Increased exposure (travelling or by vector)
New discoveries
Define zoonosis
Crossing of an animal pathogen into humans
Define the host range barrier
Viruses adapted to infect animals hosts are compromised in their ability to replicate and spread in humans due to the genetic difference between host factors and what the virus needs.
Define quasispecies
A group of viruses related by a similar mutation(s), competing within a highly mutagenic environment.
What is fitness cost
resistant pathogens are unable to spread beyond the treated patient
Compare active and passive immunisation
Active = body makes its own antibodies (memory cells and protection against future infection) Passive = antibodies given directly
What is a live attenuated vaccine and give an example
Whole virus with reduced virulence e.g. MMR
What is an inactivated vaccine and give an example
Dead form of a pathogen e.g. Flu
What is a subunit vaccine and give an example
Strong immunity to antigens e.g. Hep B
What is a toxoid vaccine and give an example
Injection of the toxin that causes the disease e.g. Tetanus
What is a conjugate vaccine and give an example
Binding of weak antigen to a strong antigen e.g. pneumococcus
Describe the MenC vaccine
All in one paediatric vaccine. Includes whooping cough, tetanus, diphtheria, meningitis, septicaemia, polio 1,2,3,
Describe fungi
Saprophytes that digest food extracellular
Spread via spores over large distances
eukaryotes
What makes fungi different to bacteria
Membrane bound nucleus
Cell wall
DNA vs RNA
Harder to treat
How may allergies be caused by fungi
Sensation to the spores causes allergic reaction e.g. asthma, rhinitis
What is mycotoxicases
Inhalation or ingestion of a mycotoxins typically by eating poisonous mushroom. Certain crops -> aspergillum flavus -> aflatoxin -> hepatic carcinoma
What is Mycoses
Fungal infection in animals e.g. candida
What are the three types of mycoses
Superficial - rash in all ages OUTERMOST
Mucosal - immunosuppressed
Systemic - Catheter, gut surgery, chemo DEEP
what are the 3 targets for fungi
cell membrane (ergosterol)
DNA synthesis
Cell wall