Microbiology in practice Flashcards
What are the two functions of the microbiology lab?
Clinical- to diagnosis of the infection for the patient, facilitating treatment.
Epidemiological- we want to keep track of microbial infections so that we have a baseline. This lets us know when there is an outbreak.
Name pathogens associated with periodontal disease.
A.a
P.gingivalis.
Name some pathogens associated with endodontic infections?
Polyphoromonas Endodontalis
Fusobacterium nucleatum
Name and compare the two main candida yeast?
Candia albicans- this is sensitive to fluconazole
Candida glabrata- this is resistant to fluconazole.
Classify this candidosis.
This is pseudomembranous candidosis e.g. thrush.
Classify this candidosis.
This is erythematous candidosis e.g denture stomatitis.
Classify this candidosis.
Hyperplastic candidosis e.g. candida leukoplakia.
What is our go to treatment for candida?
Oral hygiene instruction and topical Chlorohexidine.
How do we treat a patient with candida who:
- is Immunocompetent
- Has good oral hygiene
Any topical or systemic antifungal.
How do we treat a patient with candida who:
is Immunocompetent
Has dry mouth?
Topical antifungal.
How do we treat a patient with candida who:
- Is Immunocompetent
- Has a large erosive lesion.
Systemic antifungal AND topical antifungal/ chlorohexidine rinse.
How do we treat any immunocompromised patient with candida?
Systemic antifungal AND topical antifungal/ chlorohexidine rinse.
What is denture induced stomatitis ?
A mixed infection of bacteria and yeast caused by wearing a denture all the time. This causes inflammation of the gums.
How do we treat denture stomatitis?
Brush the palate daily.
Clean the denture by soaking it in chlorohexidine mouthwash or sodium hypochlorite (acrylic) for 15 minutes twice a day.
What is angular cheilitis?
A fungal infection found at the corner of your mouth.
How do we treat angular cheilitis?
Antifungal- 2% miconazole topical for 10 days.
Antibiotic ointment- Sodium fusidate applied 4 times a day for 10 days.
What is pseudomembranous candidosis?
A candida infection of the mouth that occurs in individuals with predisposing factors. e.g. antibiotic use, local corticosteroids. immunodeficiencies, nutritional deficiencies.
How do we manage pseudomembranous candiosis?
Management of the biofilm:
Cleaning the palate (covered in white plaques that can be washed away- using
- toothbrush
- Gauze
- Corsodyl mouthwash/ gel.
Removing the denture at night.
Only if the first line management fails-
Use Miconazole (unless patient is on warfarin- increased anticoagulant effect/ or statins- increased myopathy risk)
Nystatin- if the patient is on warfarin.
What is hyperplastic candiosis?
This cannot be scraped off. It grows into the tissue and should be tested for a malignancy.
What is a bacteria associated with secondary endodontic disease and describe a virulence factor
Polyphoromonas Endodontalis.
Which produces lipopolysaccharide endotoxin
Discuss the different antifungals and how they work
Topical- Miconazole oromucosal gel- inhibits the enzyme used to produce ergosterol (part of the cell membrane)
Systemic- Fluconazole- inhibits ergosterol formation in fungi.
If any of above are contraindicated
Nystatin- interacts with the fungal membrane sterols physiochemically.
How can candida become resistant?
Altering the target site to prevent azoles binding.
Altering the composition of the cell membrane to prevent insertion of polyene into the cell membrane.
