Microbiology to know for AKT Flashcards
Should an asymptomatic person who tests positive for MRSA (nasal swab) while in hospital receive treatment?
Yes. The patient should receive eradication with shampoos/nasal creams to protect those around him, and to prevent him from becoming sick with
overgrowth of his current MRSA should his immune system become compromised by
another illness or if antibiotic treatment removes competing commensals.
Which of the following statements best describes a Staphylococcus Aureus infection?
a. S. aureus is not a commensal organism.
b. S. aureus is a coagulase negative bacterium.
c. Ricardo ideally should be moved into a
side room, and the bay he was sleeping in
previously should be deep cleaned.
d. If he does not approach any of the other patients, Ricardo cannot pass on the infection.
e. S. aureus has adhesin proteins, which bind the Fc region of IgG (Fab) to disrupt their function and Protein A, which helps the bacterium adhere to host proteins as well as evade the immune system.
a. S. aureus is not a commensal organism. Incorrect. 30% of the population have S.
aureus on their skin; 10% of this is MRSA.
b. S. aureus is a coagulase negative bacterium. Incorrect. Staph Aureus is Coagulase
positive. Coagulase stimulates clotting and plays a role in immune evasion.
c. Ricardo ideally should be moved into a side room, and the bay he was sleeping in
previously should be deep cleaned. Correct. It is important that the chain of infection
is broken. Cleaning items which may act as fomites will prevent indirect transmission
to other patients. In practice, this rarely due to lack of side rooms and patients are
barrier nursed.
d. If he does not approach any of the other patients, Ricardo cannot pass on the
infection. Incorrect. He can still pass it on by indirect transmission. Therefore, he
needs to be moved into a side room or barrier nursed so that he is not touching items
that other patients will then be handling.
e. S. aureus has adhesin proteins, which bind the Fc region of IgG (Fab) to disrupt their
function and Protein A, which helps the bacterium adhere to host proteins as well as
evade the immune system. Incorrect. S aureus has both; however, the functions are
reversed.
Staph aureus is coagulase
positive
What action does coagulase have in bacteria?
Coagulase stimulates clotting and plays a role in immune evasion.
What do adhesion proteins do, such as those found in Staph aureus?
Adhesion proteins help the bacterium adhere to host proteins as well as
evade the immune system.
What the function of Protein A in Staph aureus bacteria?
Protein A binds the Fc region of IgG (Fab) to disrupt their function.
Time elapsed between exposure to a pathogen
and developing symptoms.
Incubation period
The presence of bacteria on a body surface
without causing harm.
Bacterial colonisation
A symbiotic relationship in which one population
derives benefit and the other is neither harmed
nor benefits.
Commensalism
Molecules produced by a pathogen that
increase its’ effectiveness at causing disease.
Virulence factors
An infection that does not produce symptoms
unless activated but may still be transmissible.
Latent infection
An infection caused by multiplication of an
organism that was already present in the body.
Endogenous infection
The mechanism by which latent infections begin
to multiply and spread.
Reactivation
An infection caused by invasion by a bacterium
from the environment.
Exogenous infection
A commensal bacteria of anterior nares
Staph aureus
Which type of bacteria forms “golden colonies” on blood agar?
Staph aureus
Microscopic appearance/staining of Staph aureus?
Gram positive cocci in clusters
What percentage of the population are carriers of Staph aureus?
20-60%
What virulence factors of S.aureus provide (host) tissue adherence and immune evasion “cloaking?”
Adhesion proteins
Elastin-binding protein, collagen-binding protein, and fibronectin binding protein are examples of
Adhesion proteins
Surface proteins such as adhesion proteins are associated with which growth phase of bacteria?
Exponential (log) growth phase
Secreted proteins of S. aureus are associated with which growth phase of the bacteria?
Stationary phase
How does the capsule of S. aureus play a role in evading the immune system (preventing opsonisation?)
It blocks antibodies from binding to antigens such as the peptidoglycan layer, and also by binding of cell wall opsonins to complement receptors and Fc region of antibodies blocks opsonisation
Commonest cause of bacteraemia?
Staph aureus
These cytotoxins
-Pore-forming toxins, lyse host cells
- PVL- lyses immune cells
Are associated with what type of bacteria?
Staph aureus
Staph aureus’s exfoliative toxins (Proteases) target what type of proteins?
The exfolative toxins target epidermal structural proteins
Enterotoxins are also known as
superantigens
How does our IMMUNE system respond to enterotoxins from Staph aureus?
Stimulate massive T cell activation and immune invasion
What type of illness is produced when Staph aureus (a strain with enteroxins) is ingested?
Food poisoning
Rapid, brief illness
+++vomiting
Minimal diarrhea
Staph aureus virulence factors:
Substances involved in adherence to nasal mucosa?
Adhesions
Staph aureus virulence factors:
Ability to invade tissues? (2)
Cytotoxins and enzymes
Staph aureus virulence factors:
What two things help the bacteria evade immune clearance?
Protein A and polysaccharide capsule
Lipoteichoic and teichoic acid are found in what type of bacteria- gram positive or gram negative?
Gram positive
What substance do gram negative bacteria have in their outer membrane?
Lipopolysaccharide
Which branch of our immune system is very sensitive to lipopolysaccharide?
Innate
Lipopolysaccharide interacts with ______-_____ receptors (esp TLR4) on monocyte/macrophage lineage cells, as well as endothelium
Toll-like
_______________ interaction with toll-like receptors results in activation of inflammatory pathways, coagulation and clotting pathways, and changes endothelial integrity
Lipopolysacharride
What is the main reason why people get very sick with gram negative infections?
The lipopolysaccharide acts as an endotoxin in the blood, which produces a systemic activation of immune responses
Do gram positive bacteria have endotoxins?
No
Lipoteichoic acid and peptidoglycan are components of what type of bacterial cell wall?
Gram positive
Neisseria meningitidis produces what disease?
Meningococcal septicaemia
A non-blanching “purpuric” rash (glass test) is indicative of what type of infection?
Meningococcal septicaemia
N.meningitidis has adhension proteins that adhere to which two host tissues?
Respiratory epithelium and meninges
What three components contribute to pathogenicity of N.meningitidis?
- Adhesions
- LPS
- Capsule
In microscopy, the N.meningitidis __________ is the result of shedding endotoxin
blebbing
Pneumococcal pneumonia shows what type of bacteria under the microscope?
Gram-positive diplococci (pneumococcus)
What bacteria has specific adhesions for respiratory mucosa, pneumolysin, secretory IgA protease, and a capsule?
Streptococcus pneumoniae
This virulence factor binds host cell membrane cholesterol, forms pores and lyses in ciliated cells, and lyses host phagocytic cells
Pneumolysin
This substance breaks down secreted IgA, preventing mucosal clearance
Secretory IgA protease
What are the four virulence factors for Streptococcus pneumoniae? (Think- StreptoCAPS pneumonia)
- Adhesion molecule specific to respiratory mucosa
- Pneumolysin
- Secretory IgA protease
- Capsule
What is the commonest cause of pneumonia?
Streptococcus pneumonae
In its disseminated form, this bacteria can cause bacteraemia, endocarditis, sinusitis, OM, and meningitis
Streptococcus pneumonia
What are five types of toxins produced by bacteria?
- Lysins
- Tissue enzymes like elastase, collagenase, coagulase
- Exfoliative toxins, enterotoxins
- Enzymes targeting host immune responses (Secretory IgAase
- Endotoxin
Classification of Clostridium difficile? (shape and stain?)
Gram positive rods
C.diff bacteria- aerobic or anaerobic?
Anaerobic
C.difficile is a ________-forming bacteria
spore
Which patients are especially susceptible to C.diff infection?
Elderly patients on antibiotics
Pseudomembranous colitis is a severe form of diarrhea associated with which bacteria?
Clostridium difficile
Some virulent strains of C.difficile, such as 027, lose regulation of toxin ____, and become hyper-producers of additional ______
genes, toxins
What causes the diarrhea in C. diff infection?
The bacteria produces toxins which cause fluid secretion into the gut, which leads to diarrhea
__________ pathogens always cause disease, while ________ pathogens only cause disease in immunocomprimised patients
professional, opportunistic
The chain of infection is composed of 6 parts:
1. \_\_\_\_\_\_\_\_\_\_\_ agent 2. r\_\_\_\_\_\_\_\_\_\_\_ 3. Portal of \_\_\_\_\_ 4. Mode of \_\_\_\_\_\_\_\_\_\_ 5. Portal of \_\_\_\_\_\_\_\_ 6. \_\_\_\_\_\_\_\_\_\_\_\_ host
- Causative
- Reservoir
- Exit
- Transmission
- Entry
- Susceptible