Midterm II (Leiel) Flashcards
A1. Describe N. Gonorrhoea (everything; morphology, cultivation, biochemical properties, etc.).
Naturally appearance:
- only in human beings
- obligate human pathogen
Morphology: Diplococci
Staining: Gram-negative
Biochemical: Oxidase positive
- *Cultivation:** TM (Thayer-Martin-culture media), chocolate agar, MB staining
- *Virulence factors:**
- adhesive fimbria
- IgA protease
- *Antigenic structure:** K antigen
- *Pathogenesis:**
- sexually transmitted disease
- Men: urethritis (-> Prostatitis, Orchitis)
- Women: Cervicitis, urethrisits, vaginal discharge, rectal inflammation (PID - pelvis inflammatory disease)
- Neonates: conjunctivitis (prevention: Credé eye drops)
- Meningitis, endocarditis, arthritis (Asymmetric polyarthritis)
Facultative intracellular, invading PMNs
- *Therapy**: Cephalosporin, Penicillin, Cephtriaxon
- *Immunity:** local infection - no lifelong immunity
A2. List the diseases of S. Pyogenes (only name)
- Pharyngitis
- impetigo
- cellulitis and erysipelas
Infections caused by the toxins:
- Scarlet fever
- toxic-shock syndrome
- necrotizing fasciitis
Complications:
- rheumatic fever (polyarthritis, heart problems, subcutaneous nodules, erythema marginatum, chorea)
- glomerulonephritis
In Agoston’s slides:
- Pyogenic inflammation
- Tonsilitis
- Otitis media
- Puerperal fever
A3. List the causes of Dysentery.
Shigella
EIEC enteroinvasive E. coli
Campylobacter bacteria
A4. Cultivation of C. Diphteria.
Clauberg:
- Glycerin, Blood, Cystin and tellurite (Selective)
- Reduce the tellurite to different extent
- Grey - Black
- Garlic smell
- Gravis, intermedius and mitis biotypes
Löffler:
- Ivory color
- Clotted bovine serum, egg, heart extract.
- Rapid growth, strong volutin granule formation
A5. symptoms of Diphteria.
- soar throat
- fever
- running nose
- regional lymph node enlargement → odema on the whole neck (bull’s neck) (nausea, vomiting, and painful dysphagia)
- arrhythmias
- heart blocks
- affects the (Cranial) nerves of the eye, palate, pharynx, larynx, heart, and limb muscles.
A6. List gram negative coccobacilli.
- Haemophilus
- Brucella
- Bordetella
- Francisella
- Legionella
B1. Describe E. Coli (everything; morphology, cultivation, biochemical properties, etc.).
Characteristics:
- Gram negative rods (2-4 μm)
- Facultative anaerobes
- O, K, H antigens
Biochemical properties:
- + Dextrose, lactose, indol
- - Urease, H2S
- Oxidase negative
Cultivation:
- Simple agar
- Eosine-methylene blue - Dark purple (lactose +)
Escherichia coli infections
- UTI
- Neonatal meningitis
(Enterovirulent E. coli !)
- EPEC - colitis of the newborns
- ETEC - „Travellers’ diarrhea”
- EHEC - Dysenteriform diarrhea (Severe, bloody enteritis, without fever); Maybe HUS
- EIEC - Classic dysentery !
- EAEC - Severe watery diarrhoea, often chronic (>14 days); rel. high lethality!
B2. S. Aureus diseases.
Skin:
- Furuncles, folliculitis, carbuncles
- Impetigo
- Infection of burnt wounds
- Scalded skin syndrome
Respiratory system:
- Pneumonia
Gastrointestinal tract:
- Enterocolitis
- Gastroenteritis
Heart:
- Endocarditis
Urogenital tract:
- Chronic nephritis
Bone:
- Osteomyelitis
Other:
- Meningitis
- TSS (toxic shock syndrome)
- Sepsis
- Eye infection
Nosocomial infection:
- by MRSA
- at perinatal intensive care unit
- at intensive care units
- at surgery
B3. Gram positive rod non spore forming bacteria.
- Corynebacterium diphtheria
- Listeria monocytogenes
- Lactobacillus acidophilus
B4. Bacteria that are related to food poisoning.
- Staphylococcus Aureus.
- Salmonella
- Vibrio cholera
- E. coli. (EHEC)
- Listeria monocytogenes
Yersinia genus
Campylobacter
B5. Strawberry like tongue, which bacteria?
Streptococcus pyogenes
B6. Which bacteria should have X and V factors for growth?
Haemophilus influenzae
C1. Describe Salmonella Typhi (everything; morphology, cultivation, biochemical properties, etc.).
- Gram negative, facultative anaerobic rod
- Obligate human pathogens
Biochemical properties
- + Glucose, H2S
- - lactose, indol, urease
Culture: selective / differentiating media !!
- Eosin-methylene blue medium (EM): pink colonies (lactose -)
- Brillant green or bismuth sulphite medium
Pathogenesis:
- Fecal-oral infection
- First 2 weeks: primary bacteremia
- bacteria entering enteral macrophages (in Peyer’s patches)
- delivered to mesenteral lymph nodes -> blood
- asymptomatic phase
- Multiplication in different organs (RES)
- liver (Kupfer cells), gall bladder
- Second bacteremia
- with high number of bacteria!
- Bacteria back to small intestine with bile
- multiplication in Peyer’s patches
- ulceration, perforation
- Symptoms:
- Fever: gradually increasing to high levels („typhosus” head)
- Diarrhoea: NOT characteristic
- might contain blood
- Hepatosplenomegaly
- Roseoles on chest & belly
Possible outcomes of the infection:
- spontaneous recovery in 1 week
- complications:
- temporary bacteremia - long-term bacteremia (in young children, elderly, immunosuppressed)
- focal infections (lung, brain, implementates)
- asymptomatic carriage !
Antibiotic:
- Obligatory in severe cases (high fever, septicemia)
- Maybe for children, elderly
- Can enhance carriage !
- Ampicillin, fluoroquinolons, 3rd gen. cephalosporins, ceftriaxone
- TMP/SMX
C2. Spreading of plaque.
- Reservoir: rodents (~200 different species) („sylvatic cycle”)
- Transmission: rodent’s flees („urban cycle”)
- Manifestation: bubonic, septicemic, and pneumonic plague
Urban plague
- is maintained in rat populations
- spread among rats or between rats and humans by infected fleas (fleas become infected during a blood meal from a bacteremic rat)
- urban plague has been eliminated by the effective control of rats
Sylvatic plague
- is difficult or impossible to eliminate
- mammalian reservoirs and flea vectors are widespread
- Y. pestis produces a fatal infection in the animal reservoir
- infections can be acquired:
- flea bite
- ingestion of contaminated animals
- handling of contaminated animal tissues
- human-to-human - respiratory droplets
- Clinical Diseases; two clinical manifestations:
-
Bubonic plague
- incubation period 7 days
- high fever and a painful bubo (inflmmatory swelling of the lymph nodes) in the groin or axilla
- bacteremia develops - 75% die.
-
Pneumonic plague
- incubation period 2 to 3 days
- fever and malaise pulmonary signs develop within 1 day
C3. C. Diphteria diseases.
LOCAL exotoxin effect:
- harming the mucosal membrane, pseudomembrane formation (difficult to remove, gray-greenish; fibrin + dead leukocytes + red blood cells)
DISTANT exotoxin effect:
- organ failures (heart /myocarditis/, liver, kidney)
- temporary paralysis of arms, legs, or eye muscles
- slurred speech, double vision
C4. Rice-water like diarrhea, which bacteria?
Vibrio cholerae
C5. List bacteria that cause meningitis.
- Streptococcus agalactiae (B-group)
- Listeria monocytogenes
- Haemophilus influenzae
- E. coli
- Staphylococcus aureus
- Streptococcus pyogenes
- Streptococcus pneumoniae
- Neisseria meningitidis
- Campylobacter
C6. List bacteria that are lactose positive.
- Escherichia coli
- Klebsiella
- Enterobacter
Slow fermenters:
- Serratia
D1. Describe B. Pertusis (everything; morphology, cultivation, biochemical properties, etc.).
- Obligate human pathogen
Morphology: Gram-negative, strict aerobic, 0.2x1µm coccobacillus
Cultivation:
- fastidious! -> Bordet-Gengou plate (10% blood, potato, glicerol)
- 3-7 days, moist environment, mild haemolysis
Virulence factors:
- Fimbria
- Exotoxin
- tracheal citotoxin - inhibition of cilia movement
- dermatonecrotic toxin - tissue destruction
- pertussis toxin - increase cAMP
- filamentous haemagglutinin - attachment to ciliated cells
- pertactin - attachment to ciliated cells
- adenylate cyclase - increase cAMP
- endotoxin
- *Disease**: whooping cough
- *Spreading:**
- airborne infection - by respiratory droplets
- is very infectious - each primary case produces approximately 15 secondary cases
- co-infection is very common
Vaccine: aP - A cellular pertussis (usually given with Diphtheria and Tetanus Toxoids as DTaP)
D2. List the causes for pneumonia.
- Streptococcus pneumoniae
- Staphylococcus aureus
- Haemophilus influenzae
- Legionella
- Klebsiella
Acinetobacter
Moraxella
D3. E. coli diseases.
- UTI
- Neonatal meningitis
- EPEC enteropathogenic E. coli dyspepsia coli - colitis of the newborns
- ETEC enterotoxic E.coli - cholera like diarrhea, „traveler’s disease”
- EIEC enteroinvasive E. coli - dysentery
- EHEC enterohaemorrhagic E.coli - dysenteriform diarrhea
- EAEC
D4. Describe special culture media and staining and the type of the appropriate bacteria.
Corynebacterium diphtheriae:
- Clauberg:
- Glicerin, Blood, Cystin and tellurite (Selective)
- Reduce the tellurite to different extent
- Grey - Black
- Garlic smell
- Gravis, intermedius and mitis biotypes
- Löffler:
- Ivory color
- Clotted bovine serum, egg, heart extract.
- Rapid growth, strong volutin granule formation
Legionella:
- Do not stain with common staining, needs silver stain to be visualized
- Require media supplemented with L-cystein, and growth is enhanced by iron
D5. Hib vaccination.
Hemophilus influenzae type b vaccine- the polysaccharide capsule is conjugated to another bacteria or another immunogenic carrier, because it’s not strong enough alone as an antigen, given between 2-18 months of age
(prevents meningitis caused by B serotype)
D6. One hour after eating ice cream the patient had diarrhea. Mediated diseases? Bacteria?
Staphylococcus aureus
E1. shigella dysenteria.
- Causes dysentery
- Produces Shiga-toxin
- inhibition of protein synthesis
- ulceration of large intestine
- mainly by S. dysenteriae type I
Morphology: Gram-negative, facultative anaerobic, nonspore-forming, nonmotile, rod-shaped bacteria
Biochemical:
- lactose -, H2S -, uresae -
Cultivation:
- Hektoen Enteric Agar
Pathomechanism:
- First they infect the M cells (in the Peyer’s patches)
- From here, they can infect the epithel cells from the side
- They can go from M cells into macrophages
- Being released from dead macrophages, they can infect the basal surface of the epithel cells
Clinical findings:
- Incubation time: few days
- First symptom: diarrhea
- Fever, tenesmus (improductive)
- Stool: blood, mucus, pus
- Most severe disease: S. dysenteriae
- toxin production!
- Frequent complication: HUS (haemolytic uremic syndrome)
- Outcome:
- usually spontaneous recovery
- might result carriage
- reactive arthritis
- Other dysentery causative agents:
- bacterial: EIEC
- protozoan: Entamoeba hystolytica
E2. Causes of impetigo.
- Staphylococcus aureus
- Streptococcus pyogenes
E3. Name exotoxin mediated diseases.
Strep progenes:
- pyrogenic exotoxin-A - TSLS
- pyrogenic exotoxin-B - necrotizing fasciitis (=protease)
Staphylococcus aureus:
- TSST-1 (toxic shock syndrome toxin)
- staphylococcal scalded skin syndrome (Ritter disease)
Bordatella pertussis:
- tracheal toxin (blockage of mucociliary clearance → characteristic whooping cough)
E4. Content of DtaP.
Diphtheria and Tetanus toxoids and acellular Pertussis vaccine
E5. lactamase in the enterocococeae family.
ESBL (Extended spectrum beta-lactamases)
- Often on plasmids (easy transfer to each other!), or chromosomal
- „simple” ESBLs:
- TEM, SHV, …
- Resistance to penicillins and cephalosporins
- Klebsiella, E. coli
- MBLs: (Metallo-beta lactamases)
- Resistance to all β-lactams, including carbapenems !
- Klebsiella, Pseudomonas, Acinetobacter
Treatment of Enterobacteriaceae infections
- Always after antibiogram !!
- ESBL production !!!
- β-lactam + enzyme inhibitor combination
- 3rd gen. cephalosporins
- carbapenems
- aminoglycosides
- fluoroquinolones
E6. If x drunk non pasteurized milk + he complains of muscle pain, arthritis, fever what bacterium caused it?
Brucella genus
F?1. Describe S. Pyogenes
***NOT COMPLETE***
Morphology:
- Gram-positive cocci, arranged in chains
Cultivation: fastidious!
- small, pin-point colonies
- strong β-hemolysis
Virulence factor:
- Capsule made of hyaluronic acid (!)
- M protein
F?2. Which diseases can be caused by Haemophilus group?
Capsulated strains (mainly b): invasive infections
- meningitis (high mortality!)
- respiratory tract infections (pneumonia, epiglottitis)
- cellulitis
Non-capsulated (NT) strains: milder upper RTI
- otitis media, sinusitis !!
Asymptomatic carriage!!
F?3. List the gram negative and urease positive.
- Klebsiella
- Helicobacter
F?4. Someone who travelled gets diarrhea (not bloody), Which bacteria might cause that
- ETEC - Enterotoxigenic E. Coli
- Vibrio choleara
