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BDI > Nontuberculosis Mycobacterium > Flashcards

Nontuberculosis Mycobacterium Flashcards

1
Q

Nontuberculosis Mycobacterium (NTM)

A

NOT Transmitted person to person
Environmental organisms (live in biofilms, Commensal with amoebas)

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2
Q

NTM are divided into

A

Slow growing (>2 weeks on AFB) and Rapid growing (4-7 days on blood agar)

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3
Q

NTM Scotochromogens

A

Always pigmented

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4
Q

NTM photochromagens

A

Pigmented only when exposed to light

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5
Q

Non-chromogenic NTM

A

Not pigmented

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6
Q

Diseases caused by NTM

A

Pulmonary disease (MAC, M kansasii, M xenopi, M abscessus)
Skin and soft tissue infections (M chelonae, M abscessus, M fortuirum)
Lymph node (MAC)
Disseminated (MAC-HIV, M chelonae, M abscessus)
Line associated bacteremia

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7
Q

Slow growing Mycobacterium

A

M avium/intracellularae- most common
M kansasii
M marinum
M xenopi
M gordonae
Mostly cause pulmonary disease but can cause SSTI, lymphatic, and disseminated infections

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8
Q

M avium/intracellularae

A

Most common Mycobacterium
Present in water, soil, dust
Acquisition through inhalation

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9
Q

MAC pulmonary disease

A

Most common in immunocompetent
symptoms + microbiology + disease (cough, sputum production, fevers, weight loss)
Two patterns: older male smokers, older women (thin, pertussis, RML, bronchiectasis, Lady Windermere syndrome)

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10
Q

NTM in children

A

M avium most common
Manifests as chronic granulomatous lymphadenopathy in neck
Treatment involves surgical resection without antibiotics

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11
Q

M kansasii

A

Second most common mycobacterium
Almost always associated with disease
Photochromogenic colonies bright yellow/orange with exposed to light
Causes pulmonary disease
Treatment: Azithromycin, Ethambutol, Rifampin

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12
Q

Mycobacterium marinum

A

Fish tank granuloma
Infection after trauma or inoculation
Organisms produce membrane lipids to recruit macrophages to a site of infection
Transfer to more permissive host for growth and dissemination
Virulence factors seen in Tb
treatment: clarithromycin and ethambutol

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13
Q

Rapid growing Mycobacterium

A

M fortuitum
M chelonae
M abscessus
Skin and subcutaneous tissue infections (SSTI)
Affects immunocompetent people

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14
Q

M abscessus

A

Soil and water
Pulmonary and SSTI
Resistant to disinfectants (postsurgical and post-procedural infections)
Can grow in tattoo dyes
Treatment: difficult due to antibiotic resistance
Surgical debridement if SSTI
IV amikacin

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15
Q

M fortuitum and M chelonae

A

SSTI
Treat with 2-3 antibiotics

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16
Q

M leprae

A

Causes leprosy
Cannot grow in culture
Transmission not understood but thought to be person to person
Lesions 2 to 5 years after incubation
Presentation depends on immune response
3 cardinal signs: skin lesions, areas of cutaneous anesthesia, enlarged perephrial nerves

17
Q

Two forms of leprosy

A

Tuberculoid- vigorous immune response, well formed granuloma, few AFB
Anesthetic macula’s or plaques
Lepromatous- minimal immune response, no granuloma, many AFB
Lesions on cooler parts of body

18
Q

Organisms that look like Mycobacterium

A

Nocardia And actinomycetes (aerobic and anaerobic) filamentous gram - rods
How to determine what is what
Acid fast positive: Mycobacterium
Modified acid fast positive: Nocadia, aerobic actinomyces
Neither : actinomycetes

19
Q

Aerobic actinomycetes

A

Gram +
Filamentous
Branched
Responsible for antibiotic production
Recovered in mycology or mycobacterium areas of lab
Sequencing is only adequate identification
Nocardia are most significant pathogen in this group

20
Q

Nocardia

A

Gram + rod (beaded)
Modified acid fast stain
Slow growing, requires special culture
Aerobe, soil organism
Nocadia asteroides is most common

21
Q

Nocadia infections

A

Immunocompetent (SSTI and pulmonary)
Inhalation for pulmonary infections
Immunocompromised (pulmonary disease- cough, fever, weight loss, cavitary lesions)
High risk for CNS disease
Treatment: sulfonamides

22
Q

Anaerobic actinomyces

A

anaerobic branching
Gram + rod
Actinomyces Israeli most comin
Chronic granulomatous infection
Cervicofacial, pulmonary and abdominopelvic lesions
Treatment= PCN

BDI (18 decks)

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