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immuno/micro exam 2 > pneumococcus- daniels > Flashcards

pneumococcus- daniels Flashcards

1
Q

Streptococcus pneumoniae overview

A

Gram positive cocci

  • Diplococci
  • Aerotolerant anaerobe
  • Non-spore forming
  • Encapsulated
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2
Q

what bacteria is responsible for most community-acquired pneumonia?

A

Streptococcus pneumoniae

over a million deaths a year

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3
Q

Phenotyping Strep pneumoniae

A

A) alpha-hemolysis
B) gram positive
C) catalase negative
D) OPTOCHIN succeptability- zone of inhibition

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4
Q

Risk factors for establishment of infection by Strep pneumoniae

A 
Viral infection (esp. influenza)
Smoking
Loss of consciousness (aspiration)
Edema (fluid) in lungs for any reason
High risk comorbidities, age, and demographics
Seasonality (Winter/spring)
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5
Q

what are the 4 stages of pathogenesis (multiplication/spread in lungs)

A

1) Alveoli fill with fluid
2) Early consolidation phase- neutrophil induced inflammation
3) Late consolidation phase
- -alveoli are filled with neutrophils
- -effected tissue is hard not spongy/healthy

4) recovery phase
- –Macrophages phagocytose debris
- –Normal architecture is re-established

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6
Q

Potential sequelae to pneumonia in adults

A

Pleural effusion = fluid in the chest outside lungs

Bacteremia –> Meningitis

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7
Q

treatments for Pneumococcus infection

A

1) Penicillins and other β-lactams
2) Macrolides- Erythromycin, Azithromycin
3) Fluoroquinolones- Levofloxacin

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8
Q

what is the main concern when treating Pneumococcus with Penicillins and other β-lactams?

A

Resistance is a concern unlike group A Strep

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9
Q

what are Strep pneumoniae vaccines comprised of?

A

Vaccine products are comprised of polysaccharide antigens (capsular) from multiple strains of S. pneumoniae

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10
Q

Legionella pneumophila- where was it discovered?

A 
Philadelphia, PA 1976
Annual American Legion Convention
221 hospitalizations
34 Deaths
CDC outbreak investigation traced to A/C system
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11
Q

Legionella pneumophila overview

A

1) Gram negative pleomorphic rod
2) Obligate aerobe
3) Fastidious = special conditions for cultivation in lab
* ***Cysteine requirement is identifying characteristic

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12
Q

where is L. pneumophila encountered?

A

Contaminated water

Environmental aerosols (Not spread by cough)

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13
Q

Multiplication/spread of L Pneumophilia

A
  • Bacteria in alveoli phagocytosed by alveolar macrophages

- Virulent strains multiply within autophagosomes

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14
Q

Damage/Immune response to L. Pneumophilia

A

Cell-mediated immune response

1) release IFN-gamma
2) Causes iron sequestration

Virulence/Proinflammatory mechanisms

1) survival in macrophages
2) LPS, Flagellin

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15
Q

how to treat Legionalla Pneumophilia infections

A

Antimicrobial drugs with good intracellular penetration

  • Macrolides
  • Fluoroquinolones
  • Tetracyclines
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16
Q

why is penicillin not used to treat L. Pneumophilia?

A

because they do not achieve therapeutic concentrations in the macrophages

17
Q

Bordetella pertussis and parapertussis- overview

A

A) Gram negative rod
B) Obligate aerobe
C) Cause of whooping cough
D) VERY CONTAGIOUS

18
Q

Pertussis Encounter, Entry, Spread

A

A) Adults are believed to be reservoir
B) Nasopharynx colonized
C) Organism accesses trachea/bronchi
D) Ciliary Adherence

19
Q

which substances allow ciliary adhesion in Pertussis?

A

Filamentous hemagglutinin (Fha)
Pilli (a.k.a. Fimbriae)
Pertactin (a protein)

20
Q

Damage - Toxin production for B. pertussis

A

A) Pertussis toxin and Adenylate cyclase/hemolysin
B) Both upregulate host cAMP
Decreased neutrophil function

also produce endotoxin- like every other G- bacteria

21
Q

what is the main difference between B. pertussis and P. parapertussis

A

P. parapertussis does NOT produce pertussis toxin

22
Q

what is the catarrhal stage of pertussis infection?

A

A) Catarrhal means really really bad runny nose

B) EXTREMELY CONTAGIOUS

23
Q

paroxysmal stage

A

fits of numerous, rapid coughing followed by low “whoop” sound

24
Q

why is laboratory diagnosis of pertussis difficult?

A

Fewer organisms shed in paroxysmal phase

Must use deep nasal swab and bacterial culture

25
Q

Vaccines have what form of pertussis?

A

acellular pertussis

26
Q

Bordatella bronchiseptica

A

1) Part of “kennel cough complex”
2) Very rarely affects human beings
- – HIV and chemo patients

27
Q

what are the 2 diseases that Mycobacterium spp. can cause?

A

Tuberculosis and leprosy

28
Q

what are the 3 forms of tuberculosis?

A

M. tuberculosis – Highly Contagious
M. bovis
M. avium-intracellulare

29
Q

Dodgy tattoo artists, plastic surgery, environmental (i.e. contaminated deep wounds) can all lead to what?

A

Opportunistic Disease caused by rapidly growing mycobacteria (RGM)

30
Q

Mycobacterium spp. are what?

A

Acid-fast bacteria

31
Q

Mycobacterium spp.- overview

A

1) Obligate aerobes
2) Non-spore formers
3) Thick, waxy cell wall
4) Mycolic acid binds carbol fuscin dye

32
Q

Immunology of granuloma formation- M. tuberculosis

A

A) multiplication in Macrophages
B) Activation of CD4+ (TH1)
C) Recruitment of more MΦs

ends up causing “multi-nucleated giant cells”

33
Q

Intradermal skin test for tuberculosis

A

A) Use of killed antigen “tuberculin” “PPD”
B) Relies on Delayed Type Hypersensitivity
Activation of specific CD4+
—Local inflammation at injection site
—False +s, False –s possible

34
Q

M. Leprae overview

A

A) Granulomatous disease (like TB)
B) Organism prefers lower temperature (skin)
C) Spread via respiratory route

35
Q

what are the 2 forms of Leprosy

A

Tuberculoid Leprosy

Lepromatous Leprosy

36
Q

what are the characteristics of Tuberculoid Leprosy

A

Milder form of disease
May be self limiting
Very few bacteria present in lesions

37
Q

what are the characteristics of Lepromatous Leprosy

A

A) Severe, disfiguring
B) Many organisms in lesions
C) Cell mediated immunity is significantly decreased

38
Q

how is M. leprae grown for study?

A

Uncultivable in vitro
-Can inocluate mouse footpad

Armadillos are carriers and may have Lepromatous disease

immuno/micro exam 2 (7 decks)

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