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Microbiology 3 Respiratory Infection > Pneumonia > Flashcards

Pneumonia Flashcards

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1
Q

What is Pneumonia and who does it inflict

A

Inflammation of the lungs accompanied by fluid filled alveoli and bronchioles.
It is the most common cause of death from infection in the elderly.

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2
Q

How are Pneumonia bacteria getting into the lungs?

A
  • Inhalation of aeroslas
  • Aspiration of normal flora including UTI and GI microbes
  • Hematogenous spread from another site of infection
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3
Q

What are the Types of Pneumonia

A

bacterial, viral, fungal
Example of Bacteria pneumonia
Pneumococcal pneumonia

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4
Q

Where is Pneumonia acquired

A

Community acquired CAP
Hospital acquired HAP*
-2nd leading type of nosocomial infection
-Highest mortality of all nosocomial infections

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5
Q

What are the Symptoms of Pneumonia-Define them

A

Hemoptysis-expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs.

  • Abrupt onset
  • Fever, Chills
  • Congestion
  • Shortness of breath
  • Chest pain
  • Productive cough
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6
Q

Bacteria That cause Pneumonia

A 
Streptococcus pneumoniae (Most common)
Klebsiella pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus
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7
Q

Whats the Characteristics of Streptococcus pneumoniae (pneumococcus) 10 in total

A 
Normal flora of URT for approximately 70% of the adult population.
Lobar pneumonia
Gram positive
Pairs or chains
Alpha hemolytic
Blood agar
CAPSULE
Adhesin
IgA protease
Pneumolysin: lyses ciliated epithelial cells
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8
Q

How is Streptococcus pneumoniae Diagnosed

A

Sputum sample:
-Rust colored

 - Microscopy
     - gram positive cocci and              numerous PMNs                
 - Antigen agglutination
     - Secreted in urine as well as sputum

Hemolysis

Optochin sensitive

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9
Q

Factors Affecting Occurrence of Pneumonia

A

fall & winter
CAP

Predisposing factors: 
Viral infection
Influenza
HIV
Alcoholism
Children
Elderly
Splenectomy
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10
Q

Pneumonia Vaccination

What are its name and the age catatory ?

A

Pneumovax (PPSV23): 23 most common capsule serotypes.
For Adults

Pneumococcal conjugate vaccine
(PCV13)
For Children 2 months -59 months

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11
Q

Name Atypical Pneumonia

A

Mycoplasma pneumoniae
Chlamydophila spp.
Legionella pneumophila
Coxiella burnetii

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12
Q

Describe atypical Pneumonia and its symptoms

A

Organisms not seen with Gram stain (except Lp)

Signs and symptoms
fever
headache
malaise
myalgia
nausea
diarrhea
nonproductive cough (no sputum)
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13
Q

Whats are the symptoms and occurrence of Mycoplasma pneumoniae

A 
Primary atypical pneumonia
CAP
Symptoms: 
fever
headache
malaise
myalgia
nausea
diarrhea
persistent nonproductive cough (no sputum)
Excessive sweating

May last several weeks to months
Lack of seasonality
Predominant in high school and college age students

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14
Q

Whats are the characteristics of Mycoplasma pneumoniae

A 
Smallest free living microbe
No cell wall
Capsule
Adhesin:  attachment to the base of the cilia
Transmission: Inhalation of aerosols
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15
Q

How is Mycoplasma pneumoniae diagnosed and how is it treated

A 
Usually can not see the bacteria with microscopy
Large number of PMNs
Grows very slowly in culture, 2-6 weeks
Cold agglutinins
PCR

Treatment:
Erythromycin
Doxycycline

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16
Q

Whats are the characteristics Chlamydophila pneumonias

A 
Characteristics:
-Gram negative 
-CAP
-obligate intracellular bacteria
-2 stages of infection
   1-Elementary body
   2 -Reticulate body
17
Q

How is Chlamydophila pneumonias diagnosed

A 
Diagnostics:
-Microscopy/Gram stain:
       -no organisms seen 
        large number of PMNs
-ELISA
18
Q

What is the mode of Transmission and treatment of Chlamydophila pneumonias

A

Respiratory droplets

Treatment:
Doxycycline
Erythromycin

19
Q

What are the symptoms of Chlamydophila pneumonias

A

Mild Fever
Sore throat
Malaise
Persistent cough

20
Q

What are the characteristics of Pneumonia Psittacosis and name some of its treatment.

A

Atypical
Caused by Chlamydophila psittaci
Parrot fever
Disease of birds can be transmitted to humans

Treatment:
Doxycylcine
Erythromycin

21
Q

What is the risk factor associated with Legionella pneumophila

A 
Smokers
COPD
High alcohol consumption
Elderly
Immunosuppressed
Renal transplant patients or  patients on dialysis
22
Q

How is Legionella pneumophila diagnosed?

A

Culture: fastidious

Buffered charcoal yeast extract- need Fe salts and cysteine to grow

Fluorescent antibody staining
-Antigen can be detected in urine

23
Q

Which Microbes are the common causes of nosocomial pneumonia (HAP)

A 
Pseudomonas aeruginosa
S. aureus
H. influenza
Enterics
   -Enterobacter 
   -Klebsiella
   -E. coli
   -Serratia marcescens
24
Q

What are characteristic of Pseudomonas aeruginosa:

13 in total

A
  • Gram-negative rod
  • Ubiquitous
  • Capable of growing on many substrates
  • Temperatures 4-42C
  • Aerobic
  • Forms a biofilm
    • Alginate capsule
  • Highly antibiotic resistant
  • Characteristic color
  • Characteristic sweet grape like odor
  • Motile
    • Flagella
    • Pili
  • Oxidase positive
  • Opportunistic infections
  • Nosocomial infections
25
Q

What are the risk factors Pseudomonas aeruginosa and name treatments.

A
  • Cystic fibrosis
    • S. aureus first
    • Colonized with P.a. by 5 yr old
    • Burkholderia cepacia
  • Hospitalized on ventilation
    • VAP
    • P.a . & Burkholderia cepacia

Treatment:
very difficult to treat
Resistant to many antimicrobials

26
Q

Cystic Fibrosis

Causes

A

Autosomal, recessive disease

1 every 3,500 live births

Caused by a defective Cystic Fibrosis Transmembrane Regulator

27
Q

What kind of pulmonary disease does can you get with CF

A

Chronic microbial colonization

Spectrum of pathogens
-Pseudomonas aeruginosa

28
Q

Some clinical presentation of CF

A

Most patients acquire chronic Pseudomonas aeruginosa infection by early teenage years.

  • Mucoidy
  • Biofilm

Chronic infections which can last several years.
-lead to the appearance of antibiotic resistant strains

More than 90% of the cystic fibrosis patients die from lung infection with P. aeruginosa

29
Q

What is Alginate and describe it.

A

Alginate is very important for lung infections by P. aeruginosa

Alginate contributes to the biofilm formation
Fresh isolates of P. aeruginosa from CF patients are mucoidy
In vivo and in vitro switching in the mucoidy phenotype

30
Q

What are the causes Anaerobes in LRT infection.

A
  • Aspiration of respiratory or gastric material
  • Dental work
  • Loss of consciousness
31
Q

Name two anaerobes that exist together in infection and what they cause

A

Mixture of Bacteroides and Fusobacterium causes necrotizing lung abscesses, empyema
At Copious amounts causes foul smelling sputum

32
Q

What is the treatment for Anaerobes

A

Metronidazole

2-4 months

33
Q

Potential bioterroism agents

A 
Anthrax
Plague
Q fever
Tularemia
Brucellosis
34
Q

Bacillus anthracis, character and Virulence Factors

A

Gram Positive Rod
Aerobic, non-motile
- Forms resistant endospores
- Spores remain viable for years in soil, dried or processed hides
- Present in air, water, soil and vegetation

HIGH MORTALITY RATE

Virulence Factors : Capsule – polyglutamic acid capsule (AA capsule)

Anthrax toxin

35
Q

Bacillus anthracis symptoms

A 
Initial:
Sore throat
Mild fever
Myalgia – muscle aches and pain
Cough 
After several days:
Severe coughing
Nausea/vomiting
Lethargy
Confusion
Shock
Death

Chest Pain + Heavy Breathing
Tissue Destruction, bleeding, and death of host

36
Q

Bacillus anthracis diagnosis

A

Box-car-like arrangement

Microscopy/Gram stain of sputum

Microbiology 3 Respiratory Infection (6 decks)

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