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Microbiology > Respiratory > Flashcards

Respiratory Flashcards

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Biology 101 flashcards
1
Q

Streptococcus pneumonae characteristics:

A

Gram + cocci

lancet shapped diplococci

Alpha hemolytic on blood agar

Catalase negative

colonizes upper respiratory tract, important cause of infection in normally sterile parts of tract

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2
Q

Streptococcus pneumonae immunity:

A

Antibody requires days to develop

90 different CPS that prevent phagocytosis (antigenic variation)

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3
Q

Streptococcus pneumonae Epidemiology:

A

Mucosal surface of nasopharynx, humans are the only host

most common in non-immune hosts (infants and elderly)

also common when there is impaired antibody production or defective clearance of opsonized bacteria

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4
Q

Diseases caused by Streptococcus pneumonae

A

-lobar pneumoina: most common community acquired pneumococcal pneumonia

shows patchy alveoli filled with acute inflammatory cells (structure in tact so usually clears with no damage)

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5
Q

Treatment of Streptococcus pneumonae:

A

altered penicillin binding proteins reduced affinity for penicillin

PBP confers resistance to most beta lactams

natural transformability exchanges these altered genes

resistant to most beta lactams - but can still be useful if concentration used is above organisms MIC (minimum inhibitory concentration)

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6
Q

Hemophilus influenzae characteristics:

A
  • gram negative coccobacillus
  • colonized upper respiratory tract
  • requires two growth factors found in blood: hematin and NAD+
  • 6 types of capsules, B most virulent
  • resides in human nasopharynx
  • encapsulated strains cause invasive infection
  • nontypeable strains are unencapsulated, cause only upper respiratory tract infections
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7
Q

Hemophilus influenzae epidemiology:

A
  • nontypeable is leading cause of acute otitis media and conjuctivitis in children
  • COPD: chronic bronchitis in adults
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8
Q

Middle ear infections:

A
  • common in children
  • fluid in middle ear space
  • becomes infected with organisms in the upper respiratory tract
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9
Q

Hemophilus influenzae type B:

A
  • most virulent
  • immunity based on antibody to CPS
  • controlled by immunization to type B
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10
Q

Hemophilus influenzae treatment:

A
  • most are still sensitive to penicillin

- when resistant it is due to expression of beta lactamase so cephalosporins still effective

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11
Q

Neisseria meningitidis characteristics:

A
  • gram negative bean shaped diplococcus
  • identical staining to neisseria gonorrhoeae
  • ultrastructural level has a prominent antiphagocytic polusaccharide capsule
  • 12 serogroups (A, B, C, Y and W-135 predominant)
  • antigenic varriation
  • DOES NOT CAUSE PNEUMONIA
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12
Q

Neisseria meningitidis epidemiology:

A
  • nasopharynx
  • older children, young adults (dorms, barracks)
  • resides in the upper respiratory tract but DOES NOT CAUSE DISEASE THERE
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13
Q

Neisseria meningitidis treatment:

A
  • penicillan
  • third generation cephalosporin
  • vaccine (none to serogroup B)
  • antibiotic prophylaxis in outbreaks
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14
Q

Clinical diseases by Neisseria meningitidis:

A
  • two presentations:
    1) meningococcemia: skin lesions (petechiae and purpura), sepsis fulminant disease
    2) acute bacterial meningitis
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15
Q

Bordetella pertussis characteristics:

A
  • gram negative coccobacillus of upper respiratory tract
  • whooping cough
  • ciliated surfaces of the upper respiratory tract
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16
Q

Bordetella pertussis toxin:

A
  • sense environmental signals such as temp which causes changes in gene regulation
  • ADP ribosylates adenylate cyclase G regulatory protein which prevents inhibition of adenylate cyclase (increases cAMP)
  • increased cAMP promotes respiratory secretions and reduces phagocytic activity
  • toxin causes marked lymphocytosis (high lymphocytes) which is a hallmark of the disease
  • toxin-mediated damage to the respiratory epithelium results in prolonged illness characterized by PAROXYSMAL COUGH
17
Q

Bordetella pertussis stages of disease:

A

1) catarrhal stage: same as viral upper respiratory tract infection
2) paroxysmal stage: coughing, may not have whoop
3) convalescent stage: 100 day cough, complications in infants who may acquire pneumonia or apnea

18
Q

Bordetella pertussis epidemiology:

A
  • high mortality in infants, spread by adults

- HIGHLY contagious

19
Q

Bordetella pertussis prevention:

A
  • diagnosis by fluorescent antibody testing or culture swab with non-routine medium (Bordet-Gengou)
  • treat with erythromycin or macrocodes
  • treat close contact
  • Immunization: acellular vaccine (DTaP), boosters for adults
20
Q

mycoplasma pneumoniae:

A
  • extracellular pathogen
  • mollicutes class: NO CELL WALL, does not take up gram stain
  • not killed by penicillins or beta lactam antibiotics
  • “atypical” pneumonia
  • test with serology or PCR, not routinely grown in labs
  • intersitial infiltrates on multiple lobes

“WALKING PNEUMONIA”

21
Q

Pseudomonas aeruginosa:

A
  • ubiquitous, opportunistic pathogen
  • gram negative rod
  • aerobic
  • minimal growth requirements, lives in many environments
  • easy to grow in lab: oxidase positive, non-lactose fermenting, pigmented and smells sweet (smell of the locker room is this bacteria)
22
Q

Pseudomonas aeruginosa epidemiology:

A
  • thrives in warm, moist, air, damage
  • environmental, not host
  • many hospital sinks, basins, toilets, etc
23
Q

Pseudomonas aeruginosa pathogenesis:

A
  • limits neutrophil mediated clearance by contact dependent injection of toxins
  • airways on CF patients become chronically infected
24
Q

Pseudomonas aeruginosa diseases:

A
  • Pulmonary: nosocomial pneumonia, chronic CF infections
  • Skin: hot tub folliculitis, infections of burns
  • otitis externea: swimmer’s eart
  • corneal infections
  • bacteremia: vascular catheter infections, neutropenic patients
25
Q

biofilms:

A

bacteria growing on a surface

  • dynamic microbial community encased in an extracellular matrix
  • frequent mode of growth for pseudomonas
  • enhanced resistance to antibiotics
26
Q

Pseudomonas aeruginosa treatment:

A
  • antibiotic resistance is major problem
  • produce beta lactamases, mutations in porins reduce uptake, exchange of plasmids encoding resistance, reduced susceptibility of biofilms
  • use anti-pseudomonal penicillins or 4th generation cephalosporins
  • combinations for synergistic (IE) anti-pseudomonal penicillin and aminoglycoside
  • no vaccine
27
Q

Other difficult to treat gram negative rods:

A
  • opportunistic respiratory
  • burkholderia cepacia
  • stenotrophomonas maltophilia
  • acinetobacter species
  • KPS: klebsiella pneumoniae produces extended sprectrum beta lactase
28
Q

Legionela pneumophila:

A
  • accidental human pathogen
  • causes legionaires diseases
  • gram negative motile coccobacilli
  • non-fermentative
  • poor gram stain
  • parasite of aquatic protozoa (amoebae)
  • falsely recognizes macrophages in human as natural host (survives in macrophage vacuole)
29
Q

Legionela pneumophila epidemiology:

A
  • water system outbreaks
  • more common in elderly
  • correlation with heavy tobacco/alcohol use
  • men more likely to get infected
  • no person to person spread
30
Q

Legionela pneumophila diseases:

A
  • infections

- pneumonia and extra-pulmonary complications

31
Q

Legionela pneumophila treatment:

A

-macrolides or fluoroquinolones

Microbiology (16 decks)

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