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Respiratory Pathogens Flashcards

1
Q

community acquired respiratory pathogens

A

-strep pneumoniae
-haemophilus influenza
-moraxella catarrhalis
-legionella pneumonphilia
-bordetella pertussis
-corynebacterium diphtheriae

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2
Q

hospital-acquired (nosocomial) respiratory pathogens

A

-legionella pneumophilia
-pseudomonas aeruginosa

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3
Q

division point - community vs hospital acquired

A

in hospital > 72 hrs, it is hospital acquired

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4
Q

upper respiratory tract infections (URIs)

A

-strep pneumonia
-haemophilus influenza
-moraxella cararrhalis
-corynebacterium diphtheriae

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5
Q

lower respiratory tract infections (LRIs)

A

-strep pneumoniae
-haemophilus influenza
-bordetella pertussis
-legionella pneumophilia
-pseudomonas aeruginosa

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6
Q

community acquired pneumonia - overview

A

*common
*risk factors include respiratory tract disease, smoking, alcohol abuse, comorbidities, immunodeficiency, and acid reducing drugs

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7
Q

which 3 community-acquired pneumonias typically follow viral infection (like flu or covid)

A
  1. strep pneumoniae
  2. strep pyogenes
  3. staph aureus
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8
Q

where does the majority of community-acquired pneumonia come from

A

aspiration of upper airway bacteria (90%)
*only 10% from hematogenous pneumonia

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9
Q

streptococcus pneumoniae - morphology

A

*encapsulated gram positive coccus
*Lancet-shaped diplococci
*ALPHA hemolytic (due to pneumolysin)

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10
Q

strep pneumoniae - virulence factors

A

ANTIPHAGOCYTIC POLYSACCHARIDE CAPSULE
*protein adhesions, IgA protease, pneumolysin
*techoic acid
*phosphorylcholine

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11
Q

strep pneumonia - pathophysiology

A

-acquired by inhalation of droplet nuclei or direct contact
-spreads to lungs through microaspiration

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12
Q

strep pneumoniae - main host defense

A

serospecific antibodies

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13
Q

what is the most common / severe infection for people who had a splenectomy

A

strep pneumoniae

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14
Q

strep pneumoniae - clinical infection

A

*lobar pneumonia (rust-colored sputum)
*sinusitis
*otitis media
*MENINGITIS

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15
Q

strep pneumonia - diagnosis

A

-gram stain of sputum (lancet-shaped diplococci; gram +)
-culture of sputum or sterile body fluid

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16
Q

haemophilus influenza

A

*gram negative coccobacilli
*requires CHOCOLATE agar
*factor X and V required for growth

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17
Q

what agar is necessary to grow haemophilus influenza

A

chocolate agar

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18
Q

what factors are necessary for haemophilus influenza

A

factor X and V

19
Q

what is the most virulent strain of haemophilus influenza

20
Q

haemophilus influenza - virulence factors

A

*antiphagocytic polysaccharide capsule (polyribitol phosphate - PRP)
*PILI
-lipooligosaccharide
-IgA proteases
-beta lactamases

21
Q

what is the main host defense against haemophilus influenza

A

serospecific antibodies

22
Q

haemophilus influenza - clinical infection

A

*lobar pneumonia
*sinusitis
*otitis media
*MENINGITIS
*EPIGLOTTITIS
*conjunctivitis

23
Q

haemophilus influenza - diagnosis

A

*gram stain or culture (chocolate agar)
*PCR of CSF or blood

24
Q

moracella catarrhalis

A

*gram negative coccobacillus
*looks like haemophilus influenza
*less virulent that haemophilus influenza

25
legionella pneumophilia
***gram negative rod** *requires cysteine for growth (BCYE agar) *serogroup 1 is the most important *can cause community and hospital acquired pneumonia
26
legionella pneumophilia - virulence factors
*LPS/lipid A (endotoxin) *facultative INTRACELLULAR bacteria (not killed by ROS or phagocytosis)
27
legionella pneumophilia - pathophysiology
***acquired by inhalation of droplets from an infected AEROSOL (water droplets in environment)** *cooling towers, showers, spas, whirlpools, fountains, grocery store and flower show misters *able to survive in hot water tanks
28
legionella pneumophilia - clinical infection
*severe pneumonia *systemic inflammatory response can be quite severe, causing septic shock *high fatality rate
29
legionella pneumophilia - pontiac fever
*much less severe, influenza-like illness *host response causes the majority of symptoms
30
legionella pneumophilia - risk factors
-older age -lung disease -kidney, liver, or heart disease -immunocompromised -cigarette smoking -alcohol abuse
31
legionella pneumophilia - diagnosis
*detection of serogroup 1 specific lipopolysaccharide antigens in URINE (using ELISA testing)
32
legionella pneumophilia - prevention
-monitor water sources through periodic culturing -hyperchlorination or superheating of water -discontinuing or shutting off problematic water features
33
pseudomonas aeruginosa
***gram negative rods *GREEN PIGMENT *musty GRAPE ODOR** *found in most, warm environmental soils, plant materials, and water
34
pseudomonas aeruginosa - virulence factors
**ALGINATE (helps biofilms) *EXOTOXIN A (kills host cells) *virulence genes controlled by quorum sensing
35
pseudomonas aeruginosa - pathophysiology
*inhalation of droplets from infected aerosol or other environmental source *introduced to lung through microaspiration *can also go into skin *colonization extremely common in hospitalized and very ill people (including IV drug users)
36
pseudomonas aeruginosa - clinical presentations
-pneumonia -UTIs -hot tub folliculitis
37
bordetella pertussis (whooping cough)
***gram negative coccobacilli** *many nutritional requirements
38
bordetella pertussis - virulence factors
1. attachment: *fimbriae *FHA *pertussis toxin - ciliary paralysis 2. evasion of phagocytosis *adenylate cyclase toxin (inhibits cAMP)
39
bordetella pertussis - pathogenesis
*inhalation and subsequent adherence to ciliated respiratory epithelial cells *local tissue damage and loss of protective respiratory cells *COUGH *VERY CONTAGIOUS
40
bordetella pertussis - 3 phases of clinical manifestation
1. catarrhal (1-2 weeks): upper airway 2. paroxysmal (2-3 months): lower airway 3. convalescent (1-2 weeks): recovery
41
bordetella pertussis - clinical manifestations during paroxysmal phase
*coughing paroxysms *inspiratory "whoop" *post-tussive emesis (coughing to the point of throwing up)** *LYMPHOCYTOSIS is a clue
42
prevention of bordetella pertussis
*vaccination of children *macrolide prophylaxis
43
diagnosis of bordetella pertussis
PCR of nasopharyngeal swab or aspirate ("gold standard")

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