Skin- Bacteria Flashcards
What gram stain is Staph Aureus
+
Is Staph Aureus thick or thin walled
Thick
Where are the granulocytes for Staph Aureus found
Intracellularly
What hemolytic is Staph Aureus
Beta
What kind of agar does Staph Aureus grow on
Blood agar
Is Staph Aureus aerobic or anerobic
Aerobic
What color colonies does Staph Aureus grow
White, becomes yellow with age
What catalase and coagulase is S. Aureus
Positive
Is Staph Aureus found normally on the body
Yes found in anterior nares for 30% of population
What is the mechanism of escape for Staph Aureus
Staph in general is coated with fibrin, makes it resistant to phagocytosis
What are other biologically active substances in Staph Aureus
Hemolysins Hyaluronidase Nuclease Lipase Protease
What is the toxin found in S. Aureus
Alpha toxin (Cytotoxin)
What is the action of the toxin found in S. Aureus
Causes necrosis/ Death
Membranes leak
Causes RBCs to lyse
What kind of toxin is Panton- Valentine Leukocidin
Cytotoxin
What is the action of Panton Valentine Leukocidin
Lyses neutrophils, damages host cells
What diseases are associated with Panton Valentine Leukocidin
Pneumonia
Skin Infections
MRSA
What is the virulence of S. Aureus
10^5- 10^6 to start infection
10^ 2 if a suture is present
How does Staph cellulitis act?
Alternates btwn walling off and rapid extension of infection
What is a furuncle what infection causes it
Boil in hair follicle
Can give rise to stye
Staph
Where are carbuncles mostly found?
Back of the neck, formed from furuncle
What causes Chronic furunculosis
Delayed hypersensitivity to staphylococcal
Responsible for inflammation and necrosis
What disease is chronic staph associated with
Chronic granulomatous Dx
Diabetes
Impetigo is a bacterial infection composed of what
S. Aureus, 30% of the time found with streptococci
What is bullous impetigo
Caused by S. Aureus, causes skin to exfoliate.
Blisters contain many staphylococci
Where do the majority of wound infections come from
S. Aureus.
Patients own strain
Hospital acquired
When do you find Staphylococcal pneumonia
Secondary to another lung injury: influenza, aspiration
What causes scalded skin syndrome
S. Aureus
How does Scalded skin present
Toxin absorbed into blood causing erythema and intraepidermal desquamation
What causes Exfoliatins?
S. Aureus
How does exfoliatins present?
Intercellular splitting of epidermis
Split between Statum Spinosum and stratum granulosum
Disruption of intercellular junctions
What infection causes toxic shock
S. Aureus
What are some signs of toxic shock
Rash
Strawberry tongue
How is rash from toxic shock differ from scalded skin syndrome
Rash develops then desquamation at deeper levels than scalded skin syndrome
Pyrogenic exotoxin
Toxic shock syndrome toxin 1
Stimulates cytokines
Direct toxic effect on endothelial cells
Pathogenicity of Pyrogenic exotoxin
Similar to exotoxin of Group A strep
Stimulates enhanced T lymphocytes
Treatment for S. Aureus
Methicillin
Many strains resistant: MRSA
What is the difference between hospital and community acquired MRSA
Community acquired is susceptible to clindamycin, also carries PVL toxin
Typically an uncomplicated skin infection. needs incision and drainage
Where is coagulase negative staphlococci usually found?
Skin, anterior nose
What do coagulase neg staphlococci have for virulence factors
Lacks major virulence factors
Not beta hemolytic
What are the characteristics of S. Iugdunesis
Coagulase negative
Cuases infections similar to S. Aureus
Forms abcesses
What is the virulence factor for S. Epidermidis
Produces extracell polysaccharide slime/biofilm
Protects it from phagocytosis, antibiotics
What is the clinical significance of coagulase neg staph
Normal flora
Need to collect deep invasive samples
When is coagulase neg staph detection significant
If intracellular gram + cocci are seen in gram stain
Where is coagulase neg staph usually found
On implants
Characteristics of streptococci
Normal flora
Found in mouth
GI
Gram + cocci/ chains
Characteristics of pyogenic streptococci
Beta hemolytic
Causes purulent infections
What kind of toxin is released by Group A toxin
Pyrogenic exotoxin (SPE)
What are the effects of SPE (pyrogenic exotoxin )
Stimulates cytokine release
Red rash on skin- scarlet fever
Pharyngitis is found in which strep
Group A
How does Group A strep phryngitis spread
Direct contact or aerosols
Scarlet fever has what characteristics
Strawberry tongue
Sandpaper rash
Deep red color cheeks
Punctate hemorrhages on palates
What is a complication for post strep
Acute Rheumatic fever Acute glomerulonephritis (antigen/antibody complex in kidneys)
Characteristics of Impetigo
Group A strep infection of skin
Glomerulonephritis is a complication
Difference between cellulitits and erysipelas
Cellulitis- deep dermis rash with fever (s. Aureus)
Erysipelas- upper dermis (Group A >C,G)
Both are beta hemolytic
Erysipelas presentation
Group A strep infection of upper dermis
Typically on face
Necrotizing fascitis is typically seen where
Beta hemolytic group A Streptococcus
Vascular compromise can be seen in what
Strep A TSS
How to diagnose Beta Streptococcus infections
Gram Stain
Blood cultures
Wound cultures
Human bites related to which infections
Group A strep infections
Which strep is known for deep tissue abscesses
S. Milleri
What causes dental caries
S. Mutans (viridan species)
Nutitionally deficient streptococci
Abiotrophia
What is needed to grow abiotrophia?
Vitamin or nutrients from other bacteria/ human cells
Causes bacterial endocarditis
Need to add feeder colony
what kind of hemolytic strep is enteroccus
non-hemolytic strep
Which corynebacterium is related to skin infections
Corynebacterium ulcerans
Which corynebacterium is related to nosocomial blood and wound infections
Corynebacterium jeikeium
Characteristics of Erysipelothrix Rhusiopathiae
Gram +, found in animals meat and seafood
Characteristics of Erysipeloid
Slow spreading skin infection
Found in fishermen, butchers, vets
Tx penicillin
Characteristics of anaerobic infections
Mixed gram + and -
Where are anaerobes normally found on human body
Stool of colon
Mouth
Vagina
Sebaceuous gland
When do anaerobes attack
After tissue trauma/injury
How to collect anaerobes in culture
Abscess aspirate
Surgically removed tissue
Blood
Characteristics of clostridium perfringens
Gram + Spore forming rods Fast growing anaerobic fermenter (generates H2 and CO2) Encapsulated/ non motile Found in colon and soil
What are the culture characteristics of Clostridium perfringens
Double zone hemolysis (blood agar)
Litmus milk stormy fermentation
What are the toxins associated with clostridium perfringens
Alpha: Main pathogenic factor- causes necrosis
Theta: Toxic for heart muscle/ capillaries (similar to streptolysin O in beta strep)
Enterotoxin: food poisoning
Clinical presentation of C. Perfringens
Gas necrosis ( crepitation ) Destruction of collagenase DNAse Hyaluronidase Protease
Where does C. Perfringens occur?
Traumatic wounds
What kind of diagnosis is gas gangrene
clinical diagnosis
How is anaerobic cellulitis different from other forms of cellulitis
Less pain and swelling
What would be seen with a dog bite
Anaerobic cellulitis
Mixed anaerobic flora
Pathogenic non-sporeforming gram + anaerbic rods
Actinomyces
Propionibacterium
Less pathogenic non-sporeforming gram + anaerobic rods
Mobiluncus (vaginitis)
Lactobacillus
Eubacterium
Rothia
Characteristics of actinomyces
Long Gram + rods
Branching
no spores/ not acid fast
Sulphur granules
Most common actinomycetes
A. Israelii
Mouth infection 4-10 days to grow
Where does actinimyses usually colonize
Mouth, Pneumonia, neck/head
Characteristics of Propionibacterium
Anaerobe
Gram +, non-sporeforming rods
Part of normal skin flora
What is the most common gram neg rod causing anaerobic infections
Bacteroides Fragilis
Louse borne typhus fever is from what
Rickettsia Prowazekii
Characteristics of typhus fever
Rash 10 days after illness
Comprises circulation
Lab diagnosis for Rickettsia
Culture difficult
PCR best
Immuno assays for antibody
Classic lyme disease
Tick bite-> spirochete
Erythema chromicum migrans
Constitutional sx for months
Meningeal irritation
Diagnosis of burgdorferi
EIA antibody/ western
Enzyme immuno assay