SM 181 Respiratory Bacterial Pathogens Flashcards
What 4 bacteria cause pharyngitis?
Strep pyogenes, Chlamyidiea pneumoniae, Mycoplasma pneumoniae, C. diptheriae
Is there a vaccine for C. diptheriae?
Yes, the Diptheria toxoid
What 4 bacteria are enterobacteria?
E. coli, Klebsiella, Serratia, Enterobacter
Describe the shape and stain of C. diptheriae?
Club shaped Gram positive bacilli
Which respiratory pathogen lacks cell walls?
Mycoplasma pneumoniae
Describe the shape and staining of Strep pneumo?
Gram positive lancet shaped diplococci
What is the effect of diptheria toxin?
Inhibits protein synthesis in pharyngeal epithelial cells, leading to necrosis
Where does H. influenzae colonize?
H. influenzae infects the upper respiratory tract of healthy individuals
How does C. diptheriae present?
C. diptheriae presents with pseudomembranes in the airways, sore throat, fever
What are nocosomial pneumonias?
HAP’s and VAP’s
What is the treatment for Mycoplasma pneumoniae?
Macrolides (-mycin), tetracycline, and fluorquinolones
Describe the shape and stain of H. influenzae?
Small Gram negative coccobacilli
What is the life threatening manifestation of H. influenzae?
Epiglotitis
Where does Strep pneuomo colonize?
Oropharynx and nasopharynx
What are treatments for Legionella?
Azithromycin or ciprofloxacin
What is a community acquired pneumonia?
CAP = pneumonia acquired while in the community
How can H. influenzae be diagnosed in ab?
Growth on chocolate agar but not sheep blood, because it requires Hemin and NAD to grow
What is the purpose of pneumolysin in Strep pneumo?
Degrades Hemoglobin, forms pores in RBC = alpha hemolysis
What are 8 common causes of acute CAP?
Strep pneumo, H. flu, Mycoplasma, Chlamydia Pneumo, S. aureus, Legionella, M. catarrhalis, aspiration pneumonia
What disease does Legionella cause?
Legionella causes Legionairre’s Disease
How does Strep pneumo show up on culture?
Gram positive diplococci in pairs and chains
How does diptheria toxin work?
ADP ribosylation of EF-2
How does peptidoglycan contribute to inflammation?
Peptidoglycan activates the complement cascade leading to inflammation and tissue damage
Is Strep pneumo optochin susceptible or optochin resistant?
Strep pneumo is optochin susceptible
What does aspiration pneumonia look like on CXR?
Consolidation in dependent lung fields
What can Mycoplasma pneumoniae cause?
Pharyngitis, CAP
What laboratory test can detect Strep pneumo?
Urinary antigen test
How does Strep pneumo show up on CXR?
Lobar infiltrate, and may cause empyema
What are 4 causes of Ventilator Associated Pneumonia?
S. aureus, Legionella, Pseudomonas, Acinetobacter
Which strain of H. influenzae can be prevented and how?
Type B, via capsular conjugate vaccine (Hib)
What is Pseudomonas Aeroginosa?
Gram negative aerobic bacilli that frequently causes HAP and VAP, with many antibiotic resistances
What type of pneumonia does Legionella cause?
Atypical community acquired or nocosomial pneumonia with very high fever, associated with water towers
What are 3 common causes of chronic CAP?
TB, Nocardia, Actinomycines Israelii
Describe the shape and stain of Legionella pneumophila?
Legionella is an aerobic Gram negative-like bacillus, but does not take up Gram stain
What can H. influenzae cause in adults?
Bronchitis, CAP
How can H. influenzae be treated?
Ampicillin if Beta-Lactamase Negative, Cephaolsporins if Beta-lactamase Positive
What 5 bacteria can cause acute bronchitis?
Strep pneumo, H. influenzae, Mycoplasma Pneumoniae, Chlamydia pneumoniae, Bordatella Pertussis
What are predisposing conditions for a Strep pneumo infection?
Antecedent viral infection like Influenza, HIV, COPD
Describe the shape and stain of Staph Aureus?
Gram positive cocci that may have gold appearance
Describe the shape and stain of Mycoplasma pneumoniae?
Mycoplasma pneumoniae is an extracellular pathogen that lacks cell walls and is therefore pleimorphic in shape
What can cause typical pneumonia?
Strep pneumo, H influenza,
What is a ventilator associated pneumonia?
VAP = pneumonia that occurs 48+ hours after mechanical ventilation
What bacteria causes aspiration pneumonia?
Fusobacterium
Does Mycoplasma pneumoniae cause a typical or an atypical pneumonia?
Atypical pneumonia = gradual onset and cough without sputum, “walking pneumonia” is less severe
What is the dot locus?
Defect in organelle trafficking, specific to Legionella, that is used to prevent phagolysosome fusion in host cells
Describe the shape of Chlamydia pneumoniae?
Closely related to the STD, causes atypical CAP
What is Acinetobacter baumannii?
Gram negative aerobic bacillus or coccobaciluus that causes HAP and VAP, with many antibiotic resistances
How is Mycoplasma pneumoniae diagnosed?
Radiographic findings»_space; clinical findings; CXR shows essentially any pattern; also, via specific antibody titers in the blood
What is the treatment of choice for Strep pneumo?
Historically, Penicillin, but resistance has lead to the use of other antibiotics such as vancomycin and cephalosporin
What kind of pneumonias do Staph Aureus cause?
CAP and Nocosomial pneumonia
How does Strep pneumo present in clinic?
Strep pneumo presents with fever, cough with rusty sputum, and diminished respiration/splinting on the affected side
How does aspiration pneumonia present?
Cough, fever, or foul sputum
What causes whooping cough?
Bordtatella Pertussis via pertussis toxin
How is C. diptheriae treated?
Macrolides like Erythromycin, Penicillin
What can H. influenzae cause in children?
Otitus media, sinusitis, meningitis, and pneumonia
What are the determinants of pathogenicity for Step pneumo?
Capsule (evade Macrophages), pneumolysin (degrades Hgb), peptidoglycan (Gram+), and IgA protease (cleaves IgA)
What is the purpose of the capsule of Strep pneumo?
Evades macrophages, but a target for antibodies
Does Strep pneumo only affect healthy or previously ill people?
Both, and can cause pneumonia in both groups
What is aspiration pneumonia?
A form of pneumonia seen in patients with depressed gag reflex, such as elderly patients and alcoholics actively blacking out
How does Strep pneumo spread?
Person to person via aerosols, and only affects humans
What are the treatments for Chlamydia pneumoniae?
Erythromycin and Tetracycline
Why is Mycoplasma pneumoniae resistant to penicillins?
It lacks a cell wall, so penicillins can’t impair cell wall synthesis
How is non-MRSA treated?
Nafcillin
Is Strep pneumo catalase positive or catalase negative?
Strep pneumo is catalase negative
How does Legionella spread?
Infection may spread via aspiration or inhalation of aerosol
How does H. influenzae spread?
Airborne droplets and direct contact with secretions
What is a hospital acquired pneumonia?
HAP = pneumonia that occurs 48+ hours after hospitalization
What are the two vaccines for Strep pneumo and how are they different?
Pneumococcal polysaccharide vaccine as well as pneumococcoal polysaccharide-protein conjugate vaccine; the polysaccharide-protein conjugate produces specialized T cells and lasting immunity
What is the significance of the capsule of H. influenzae?
6 types of a polysaccharide capsule, which is antiphagocytic but susceptible to antibodies; capsulated strains of H. influenzae tend to infect children because they have not yet formed antibodies to the capsule
What 3 bacteria cause acute sinusitis?
Strep pneumo, H. flu, M. catarrhalis
What protein is important for Mycoplasma pneumoniae pathogenicity?
P1, which allows for extracellular adherence to host cells
What distinguishes typical and atypical pneumonia?
Typical pneumonia is abrupt, produces sputum, and makes people very ill; atypical pneumonia is gradual in onset, does not produce sputum, and usually mild
How is MRSA treated?
Vancomycin or Linezolid
How does Mycoplasma pneumoniae spread?
Person to person via aerosols