T1 Flashcards
Genera of Gram + bacteria
Actinomyces Bacillus Bifidobacterium Clostridium Corynebacterium, Propionibacterium (& other diphtheroids) Enterococcus Gardnerella Lactobacillus Listeria Mobiluncus Peptostreptococcus Staphylococcus Streptococcus
med-important G+ cocci
Strep
Staph
Enterococcus
general of bacterial endospore-formers
Clostridium
Bacillus
Genera of acid-fast + pink bacteria
Mycobacteria
Nocardia (usually)
cell shaped determined by
murein sacculus and cytoskeleton
cocci arrangements
diplococcus (pairs) G- : (kidney bean) G+: (lancet) chains (strep) clusters (staph)
bacillus/rod
v. short: G- short, thin: G- short, thin, needle-like: fusiforms, G- long, thick: G+ short, thick: G+ clubbed-shaped: G+ -thin, branching filamentous rods w. club ends *arranged as single cells, pairs (doublet) or chains
helicoidal
curved, comma: (G-)
curved, comma: (G+)
spirochetes
*arranged as single cells, pairs, chains
pleomorphic
can vary in size/shape:
flagella
H-Ag, protein composition
plain: extend out from cell surface
endoflagella: internal structure (spirochetes)
motility, sensory system (chemotactic), surface translocation, aids in identification, virulence factor (chemotactic)
Pili (Fimbriae)
protein composition
normal (I-IV) and sex pili extend out into environment
adherence (virulence factor), antiphagocytic, surface translocation (v.f.)
sex pilus: conjugation
capsule
glycocalyx, exopolysaccharides (EPS)
mucoid-like coat around cell, slime layer
polysacch. polymers: K-Ags: single, complex, D-glutamic acid repeating units OR O-Ag: LPS (G-)
biofilms
communal, protected, complex, 3-D structure (bac/yeast)
in exopolysacch. film, sometimes protein amyloid fibers
CDC: 50% human bac inf. involved biofilms
phenotypic changes: become sessile in biofilm, MDR, quorum sensing–>activation?
can revert to normal/planktonic form–>recurrent inf.
D-A.A. can disrupt amyloid protein connections–>release bad
*are a capsule
clin sig of EPS/biofilms
adherence, anti-phagocytic, anti-antibiotic, anti-dessication, Ag used to ID some human pathogen
HKO Ag
H: flagella K: capsular O: LPS (acts as capsule) G+: capsule or no capsule G-: O+K-, O+K+, O+,K- (again)
S-layers
A- or T-layers, (glyco)protein composed, 10-20% cell mass
present on some human normal flora AND pathogens
on cell wall, rigid layer w. pores of fixed diameter
virulence factors: anti-complement (C3b), anti-phago(PMN)
translocation
thru human cells to new site
paracellular, sliding motility (biofilms)
cell membrane contains no sterols except
Mycoplasma
Helicobacter
Ehrlichia
Anaplasma spp.
Type III secretion system
injectosome; conserved multiprotein system used by G- bac to insert protein toxins into human cells
cell membrane contains respiratory system
ETC, ATP synthase, PMF/ion current
cell membrane systems
perm/transport, respiration, cell wall synthesis components, cellular replication components, osmoreg/sensory (chemotactic) mechanisms (hypertonic to ext. environ.)
G+ or G-: polysacchs are covalently linked to peptidoglycan layer in cell wall and lipoteichoic acid polymers are anchored in cell membrane
G+
G+ or G-: contains an outer membrane with LPS, peptidoglycan layer located in periplasm
G-
cell wall functions
sieve, prevents bursting, mech. strength, vir/tox factors, Ag-comps, rec. for Abs, sex pilus, bacteriophages; anchors external bac structures (flag, pili, caps)
peptidoglycan layer
“fabric” of crosslinking, covalently bound threads: N-acetylmuramic acid (NAM) and N-actelyglucosamine (NAG)
- cleavage by lysozyme (human tears/saliva)–>bac lysis
- all peptide stems possess some D-a.a.s (i.e. D-alanine)
lytic transglycosylases
cell wall enzyme, causes cell wall turnover during exponential phase growth
product recognized by TLRs–>SIRS!
pathogenic bacteria WITHOUT peptidoglycan
Mycoplasma
Rickettsia
Ehrlichia
Anaplasma
G+ or G-: contain periplasm and an outer membrane
G- (thin pep. layer)
*confers resistance to dyes, hydrolytic enzymes, detergents
periplasm functions
osmotic protection (for thin pep. layer), nutrient uptake from OM–>CM, chemotactic sens. mech, degradative enzyms, osmoreg
OM functions
bac-environ interaction site, vir/tox factors, Ag-comps, ref for Abs, sex pilus, bacteriaphages, anchors ext. structures of bac, shield against dyes, hydrolytic enzymes, detergents
OM comp
lipopolysacc, phoslip, proteins (OMP)
OM structure
lipid bilayer (NOT phoslip bilayer) LPS as outer leaflet, phoslip inner porins: OMP, allows hydrophilics to pass thru
LPS
aka: endotoxin, exogenous pyrogen
Lipid A + core + O-Ag
Lipid A
disacch, phos grps, fatty acids, toxic factor
Core oligosacch of LPS
sugars, aminosugars, sugar acids, or sugar alcohols
-ketodeoxyoctulonate (KDO): common Ag in enteric bac
terminal polysacch.
aka O-Ag, repeating unit, contains sugars (like core), highly specific btw genera AND species
Lipooligiosaccharide (LOS)
lipid A + extended core, NO O-Ag
syn. instead of LPS, assoc. w/ Neisseria meningitidis and N. gonorrhoeae; Haemophilus influenza and H. ducreyi
props of LPS/LOS
part of OM, chromosome encoded, broad sp.(effects many org sys in susc. host) i.e. induction of IL-1 (endo. pyro), also acts directly on hypothalamus itself (exogenous pyrogen)
act. alt compl pathway, activator of Hageman factor (XII), induction release of endo mediators, heat stable, does not form toxoids
endogenous mediators induced/released by LPS/LOS
TNF-a, IL-1, IL-6
arch acid metals, bradykinin, histamine, NO, free radicals
only ways to disrupt primary structure of LPS/LOS
burning, oxidation –>detoxifies the endotoxin
Endotoxin/LPS/Lipid A is a potent immunomodulatory substance
SIRS–>distributive shock (DS) (G-)
systemic w. macros, PMNs, endothelial cells
SIRS activated by
50%: infection (usually G- (contain LPS))
50%: non-inf. etiology
initiation of SIRS
LPS binds LBP–>LPS-LBP complex interacts with mem-bound CD14 rec on PMS, macros/monos–>LPS-CD14 binds TLR–>signal transduction–>cytoplasm–>nucleus
–>induction/release of endogenous mediators
soluble CD14 rec in serum–>binds ECs–>dysfunction/leakiness>hypotension/vascular leak syndrome (ARDS: feature of DS, not SIRS)
why endotoxin (LPS) is not a true toxin
human response to presence is what causes fatality, not toxin itself
SIRS classification
2+:
temp >38 or =90 bpm
tachypnea >=20
leukocytosis: >12000 or
3 pathophys processes of sepsis etc.
systemic inflammation (“hyperinflammatory state”)
coagulation activation
fibrinolysis inhibition
Disseminated Intravascular Coagulation (DIC)
LPS activates Hageman factor (XII)–>activation of coag (fibrin deposition)–>fibrinolysis activated by this but inhibited by plasminogen activator inhibitor–>accumulation of undiss. thrombin in microcirculation
DIC–>MOF +/- purpura fulminans
if survived hyperinflammatory state of sepsis, pt enters
“immunoparalysis”; hypoinflammatory state:
loss of type IV hypersn, failure to clear primary infection, dev. of new secondary infections, dormant viruses may “awaken” (HSV-1, EBV, CMV, HHV-7)
sepsis classification
2+ of SIRS criteria PLUS proven infection: i.e. pneumonia, UTI, bacteremia
severe sepsis
sepsis criteria PLUS organ failure (OD, MOD, MOF) most: heart, lungs, liver, kidneys
septic shock
severe sepsis criteria PLUS refractory hypotension
shock
inadequate profusion of tissues; 3 forms:
cardiogenic, vascular obstructiv, hypovolemic (DS)
distributive shock (DS)
“warm shock” (dilation)
- EC dysfunction/leakiness–>loss of plasma into tissues–>hypotension
- loss of vasc resistance–>hypotension
- coagulopathy–>DIC
- septic cardiomyopathy: rev., does not damage heart structure–>reduces CO (LPS, C5A, IL-1B, TNF-a, IL-6)
clinical manifestations of DS
fever or hypothermia, chills, leukopenia/cytosis tachy x2 DIC hypotnsn, shock, DIC-->OD, MOD, MOF
Early Goal-Directed Therapy (EGDT) for SIRS/DS
- sepsis resuscitation bundle: measure serum lactate, obtain blood spec for culture, admin broad spec Ab, if hypotnsv: admin fluids: iconic crystalloid or iso-onccotic colloid (4% albumin) or vasopressin, achieve O2 sat goals
- sepsis management bundle: corticosteroids, tight glycemic control
failed SIRS/DS tx
eritoran tetrasodium: anti-TLR-4 compound
Drotecogin alfa: act. recombinant protein C, approved, no proof of benefit
detection of LPS in pharm industry
Limulus Amebocyte lysate test and/or monoclonal Abs (MoAb) against LPS (detects nanogram amounts of endotoxin)
G+ peptidoglycan layer
larger (50% cell wall) and more cross linked than G-
can induce TNF-a, IL-6
can lead to SIRS/shock/DS (not as much as LPS)
Lipoteichoic acid structure
polymer of glycerol-PO4 or ribitol-PO4, covalently bound to glycolipid, integrated/NON-COVALENTLY bonded into outer leaflet of CM, extends thru cell wall/pep layer into environ
*adhesion of Strep. pyogenes to fibronectin on surface of pharyngeal epithelial cells
Teichoic acids (and other polymers)
polymer of glycerol-PO4 or ribitol-PO4, covalently bound to peptidoglycan, extends thru cell wall/pep layer into environ
- peptidoglycan + teichoic acids–>can produce endotoxin-like shock in pts with Staph aureus infections
- interacts with CRP–>activates alternative comp pathway–>inflammatory response
PAMPs (pathogen assoc. molecular patterns)
on pathogen, recognized by PARs/PRRs–>can initiate release of endogenous mediators that cause SIRS/DIC/DS
*caused DIC/DS to occur in absence of endotoxin: G+ bac inf., fungal inf., viral inf.
PARs (PRRs)
NOD1/2: internal/cytoplasmic *NOD2 def. related to Crohn’s
TLR rec: extracellular, 11 total, bind to sp. PAMPs: peptidoglycan, teichoic acid polymers, N-f-met-leu-phe, CpG nucs, LPS
bacterial spores
-most bac do not form spores, help survive adverse conditions, forms inside mother cell (dies), complete but inactive cell in protective shell, germination when conditions are favorable
bacterial endospores have increased
longevity, resistances to heat/temp, desiccation, chem agents *req special disinfectants/sterilization
medically important spore-forming bacteria
Bacillus
Clostridium
small colony variants (SCV)
growth-def variants, form colonies 1/10 normal size
enhanced resistance to Ab (*aminoglycosides)
formed by both G+/G-: Staph aureus, Pseudomonas aeruginosa, E.coli, UTIs
phenotype switching: able to revert to normal size
SCVs are associated with chronic, recurrent infections of
bones, heart, lungs, urinary tract
bac are good metabolizers b/c
large surface:volume ratio, close contact w. environ, accumulate nutrients quickly, grow rapidly
autotrophs
“fix CO2”, cell energy from redox of inorganic ions (chemoautotroph) OR harvesting light energy (photoautotroph)
heterotrophs
oxidize organic molecules for cellular energy
*all bac which cause disease in humans
heterotrophs utilize..
carbs, proteins, then lipids
fastidious bacteria
will not grow on blood agar (complex growth req)
non-fastidious do
optimal growth occurs at temps..
closer to maximum
min determine primarily by reduced enzyme activity and red. mem fluidity
max: protein denaturation
mesophile growth occurs btw
20-50 degrees C
*most pathogens are mesophiles: 35-36 C
thermophiles
(obl. or fac) >55 C
psychrophiles/cryophiles
(obl, fac)
microaerophilic organisms
grow in presence of red. O2 conc.
facultative anaerobe
*most pathogens
aerobic respiration when O2, otherwise fermentation
-early on use aerobic, consume all O2, switch to anerobic
aerotolerant anaerobe
grow best in absence of O2 (only fermentation) but can grow in O2
obligate anaerobe
only grow in absence of O2 (only fermentation)
bacteria become O2 tolerant when..
they produce enzymes (SOD, catalase) to detoxify the byproducts of O2 metab (O2-, H2O2, respectively)
if bac are O2 intolerant
they lack nec. enzymes, so toxic agents (O2-, H2O2) kill them
special ionic requirements
non-halophile vs halophiles (need Na+) eg: low Fe+++: C. diph-->produces diphtheria toxin low Ca++: plague bac-->produces exotoxin low Mg++: S. aureus strains-->TSST-1
glycolysis
catabolic pathway; partially oxidizes organic matter–>end products are substrates for other pathways; phosphorylation generates ATP
- additional energy if end-products enter:
- TCA(gen red power (NADH2)–>respiration (gen ATP, recyc. NADH2)
- fermentation pathways
TCA
completes oxidization of organic carbon into CO2
gen. intermed. for anabolic pathways
gen. reducing power (NADH2) for ana/catabolic pathways
FADH2 and/or NADH2 is recycled in resp/anabolism
fermentation pathways
produce shorter C chain-org comps +/-CO2
recycle NADH2 for ana/catabolic pathways
may gen ATP via substrate level phosphorylation* sole source energy
respiration must occur
in mem vesicle/sack, generates energy: ion current (PMF) for ATP synthesis, occurs during recycling of NADH2–>NAD+(oxidized) *Abs exist that collapse the gradient
1st part of respiration: ETC..
transfers e-s and H+ from NADH2 to TEA–>generates both PMF and reduced TEA
oxidase test
determines presence of ETC comp (cytochrome C) in some bac that can oxidize derivatives of P-phenylenediamine to a colored product
-used by lab to ID bac: enterobacteria (oxidase -)
other G- rods (oxidase +)
2nd part or respiration: ATP synthetase…
uses PMF to synthesize ATP from ADP and inorg. phos
aerobic respiration
(oxidative phosphorylation)
TEA is O2–>red. to H2O by ETS
*common pathway among pathogens and humans
anaerobic respiration
TEAs are inorganic comps
med sig:
-methemoglobinemia (MetHb) happens when elevated levels of NO3 are in drinking water
-GI tract NF convert NO3–>NO2–>if absorbed in blood–>MetHb (risk esp to fetus)
fermentation
simpler than respiration, incomplete oxidation of C substrate, utilizes substrates less efficiently (NO respiration), but still allows growth, occurs in cytosol (NOT vesicle), does NOT directly produce PMF
fermentation substrates are..
partially oxidized to 1-4 C compounds and some CO2, these serve as TEA (accept e- from NADH2, H+) during recycling of NADH2–>NAD+
–>then excreted from cell (pyruvate–>ethanol +CO2)
microbial end products of fermentation cause..
dental caries; end prod. is lactic acid from homolactic fermentation (like hum. musc.)
microbial end products of fermentation lead to…
acidic pH of vagina and skin (lactic acid, again, and propionic acid, acetic acid, CO2)
microbial end products of fermentation cause abscesses..
that are acidic and anaerobic
- many Abs not effective at low pH
- many Abs bind free NAs and render them unavailable
- low pH kills surrounding viable human cells –>rel. compounds that bac req for growth (para-aminobenzoid acid) –>Abs like sulfas are ineffective
microbial end products of fermentation help..
ID bac
- mixed acids: lactic, acetic, formic, succinic, etOH, CO2, H2
- typical of enteric bac of human gut (coliforms)
certain bac can only grow fermentatively
- lack cytochrome/ETC OR cannot use it for energy prod.
- do not use NAD+ or NADP+ as e- and H+ ion carrier, rather ferredoxin is used–>must be recycled to oxidized form
aerotolerant anaerobes
(Strep and Lactobacillus)
-produce lactic acid and H2O2 (from ferredoxin recycle)
H2O2 detoxed by human host’s peroxidase (otherwise can’t grow)
fermentation by Clostridium
end products include H2, CO2 and 4 C compounds; recycling of ferredoxin catalyzed by hydrogen lyase (not aerotolerant?) –>H2 byproduct
H2 gas produced by Clostridium’s fermentation can cause..
Gas gangrene! (myonecrosis)
H2 is insoluble in tissues, tracks along fascial planes (sep muscles, collapses blood vessels, impeding perfusion (anaerobic)
alkaline end products are NOT
fermentative or oxidative phosphorylation end products
i.e. Proteus spp. (cause UTIs, kidney stones) rel. urease–>hydrolyzes urea in urine–>ammonia and CO2–>raises pH to above 7, allows Proteus to grow–>Ca++ and NH4+ ions form salts, precip. at alkaline pH–>renal calculi
renal calculi are composed of
triphosphate: Struvite: Mg ammon phos)and poorly crystalline form of apatite (hydroxylated Ca phos (some repl by carbonated)
H. pylori cause..
type b and duodenal ulcers
produce urease–>cleaves urea to CO2, NH4+–>raises microenvironment pH (stomach mucous lining) so bac can grow
primase
synthesizes short ssRNA primers for DNA synthesis
DNA gyrase (topoisomerase II)
negatively supercoils bac genome and plasmid DNA
relieves torsional stress cause by helicase: “unwinding”
topoisomerase IV
required for decatenation (separation of 2 daughter chromosomes (rings))
*both topo. II and IV are essential for bac DNA sun
DNA synthesis originates..
at one origin of replication in prokaryotes is bidirectional (as is eukaryotic)
DNA synthesis must be primed with..
RNA
primes synthesizes primers
partitioning of daughter strands
- in prok: req membrane attachment
- in euk: utilize spindle fibers and centromere to sep. each chromosome
DNA synthesis occurs when
prok: lag and exponential phase
euk: S-phase
RNA synthesis produces
mRNA, tRNA, rRNA
why antimicrobial protein synthesis inhibitors are so effective
mRNA in bac has a v. short 1/2 life
some gene transcription req. DNA gyrase
to neg. supercoil DNA
protein synthesis occurs in the
cytoplasm
bac ribosomes
free, 70S (30S + 50S)
rRNA + proteins + accessory comps
charged tRNAs accomplished by
aminoacyl-tRNA synthetase: covalently bond sp. aa’s to appropriate tRNA (mRNA is template)
mRNA is codon, tRNA is anticodon (base-pair)