The Bugs

Question 1

bacterial findings

Answer 1

gram stain + violet
gram stain - red

obligate anaerobes
low 02

facultative anaerobes
grow with or without 02

facultative aerobes
live with 02

obligate aerobe
can’t live without o2

rods or bacilli
same thing

cocci
spear shaped bacteria

coccobacillus
Bacteria that fall between the two shapes

Spirochetes
slender curved spiral, highly mobile
gram-negative bacteria

Question 2

atypicals

Answer 2

legionella, chlamydophila, mycoplasma coxiella
do not collar on gram stain

Question 3

legionella

Answer 3

gram neg dx bacilli
atypical
diagnosis
legionella urinary testing
sensitive to serogroup 1

treat azithromycin
levofloxin
tetracycline

Question 4

chlamydia

Answer 4

diagnosis
PCR based assay
cell culture ; not used

C pneumonia:
human to human via resp droplets
close quarters living
resp tract infection

C trichomonas
sexually organism transmitted

tetracycline 500 10-14 days (pneumoniae)
doxycycline Uritis bid x 7 D and azithromycin x1
tetracycline

Question 5

mycoplasma pneumonia

Answer 5

short rod : atypical
lack cell wall
dx for a small select of pts
NAAT or PCR

bacterial sources and infection
human to human via resp
URI and bronchitis are the most common
encephalitic or hemolytic anemia carditis

Treatment:
macrolides
tetracyclines
fluoroquinolones

Question 6

coxeilla burnetii

Answer 6

short pleomorphic rod
strict intercellular bacterium

diagnosis:
serologi testing with immunoflourescence assay (IFA)

bacteria sourse and infection:
mannals birds ticks
shed via urine feces milk and placenta
humans or hosts
Q fever
flu like symptoms

treatment :
doxycycline 100mg po BID x 14 d

Question 7

pseudomonas due to atypical pathogens

Answer 7

30% of CAP
M. pneumoniae
c pneumonia
legionella pneumonia
chlamydophila psittaci
Coxiella burnetti
viral pneumonias

Question 8

Gram-negative bacteria

Answer 8

H. A. C.E.K. group
slow growing gram neg
do not grow on media

Haemophilus gram negative endocarditis
Aggregabacter
Cardiobacterium
Ekenella corrodens
Kingella Kingae

Source:
Oral cavity local and mouth infections

DX:
culture

Treatment:
Rocephin: main choice
ampicillin/sulbactam
levofloxacin

Question 9

Bacteroids:

Answer 9

gram negative:
predominant genus in human intestine
bacteroids fragilis
most significant

Source:
found in colon
abscess formation with bowel adenocarcinoma

Diag:
culture

Treatment:
metronidazole
piperacillin/taxobactam

Question 10

enterbacteriaceae

Answer 10

gram neg bacilli
:
E coli
klebiella
shigella
enterbactor
samanella

complex cell membrane
virulant
multi drug resistance
ESBL
hard to kill

treatment:
local incidence of MDR < 10-15 %
pipercillin/tazobactum
azteropam
ciprofloxicin
cefepime

> 15 %
meropenem
consult ID

Question 11

Escherichia coli

Answer 11

gram neg bacilli
ability to produce ESBL

Bacteria source and infection:
community acquired
GI, GU, or blood

treatment
ce[jalosprrin
florquinolone
carbapenem
ESBL

Question 12

Klebsiella pheumoniae

Answer 12

gram negative bacilli
ability to produce ESBL

lobular pneumoniae
liver abcess
UTI

dx
culture and GS

treatment
bases on susepitbility

Question 13

pseudomonas aeruginosa

Answer 13

gram neg rod
hard to kill
multi drug resistance

bacteria source and infection
nosocomial
UTI, VAP, CLABSL or CAUTI
susceptible patients
cystic fibrosis, neutropenic , burns, or wound infections

dx
sputum culture

treatment
antipseudomonal pencillin’ beta lactamase
cephalosporin with antipseudomonal activity
monobactam
carbapenem

Question 14

Bordetella pertussis

Answer 14

gram neg aerobic

bacterial source and infection
highly communicable

Dx
nasopharyngeal culture , PCR and serolgic assay

tx
azithromycin
supportic care

Question 15

neisseria gonorrhoae

Answer 15

neisseria gonohorea
2nd most common reported disease

findings
urtherittis
cervicits
PID
infertility
etopic preg
rectal and pharynx infecions
asymptomatic
diessminaed infections endocardidis and meningittis
uncommon
serious morbitiy

Question 16

dx gonorrhoae

Answer 16

d
x;
microbiologic dx is required
rapid gonococcal screeing

NAAT :
widely used
urine or swab

treat:
rocephin 200mg IM + azithromycin 1 gram po x 1
avoid florquinolones
disseminated infections
rocephin 1 gram iv and po until 48 hours of improvement

Question 17

treponema pallidum

Answer 17

MSM ususally

infection:
spirochete
gram neg
progress to chronic disease

tranmission
sex contact

Question 18

clinical manafestaion

Answer 18

protean
two major stages

early infectious
late

primary lesions on anorectal regions

multiple cancers esp on HIV Pts
secondary rash , highly contagious
occular and otologic with hearing loss
tertiray :
neuro and ortic insuffency

Question 19

DX treponema

Answer 19

nontreponemal antibody test VDRL or RPR
most commonly used nonspecific

treponema antibody positive testing
TPPA