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Medical Microbiology II - 4336 > Unit 1; Chlamydia, Ricketsia, Spirochetes > Flashcards

Unit 1; Chlamydia, Ricketsia, Spirochetes Flashcards

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1
Q

What Chlamydia species can cause human infections?

A

C. trachomatis, C. psittaci, C. pneumoniae

C. pneumoniae is least pathogenic due to lack of plasmid

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2
Q

What Chlamydia species can cause infections in animals?

A

C. abortus, C. pecorum

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3
Q

How is Chlamydia similar to viruses?

A

Chlamydia requires host resources for their metabolism

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4
Q

because chlamydia is gram-negative, the LPS has little __________ activity.

A

endotoxic

????

small amount of peptidoglycan?

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5
Q

Chlamydia:

Major outer membrane protein (MOMP)-very diverse, but very conserved in _____________.

A

C. pneumoniae

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6
Q

Plasmid DNA is present in what species of chlamydia? but not in which one?

A

C. trachomatis and C. psittaci,

not in C. pneumoniae

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7
Q

Glycogen-containing inclusions only in C.__________

A

trachomatis

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8
Q

Susceptibility to sulfonamides: C.__________

A

trachomatis

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9
Q

What are the two components of chlamydia life cycle?

A

Intracellular: reticulate body (RB)-replicative

Extracellular: elementary body (EB)-infective

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10
Q

What is the most common sexually transmitted bacteria in the US?

A

Chlamydia Trachomatis

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10
Q

What is the most common sexually transmitted bacteria in the US?

A

Chlamydia Trachomatis

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10
Q

What is the most common sexually transmitted bacteria in the US?

A

Chlamydia Trachomatis

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11
Q

C. Trachomatis:

_____ serovars (outer membrane proteins) based on MOMP antigenic differences

A

18

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12
Q

What complications can C. Trachomatis cause?

A

PID, ectopic pregnancy and infertility
GTI in females ages of 15 and 24 yr

Lymphogranuloma venereum (LGV): acute and chronic (e.g. rectal fistulas, rectal stricture etc.)

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13
Q

How common is Ocular trachoma?
Blindness?

A

84 million worldwide

7 to 9 million worldwide

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14
Q

Prevalent areas of chlamydia?

A

Africa, Asia, Central and South America

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15
Q

What is the major transmitsion for C. Trachomatis?

A

direct contact (human to human)

Vertical transmission: neonatal pneumonia or inclusion conjunctivitis

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16
Q

In US: C. Trachomatis causes ____% NGU

A

60

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17
Q

What are the oculogenital infections caused by chlamydia?

A

acute inclusion conjunctivitis in adults and newborns, GTI (urethritis, cervicitis, bartholinitis, salpingitis, proctitis, epididymitis and acute urethral syndrome in females, NGU

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18
Q

Is chlamydia always easily recognized?

A

no, Many asymptomatic and not easily recognized

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19
Q

What are the usual symptoms of chlamydia?

A

unusual discharge and pain, symptoms similar to gonorrhea

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20
Q

How is chlamydia diagnosed in the lab?

A

Preferred for screening: endocervix sample.

Others: Urogenital swab and fresh urine sample.
*Bacteria is labile, so keep sample cold and transport ASAP.

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21
Q

plasmid DNA is responsible for causing ________.

A

disease

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22
Q

Whare are the basic steps of chlamydia life-cycle?

A
  1. specific host cell receptor binding
  2. endocytosed into cell
  3. EB recognized into large reticular body
  4. multiplication by binary fission —-> produces an inclusion
  5. condensation into EB forms
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23
Q

What can chlamydia sometimes be mistaken for by doctors?

A

benign tumors

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24
Q

What is a major way the immune system can stop the spread of chlamydia?

A

stop the production of the receptor needed for chlamydia to be taken into the cell.

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25
Q

Why are cultures not usually done for chlamydia?

A

because it is intracellular. But if done, must use cell lines.

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26
Q

Why are cultures done for chlamydia only 70-90% sensitive?

A

some cells in the culture may not have the receptor needed to become infected.

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27
Q

What is the transport media used for chlamydia?

A

2SP, 0.2M sucrose-phosphate transport medium with antibiotics (prevents other bacteria from contaminating it)

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28
Q

What culture media is sometimes used for chlamydia but less frequently?

A

McCoy, HeLa and monkey kidney

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29
Q

48-72 hr culture, stained with fluorescent labeled monoclonal antibody

A

cell lines

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30
Q

Chlamydia cultures are _____% specificity and _____% sensitivity.

A

100, 70-90

this method is preferred for legal implications

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31
Q

What are the three direct detection methods for chlamydia?

A
  1. Inclusion bodies: round, vacuolar (by DFA staining)
  2. Antigen detection: EIA
  3. NA hybridization: Digene hybrid capture II assay (uses RNA probe to detect DNA in a sample)
32
Q

chlamydia inclusions can be stained by use of _________.

A

iodine

-100% specificity with the presence of inclusion bodies

33
Q

C. Psittaci is ______________ resistant.

A

Sulfonamide

34
Q

type of chlamydia that is more common in birds and domestic animals

A

C. Psittaci

35
Q

What are the symptoms of C. Psittaci?

A

Birds: diarrhea or no symptoms
Bird to human: aerosols, IP: 5-15 days
Pnumonia, severe headache, mental status changes, hepatospenomegaly

36
Q

Should use BSL___ for C. Psittaci.

A

3

37
Q

How is C. Psittaci diagnosed?

A

almost always by serology
IgM titer: 1:32 or greater for diagnosis
PCR: rRNA sequences followed by RFLP

38
Q

What are the symptoms of C. pneumoniae?

A

Pnumonia, brochitis, pharyngitis, sinusitis and flulike illness
May be the causative agent of atherosclerosis.

39
Q

C. peneumoniae is more common in…
how is it spread?

A

More common in human, no birds or animals
Person to person: aerosolized droplets

40
Q

How can C. pneumonia be diagnosed?

A

Direct methods: NAAT (RCR and real-time PCR)
Cultivation: oropharynx swab, cold in TM, culture in McCoy cell lines- multiple blind passages
Use monoclonal antibody to detect organism
Serodiagnosis: CFT, 4 fold rise in IgG or IgM

41
Q

Drugs for C. trachomatis?

A

Tetracyclines, azithromycin, doxycycline, erythromycin,fluoroquinolones and other macrolide antibiotics

-similar for C. trachomatis?

42
Q

What is the drug of choice for treating C. psittaci?

A

Tetracycline

43
Q

-Obligate intracellular and fastidious organism
-Can survive briefly outside of host
-Small (1-2 micron), pleomorphic and gram –ve
-Human: accidental host in most cases
-Multiply intracellularly, but not intracellular development
-Damage endothelial cells, cause cell injury and death

A

Rickettsia

44
Q

What are the three groups of Rickettsia based on arthropod mode of transmission?

A
  1. spotted fever group, 2. the typhus group, 3. the scrub typhus group
45
Q

What is the vector for R. conorii, R. rickettsia, and R. parkeri?

A

Tick

46
Q

causes Indian or kenya tick typhus, & Mediterranean or Israeli spotted fevers

A

R. conorii

47
Q

cause Rocky Mountains spotted fever

A

R. rickettsia

48
Q

causes mild illness with no reported fatalities

A

R. parkeri

49
Q

Lice is the vector for…

A

R. prowazekii: epidemic typhus and Brill-Zinsser diseases

50
Q

Fleas are the vector for…

A

R. typhi: Murine typhus

51
Q

How is Rickettsia diagnosed?

And specimen

A

common PCR or RFLP, others: EIA, IFA and DFA (useful for R. rickettsii, Ab produced 2 wks after infections in others)
Specimen: biopsy from the rash (preferred)

52
Q

Three bacteria that…
-cannot survive outside the host cell
-very little is known

A

-Ehrlichia sp.
-Anaplasmam phagocytophilium,
-Neorickettsia sennetsu

53
Q

E. chaffeensis infects ___________.

What is the vector?

A

monocytes

ticks

54
Q

A. phagocytophilium infects…

A

bone marrow, primarily neutrophils.

55
Q

A. phagocytophilium causes…

What is the vector?

A

Anaplasmosis (fever, chills, headache, muscle ache.

Vector: ticks (black legged)

56
Q

What symptoms does Neorickettsia sennetsu cause?

Vector?

A

Sennetsu fever: in SE asia, high fever, muscle aches

vector unknown (maybe raw fish??)

57
Q

How are these bacteria diagnosed in the lab?

-Ehrlichia sp.
-Anaplasmam phagocytophilium,
-Neorickettsia sennetsu

A

-Giemsa stain of WBC (because parasite present in monocytes)
-Serodiagnosis: EIA, IFA, DFA
-PCR

58
Q

What is Q fever and what is the causative agent?

A

an acute systemic infection of the lungs

Coxiella burnettii

59
Q

Can Coxiella burnettii survive outside the host cells?

A

yes, but can only be grown in lung cells

60
Q

Is Coxiella burnettii resistant?

A

More resistant to various chemical and physical agents

61
Q

What are the two Coxiella burnettii antigenic states in life cycle?

A
  1. Large-cell varient form: highly infectious
  2. small-cell variant form: spore like, not infectious, can survive extracellular, seen in cultured cell lines
62
Q

Coxiella is mostly found in…

A

domestic animals (cattle, sheep, and goats)

63
Q

What is the difference between Q-fever and Coxiellosis?

A

Q-fever- acute

Coxiellosis- chronic

64
Q

How prevalent is Q-fever?

A

endemic worldwide except in New Zealand

65
Q

What are the symptoms associated with Coxiella infections?

A

*No rash developed (because the infection is in the lungs)
-Atypical pneumonia, granulomatous hepatitis, endocarditis, neurological manifestations, osteomyelitis
*only causes internal infections

66
Q

How is Coxiella diagnosed?

A

-Diagnosis: must use BSL3
-Culture: 6-14 days at 370C in *CO2 environment – direct IFA
-NAAT, PCR, serology tests: EIA, IFA

67
Q

What drug is used for both acute and chronic Q fever?

A

Tetracycline

68
Q

How does chronic coxiellosis usually manifest?

A

1 to 20 years later as endocarditis
-Others: chronic hepatitis, osteomyelitis, septic arthritis, lung diseases

69
Q

Coxiella infections can occur even with treatment, and mortality can be as high as _____%.

A

60

70
Q

characteristics of Bartonella

A

intracellular, fastidious, facultative anaerobic, zoonotic.

71
Q

causes similar symptoms to Rickettsia, associated with trench fever

What is the vector?

A

Bartonella quintana

lice

72
Q

Is bacteria causes acute hemolytic bacteremia (Oroya fever), chronic vasoproliferative diseases, mortality 40-90%

A

Bartnonella bacilliformis

73
Q

Bacteria associated with cat scratch disease?

A

Bartonella henselae

74
Q

How is Bartonella diagnosed?

What is the treatment?

A

Diagnosis: Culture, PCR, serology
Treatment: Similar to C. trachomatis

75
Q

What bacteria is associated with Whipple’s disease?

A

Tropheryma whippelii

76
Q

What is Whipple’s diseases?

A

(arthralgia, diarrhea, weight loss, lymphadenopathy, hyperpigmentation)- in middle-aged men
Leads to malabsorption

77
Q

How is Tropheryma whippelii diagnosed?

A

-Can not culture
-Diagnosis: NAAT, PCR and other techniques

78
Q

What is the treatment for Tropheryma whippelii?

A

Trimethoprim/sulfamethoxazole
Macrolides
Aminoglycosides
Tetracycline
Penicillin

Medical Microbiology II - 4336 (20 decks)

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