Haemophilus & Other GNR

Question 1

Haemophilus General

Shape, requirements, where, trans, clinical

Answer 1

Shape: G- pleomorphic coccobacilli or rods

Requirements: fastidious, needs X factor (hemin) and/or V factor (NAD), increased CO2

Habitat: normal flora except for H. ducreyi

Transmission: person to person, H. ducreyi sexual contact

Clincal: H. influenzae - pneumonia, meningitis, otitis, sinitis | H. ducreyi - chancroid | H. aegyptius - conjunctivitis

Question 2

Haemophilus Virulence Factors

two

Answer 2

Capsule: attachment, antiphagocytic
Pili and surface factors: attachment

Question 3

Haemophilus Infection

3, and who

Answer 3

Epiglottitis
- Life threatening if blocks airways
- H. influenzae type B
- Can also see bacteremia

Conjunctivitis
- H. aegyptius
Pink eye
- Purulent discharge
- Mostly children

Chancroid
- H. ducreyi
- Genital lesion, papule with red base, ulceration, lymphadenopathy
- Africa and Asia, woman can be asymptomatic

Question 4

HACEK Group Acronym

Answer 4

Haemphilus spp.
Aggregatibacter
Cardiobacterium
Eikenella
Kingella

Question 5

HACEK Group Basics

Shape, requirements, where, trans, clinical

Answer 5

Shape: G-, coccobacilli/bacilli
Requirements: fastidious, some need heme, increased CO2
Where: normal flora of oral cavity, Eikenella and Cardiobacterium in GI and female genital tract
Transmission: endogenous, bites
Clinical: opportunistic - dental, slow endocarditis, soft tissue, bone and joints, septic arthritis (kingella)

Question 6

Pasteurella Basics

Shape, requirements, where, trans

Answer 6

Shape: small or coccoid G- bacilli
Requirements: fastidious, heme and CO2
Habitat: nasopharynx of wild animals
Transmission: bite or scratch

P. multocida = cats
P. canis = dog

Question 7

Pasteurella Infections

and virulence

Answer 7

Virulence factor: capsule

Infection
- Soft tissue: most common in normal population
- Cellulitis
- Systemic disease in immunocompromised: endocarditis, septicemia, meningitis
- Aggressive skin infection fast after bite

Question 8

Brucella Basics

Shape, requirements, where, trans, animals

Answer 8

Shape: very small G- coccobacilli/rods
Requirements: strict aerobe, complex media, heme, CO2
Habitat: animals
Transmission: worldwide, eating raw milk/cheese, inhalation, direct contact, lab exposure
Animals
- B. abortus: cow
- B. melitensis: sheep/goat
- B. canis: dog
- B. suis: swine

Question 9

Brucella Risk Factors

For each animal

Answer 9

B. abortus: cow
- Almost all gone from the US
- Some from wild bison and elk

B. melitenis: goat/sheep
- Pretty much gone
- Infections from consuming unpasteurized dairy from countries where disease is present

B. canis: dog
- Close contact with breeders, vet staff that help with birthing

B. suis: swine
- Wild hog hunters at risk

Question 10

Brucella Virulence & Significance

Answer 10

Virulence: intracellular pathogen

Clinical: brucellosis, bioterrorism agent

Question 11

Bioterrorism Agents

3 categories

Answer 11

Category A
- Highest priority
- Easy transmission, person to person
- High mortality, public panic, special action required

Category B: Brucella
- Second highest priority
- Moderately easy to disseminate
- Moderate morbidity rates, low mortlity
- Specific enhancements of CDC capacity and surveillance

Category C
- Third highest priority
- Includes emerging pathogens that could be engineered for mass dissemination
- Availability, ease of production and dissemination
- Potential for high morbidity and mortality rate, major health impact

Question 12

Brucella Infection: Brucellosis

And animal types

Answer 12

Acute: 1-3 week after exposure
- Malaise, chills, sweats, weight loss, nonproductive cough
- Relapse can happen 3-6 months after therapy

B. abortus and canis: milder
B. suis: chronic, destructive lesions
B. melitensis: acute, severe, complications

Question 13

Francisella Tularensis Basics

Shape, requirements, where, trans

Answer 13

Shape: G- coccobacilli
Requirements: strict aerobe, complex media
Habitat: rodents, rabbits, beavers, ticks, North America, worldwide
Transmission: ingestion, handling carcasses, tick bites, infected animal bites

Question 14

Francisella Tularensis Virulence and Infections

Three infections

Answer 14

Virulence: intracellular, capsule

Ulceroglandular tularemia: painful papule at site of inoculation, ulcer

Oculoglandular tularemia: from the eye, painful conjunctivitis

Pneumonic tularemia: pneumonitis, sepsis, rapid development, high mortality

Question 15

Legionella Basics

Shape, requirement, where+survival, transmission, main species

Answer 15

Shape: pleomorphic, G- bacilli
Requirements: strict aerobe, require L-cysteine
Habitat and survival: aquatic, chlorine tolerance, can survive temperature, can survive in amoeba, biofilms
Transmission: inhale water, swallow water and into lungs, can also be in AC units in the air
Species: Legionella pneumophila

Question 16

Legionella Virulence and Infection

2 infections

Answer 16

Virulence: intracellular
Asymptomatic infections: can be common

Pontiac fever
- Quick incubation
- Non pneumonic form of legionellosis
- Self limited, lasts ~1 week

Legionnaires disease
- Atypical pneumonia
- 2-14 incubation
- Higher mortality

Question 17

Legionella Risk Factors

Answer 17

• 50 years or older
• Smoker (pneumonia)
• Men > women
• Immune system
• Chronic condition

Question 18

Bordatella Basics

Type, species, where, trans, clinical

Answer 18

Type: strict aerobe, fastidious, coccobacilli
Species: B. pertussis, parapertussis, bronchiseptica
Where: respiratory pathogens
- Pertussis, parapertussis = human host
- Bronchiseptica = birds and mammals

Transmission: person to person, aerosols
Clinical: coughs

Question 19

Bordatella Virulence

Answer 19

Pertussis toxin
- A and B subunits
- Inhibits recruitment of neutrophils and macros
- Then prolong inflammation by upregulating cyto/chemokines
- Causes tissue damage

Adenylate cyclase/hemolysis toxin: inhibits phagocytic killing and mono migration

Question 20

Bordatella Infection

3 stages

Answer 20

Whooping cough: caused by pertussis and parapertussis
Has three stages
1. Catarrhal: like a cold, peak of bacteria
2. Paroxysmal: whooping cough
3. Convalescent: decrease, maybe secondary complications

Question 21

Bartonella Basics

Type, species, where, trans, clinical

Answer 21

Type: rods, aerobic, fastidious
Species: B. quintana and henselae
Where: vectors
- quintana: human body louse
- henselae: cats and their fleas

Transmission: contaminated feces of human body louse, cat bites/scratches
Clinical: bacillary angiomatosis, trech fever, cat scratch disease

Question 22

Bartonella Infection: Trench Fever

caused by, symptoms

Answer 22

Caused by Bartonella quintana
Symptoms: bad headache, fever, weakness, long bone pain, “urban trench fever”
- Found in homeless, alcoholic, poverty, poor hygiene
- Trench soldiers in WWI

Question 23

Bartonella Infection: Cat Scratch

species, infection, comments

Answer 23

Caused by Bartonella henselae
Chronic regional lymphadenopathy
- Benign in children
- Mostly from kittens

Question 24

Bartonella Infection: Bacillary Angiomatosis

Answer 24

• Vascular proliferative
• Immunocompromised
• Skin, subcutaneous tissue, and bones
• Pts often infected with HIV
• Knots of capullaries, benign

Question 25

Streptobacillus Moniliformis Basics

Type, where, trans, clinical

Answer 25

Type: pleomorphic, beaded, long thin rods, aerobic fastidious
Where: nasopharynx of rats and rodents, animals that eat rats/rodents
Transmission: infected roden bites, contaminated food/water
Clinical: rat-bite fever, Haverhill fever

Question 26

Streptobacillus Moniliformis Infection

Answer 26

Rat bite fever/Haverhill fever
Symptoms: chills, fever, joint, pain, redness

Haverhill fever: only through food/water

Question 27

Treatment/Prevention

Answer 27

Vaccines: H. influenze type b, Brucella (animals), DTaP for Bordatella

Water management, insect repellent, food safety, antibiotics