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Microbiology > Bacterial Pneumonias 1 > Flashcards

Bacterial Pneumonias 1 Flashcards

1
Q

What are 4 causitive agents of typical pneumonia?

A

S. Pneumo, H. Flu, K. Pneumoniae, S. Aureus

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2
Q

What are the three zoonotic pathogens of atypical pneumonia?

A

Chlamydia psittaci, francisella tularensis, coxiella burnetti

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3
Q

What are the three non-zoonotic pathogens of atypical pneumonia?

A

Chlamydia pneumoniae, mycoplasma pneumoniae, legionella pneumoniae

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4
Q

How does the typical bacterial pneumonia present?

A

Sudden onset, appears sick, higher fever (over 103), Chills and shaking, productive cough, frequent pleurisy, well-defined consolidation on a CXR, SOB

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5
Q

How does the atypical bacterial pneumonia present?

A

Gradual onset, appear well, lower fever (less than 103), Patchy infiltrates, non-productive cough, patchy infiltrates (diffuse), body aches, diarrhea, abdominal pain

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6
Q

What are the characteristics of S. Pneumo?

A

Gram positive lancet shaped diplococcus
alpha hemolytic
optochin sensitive
encapsulated=virulent

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7
Q

What is the major reservoir for s. pneumo?

A

asymptomatic carriers due to normal flora

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8
Q

What is the major virulence factor for s. pneumo, what is it the basis for, and how does it have its action?

A

The capsule, basis for serotyping and anti-pneumococcal vaccines, inhibits phagocytosis which interferes with complement activity by preventing opsonization of the bacteria by C3b

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9
Q

What are two virulence factors utilized by s. pneumo to enhance protection?

A

IgA protease, hydrogen peroxide (apoptosis in host cells and elimination of competing bacteria)

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10
Q

What are the two virulence factors that contribute to the binding capacity of s pneumo?

A

Pili (activate production of large quantities of TNF and help colonize UR tract) and surface proteins (choline binding proteins)

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11
Q

What is the role of peptidoglycan-teichoic acid complex in producing virulence for s. pneumo?

A

it is a potent immune modulator so it illicits a significant immune response

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12
Q

What is the virulence factor of s pneumo that activates complement by forming transmembrane pores?

A

Pneumolysin

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13
Q

What effect do neuraminidase and hyaluronidase have on s pneumo virulence?

A

They chew away tissue matrix to embed itself into the tissue to get away from abx

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14
Q

What is autolysin released in response to? What does it do as a virulence factor for s pneumo?

A

in response to abx tx and stationary phase as an attempt to dampen the host immune response by causing lysis of pneumococcus and release of pneumolysis and host cell apoptosis

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15
Q

What is a way to presumptively ID s. pneumo?

A

optochin sensitivity

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16
Q

What is a way to confirm s. pneumo?

A

bile solubility– bile will lyse s. pneumo but not other alpha hemolytic strep

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17
Q

What is used to observe s. pneumo capsules?

A

A Quellung reaction (agglutination test)

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18
Q

What is the name of the test that looks for s pneumo specific rRNA and is quick, accurate, and relatively inexpensive?

A

Genetic probe test

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19
Q

What is the DOC for s. pneumo?

A

PCN G, but it is becoming increasingly resistant so may have to replace with vancomycin and watch blood levels

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20
Q

What population is the 23-valent s. pneumo vaccine indicated for?

A

65+ and persons with predisposing factors

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21
Q

What population is the 13-valent s. pneumo vaccine used for?

A

children 6 years and under, it includes 75% of strains of penicillin-resistant s. pneumo

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22
Q

You find a non-motile, gram negative bacillus with a thick slimy capsule. What is it most likely to be and what populations should you watch out for it in?

A

Klebsiella pneumoniae,

ALCOHOLICS, DM, and homeless population

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23
Q

Where is Klebsiella found?

A

It is considered normal intestinal flora, but is important cause of nosocomial infections

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24
Q

What is the primary virulence factor for Klebsiella pneumo?

A

polysaccharide capsule which prevents MAC-mediated lysis

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25
Q

What is another virulence factor of klebsiella? What does it help to do?

A

adhesins, which are receptor specific and either fimbrial or non-fimbrial; once patient aspirates, it helps cause aggressive necrotizing CAP with lots of blood and severe illness with rapid onset.

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26
Q

What is the CP of Klebsiella? What is the outcome?

A

Acute onset of high fever and a productive cough with a thick, blood tinged, CURRENT JELLY sputum, often absess formation, cavitation, and pleuritic chest pain; Often fatal, even with antibiotic treatment

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27
Q

What is the treatment for Klebsiella?

A

AG+3rd gen. cephalosporin+fluoroquinolone

28
Q

What organism is the smallest of free-living bacteria, lacks cell walls, stains poorly, creates a “fried egg” appearance in culture, and is pleomorphic in shape?

A

Mycoplama pneumo

29
Q

What is the CP of mycoplasma pneumo?

A

non-productive cough that lasts 1-2 months, fever, crackles, headache, and chest pain, RELAPSE IS COMMON

30
Q

What allows mycoplasma pneumo to go undetected? What is one other virulence factor?

A

Sterol appears like host membrane, H2O2 production

31
Q

What is the target population of mycoplasma pneumoniae?

A

Ages 5-20

32
Q

What is unique about the colonies of sputum culture from mycoplasma?

A

They are mulberry colored

33
Q

What test is used to detect mycoplasma antibodies that bind to the I antigen on the surface of RBCs at 4 degrees C?

A

Cold agglutinin assay

34
Q

What is the DOC for mycoplasma?

A

Azithromycin/tetracycline

35
Q

you have a tiny, non-motile, coccoid shaped bacteria that must exist as an intracellular parasite. It is gram negative. What is it?

A

Chlamydophila pneumo

36
Q

What are the two forms of Chlamydophila pneumo?

A 
Elementary bodies (EB)= infectious form
Reticulate bodies (RB)=intracellular form (EB--RB--EB---RELEASE)
37
Q

What is the CP of chlamydophilia?

A

persistent, non-productive cough and malaise, usually unilateral lower lobe involvement

38
Q

What age group is most affected by chlamydophilia pneumo?

A

age 60+

39
Q

What two causitive agents of atypical pneumonia will not produce very long lasting immunity?

A

Mycoplama and chlamydophilia

40
Q

How long does Chlamydophilia infection last for?

A

weeks to months

41
Q

What bacterium contains LOS in cell wall?

A

H. flu

42
Q

Where is nontypeable H. Flu found?

A

In normal flora, in debilitated hosts such as asthma, COPD, smoking, immunocompromised pts

43
Q

What are the virulence factors of H flu?

A

PRP to resist phagocytosis by PMN, NA and IgA protease, LOS layer

44
Q

What type of H flu causes infection and disease?

A

Non-typeable (non capsular) due to an imbalance. They contain adhesins to bind mucins in respiratory tract

45
Q

What does LOS cause in the host cell?

A

Loss of cilia, inflammation, and sloughing off of damaged cells

46
Q

What type of agar is H Flu grown on?

A

Chocolate Agar

47
Q

What is the name of the phenomenon where blood agar can grow H flu?

A

Satellite pneomenon

48
Q

After chocolate agar growth, what other tests on H Flu will be positive?

A

Catalase and oxidase, then more serology to determine if capsule is present

49
Q

What is the LAT, what is it used to detect, and why is it beneficial?

A

Latex Particle Agglutination test, H Flu capsule, you don’t need viable bacterium, just antigen!

50
Q

Pertaining to Legionella, which species causes 90% of human infections? What serogroup?

A

Pneumophilia, serogroup 1

51
Q

You have a thin, pleomorphic, gram-negative bacillus with fimbriae, a single, polar flagellum, and long strands. What is it most likely?

A

Legionella pneumophila

52
Q

What tests are positive in legionella pneumophila?

A

B lactamase producer, catalase, and oxidase

53
Q

How does infection by legionella occur?

A

Through aerosol inhalation, opsonization with C3b, phagocytosis, then survival intracellularly by inhibiting PHAGOLYSOSOME FUSION. Replication inside phagosome, then the host cell is killed and toxic enxymes are released

54
Q

What is the CP of Pontiac Fever and which microbe causes it?

A

Fever, chills, malaise, myalgia, HA, NO SIGN OF PNEUMONIA, self limited, usually does not need treatment, caused by Legionella

55
Q

What is the CP of Legionnaires’ Disease caused by Legionella?

A

A SEVERE, ACUTE, ATYPICAL PNEUMONIA with a high no tx mortality rate. Fever, chills, dry/nonproductive cough, HA, GI AND NEURO COMMON.

56
Q

What type of pneumonia results from Legionnaires’ disease?

A

Acute, fibropurulent, necrotizing pneumonia which quickly restricts airfow

57
Q

You take a shower in a locker room of a football stadium in Illinois and now you are really sick. What agent caused it and where does it replicate?

A

Legionella pneumophilia, in protozoans, is then transmitted through aerosols SPORADICALLY

58
Q

What pneumonia should anyone with compromise in pulmonary and/or immune function be exceptionally at risk for?

A

Legionella

59
Q

What is the gold standard of diagnosis for legionella? What is another type of test used to check for antigen?

A

Buffered Charcoal Yeast Extract (BCYE); EIA urine antigen test

60
Q

You identify a gram negative, motile bacillus that is blue tinged. What is it most likely?

A

Pseudomonas

61
Q

What are the key virulence factors of pseudomonas and how do they make their impact?

A

Pyocyanin=ROS production for apoptosis
Exotoxin A=ciliastasis and immune suppression
Elastases A&B=destroys lung tissue
Alginate: mucoid polysaccharide to inhibit mucociliary escalator and form a glycocalyx
LPS=endotoxin to produce shock, DIC, etc

62
Q

How is pseudomonas transmitted?

A

Via fomites (plants, fruits, hands)

63
Q

What is the most common cause of death of CF patients? What is the second leading cause of infection in burn patients? What makes it so virulent?

A

PSEUDOMONAS, A significant break in normal defense

64
Q

What type of media supports growth of pseudomonas? What will it produce?

A

BAP & MacConkey; blue-green pigment +/- fluorescence, “fruity smell”

65
Q

What is the treatment of pseudomonas NP? What should be avoided??

A

4th generation cephalosporin (cefepime)+ Levofloxacin. BROAD SPECTRUM SHOULD BE AVOIDED!

Microbiology (14 decks)

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