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Microbiology > X - Gram-Negative Bacteria > Flashcards

X - Gram-Negative Bacteria Flashcards

1
Q

Gram (-) diplococci, encapsulated, ferments maltose and glucose, kidney bean-shaped, large polysaccharide capsule, oxidase (+) on chocolate agar

A

Neisseria meningitidis

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2
Q

Neisseria meningitidis: Location

A

upper respiratory tract, humans - only natural host

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3
Q

Neisseria meningitidis: Transmission

A

respiratory droplets, close quarters (military, dormitories, camps)

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4
Q

Neisseria meningitidis: Virulence factors

A

antiphagocytic polysaccharide capsule, endotoxin (LPS), IgA protease, complement deficiencies in the late-acting complement components (C5-C9)

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5
Q

Neisseria meningitidis: Diseases

A

meningitis, meningococcemia, Waterhouse-Friderichsen

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6
Q

Most common cause of meningitis among children 2-18 y.o.

A

Neisseria meningitidis

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7
Q

Fever, headache, stiff neck, increased level of PMNs in spinal fluid

A

Meningitis (Neisseria meningitidis)

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8
Q

Dissemination of meningococci into the bloodstream, multiorgan disease, consumptive coagulopathy, petechial or purpuric rash (purpura fulminans)

A

Meningococcemia

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9
Q

Most severe form of meningococcemia, high fever, shock, widespread purpura, disseminated intravascular coagulation, thrombocytopenia, adrenal insufficiency (bilateral hemorrhagic destruction of the adrenal glands)

A

Waterhouse-Friderichsen

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10
Q

Neisseria meningitidis: Treatment

A

Penicillin G, Ceftriaxone

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11
Q

Neisseria meningitidis: Prevention

A

capsular polysaccharide (A, C, Y, W-135) coupled to a carrier protein (diphtheria toxoid) to enhance immunogenicity, Rifampin chemoprophylaxis for close contacts

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12
Q

Gram (-) diplococci, ferments glucose only, kidney bean-shaped, insignificant capsule, oxidase (+) on Thayer-Martin medium

A

Neisseria gonorrhoeae

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13
Q

Neisseria gonorrhoeae: Location

A

genital tract

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14
Q

Neisseria gonorrhoeae: Transmission

A

sexual contact, passage through the birth canal

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15
Q

Neisseria gonorrhoeae: Virulence factors

A

pili, lipo-oligosaccharide (LOS), complement deficiencies in the late-acting complement components (C5-C9), usual co-infection with C. trachomatis

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16
Q

Neisseria gonorrhoeae: Localized

A

ophthalmia neonatorum, gonococcal urethritis, pelvic inflammatory disease

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17
Q

Neisseria gonorrhoeae: Disseminated

A

septic arthritis

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18
Q

Purulent conjunctivitis in newborns

A

Ophthalmia Neonatorum

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19
Q

Most common cause of urethritis

A

Neisseria gonorrhoeae

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20
Q

Urethritis and epididymitis in men

A

Gonococcal Urethritis

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21
Q

Most common cause of PID

A

Neisseria gonorrhoeae

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22
Q

Complications of PID

A

sterility, ectopic pregnancy, chronic pelvic pain dyspareunia, Fitz-Hugh-Curtis

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23
Q

Violin-string adhesions, complication of PID

A

Fitz-Hugh-Curtis

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24
Q

Most common cause of septic arthritis in sexually active adults

A

Neisseria gonorrhoeae

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25
Q

Arthritis, tenosynovitis, pustules on the skin

A

Septic Arthritis (Neisseria gonorrhoeae)

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26
Q

Neisseria gonorrhoeae: Treatment

A

Ceftriaxone + Doxycycline (C. trachomatis co-infection)

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27
Q

Neisseria gonorrhoeae: Prevention

A

barrier contraception, treat sexual partner, erythromycin ointment or silver nitrate to prevent conjunctivitis

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28
Q

Cause culture (-) subacute bacterial endocarditis in patients with pre-existing heart disease

A

Eikenella corrodens, Kingella kingae

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29
Q

HACEK Organisms

A

Haemophilus aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae

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30
Q

Gram (-) coccobacillary rods, enriched chocolate agar, polyribitol phosphate capsule, requires factor X (hemin) and V (NAD) for growth, satellite phenomenon around S. aureus

A

Haemophilus influenza type B

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31
Q

Haemophilus influenza type B: Location

A

upper respiratory tract

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32
Q

Haemophilus influenza type B: Transmission

A

respiratory droplets

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33
Q

Haemophilus influenza type B: Pathogenesis

A

type b (polyribitol phosphate), IgA protease, children 6-12 mos. (decline in maternal IgG and immature immune system)

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34
Q

Sinusitis, otitis media, pneumonia, meningitis, epiglottitis, COPD exacerbations

A

Haemophilus influenza type B

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35
Q

Most common cause of epiglottitis, cherry red epiglottis, thumb sign

A

Haemophilus influenza type B

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36
Q

Most common cause of COPD exacerbations

A

Haemophilus influenza type B

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37
Q

Laryngotracheobronchitis (Croup): Etiology

A

Parainfluenza Virus 1 & 2

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38
Q

Laryngotracheobronchitis (Croup): Radiographic Sign

A

Steeple Sign

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39
Q

Laryngotracheobronchitis (Croup): Treatment

A

Racemic Epinephrine

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40
Q

Haemophilus influenza type B: Treatment

A

Ceftriaxone

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41
Q

Haemophilus influenza type B: Prevention

A

HiB vaccine containing te type b capsular polysaccharide conjugated to diphtheria toxoid (2-18 mos.)

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42
Q

Gram (-) rods, Bordet-Gengou/Regan-Lowe agar, whooping cough

A

Bordatella pertussis

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43
Q

Bordatella pertussis: Location

A

upper respiratory tract

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44
Q

Bordatella pertussis: Transmission

A

respiratory droplets

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45
Q

Bacterial Croup: Etiology

A

Bordatella pertussis

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46
Q

Bordatella pertussis Virulence Factors: Mediates attachment

A

Filamentus Hemagglutinin

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47
Q

Bordatella pertussis Virulence Factors: Causes ADP-ribosylation and lymphocytosis

A

Pertussis Toxin - inactivates Gi (turns off the “off button”)

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48
Q

Bordatella pertussis Virulence Factors: Inhibits phagocytic activity

A

False Adenylate Cyclase

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49
Q

Bordatella pertussis Virulence Factors: Damages ciliated cells, causes whooping

A

Tracheal Cytotoxin

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50
Q

Paroxysmal pattern of hacking coughs, accompanied by production of copious amounts of mucus, cough ends with an inspiratory “whoop”

A

Pertussis (Tuspirina)

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51
Q

Pertussis: Incubation

A

7-10 days

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52
Q

Pertussis: Catarrhal Phase

A

1-2 weeks

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53
Q

Pertussis: Rhinorrhea, malaise, fever, sneezing, anorexia, best time for blood CS

A

Catarrhal Phase

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54
Q

Pertussis: Paroxysmal Phase

A

2-4 weeks

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55
Q

Pertussis: Repetitive cough with whoops, vomiting, leukocytosis

A

Paroxysmal Phase

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56
Q

Pertussis: Convalescent Phase

A

3-4 weeks

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57
Q

Pertussis: Diminished paroxysmal cough, development of secondary complications (pneumonia, seizures, encephalopathy)

A

Convalescent Phase

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58
Q

Bordatella pertussis: Treatment

A

Erythromycin

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59
Q

Bordatella pertussis: Prevention

A

acellular vaccine combination with diphtheria and tetanus toxoids (DTaP)

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60
Q

Gram (-) rods, poorly gram staining, silver stain, charcoal yeast agar (iron, cysteine), airconditioning, facultative intracellular bacteria, rapid urinary antigen test

A

Legionella pneumophila

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61
Q

Facultative Intracellular Bacteria

A

Salmonella, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia

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62
Q

Legionella pneumophila: Location

A

environmental water sources

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63
Q

Legionella pneumophila: Transmission

A

aerosol from water source (no human-to-human transmission)

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64
Q

Legionella pneumophila: Sole virulence factor

A

Endotoxin

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65
Q

Replicates intracellularly, eliminated by cell-mediated immunity, inhibits lysosomal fusion

A

Legionella pneumophila

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66
Q

Legionella pneumophila: Risk Factors

A

old age, smoking, high alcohol intake, immunosuppression

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67
Q

Pneumonia, confusion, non-bloody diarrhea, hyponatremia, proteinuria, hematuria

A

Atypical Pneumonia (Legionella pneumophila)

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68
Q

Mild, flu-like illness caused by Legionella pneumophila

A

Pontiac Fever

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69
Q

Legionella pneumophila: Treatment

A

Azithromycin, Erythromycin

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70
Q

Legionella pneumophila: Prevention

A

reduce cigarette and alcohol consumption, eliminate aerosols from water sources, high temperatures and hyperchlorination of hospital water supply

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71
Q

Facultative gram (-) rods, lactose fermenter on EMB or MacConkey’s agar, green sheen on EMB agar (metallic sheen), acid slant and acid butt on TSI without H2S, typing by O and H antigens

A

Escherichia coli

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72
Q

Lactose fermenters

A

Citrobacter, Klebsiella, Escherichia coli, Enterobacter

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73
Q

Escherichia coli: Location

A

colon, vagina, urethra

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74
Q

Escherichia coli: Transmission

A

ascending UTI, neonatal meningitis, fecal-oral

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75
Q

Escherichia coli: Virulence Factors

A

pili, flagellum (H), capsule (K), endotoxin (O), enterotoxins - HST & HLT (watery diarrhea), verotoxin (Shiga-like) bloody diarrhea in HUS

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76
Q

Enterobacteriaceae

A

Morganella, Escherichia, Shigella, Salmonella, Yersinia, Serratia, Proteus, Enterobacter, Citrobacter, Klebsiella

77
Q

Enterobacteria: Features

A

capsular antigen (K), O antigen, flagellar antigen (H), ferments glucose

78
Q

Most common cause of community acquired UTI

A

Escherichia coli

79
Q

2nd most common cause of neonatal meningitis worldwide, most common cause in the Philippines

A

Escherichia coli

80
Q

Causes of Neonatal Meningitis

A

B group Streptococci (S. agalactiae), Escherichia coli, Listeria monocytogenes

81
Q

Escherichia coli: Watery diarrhea, traveller’s diarrhea, Montezuma’s Revenge, Delhi Belly

A

Enterotoxigenic (ETEC)

82
Q

Escherichia coli: Watery diarrhea of long duration, mostly infants (Pedia), often in developing countries (Philippines)

A

Enteropathogenic (EPEC)

83
Q

Escherichia coli: Bloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome (HUS)

A

Enterohemorrhagic (EHEC), O157:H7

84
Q

Escherichia coli: Bloody diarrhea, utilize adhesin proteins to bind to and enter intestinal cells

A

Enteroinvasive (EIEC)

85
Q

Escherichia coli: Persistent watery diarrhea in children, HIV patients (AIDS)

A

Enteroadherent (EAEC)

86
Q

Escherichia coli: Treatment

A

Ampicillin or Sulfonamides for UTI (Quinolones in the Philippines), 3rd gen. Cephalosporins for meningitis and sepsis, rehydration for Traveller’s Diarrhea

87
Q

Escherichia coli: Prevention

A

limiting urinary catheterization, switching IV lines promptly, boiling water

88
Q

Non-lactose fermenting facultative gram (-) rods, motile, oxidase (-), H2S producer, Widal test detects antibodies, XLD medium (xylose-lysine-deoxycholate agar)

A

Salmonella

89
Q

Salmonella: Location

A

colon (S. typhi), enteric tract of humans and animals (S. enteritidis)

90
Q

Salmonella: Transmission

A

fecal-oral

91
Q

Salmonella: Enterocolitis

A

S. enteritidis/S. typhimurium

92
Q

Salmonella: Typhoid Fever

A

S. typhi

93
Q

Salmonella: Septicemia

A

S. choleraesuis

94
Q

Invasion of the epithelial and subepithelial tissue of SI and LI, high infectious dose, gastrectomy and antacids lower infectious dose

A

Enterocolitis (S. enteritidis/S. typhimurium)

95
Q

Due to Vi capsular antigen, organisms enter, multiply in Peyer’s patches, spread to reticulo-endothelial system, predilection for invasion of the gallbladder (chronic carrier state)

A

Typhoid Fever (S. typhi)

96
Q

Bacteremia results in the seeding of many organs, osteomyelitis, pneumonia, meningitis, sickle cell anemia

A

Septicemia (S. choleraesuis)

97
Q

Salmonella Enterocolitis: Incubation Period

A

12-48 hours

98
Q

Typhoid Fever: Incubation Period

A

5-21 days

99
Q

Salmonella: Nausea, vomiting, abdominal pain, non-bloody diarrhea

A

Enterocolitis

100
Q

Salmonella: Fever, little or no enterocolitis, focal symptoms (bone, lungs, meninges)

A

Septicemia

101
Q

Typhoid Fever Findings: Week 1

A

stepwise fever, anorexia, malaise, relative bradycardia, bacteremia

102
Q

Typhoid Fever Findings: Week 2

A

abdominal pain, bloating, constipation, rose spots (salmon papules), hepatosplenomegaly, jaundice

103
Q

Typhoid Fever Findings: Week 3

A

bleeding, ileitis, pneumonia

104
Q

Typhoid Fever Findings: Week 4

A

recovery or death

105
Q

Typhoid Fever Culture: Week 1

A

blood, bone marrow

106
Q

Typhoid Fever Culture: Week 2

A

urine, rose spots, bone marrow

107
Q

Typhoid Fever Culture: Week 3

A

stool, bone marrow

108
Q

Typhoid Fever Culture: Week 4

A

bone marrow

109
Q

Typhoid Fever Culture: Chronic Carrier

A

bile, stool, bone marrow

110
Q

Salmonella: Treatment

A

Ceftriaxone, Ciprofloxacin

111
Q

Salmonella: Treatment in the Philippines

A

Amoxicillin, Chloramphenicol, Cotrimoxazole

112
Q

Salmonella: Treatment for Gallbladder Infection

A

Ampicillin - enterohepatic recycling

113
Q

Salmonella: Prevention

A

public health measures - sewage disposal, chlorination, hand washing, food safety, S. typhi vaccine

114
Q

Non-lactose fermenting gram (-) rods, non-motile, oxidase (-), H2S non-producer, O antigen, XLD medium (xylose-lysine-deoxycholate agar)

A

Shigella

115
Q

Shigella: Location

A

colon

116
Q

Shigella: Transmission

A

food, fingers, feces, flies

117
Q

Invades the distal ileum and colon, low infectious dose (highly infectious), locally accompanied by ulceration, enterotoxin (Shiga toxin)

A

Shigella

118
Q

Most common cause of bacillary dysentery

A

Shigella sonnei (Duval’s bacillus)

119
Q

Most severe form of bacillary dysentery, most common cause of epidemic dysentery

A

Shigella dysenteriae Type 1 (Shiga bacillus)

120
Q

Group A - Shigella dysenteriae Type 1

A

Shiga bacillus

121
Q

Group A - Shigella dysenteriae Type 2

A

Schmitz bacillus

122
Q

Group B - Shigella flexneri

A

Flexner’s / Hiss and Russell’s bacillus

123
Q

Group C - Shigella boydii

A

Newcastle Manchester bacillus

124
Q

Group D - Shigella sonnei

A

Duval’s bacillus

125
Q

Incubation period of 1-4 days, fever, abdominal cramps, diarrhea (watery to bloody) resolving in 2-3 days

A

Bacillary Dysentery

126
Q

Shigella: Treatment

A

fluid and electrolyte replacement, Ciprofloxacin for severe cases

127
Q

Shigella: Prevention

A

public health measures - sewage disposal, chlorination, hand washing, food safety

128
Q

Gram (-) rods, comma-shaped, motile, oxidase (+), shooting star, marine organism, thisulfate citrate bile salts sucrose (TCBS) agar, high infectious dose

A

Vibrio

129
Q

Vibrio: Location

A

colon (V. cholerae), saltwater (V. parahemolyticus, V. vulnificus)

130
Q

Vibrio: Transmission

A

fecal-oral (V. cholerae), contaminated raw seafood (V. parahemolyticus), trauma to skin, shellfish handlers, ingestion of raw shellfish (V. vulnificus)

131
Q

Vibrio Virulence Factors: Acts by ADP-ribosylation

A

Enterotoxin (Choleragen) - activates Gs (turns on the “on button”)

132
Q

Vibrio Virulence Factors: Enhances attachment to the intestinal mucosa

A

Mucinase

133
Q

Vibrio: Pandemics

A

Vibrio cholerae O1 biotype El Tor (Cholera El Tor)

134
Q

Watery diarrhea in large volumes (rice-water stools), cardiac and renal failure, non-gap acidosis, hypokalemia

A

Cholera (V. cholerae)

135
Q

Self-limited with an explosive onset of watery diarrhea, nausea, vomiting, abdominal cramps, headache, low-grade fever

A

Gastroenteritis (V. parahemolyticus, V. vulnificus)

136
Q

Wound infections associated with exposure to contaminated water

A

V. parahemolyticus, V. vulnificus

137
Q

Vibrio: Treatment

A

cholera - fluid and electrolyte replacement, Tetracycline/Azithromycin shortens duration, V. parahemolyticus/V. vulnificus - Minocycline + Fluoroquinolone/Cefotaxime

138
Q

Vibrio: Prevention

A

public health sanitation, cholera vaccine - short-term immunity, herd immunity

139
Q

Gram (-) rods, comma-shaped, microaerophilic, Skirrow’s agar (42°C), Campy medium (antibiotics)

A

Campylobacter jejuni

140
Q

Campylobacter jejuni: Location

A

human and animal feces

141
Q

Campylobacter jejuni: Transmission

A

fecal-oral

142
Q

Most common cause of bacterial gastroenteritis

A

Campylobacter jejuni

143
Q

Possibly enterotoxin-mediated diarrhea, invades mucosa of the colon but does not penetrate, sepsis rarely occurs, histologic damage to the mucosal surfaces of the jejunum

A

Campylobacter jejuni

144
Q

Watery, foul-smelling diarrhea followed by bloody stools accompanied by fever and severe abdominal pain, from undercooked chicken

A

Campylobacter jejuni

145
Q

Campylobacter jejuni: Antigenic cross-reactivity between oligosaccharides in bacterial capsule and glycosphingolipids on surface of neural tissues

A

Guillain–Barré Syndrome (GBS)

146
Q

Campylobacter jejuni: Reactive Arthritis

A

Reiter’s Syndrome

147
Q

Campylobacter jejuni: Treatment

A

symptomatic, Erythromycin for severe cases

148
Q

Campylobacter jejuni: Prevention

A

public health measures

149
Q

Gram (-) rods, curved, comma-shaped, urease (+), microaerophilic

A

Helicobacter pylori

150
Q

Urease (+) Bacteria

A

Proteus mirabilis, Klebsiella pneumoniae, Helicobacter pylori, Ureaplasma urealyticum

151
Q

Helicobacter pylori: Location

A

stomach

152
Q

Helicobacter pylori: Transmission

A

ingestion

153
Q

Damages goblet cells of the gastric mucosa, production of large amounts of ammonia from urea by the organism’s urease, ammonia neutralizes stomach acid

A

Helicobacter pylori

154
Q

Helicobacter pylori: Diagnosis

A

EGD with biopsy, urease breath test, H. pylori stool antigen

155
Q

Recurrent pain in the upper abdomen, frequently accompanied by bleeding into the GIT

A

Peptic Ulcer Disease

156
Q

Helicobacter pylori: Disease Associations

A

gastric CA, MALT lymphomas

157
Q

Helicobacter pylori: Triple Therapy

A

Bismuth salicylate + Metronidazole + Tetracycline, Ranitidine bismuth citrate + Tetracycline + Clarithromycin or Metronidazole, Omeprazole or Lansoprazole + Clarithromycin + Metronidazole or Amoxicillin

158
Q

Helicobacter pylori: Quadruple Therapy

A

Omeprazole or Lansoprazole + Bismuth salicylate + Metronidazole + Tetracycline

159
Q

Facultative gram (-) rods, lactose fermenter, urease (+), extended spectrum beta-lactamase (ESBL), large polysaccharide capsule

A

Klebsiella pneumoniae

160
Q

Klebsiella pneumoniae: Location

A

upper respiratory tract, GIT

161
Q

Klebsiella pneumoniae: Transmission

A

aspiration, inhalation, ascending spread of fecal flora

162
Q

Klebsiella pneumoniae: Diseases

A

Necrotizing Pneumonia, UTI

163
Q

Thick, bloody sputum (currant jelly), usually nosocomial

A

Necrotizing Pneumonia (Klebsiella pneumoniae)

164
Q

Most common cause of pneumonia in alcoholics

A

Klebsiella pneumoniae

165
Q

Klebsiella pneumoniae: Treatment

A

culture-guided, Cephalosporins ± Aminoglycosides

166
Q

Non-lactose fermenting gram (-) rods, swarming, oxidase (-) H2S producer, urease (+), facultative

A

Proteus mirabilis

167
Q

Urease hydrolyzes the urea in urine to form ammonia, raises pH producing alkaline urine, encourages the formation of struvite stones (magnesium-ammonium-phosphate)

A

Proteus mirabilis

168
Q

UTI associated with nephrolithiasis, staghorn calculi form on renal calyces

A

Complicated UTI (Proteus mirabilis)

169
Q

Proteus mirabilis: Treatment

A

TMP, Ampicillin, Quinolones (Philippines), surgery for large stones

170
Q

Non-lactose fermenting gram (-) rods, oxidase (+), H2S non-producer, obligate aerobes, pyocyanin (blue-green), sweet grape-like odor, Cetrimide agar

A

Pseudomonas aeruginosa

171
Q

Pseudomonas aeruginosa: Location

A

environmental water sources (hospital respirators and humidifiers, “sterile” fluids), skin, upper respiratory tract, colon (10%)

172
Q

Pseudomonas aeruginosa: Transmission

A

water aerosols, aspiration, fecal contamination

173
Q

Pseudomonas aeruginosa: Virulence Factors

A

endotoxin, exotoxin A, elastase, proteases, pyocyanin, verdoglobin

174
Q

Pseudomonas aeruginosa Virulence Factors: Tissue necrosis, inactivates EF-2, type III secretion system facilitates exotoxin transfer

A

Exotoxin A

175
Q

Pseudomonas aeruginosa Virulence Factors: Damages the cilia and mucosal cells

A

Pyocyanin

176
Q

Pseudomonas aeruginosa Virulence Factors: Hemoglobin breakdown

A

Verdoglobin

177
Q

Burn wound infections, hot tub folliculitis, skin graft loss, green nail syndrome, puncture wound osteomyelitis, pubic osteomyelitis (IV drug abusers), otitis externa (malignant in diabetics), chronic suppurative otitis media

A

Pseudomonas aeruginosa

178
Q

Most common cause of otitis externa (malignant in diabetics), chronic suppurative otitis media

A

Pseudomonas aeruginosa

179
Q

VAP, high-risk CAP, bronchiectasis, cystic fibrosis, typhitis (necrotizing enterocolitis), Shanghai fever (milder form of typhoid), peritonitis (peritoneal dialysis), UTI

A

Pseudomonas aeruginosa

180
Q

3rd most common cause of nosocomial UTIs

A

Pseudomonas aeruginosa

181
Q

Pseudomonas aeruginosa Sepsis: Hemorrhagic lesions

A

ecthyma gangrenosum

182
Q

Pseudomonas aeruginosa Sepsis: Leukemia or lymphoma post chemo- or radiation therapy, severe burns

A

febrile neutropenia

183
Q

Pseudomonas aeruginosa: Treatment Combinations

A

Ceftazidime + Amikacin, Piperacillin + Amikacin, Azlocillin + Ciprofloxacin

184
Q

Pseudomonas aeruginosa: Treatment for refractory cases

A

Rifampin

185
Q

Pseudomonas aeruginosa: Prevention

A

disinfection of water-related equipment, hand washing, prompt removal of catheters

186
Q

Gram (-) rods, predominant anaerobe of the human colon, bowel trauma, perforation or surgery

A

Bacteroides fragilis

187
Q

Infections commonly due to combinations of bacteria in synergistic pathogenicity, LPS with low endotoxic activity, capsule (antiphagocytic and anticomplement), foul-smelling discharge, short-chain FA products

A

Bacteroides fragilis

188
Q

Bacteroides fragilis: Diseases

A

abdominal and cerebral abscesses, peritonitis

189
Q

Bacteroides fragilis: Treatment

A

Metronidazole, Clindamycin, Cefoxitin, surgical drainage of abscess

Microbiology (17 decks)

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