Bacterial 1 Gram (-)

Question 1

Three Bacterials

Answer 1

Pseudomonas

Bordetella

Legionella

Question 2

Tricks of Pseudomonas aeruginosa

Answer 2

Biofilms
Efflux pumps
Type III secretion systems
Antibiotic resistance

Question 3

Pseudomonad Transmission

Answer 3

An opportunist; only causes disease when:
Body is weakened:
-Iatrogenic breaches
-Immunocompromisation
-Cystic fibrosis, burns
Excessive exposure

Question 4

Pseudomonad Symptoms

Answer 4

Depends on:
-Host’s health
-Exposure route
-Length/“volume” of exposure
Most common problems:
-Bronchopneumonia
-Skin infections (otitis externa aka swimmer’s ear, “hot tub” folliculitis)

Question 5

Pseudomonad Treatment

Answer 5

Some cases self-resolving

Antibiotics: choice differs by disease:

• Aminoglycosides
• Cephalosporins
• Many others

Question 6

Pseudomonad Prevention & Control

Answer 6

-Remove swimwear quickly; shower well
-Keep water clean
-For SE: ear drops of alcohol and vinegar
For burns:
-Silver sulfadiazine, topical
-Debridement

Vaccines: many attempts, poor results

Question 7

What B. pertussis Does to Tracheal Cells

Answer 7

• Trachael cytotoxin
• Cells get “gummed up”
• Mucus can’t be cleared

Question 8

Pertussis Transmission

Answer 8

Humans are only host

Highly contagious

Respiratory secretions

• Directly (aerosolized form)
• Indirectly (fomites)

Sometimes asymptomatic vectors

Question 9

Symptoms of Pertussis in Stages

Answer 9

Catarrhal: Cold-Like Symptoms, Dry cough

Paroxysmal: Violent coughing fits, “Whoop” afterwards, Vomiting after fits, Bleeding (petechiae)

Convalescent: Cough wanes

Question 10

Pertussis Treatment

Answer 10

For the bacteria: Macrolides

For the patient:

• Cough-suppressive therapies
• Suctioning
• Oxygen
• Nutrition, hydration therapies

Question 11

Pertussis Prevention & Control

Answer 11

• Immunity fades with age
• Prophylactic antibiotics to suspected cases
• Vaccines

Question 12

Environment of Legionella pneumophila

Answer 12

Lives in aquatic or moist environments

Question 13

History of Legionnaire’s Disease

Answer 13

1965: St. Elizabeth’s Hospital (Washington DC)
1968: Pontiac, MI County Health Department
1976: American Legion Convention in Philadelphia, PA

Question 14

Legionnaires’ Disease Transmission

Answer 14

Aerosolization of contaminated water

Aerosolization of contaminated dirt (rarer)

No person-to-person spread

Question 15

Legionnaires’ Disease Symptoms

Answer 15

Legionnaire’s Disease: Pneumonia

Pontiac Fever: Influenza like, Muscle aches

Question 16

Legionnaires’ Disease Treatment

Answer 16

Effectiveness is related to speed of administration

Antibiotics:

• Macrolides
• Fluoroquinolones

Side effects may linger for up to a year

Immunity is for life

Question 17

Legionnaires’ DiseasePrevention & Control

Answer 17

Chlorination of water sources

Cleaning sources

Maintenance of clean medical facilities (nosocomial cases in the elderly)