9-4 Pseudomonas & Gram negative bacteria Flashcards Preview

M2 PATHO EXAM 3 > 9-4 Pseudomonas & Gram negative bacteria > Flashcards

Flashcards in 9-4 Pseudomonas & Gram negative bacteria Deck (17)
Loading flashcards...
1

A:L What type of pts acquire [Pseudomonas Aeruginosa] (4)? 

B: How is it incorporated into the normal flora

C: Where do [Pseudomonas Aeruginosa] typically occur? 

1. Burn patients
2. Cystic fibrosis patients
3. Patients with hematologic malignancies
4. Immunocompromised patients

B: Can be part of the microbial flora in
hospitalized patients and ambulatory,
immunocompromised hosts

C: Infections occur at any site where moisture tends to accumulate (external ear or indwelling catheters) 

2

Most common cause of VAP (Ventilator Associated PNA)

[PseudoMONAs Aeruginosa]

3

Describe [Pseudomonas Aeruginosa] 
EXOTOXIN A (3)

 

Exotoxin A

– Blocks protein synthesis like the [diphtheria toxin]
– Wound dermatonecrosis 
--Lung Tissue Damage 

4

Describe [Pseudomonas Aeruginosa] 
EXOTOXIN S (2)

Exoenzyme S (S for Spreading) 
– ADP-ribosylating toxin
–  Epithelial cell damage facilitates bacterial spread, tissue invasion and necrosis

5

Describe [Pseudomonas Aeruginosa] 
ELASTASE (3)

Elastase:
– Results in tissue destruction and [erythematous hemorrhagic lesions]---->  [ecthyma gangrenosum]

–  2 enzymes: Las A and Las B act synergistically to degrade elastin

– Degrades compliment components and inhibits neutrophil chemotaxis/function

6

A: What bacteria causes Melioidosis ? 

B: What is the habitat for this bacteria

C: Is this a Biothreat agent? 

A: Burkholderia Pseudomallei 

B: Soil and Water 20º north and south of equator (SE Asia)

 

C: CATEGORY B BIOTHREAT AGENT

7

Describe the 3 Different Types of Burkholderia ________ Melioidosis

[Burkholderia pseudomallei] Melioidosis:

1.  Acute Disease: septicemia with metastatic lesions. 95% mortality if untreated

2. SubAcute Disease: MOST COMMON. TB like pneumonia with cellulitis and lymphangitis

3. Chronic Disease: localized cellulitis. Treat with antibiotics BEFORE DRAINING otherwise pt will become bacteremic

8

What's the most common autosomal recessive genetic dz in Caucasians? 

CYSTIC FIBROSIS

(Requires TWO DYSFUNCTIONAL ALLELES to have Dz) 

9

A: Etiology for Cystic Fibrosis

B: Symptoms (5) 

C: What is [Pulmonary Exacerbation] (2) 

A: Gene mutation in CFTR (cystic fibrosis transmembrane regulator

B: "Cystic Fibrosis can cause PIINE and is associated with Serious Bronchial Problems"
º Pulmonary Exacerbation 

ºInternalization of bronchial bacteria FAILS 

ºINC inflammation

° Electrolyte transport abnormality---> [thick/sticky mucus accumulation]---> PERFECT NICHE for chronic lung infection

C: Pulmonary Exacerbation = 
-neutrophil recruitment with inappropriate elastase activity
-cytokine release

10

3 Main bacteria implicated in Cystic Fibrosis Infections

"Cystic Fibrosis can cause PIINE and is associated with Serious Bronchial Problems"

1.  Staph aureus

2. Burkholderia Cepacia complex

3.  Psuedomonas aeruginosa

11

3 Lab Characteristics of [Burkholderia Cepacia]

- Glucose NON-FERMENTER
-Yellow pigmented  
-SLOW oxidase-positive

12

[Stenotrophomonas maltophilia]

A: [Community Acquired] or [Hospital Acquired]

B: What's this bacteria 2nd leading cause of? 

C: What's the Hallmark for [Stenotrophomonas maltophilia]
 disease

D: Natural Habitat (3) 

Stenotrophomonas maltophilia :
A: [hospital acquired]

B: 2nd leading cause of [gram-negative nonfermentative bacillary infections]

C: Hallmark = life- threatening systemic infections in debilitated patients

D: 
ºWorldwide Distribution but is NOT APART OF OUR EXTERNAL FLORA
ºClinical sites 

° Respiratory Tract 

13

A: List the Opportunistic Infections [Stenotrophomonas maltophilia] can cause (5)

B: Oxidase negative or positive

C: Color? 

"Steno Maltophilia can cause a Wound BUMP"

1. Wound Infection

2. Bacteremia

3. UTI

4. Meningitis 

5. PNA

 

B: OXIDASE NEGATIVE and some strains have yellow pigment 

14

Tx for [Stenotrophomonas maltophilia]

1. Inherently resistant to ______ agents including ______ and ______

2. Drug of Choice

3. Alternates if someone is allergic (5) 

[Stenotrophomonas maltophilia]

1. Inherently RESISTANT to [beta lactam] and aminoglycoside agents 

2. ►USE BACTRIM for Tx***

3. Alternate: [ticarcillin/clavulanate], ceftazidime, Levofloxacin, Minocycline, tigecycline

"Use LMT-CT if BACTRIM isn't avail" 

15

 [Elizabethkingia meningoseptica] 

A: Disease (3)

B: Tx (4) 

C: Oxidase negative or positive

D: + or - growth on MacConkey Agar 

"Queen Elizabeth Probably BreastFed Neonates!" 

A:

1. Potential PNA in [intensive care adults] 

2. Breast Pumps are common cause of Nosocomial Outbreaks in hospital nurseries

3. Neonatal meningitis 
-------------------------------------------------------------------------------
B: Tx= (It is VERY RESISTANT to [beta lactam agents]) So you have to use a QBRIM for Tx: 
º Quinolones
º Bactrim
ºRifampin
° Minocycline 

C: OXIDASE PoSitive 

D: NO GROWTH on MacConkey Agar

16

What's the Most common [gram negative organism] carried on [hospital personnel skin]

B: This bacteria also colonizes many of what type of patients

C: Tx (4) 

Acinetobacter baumannii

B: inpatient tracheostomy

C: Tx = FICA
 -[Fluoroquinolone + (Amikacin or Ceftazidime) ] 

-Imipenem / Meropenem

-Colistin

-Ampicillin/Sulbactam

 

17

What's the Minimum Identification Criteria for [Acinetobacter baumannii]? (4) 

5 Minimum Identification Criteria: 

"You Need a COMB to identify Acinetobacter Baumannii "

1. Non-motile

2. Coccobaccilli 

3. Oxidase POSITIVE

4. MacConkey Agar growth 

5. Blood Agar Growth