other infections caused by bacillus cereus eye infections - penetration by objects ... - 3 toxins implicated are: IV .... infections bacteraemia and me... - immun.... Endocarditis - IV drug ....

penetration of objects contaminated by soil 3 toxins implicated - a heat labile entertoxin - a haemolysin (Cereolysin) - phopholipase C IV catheter infection bactermia and meningitis - immunocomprimised Endocarditis - IV drug abusers

BACILLUS AND CLOSTRIDIA Flashcards by Caleb hansen

gram positive spore forming rods

Spore forming bacteria of the family …

two clinically important genera:

Number of species of Bacillus and is what types of pathogen with names

Bacillaceae

Bacillus

Clostridia

51 species of which only one is a strict pathogen. B anthracis

B,cereus is an opportunistic

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Bacillus sp.

Respires in what ways

Most species are what 2 things

Soil ….

spore formation in…..

aerobic of facultatively anaerobic

varied motitily
catalase positive

oragnisms

B.anthracis
B.cereus

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B.anthracis

charcoal …..

large organisms of what size

motile?

Charcoal carbuncle

1x3-5um.

non motile

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B.anthracis.

single or paired…. bacilli in …. specimens

Single or paired bacilli in clinical specimens.

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B.anthracis

Long serpentine chains in culture

gluta……
poly….
a to….

Glutamic acid capsule
Polysaccharide cell wall antigen
A toxin.

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B.anthracis

Anthrax….

3 antigenically distinct, heat labile components:

The combination of protective antigen and either of the other two is

anthrax toxin

protective antigen
lethal factor
oedema factor

the combination of protective antigen and either of the other two is toxic.

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B. anthracis

Virulence factors:

toxin can be

Anthrax is primarily an

Human disease occurs through exposure to

Causes serious problems in countries without

Virulence factors:
Toxin
Capsule.

Toxin can be lethal.

Anthrax is primarily an animal disease.

contaminated animals or their products.

vaccination

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anthrax in humans

Inoculation

what percentage of infection in humans

spores enter …

spores germinate and cause

Cause of 95% human infection

Spores enter exposed skin from soil or infected animal products eg.
Hides
Goat hair
Wool.

Spores germinate and cause cutaneous anthrax

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Anthrax in Humans.

Inhalation

name of disease

bacterial growth in the lung leads to

now very rare in

Inhalation of spores which enter …. and ……

Wool-sorters disease

Bacterial growth in the lung leads to:
Pulmonary oedema
Bacteraemia
Death.

Now very rare in developed countries

Inhalation of spores which enter alveolar macrophages and germinate.

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Anthrax in Humans.

Ingestion

Gastrointestinal disease is …… in humans

common in …..

bacilli excreted in what 3 things

Gastrointestinal disease is rare in humans

Common in herbivores.

Bacilli excreted in faeces urine and saliva.

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Bacillus cereus

what type of pathogen

what coloured

what 3 causes

gastroenteritis
eye infections
IV catheter related sepsis

Gastroenteritis mediated by one of two enterotoxins:

….. toxin
…. toxin

Opportunist pathogen.

‘cereus’ wax coloured.

Causes:
Gastroenteritis
Eye infections
IV catheter related sepsis.

Gastroenteritis mediated by one of two enterotoxins :
Emetic toxin.
Diarrhoeal toxin

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Bacillus cereus food poisoning

Emetic form

caused by … toxin
caused by reheating … and how

how many hrs incubation period after ingestion and the symptoms

duration

Caused by heat stable toxin.

Caused by eating reheated contaminated rice.
When heat resistant spores survive and germinate if the rice is not refrigerated.

1-6 hrs incubation period after ingestion of rice.
Vomiting
Nausea
Abdominal cramps.

Short duration, < 24 hours.

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Diarrhoeal form

heat labile toxin similar to … and ….

stimulates …. cyclase - ….. system in intestinal …. cells

consumption of ….., …… or …..

longer …. period

dia. ..
nau. ..
adom. …

lasts ….

Diarrhoeal form.
Heat labile toxin similar to E.coli and V.cholera.

Stimulates adenylate cyclase -cyclic AMP system in intestinal epithelial cells.

Consumption of contaminated meat, vegetables or sauces. 
Longer incubation period. 
Diarrhoea
Nausea 
Abdominal cramps

Lasts >24 hours.

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other infections caused by bacillus cereus

eye infections

penetration by objects …
3 toxins implicated are:

IV …. infections

bacteraemia and me…
- immun….

Endocarditis
- IV drug ….

penetration of objects contaminated by soil

3 toxins implicated

a heat labile entertoxin
a haemolysin (Cereolysin)
phopholipase C

IV catheter infection

bactermia and meningitis
- immunocomprimised

Endocarditis
- IV drug abusers

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Clostridium

Anaerobic or aerobic?

…. forming
gram…. bacilli

what natural and in living things are they in

Many are harmless …..

others are the caused of human disease, name 6

Anaerobic
Spore forming
Gram positive bacilli.
Found in soil, water, sewage and intestinal tract of humans and animals.
Many are harmless saprophytes
Others  are the cause of human disease, e.g.
C.tetani
C.botulinum, C.butyricum
C.perfringens,C.septicum, C.novyi

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Clostridium

The range and success of pathogens is achieved by what 3 things

The ability to survive in adverse
environments by spore formation.
1. The ability for rapid growth in nutritionally enriched environment in anaerobic conditions.
2. Production of a range of toxins including enterotoxins and neurotoxins

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C.perfringens

is large …. Gram …. bacillus

Motile?

has characteristic spreading…. on media
haemolytic

Grows rapidly in … and in culture

Produces 4 lethal toxins 
-
-
-
-

Isolates of 5 types A to …
Type A causes most ….

Large rectangular Gram positive bacillus.
Non-motile
Has characteristic spreading growth on media.
Haemolytic.
Grows rapidly in tissue and in culture.
Produces 4 lethal toxins
Alpha
Beta
Epsilon
Iota. 
Isolates of 5 types, A-E.
Type A causes most human infection.

C. perfringens

Alpha

Alpha produced by

Is a lect,,,,

lyses …. cells. white cells platelets ,,,,, cells

Causes …., ….. and /….destruction

Produced by all types

Is a lecithinase (phospholipase C)

lyses red cells white cells platelets endothelial cells,

Causes haemolysis, bleeding and tissue destruction

C. perfingens

Beta

Causes ….. lesions in necrotising ….

Induces ….

Causes necrotic lesions in necrotising enteritis

induces hypertension

C, perfringens

Epsilon

Protoxin activated by …

Increases the permeability of

Protoxin activated by trypsin

Increases the permeability of the gastrointestinal wall

C. perfringens
Lota

…. activity

increases ,,,,

necrotic activity

increases vascular permeability

c. perfringens

enterotoxin

Heat labile … produced in the ….

Released during …. formation

Produced by type … but also …. and ….

Alters membrane …..

Heat labile toxin produced in the colon

Released during spore formation

Produced by Type A but also C and D

Alters membrane permeability

Disease caused by C.perfringens

Type A causes:

Gas….
Soft ti..
Food ….

Gas gangrene (myonecrosis)

full potential of …
clostridia introduced by …. or …..

Type A causes:
Gas gangrene
Soft tissue infections
Food poisoning.
Gas gangrene (myonecrosis) 
Full potential of virulence factors.
Clostridia introduced by trauma or surgery.
Extensive:
Muscle necrosis
Shock renal failure
Death within 2 days. 
Gas in tissues.

Disease caused by C. perfringens

The bacteria can also colonise …

may caused …. and ….

If found in blood cultures:

Transient ….
Contam…
Must be interpreted in ….

Necrotising enteritis

Rare disease of the ….
Caused by Beta toxin producing ……

The bacteria can also colonise wounds.
May cause cellulitis and fasciitis.
If found in blood cultures:
Transient bacteraemia
Contamination. 
Must be interpreted in relation to clinical findings.
Necrotising enteritis 
Rare disease of the jejunum. 
Caused by Beta toxin producing Type C.

Disease caused by C.perfringens Food Poisoning. - Short incubation and lasts less than.. - Ingestion of meat contaminated (10^8- 10^9) Type A Enterotoxin acts as .. prevented by ....... of food after cooking and ..... reheating

Food poisoning. Short incubation and lasts less than 24 hours. Ingestion of meat contaminated (108 -109) Type A. Enterotoxin acts as superantigen. Prevented by refrigeration of food after cooking and adequate reheating.

Clostridium Difficile. toxin producing C.difficile - Now known to cause ,,, antibioic associated diarrhoe self limiting diarrhoea to life threatening May be part of normal bowel ... and is present in

Toxin producing C. difficile Now known to cause antibiotic associated diarrhoea. Self-limiting diarrhoea to life-threatening pseudomembranous colitis. May be part of normal bowel flora and is present in soil, water and sewage.

Clostridium Difficile Proliferates when normal balance of bacteria is disturbed by.... Important pathogen in hospital associated diarrhoea. - Spores survive .... ``` Virulence factors: _ toxin... - toxin ... adhes.... spore.... ```

Proliferates when normal balance of bowel bacteria is disturbed By antibiotics. Important pathogen in hospital associated diarrhoea. Spores survive easily in the environment. Virulence factors: Toxin a (enterotoxin) Toxin B (cytotoxin) Adhesion factor and hyaluronidase Spore formation.

Clostridium Difficile both toxins procuced in the .... Induce: what 4 things Pseudomembrane consists of ...., ......, and ..... cells

Infiltration of neutrophils into the ileum Cytokine release Haemorrhagic necrosis. Destroy cellular cytoskeleton. Pseudomembrane consists of mucus, fibrin and inflammatory cells.

Clostridium Difficile : Treatment and diagnosis. Treatment what 2 things: - - Diagnosis by detection of .... by .....

Treatment: Stop antibiotics Treat if necessary with oral vancomycin or metronidazole. Diagnosis by detection of the toxins by EIA. Careful cleaning of the affected rooms.

C. Botulinum Fastidious heterogenouse group of .... Found in .... and .... divided into 4 groups. most human diseases caused by type ... and ... strains 7 distince toxins from Usually only one toxin per

Latin ‘botulus’ sausage. Fastidious heterogenous group of spore forming anaerobic bacteria. Found in soil and water. Divided into 4 groups. Most human disease caused by Types I and II strains. 7 distinct toxins A-G. Usually only one toxin per type.

C. Botulinum disease caused by the ...... toxin - A powerful ..... 150-165 kda progenitor complex with ..... - Consisting of .... - Non-toxic B or ..... Proteolytic cleaving makes the .... cleaved by clostridial ..... or ..... proteases

Disease caused by the botulinum toxin A powerful neurotoxin. 150 -165 Kda progenitor complex with derivative toxin (A-B toxin) Consisting of neurotoxin subunit (light or A chain) Non-toxic B or heavy chain subunit. Proteolytic cleaving makes the toxin active. Cleaved by clostridial proteases or gastric proteases

C. Botulinum Toxins ... and .... are also found in some strains - Their function is ... Botulinum toxin blocks ..... at peripheral cholinergic synapses by preventing ..... 3 types of clinical syndromes: - food borne .... infant .... .wound ....

Toxins C2 and C3 are also found in some strains Their function is unclear. Botulinum toxin blocks neurotransmission at peripheral cholinergic synapses by preventing release of acetylcholine. 3 types of clinical syndromes: Foodborne botulism Infant botulism Wound botulism.

Food borne botulism associated with consumption of ....... particularly ``` 1-2 days incubation follwed by : - - - - - ``` Muscle weakness and flaccid .... Binding of toxin is .....

Associated with the consumption of contaminated food - Particularly canned food ``` 1-2days incubation followed by: Dizziness blurred vision abdominal pain dilated pupils Dry mouth ``` muscle weakness and flaccid paralysis, Binding of toxin is irreversible

Infant botulism Most common form of botulism in the USA Colonisation of the G.I tract of young.... Neuro.... producing C.botulinum Non-specific symptoms in <1 year olds Mortality is low (1-2%) Associated with spores in

Colonisation of the G.I tract of young infants Neurotoxin producing c.botulism associated with spores in honey

Wound botulism In ..... production of toxin in wounds Similar symptoms to ... disease: Longer ..... Less ...... involvement Botulinal toxin can be used to treat disabling muscle spasms (dystonias) which can me

In vitro production of toxin in wounds Similar symptoms to foodborne disease: Longer incubation period Less gastrointestinal involvement Botulinal toxin can be used to treat disabling muscle spams (dystonias). Cross eyes, face and neck spams

C.tetani Rare in developed countries because .... Organism has terminal spores susceptible to oxygen .... so .... and live in soil and GI tract of animals. Often stains .... negative Motile or non motile?

Rare in developed countries because of vaccination but still causes a million deaths per year worldwide. Organism has terminal spores. Susceptible to oxygen toxicity so sporulate and live in soil and GI tract of animals. Often stains Gram negative. Motile.

Tetanus symptoms caused by .... - 4 clinical .... Toxins: Tetanolysin is ,,,, Tetanospasmin is a plas....

symptoms caused by toxin - 4 clinical manifestations Toxins: Tetanolysis is an oxygen labile haemolysis - Related to other clostridal haemolysis and Streptolysin 0) Tetanspasmin is a plasmid encoded, heat labile neurotoxin

Tetanus teanospasmin synthesised as... light chain, like botulinum toxin is a Neurotoxin- blocks release of Spastic ....

Tetanospasmin synthesised as 151 Kda peptide cleaved by protease. Light chain, like botulinum toxin is a zinc endopeptidase. Neurotoxin - blocks release of gamma-aminobutyric acid (GABA). Spastic paralysis.

Tetanus wound infection leads to generalised tetanus including: - - Cephalic tetanus if wound on head or ear = Localised infection of muscle in.... neonatal infection associated with

Wound infection leads to generalised tetanus including: Lockjaw Back spasms etc. Cephalic tetanus if wound on head or ear - poor prognosis. Localised infection of muscles in area of injury. Neonatal infection associated with infected umbilical stump.

Diagnosis, treatment and control of tetanus treatment involves: - debri... - treatment with metro.... - human tet... - v....

Diagnosis by clinical presentation. ``` Treatment involves: Debridement of wound Treatment with metronidazole Human tetanus immunoglobulin Vaccination. ```