Bacteria Flashcards
(265 cards)
1
Q
community acquired pneumonias
A
Strep pneumo, Haemophilus influenza, Moraxella catarrhalis, Legionella pneumophilia, Bordetella pertussis
2
Q
nosocomial acquired pneumonias
A
Pseudomonas aeruginosa, Legionella pneumophilia
3
Q
Streptococcus pneumoniae morphology
A
gram positive coccus
encapsulated
alpha hemolytic
sensitive to optochin
4
Q
Streptococcus pneumoniae virulence factors
A
anti-phagocytic polysaccharide capsule
IgA protease
Teichoic acid (pro-inflammatory cell wall component)
Pneumolysin (ciliated and phagocytic cell wall lysis)
5
Q
Streptococcus pneumoniae transmission
A
acquired by inhalation of droplet nuclei or direct contact with other persons
blood stream infection possible
6
Q
Streptococcus pneumoniae clinical aspects
A
lobar pneumonia, sinusitis, otitis media, meningitis, endocarditis, bacteremia
7
Q
Streptococcus pneumoniae host defense
A
serospecific antibodies
8
Q
Streptococcus pneumoniae risk factors
A
smoking, lung disease, splenectomized, hypogamaglobinemia
9
Q
Streptococcus pneumoniae diagnosis
A
gram stain, culture, PCR, serotype using specific antibodies
10
Q
Streptococcus pneumoniae treatment
A
beta-lactam, macrolide or fluoroquinolone
11
Q
Streptococcus pneumoniae prevention
A
vaccine given to children, elderly, immunocompromised or splenectomized
12
Q
Haemophilus influenza morphology
A
gram negative bacillus/coccobacilli
encapsulated
requires Factor V and Factor X for growth
13
Q
Haemophilus influenza virulence factors
A
anti-phagocytic capsule (contains polyribitol phosphate)
pili
lipooligosacaride cell wall (lipid A endotoxin)
IgA protease
beta lactamases
14
Q
Haemophilus influenza transmission
A
acquired by inhalation of droplet nuclei or direct contact with other persons
15
Q
Haemophilus influenza host defense
A
serospecific antibodies
16
Q
Haemophilus influenza clinical aspects
A
lobar pneumonia, sinusitis, otitis media, meningitis, epiglottitis
17
Q
Haemophilus influenza risk factors
A
smoking, lung disease, splenectommized, hypogammaglobinemia
18
Q
Haemophilus influenza diagnosis
A
gram stain, culture, PCR, serotype using specific antibodies
19
Q
Haemophilus influenza treatment
A
beta lactase stable beta-lactam, macrolide or fluoroquinolone
20
Q
Haemophilus influenza prevention
A
conjugated HiB vaccine given to children and splenectomized adults
Rifampin is given to close contacts of patients with HiB infection
21
Q
Moraxella catarrhalis
A
Haemophilus influenza “want to be”, but less virulent
22
Q
Legionella pneumophilia morphology
A
gram negative rods
poor staining –> need silver stain to see
requires buffered charcoal yeast extract (BCYE) agar for growth
requires cysteine and Fe for growth
23
Q
Legionella pneumophilia virulence factors
A
biofilm
lipopolysaccharide cell wall
facultative intracellular bacteria (produce proteolytic enzymes that kill the host when the vacuole is lysed)
24
Q
Legionella pneumophilia transmission
A
acquired by inhalation of droplet nuclei from an infected aerosol (i.e. cooling towers, showers, spas, hot tubs)
blood stream infection is uncommon
organisms able to survive in hot water tanks (due to biofilm and intracellular ability)
25
Legionella pneumophilia clinical aspects
Pontiac fever (mild flu like illness)- fever, cough, lobar pneumonia
26
Legionella pneumophilia risk factors
increased age, lung disease, smokers, immunocompromised, alcoholics, concurrent kidney, liver or heart disease
27
Legionella pneumophilia diagnosis
culture of charcoal yeast extract agar, detection of antigens in urine
28
Legionella pneumophilia prevention
monitor water sources, hyperchlorination or superheating of water
29
Pseudomonas aeruginosa morphology
gram negative bacillus
obligate aerobe, oxidase positive
produces pyocyanin (green pigment)
characteristic musty grape odor
30
Pseudomonas aeruginosa virulence factors
pili (facilitate attachment)
exotoxin A
alginate
31
Pseudomonas aeruginosa transmission
acquired by inhalation of droplet nuclei from an infected aerosol or other environmental source
found in moist, warm environmental soils, plant materials and water
common nosocomial bacteria
32
Pseudomonas aeruginosa risk factors
chronicle ill or hospitalized patients
33
Pseudomonas aeruginosa clinical aspects
pneumonia, UTIs, bacteremia, wound infections, superficial "hot tub folliculitis", bone and joint infection
34
Pseudomonas aeruginosa diagnosis
gram stain, culture, PCR
35
Pseudomonas aeruginosa treatment
anti-pseudomonas penicillin, cephalosporin or carbapenem
36
Pseudomonas aeruginosa prevention
hospital infection prevention (disinfection of medical devices, such as ventilators)
37
Bordetella pertussis morphology
gram negative coccobacilli
| growth inhibited by unsaturated FAs (cotton swab and rayon swabs)
38
Bordetella pertussis virulence factors
fimbriae
tracheal cytotoxin (destroys mucocilliary cells)
adenylate cyclase toxin (acts like adenylate cyclase to increase cAMP which increases mucus production and respiratory secretions)
pertussis toxin (inactivates the protein that controls adenylate cyclase activity)
39
Bordetella pertussis transmission
highly contagious, person-to-person transmission through aerosolized large respiratory droplets
40
Bordetella pertussis clinical aspects
"whooping cough"
catarrhal phase- like a cold
paroxysmal phase- inspiratory whoop, coughing fits
convalescent phase
41
Bordetella pertussis diagnosis
PCR, serology
| **culture is difficult and not sensitive
42
Bordetella pertussis treatment
macrolide or fluoroquinolone
43
Bordetella pertussis prevention
acellular vaccination of children
| macrolide prophylaxis of close contacts
44
toxin food poisoning
Staph aureus, Bacillus cereus, Clostridium perfringens
45
watery diarrhea
mechanism- enterotoxin, adherence, superficial invasion
| Salmonella, E. coli, Clostridium perfringens, Vibrio cholera
46
bloody diarrhea
mechanism- invasion and/or cytotoxin
| Campylobacter, Shigella, Yersinia, Vibrio parahemolyticus, enteroinvasive E. coli (EIEC), EHEC
47
Campylobacter morphology
gram negative curved/helical bacillus
obligate aerobe- oxidase positive
invasive, thermophilic
48
Campylobacter virulence factors
```
flagella (motile)
corkscrew shape (facilitates penetration)
```
49
Campylobacter clinical aspects
reactive arthritis, bloody diarrhea, post infection Guile-Barre syndrome (ascending flaccid paralysis due to acute inflammatory demyelination)
50
Campylobacter risk factors
developing countries
51
Campylobacter transmission
through contaminated poultry
| fecal-oral, food borne or water borne transmission
52
Campylobacter treatment
macrolides
53
Enterobacter morphology
gram negative bacillus
lactose fermenter
motile
54
Enterobacter clinical aspects
nosocomial pneumonia, UTIs, wound infections, catheter related infections
55
Enterobacter risk factors
hospital patients, neonates, immunocompromised
56
Escherichia coli morphology
gram negative bacillus
sorbitol sensitive
lactose fermenter
catalase positive
57
Escherichia coli virulence factors
encapsulated- LPS lipid A (endotoxin)
58
Escherichia coli clinical aspects
UTIs, diarrhea
59
Escherichia coli treatment
treat with hydration
60
Escherichia coli diagnosis
can't use culture, must use PCR
61
Escherichia coli transmission
EHEC- under cooked meat
| ETEC- contaminated water
62
EHEC
serotype O157-H7, shiga toxin producing (cytotoxic to endothelial cells)
63
ETEC
traveler's diarrhea, profuse watery diarrhea
heat labile toxin (LT1) increases cAMP production
heat stable toxin (STa) increases cGMP production
64
UPEC
virulence- PAP adhesion presents on tip of P fimbriae and binds to Gal-Gal receptor
65
EAEC
adherence via fimbrae, heat stable toxin and plasmid encoded toxin, forms biofilms, stack of bricks adherence of hep2cells
66
EPEC
intim- polymerizes actin and disrupts normal microvillus structures
67
Helicobacter pylori morphology
gram negative curved bacillus
68
Helicobacter pylori virulence factors
flagella- motility
acid inhibitory protein- blocks acid production
urease- neutralizes gastric acids and byproducts can cause local tissue damage
69
Helicobacter pylori clinical aspects
duodenal ulcers, gastric adenocarcinoma, mucosa associated lymphoid tissue (MALT) lymphomas, acute and chronic gastritis
70
Helicobacter pylori risk factors
low SES classes, developing countries
71
Helicobacter pylori transmission
humans are the primary reservoir, person to person spread (fecal-oral)
72
Helicobacter pylori diagnosis
blood antibody test, stool antigen test
73
Helicobacter pylori treatment
proton pump inhibitors, amoxicillin and clarithromycin (need all 3)
74
Klebsiella morphology
gram negative bacillus
75
Klebsiella virulence factors
capsule- mucoid appearance
76
Klebsiella clinical aspects
lobar pneumonia, UTIs, currant jelly sputum, abscess'
77
Klebsiella risk factors
alcoholics
78
Listeria morphology
gram positive coccobacillus, beta hemolytic, growth in cold and high salt environments
79
Listeria virulence factors
flagella- motile
facultative intracellular pathogen- actin directed intracellular motility
hemolysis
80
Listeria clinical aspects
meningitis
81
Listeria risk factors
pregnant women, elderly, neonates, immunocompromised
82
Listeria treatment
penicillin or ampicillin
83
Proteus morphology
gram negative bacillus
| swarms on the culture (very motile)
84
Proteus clinical aspects
fishy odor, UTIs, kidney infection, pyelonephritis, struvite (Mg) and apatite (Ca) crystals, staghorn calculi
85
Salmonella morphology
gram negative bacillus
encapsulated
acid labile- which means you need a lot of the organism to infect the host
86
Salmonella virulence factors
type 3 secretion system
facultative intracellular- evades host's immune response by blocking lysosome movement and then remaining and replicating in endocytotic vesicles
87
Salmonella clinical aspects
watery diarrhea, enteric fever (typhoid fever- rose spots, constipation, systemic illness with fever and abdominal symptoms), osteomyelitis, gastroenteritis, bacteremia, endovascular infection
88
Salmonella transmission
through food/water (poultry, eggs, milk) or through pets (turtles, snakes, ducklings)
colonizes in the gallbladder of chronic carriers
89
Salmonella treatment
only treat infants, adults over the age of 50 or high risk patients
90
Serratia morphology
gram negative bacillus, motile, produces a red pigment
91
Serratia clinical aspects
nosocomial pneumonia, UTIs, wound infections, catheter related infections
92
Shigella morphology
gram negative bacillus, immotile
| Shigella dysenteriae- acid stable (low infective dose)
93
Shigella virulence factors
type 3 secretion system
facultative intracellular- enter M cells, evade host lysis in cell cytoplasm, multiply intracellularly, cell to cell spread using the host cell actin for locomotion
94
Shigella clinical aspects
watery diarrhea for 2-3 days and then bloody diarrhea
| biphasic fever
95
Shigella treatment
ciprofloxacin
96
Vibrio morphology
gram negative bacillus (comma shaped/curved), requires salt for growth, susceptible to stomach acids but tolerable to a wide range of pH
97
Vibrio shared virulence factors
flagella (motility), pilli, LPS containing lipid A endotoxin
98
Vibrio treatment
rehydration
99
Vibrio cholerae virulence factors
cholera toxin (interacts with G protein controlling adenylate cyclase to increase cAMP production)
100
Vibrio cholerae clinical aspects
rice water stools, rapid onset diarrhea
101
Vibrio cholerae transmission
through contaminated food/water (fecal to oral)
102
Vibrio cholerae treatment
fluid and electrolyte replacement
| single dose of azithromycin
103
Vibrio parahemolyticus virulence factors
acidic polysaccharide capsule- important for disseminated infections
104
Vibrio parahemolyticus clinical aspects
wound infection, bacteremia, watery diarrhea, n/v
105
Vibrio parahemolyticus transmission
shellfish and sea water
106
Vibrio parahemolyticus treatment
hydration and tetracyclines
107
Vibrio vulnificus virulence factors
polysaccharide capsule, RtxA toxin, iron acquisition systems
108
Vibrio vulnificus clinical aspects
wound infections, primary sepsis
109
Vibrio vulnificus risk factors
patients with chronic underlying disease (i.e. liver disease, hemochromatosis)
110
Vibrio vulnificus treatment
combination of doxycycline and ceftriaxone
111
Vibrio vulnificus transmission
shellfish and seawater
112
Yersinia morphology
gram negative bacillus
encapsulated
needs factor V (NAD) and factor X (hemolin) to grow
113
Yersinia virulence factors
type 3 secretion system- to resist phagocytic killing
114
Yersinia pestis clinical aspects
bubonic plague, pneumonic plague
115
Yersinia pestis diagnosis
safety pin appearance of gram stains
116
Yersinia pestis treatment
gentamicin and fluoroquinolone
117
Yersinia enterocolitica transmission
```
food born (undercooked meats), contacts with pets
can grow in the cold
```
118
Yersinia transmission
animal stools, fleas, carried in rodents
119
Streptococci general characteristics
ubiquitous, rapidly growing, gram positive cocci
facultative anaerobes
alpha (viridian's and pneumo), beta (pyogenes, agalaciae) or gamma (enterococcus) hemolytic
cocci form pairs on gram stain
catalase negative
120
Streptococci pyogenes (Group A) virulence factors
lipoteichoic acid (cellular adhesion)
M protein (adheres to specific host cell receptors and interferes with complement and opsonization)
hyaluronic acid capsule (helps to avoid host defenses
streptococcal pyrogenic exotoxins (Spe)- a super antigen that causes scarlet fever, TSS, necrotizing fasciitis
streptolysin S and O- hemolysins
streptokinase- cleaves plasminogen (thus lyses blood clots)
121
Streptococci pyogenes (Group A) clinical aspects
pharyngitis, cellulitis, pneumonia, bacteremia, necrotizing fasciitis, scarlet fever, pyoderma (pustules), erysipelas, streptococcal toxic shock syndrome, rheumatic fever (due to production of Ab against M protein), post streptococcal glomerulonephritis
122
Streptococci pyogenes (Group A) transmission
direct contact and the environment (respiratory droplets)
123
Streptococci pyogenes (Group A) diagnosis
gram stain, culture, swab of oropharynx, PCR
| anti-streptolysin O, anti-hyaluronidase or anti-DNase antibodies in serum suggest recent infection
124
Streptococci pyogenes (Group A) treatment
beta lactam, macrolide, tetracycline
| antibiotic treatment for pharyngitis prevents rheumatic fever
125
Streptococci agalactiae (Group B) virulence factors
```
polysaccharide capsule (prevents opsonization)
sialic acid surface expression (inhibits alternate complement pathway)
```
126
Streptococci agalactiae (Group B) clinical aspects
bacteremia, sepsis, meningitis, pneumonia
127
Streptococci agalactiae (Group B) diagnosis
PCR of rectal or vaginal swab, culture
128
Streptococci agalactiae (Group B) treatment
beta lactam/penicillin, clindamycin
129
Streptococci agalactiae (Group B) prevention
test pregnant women between 35-37 weeks, give intrapartum penicillin if infected
130
Enterococcus morphology
gamma hemolytic, NaCl and bile resistant (makes it very hard to kill)
normal flora of the large intestine
131
Enterococcus virulence factors
biofilms, antibiotic resistance
132
Enterococcus host defense
opsonization and phagocytosis
133
Enterococcus risk factors
immunocompromised, neutropenic patients, comorbidities, GI surgery, hospitalizations, catheters
134
Enterococcus clinical aspects
UTI, endocarditis, biliary tract infection
135
Enterococcus diagnosis
PCR of blood, culture
136
Enterococcus treatment
ampicillin (aminoglycosides in addition if severe infection because of the synergistic effect of the two antibiotics)
137
Viridians streptococci virulence factors
no capsule but have dextran extracellular polysaccharides to facilitate adherence
138
Viridians streptococci clinical aspects
dental caries, periodontal, head and neck infections, endocarditis, prosthetic joint infection
139
Viridians streptococci treatment
beta lactams, vancomycin, macrolide, clindamycin
140
Staphyococci general characteristics
gram positive coccus
facultative anaerobes
beta hemolytic
catalase positive
141
Staphylococci aureus virulence factors
capsule, coagulase, hyaluronidase, biofilm, teichoic acid (pro-inflammatory), protein A (binds IgG receptors)
enterotoxins (superantigens), toxic shock syndrome toxin, exfoliative toxin A (EtA), quorum sensing
142
Staphylococci aureus host defense
intact mucosa, antibody opsonization, phagocytosis, neutrophil mediated killing
143
Staphylococci aureus risk factors
immunocompromised, splenectomized, phagocytic disorders, IV drug use
144
Staphylococci aureus clinical aspects
toxin mediated food poisoning (from meats and mayonnaise), rapid onset, scalded scalp syndrome (due to exfoliative toxins A and B), toxic shock syndrome, impetigo, skin abscesses, endocarditis, bone infection, joint infection, heart valve infection
**post-influenz pneumonia
145
Staphylococci aureus diagnosis
gram stain, culture, mannitol salt agar plates (turns yellow), PCR (to discriminate MRSA from methicillin sensitive)
146
Staphylococci aureus treatment
beta lactam, macrolide, sulfa, tetracycline
| vancomycin for MRSA
147
Staphylococci aureus prevention
isolation in hospitals, hygiene and disinfection in the community
148
Staphylococci epidermidis virulence factors
biofilm, less virulent
149
Staphylococci epidermidis clinical aspects
commonly associated with medical device infections
| common blood culture contaminant
150
Staphylococci saprophyticus clinical aspects
UTIs especially in young sexually active females
151
Treponema pallidum morphology
spirochete, need to use a silver stain, dark field microscopy or fluorescent antibody testing to observe
152
Treponema pallidum virulence factors
minimal species specific antigens on surface (evade immune response)
fibronectin (adheres to host)
hemolysins, vasculitis
153
Treponema pallidum transmission
direct sexual contact, transfusion through contaminated blood, congenital transmission
154
Treponema pallidum clinical aspects
syphillis
primary- painless genital chancre
secondary- flu like syndrome, rash that includes the palms and soles of the feet, condyloma lata
tertiary- tabes dorsalis, Argyll Robertson pupil, aortitis, skin and bone granulomatous lesions, uveitis, deafness
congenital- hutchinson teeth, mulberry molars, saddle nose, saber shins, uveitis
155
Treponema pallidum diagnosis
dark field or fluorescent microscopy
non treponema serology (RPR and VDRL) followed by treponema serology (fluorescent treponemal antibody absorption (FTA-ABS)
156
Treponema pallidum treatment
penicillin!! desensitize pregnant women and immunocompromised instead of giving a different drug
157
Borrelia burgdorferi morphology
spirochete, poorly stains with gram stain
158
Borrelia burgdorferi virulence factors
outer surface protein A (OspA)- binds to gut proteins
| outer surface protein C (OspC)- critical for transmission
159
Borrelia burgdorferi transmission
via the Ixodes tick
160
Borrelia burgdorferi clincal aspects
lymes disease
stage 1- erythema migrant, fever, headache
stage 2- muscle pain, neck pain, hepatitis, mild encephalopathy, motor or sensory radiculitis, AV block, myocarditis
stage 3- recurrent arthritis (especially in large joints like the knee), encephalomyelitis
161
Borrelia burgdorferi diagnosis
disseminated infection- serologic testing; step 1- ELISA for IgM and IgG antibodies, step 2- western blot to confirm
162
Borrelia burgdorferi treatment
early- oral doxycycline, amoxicillin
| secondary lyme- ceftriaxone
163
Leptospira interrogans morphology
observed by dark field microscopy or by direct fluorescent antibody testing or by silver stain
164
Leptospira interrogans transmission
contaminated water; organism is shed in urine of infected mammals for weeks to months
165
Leptospira interrogans clincal aspects
early symptoms- fever, headache, stiff neck, myalgia
| 2nd phase- Weil's disease- conjunctival suffusion, thrombocytopenia, pulmonary hemorrhage, liver and kidney dysfunction
166
Leptospira interrogans diagnosis
serology, dark field or silver stain of CSF
167
Leptospira interrogans treatment
ceftriaxone, doxycycline
168
Clostridium difficile morphology
obligate anaerobe
| gram positive rods, spore forming
169
Clostridium difficile virulence factors
```
toxin A (enterotoxin)-stimulates infiltration of neutrophils, increases permeability of intestinal wall through disrupting tight junctions
toxin B (cytotoxin)- causes actin to depolymerize and destroy cellular cytoskeleton
```
170
Clostridium difficile clinical aspects
acute onset of watery diarrhea, pseudomembranous colitis, fever, toxic megacolon
171
Clostridium difficile risk factors
recent antibiotic exposure within a month (clindamycin and fluoroquinolone are highest), hospitalizations
172
Clostridium difficile diagnosis
ELISA to demonstrate toxin A and B, PCR of stool to look for toxins
173
Clostridium difficile treatment
oral vancomycin, stool transplant, colectomy if necessary
174
Clostridium perfringens morphology
beta hemolysis (double ring)
175
Clostridium perfringens virulence factors
alpha toxin- mediates massive hemolysis, increases vascular permeability
beta toxin- intestinal stasis, formation of necrotic lesions
enterotoxin- alters membrane permeability of ileum and jejunum, leads to increased loss of fluids and ions (acts as a super antigen)
176
Clostridium perfringens clinical aspects
gas gangrene, cellulitis, fasciitis, often follows trauma/open wounds
177
Clostridium perfringens diagnosis
gram stain and culture
178
Clostridium perfringens treatment
high dose of penicillin
179
Clostridium tetani virulence factors
tetanus toxin- inhibits inhibitory neurons (irreversible lack of inhibition of motor neuron produces tents- inhibits release of GABA through cleaving SNARE protein)
180
Clostridium tetani clinical aspects
tetanus, uncontrollable muscle spasms, grinning face
181
Clostridium tetani host defense
antibody against the toxin
182
Clostridium tetani diagnosis
demonstration of seronegative state
183
Clostridium tetani treatment
tetanus immunoglobulin (TIG), penicillin (to decrease organism number)
184
Clostridium tetani prevention
vaccination with tetanus toxoid
185
Clostridium botulinum virulence factors
botulinum toxin (inhibits the release of acetylcholine by the presynaptic cell by cleaving SNARE)
186
Clostridium botulinum host defense
antibody against the toxin
187
Clostridium botulinum risk factors
contamination and improper presentation of canned/stored foods, giving raw honey to infants
188
Clostridium botulinum clinical presentation
descending flaccid paralysis, ptosis, blurred vision
189
Clostridium botulinum diagnosis
clinical presentation, epidemiology, isolation of bacteria and toxin from food source, isolation of organism from stool
190
Clostridium botulinum treatment
botulinum antitoxin
191
Actinomyces morphology
branching gram positive rod
obligate anaerobe
dentate appearing colonies on agar
active infections tend to produce sulfur granules in pus
192
Mycoplasma general characteristics
NO cell wall --> resistant to beta lactams (penicillin, cephalosporin, vancomycin, etc)
cell membrane contains sterols
193
Mycoplasma treatment
macrolide, tetracycline, fluoroquinolone
194
Mycoplasma pneumoniae virulence factors
```
P1 adhesion (destroys ciliated epithelial cells)
functions as a super antigen to stimulate inflammatory cells to migrate to site of infection and release cytokines
rapidly changes expression of surface lipoproteins (allows it to evade host immune response)
```
195
Mycoplasma pneumoniae transmission
via large respiratory droplets
196
Mycoplasma pneumoniae clinical aspects
walking pneumonia
197
Chlamydia general characteristics
obligate intracellular, gram negative
LPS with weak endotoxin activity (from lipid A)
life cycle- elementary bodies (infectious form) and reticulate bodies (metabolically active form)
198
Chlamydia treatment
macrolid, tetracycline, fluoroquinolone
199
Chlamydia pneumoniae clinical aspects
walking/atypical pneumonia, sinusitis, pharyngitis
200
Chlamydophila trachomatis clinical aspects
serotypes A-C- trachoma, blindness, chronic inflammatory granulomatous of the eye
serotypes D-K- urogenital infections, commonly asymptomatic in women, inclusion conjunctivitis
serotypes L1-L3- lymphogranuloma venereum, painless ulcer followed by inflammation and swelling of the lymph nodes
201
Chlamydophila trachomatis risk factors
sub-Saharan Africa (trachoma), impoverish areas, having another STI
202
Chlamydophila trachomatis transmission
person to person, oral-genital contact
203
Chlamydophila trachomatis diagnosis
nucleic acid amplification test (NAAT)
204
Neisseria general characteristics
gram negative diplococci, oxidase positive, catalase positive, transferred from one person to another
205
Neisseria meningitidis virulence factors
pili for attachment, IgA protease, LOS (from capsule)
206
Neisseria meningitidis risk factors
kids, teenagers, young adults, sickle cell patients, splenectomized patients, immunocompromised, elderly, those who live in closed populations
207
Neisseria meningitidis clinical aspects
meningitis, petechial rash, hypotension due to vasodilation and capillary leak, Waterhouse-Frederickson syndrome (bilateral adrenal hemorrhage)
208
Neisseria meningitidis diagnosis
PCR, gram stain, culture on chocolate agar
209
Neisseria meningitidis treatment
ceftriaxone or cefotaxime
210
Neisseria meningitidis prevention
chemoprophylaxis for those with significant exposure to patients
vaccination for all strands but B (given to all adolescents prior to college entry and travelers to sub-Saharan africa during dry season)
211
Neisseria gonorrhoeae virulence factors
opacity protein for attachment
212
Neisseria gonorrhoeae risk factors
more common in SE US, minorities
213
Neisseria gonorrhoeae clinical aspects
women are more likely to be asymptomatic
| urethritis, cervicitis, PID, Fitz/Hugh Curtis (adhesions and inflammation around the liver and subdiaphragmatic space)
214
Neisseria gonorrhoeae diagnosis
nucleic acid amplification test (NAAT), gram stain, culture on chocolate or Thayer Martin agar
215
Neisseria gonorrhoeae treatment
ceftriaxone (with macrolide or doxycycline for chlamydia coverage)
216
Chlamydia trachomatis treatment
macrolide or doxycycline (with ceftriaone for gonorrhea coverage)
217
Rickettsiaceae general characteristics
```
gram indeterminate but structurally similar to gram negative rods (have LPS in cell wall)
visualized best with Geimsa or Gimenez stain
obligate intracellular (have phospholipase to dissolve phagosome membrane)
```
218
Rickettsiaceae rickettsia transmission
dermacentor ticks (dog ticks, wood ticks)
219
Rickettsiaceae rickettsia epidemiology
southeastern US; peak season is May-July
220
Rickettsiaceae rickettsia clinical aspects
infects vascular endothelium and causes small vessel vasculitis, Rock mountain spotted fever!!!, incubation period of 2-14 days, fever, headache, myalgia, petechial rash that spreads from the extremities to the trunk
221
Rickettsiaceae rickettsia diagnosis
serology- usually takes 7-10 days after the onset of symptoms for seroconversion
222
Rickettsiaceae prowazekii transmission
louse (lice transmit to humans)
223
Rickettsiaceae prowazekii epidemiology
mountainous regions of central and eastern africa, central and south america, asia
224
Rickettsiaceae prowazekii clinical aspects
epidemic typhus, meningoencephalitis, petechial rash that spreads from the trunk to the extremities (opposite RMSF), no eschar
225
Rickettsiaceae prowazekii diagnosis
serology or PCR
226
Rickettsiaceae treatment
doxycycline
227
Brucella mophology
gram negative coccobacillus
| non-motile, facultative intracellular
228
Brucella epidemiology
developing world, US/Mexico border, bioterrorism agent
229
Brucella transmission
from contaminated milk or cheese, spreads through the reticuloendothelial system and bloodstream
230
Brucella clinical aspects
Brucellosis; fever, hepatomegaly, splenomegaly, lymphadenopathy
231
Brucella prevention
pasteurize milk and cheese, vaccinate food producing animals
232
Franciscella tularensis morphology
gram negative coccobacillus, non-motile, facultative intracellular
233
Franciscella tularensis virulence factors
resistant to serum killing and phagocytosis
234
Franciscella tularensis epidemiology
central US
235
Franciscella tularensis transmission
rabbits, ticks, inhalation or ingestion
236
Franciscella tularensis clinical aspects
Tularemia- fevers, chills, ulcerated painful skin lesions, regional lymphadenopathy
237
Franciscella tularensis prevention
education of outdoorsmen, avoid reservoirs and vectors of infection
238
Yersinia pestis virulence factors
facultative intracellular (in macrophages), type 3 secretion system
239
Yersinia pestis transmission
rodents or fleas; direct contact with an infected animal, cat bite, scratch, airborne
240
Yersinia pestis clinical aspects
plague- pneumonic, septicemic, bubonic
| SOB, chest pain, GI symptoms
241
Yersinia pestis prevention
rodent and flea control; antibiotic prophylaxis of contacts or exposures to infected individuals
242
Bacillus anthracis morphology
gram positive bacillus, spore forming, non-motile
243
Bacillus anthracis transmission
cattle, goats, sheep, contaminated hides, wool; contact, ingestion or inhalation of infective spores
244
Bacillus anthracis virulence factors
edema factor (acts like adenylate cyclase to increase cAMP), lethal toxin (increases cytokines and leads to shock/cell death)
245
Bacillus anthracis clinical aspects
Anthrax- lesion progresses to eschar, tissue necrosis, edema, widened mediastinum, pleural effusion
246
Bacillus anthracis treatment
once exposed prophylaxis (60 day course) of ciprofloaxcin and doxycycline
247
Coxiella brunetti morphology
pleomorphic rod, obligate intracellular (in macrophages)
248
Coxiella brunetti virulence factors
antigenic variation, intracellular survival
249
Coxiella brunetti epidemiology
more prevalent in Europe and northern Australia
250
Coxiella brunetti transmission
cattle, sheet, goats, cats; often acquired during assisting with birthing or placental contact
aerosol transmission
251
Coxiella brunetti clinical aspects
Q-fever, flu like symptoms, fever, pneumonia, hepatitis, splenitis
252
Coxiella brunetti diagnosis
serology
253
Coxiella brunetti prevention
education and safety
254
Bartonella henselae transmission
cat bite, lick or scratch
255
Bartonella henselae clinical aspects
cat scratch fever, fever with papule at inoculation site, regional adenopathy
256
Pasteurella multocida morphology
gram negative coccobacilli
257
Pasteurella multocida transmission
animal contact from dogs and cats (bites, scratches, shared food)
258
Pasteurella multocida virulence factors
capsule and endotoxin
259
Pasteurella multocida clinical aspects
pneumonia, systemic infection with bacteremia and septic shock in immunocompromised/liver disease patients
260
Mycoplasma tuberculosis morphology
impermeable to staining, need acid fast staining to see --> resistant to acid, alkali, drying and germicides
261
Mycoplasma tuberculosis risk factors
associated with overcrowding, poor hygiene, malnutrition, workers in congregate settings where disease is more prevalent and defects in cell mediated immunity (**HIV)
262
Mycoplasma tuberculosis transmission
determinants of contagion = distance to source, duration of exposure, infectiousness of source
clinical factors enhancing infectiousness = presence of cough, production of sputum which is smear positive for acid fast bacteria, cavitary lesion on CXR
263
Mycoplasma tuberculosis clinical aspects
primary TB- Ghon complex (focal caseation in parenchyma and hilarious nodes; undergoes fibrosis and calcification; can be seen radiologically); bilateral hilar lymphadenopathy
secondary (reactivation) TB- most commonly involves the apex of the lung; causes cavitary lesions with caseous necrosis
miliary TB- consequence of blood-borne spread; granulomatous inflammation with multinucleate giant cells; miliary usually in the liver and spleen
264
Mycoplasma tuberculosis diagnosis
PCR, acid fast stain
265
Mycoplasma tuberculosis treatment
long term treatment with a combination of drugs (two phases- induction and continuation)
active TB treatment- isoniazid, rifampin, pyrazinamide, pyridoxine and ethambutol
latent TB treatment- isoniazid and pyridoxine
