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FRCpath microbiology part 2 > Bacterial infections > Flashcards

Bacterial infections Flashcards

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1
Q

What is Tularaemia ?

A

(The rabbit fever)
~Caused by Francisella tularensis
~Symptoms may include fever, skin ulcers, and enlarged lymph nodes.
~Occasionally, pneumonia or a throat
~ Spread: tick bite
deer flies, contact with infected animals and or contaminated water

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2
Q

Meningococcal serogroups?

A

At least 12 serotypes

#A, B and C account for about 90%
#Recent outbreaks of group Y and W135 strains
#Serogroup B (MenB) is the predominant in UK followed by serogroups W and Y
#Serogroup A is rare in the UK but more common in Africa and Asia

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3
Q

What are the virulence factors of N. meningitidis?

A

1- Polysaccharide capsule
2- Pili for attachment
3- Outer membrane proteins (PorA, PorB, and Opa ) for adhesion and invasion.
4- Lipooligosaccharide (LOS) endotoxin
5- IgA1 protease

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4
Q

IP for meningococcal disease?

A

3-4 days

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5
Q

Meningococcal rash?

A

non-blanching petechial or purpuric

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6
Q

Spectrum of meningococcal diseases?

A

1- Meningitis
2- Meningococcal septicemia
3- Meningococcemia
4- Pneumonia
5- Conjunctivitis

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7
Q

T/F
Meningococcus is a Hazard Group 3 organism ?

A

False
hazard group 2 and samples should be Process at Containment Level 2

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8
Q

selective media for N meningitis and gonorrhoea?

A

Thayer Martin for gonorrhoea and GC media for meningococci

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9
Q

Colony appearance of meningococci?

A

Small grey colonies on blood or chocolate agar

#Grow best on 5-10% CO2 35-37C
#Catalase and Oxidase positive
# GC agar is the selective media

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10
Q

Biochemical characteristics of meningococcus?

A

1-Oxidase-positive
2- Catalase-positive
3- Glucose and maltose fermentation positive (MeninGococci - Maltose and Glucose; Gonococci - Glucose only)

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11
Q

treatment of meningococca disease ?

A

Mild-moderate allergy - Meropenem 2gms TDS

IV Ceftriaxone 2 grams IV BD

#Severe allergy/anaphylaxis - Chloramphenicol 25 mg/kg intravenously every 6 hours

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12
Q

Meningococal prophylaxis (PEP)

A

Ciprofloxacin 500 mg po stat
or rifampicin 600 mg po bd for 2 days

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13
Q

Meningococcal UK vaccination protocol?

A

MenB vaccine (Bexsero or Trumenba):

Routine for infants (3 doses at 2, 4, and 12 months)
Catch-up for adolescents and high-risk groups
#MenACWY vaccine:
Routine immunization for adolescents (single dose at 14 years)
University entrants up to 25 years of age
#MenC vaccine:
Now part of the Hib/MenC combination vaccine given at 12 months

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14
Q

What is the causative agent for Enteric fever?

A

Salmonella enterica
1- Serotype typhi
2-Serotype para typhi A, B, C

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15
Q

What is the Multidrug-resistant Enteric Fever (MDR EF)?

A

R to ampicillin, chloramphenicol and co-trimoxazole.

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16
Q

What is the Extensively drug -resistant Enteric Fever (XDR EF)?

A

it is MDR EF with additional resistance to ciprofloxacin and third-generation cephalosporins.

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17
Q

What tests are available for H pylori?

A

1-Urea breath test-UBT
2-Stool antigen test -SAT
3- Antibody test- serology HiG
4-Microscopy and culture of gastric biopsy
5 Histology
6- PCR to detect clarithromycin resistance

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18
Q

T/F
H pylori are immotile bacteria under microscope??

A

It has rapid, darting (corkscrew) mobility using flagella.

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19
Q

what is the H pylori selective media?

A

Oxoid Dents media

[blood agar with dent supplement (vancomycin, trimethoprim, cefsoludin and amphotericin B)]

Also: can use Urea Agar (Christenson’s broth) for detection of urease

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20
Q

H pylori incubation ?

A

Microaerophilic
3-5% H2
At 35 degrees C
For 10 days

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21
Q

What is the definition of Extended-spectrum beta-lactamase (ESBL) enteric fever ?

A

It is the Salmonella spp that is resistant to third-generation cephalosporins but susceptible to at least one of :
1- chloramphenicol , Or:
2- co-trimoxazole, Or:
3- ciprofloxacin.

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22
Q

What are the pathogenic proteus spp?

A

Proteus mirabilis
Proteus vulgaris
Proteus penneri

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23
Q

erecurrennt Proteus UTI can lead to struvite stones?

Study These Flashcards
A

T
it can hydrolyze urea and raise urinary pH. Alkalinization

24
Q

What is the proteus intrinsic resistence pattern??

Study These Flashcards
A

1- All Proteus spp is intrinsically R to:
- nitrofurantoin
- colistin/polymyxin
- tetracycline.

2- Proteus penneri and vulgaris also intrinsically resistant to:
- amoxicillin
- 1st & 2nd gen cephalopsorin.

25
How many spp of Serratia and what are the 2 commonest cause of human infections?
Serratia marcescens Serratia liquefaciens
26
What is teh intrinsic R pattern for Ceratia marcesence ?
1-colistin/polymyxinB 2-macrolides 3- nitrofurantoin Also: 4- narrow-spectrum penicillins ( ampicillin, amoxicillin, coamoxiclav, ampicillin-sulbactam and 1st and 2nd cephalosporins [inducible chromosomal ampC] 5- SME carbapenemase [ can hydrolyses penicillin, aztreonam, and first-gen cephalosporins in addition to imipenem]
27
28
What are the Enterobacteriaceae??
o E.coli o Klebsiella o Enterobacter o Citrobacter o Raoultella o Klyuvera o Salmonella o Shigella
29
30
What is Friedlander's disease ?
It is sever lobar pneumonia caused by klebseilla pneumoniae
31
What is the cause of donovanosis?
Klebseilla granulomatis
32
What are teh Klebsiella spp vitrulance factors?
- Polysaccharide capsule K1,2 - Fimbriae/pili - types 1 and 3 pili for adhesion - Aerobactin, a siderophore - Lipopolysaccharide - Type 6 secretory system
33
What are the non-enterococcus gram Positive bacteria that are intrinsically R to vancomycin?
Leuconostoc Lactobacillus Pediococcus Erysipelothrix
34
Pathogenesis of Vibrio vulnificus?
1-Capsule –prevents phagocytosis 2-Toxins - metalloproteinase-hemolysin 3-Lipopolysachharide 4-Iron acquisition system
35
What are teh clinical syndromes that can caused by V vulnificus?
1-septicaemia 2- SSTI 3-Gastroentritis
36
What are the types of E coli that can cause gastroentritis??
1- Enterohaemorrhagic E. coli (EHEC) [also called Shiga toxin-producing E. coli (STEC), or Verocytotoxin-producing E. coli (VTEC)] 2- Enterotoxigenic E. coli (ETEC), 3- Enteroinvasive E. coli (EIEC), 4- Enteropathogenic E. coli (EPEC), 5- Enteroaggregative E. coli (EAggEC) 6-Diffusely adherent E. coli (DAEC).
37
What are the virulence factors of STEC?
1-Cytotoxins (stx1 and stx2) – inhibit the host cell’s protein synthesis. 2-The outer membrane protein intimin (encoded by the eae gene) helps attachment- used as targets for PCR testing 3-AggR activator (encoded by the aggR gene): helps in attachment and colonisation.
38
Causes of acute bloody diarrhoea ?
1-Campylobacter 2-Shigella 3-STEC 4-Salmonella 5-Entamoeba histolytica
39
What is the infectious dose of STEC and STEC O157
<100 for STEC <10 organisms for STEC O157
40
in a case of community-acquired gastrointestinal infection what are the organisms that usually routinely tested for?
Salmonella, Shigella, Campylobacter, STEC (including O157) Norovirus Giardia species and Cryptosporidium
41
How do we get Plesiomonas shigelloides infection?
1-Consumption of raw or poorly prepared : - seafood, especially shellfish -Chicken 2-Consuming contaminated water
42
T/F: Plesiomonas infection can be ass with co-infections with other pathogens?
~30% are ass with other pathogens e.g: rotavirus, Salmonella, Aeromonas, and Vibrio parahaemolyticus
43
What disease does Cronobacter sakazakii cause?
In infants, it is known to cause meningitis(abscess, and hydrocephalus), septicaemia, and necrotising enterocolitis. Clonal complex sequence type 4 (ST4) is strongly associated with CNS infection. In adults: bacteremia, UTI, pneumonia, conjunctivitis, intraabdominal infection & SSTI
44
What are the commonest SSTI can be caused by PSA?
- Hot tub folliculitis - Infection in burn patients - Ecthyma gangrenosum - Osteomyelitis/septic arthritis following a nail puncture wound - Green nail syndrome
45
T/F: A baumanii can survive on dry surfaces for prolonged periods, facilitating environmental contamination
T
46
Infections caused by A baumanii?
Ventilator-associated pneumonia, HAP Bloodstream infections Wound infections Urinary tract infections Meningitis (less common)
47
How to prevent A baumanii healthcare ass outbreaks?
1-Strict hand hygiene protocols 2-Contact precautions 3-Environmental cleaning and disinfection 4-Antibiotic stewardship to reduce selection pressure 5-Active surveillance in high-risk units
48
49
What is the Multidrug-Resistant Acinetobacter baumannii (MDRAB)?
It is an A baumanii that are susceptible to two or fewer of: 1- meropenem or imipenem 2-(third-generation cephalosporins), 3-piperacillin/tazobactam 4-(tigecycline) 5-Aminoglycosides 6-Quinolones 7-Cotrimoxazole 8-Colistin where agents in brackets lack EUCAST breakpoints.
50
51
What are the classical pertusses clinical phases?
catarrhal paroxysmal convalescent
52
What is the DTP criteria to diagnose CRBSI?
DTPis the growth of microbes from a catheter blood sample at least 2 h before microbial growth is detected peripheral blood
53
C/I of line salvage in CRBSI?
#Severe sepsis #Suppurative thrombophlebitis #Endocarditis #Ongoing bactraemia despite >72 h of antimicrobial therapy #Infections due to S. aureus, P. aeruginosa, fungi, or mycobacteria.
54
What are the commonest bacterial spp that can cause Vincent's angina.
1- Borrelia vincentii 2-Fusobacterium species
55
What are the commonest infectious agents that can cause oral ulcers?
1- Commonly viral (eg Herpes simplex) 2- syphilis, tuberculosis and histoplasmosis
56

FRCpath microbiology part 2 (10 decks)

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