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Infeksjonsmedisin > Bakterier - Amboss Ikke ferdig > Flashcards

Bakterier - Amboss Ikke ferdig Flashcards

1
Q

Hvordan klassifiserer man bakterier?

A

Humanpatogene bakterier kan bli klassifisert basert på:

Morfologogi; cocci, bacilli (staver), coccobacilli, spital, or presence of braching filament

Gramfarging; gram positiv/negativ og atypisk

Metabolsk aktivitet; aerob, anaerob, mikroaerofil eller fakultativ

Virulensfaktorer; kapslet, pili, proteiner, formasjon av koagulase, katalase eller enterotoksiner

++

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2
Q

Hvilke kokker har gramfargingsegenskaper?

A
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3
Q

Hvilke basiler/staver har gramfargingsegenskaper?

A
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4
Q

Hvilke coccobacilli har gramfargingsegenskaper?

A
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5
Q

Hvilke grendannenende bakterier har gramfargede egenskaper?

Branching filamentous

A
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6
Q

Fyll inn

A
Classification of gram-positive bacteria.
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7
Q

Fyll inn

A
Classification of gram-negative bacteria.
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8
Q

Fyll inn

A
Classification of gram-negative bacteria.
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9
Q

Hvilke humanpatogene bakterier har atypiske gramfargingsegenskaper?

A
Mycoplasmata were formerly classified as gram-positive bacteria, because they most likely evolved from these bacteria. Spirochetes were formerly classified as gram-negative bacilli, even though they stain poorly on Gram stain.
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10
Q

Hva er alle stafylokokker?

A

Alle slafylokokker er katalasepositiv

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11
Q

Hvilke to kategorier deler man staphylococcus aureus (s.aureus) inn i?

A
Grampositiv.
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12
Q

Hvor finner man s.aureus?

A
Detectable in the nostrils of ∼ 15% of the healthy population.
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13
Q

Hvilken bakteriekultur dannes ved s.aureus?

A
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14
Q

Hva viser bildet?

A
Staphylococcus aureus (S. aureus); Colorized scanning electron micrograph: S. aureus is spherical and forms grape-like clusters (the word Staphylococcus name derives from the Greek word "staphyle" = bunch of grapes). This characteristic distribution pattern arises because Staphylococci replicate randomly in all directions; the bacteria themselves are, however, immotile.
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15
Q

Hvilke virulens og motstandsfaktorer har s.aureus?

A
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16
Q

Hvilke tilstander kan s.aureus føre til?

A
Enzymes produced by S. aureus (e.g., coagulase, clumping factor A) facilitate clotting of fibrin and the formation of abscesses.
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17
Q

Hvilket ab. bør brukes ved s.aureus infeksjon?

MSSA og MRSA

A

MSSA

Betalaktamasestabile penicilliner (isoxazolyl penicillin); kloksacillin

Linkosamid.; Klindamysin

MRSA

Glykopeptidab.; Vankomycin

Oxazolidionab.; Linezolid

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18
Q

Ved S.epidermidis, nevn hhv.:
- Gramfarging
- Kogagulaseegenskaper
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander

A
Grampositiv, koagulasenegativ stafylokokk. Urease production is used to identify S. epidermidis in biochemical testing.
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19
Q

Hvilke ab. kan man bruke ved s.epididermis?

A

Betalaktamasestabile penicilliner; kloksacillin

Linkosamid; Klindamycin

Ved meticillinresistens;

Glykopeptidab.; Vankomycin

Lipopeptid; Daptomycin

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20
Q

Ved S.saprophyticus: nevn hhv.;
- Gramfarging
- Koagulaseegenskaper
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander

A
Grampositiv, koagulasenegativ. Second most common causative pathogen of uncomplicated UTI in young women, following E. coli
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21
Q

Hvilken ab. kan man bruke ved s.saprophyticus?

A

Førstegenerasjons cefalosporin; Cefaleksin

Bredspektret penicillin; Amoksicillin + klavulanat

Fluorokinolone; Ciprofloksasin

Nitrofuran; Nitrofurantion

Sulfonamider og diaminopyrimidiner; Trimetoprim + sulfametoksazol

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22
Q

Hvilke egenskaper har alle streptokokker?

A

Alle streptokokker er katalasenegative

De klassifiseres basert på type hemolyse de har på blodagar:
- Alfa-hemolyse
- Beta-hemolyse
- Gamma-hemolyse

De fleste er penicillinsensitive

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23
Q

Hva skiller de ulike formene for hemolyse på blodagar?

A
Types of hemolysis; Bacterial culture (grown on Columbia horse blood agar): Left: α-hemolysis. Partial hemolysis produces a greenish intermediate product. α-hemolytic Streptococcus species are called viridans streptococci (from Latin “viridis,” green), the most common being S. pneumoniae. Middle: β-hemolysis. Complete hemolysis manifests as translucent agar. β-hemolytic Streptococcus species can be classified according to Lancefield groups (clinically relevant: A and B), S. pyogenes (group A) being the best known. Right: γ-hemolysis. The term γ-hemolysis is a misnomer, as, in fact, no hemolysis takes place. The best known γ-hemolytic species are those of the Enterococcus genus.
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24
Q

Ved Streptococcus pneumoniae (s.pneumoniae), nevn hhv.:
- Gramfarging
- Hemolyse
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander

A
Grampositiv, alfa-hemolyse. OPSI; Overwhelming postsplenectomy infection.
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25
Q

Hva viser bildet?

A
Streptococcus pneumoniae with capsule; Photomicrograph of streptococcus pneumoniae (Neufeld test). Four of the five diplococci visible are encapsulated, as indicated by the white rim (halo) surrounding them. The Neufeld-Quellung test used here uses antibodies that react with the polysaccharide bacterial capsule, causing it to appear thick and opaque.
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26
Q

Hva viser bildet?

A
Streptococcus; Photomicrograph of Streptococcus (Gram stain): The chains of bluish-purple (gram positive) cocci seen on this Gram stain are characteristic of the genus Streptococcus.
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27
Q

Hvilke typer ab. bruker man for s.pneumoniae (pneumokokker)?

A

Betalaktamasefølsomme penicilliner; Benylpenicillin

Tredje gen. cefalosporiner; ceftriakson

Makolider (hos pas. med penicillinallergi); erytromycin

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28
Q

Ved Viridians streptokokker, nevn hhv.:
- Gramfarging
- Hemolyse
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander

A
Grampositive, alfahemolytiske.
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29
Q

Hvilke typer ab. kan man bruke mot viridans streptokokker?

A

Betalaktamasefølsomme penicilliner; Benzylpenicillin

Tredje gen. cefalosporin; ceftriakson

Makrolider (hos pas. med penicillin allergi); erytromycin

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30
Q

Hva slags gramfarging og hemolyse har Streptococcus pyogenes (Gruppe A streptokokk)?

A

Grampositiv

Beta-hemolyse

Beta-hemolytic Streptococcus pyogenes; Petri dish containing a growth medium (trypticase soy agar supplemented with defibrinated sheep's blood) that has been inoculated with Streptococcus pyogenes: The yellowish halo surrounding the bacterial colonies indicates complete degradation (beta-hemolysis) of the red blood cells in those areas. Beta-hemolysis is a characteristic feature of S. pyogenes.
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31
Q

I hvilket reservoar kan man finne S.pyogenes?

A

Nasofarynx

Mennesker er den eneste verten

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32
Q

Hva kjennetegner bakteriekulturen ved S.pyogenes?

A
33
Q

Hvilken virulens- og motstandsfaktorer har S.pyogenes?

A
34
Q

Hvilke assosierte tilstander har S.pyogenes?

A
35
Q

Hvilken ab. kan man bruke ved S.pyogenes (GAS) infeksjoner?

A

Betalaktamasefølsomme penicilliner; Benzylpenicillin

Eller

Første gen. cefalosporin

Eller

Andre gen. cefalosporin

Makrolider til pas. med penicillinallergi

36
Q

Hvilken gramfarging og hemolyse har Streptococcus agalactiae (Gruppe B streptokokker; GBS)?

A

Grampositiv

Beta-hemolyse

37
Q

I hvilket reservoar finner man S.agalactiae?

A

Genitalia og urinrørssystemet

GI-traktus

38
Q

Hvilken bakteriekultur gir GBS?

A
Used to identify S. agalactiae.
39
Q

Hvilken virulens- og motstandsfaktorer har GBS?

A

Kapsel

40
Q

Hvilke tilstander er assosiert med GBS?

A

B is for Babies; Group B streptococci primarily affect neonates.

Pregnant women at 36–38 weeks of gestation with a positive rectal and/or vaginal swab should receive intrapartum penicillin prophylaxis.
41
Q

Hvordan behandler man GBS?

A

Betalaktamasefølsomme penicilliner; Benzylpenizillin

Eller

Første gen. cefalosporin

Eller

Andre gen. cefalosporin

Pasienter med penicillinallergi

Første gen. cefalosporin; Cefalzolin

Eller

Linkosamid; Klindamycin

42
Q

Ved Streptococcus gallolyticus; nevn hhv.:
- Gramfarging
- Hemolyse
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte infeksjoner

A
Grampositiv, betahemolyse. Formerly known as S. bovis biotype I. Isolated in up to 10% of the population (higher rates in patients with colorectal cancer). Helps differentiate S. gallolyticus from other species of streptococci.
43
Q

Hvilken ab. behandling gir man mot S.gallolyticus?

A

Betalaktamasefølsomme penicilliner; Benzylpenicillin

Tredje gen. cefalosporin; Ceftriakson iv. + aminoglykosid (gentamicin)

44
Q

Ved Streptococcus angiosus, nevn hhv.:
- Gramfarging
- Hemolyse
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander

A
Grampositiv, betahemolyse. Formerly known as S. milleri. They have inconsistent expression of Lancefield groups, beta-hemolysis, and enzymes depending on the subtype.
45
Q

Hvilke ab. bruker man ved S.angiosus?

A

Betalaktamasefølsomme penicilliner; Benzylpenicillin

Bredspektrede penicilliner; Ampicillin

Tredje gen. cefalosporin

46
Q

Hvilke egenskaper har andre typer grampositive kokker?

A

Peptostreptococci og enterococci er katalase negative

47
Q

Ved Peptostreptococcus, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Assosierte tilstander
- Ab. behandling

A
Grampositiv. Common in individuals with alcohol use disorder, due to increased risk of aspiration.
48
Q

Ved Enterococcus, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Assosierte tilstander
- Ab. behandling

A
49
Q

Hva viser bildet?

A
Enterococcus faecalis; Bright-field photomicrograph (Gram stain; 1000x magnification): Large numbers of gram-positive bacteria are visible. The bacteria form pairs (examples indicated by arrowheads) and short chains (examples indicated by circles).
50
Q

Hvilken egenskap har alle Clostridia?

A

Alle Clostridia er:

Grampositive

Obligat anaerob;
- I betydningen obligat anaerob, brukes betegnelsen om en bakterie eller annen mikroorganisme som ikke kan bruke fritt oksygen i sitt stoffskifte og ikke kan leve i nærvær av det (SNL).

Sporedannende staver

51
Q

Ved Clostridioides difficile, nevn hhv.:
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktor
- Assosierte tilstander
- Ab. behandling

A

Clostridioides difficile (tidligere kjent som Clostridium difficle):

GI-traktus

Fakultativt patogen

Toxin A (enterotoksin) og Toksin B (cytotoksin)

Pseudomembranøs kolitt

Ab. behandling er:
- Metronidazol
- Po. vankomycin
- Fidaksomicin (makrosyklisk ab.)

52
Q

Ved Clostridium perfringens; nevn hhv.:
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Responsible for food poisoning.
53
Q

Hva viser bildet?

A
Clostridium perfringens; Photomicrograph (Gram stain; high magnification): Multiple rod-shaped, Gram-positive, Clostridium perfringens bacteria can be seen. They have been cultivated in Schaedler broth. Clostridium perfringens can be found in gas gangrene and, more rarely, in food poisoning.
54
Q

Ved Clostridium tetani, nevn hhv.:
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
55
Q

Hva viser bildet?

A
Clostridium tetani; Photomicrograph of a specimen cultivated on a blood agar plate (Gram stain, 956x magnification): Multiple rod-shaped bacteria are visible. Some show an enlarged end with a characteristic “drumstick” shape (example shown in magnification and illustration). This appearance is typical of Clostridium tetani.
56
Q

Ved Clostridium botulium, nevn hhv.:
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktor
- Assosierte tilstander
- Ab. behandling

A
57
Q

Hva viser bildet?

A
Clostridium botulinum; Photomicrograph of Clostridium botulinum (crystal violet stain; high magnification): Clostridium botulinum bacteria (rod-shaped) and endospores (smaller oval shapes) are visible.
58
Q

Hvordan virker botulinumtoksinet?

A

Mechanism of action: botulinum toxin

Left image: physiological neuromuscular transmission at the motor end plate

Action potential reaches the motor end plate → SNARE protein complex facilitates the fusion of vesicles containing acetylcholine (ACh) with the prejunctional membrane → release of ACh into the synaptic cleft → reversible binding of ACh with ACh receptors on the postjunctional membrane → opening of the ion channels of ACh receptors → depolarization of the muscle.

Acetylcholinesterase present on the postjunctional membrane breaks down ACh and releases it into the neuromuscular junction cleft → choline is taken up by the choline transporter on the prejunctional membrane and recycled in ACh synthesis.

Right image: cleavage of SNARE proteins by botulinum toxin

Botulinum toxin is endocytosed by cholinergic axon terminals (depicted in the left image)

The light chain of botulinum toxin released into the prejunctional neuron cleaves the SNARE protein complex → failure of fusion of vesicles containing ACh with the presynaptic membrane → ACh is not released into the neuromuscular junction → neural impulse is not transmitted to the muscle → flaccid paralysis of the muscle.

59
Q

Ved Clostridum septicum, nevn hhv.:
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Alternatively chloramphenicol, metronidazole, OR vancomycin for patients who are allergic to penicillin.
60
Q

Ved Listeria monocytogenes, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulen- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Grampositiv. The pathogen is able to survive and grow in chilled milk products.
61
Q

Hva viser bildet?

A
Cell-to-cell spread of Listeria monocytogenes; Fluorescence microscopy (very high magnification): Listeria monocytogenes (green rod-shaped bacteria) is visible within two adjacent cells. Actin filaments with a tail-like appearance (shown in red) behind the bacteria are visible inside, and connected to, the cell membrane. Listeria monocytogenes polymerizes host cell actin and uses it to push itself into adjacent cells via so-called “listeriapods” (a type of pseudopod), avoiding the extracellular compartment and evading an immune response. Cell-to-cell spread involves a process called actin-based motility.
62
Q

Ved Corynebacterium diphtheriae, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Grampositiv.
63
Q

Ved bacillus anthracis, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Grampositiv. Only obligate pathogen of the Bacillus genus. Bacillus anthracis is the only bacterium with a polypeptide capsule.
64
Q

Hva viser bildet?

A
Bacillus anthracis (Gram stain): The gram-positive (dark purple) bacteria Bacilli anthracis often form long chains. Each chain link is a single bacterium.
65
Q

Hva viser bildet?

A
Bacillus anthracis spores; Colorized scanning electron micrograph of Bacillus anthracis spores: Spores are formed if external circumstances do not permit normal bacterial growth. They are strongly resistant to heat and disinfectant, potentially remaining viable for decades. Spores are commonly found in soil. Clinical manifestations of an infection depends on the site of spore entry (cutaneous, gastrointestinal, or inhalation anthrax).
66
Q

Ved bacillus cereus, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktor
- Assosierte tilstander
- Ab. behandling

A
B. cereus grows in the presence of oxygen but can survive without it.
67
Q

Nevn noen bakteriearter som er gramnegative kokker?

A

Neisseria og Moraxella

68
Q

Ved Neisseria Meningitidis, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte sykdommer
- Ab. behandling

Meningokokker

A
Gramnegativ. The classification of Meningococcus into serogroups is based on the capsular antigens; the most common serogroups in the US are B, C, and Y.
69
Q

Hva viser bildet?

A
Neisseria meningitidis; Photomicrograph of a cerebrospinal fluid (CSF) sample (Gram stain; 1000× magnification): Gram-negative diplococci (examples indicated by arrowheads), the classic morphology of Neisseria meningitidis, are visible.
70
Q

Ved Neisseria gonorrhoeae, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulen- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Gramnegativ. A single dose of ceftriaxone is sufficient in uncomplicated gonorrhea.
71
Q

Hva viser bildet?

A
Neisseria gonorrhoeae; Photomicrograph of an urethral smear specimen (Gram stain with fuchsin counterstain; high magnification): The smear shows an abundance of neutrophils recognizable by their typical segmented nuclei and accumulations of diplococci, in the intracellular (within neutrophils; examples indicated by white arrowheads in magnification) and extracellular space (examples indicated by black arrowheads). This microscopic finding is characteristic of acute gonorrhea caused by Neisseria gonorrhoeae. Diagnosis must be confirmed by cultural isolation and identification of the pathogens.
72
Q

Ved Moraxella catarrhalis, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
73
Q

Nevn noen eks. på gramnegative coccobacilli

A

Haemophilus

Brucella

Bordetella

Pasteurella multiocida

Acinetobacter baumannii

74
Q

Ved Haemophilus influenzae, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Gramnegativ. H. influenza is incapable of hemolysis on its own. It requires blood components hemin (factor X) and NAD+ (factor V) for its growth. Hence, it will only grow on blood agar in the presence of hemolytic bacteria. Particularly capsule type B causes superinfection. Invasive infections have become rare since the introduction of the Hib vaccine.
75
Q

Ved Haemophilus ducreyi, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Gramnegativ. Requires the growth factor X present in blood. Chancrois; A sexually transmitted disease caused by Haemophilus ducreyi. Patients present with one or more painful genital ulcers and painful, suppurative inguinal lymphadenopathy. Commonly seen in Southeast Asia, sub-Saharan Africa, and Latin America.
76
Q

Ved Brucella melitensis og Brucella abortus, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Gramnegative. The name "abortus" refers to the increased rate of abortions among infected cattle. Brucellosis; A zoonotic infection caused by Brucella bacteria. Transmitted through ingestion of infected animal products, contact with infected animals, and inhalation of bacteria. Typically manifests with flu‑like symptoms and can cause undulant fever. In some studies, a combination of doxycycline with streptomycin was found superior to a combination with rifampin. However, the CDC recommends the use of rifampin, as it can be given orally, is widely available, and is more cost-effective than streptomycin.
77
Q

Hva viser bildet?

A
Brucella melitensis; Photomicrograph (Gram stain; high magnification): Multiple coccobacilli are visible. They appear reddish because they do not Gram-stain well (gram-negative).
78
Q

Ved Pasteurella multocida, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulens- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A
Gramnegativ.
79
Q

Ved Acinetobacter baumannii, nevn hhv.:
- Gramfarging
- Reservoar
- Bakteriekultur
- Virulen- og motstandsfaktorer
- Assosierte tilstander
- Ab. behandling

A

Infeksjonsmedisin (14 decks)

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