Clostridiia Flashcards

(37 cards)

1
Q

Two Major Bacterial Disease Mechanisms

A
  1. Toxin Mediated
    - no organisms required
    - ex botulism or Staph A. Food poisoning
  2. Invasion
    - bacterial tissue invasion
    - overactive inflammation
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2
Q

Types of Toxin Mediated Disease

A
  1. Pre-Formed Toxin
    -Bacteria colonize external environment (like food)
    -produce toxins
    -toxins enter person (i.e. Ingestion)
    Example: Botulism
  2. Bacterial Invasion
    - ingestion of microorganisms-
    - colonization in gut
    - toxin secreted while organism is in body
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3
Q

Clostridium (General Facts)

A

Obligate Anaerobe

Gram Positive Rods

SPORES

Catalase Negative

Oxidase Negative

Many species

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4
Q

Where is C. Tetani Found? And other epi

A

Found in SOIL

One serological type

Very rare- usually non-immunized ind

60% fatality :0

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5
Q

What is Tetanus Toxin and how does it work?

A

Neurotoxin with A and B subunits

Inhibit release of n.transmitter GLYCINE and GABA

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6
Q

What does Tetanus cause?

A
  • > SPASTIC PARALYSIS

- convulsive contractions

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7
Q

What are the clinical syndromes of Tetanus?

A

Violent muscle spasms (predominantly flexor muscles)

If involves respiratory muscles can lead to respiratory failure

Aspiration if pharyngeal muscles involved

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8
Q

Tetanus pertinent negatives?

A

NO FEVER

NO SENSORY DEFICIT

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9
Q

How do clinicians diagnose Tetanus?

A

Mostly clinically

Organisms rarely seen in wound site

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10
Q

Treat Tetanus

A

*Human Tetanus immunoglobulin

Penicillin plus wound cleaning

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11
Q

How are we gonna prevent Mr. Tetanus?

A

Immunize with TOXOID
-3 doses in first 6 months of life

Booster every 10 years

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12
Q

Clostridium spore location

A

Tetani: TERMINAL SPORE (diagnostic)

Botulinum: Subterminal oval spore

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13
Q

Botulism epi

A

Very low incidence

Found in soil

Spores very resistant to heat and chemicals

Can grow in CANNED FOOD

Can infect wounds

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14
Q

What is Botulism Toxin?

A

HEAT LABILE protease
But resists acid

Extremely POTENT

7 types

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15
Q

How does Botulism Toxin cause disease?

A

Absorbed by intestines

Carried via blood to peripheral nerve synapses

Enters NERVE CELLS by receptor mediated endocytosis

BLOCKS ACETYLCHOLINE RELEASE into synapse

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16
Q

How does botulism manifest clinically?

A

18-36 hr incubation

Weakness or FLACCID PARALYSIS

SYMMETRICAL

Dilated pupils, dry throat

May affect respiration

17
Q

What are the Pertinent negatives for botulism?

A

NO FEVER

NORMAL MENTAL STATUS

NO SENSORY DEFICIT

18
Q

How do we diagnose Botulism?

A

Clinical

Usually can’t culture (preformed toxin)

Detect toxin in serum

Detect source toxin in food

19
Q

What other disease look like botulism?

A

Myasthenia Gravis

Gillian Barre Syndrome
-ascending paralysis

20
Q

Prevention

A

No vaccine

COOK CANNED FOOD

21
Q

What is Infant Botulism?

A

1-8 months of age

Honey common source

Babies eat bacteria and toxin formed in the gut

Subtle symptoms (constipation, weak head control)

22
Q

How do you treat Botulism?

A

Early: remove toxin from stomach

ANTITOXIN
-toxin specific, remember there’s different types

23
Q

Clostridium Difficile EPI

A

Common cause of antibiotic resistant diarrhea

Found in GI tract of some health individuals (esp those in hospital)

24
Q

How does C. Diff cause disease?

A

When normal flora is suppressed (i.e. Antibiotic therapy)

-> C. Diff able to colonize and grow

Produces exotoxins

25
What are the toxins produced by C. DIff?
Exotoxin A: - enterotoxin - binds to gut receptor EXOTOXIN B: - cytotoxin - damages colonic mucosa ->bleeding - leads to PSEUDOMEMBRANE
26
How does C. Diff manifest?
Diarrhea Pseudomembrane - Yellow/white plaque PMN in stool Blood in stool
27
How do we Diagnose C. Diff?
History of antibiotic use Exotoxin B in stool ELISA for toxins Stool culture doesn't mean disease
28
How do you treat C. Diff?
Stop offending antibiotics Treat with METRONIDAZOLE or VANCOUVER
29
What in the world is Clostridium Perfringens?
Causes GAS GANGRENE Hallmark tissue necrosis Found in soil and Gi
30
What are the two manifestations of C. Perf?
1. Gas Gangrene - Invasive rapidly progressing - requires surgery to treat 2. Self limiting diarrhea
31
How does Gas Gangrene happen?
Tissue infection Anaerobic environment Toxins necrose tissue Releases gas (H2 and CO2)
32
What are the important C. Perf toxins?
ALPHA TOXIN - lecithinase -damages host cell membrane Collagenase and Hyaluronidase -break down extracellular protein matrix
33
How does C. Perf poison us through food?
Growth in food Ingest bacteria Pre-synthesized enteroxtins released
34
How does Gas Gangrene Manifest?
Dependent on anatomy and location of infection Cellulitis necrotizing cellulitis Necrotizing fasciitis
35
What does C. Perf food poisoning look like?
Ab cramps Watery diarrhea within 8-24 hours
36
Clinical diagnosis for C. Perf?
Crepitus (from gas) Discoloration and edema Special culture
37
How would you treat gangrene?
SURGERY and wound cleaning Penicillin to kill all that remains Hyperbaric oxygen if available