Flashcards in Community Acquired Bacterial Infections Deck (35)
Define virulence factor.
Molecules produced by pathogens that contribute to the pathogenicity of the organism
List some common bacterial virulence factors and include their function.
Flagella – movement and attachment
Pili – adherence factors
Capsule – protects against phagocytosis
Endospores – metabolically dormant forms of bacteria – they are heat, cold, desiccation and chemical resistant
Biofilms – organised aggregates of bacteria embedded in a polysaccharide matrix – antibiotic resistant
Give examples of bacteria that possess the following virulence factors:
What are exotoxins?
A toxin released by a living bacterial cell into its surrounding
What are the five different types of exotoxin? Give examples of bacteria that produce such toxins.
Infection diarrhoea –Vibrio cholerae, E. coli, Shigella
Food poisoning –Bacillus cereus, S. aureus
Tissue invasive toxins
What is an endotoxin?
This is the lipid A part of lipopolysaccharide that is found on the outer membrane of Gram-negative cells
NOTE: so ONLY Gram-negative cells can produce endotoxins
Why can treating patients with Gram-negative infection sometimes worsen their condition?
Antibiotics can cause lysis of the bacteria meaning that the endotoxins are released into the circulation in large quantities
This can trigger an immune response that leads to SEPTIC SHOCK
What is an outbreak?
A greater than normal or greater than expected number of individuals infected or diagnosed with a particular infection in a given time period, or a particular place, or both
How can an outbreak be identified?
Good and timely reporting systems are necessary
What was the 2011 E. coli outbreak in Germany caused by?
Enteroaggregative shiga toxin producing E. coli
What were the symptoms of infection by this bacterium?
Haemolytic uraemia syndrome (acute renal failure + haemolytic anaemia + thrombocytopenia
What was special about the bacterial strain that caused by outbreak?
The bacterial strain was an enteroaggregative E. coli strain (EAEC) that had acquired the ability to produce shiga toxin (through phagetransfer)
Shiga toxin production is a feature of Enterohaemorrhagic E. coli(EHEC)
This produced a new strain called Enteroaggregative haemorrhagic E. coli (EAHEC
Describe the structure of shiga toxin.
There is an A subunit that is non-covalently associated with a pentamer of protein B
Describe the action of shiga toxin.
Subunit A is the enzymatically active domain
Subunit B is responsible for binding to the host cell membrane
Subunit A cleaves 28S ribosomal RNA in eukaryotic cells thus inhibiting protein synthesis
Bacterial ribosomes are also a substrate for subunit A so it can lead to decreased proliferation of susceptible bacteria (e.g. commensal microflora of the gut)
How was the shiga toxin gene transferred between bacteria?
What is the important virulence factor in EAEC?
Aggregative adherence fimbriae (AAF) – this is required for adhesion to enterocytes
What type of bacterium is Legionella pneumophila and what is the route of infection?
It is transmitted through inhalation of contaminated aerosols
Which cells within the human host does L. pneumophila infect and grow inside?
What is the important virulence factor for L. pneumophila?
Type IV secretion system
What feature of Mycobacterium tuberculosis makes it more difficult to treat?
It has a mycolic acid outer membrane – this prevents normal antibiotics from getting into the cell
State three bacterial sexually transmitted diseases including the species of bacteria that cause the diseases.
Chlamydia - Chlamydia trachomatis
Syphilis –Treponema pallidum
Gonorrhoea –Neisseria gonorrhoeae
What is a major consequence of Chlamydia in the developing world?
Blindness (due to eye infection)
How does N. gonorrhoeae establish infection in the urogenital tract?
It interacts with non-ciliated epithelial cells
What are the important virulence factors of N. gonorrhoeae?
Antigenic variation escapes detection and clearance by the immune system
What is the most commonly reported infectious GI disease in theEU?
What is the route of infection of Campylobacter and Salmonella?
Ingestion of undercooked poultry
State some important virulence factors of Campylobacter jejuni.
Adhesion and invasion factors
Type IV secretion system
Which subset of the population has the highest incidence of Salmonella and Campylobacter infection?
Young children (0-4 years)
What is an important virulence determinant of Salmonella sp.?
Type III secretion system
NOTE: Salmonella sp. can cause outbreaks whereas Campylobactertends to be sporadic cases