Encapsulated org

Question 1

Disease is associated with which variant of H. influ?

S. pneumo? N. meningitis?

Answer 1

H. influ: Type B in unvaccinated pop

S. pneumo: 12 serotypes

N. meningitis: Type A serogroup

Question 2

bacterial meningitis colonizes where prior to an epidemic?

Answer 2

Colonizes upper respiratory tract of a sig. proportion of the pop

Question 3

What were the majority of DEATHS during the influenza pandemic caused by?

Answer 3

Secondary bacteria pneumonia from:

• S. pneumo
• H. influ
• S. pyogenes
• S. aureus

Question 4

Which organisms are more severe in:
Meningitis
Bacteria Pneumonia
Otitis media (middle ear infxn)

Answer 4

Meningitis:
- S. pneumo> N. meningitis&raquo_space; H. influ

Bacteria Pneumonia:
- S. pneumo > H. influ

Otitis media (middle ear infxn)
- S. pneumo > Moraxella > H. influ

Question 5

Teichoic acids (TA) + Peptidoglycan (PG) +
Pneumolysin

Answer 5

enhances production of cytokines –> cytokine storm

Lysis of organism –> inflammation and more serious infxn

Question 6

Do unencapsulated encapsulated strains of S. pneumo and N. meningitidis cause major disease?

Answer 6

Encapsulated

*unencapsulated strains do cause morbidity but not as high

Question 7

Coccobacillus

Answer 7

H. influ

Question 8

Media to grow H influ

Answer 8

Chocolate agar

- needs X (heme) and V (NAD)

Question 9

Presence of anticapsular ________ in blood stream protects against serious invasive meningitis disease.

Answer 9

IgG or IgM

*person with no anticapsular antibody are at high risk for meningitis

Person with IgA blocking Ab have a high risk for meningitis, even if they have anticapsular ab

Question 10

Why not immunize children

Answer 10

Respond poorly to T cell independent Ag such as capsular polys

*the protective Ab may come from an immune response normal flora Ag which cross-react (ie: have similar antigenic structure) with the capsules of virulent species

Question 11

What helps immunize people against H influ type b when they cannot get vaccinated?

Answer 11

Normal flora produce Ag similar to capsule

*but not we have a conjugate vaccine we can give

Question 12

Who should receive the Hib vaccine in comb with DTap?

Answer 12

CHildren

Question 13

Why is the pneumonia vaccine a misnomer?

Answer 13

It has efficacy against invasive pneumococcal disease, not against non-bacteremic pneumococcla pneumonia
- not immunogenic in children

Question 14

Prevnar vaccine

Answer 14

Conjugated vaccine made from 13 capsule types of S. pneumo that are linked to Diphteria toxoid CRM

Question 15

Haemophilus species that require only Factor X and only Factor V? Which one requires both?

Answer 15

X: H. ducreyi

V: H. parainfluenzae

X+V: H. influenzae

Question 16

What is a satellite colony? What is an example?

Answer 16

Colonies of bacteria that like to grow near others

ie: H. influ likes to grow near Staphylococci on blood agar
getting their NAD from Staph

Question 17

GP diplococci vs

GN diplococci

Answer 17

GP diplo: Strep pneumo

GN diplo: N. gonorrhea

Question 18

Agglutination test

Answer 18

Antibodies to capsules (organisms with specific antigens)

Question 19

Countercurrent Immunoielectrophoresis

Answer 19

Detects the presence of capsule in bodily fluids
- look for precipitin band

Useful if pt has already been treated with antibiotics bc these organisms shed the capsular polysaccharied where it can be detected (into their urine)

Question 20

Possible cross reactivity that can occur with:
H. influ
S. pneumo
N. meningitis

Answer 20

H. influ:
- teichoic acids of many GP + nl flora

S. pneumo
- Hu ABO antigens

N. meningitis
- K1 capsule of E. coli & brain gangliosides

Question 21

What happens if you lyse pneumococcus organisms with a capsule containing TA, PG, + Pneumolysin with autolysin or B-lactam antibiotics?

Answer 21

Release contents –> activates complement, binds Fc portion of Ab, triggers cytokine release –>

Inflammation and tissue damage

Question 22

PCV13 vs PPSV23 (valent)

Answer 22

PCV13: higher and more sustained response.

Immunocompromised, asplenic, CSF leaks, or cochlear implants should recieve PCV13 first and then PPSV23 6-12 mo later. (low–> stronger)

Or is youre >65, and have already recieved the PPSV23, then get the PCV13 booster 1 year after.