Gm- Opportunists Flashcards

(54 cards)

1
Q

List 7 commonly isolated Gram negative bacteria that often grow as opportunists in debilitated
patients.

A
Escherichia coli
Pseudomonas aeruginosa
Klebsiella pneumoniae
Enterobacter cloacae
Serratia marcesens
Proteus vulgaris & Proteus mirabilis
Acinetobacter baumanii
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain how specific known properties of each organism can contribute to its ability to cause infections.

A

Antibiotic resistance

Biofilms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List three diagnostic critera for diagnosis of Gram negative opportunists.

A

Diagnostics:

  • –Colony morphology
  • –Selective medium
  • –Biochemical tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain how infections by Gram negative opportunists are prevented and the role of antibiotics in controlling infections.

A

Treatments: Abx used dependent on infecting microbe and site of infection

Prevention: many things in combination need to be used to prevent infections

  • –Control underlying compromising factors
  • –Reduce catheter usage, increase hygiene
  • –Decontamination of medical equipment
  • –Cleaning of hospital spaces
  • –Handwashing and glove use!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List three things that can increase risk of infection by opportunistic pathogens

A
  1. Decreased/altered immune function: chronic disease, chemo/immunosuppressive therapies, antibiotics
  2. Alterations in innate protective mechanisms
  3. Breach of physical barriers: surgery, indwelling catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are opportunistic pathogens? What bacteria typically cause them?

A

Pathogens that can only cause disease in compromised people

Typically caused by Gm- bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some sources of opportunistic pathogens?

A

Everywhere! Water, soil, vegetables, us

HOSPITALS!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What general virulence factors are associated with opportunistic infections? (4)

A

LPS -> systemic response if in bloodstream
Adhesins: cell-surface structures that mediate colonization
Nutrient acquisition factors
Toxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can contribute to pneumonia from opportunistic pathogens? (5)

A
Lung/heart disease, cancer
Surgery
Lying on back for a long time
Mechanical ventilation
Sedation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are nosocomial infections? How can they be prevented?

A

Infections acquired in hospitals

Handwashing!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name two important opportunistic pathogens with high INNATE resistance to antibiotics. Why are they so resistant?

A

Pseudomonas aeruginosa
Acinetobacter baumanii

Resistant because they grow in soil and have to compete with Abx producers in soil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are biofilms? Why are they important? Where do they form?

A

Single or mixed species films of bacteria on a surface that increase their resistance to Abx

Form on catheters, sutures, chronic wounds, lung infections, endocarditis, UTIs
–65% of nosocomial infections are biofilm-related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are biofilms formed?

A

Organic layer on catheter -> surface-associated cells -> ECM -> induction of biofilm Abx resistance genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is quorum sensing? What does it have to do with virulence factors?

A

A way for bacteria to talk to one another using chemicals that will indicate that they are surrounded by a certain number of organisms of the same type

Bacteria generally only induce virulence factors when they are at high density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are three infections that can be caused by commensal E. coli?

A

UTIs
Bacteremia
Meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Uropathogenic E. coli: epidemiology, including number of serotypes

A

Cause most UTIs
-Catheters important source of infection
-Women more susceptible than men
Only a few serogroups cause infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Uropathogenic E. coli: how does infection occur?

A

Invasion and spread of bacteria into UT
Uses adhesins to aid in colonization and ascension of urethra
—Different strains = diffferent types = different colonizable locations
Form biofilms -> persistent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Uropathogenic E. coli: what are clinical symptoms? How many bacteria must be present to have a diagnosable infection?

A

Need 10^5 bacteria/ml in urine

Cystitis (inflammation of bladder)

  • -Dysuria (burning during urination)
  • -Frequent/urgent urination

Acute pyelonephritis (kidney infection)

  • -Flank pain and tenderness
  • -Fever
  • -Dysuria (burning during urination)
  • -Frequent/urgent urination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Uropathogenic E. coli: how is it treated?

A

Acute and self-limiting
Treat pyelonephritis with Abx

Commonly reoccur: human behavioral, biofilm formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Uropathogenic E. coli: what is the P-pili? What does it bind to?

A

Binds to glycolipids found on human P blood group (Gal-Gal moiety)

  • -Common in PYELONEPHRITIS
  • -Different individuals have different P blood groups -> different susceptibility to P-pili/E. coli UTIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Uropathogenic E. coli: what are type I pili?

A

Mannose-binding pili - allow them to bind mannose on host uroepithelial cells
–Common in CYSTITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

E. coli bacteremia: epidemiology, pathogenesis

A

Leading cause of nosocomial bacteremia

–Commonly invades through IV catheters or UTIs with obstructed urine flow

23
Q

E. coli bacteremia: how does it resist serum?

A

Produces K1 capsule: polysialic acid capsule (same as N. meningitidis)
–Sialic acid is on host glycoproteins/lipids, so no effective immune response

24
Q

E. coli bacteremia: what is its most dangerous virulence factor?

A

LPS! Life-threatening

25
E. coli meningitis: what is it? What virulence factors are important for it? Briefly describe its pathogenesis.
Causes meningitis in neonates Main virulence factor = K1 polysialic acid capsule (escapes phagocytosis) --Siderophores very important Proliferates in CSF -> inflammation, tissue damage
26
Pseudomonas aeruginosa: what range of infections can it cause?
Infections of burns, eyes, wounds, catheters, implants Pneumonia, especially ventilator-associated Bacteremia in immunocompromised patients
27
Pseudomonas aeruginosa: role in cystic fibrosis
Forms biofilms -> recalcitrance and resistance Infects more than 80% of CF patients Die in mid-30s due to inflammation/infection Cannot be cleared
28
Pseudomonas aeruginosa: how does it evolve in chronic infections (CF)? (may not be important)
Produces alginate slime that may block phagocytosis (very mucousy)
29
Pseudomonas aeruginosa: virulence factors (5)
LPS Extracellular elastases (proteases) and phospholipases T3SS exotoxins: --ExoA. Inhibits protein synthesis. –ExoS and ExoT. Exoenzymes that modify host cell regulatory proteins –ExoU. Phospholipase activity within host cell Pyocyanin
30
Pseudomonas aeruginosa: why does it produce a green color?
Blue-green pigment = toxin called pyocyanin | --Affects host cell function, generates ROS
31
Klebsiella pneumoniae: clinical syndromes
``` Pneumonia when other conditions are present --Associated with alcoholism --Red currant jelly sputum UT, wound infections Diarrhea by enterotoxigenic strains Bacteriemia and meningitis ```
32
Klebsiella pneumoniae: virulence factors
CAPSULE: - -Reduced phagocytosis and complement susceptibility - -Produces mucoid phenotype
33
Enterobacter cloacae: epidemiology
Hospital-associated! - --Associated with burns, wounds, respiratory/UT/catheter associated infections - --Forms biofilms Virulence factors unknown
34
Serratia marcesens: epidemiology, virulence factors
``` Very common enterobacteriaciae ---Produces a red color when grown (pink color on showers, water bottles!) - likes water Most common in respiratory/UT infections ---Can colonize joints, most tissues Generally seen secondary to immune problems, instrumentation, Abx use Virulence factors: ---MS-fimbrae ---Proteases ---Siderophores ---Swarming motility (see Proteus) ```
35
Proteus vulgaris & mirabilis: clinical syndromes, virulence determinants (2)
Commonly causes UTIs Virulence determinants: --Flagella (swarm motility- make a surfactant, then swim through it) --Urease production: can contribute to stone formation due to urine pH change
36
Acinetobacter baumanii: characteristics, epidemiology
``` Similar to P. aeruginosa (non-fermenter) ---Oxidase negative ---Short rod ---Increasingly multi-drug resistant Causes nosocomial infections, especially with indwelling devices ```
37
UPEC: virulence factors (5)
``` Pili LPS Capsule Motility Exotoxins (including hemolysin) ```
38
Classify P. aeruginosa's oxygen usage.
Obligate aerobe (cannot ferment sugars)
39
Acinetobactor baumanii: virulence factors (4)
Capsular polysaccharides Adhesins Proteolytic/lipolytic enzymes LPS
40
E. coli: energy metabolism
Facultative anaerobe
41
E. coli: lactose fermenting?
Positive
42
K. pneumonia: energy metabolism
Facultative anaerobe
43
K. pneumonia: lactose fermenting?
Positive
44
S. marcescens: energy metabolism
Facultative anaerobe
45
S. marcescens: lactose fermenting?
Negative
46
E. cloacae: energy metabolism
Facultative anaerobe
47
E. cloacae: lactose fermenting?
Positive
48
P. mirabilis: energy metabolism
Facultative anaerobe
49
P. mirabilis: lactose fermenting?
Negative
50
A. baumanii: energy metabolism
Non-fermenter
51
A. baumanii: lactose fermenting?
Negative
52
P. aeruginosa: energy metabolism
Obligate aerobe
53
P. aeruginosa: lactose fermenting?
Negative
54
What is CRE?
Carbapenem-resistant enterobacteriaceae