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Gram-positive Bacilli Flashcards

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1
Q

Classification of bacilli

A 
Familybacillaceae
Aerobic 
spore forming 
Gram positive 
B.anthracis
B.cereus
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2
Q

Classification of gram positive bacilli

A 
Endospore
Formers:bacillus,clostridium
Non formers:listeria,erysipelothrix
Irregular shaped and staining properties :
Corynebacterium 
Mycobacterium
Actinomycetes
No cardio
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3
Q

Bacillus anthrax

A

Non motile
Capsulated
Spores
Zoonotic

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4
Q

Diseases of anthrax

A

Inhalation(pulmonary anthrax) I :5% M:95%
Wool sorters disease
Pre treatment :duckering i.e treating with formaldehyde
D/s:mediastinitis,pneumonia is

Contact/inoculation(cutaneous anthrax) I:95% M:20%
Hide porters disease
Malignant pustule/blackeschar with necrosis @ center

Ingestion(intestinal anthrax) in I:rare M:95%

Cerebral anthrax: Haemorrhagic CCF

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5
Q

Anthrax bioterrorism category and safety

A

Type A

BSL 3

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6
Q

Culture bacillus anthrax

A

PLET
Medusa head

Gelatin stab
Inverted fir tree

Blood agar with penicillin
L forms
Pearl on a string appearance

Nutrient agar
Ground glass appearance

Soil/in Vitro cx : bamboo stick/ box car on gram staining

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7
Q

Investigation

A 
PCR
Elisa
If
Gamma phage typing
Multilocus sequence typing
Mcfaydean reaction
Aescoli’s gel precipitation test
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8
Q

Mcfaydean reaction

A

Capsule turns blue on methylene blue staining

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9
Q

Aescolis gel precipitation test

A

Double diffusion single dimension

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10
Q

Virulence factors of anthrax

A 
Oedema factor 
Lethal factor(cleaves MAPK)
Protective antigen factor(Stimulate entry of above  two cytolytic toxins)
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11
Q

Historical significance of bacillus anthrax

A 
First bacteria
     To be isolated by culture
      To be seen under microscope
      Used for  kochs postulates
       To involve a communicable disease through blood
        To be found a vaccine
        In where precipitation test done
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12
Q

Spores of B.anthrax

A

Not seen in tissue i.e in Vivo

Seen in soil and culture only

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13
Q

Bacillus cereus

A

Non sporing
Non capsule
Motile
Gram positive

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14
Q

Toxins of bacillus cereus

A 
Food poisoning(vomitting)
Pre formed(<6hrs)
Increase in bacteria
Increase in cGMP
Heat stable

Diarrhoea
Not preformed(>12 hrs)
Loose stools 
Decreased number of bacteria
Increase in cAMP

Toxins similar to E. coli

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15
Q

Investigation of bacillus cereus

A

Stool culture MYPA

Diagnostic >10 to power 5 cfu/gm of stool

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16
Q

MYPA

A

Mannitol
Yolk sac
Phenol red/polymycin
Agar(novo biocin)

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17
Q

PLET Medium

A

Polymyxin
Lysozyme
EDTA
Thallium acetate

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18
Q

Corynebacterium diphtheria toxins

A 
Toxin A 
Required from beta phage
Tox gene
Inhibits EF 2
Inhibits protein synthesis

Toxin B
attachment
Entry of toxin A

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19
Q

Culture media of diphtheria

A

Loefflers serum slope
Pigment production enhanced
Early detection

Potassium telluride agar
Mitis poached egg
Gravis daisy head
Intermedius frog egg

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20
Q

Bio types of clostridium diphtheriae

A

Mitis
Endemic
Obstructive
Mild

Intermedius
Epidemic
Hemorrhagic
Moderate

Gravis
Epidemic
Hemorrhagic paralytic
Severe

Belfani
All are nitrate positive except belfani

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21
Q

Other corynebacterium

A 
Immunocompetent
Ulcerans (milk)
Pseudo tb(zoonosis suppurations lymphadenitis)
Arcanobact haemolyticum(beta hemolysis)
Minutissimum(erythrasma)

Immunocompromised
Jeikium
Xerosis
Hofmani
Equi

C parvum
C urealyticum

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22
Q

Schiks test

A 
Immunogenicity susceptibility testing
Intradermal inj of toxin 0.2 ml /1/50 ml
Another hand heated inactivated toxin
If toxin (+) reaction =susceptible 
If antitoxin (+)=hypersensitivity
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23
Q

DT toxoid

A

Formalin treated for 30 days
Dose 25-30 lf units/dose
Older children and adults 1-2 lf units/dose

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24
Q

Lf units

Study These Flashcards
A

Limes flocculations

25
Mycobacterium
TB Lepra NTB
26
Mycobacterium tb
Acid fast Long slender beaded Bacilli Aerobic
27
Culture of tb bacilli
Egg media LJ medium Dorset egg media ``` Liquid BACTEC 460 radiometric method C14 to CO2 BGIT Decreasing O2=increasing fluorescence BACT alert/MBsystem Septi check ESP Culture system 2 ```
28
Investigation of mycobacterium tb
Gamma interferon assay Antigen injected Lymphocyte activated Gamma interferons Mantoux(LATENT TB) Intradermal injection of 0.1ml ppd or 5TU of ppd or 1TU of RT 23 strain 48-72 hrs 10 mm positive exposure in adults or diagnostic in children 5-9 doubtful <4 negative IS6110 rflp gene sequencing M bovis Spoligotyping(spaced oligonucleotide typing) Gene expert CBNAAT rifampicin resistance
29
False positive mantoux
Atypical bact kansasi
30
False negative mantoux
Miliary Tb Immunocompromised Measles
31
Types of tb
Primary/latent | Secondary/active
32
Primary to
``` GHONS focus(lower lobe) GHONScomplex LL +enlarged LN Rheinkes complex Calcified enlarged LN ```
33
Secondary to
Simons focus Upper lobe(apex of lung) Heamatogenous seeding Ashermans focus B/L calcified nodules Infraclavicular
34
Resistance of tb
``` Inh Katg Deletion of catalase peroxidase Inh A defect in function of mycolic acid ``` Rifampicin RpolB Muatation in rna polymerase beta subunit Streptomycin Gamma psl/Rrs Mutation in ribosomal s12 protein &16srna Gyr A Defect in DNA gyrase
35
Lj medium
Egg solidifying agent Glycerol dSource of carbon Malachite green
36
Time taken in culture and other BACTEC systems
3 to 4 weeks in LJ medium 7 to 14 days in BACTEC <7 days in NTB IN BACTEC
37
Preparation of sputum
Petroffs technique 4% NAOH Disinfectant For comtaminants N actylcysteine Mucolytic agent Centrifugation
38
Middle brooks media
7H9 1%proportion technique Drug sensitivity testing method Ratio of numbers of colonies in drug containing media to drug free media >=1 resistance present
39
acid fast staining concentration
``` My lepra 5%sulphuric acid My TB 10% Nocardia 1% ```
40
Mycobacterium lepra
Acid fast(5%) Short stout straight bacilli Foam cells Cigar bundle appearance in histiocytes/macrophages(>50bacilli)
41
Clinical features of leprosy
``` Lionen facies Sagging muscles Nodular lesions Madarosis Claw hand Wrist drop Foot drop ```
42
Nerves involved
Ulnar>post auricular nerve NEVER INVOLVED MEDIAN POPLITEAL NERVE
43
Slit skin smear
``` Buttock Ear lobule Forehead Chin Cheeks Nasal mucosa ``` 4 samples minimum
44
Bacteriological and morphological index
Bacteriological No of bacilli Morphological No of viable bacilli =>1 resistance
45
Types of leprosy
``` Tuberculoid(CMI) Borderline tuberculoid Borderline Borderline lepromatous Lepromatous (antibody) ```
46
Lepra reaction
``` Three types Type 1 d/t CMI TYPE 4 HS 2 subtypes Reverse and downward Reverse is after drug admin Downward is before drug admin Inflammation in existing lesions Thickening of nerves/neuritis (ulnar nerve M/C) Treatment:glucocorticoid ``` Type 2 d/t TYPE 3 IC Erythema nodosum leprosariums Painful erythematous populist to nodules Type 3 d/t TYPE 3 IC Lucio reaction Diffuse dermal infiltration Ischemic necrosis of epidermis dermis lower limb mainly Treatment:glucocorticoid If not responsive thalidomide ,glucosamine
46
Culture of lepra
Cannot be cultured Does not obey Koch postulate Food pad of mouse(thymectamised to cause lepromatous leprosy) Footpad of armadillo 9 banded(natural infection with favourable temp for bacilli demonstration in tissue)
48
Lepromin test
Early Fernandez Similar to mantoux 48 hrs Previous exposure present Late Mitsuda Due to current injection of Dharmendra antigen 3-4 weeks
49
Lepromin test vs lepra reaction
Lepromin test Prognosis of disease Transition through spectrum From tuberculoid to lepromatous or vice versa Intact CMI gives positive results either late or early Tuberculoid spectrum CMI mediated and hence gives positive results Lepra reaction It’s normal in course of disease in relation to treatment Just a treatment response But has to be made sure by seeing prognosis of disease by lepromin test Patient compliance to drug is the cornerstone to cure of disease and so he must be assured of these reactions at the start of treatment
50
Vaccines for leprosy
ICRC Bacilli not used M vaccae immunomodulator function in Tuberloid to prevent lepromatous
51
Treatment of leprosy
Paucibacillary Dapsone daily Rifampicin monthly 6 months ``` Multibacillary Dapsone daily Rifampicin monthly Clofazimine monthly 1 year ``` ``` Single lesion Rifampicin Ofloxacin Minocycline Single dose ```
52
Listeria monocytogenes
Only gram positive bacilli to have endotoxins Tumbling motility @ 25 deg Celsius Favour growth by cold enrichment (2-8 deg Celsius) Therefore present in refrigerated foods Eg cheese
53
Toxins of listeria
Listeriolysin Cytotoxin Both people l/t TH1 response and granuloma Int A and Int B( e cadtherin) Actin A ( polymerisation of actin filaments)
54
Diseases of listeria monocytogenes
``` Early Granulosus Maternal symptomatic IUtransmission Shortly after birth ``` Late Neonatal meningitis Transmission through health care workers 1 week to 1 month
55
PALCAM
``` Stool culture Selective media Polymyxin Acriflavine Lithium chloride Ceftazidime Aesculin Mannitol motility at 25 deg Celsius in palcam Blood/chocolate agar Cold enrichment @ 2 to 8 deg followed by incubation in selective media ```
56
Complications of listeria
``` Septicaemia through maternal IU transmission Chorioamnionitis PROM Preterm birth Abortions ``` In non pregnant women Sepsis immunocompromised
57
Erysipelothrix rhusiopathiae
Swine turkey fish Erysepeloid(human) ``` Seal/whale finger Following trauma to hand Reddish blue edematous lesion Alpha haemolytic Hydrogen sulphide ``` Transmission Direct inoculation Animal products
58
Antons test
Instillation of bacteria in to rabbits eye | Keratoconjuctivitis

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