hemophilus and bordetella

Question 1

H. influenza stain and morphology

Answer 1

gram negative coccus-to-rod (coccobacillus)

Question 2

H. influenza special features

Answer 2

small pleomorphic.

Question 3

how many serotypes of H. influenza

Answer 3

6. type b causes the most severe disease consisting on meningitis and sepsis.

Question 4

what characterizes the most pathogenic strains of H. influenza

Answer 4

capsule

Question 5

what is important about the NTHi strains of H. influenza

Answer 5

they are not encapsulated and thus not covered by the vaccine. they are of lower pathogenicity

Question 6

how do we grow H. influenza

Answer 6

lab media with addition of factors X (heme) and V (NAD)

Question 7

what organisms does H. influenza infect

Answer 7

human restricted

Question 8

how is H. influenza transmitted

Answer 8

through respiratory droplets. colonization maybe asymptomatic or cause respiratory illness

Question 9

what respiratory illnesses are characteristic of H. influenza

Answer 9

otitis media, sinusitis, pneumonia

Question 10

what virulence factors for H. influenza aid int he pathogenicity

Answer 10

IgA protease for the mucus membranes.

Question 11

does H. influenza have an exotoxin/

Answer 11

NO. only capsule and endotoxin.

Question 12

who is most often affected by H. influenza

Answer 12

children 6months-6 years. peak 6 months to 1 year. this is due to the maternal antibody waning and the lack of response from the child.

Question 13

can H. influenza be normal flora

Answer 13

yes. can spread this way

Question 14

can H. influenza cause complications of birth

Answer 14

postpartum sepsis, abscess, early-onset meningitis, sepsis.

Question 15

what local infections are caused by H. influenza

Answer 15

otitis media, conjunctivitis, sinusitis. also can cause septic arthritis, cellulitis, sepsis, pneumonia.

Question 16

what illnesses predispose patients to H. influenza

Answer 16

asthma, malignancy, CF, advanced age, other immune suppression. not covered by vaccine

Question 17

diagnosis of H. influenza meningitis

Answer 17

rapid onset fever, HA, stiff neck. typical of HiB

Question 18

diagnosis of H. influenza otitis media/sinusitis

Answer 18

pain and swelling in the area, bulging of the tympanic membrane usually NTHi

Question 19

H. influenza epiglottis

Answer 19

swollen, cherry red epiglottis that can block the airway. classic of HiB

Question 20

labs for H. influenza

Answer 20

isolate on chocolate agar with and without factors. growth with only factors is usually sufficient for diagnosis. biochemical and immunological tests can be done.

Question 21

treatment for H. influenza meningitis/other serious

Answer 21

ceftriaxone

Question 22

treatment of H. influenza URI

Answer 22

amoxicillin + clavulanate or sulfa-trimeth

Question 23

how to treat local NTHi

Answer 23

seldom spread, so let patient decide unless there is a predisposition

Question 24

prevention of H. influenza

Answer 24

vaccine. made of capsular polysaccharide of B. and conjugated to diptheroid toxoid. made of polyribosyl ribitol phosphate PRP

Question 25

who gets the H. influenza vaccine routinely

Answer 25

2-15 month olds.

Question 26

what do close contacts of H. influenza patients receive

Answer 26

prophylactic rifampin

Question 27

bordetella pertusis stain and morphology

Answer 27

gram negative rod (coccobacillus)

Question 28

is bordetella pertusis encapsulated

Answer 28

yes.

Question 29

is bordetella pertusis human-restricted

Answer 29

yes

Question 30

how contagious if bordetella pertusis

Answer 30

very contagious

Question 31

who gets infected with bordetella pertusis

Answer 31

historically infants and children, but now its reaching adolescents and adults in areas with low vaccine coverage. can also be seen in children that have not completed the vaccine

Question 32

what is the virulence factor of bordetella pertusis

Answer 32

filamentous hemagluttinin pilus. attaches the bacteria to cilia of epithelial cells lining the respiratory tract. pertussis toxin tracheal cytotoxin,

Question 33

what kind of toxin is bordetella pertusis pertussis toxin and what does it do?

Answer 33

A-B subunit ADP-ribosylator. kills ciliated cells giving the bacteria resistance against coughing. also inhibits chemokine signal transduction and thus lymphocytosis.

Question 34

what does bordetella pertusis tracheal cytotoxin do?

Answer 34

kills ciliated cells.

Question 35

what disease does bordetella pertusis cause

Answer 35

whooping cough

Question 36

clinical features of bordetella pertusis whooping cough

Answer 36

acute tracheobronchitis progressing into severe paroxysmal cough. characteristic pattern of cough. infants turn blue and children turn red and vomit. lasts 1-4 weeks.

Question 37

what is the characteristic pattern in whooping cough caused by bordetella pertusis

Answer 37

there is series of hacking coughs, copius mucous production, inspiratory whoop as air rushes in past the narrowed epiglottis.

Question 38

does bordetella pertusis become septic.

Answer 38

no. it usually sticks to the respiratory system.

Question 39

what is a common non lethal complication of bordetella pertusis

Answer 39

CNS anoxia and exhaustion.

Question 40

can bordetella pertusis be fatal?

Answer 40

yes. in predisposed patients from pneumonia.

Question 41

what does bordetella pertusis look like in adults?

Answer 41

there is usaully no whooping cough, but instead there is a prolonged 100-day cough. URI.

Question 42

labs for bordetella pertusis

Answer 42

pronounced leukocytosis 70% lymphocytes, need to culture swabs (slow). samples or cultures tested for ab's. PCR is available.

Question 43

how do we culture bordetella pertusis

Answer 43

on bordet-gengoiu agar. but grows slowly

Question 44

treatment for bordetella pertusis

Answer 44

macrolides kill bacteria, but do not heal the respiratory lining. can be coughing for 3 months. infants and children will need supplemental O2 and mucous suctioning during the paroxysmal stage. if the baby turns blue admit.

Question 45

prevention of bordetella pertusis

Answer 45

acellular vaccine and killed vaccine.

Question 46

acellular vaccine for bordetella pertusis

Answer 46

genetically inactivated pertussis toxoid filamentous hemaglutinin, pertactin and fimbriae types 2 and 3. raises a good protective response safely.

Question 47

killed vaccine for bordetella pertusis

Answer 47

heat-killed bordetella pertusis linked to a small risk of encephalopathy.

Question 48

what is the effectiveness of the bordetella pertusis vaccine

Answer 48

neither are 100% sporadic cases still occur. 10 year boosters are needed and is part of the recent resurgence of the disease.

Question 49

what do we give to children at risk for bordetella pertusis

Answer 49

erythromycin

Question 50

should we vaccinate or boost nearby contacts of newborn babies>

Answer 50

yes. strongly recommended

Question 51

should we vaccinate during pregnancy,

Answer 51

no. afterward.