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Flashcards in Hospital-Acquired Gram(-) Deck (27):
0

Where is P.aeruginosa found?

1. Soil
2. Water
3. Plants
4. Animals
5. Intestinal flora
6. Skin

1

How is P.aeruginosa transmitted?

1. Medical devices
2. Hands of healthcare workers

2

What is the metabolism of P.aeruginosa?

1. Obligate aerobe
2. Non-lactose fermenter
3. Oxidase-positive

3

What is the virulence of P.aeruginosa?

1. Motile (polar flagella)
2. Hemolysin
3. Collagenase
4. Elastase
5. Fibrinolysin
6. Phospholipase C
7. DNAse
8. Antiphagocytic capsule (some strains)

4

What are the toxins of P.aeruginosa?

Exotoxin A (similar to diphtheria toxin) - inhibits protein synthesis by blocking EF2.

5

What can P.aeruginosa cause?

BE PSEUDo.
1. Burn-wound infection
2. Endocarditis
3. Pneumonia
4. Sepsis
5. External malignant otitis media
6. UTI
7. Diabetic osteomyelitis

6

How can we identify P.aeruginosa?

Culture:
Greenish metallic appearing colonies on blood agar, which have fruity (grape) smell.

7

What is important to keep in mind about P.aeruginosa?

1. Common infection in neutropenic patients.
2. Produces pigments when cultured:
a. pyocyanin (blue pigment)
b. pyoverdin (green pigment)

8

Where is Burkholderia cepacia found?

1. Soil
2. Water
3. Plants
4. Animals
5. Lungs of cystic fibrosis patients

9

How is Burkholderia cepacia transmitted?

1. Medical devices
2. Hands of healthcare workers
3. Between cystic fibrosis patients (?)

10

What is the metabolism of Burkholderia cepacia?

1. Oxidase (+)
2. NON-lactose fermenter

11

What is the virulence of Burkholderia cepacia?

Extremely antibiotic and disinfectant resistant.

12

What can Burkholderia cepacia cause?

1. Pneumonia in cystic fibrosis patients.
2. Infections in patients with chronic granulomatous disease.

13

How can we identify Burkholderia cepacia?

May use selective media with colistin to select for growth.

14

Where is Stenotrophomonas maltophilia found?

1. Soil
2. Water
3. Plants
4. Animals
5. Normal respiratory flora

15

How can Stenotrophomonas maltophilia transmitted?

1. Medical devices
2. Hands of healthcare workers

16

What is the metabolism of Stenotrophomonas maltophilia?

1. Oxidase (-)
2. Non-lactose fermenter

17

What is the virulence of Stenotrophomonas maltophilia?

Extremely antibiotic and disinfectant resistant.

18

What can Stenotrophomonas maltophilia cause?

1. Pneumonia in ventilated patients on broad antibiotics.
2. Line-related bacteremia.

19

What is important to keep in mind about Stenotrophomonas maltophilia?

Often a non-pathogenic colonizer of respiratory flora.

20

Where is Acinetobacter baumannii found?

1. Soil
2. Water
3. Skin
4. Secretions

21

How is Acinetobacter baumannii transmitted?

1. Medical devices
2. Hands of healthcare workers

22

What is the metabolism of Acinetobacter baumannii?

1. Obligate aerobe
2. Oxidase (-)
3. Non-lactose fermenter

23

What is the virulence of Acinetobacter baumannii?

Multiple acquired mechanisms of antibiotic resistance.

24

What are the toxins of Acinetobacter baumannii?

1. Bacteriocin production
2. Protective capsule (inhibits phagocytosis)

25

What can Acinetobacter baumannii cause?

1. Pneumonia
2. Line-related bacteremia
3. UTI
4. Burn/wound infections
5. Eye infections

26

What is important to keep in mind about Acinetobacter baumannii?

1. May be mistaken for Neisseria
2. Guide therapy with antibiotic susceptibilities.