Intro to Infectious Disease, Bacteriology and Vaccines Flashcards
(179 cards)
1
Q
Microorganisms are _____ inside everyone. However, if they _______, that’s when there can be problems.
A
Normally
Overgrow
2
Q
T or F: can normal gut flora cause infectious?
A
True
3
Q
Some ways normal gut flora can cause infectious disease?
A
Translocation to an area they’re not supposed to be (often from a break in the skin - our body’s first line of defense)
Overgrowth in areas by elimination of the good bacteria
Bacteria spread by food, animal bites, hospital or community transmission, etc.
4
Q
Which bacteria are mostly found on the skin?
A
Staph and Strep
5
Q
What is a different kind of bacteria found on the skin that is most responsible for acne?
A
Proprionibacterium acnes
6
Q
Which bacterium often colonizes catheters and medical devices that penetrate the skin?
A
Staph epidermidis
7
Q
Environment of the skin?
A
Dry, slightly acidic, aerobic
8
Q
What limits the eye from bacterial colonization?
A
Lysozymes found in tears keep the eye sterile
9
Q
Which bacteria, if they do, can colonize the conjunctiva and the eye?
A
Same as those on the skin: staph and strep
10
Q
Which bacterium is largely responsible for plaque formation on the teeth?
A
Strep mutans
11
Q
What do we worry about with dental surgeries (in regards to bacteria?)
A
That bacteria (strep mutans) may enter the bloodstream
12
Q
Which bacteria can be responsible for infective endocarditis and how?
A
Step. mutans, because it can colonize damaged or prosthetic heart valves
13
Q
Which bacteria can cause bacterial pneumonia?
A
Strep pneumoniae
14
Q
When does strep pneumoniae often strike?
A
Following a respiratory viral infection due to impaired immune system
15
Q
Where do gram pos anaerobes live in the mouth?
A
Underneath the gingiva, at the root of the teeth
16
Q
What types of bacteria are found in the mouth?
A
gram pos
anaerobes
17
Q
What types of bacteria are found in the gut?
A
gram neg
anaerobes
(gram pos, too, but they’re virutally everywhere)
18
Q
Where in the intestines is are the most microorganisms found?
A
colon
19
Q
Where in the alimentary canal is the least amount of mircroorganisms?
A
stomach
20
Q
20% of fecal mass is what?
A
Bacteria
21
Q
Which species of bacteria constitiutes the most % in the colon?
A
Anaerobic Bacteroides species
22
Q
Which bacteria is primarily found in the vagina? and why?
A
Lactobacillus species
Helps maintain low pH
23
Q
Antibiotics do what to the normal vaginal flora?
A
Decrease lactobacillus populations, therefore increasing the pH and causing an overgrowth of pathogens (like candida)
24
Q
Which bacteria are found in the urogenital tract?
A
Gram neg (because of the proximity to the anus) Some anaerobes Gram pos (staph has one of the more common bugs; from translocation of the skin into the urinary tract)
25
Some beneficial functions of normal flora?
Helps get rid of waste, provides nutrients, some produce antimicrobial substances, they outcompete harmful pathogens, aid in digestion and nutrietn absorption
26
Communicabilty ease of cholera vs botulism?
Cholera is highly communicable, botulism is noncommunicable
27
Which are some viruses we can treat?
Hep C, HIV, HSV, BCV
28
What is one of the best ways to figure out what bugs are on an area?
Gram staining
29
What does gram staining do?
Helps identify whether the bacteria is pos, neg, or variable
Helps identify the shape
All so that we can better choose which antibiotics to use
30
Which lab test is used to identify mycobacteria species?
Ziehl-Neelsen staining: Acid-fast bacilli
31
What stains detect fungi?
KOH, India ink, Giemsa stains
32
What does culture negative endocarditis mean? And why does that happen?
The bacteria doesn't grow on the agar for gram stains, so you get a neg culture. Because this bacteria doesn't grow, you need to do other staining techniques to better identify which bugs are present
33
RDT can identify pathogens in how long?
3 hours
34
What is the most definitive method for diagnosis and treatment of an infection?
Culture
35
How long does a culture take?
24-72 hrs
36
Which bugs are generally slower to grow on a culture?
Gram neg
37
What does an MIC tell us?
The lowest concentration of a drugs that will inhibit visible bacterial growth
38
What is bactericial and bacteriostatic?
Bactericidal - kills the bacteria
| Bacteriostatic - inhibits its growth (so this requires a good immune system to finish off the infection)
39
Which type of medicaitons (bactericidal or bacteriostatic) will get rid of the bug, and therefore, the infection sooner?
Bactericidal medications
40
What are some examples of bacteriostatic antiobiotics?
```
Chloramphenicol
Erythryomycin
Clindamycin
Sulfonamides
Trimethoprim
Tetracylcines
```
41
What are some examples of bactericidal antibiotics?
```
Aminoglycosides
Beta-lactams
Vancomycin
Quinolones
Rifampin
Metronidazole
```
42
What is a breakpoint in terms of antibiotic susceptibility?
The concentration at which antibiotic/bacteria is considered susceptible, intermediate, resistant
43
What is a breakpoint in terms of MIC?
The MIC concentrations of an antibiotic that separate the susceptibility categories, or concentration at which antibiotic/bacteria is considered susceptible, intermediate, resistant
44
What does susceptible mean?
Bacteria tested will have low MIC and will most likely be eradicated since the concentrations are easily achievable by standard dosing
45
What does intermediate mean?
Bacteria tested has a higher MIC and thus successful treatment may or may not occur or might need a higher dose
46
What does resistant mean?
Bacteria tested has a very high MIC that exceeds the achievable serum concentration of the antibiotic even if high doses are used and poor patient response would be expected
47
T or F: If an antibiotic has the lowest MIC, that's usually the best antibiotic for treatment.
No, there are lots of other factors (like location of the infection, etc.) so we don't target a specific MIC
48
An antibiogram shows what?
Report of the antimicrobial susceptibility profiles of the organism isolated with a hospital and surrounding community
49
What is a primary resistance?
Naturally-occurring trait of the organism
ex: Vacomycin resistance in E. coli
50
What is acquired resistance?
Spontaneous mutation of the target enzymes, or a transfer or genetic resistance determinants from other organisms
51
What is an example of acquired resistance?
VRSA, or MRSA
52
What bacteria have a high resistance?
Enterobacteriaceae
Staph aureus, strep pneumoniae, enterococci, psuedomonas aeruginosa, acinetobacter, C. diff
53
Which rapid diagnostic testing is used for MRSA?
mecA PCR
54
What is an example of a time-dependent killing antibiotic?
Beta lactams - penicillin, cephalosporins, carbapenem
55
What does it mean if an antibiotic is time-dependent killing?
The longer the serum concentration of the drug is over the MIC, the better it works
56
What is does it mean if an antibiotic is concentration-dependent killing?
Higher doses will kill the bacteria more
57
When would non-specific inflammatory markers like ESR and C-reactive proteins be used?
To check inflammation trends
58
Procalcitonin tends to rise in what kind of infections?
Bacterial
59
What is the half life of procalcitonin?
~24hrs
60
What's the most important thing to consider when managing infections?
Source control, if we can't do that, we'll delay how fast we can treat the infection and increase morbidity and mortality
61
When do systemic effects from a bacterial infection happen?
When the bacteria gets into the bloodstream
62
What are the steps for a systematic approach to select antimicrobials?
1. Confirm presence of infection (s/s, fever, predisposing factors)
2. Identifying the pathogen (collection of infected material, stains, serology, culture)
3. Selection of presumptive therapy (host and drug factors)
4. Monitor therapeutic response (clinical assessment, laboratory tests, assessment of therapeutic failure)
63
What could mask a fever from an infection?
Antipyretics (Tylenol, NSAIDs)
64
Community-acquired infection?
Infection that originates int he outpatient or community setting or could be present on admission
The patient has NOT had a recent hospitalization or invasive medical procedure
65
Healthcare-associated infection?
Infection associateed with a medical or surgical intervention; includes long-term care and skilled-nursing facilities
includes terms such as "nosocomial" and "hospital-acquired"
66
Definition of colonization?
Organisms do not invade the host, but are a part of the normal flora of the site
67
Definition of infection?
Organisms invade the host and the patient has signs and symptoms of infectious process
68
What is empiric treatment?
Before we know the infectious organism - in this case, usually a broad-spectrum antibiotic
69
What is definitive treatment?
Treatment aimed at the diagnosis and positively-cultured bacterium
70
What is prophylactic treatment?
Preventative treatment against infection; in this case it is often done secondarily to prevent a follow up infection
71
When is a broader spectrum antibiotic required?
When covered multiple, mixed organisms involved in the infection
72
What could result because of the overuse of broad-spectrum antibiotics?
Superinfection
73
What is antagonism?
When we kill our normal flora, allowing the bad bacteria to proliferate
74
Some signs that an infection is improving?
WBC and temperature normalizes
Lab values decrease
Physical complaints/symptoms from patient should diminish
Appetite should improve
75
What most often causes antibiotic failure?
Using the wrong drug or resistance
76
What bugs often cause UTIs?
E. coli
Enterobacteriaeceae
Staph saprophyticus
Psuedomonas aeruginosa
77
What bugs often cause URIs?
Strep. pyogenes
| H. influenza
78
What bugs cause gastritis?
Helicobacter pylori
79
What bugs can cause eye infections?
Staph. aureus
Neisseria gonorrhoeae
Chlamydia trachomatis
80
What bugs can cause food poisoning?
```
Campylobacter jejuni
Salmonella
Shigella
Clostridium
Staph aureus
E. coli
```
81
What bugs cause sinusitis?
Strep. pneumoniae
| H. influenzae
82
What bugs cause skin infections?
Staph. aureus
Strep pyogenes
Pseudomonas aeruginosa
83
What bugs often cause community-acquired pneumonia?
Strep pneumoniae
H. influenzae
Staph aureus
84
What atypical bugs can cause pneumonia?
Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumonphila
85
What bug causes TB?
Mycobacterium tuberculosis
86
What bug causes otitis media?
Strep pneumoniae
87
What bugs can cause bacterial meningitis?
```
Strep pneumoniae
Neisseria meningitidis
H influenzae
Step agalactiae
Listeria monocytogenes
```
88
What are gram pos bacteria?
Staph
Strep
Enterococcus
Corynebacterium diptheriae
89
What staph species are Coagulase negative?
Staph saprophytics and staph epidermidis
90
What strep species is responsible for strep throat?
Strep pyogenes
91
What are the two Enterococcus species we're worried about?
Which is easier/harder to treat and why?
E. faecalis (easier to treat)
| E. faecium (hardt to treat - more likely to have resistance)
92
Where is corynebacterium usually found?
Normal skin flora
93
What is the most common pathogen for virtually every infection?
Staph
94
What are some common infections associated with staph?
Cellulitis, endocarditis, osteomyelitis, bacteremia
95
How do you differentiate between staph aureus from staph saprophyticus or epidermis?
Coagulase test (staph aureus is the only pos)
96
Which bug has the most potential to cause endocarditis?
Strep infections (mostly mutans)
97
What are some gram neg bugs?
```
Klebsiella pneumoniae
Proteus mirabilis, proteus vulgaris
Pseudomonas aeruginosa
E. coli
Moraxella catarrhalis
H. influenzae
Neisseria gonorrhea, meningitides
Citrobacter
Campylobacter jejuni
Salmonella
Serratia marcescens
H. pylori
Shigella
Vibrio cholerae
Acinetobacter
Enterobacter cloacae
Bordatella pertussis
Pasteurella multocida
Providencia species
```
98
What bug is most common in GI infections?
campylobacter jejuni
99
citrobacter is usually found where, but can be pathogenic where?
normal gut flora
Can be pathogenic in UTIs, pneumonia
100
Where is moraxella catarrhalis often found?
101
Klebsiella pneumonia is commonly found in what kind of infections?
UTIs and URIs
102
proteus infections are often found where?
UTIs
103
Pseudomonas aeruginosa is often found in what infections?
VAP/HAP, respiratory, UTIs, and SSTI in swimming pools
104
What is the most common pathogen in UTIs?
E. coli
105
What infections is salmonella found?
GI and typhoid fever
106
What infections are caused by serratia marcescens?
Nosocomial infections in UTIs, bacteremia
107
What does shigella cause?
dysentery, gastroenteritis
108
Vibrio cholerae causes what? What is it found in?
Chloera and bacteremia in immunocompromised patients
salt water sources, raw fish
109
What bug is common gut flora? When can it get pathogenic?
enterobacter cloacae
UTIs, respiratory infections
110
What bug is responsible for "whooping cough?"
bordatella pertussis
111
What is the most common bug found in animal bites?
pasteurella multocida
112
What are the more common anaerobes we'll see?
```
Bacteroides fragilis
Clostridium species (C. diff, C. tetani, C. botulium)
```
113
What bug causes botulism?
C. botulinum
114
What bug cauess C. diff?
C. difficile
115
What bug causes tetanus?
C. tetani
116
What bug causes gas gangrene?
C. perfringe
117
Where is bacteroides fragilis often found?
Common gut flora
118
When can bacteroides fragilis become pathogenic?
perforated bowel, trauma, intraabdominal infections
119
Atypical bacteria?
Chlamydia pneumoniae
Legionella pneumophila
Mycoplasma pneumoniae
120
Which bacteria can come from HVAC systems, freezers, refrigeration and swimming pools and is a respiratory pathogen?
Legionella pneumophila
121
What bug is responsble for walking pneumonia?
mycoplasma pneumoniae
122
What is often found as a cause of atypical pneumonia?
Chlamydia pneumoniae
123
What bug is associated with Lyme Disease?
borrelia burgdorferi
124
What bug is associated with syphilis?
Treponema pallidum
125
How do you treat stenotrophomonas infection?
Opportunistic bug that causes bacteremia, PNA, UTIs (can be multi-drug resistant)
Bactrim!
126
What bug is responsible for Rocky Mountain Spotted Fever?
Rickettsia ricketsii
127
What bug is responsible for anthrax?
Bacillus anthracis
128
What bug is responsible for the bubonic plague?
yersinia pestis
129
When is a Hep A vaccine indicated?
Travelers or in areas with a local outbreak
130
How often is a Hep A vaccine treatment?
2 doses 6 months apart
131
Typically, a Hep A infection is _______?
self-limiting
132
What is the first vaccine given after birth?
Hep B
133
About 10% of those who get a Hep B vaccine are what? Why does this happen?
nonresponders
They don't develop antibodies
134
How do we treat Hep B nonresponders?
As if they've never gotten the vaccine at all - they get an immune globulin if they were exposed
135
Is Hep B curable?
No
136
What bug is the most common cause of acute gastroenteritis in kids?
rotavirus
137
When is rotavirus vaccine contraindicated and why?
infants with immunocompromised hx and in those with a history of intussusception
138
Is the rotavirus vaccine inactive or live?
live
139
When is the first dose of the rotavirus vaccine given?
2 months
140
Live vaccines are contraindicated in what kind of patients?
Pregnant and immunocompromised
141
What do the capital letters indicate in DTaP, Tdap, Td, DT, DTap?
There's more antigens for those bugs whose letters are capitalized.
T = tetanus
D = diphtheria
aP = acellular pertussis
142
Which vaccine is a 5 dose series?
DTap, starts at 2 months, ends at 4-6 yo
143
When are vaccines without pertussis indicated?
In kids with encephalopathy after initiall doses
144
How often should you get your Tdap, Td?
every 10 years; and Tdap at each pregnancy
145
What drug is a common cause of bacerial meningitis, respiratory illness in peds?
H. influenzae
146
When do kids start their H. influenzae vaccine? How many shots is it?
about 2 months; 2-3 doses
147
What H. influenzae vaccine allows for a prolonged immune response?
Type B conjugate vaccine (Hib)
148
PCV, PCV13, and PPSV are vaccines to prevent which bug?
Step pneumoniae
149
When is the PCV13 pneumococcal drug started?
Pediatric patients starting at 2 months
150
Which of the pneumococcal vaccines are given between the ages of 18-65yo and why?
PCV, to elicit prolonged immune response due to priming of the immune system
151
PPSV23 pneumococcal vaccine is given how often and to what age group?
2 doses before and after the age of 65
152
For the flu vaccine, what's the difference between live and inactivated vaccines?
There doesn't seem to be much of a difference between the two, except that the live may be inferior?
153
For those pts older than 65, which flu shot is preferred?
FluZone (because of its high dosing)
154
H1N1 is included in _______?
Flu vaccines
155
When should you get your flu vaccine? Initial dosing?
Every year after 6 months of age; Initial series is 2 doses given 4 weeks apart
156
MMR is a live or inactive vaccine?
Live
157
You should avoid becoming pregnant for how many days after an injection from MMR?
28 days
158
Is the chickenpox vaccine live or inactive?
live
159
How many doses is the chickenpox vaccines and when should you start them?
2 doses; start as early as 12 months
160
For whom is the zoster vaccine indicated?
For pts >50yo
161
Which zoster vaccine seems to have the higher efficacy?
Shingrix - inactive
162
T or F: the Zoster vaccine is recommened even if there is no history of chickenpox
T
163
T or F: HPV vaccine is one of the few vaccines actually proven to reduce the risk of cancer
T
164
Should males or females get the HPV vaccine?
Both!
165
For what age groups shoule the HPV vaccine be given?
Between 9 and 45
| But for those > 27, it's dependent upon risk factors
166
How many doses is the HPV vaccine?
2-3
167
Which strains of HPV are most implicated in causing cervical cancer?
16, 18
168
What strains of HPV are implicated at causing anogenital warts?
6, 11
169
Which bug does the meningococcal vaccine prevent against?
Neisseria meningitidis
170
For what age group is the meningococcal serogroup B vaccine (MenB) indicated?
college age (they have the highest risk)
171
The Quadrivalent ACWY vaccine is how many doses and at what age group is this given to prevent neisseria meningitidis?
2 doses given starting at age 11
172
At what age is the COVID vaccine indicated?
Now as young as 5 yo
173
What are the 3 FDA approved COVID vaccines and their dosing?
Pfizer (mRNA-based) 2 doses + booster
Moderna (mRNA-based, has a higher antigen load) 2 doses + booster
Janssen (J&J - adenoviral vector) 1 dose + booster
174
Which COVID vaccine has shown a higher incidence of Guillaine-Barre and thrombosis?
Adenoviral vector borne (Janssen, J&J)
175
T or F: Mixing COVID vaccine types is bad
F
176
How soon after COVID infection can you get a COVID vaccine?
90 days, and you have to be feeling "well"
177
T or F: In general, non-live vaccines should never be administered together
F
178
Live vaccines, if they are not given on the same day, must be separated by how many weeks?
4
179
T or F: Live and non-live vaccines can be administered together.
T
*Except for meningococcal and pneumococcal, they should be separated by ~4 weeks in immunocompromised pts
