Lectures 1 & 2 - Clinical Bacteriology I & II Flashcards
(148 cards)
What is the human microbiome?
Ecological community of commensal, symbiotic, and pathogenic bacteria that share our body space
Which is larger: the human microbiome or the human genome?
Human microbiome (over 1M genes compared to 23K)
Does the microbial community composition differ at different body locations?
YUP
What are the 6 dominant bacterial phyla in each of the different body sites?
- Firmicutes
- Bacteroidetes
- Fusobacteria
- Actinobacteria
- Cyanobacteria
- Proteobacteria
Do we all have the same core composition of our microbiome?
YUP
What is dysbiosis?
Shifts in the microbiome that cause many infectious diseases (e.g. IBD, T2 DM, necrotizing enterocolitis)
What are biofilms? What to note? Example?
Bacterial communities growing in an organized manner on surfaces
Note: cells growing in biofilms are different from those growing in fluid (planktonic growth) => biofilm bacteria grow slower, they may use different metabolic pathways, are more antibiotic resistant, and have greater opportunity for horizontal gene transfer
Example: with a UTI, the bacteria in the urine have a different phenotype from those attaching to the bladder epithelium
Why do biofilms not have a lot of time to grow?
Because the barrier epithelia desquamate
What are the 3 non-shedding surfaces of the human body?
- Teeth
- Bone
- Prosthesis such as dentures, joints, heart valves, etc.
Describe the growth of a biofilm. 5 steps.
- Adhesion to the surface of the substratum by receptor-ligand interactions: random event influenced by surface free energy and proinquity (nearness) of bacterial cells that are in fluid and bounce by Brownian movement
- Colonization: cell division
- Accumulation: creating a linking film
- Climax community: this causes physiological changes to the environment due to consumption and production of molecules, which permits other bacteria to attach to pioneers = succession causing interbacterial aggregation + formation of fluid channels in between micro-colonies of microorganisms
- Dispersal: the climax community is a dynamic entity where cells enter or leave promoting diversification => pieces of the climax community break off when they cannot resist the shear force of the fluid phase => can reattach downstream to start a new biofilm thanks to the extracellular polysaccharide
Is adhesion of bacterium to the surface of the substratum reversible?
YUP
What are pioneer organisms?
Bacterial species that originally adhere to the surface of the substratum
Other name for interbacterial aggregation in a biofilm?
Co-aggregation
Are the pioneer organisms actually binding to the subtratum?
NOPE - they are binding to a conditioning film derived from the fluid phase (e.g. plasma, saliva, respiratory secretions) by selective absorption of proteins
Can climax communities grow on shedding surfaces of the body? What to note?
NOPE - unless there is a wound
What allows bacteria to adhere to each other in a climax community?
Extracellular polysaccharides
What are the pioneer bacteria on teeth?
Alpha-hemolytic streptococci
Can biofilms grow on both biotic and abiotic surfaces?
YUP
3 types of abiotic surfaces that biofilms grow on?
- Medical devices: orthopedic devices, transcutaneous devices, catheters
- Hospital equipment: hemodialysis machines, mechanical ventilators, shunts, surfaces
- Others: contact lens cases
3 examples of diseases characterized by the growth of biofilms?
- Osteomyelitis
- Cystic fibrosis
- Otitis media
How do clinicians think about bacteria?
As individual infectious agents that need to be isolated, identified, and tested for antibiotic susceptibility
Describe the diagnostic cycle of infectious diseases. 11 steps.
- Patient consults a physician because of signs or symptoms suggesting an infectious disease
- Physician examines patient and makes a tentative clinical diagnosis
- Cultures from one or more anatomic sites may be indicated, depending on the findings of medical history and physical examination
- An appropriate specimen for culture must be collected and a transport container(s) selected that will maintain the viability of any pathogenic organisms during transit
- Once the specimen is received in the laboratory, the information on the request form is entered into a computer file or log book
- The specimens are examined visually and, depending on the physician’s order and the nature of the specimen, wet mounts and smears may be prepared and stained for microscopic examination
- Observations may or may not be immediately reported to the physician depending on the definitiveness of the results and specimens that require definitive identification of potentially pathogenic microbes are processed further
- One or more culture media are selected, or if viral diseases are suspected, appropriate cell lines are chosen that will be inoculated with a portion of the specimen. All agar plates are streaked for colony isolation; then plates, broths, and cell cultures are placed in an incubator with appropriate temperature and environmental conditions to maximize the growth and replication of microbes
- After a specified incubation period, the cultures are examined both visually and microscopically. Often presumptive microbial identifications can be made and antibiotic sensitivity testing is conducted.
- A final report is issued if a definitive answer can be given; if not, the report should be delayed while subcultures and additional test procedures are performed to identify the organisms definitively
- Physician interprets reports and institutes appropriate therapy
How should a specimen container be labeled? What should be sent along with it?
The specimen container must be properly labeled with the patient’s name, location, date and time of collection, and type of specimen
Should be accompanied by a physician’s orders to be transcribed to a laboratory request form or entered into a computer data file (or both), including essential clinical findings, a working diagnosis, and any information that may require laboratory personnel to apply other than routine procedures to recover uncommon or particularly fastidious microorganisms
What should a physician do when sending a specimen to a lab if an infectious disease, caused by less commonly encountered or fastidious microorganisms, is suspected? Why? Example?
Physicians should either call the laboratory or indicate on the laboratory request slip
Reason: certain culture media required for the optimum recovery of certain fastidious or slow-growing microorganisms may not be available or used in many laboratories
For example: the recovery of bacterial species belonging to the genera Brucella, Pasteurella, Moraxella, Haemophilus, Neisseria, Leptospira, Vibrio, Campylobacter, and Legionella, among others, may require special culture media or alternative techniques