Micro Test 3: Mycoplasma, Chlamydia, Chlamydophila, and Spirochetes

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Micro Test 3: Mycoplasma, Chlamydia, Chlamydophila, and Spirochetes
2012-12-03 18:19:27
Mycoplasma Chlamydia Chlamydophila Spirochetes

Mycoplasma, Chlamydia, Chlamydophila, and Spirochetes
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  1. 3 most common causes of CA-pneumonia
    • Streptococcus pneumoniae
    • Haemophilus influenzae
    • Staphylococcus aureus
  2. Name other causes of CA-pneumonia besides 3 most common.
    • Mycoplasma pneumoniae
    • Chlamydophila pneumoniae
    • Viruses
    • Aspiration
    • Gram-N bacillus
    • Legionella species
  3. Mycoplasma and Ureaplasma
    • Smallest free-living bacteria
    • lack a cell wall
    • facultative anaerobes (M. pneumoniae is a strict anaerobe)
  4. Smallest free-living bacteria
    Mycoplasma and Ureaplasma
  5. Which genus lacks cell walls and are thus pleomorphic?  They are also not stainable.
  6. Mycoplasma have no cell wall, but their cell membranes contain
    sterols (obtained from exogenous media)
  7. 4 Mycoplasma Diseases
    • Mycoplasma pneumoniae
    • M. hominis- pyelonephritis, salpingititis, post-partum fever, peripartum sepsis, neonatal conjunctivitis
    • M. genitalium- non-gonococcal urethritis
    • Ureaplasma urealyticum- endometriosis
  8. Transmission of mycoplasma pneumoniae
  9. Virulence factor of Atypical or Mycoplasma Pneumoniae
    P1 Adhesion protein (binds sialic-rich glycoproteins)
  10. Pathogenesis of M. pneumoniae
    • Remains extracellular
    • Binds to respiratory ciliated epithelium via P1 protein
    • Adhesion >> ciliostasis >> cell destruction
    • loss of ciliated cells >> reduced ciliated clearance
    • Bacteria gain entrance to lower respiratory tract
    • Persistent non-productive cough
    • Usually self-limited and non-fatal
  11. Ciliostasis
    Reduction in number of cilia per cell.  Seen in M. pneumoniae.
  12. M. pneumoniae causes upper or lower respiratory infections?
    Both, but upper is more common
  13. Tracheobronchitis
    Bronchial passages infiltrated with lymphocytes and plasma cells, seen in M. pneumoniae
  14. Mycoplasma Pneumoniae results in what type of immunity?
    Incomplete immunity, secondary infections are common
  15. Mucocutaneous eruptions can be caused by
    M pneumoniae
  16. Oral ulceration with skin rash and conjunctivitis.  Tx?
    Stevens-Johnson Syndrome, associated with M. pneumoniae

    Tx= Corticosteroids
  17. Tx of Mycoplasmas
    • Azithromycin, doxycycline, or levofloxacin
    • Clindamycin used for M. hominis, M. gentalium
  18. Chlamydiaceae:  ]
    Visible on Gram-stain?
    • Obligate intracellular bacteria
    • NOT visible on gram stain, lacks peptidoglycan (don't treat with penicillins, cephalosporins, vancomycin or other cell wall active antibiotics).  Has lipopolysaccharide between outer membranes.
  19. Which bacteria would you not want to treat with cell wall active antibiotics?  Why?
    • Chlamydiaceae
    • Lack peptidoglycan of typical cell wall
  20. 2 Distinct morphologic forms of Chlamydiaceae
    • Elementary Body (EB)- small, infectious
    • Reticulate Body (RB)-larger, non-infectious

    Not cultured in routine laboratory media-grown in tissues
  21. Which form of Chlamydiaceae is an intracytoplasmic includsion body?
    Elementary body
  22. Which form of Chlamydiaceae is the metabolically active, replicating form?
    Reticuluate body
  23. Pathogenesis of Chlamydia trachomatis
    • EB accumulate and rupture cells, infect adjacent cells
    • No long-lasting immunity (like Mycoplasma)
  24. Chlamydia trachomatis can cause? (other than genito stuff)
    Eye infections and blindness
  25. Chronic inflammatory condition of the ocular and palpebral conjunctiva and cornea in a setting of poor hygiene and crowding.  Watery discharge, flies can carry this.  Can lead to blindness after multipel re-exposures.
    Trachoma (Chlamydia trachomatis)
  26. Which organism uses the SAFE Strategy for prevention?  What is the SAFE strategy?
    • Chlamydia trachomatis prevention
    • Surgery, Antibiotics, Face washing, Environmental change (better sanitation)
  27. Important cause of bronchitis, pneumonia, and sinusitis that is generally asymptomatic, but more severe in adults
    Chlamydophila pneumoniae
  28. Neonate exposure to ____ through the mother's service and can result in Perinatal Conjunctivitis
    C. trachomatis
  29. Diagnosis of these organisms requires tissue culture.
    Tx of these organisms?
    • N. gonorrhoeae
    • H. influenzae
    • S. pneumoniae or HSV

    Tx:  Azithromycin or doxycycline
  30. Initial presentation of upper respiratory tract infection followed by bronchitis or pneumonia with rhonchi or rales
    Chlamydophila pneumoniae
  31. "Parrot Fever" (Psittacosis or Ornithosis) causative agent?
    Chlamydophila psittaci
  32. Reservoir of Chlamydophila psittaci?  Transmission?  Common among?
    • Birds (parrot fever, ornithosis)
    • Transmission via inhalation of dried bird feces, urine, and respiratory secretions
    • Common among pet shop workers, poulty-processing plant workers
  33. Tx of Chlamydophila psittaci
  34. Diagnose Chlamydophila psitacci with
    IFA or CF
  35. Thin, helical, Gram-N, mostly ANAEROBIC bacteria
    Motile (corkscrew motion)
    Not visible with conventional light microscopy, must use dark-field microscopy
  36. 3 Spirochete  Disease Agents
    • Treponema (Venereal syphilis)
    • Borrelia (Lyme disease)
    • Leptospira (Leptospirosis)
  37. Causative agent of Venereal syphilis (STD)?
    T. pallidum pallidum (Treponema; spirochete)
  38. Nonvenereal Treponemal Infections (3)
    • Yaws (warm humid tropical areas)- children
    • Bejel (desert areas)- children
    • Pinta (tropical areas)- young adults
  39. How are Yaw, Bejel, and Pinta (nonvenereal treponemal infections) spread?
    Spread person-to-person by direct contact
  40. Yaws, Bejel, or Pinta:  Small puritic papules that enlarge and persist for years, disseminated and recurrent within 3-9 months.  Become pigmented with age.  Skin is ONLY organ involved.
  41. Yaws, Bejel, or Pinta:  Leads to disfiguring pigment changes and scarring, skin has mottled appearance
  42. Yaws, Bejel, or Pinta:  Primarily oral lesions, can have gummas
  43. Yaws, Bejel, or Pinta:  Initial lesion becomes a large papilloma, secondary disease produces multiple cutaneous lesions, tertiary stage produces bone and joint deformities
  44. Treatment of Novenereal Treponemal Infections
    • Penicillin G (IM)
    • Oral doxycycline, tetracycline, or erythromycin
  45. Thin, coiled, Gram-N, aerobic, motile, hooked ends w/ paired axial flagella (burrow into tissue)
    Leptospira interrogans or biflexa
  46. Contact with water, food, or soil containing rodent urine increases risk for?
    Leptospira interrogans or biflexa
  47. Influenza-like symptoms with conjunctival suffusion, recovery when opsoniziing IG induces immune clearance
    Clinical Leptospirosis
  48. Severe disseminated disease (multi-organ involvement) w/ high fever (>104F), Vascular collapse, Severe pulmonary hemorrhagic, etc.
    Weil Syndrome (Leptospira interrogans)
  49. Leptospirosis diagnosis and tx?
    • Diagnosis:  Serology, ELISA, PCR, culture
    • Tx:  Doxycycline, amoxicillin