Micro Test 2

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Author:
Marine
ID:
311044
Filename:
Micro Test 2
Updated:
2015-11-15 18:59:45
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micro
Folders:
Micro
Description:
Special Bacteriology, Special Virology Special Mycology
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  1. Staphylococci General Features
    • 0.5-1.5 micrometers
    • Gram + cocci
    • Grape like groups
    • Facultative anaerobes
    • non-motile
    • catalase +
    • Grow on Blood Agar

    Staphylococcus Aureus is the only Coagulate +
  2. Staphylococci Virulence Factors (16)
    • Capsule
    • Peptidoglycan
    • Teichoic Acid
    • Protein A (S. Aureus)
    • Cytoplasmic Membrane
    • Cytotoxins (alpha, beta, gamma, delta, PV Leukocidin)
    • Exfoliative Toxins (A, B)
    • Enterotoxins (A, B, C, D, E, G, H, I)
    • Toxic Shock Syndrome Toxin 1
    • Coagulate (only S. Aureus)
    • Catalase
    • Hyaluronidase
    • Fibrinolysin
    • Lipases
    • Nucleases
    • Penicillinases (only penicillin resistant staphylococci)
  3. Staphylococcal Diseases
    • Skin and Soft Tissue Infections (SSTI)
    • - folliculitis
    • - impetigo
    • - furuncles
    • - carbuncles
    • - abscess
    • - wound / surgical site infections
    • systemic infections
    • - osteomyelitis
    • - septic arthritis
    • - endocarditis
    • - pneumonia
    • - bacteremia
    • - organ infection
    • - enterocolitis
  4. Staphylococcal Superantigens
    • Exfoliative Toxins
    • Enterotoxins
    • Toxic Shock syndrome Toxin 1
  5. Which Toxins Cause Necrotising Pneumonia
    Staphylococcal Pantone Valentino Leukocidin (PVL)
  6. Which Toxins Cause Food Poisoning
    Staphylococcal Enterotoxins
  7. Which Toxins Cause Toxic Shock Syndrome
    • Staphylococcal Toxic Shock Syndrome Toxin 1 (TSST1)
    • Staphylococcal Enterotoxins B
    • Streptococcal Pyrogenic Exotoxins (speA, speC)
  8. Which Toxins Cause Staphylococcal Scalded Skin Syndrome
    Staphylococcal Exfoliatins A and B
  9. ESKAPE Pathogens
    • Enterococcus Faecium
    • Staphylococcus Aureus
    • Klebsiella Pneumoniae
    • Acinobacter Baumannii
    • Pseudomonas Aueriginosa
    • Enterbacter Species
  10. Steps in becoming a Superbug
    • 1. Penicillinase
    • 2. Penicillin Binding Protein 2' (PBP2') - MRSA
    • 3. vanA gene (from enterococci) - VRSA / GRSA
  11. MRSA Typing Methods
    • MultiLocus Sequence Typing (MLST)
    • Staphylococcal Chromosome Cassette (SCC) typing
    • Staphylococcal Protein A (spa) typing
  12. What are the differences between community and hospital acquired MRSA?
    • Hospital:
    • SCC type 1, 2, 3
    • Multidrug Resistant
    • PVL toxin is rare

    • Community
    • SCC type 4
    • Resistant to beta lactams
    • PVL toxin is common
  13. Penicillin resistance in staphylococci is due to
    • Beta lactamases, specifically penicillinases
    • Coded on plasmid
  14. MRSA resistance is due to
    • Methicillin Resistant Staphylococcus Aureus
    • Altered penicillin binding protein PBP2'
    • Coded by mecA gene
  15. VISA esistance is due to
    • Vancomycin Intermediate Staphylococcus Aureus
    • Thicker cell wall with more binding sites for vancomycin. A higher concentration is needed to get a response
  16. VRSA / GRSA resistance is due to
    • Vancomycin Resistant Staphylococcus Aureus / Glycopeptide Resistant Staphylococcus Aureus
    • D alanine replaced by D lactate so vancomycin can no longer bind. Cross links form as normal
    • Coded by vanA gene from enterococci
  17. MLSB resistance
    • Macrolides
    • Lincosamides
    • Streptogramin B
  18. Streptococci General Features
    • Gram + cocci
    • Pairs / chains
    • Facultative anaerobes
    • Some grow only in enhance CO2 atmosphere
    • non-motile
    • catalase -
    • Grow on Blood / Serum enriched Agar
  19. Differentiating Streptococci
    • Hemolytic Patterns
    • Serological Lancefield Groups
    • Biochemical Properties
  20. Streptococcus Pyogenes General Features
    • Gram + cocci
    • Pairs / long chains
    • Catalase negative
    • Beta Hemolytic
    • Group A lansfield
  21. Streptococcus Pyogenes Virulence Factors (14)
    • Capsule
    • Lipoteichoic Acid
    • M protein (Class 1, Class 2)
    • M-like protein
    • F protein
    • T protein
    • Pyrogenic exotoxins - erythrogenic toxin (A,B,C,F)
    • Streptolysin (S, O)
    • Streptokinase (A,B)
    • DNase (A,B,C,D)
    • C5a Peptidase
    • Hyaluronidase
    • Hemolysin
    • Bacteriocins
  22. Streptococcus Pyogenes Diseases
    • Pharyngitis
    • Scarlet Fever
    • Skin and Soft Tissue Infections (SSTI)
    • - pyoderma
    • - erythema
    • - cellulitis 
    • - necrotising faciitis
  23. Which Toxins Cause Rheumatic Fever
    Class 1 M protein
  24. Which Toxins Cause the rash of Scarlet Fever
    Streptococcal Pyrogenic Exotoxins - Erythrogenic Toxin
  25. Which Toxins are not found in streptococcal skin infections
    Streptolysin O - inhibited by cholesterol
  26. Streptococcus Pyogenes Treatment
    • Penicillin
    • Macrolides (Erythromycin) in patients who are allergic
  27. Streptococcus Pneumoniae General Features
    • Gram + cocci
    • Lancet shaped Pairs
    • Catalase negative 
    • Alpha Hemolytic
    • Soluble in bile
  28. Streptococcus Pneumoniae Virulence Factors (11)
    • Capsule
    • Lipoteichoic Acid - C polysaccharide / F antigen
    • Pneumococcal Surface Adhesins A
    • Neuraminidase
    • Pneumococcal Surface Protein A
    • Pneumococcal Surface Protein C
    • Autolysin
    • Pneumolysin
    • IgA1 protease
    • PhosphorylCholine
    • Hydrogen Peroxide
  29. Streptococcus Pneumoniae diseases
    • Pneumonia
    • Meningitis
    • Otitis
    • Sepsis
  30. Streptococcus Pneumoniae Treatment
    • Penicillin
    • Macrolides (Erythromycin) in patients who are allergic
    • But usually concentrate on vaccination using capsular protein
  31. differences between Streptococcal and Staphylococcal Endocarditis
    • Streptococci have subacute endocarditis because need more infections to have endocarditis
    • staphylococci acute endocarditis
  32. Types of hypersensitivity
    • Type 1 - histamine - allergies
    • type 2 - cross recativity (e.g. endocarditis in strep and staph)
    • type 3 - antigen antibody complexes accumulate in tissue (acute glomerulonephritis - strep pyogenes)
    • type 4 - delayed T cell hypersensitivity (tuberculosis)
  33. Differences between Streptococcal and Staphylococcal Toxic Shock Syndrome
    • in Streptococcal Toxic Shock there is bacteremia and is often linked to necrotizing faciitis
    • in Stpahylococcal Toxic Shock there is no bacteremia
  34. Enterococci General Feataures
    • Gram + cocci
    • Pairs / short chains
    • Catalase negative
    • Usually alpha and Gamma Hemolytic
    • Group D lansfield
    • Grow in 6.5% NaCl / 40% bile salt
    • Resistant to many antibiotics
  35. Enterococci Virulence Factors (7)
    • Aggregation substance
    • Enterococcal Surface Protein
    • Carbohydrate Adhesin
    • Cytolysin
    • Pheremone
    • Gelatinase
    • Plasmids / chromosomal genes for antibiotic resistance
  36. Enterococcus diseases
    • Urinary Tract Infections (UTI)
    • Nosocomial infections
  37. Enterococci Resistance
    • Oxacillin
    • Cephalosporins
    • Vancomycin
  38. Enterococci Treatment
    • Linezolid
    • Quinupristin / Dalfopristin
    • Fluoroquinolone
  39. Streptococcus Agalactiae General Features
    • Gram + cocci
    • long chains
    • Catalase negative
    • Usually beta Hemolytic
    • Group B lansfield
    • CAMP positive
  40. Streptococcus Agalactiae Virulence Factors (3)
    • thick peptidoglycan layer
    • Capsule (type Ia, III, V)
    • Hydrolytic enzymes
  41. Streptococcus Agalactiae diseases
    • Meningitis
    • Pneumonia
    • Sepsis in neonates
    • Urinary Tract infections in Pregnant women
    • bone and joint infections
    • Skin and Soft Tissue Infections (SSTI)
  42. Streptococcus Agalactiae Treatment
    • Penicillin + aminoglycoside
    • 10x greater minimum inhibitory concentration of penicillin than Streptococcus Pyogenes

    Chemoprophylaxis of at risk pregnant women
  43. Haemophilus General Features
    • Gram - rods
    • Pleomorphic
    • Facultative anaerobes
    • non-motile
    • Grow on Chocolate Agar - hemin (factor X) + NAD (factor V)
  44. Haemophilus Influenzae Typing
    • Serotype - according to capsule (a,b,c,d,e,f)
    • Biotypes - according to biochemical profile - Indole / urease / ornithine decarboxylase(1,2,3,4,5,6,7,8)
    • Biogroup - according to clinical presentation
  45. Haemophilus Influenzae Virulence Factors (6)
    • Capsule (a,b,c,d,e,f) - no capsule = non-pathogenic
    • ↳Polyribitol Phosphate (PRP) in type b
    • Pili
    • Adhesins
    • lipopolysaccharides
    • Low molecular weight glycopeptide
    • IgA1 protease
  46. Haemophilus Influenzae diseases
    • Meningitis
    • Septic Arthritis
    • Otitis Media
    • Sinusitis
    • Epiglottitis
    • Bronchopneumonia
  47. Which Haemophilus Virulence Factors can be detected in urine
    PRP capsule polysaccharide of group B Haemophilus influenzae
  48. Which Haemophilus virulence factors are responsible for meningeal inflammation
    Lipopolysaccharide lipid A
  49. Which Haemophilus virulence factors are responsible for impaired cilliary function
    • Lipopolysaccharides
    • Low molecular weight glycoproteins
  50. Which Haemophilus virulence factors are used to create a vaccine
    PRP capsule polysaccharide of group B Haemophilus influenzae
  51. Haemophilus Influenzae Treatment
    • ampicillin for localized infections
    • Cephalosporin of 2nd generation / Macrolides if resistant
    • Cephalosporin of 3rd generation always works - meningitis
  52. Which Haemophilus species is responsible for ulcus mole (chancroid)
    Haemophilus Ducrey
  53. Haemophilus Ducrey Treatment
    Azithromycin
  54. Which Haemophilus species is responsible for conjunctivitis
    Haemophilus Aegyptius
  55. Which Haemophilus species is responsible for Brazilian Purpuric Fever
    Haemophilus Influenzae Aegyptius
  56. Which Bacteria Cause Bacterial (Purulent) Meningitis
    • Streptococcus of group B
    • Escherichia Coli
    • Listeria Monocytogenes
    • Neisseria Meningitidis
    • Streptococcus Pneumoniae
    • Haemophilus Influenzae type B
  57. Neisseria Meningitidis General Features
    • gram - cocci
    • diplococci (coffee bean shape)
    • aerobic
    • non motile
    • catalase +
    • oxidase + (glucose + maltose)
  58. Neisseria Meningitidis Virulence Factors
    • Capsule (A,B,C, H,I, K,L, W135,X,Y,Z)
    • Pilli - specific receptors found in nasopharyngeal nonciliated columnar cells
    • intracellular survival
    • Endotoxin - LipoOligoSaccharide (LOS) contains no O polysaccharide, just lipid A and oligosaccharide
  59. Neisseria Meningitidis diseases
    • Meningococcemia - sepsis
    • - Waterhouse Friderichsen Sydrome (DIC + bilateral destruction of adrenal glands)
    • Meningococcal Meningitis
    • local infections
    • - pneuomia
    • - endocarditis
    • - pericarditis
    • - arthritis
  60. which E. coli and N. Meningitis virulence factors show cross reactivity
    • E. coli K1 capsular antigen
    • N. Meningitis B capsular antigen
  61. Neisseria Meningitis Culturing
    • Chocolate agar and selective media plate
    • growth inhibited by anticoagulants and toxic factors in media
  62. which Neisseria Meningitis Virulence factor can be detected in urine
    • Capsular antigen
    • also found in CSF and Blood
  63. Neisseria Meningitis Treatment
    Ceftriaxon - no allergies + susceptible
  64. Neisseria Meningitis Vaccine
    • A,C,W135,Y conjugated vaccine
    • B vaccine
    • - neisserial adhesion A
    • - fHbp
    • - Neisseria Heparin Binding Antigen
  65. Bordetella General Features
    • gram - coccobacilli
    • very small
    • aerobic
    • non motile
    • non fermenter
  66. Bordetella Virulence Factors (7)
    • Filamentous Agglutinin
    • Pertactin (P69)
    • Fimbriae 
    • Pertussis Toxin (S1-5 subunits)
    • adenylate cyclase/hemolysin
    • tracheal cytotoxin
    • lipopolysaccharide - lipid A / lipid X
  67. Bordetella diseases
    Pertussis = whooping cough
  68. Pertussis Toxin structure
    • S1 - toxic subunit - ADP ribosylating activity --> increased cAMP
    • S2 - binds ciliated respiratory cells
    • S3 - binds phagocytes
    • S4 
    • S5
  69. Which Bordetella Toxins are responsible for ciliostasis
    tracheal cytotoxin
  70. Stages of pertussis
    • catarrhal - flu like 
    • paroxysmal - whooping cough, vomitting
    • reconvalescence - depends on rapidity / degree of ciliated epithelium regeneration
  71. Which Bordetella species cause pertussis
    • Bordetella Pertussis
    • Bordetella Parapertussis
  72. Bordetella Treatment
    macrolides in catarrhal stage can reduce contagiousness but not usually detected
  73. What does DTaB vaccine protect against
    • Diphtheria 
    • Tetanus
    • Pertussis
  74. What is present in Pertussis Vaccine
    • acellular
    • pertussis toxin +
    • Adhesin (filamentous hemoglutinin / pertactin / fimbriae)
  75. Enterobacteriae General Features
    • Gram - rods
    • facultative anaerobe
    • motile
    • catalase +
    • oxidase -
  76. Enterobacteriae Common Virulence Factors (7)
    • Endotoxin
    • Capsule
    • Antigenic Phase Variation
    • Type 3 Secretion system
    • Sequestration of Growth Factors - sideropores / iron chelating compounds
    • resistance to serum killing
    • antimicrobial reisstance
  77. Enterobacteriae Classification systems
    • Pathogenicity
    • - always cause disease
    • - commensal bacteria
    • - normally commensal that aquire pathogenicity
    • Biochemical
    • - lactose fermenting
    • - non-lactose fermenting
    • antigenic
    • - K antigen (capsule)
    • - O polysaccharide (LPS)
    • - H protein (flagella)
  78. Escherichia Coli General Features
    • Gram - rods
    • facultative anaerobe
    • motile
    • catalase +
    • oxidase - 
    • Ferment Lactose
    • Encapsulated
  79. Escherichia Coli Virulence Factors (17)
    • General Eneterobacteriae Virulence Factors
    • - Endotoxin
    • - Capsule
    • - Antigenic Phase Variation
    • - Type 3 Secretion system
    • - Sequestration of Growth Factors - sideropores / iron chelating compounds
    • - resistance to serum killing
    • - antimicrobial reisstance
    • Adhesins
    • - Colonisation Factor Antigen (CFA) I, II, III
    • - Aggregative Adherence Fimbriae (AAF) I, II
    • - Bundle Forming Pilli (BFP)
    • - Intimin
    • - P pilli
    • - Invasion Plasmid Antigen (IPA) protein
    • - Dr Fimbriae
    • Toxins
    • - Shiga Toxin (stx) 1, 2
    • - Heat Stable Toxin (ST) a,b
    • - Heat Labile Toxin (LT) I, II
    • - Hemolysin A
  80. Function of E. Coli Heat Labile Toxin I
    • 5 B subunits bind GM1 ganglioside surface protein
    • A subunit affects Gs receptor and causes increased cAMP formation
    • this causes decreased water reabsorption into the cell
  81. Function of E. Coli Heat Stable Toxin a
    • increases cGMP concentration
    • increases secretion of fluid from the cell
  82. Function of Shiga Toxin
    • 5 B subunits bind GB3 on intestinal Villi and renal endothelium
    • A subunit binds 28S rRNA and disrypts protein synthesis
    • villi and renal endothelial cells destroyed
  83. Escherichia Coli diseases
    • Gastroenteritis
    • UTI
    • Neonatal Meningitis
    • Septicemia
  84. Gastroenteritic Escherichia Coli
    • EnteroToxigenic
    • EnteroPathogenic
    • EnteroAggregative
    • EnteroHemorrhagic
    • EnteroInvasive
  85. Enterotoxigenic E. Coli virulence factors
    • Heat Labile Toxin I, II
    • Heat Stable Toxin a, b
    • Colonisation Factor Antigen I, II, III
    • Fimbriae
  86. Enterotoxigenic E. Coli Disease
    Traveler's Diarrhea
  87. Enteropathogenic E. Coli Virulence Factors
    • Bundle Forming Pilli
    • Intimin
    • Type 3 secretion of translocated intimin receptor
  88. Enteropathogenic E. Coli Disease
    Infant diarrhea
  89. Enteroaggregative E. Coli Virulence Factors
    • Aggregative Adherence Fimbriae I, II
    • Biofilm formation
  90. Enteroaggregative E. Coli Disease
    Infant and Traveler's Diarrhea
  91. Enterohemorrhagic E. Coli Virulence Factors
    Shiga Toxin 1, 2
  92. Enterohemorrhagic E. coli Disease
    • Bloody diarrhea
    • Hemolytic Uremic Syndrome (HUS)
    • - renal failure
    • - thrombocytopenia
    • - microangiopathic hemolytic anemia
  93. Enteroinvassive E. Coli Virulence Factors
    Actin Tails for intracellular movement
  94. Enteroinvassive E. Coli Disease
    Rare
  95. Escherichia Coli Treatment
    Antibiotic Susceptibility Tests guide therapy
  96. Salmonella General Features
    • Gram - rods
    • facultative anaerobe
    • motile
    • catalase +
    • oxidase -
    • non -fermentor
    • resistant to bile salts
  97. Salmonella Virulence Factors
    • Endotoxin Capsule
    • Antigenic Phase Variation
    • Type 3 Secretion system
    • Sequestration of Growth Factors - sideropores / iron chelating compounds
    • resistance to serum killing
    • antimicrobial reisstance
    • intracellular survival
    • tolerant to acids
    • salmonella secreted invasion protein (SSIP)
  98. Salmonella diseases
    • Enteritis
    • Asymptomatic Colonisation
    • Septicimia
    • Enteric Fever / Tyrphoid fever
  99. Salmonella Treatment
    • Enteritis - none
    • Disseminated disease - in vitro susceptibility testing
    • - uroquinolones
    • - chloramphenicol
    • - trimethoprim sulfamethaxozole
    • - broad spectrum cephalosporins
  100. Salmonella Typhi Vaccine
    • oral, live attenuated form of bacteria
    • OR
    • Vi capsular polysaccharide
    • many boosters required
  101. Shigella General Features
    • Gram - rods
    • facultative anaerobe
    • non motile
    • catalase +
    • oxidase -
    • non fermenter
    • resistant to bile salts
  102. Shigella Virulence Factor
    • Endotoxin Capsule
    • Antigenic Phase Variation
    • Type 3 Secretion system
    • Sequestration of Growth Factors - sideropores / iron chelating compounds
    • resistance to serum killing
    • antimicrobial resistance
    • Shiga Toxin (Stx) 1, 2
    • Invasion Plasmid Antigen (Ipa) A, B, C, D
  103. Shigella diseases
    • Diarrhea
    • S. Dysenteriae - dysentery
  104. Which toxin causes Hemolytic Uremic Syndrome (HUS)
    Shiga Toxin B
  105. Shigella Treatment
    • fluoroquinolones
    • trimethoprim sulfomethoxazole
    • in vitro susceptibility testing
  106. Yersinia General Features
    • Gram - rods
    • facultative anaerobe
    • non motile
    • catalase +
    • oxidase -
    • non fermenter
    • survive cold temperatures
  107. Yersinia Virulence Factors
    • Endotoxin Capsule
    • Antigenic Phase Variation
    • Type 3 Secretion system
    • Sequestration of Growth Factors - sideropores / iron chelating compounds
    • resistance to serum killing
    • antimicrobial resistance
    • plasminogen Activator (Pla) protease
    • Dephosphorylate YopH gene in macrophages
  108. Yersinia diseases
    • Y. Pestis
    • - bubonic plague
    • - pneumonic plague
    • other
    • - gastroenteritis
    • - transfusion related sepsis
    • - large mesenteric lymph nodes - mimic appendicitis
  109. Yersinia Treatment
    • streptomycin
    • tetracyclins
    • chloramphenicol
    • trimethoprim sulfamethoxazole

    vaccinations now stopped
  110. Klebsiella General Features
    • Gram - rods
    • facultative anaerobe
    • non motile
    • catalase +
    • oxidase -
    • lactose fermenter
  111. Klebsiella Virulence Factors
    Endotoxin CapsuleAntigenic Phase VariationType 3 Secretion systemSequestration of Growth Factors - sideropores / iron chelating compoundsresistance to serum killingantimicrobial resistance
  112. Klebsiella diseases
    • K. pneumoniae K. Oxytoca
    • primary lobar pneumonia with necrosis
    • wound and soft tissue infections
    • UTI
    • K. Granulomatis
    • - granuloma inguinale
    • K. rhinoscleromatis
    • - granulomatous diseas of the nose
    • K. Ozaenae
    • - chronic atrophic rhinitis
  113. Klebsiella Treatment
    • Tetracyclins
    • Erythromycin
    • Trimethoprim Sulfamethoxazole
  114. Listeria Monocytogenes General Features
    • Gram + short rods
    • single, pairs, short chains
    • facultative anaerobe
    • motile - tumbling motility
    • beta hemolytic
    • broad temperature range (1-45)
  115. Listeria Monocytogenes Virulence Factors
    • Internalins (Inl)
    • Listeriolysin O
    • Phospholipase C
    • ActaA Protein - actin tail
    • Hemolysin
  116. Listeria Monocytogenes diseases
    • Meningitis
    • Bacteremia
    • Early Onset Disease - infantiseptica in utero
    • - disseminated abscess + granulomas
    • Late Onset Disease - at or shortly after birth
    • - meningitis
    • - meningoencephalitis
    • - septicemia
  117. Listeria Monocytogenes Treatment
    • Penicillin / Ampicillin
    • Erythromycin if allergic
  118. Listeria Monocytogenes Resistance
    Cephalosporins
  119. Corynobacteriae General Features
    • Gram + irregular shaped rods
    • facultative anaerobes / aerobic only
    • non motile
    • non spore forming
    • catalase +
    • fermenter
    • mycolic acid in cell wall - acid fast
    • metachromatic granules
  120. Corynobacteriae Virulence Factors
    Diphteria Toxin - inactivates protein synthesis, very potent
  121. Corynobacteriae Diphteria / ulcerans Diseases
    • Diphteria
    • - Pseudomembranous Pharyngitis
    • - cutaneous diphtheria - non healing ulcers
    • - systemic disease due to toxin
  122. Corynobacter Diphteria treatment
    • started on basis of clinical diagnosis
    • combined therapy
    • - antibiotics
    • - antitoxin
  123. Corynobacter Diphteria Culturing
    • Normal agar
    • - hemolysis
    • - breaks down cysteine --> brown
    • Tellurite agar
    • - prevents growth of Gram - rods
    • - C. Diphteria reduced it --> grey/black
  124. Diphteria Toxin Diagnosis
    ELEK test - immunodiffusion
  125. staining metachromatic granules
    Albert Stain
  126. Corynobacter Urealyticum Virulence Factors
    Urease
  127. Corynobacter Urealyticum Diseases
    UTI
  128. Corynobacter Urealyticum treatment
    vankomycin in serious cases
  129. Corynobacter Urealyticum  resistance
    • penicillins
    • cephalosporins
    • aminoglycosides
    • macrolides (often)
    • fluorochromes (often)
  130. Corynobacter Haemolyticum diseases
    acute tonsilitis
  131. Corynobacter Haemolyticum treatment
    • macrolides
    • linkosamides
  132. Acinetobacter General Features
    • Gram - rods
    • Pairs
    • Aerobic / anaerobic when nitrate is present
    • Motile
    • Non fermenter
    • Oxidase +
    • Simple nutritional needs
    • Tolerate wide range of temperatures (4-42)
  133. Acinetobacter Baumanii diseases
    • grow on moist and dry surfaces
    • opportunistic infections
  134. Acinetobacter Baumanii treatment
    depends on susceptibility testing
  135. Pseudomonas General Features
    • Gram - rods
    • Pairs
    • Aerobic / anaerobic when nitrate is present
    • Motile
    • Ferment Glucose only
    • Oxidase +
    • Simple nutritional needs
    • Tolerate wide range of temperatures (4-42)
  136. Pseudomonas Virulence Factors
    • Capsule
    • Pilli
    • Endotoxin
    • Hemolysin
    • Antibiotic Resistance
    • Disinfectant Resistance
  137. Pseudomonas Aeruginosa Virulence Factors (15)
    • Adhesins
    • - Pilli
    • - Neuraminidase
    • Capsule --> biofilm
    • Endotoxin
    • Pyocyanin
    • Toxic Oxygen Radicals
    • Exotoxin A (ETA)
    • Elastase
    • Phospholipase C
    • Las A - serine protease
    • Las B - zinc metalloprotease
    • Alkaline Protease
    • Rhamnolipid
    • Exoenzymes S, T
    • Cytotoxin
  138. Pseudomonas Aeruginosa Diseases
    • tracheobronchitis --> necrotizing bronchopneumonia
    • ecthyma gangrenosum skin lesions
    • Endocarditis
    • Burn wound infections
    • Folliculitis
    • UTI
    • Corneal Ulcers
    • Swimmers Ear - external otitis
    • Chronic Otitis media
  139. Which Toxin causes Ecthyma Gangrenosum skin lesions
    elastase
  140. which Pseudomona Aeruginosa Toxin is responsible for dermatonecrosis in burns
    Exotoxin A
  141. Pseudomonas Aeruginosa treatment
    • combined therapy
    • - Aminoglycosides
    • - antipseudomonal penicillins (ticarcilin / piperacillin)
  142. why is monotherapy not useful in Pseudomonas Aeruginosa infection
    • often reistant
    • develops resistance
    • patients often immunocompromised so cannot help with own response
  143. Pseudomonas Aeruginosa culture
    • beta hemolysis
    • Pycocyanin - blue pigment
    • Fluorescein - yellow pigment
    • grape like odor
  144. Pseudomonas Aeruginosa resistance
    • Efflux Pumps
    • Mutated Porin genes
    • Transfer of plasmids
  145. Burkhalderia Cepacia diseases
    • highly virulent bronchopneumonia in cyctic fibrosis / granulomatous diseases
    • UTI
    • bacteremia
  146. Burkhalderia Cepacia treatment
    Trimethoprim sulfomethoxazole
  147. Stenotrophomas Maltophilia
    Oportunistic infections
  148. Stenotrophomas Maltophilia General Features
    • Gram - rods
    • aerobic
    • non fermenter
    • grows in disinfectant solutions
    • grows in ice
  149. Stenotrophomas Maltophilia treatment
    Trimethoprim Sulfomethoxazole
  150. Mycobacteria General Features
    • acid fast rod
    • aerobic
    • non motile
    • non spore forming
    • contain many mycolic acids in the cell wall
    • - slow growing
    • - resistant to detergents / antibiotics
    • - stain with Ziel Neehlsen
  151. Mycobacteria Classification
    • Pathogenicity
    • - strictly pathogenic - M. Tuberculosis / M. Leprae / M. Bovis 
    • - usually pathogenic -M. Ovium
    • - sometimes pathogenic
    • Rate of Growth + Pigments
    • M Tuberculosis - Slow + buff colored
    • Runyon Group 1 - slow + photochromogenic
    • Runyon Group 2 - slow + scotochromogenic
    • Runyon Group 3 - slow + nonchromogenic
    • Runyon Group 4 - rapid
  152. Ziehl Neelsen Staining Procedure
    • 1. flood with Carbolfuschin whilst steam heating
    • 2. decolorize using ethanol + HCl
    • 3. counter stain with methylene blue
    • Pink +
    • blue -
  153. Culturing Mycobacteria
    • alkaline solution decontamination of sputum samples etc. - does not kill mycobacetria
    • M. LEprae can only grow on tissue cultures
  154. Mycobacteria Virulence Factors
    • survives intracellularly
    • Virulence comes from host response
  155. Mycobacteria Tuberculosis General Features
    • Acid fast rod
    • Aerobic
    • Non motile
    • Non spore forming
    • Contain many mycolic acids in the cell wall
    • slow growth with buff colored colonies
  156. Mycobacteria Tuberculosis Development of Disease
    • 1. phagocytosed by alveolar macrophages
    • 2. replicate in macrophage
    • 3. macrophages and lymphocytes attracted to infection and form langerhand multinucleated cells
    • 4. infected macrophages travel to regional lymph nodes / blood
    • 5. granulomas form with fibrin clott
    • - prevents spread of tuberculosis
    • - protects tuberculosis from macrophages
    • 6. tuberculosis remain dormant for decades
  157. Mycobacteria Tuberculosis Diagnosis
    • tuberculin skin test
    • QuantiFERON TB
    • icroscopy and culture
    • chromatography of cell wall lipids
    • radiology to find granuloma
    • species specific molecular probes in cultures (no PCR)
  158. Tuberculin Skin Test
    Purified Protein Derivative (PPD) intradermal injection
  159. QuantiFERON TB test
    Interferon gamma measured after overnight incubation with tuberculosis
  160. Mycobacteria Tuberculosis Treatment
    • Susceptibility Testing
    • 1. isoniazis (INH) + ethambutol + pyrazinamide + rifampin for 2 months
    • 2. isoniazis + rifampin for 4-6 months

    • Patient is isolated
    • Prophylaxis when someone is in close contact with a patient
  161. Mycobacteria Tuberculosis Vaccine
    • BCG using Mycobacteria Bovis
    • effective if given to young children
  162. Mycobacteria Ovium Complex (MAC) species
    • M. Avium
    • M. Intracellulare
  163. MAC diseases
    • immunocompetent
    • - slowly evolving cavity disease like TB in old men who smoked
    • - Lady Windermere's syndrome- patchy nodular infiltrates in older women who hold in coughs
    • - solitary pulmonary nodules

    • immunodeficient
    • - multi organ disseminated disease
  164. MAC treatment
    clarithromycin / azithromycin + ethambutol + rifabutin for long time

    • in immunodeficient patients
    • - antiviral therapy
    • - prophylaxis
  165. Slow growing Mycobacteria that cause Pulmonary Tuberculosis
    • M. Tuberculosis
    • M. Bovis
    • M. Kansanii
  166. Slow growing Mycobacteria that cause localized lymphatic infections
    M. Scrofulaceum
  167. Slow growing Mycobacteria that cause cutaneous infections
    • M. Ulcerans
    • M. Marinum
    • M. Haemophilum
  168. Slow growing Mycobacteria that grow at cool temperatures
    • M. Ulderans
    • M. Marinum
    • M. Haemophilum
  169. Slow growing Mycobacteria that are spread by person-person contact
    • M. Tuberculosis
    • M. Bovis
  170. Rapidly growing Mycobacteria that cause disease after introduction into deep subcutaneous tissue
    • M. Fortuitum
    • M. Abscessus
  171. Slow growing Mycobacteria culturing
    3rd day grey non hemolytic colonies appear
  172. Mycobacteria Leprae diseases
    • Tuberculoid Leprosy
    • Lepromatous Leprosy
  173. in what situations does Tuberculoid Leprosy develop
    • Strong cellular Response
    • Weak humoral antibody response
  174. in what situations does Lepromatous Leprosy develop
    • Weak cellular response
    • Strong humoral antibody response
  175. Lepromatous Leprosy Diagnosis
    Microscopy
  176. Tuberculoid Leprosy diagnosis
    • Lepromin skin test
    • - uses inactive M. Leprae = lepromin
  177. Mycobacteria Leprae treatment
    • Tuberculoid - rifampicin + dapsone for 6 months
    • Lepromatous - rifampicin + dapsone + clofazimine for 12 months
  178. Narcodia General Features
    • Gram + weakly acid fast rods
    • aerobic
    • catalase +
    • form aerial hyphae
    • oxidative
    • intracellular survival
  179. Narcodia Virulence Factors
    • Cord Factor
    • Metabolise Acid Phosphatase Enzyme
    • Prevent Acidification of phagosome
    • Catalase
    • Superoxide Dismutase
  180. Narcodia Diseases
    • Bronchopulmonary Disease with necrosis and abscess formation
    • Diseemination to CNS + skin
    • Mycetoma
    • Lymphocutaneous Disease
    • Cellulitis
    • Subcutaneous Abscess
    • Brain Abscess
  181. Narcodia Treatment
    • in vitro susceptibility testing
    • 6 week therapy to prevent dissemination

    per wound care

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