Anaerobic Infection

Front 1

1) Where are anaerobes the predominant flora
2) infections results from ___

Back 1

1) mucous membranes
2) breakdown of mucosal barrier , leakage of flora into sterile sites

Front 2

Gram negative anaerobes (4)

Back 2

1) Bacteroides
2) prevotella
3) porphyromonous
4) fusobacterium

Front 3

Gram positive anaerobes (3)

Back 3

1) clostridium
2) peptostreptococcus
3) actinomyces

Front 4

anaerobe sensitivity to penicillins:
1) gram +
2) gram -

Back 4

1) Most gram positive anaerobes are sensitive to penicillins EXCEPT clostridium
2) gram negatives tend to be resistant

Front 5

What illnesses are caused by anaerobes of the mouth?

what are most of these caused by?

Back 5

1) sinusitis, otitis, dental abscess,

2) Most in the mouth are gram positive and penicillin-resistant

Front 6

Hallmark pathogenesis of anaerobes(4)

Back 6

1) Suppuration (pus formation)
2) Abscess formation
3) Thrombophlebitis
4) Tissue destruction with gas formation

Front 7

Describe anaerobe synergy

Back 7

Most infections are polymicrobial, facultative orgasnisms lower O2 and facilitate growth of anaerobes

Front 8

Virulence factors in anaerobes (5)

Back 8

1) Synergy – facultative organisms lower O2 and facilitate anaerobe growth
2) Capsule inhibits phagocytosis and promotes abscess formation
3) Exotoxins – C. diff, tetanus, botulism
4) Enzymes that chew up the tissue – proteases, collagenases, etc.
5) Beta lactamase – Bacteroides

Front 9

What infections occur at the following sites:
1)CNS
2) Thoracic cavity
3) mouth, head, neck

Back 9

1) brain abscess, sundural empyema
2) aspiration pneumonia, lung abscess, some empyemas
3) chronic otitis media, chronic sinusitis, periodontitis

Front 10

What infections occur at the following sites:
1) abdominal cavity
2) pelvic cavity
3) skin, soft tissue

Back 10

1) peritonitis, intrabdominal abscess, wound infection
2) PID, tuboovarian, vaginal abscess
3) gas gangrene, necrotizing fasciitis, diabetic foot and decubitus ulcers

Front 11

Compared to aerobic infections, anaerobic infections (3)

Back 11

1) Tend to go at a slower pace
2) Are harder to grow in culture
b)Swabs will not isolate anaerobes, have to do aspirates
3) Don’t have routine susceptibility testing

Front 12

Clinical signs that make you think of anaerobic infection (5)

Back 12

1) Adjacent to mucosa
2) Foul smelling discharge
3) Necrotic gangrenous tissue or abscesses
4) Free gas in tissue
5) Bowel perforation, aspiration of oral flora

Front 13

What sorts of samples can be cultured

Back 13

blood, pus, aspirates, not swabs

Front 14

Adjunctive therapy for anaerobic infections (3)

Back 14

1) Surgical drainage and debridement of necrotic tissue
2) Aspiration or incision/drainage of abscesses
b)Except lung abscesses, which drain spontaneously
3) Empyema requires prompt and complete aspiration

Front 15

1) what is Ludwig’s angina?
2) how is it treated

Back 15

1) spreading infection down the neck spaces
2) Augmentin or clindamycin

Front 16

Pulmonary infection
1) characteristic
2) parts of the lung
3) treatment

Back 16

1) necrotizing pneumonia with lung abscesses
2) dependent parts
3) clindamycin because most of the bugs produce beta lactamases

Front 17

What is used to treat CNS anaerobic infections?

Back 17

metronidazloe plus ceftriaxone ( or penicillin)

Front 18

What is used to treat anearobic pulmonary infection?

Back 18

clindamycin (not penicillin) bc of beta lactamase

Front 19

1) What is used to treat intraabdominal infection.

2) what significance does rebound tenderness have?

Back 19

1) combinations, Need to add treatment that covers gram negatives
o Cefepime or cipro + flagyl
2) suspect polymicrobial

Front 20

1) What is associated with IUD use
2) suspect with polymicrobial
3) treatment for pelvic infection

Back 20

1) actinomycosis
2) GC/ chalamydia
3) is drainage, cefoxitin + doxycycline (to cover GC/chlamydia)

Front 21

Antibiotic resistance in fusobacterium

Back 21

you guessed it. resistance to penicillan ( bc of beta lactamases)

Front 22

What is the predominant cause of antibiotic-associated diarrhea

Back 22

Clostridium difficile

Front 23

How long after antibiotic therapy does a c. dif infection present?

Back 23

5-10 days

Front 24

What bug is predominant colon flora

Back 24

-Bacteroides fragilis
-Non-spore-forming gram negative bacillus

Front 25

1) What is Lemierre syndrome
2) caused by

Back 25

1) pharyngeal space infection from thrombophlebitis of jugular vein
2) Fusobacterium

Front 26

1) What are the diseases caused by Clostridium toxin production
2) how are these diagnosed?

Back 26

1) -Toxins A and B lead to cytoskeleton disruption, mucosal injury, fluid secretion
-Pseudomembranes in the colon
-Infants lack the toxin receptors and are protected
2) Diagnosis by assaying the TOXIN, not doing a culture

Front 27

How is clostridium difficile infection treated?

Back 27

metronidazole and then go to oral vancomycin

Front 28

1) what does Clostridium perfringens cause
2) treatment (2)

Back 28

1) Causes gas gangrene, necrotizing fasciitis
2) a. Aggressive debridement is necessary
b. Penicillin + clindamycin (binds the toxin causing the necrosis)

Front 29

1) How does clostridium tetani cause spasms

Back 29

1) Enters CNS -> failure of NMJ transmission -> no inhibition of motor neurons -> spasms

(Produces a toxin like all of the clostridia)

Front 30

1) Clostridium botulinum toxin mechanism
2) toxin transmission
3) paralysis presentation
4) treatment

Back 30

1) Prevents Ach release and causes paralysis
2) Foodborne (preformed toxin), infant, wound, inhalation
3) descending
4) Supportive care, antitoxin from the CDC

Front 31

1) What does actinomyces look like under the microscope
2) How is infection similar to a malignancy
3) treatment

Back 31

1) Gram positive branching bacilli, not acid fast
2) grows through tissue planes (even bone)
3) sensitive to penicillin
b. doxycycline, clindamycin