Bacteriology 2 Gram Positive Rods

Front 1

Bacullus

Back 1

gram-positive, spore forming, motile rods
Mostly saprobic
aerobic
Source of antibiotics
inhabitants of soil

Front 2

Bacillus antracis

Back 2

large, block-shaped rods
centrals spores that can develop under all conditions except that of a living body.
Virulence factors polypeptide capsule and exotoxins.
cutaneous anthrax, contact spores and release through skin, black scar eschhar lest dangerous.

pulmonary-inhalation of spores
gastrointestinal ingestion of spores

Front 3

anthrax

Back 3

Zoonotic found on cattle ranches in soil
Can be extremely fatal especially if inhaled
toxemia, septemia
sporadically seen in US

Front 4

Treatment Anthrax
Vaccines

Back 4

Penicillin, tetracycline, ciprofloxacin

Vaccines: Live spores and toxoid to protect cattle
purified toxoid for special occupation inoculate toxoid 6 times 1.5 years annual boosters

Front 5

Bacillus Cereus

Back 5

food born, air born
disinfectants, antiseptics ineffective
grow on food, withstand heat and temperature, usually fried rice
ingestion of toxin vomit, cramps, diarrhea for 24 hrs, no treatment
increase in reported cases immunosuppressed

Front 6

Clostridium

Back 6

Gram-positive, spore forming rods
anaerobic
120 species
oval or spherical spores formed in anaerobic conditions
synthesize alcohols, organic acid, and exotoxins
CAUSE WOUND INFECTIONS, TISSUE INFECTIONS, AND FOOD INTOXICATION

Front 7

Clostridium Perfingens
gas gangrene
spore found?
predisposing factors?

Back 7

GAS GANGRENE SOFT TISSUE INFECTIONS AND WOUND INFECTIONS MYONECROSIS
spores found, skin, soil, vagina, intestine
Predisposing factors: surgical incision, compound fracture, diabetic ulcer, septic abortion, puncture wound, gunshot wound

Front 8

C. perfingens Virulence factors

Back 8

Toxoid: alpha toxin, ruptures RBC, edema, tissue damage
Collagenase
Hyaluronidase
DNase

Front 9

Pathology C. Perfringes

Back 9

Requires dead or damaged tissue in anaerobic conditions which stimulate:
spore germination, vegetative growth, release of exotoxins, and virulence factors.

Fermination of muscle carbohydrate produces gas which destroys tissue

Front 10

Treatment C. Prefringes

Back 10

Immediate cleansing of deep dirty wound form compound fracture, infected incisions
Debridement of damaged tissue
Large doses penicillin
Hyperbaric oxygen therapy
No vaccines

Front 11

Clostridium Difficile (5)

Back 11

1. normal endogenous resident of colon in low numbers
2. causes pseudomembranous colitis superinfection
3. antibiotic related, broad spectrum antibiotic wipes out normal flora allowing for C dif to over grow
4. Produces enterotoxins that damage intestine
Major cause of diarrhea in hospital, increasing more common in community acquired diarrhea due to gastric acid inhibitors.

Front 12

Treatment C. Difficile

Back 12

Minor complication, replace fluids and electrocutes and removal of antimicrobials

Severe infections: oral vancomycin or metroindizole and culture replacement

Increased precautions to prevent spread due to spore forming factors

Front 13

Clostridium tetani

Back 13

common resident in soil and animal gi tract
cause tetanus, lock jaw, neuromuscular disease

Most commonly found in elderly, iv drug users, neonates from developing countries

Front 14

Pathology C. tetani

Back 14

tetani enters wound, crushed bones
anaerobic conditions needed for vegetative cells to grow and release toxin
Tetnosplasmin neurotoxin causes paralysis by binding to spinal cord neurons, blocking the release of neurotransmitter for muscular contraction inhibitor cause jerky reaction
death is due to paralysis of respiratory muscles.

Front 15

C. tetani treatment

Back 15

deter degree of toxemia, anti toxin therapy
human tetanus immunoglobulin attaches and deactivates circulating toxin while not countering the toxin in which it is attached.
Control infection with penicillin or tetracycline and muscle relaxants
Vaccine available; booster needed every 10 years.

Front 16

Clostridium botulism

Back 16

Spore forming anaerobe; commonly inhibits soil and water.
Intoxication associated with inadequate food preservation Botulism

Front 17

Clostridium botulism pathology

Back 17

Spores are present on food when gathered and processed , if not properly removed
Anaerobic conditions required for spore germination, vegetative growth to release toxin botulin
Neurotoxin carried to NMJ blocking ACH
Double or blurred vision, difficulty swallowing, neuromuscular problems

Front 18

Infant botulism

Back 18

spores ingested, and spores germinate causing flaccid paralysis

Front 19

Clostridium perfinges (spores/food)

Back 19

Spores contaminate food that has not been cooked thoroughly
Spores germinate and multiply (especially if unrefrigerated)
Enterotoxin is produced in the intestine
Acts on epithelial cells, acute adnominal pain, diarrhea, nausea
Rapid recovery

Front 20

Mycobacteria

Back 20

Gram-positive irregular bacilli
Acid-fast staining
Strict aerobes
Possess mycolic acid and unique layer peptoglycan
Do not form capsules, spores, flagella
Slow to grow

Front 21

Mycobacterium tuberculosis

Back 21

Does not have enzymes or exotoxins that contribute to virulence factor

Complexes waxes and cord factor that prevent destruction by macrophage or lysosomes

Front 22

Tuberculosis

Back 22

Predisposing factors:
inadequate nutrition, suppressed immune system, poor access to health care, genetics, lung infection
1/3 of world population and 15 million in US carry tubercle bacillus
highest rate in US occurring in recent immigrants, homeless
transmitted by airborne respiratory droplets

Front 23

Infectious and disease tuberculosis

Back 23

5-10% will develop clinical disease
Untreated will progress slowly and majority of TB cases are contained in lungs
Clinical TB
Primary, Secondary, and disseminated TB (extrapulmonary)

Front 24

Primary TB

Back 24

Infectious does 10 cells
Phagocytosis by alveolar macrophages and multiply intracellulary
3-4 weeks immune system attacks form tubercles
Tubercles- granulomas with central cores bacillus surrounded by WBC gradually heal by calcification

Front 25

Secondary TB

Back 25

If untreated or no recovery from primary TB; reactivation of bacilli can occur.
Tubercles expand and drain into the bronchial tubes and upper respiratory tract.
Cause, violent cough, green/red tinged sputum, fever, anorexia, weight loss, fatigue
Untreated 60% mortality rate

Front 26

Extrapulmonary TB

Back 26

Bacilli disseminate to regional lymph nodes, kidneys, long bones, genital tract, brain, and meninges.

Complications can be grave

Front 27

Diagnosis TB

Back 27

PPD intradermal purified protein derivative look for red wheal to form 48-72 hours. Positive result from previous or current infection. Once positive always positive.
X-rays following positive PPD result
Direct identification of acid fast bacilli in specimen
florescent microscopy, acid fast stain of sputum.
Sputum culture isolation and biochemical testing

Front 28

Treatment TB

Back 28

6-24 mos. of at least 2 drugs from a list of 11
One pill regimen Rifater. First line drugs: isoniazid, rifampin, pyrazinamide
Vaccine based on attenuated bacilli strain of M bovis, used in other countries
Once vaccinated always ppd positive.

Front 29

Mycobacterium Leprae

Back 29

Hansen's disease, strict parasite, slowest growing of all species.
Multiples within host cells in large packets called globi
Cause leprosy; chronic disease begins on skin and mucous membranes, progress into nerves.

Front 30

Transmission leprosy

Back 30

Endemic regions throughout world
not fully verified, could be genetic factor
health, and living conditions contribute to susceptibility

Front 31

Leprosy Infection and disease

Back 31

Incubation 2-5 years
If untreated bacilli grow slowly in schwann cells and macrophages of peripheral nerves.
2 forms
tuberucloid, asymmetrical, shallow lesions, damage nerves, local loss of pain reception
Lepromatous: deeply nodular infection cause sever disfigurement of face and extremities. Widespread dissemination.

Front 32

Diagnosis Leprosy

Back 32

Microscopic examination of lesions
Numbness of hands and feet
loss of heat and cold sensitivity,
muscle weakness
thickened earlobes,
chronic stuffy nose
Detection of acid fast bacilli in skin lesions, nasal discharges and tissue sample
FEATHER TEST

Front 33

Treatment leprosy

Back 33

Long-term combined therapy
prevention requires constant surveillance of high risk populations
WHO trial vaccine

Front 34

NON-tuberculosis Mycobacterium

Back 34

S. avium- third most common death in AIDS patients
M. marinum water inhabitant: lesions develop after scraping on swimming pool concrete.