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33 Cards in this Set

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What are the general characteristics of the Pseudomonadaceae family
Aerobic, gram negative; do not ferment glucose; oxidase positive; polar flagellum
What are the general characteristics of Pseudomonas aeruginosa
Grape like odor; fluorescent green pigment; Ubiquitous in nature, commonly found in moist environments; Aggregates into biofilms and is resistant to many disinfectants and preservatives
What diseases are caused by Pseudomonas aeruginosa
A variety of infections, usually nosocomial. It is particularly virulent once established (highest gram-negative mortality)
What increases the risks of Pseudomonas aeruginosa infection
Impaired host defenses, such as: Disruption of skin, mucus membranes; Colonization of intravenous or urinary catheters; Compromised patients; Miscellaneous (external otitis)
80-90% of Cystic fibrosis patients develop what type of infection
Chronic Pseudomonas aeruginosa lung infections. Colonization increases with age
What is the pathogenesis of Pseudomonas aeruginosa
Ps. aeruginosa is a very virulent organism due to its capacity to invade deep within tissue and the action of its many toxins. Systemic disease can result, or LPS can cause fatal sepsis (fever, shock, DIC)
What are the virulence factors of Pseudomonas aeruginosa
Pili; Alginate capsule; pyocyanin; Exotoxins A and S; Extracellular proteases; Hemolysin; Endotoxin (LPS); Flagella with twitching motility
What do exotoxin A and S found in Ps. aeruginosa do
Exotoxin A is a potent inhibitor of mammalian protein synthesis. It and diphtheria toxin cause ADP ribosylation of EF-2
Exotoxin S also inhibits protein synthesis through ADP riboslyation, but the target is unknown
What does pyocyanin found in Ps. aeruginosa do
Impairs cilia; damages tissue via production of O2 radicals
What is twitching motility found in Ps aeruginosa
Occurs via retraction and extension of the pseudomonas pili. Necessary for biofilm formation on plastic
What is the treatment for Pseudomonas aeruginosa
Single drug therapy should be avoided because of quick drug resistance. Recommend penicillin plus an aminoglycoside
What type of infections is Acinetobacter baumanni known for
Nosocomial infections. Dramatic increase in recent years, particularly bacteremia and pneumonia. Not particularly virulent, but frequently multidrug resistant
High numbers of infections in soldiers in Iraq are caused by what
Acinetobacter baumanni
What are the 4 types of Urinary tract infections
Ascending (most common); Hematogenous (Salmonella sp, Staphylococcus aureus, Candida sp); Uncomplicated (healthy people, 80% E coli); complicated (catheterized patients, immunosuppressed; wider spectrum of causative agents; Proteus mirabilis)
What is the pathogenesis of Uropathogenic E coli
Has virulence factors on pathogenicity islands encoding P fimbriae adhesins (adhere to P group) and Hemolysins; Type 1 fimbriae
What is the pathogenesis of Proteus mirabilis (Enterobactericeae) in Urinary tract infections
Demonstrates swarming motility due to lateral flagella. Predilection for the upper urinary tract. Associated with kidney stone formation due to the action of urease
Besides Proteus mirabilis, what other gram negative rods cause complicated urinary tract infections
Pseudomonas aeruginosa; Enterobacter sp and Klebsiella pneumoniae (Enterobacteriaceae)
What is the laboratory diagnosis for uncomplicated UTI
Culture clean catch midstream urine. Presence of multiple organisms or low concentrations suggests contamination
What is the laboratory diagnosis of UTI in catheterized patients
Isolated bacteria concentrations of 10^2 to 10^4 per mL. Multiple species are likely
What is the treatment for uncomplicated UTI
Sulfonamides and trimethoprim
What are two causes of Neonatal meningitis
E coli K1 (greatest risk first 4 weeks of life)
Citrobacter freundii (not common, forms brain abscesses)
3% of bacterial pneumonia is caused by what
Klebsiella pneumonia. Urease positive, lactose fermenter; non motile, encapsulated.
Which gram negative enteric bacteria can cause wound infections
Klebsiella pneumoniae, Proteus sp., Ps. aeruginosa
What is the leading cause of bacteremia in adults
E coli. High incidence of nosocomial infections
What are the characteristics of the onset of sepsis
Often insidious- Fever, mental confusion, transient hypotension, oliguria, thrombocytopenia
What is the epidemiology of sepsis
750,000 US cases. 30% mortality rate, 40% in elderly, 50% if septic shock begins
What are the clinical signs of gram-negative sepsis in response to
Endotoxin (lipid A of the LPS)
When does continuous septicemia occur
Occurs primarily in patients with intravascular infections; occurs with septic shock. Blood culture will be positive
When does intermittent septicemia occur
In patients with infections at a distal site. Blood cultures may not be positive
What are six of the most common gram negatative enteric bacilli that cause sepsis
E. coli, Klebsiella sp., Enterobacter sp., Proteus sp., Serratia marcescens, P. aeruginosa
What two Enterobacteriaceae are frequent contaminants of parenteral fluids
Enterobacter sp and Serratia marcescens
What three gram negative enteric bacilli are associated with transfusion sepsis
Salmonella sp, Yersinia enterocolitica, Campylobacter sp.
What is gram negative shock a response to
Entodoxin-induced release of TNF-alpha by macrophages in the liver, spleen, and other body sites