Gram - Bacteria Ii

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Pasteurella multocida

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Bacterial: Pasteurellaceae (Gram -). Zoonotic. Bacteriophage confers pathogenic properties.

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P. multocida Transmission

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Farm: poultry & cattle carry it as normal resp. flora. Direct or indirect physical contact @ a wound site. Domestic: cats carry it as normal resp. flora & dogs as mouth flora. Direct or indirect physical contact esp. licking or biting.

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P. multocida Symptoms

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Begins as wart-like eruption @ site of contact. Abscesses. Often permanently scars. May progress to septicemia or organ-specific problems.

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P. multocida Treatment

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Immediate wound care. Clinical amoxicillin, fluoroquinolones, tremethoprim-sulfamethoxazole.

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Genus Haemophilus

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Bacterial: Pasteurellaceae (Gram -). Human pathogens: H. aegyptius, H. ducreyi, H. influenzae, H. parainfluenzae.

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H. aegyptius

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Transmitted thru direct or indirect contact and biting insects. Symptomatic conjunctivitis. Treated w/ antibiotic eyedrops. Prevented by cleaning children's toys and clothes.

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H. ducreyi

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Transmitted thru sex. Symptomatic genetic ulceration. Treated w/ cotrimoxazole. Prevented by good personal hygiene & restricted sexual partners.

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H. influenzae

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Transmitted thru direct physical contact w/ resp. secretions. Symptomatic otitis media, conjunctivitis, sinusitis, meningitis. Treated w/ ampicillin and chloramphenicol. Hib vaccine.

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H. parainfluenzae

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Transmitted thru autoinnoculation (often dental procedures). Symptomatic endocarditis. Treatment varies, ciprofloxacin common. Prevented by sanitary surgical technique.

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Hib Vaccine

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Polysaccharide conjugated to innocuous carrier protein. Injected. Standard in U.S.: start at 2 mos., often with DTaP.

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"Plague"

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Plague sensu lato = any epidemic disease. Plague sensu stricto = Y. pestis disease. Historically unclear which form writers refer to. "Black Death" likely combo w/ anthrax.

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Yersinia pestis

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Bacerial: Enterobacteriaceae (Gram -). Prefers lymphoid tissues of host. Produces surface proteins to dissuage phagocytes.

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Plague Transmission

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Cutaneous entry most common: flea infects skin, bacteria migrates to lymph node & may move to lungs and bloodstream. Respiratory. Incubation 2-6 days. Year-round.

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Bubonic Plague Symptoms

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Most common plague. Fever, chills, headache, exhaustion, inflammation & hemorrhage of lymph nodes, not very communicable.

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Pneumonic Plague Symptoms

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Usually a secondary form after bubonic, but can be primary (aerosolized). Highly communicable. Primary symptoms: fever, chills, headache, tachycardia, labored breathing, cough, sputum.

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Septicemic Plague Symptoms

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Can be secondary after bubonic or pneumonic, or can be sudden onset. Not very communicable. Extreme fever, convulsions, prostration, septic shock, blood clotting.

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Modern Plague Treatment

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Quarantine. Antibiotics effective only early- to mid-stages: streptomycin and gentamicin (secondary). Organ-specific supportive therapies (cardiorespiratory, renal).

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Plague P&C

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Multiple types of vaccines. Unavailable to U.S. public (low threat). Control of rodent & flea populations. Public ed.

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Salmonella enterica serovar Typhi

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Bacterial: Enterobacteriaceae (Gram -). Colonize intestine, invade lamina propria. Multiply in spleen & liver. Spread through bloodstream.

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Typhoid Fever Transmission

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Mainly thru asymptomatic carriers: remains in gallbladder. Feces or urine contamination of foods or water.

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Typhoid Mary

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Asymptomatic Irish cook who spread typhoid fever through her cooking. Identified by public health authorities and detained.

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Typhoid Fever Symptoms (General)

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Incubation 7-30 days. Acute symptoms: ingestion of bacteria, GI problems.

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Typhoid Fever Symptoms (One Week)

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Fever, anorexia, malaise, headache, flushed appearance.

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Typhoid Fever Symptoms (Two Weeks)

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Raised fever, chills, delirium, convulsion, sweating, wkness, ab pain & distention, alternating diarrhea & constipation, cough / rales, abdomen rose spots, enlarged spleen. Bacteria move from liver to gallbladder and shed into sm. intestine.

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Typhoid Fever Symptoms (Three Weeks)

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Recovery: fever, fatigue & weakness, symptoms diminish. May become fatal: intestine ulcerates & splits open, abscesses, blood clots.

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Typhoid Fever Treatment

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Antibiotics: ampicillin, ciprofloxacin, trimethoprim-sulfamethoxazole, chloramphenicol. Fluid replacement. Rest. Antichlorigenics for GI problems.

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Typhoid Fever P&C

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Sanitation, identify asymptomatic carriers and treat. Vaccines atypical: two by injection (killed) one by ingestion (live attenuated). New avirulent strains tested.