Gram + Bacteria Of Id

Front 1

Gm (+) bacteria

Back 1

Staph, Strep(includes enterococci) = cocci

Clostridium, Bacillus = rods, spore forming

Listeria, Corneybacterium = rods, NO spores

Front 2

Group A Strep

β- Hemolytic

Back 2

Streptococcus pyrogenes

Front 3

Most common cause of pharyngitis

Back 3

Virus

(Group A Strep = most common bacterial cause)

Front 4

Diagnosis of Group A Strep

Back 4

Throat culture and Rapid Antigen Detection Test (RADT)

Front 5

Group A Strep. pyrogenes toxins and antigens

Back 5

1) pyrogenic toxin - cause of scarlet fever and toxic shock syndrome, as well as pharyngitis

2) M protein - prevents comp. and phagocytosis

3) Streptolysin tissue invasive toxins - cause β hemolysis and skin infections

Front 6

Treatment for Group A Strep

Back 6

Penicillin G for 10 days or 1 shot of Benzathine

(but only if started 9 days post infection)

Front 7

Scarlet Fever

Back 7

Group A strep. pyrogenes - toxin med.

. Rough blanching red rash beginning on trunk and extending to extremities (face sparing)

. Strawberry tongue

Front 8

Rheumatic Fever

Back 8

Group A Strep. - antibody med.

. Fever, Myocarditis followed by valve damage w/ infection risk, Arthritis, Chorea, Sub-Q nodules, Eythema Marginatum rash (red margin, center clearing)

*Complication of Group A Strep pharyngitis only! (not skin infection)

Front 9

Group A Strep.

Skin Infections

Back 9

1)Impetigo - superficial w/ gold crust (also caused by Staph. aureus)

2) Erypsipelas - dermis, sharp borders

3) Cellulitis - below dermis, vague border

4) Necrotizing Fasciitis -Deep sub-Q, continues to gangrene, often polymicrobial

Front 10

Post-Strep. Glomerulonephritis

Back 10

Group A Strep. - antibody medi.

. Hematuria ("tea-colored pee"), edema, high BP due to hypervolemia

*Complication of Group A Strep skin infection!

Front 11

Peds. Autoimmune Neuro-Psych. Disorder Associated w/ group A Step. (PANDAS)

Back 11

abrupt OCD, chorea, and tics

Front 12

Group A Strep pneumonia

Back 12

Rapid, severe pneumonia w/ empyemea

Affects young/healthy and has increased mortality.

*suppuralative complication

Front 13

Group B Strep

β-hemolytic

Back 13

Streptococcus agalactiae

Front 14

Neonatal Sepsis

Back 14

Group B Strep. infection via vertical transmission from colonization in mom's vagina (*think B for Baby)

. Can lead to pneumonia or meningitis in baby

Front 15

Prophylactive trx of Neonatal Sepsis and

indications for trx

Back 15

IV penicillin or ampicillin to mom

Indications - premature, prolonged rupture of membranes, intrapatrum fever, mom cultures + or has prev. baby with sepsis

Front 16

α-hemolytic Strep.

Back 16

Strep. pneumoniae

Strep. viridans

*all capsulated (thus react w/ CRP)

*all susceptible to penicillin, 3rd Gen. cephalosporins, and vanco.

Front 17

Strep. viridans

Back 17

α-hemolytic

. Resistant to optochin, bile insoluble

. Dental infections, Subacute Bacterial Endocarditis (piling of bacteria on damaged valves to cause murmurs, Abscess

*"verde" = green (α-hemoly) -> think bacteria slowly eating a heart valve and gets some green stuff stuck in its teeth

Front 18

Strep. pneumoniae

Back 18

α-hemolytic dipplococci

. Susceptible to optochin, bile soluble, Quellung Rxn to determine capsular sub-type (many capsule serotypes = no immunity)

. #1 cause of adult bac. pneumonia, #1 bac. meningitis in adults, #1 otitis media in kids

*What group B strep is to Babies (neonatal sepsis), Pneumococcus is to Parents (adult pneumonia and meningitis and ear infections which = screaming kids)

Front 19

γ-hemolytic strep.

Back 19

1) Nutritionally variant strep. (require VitB6/pyridoxyl which can be provided by Staph coinfection)

2) Streptococcus bovis

3) Enterococcus

*Trx w/ Amp (a penicillin) + Gent or Vanco

Front 20

Enterococcus

Back 20

γ-hemolytic, Group D

. Always in GI tract waiting to prey on hospitalized pts (nosocomial infections) - include UTI, wound infections, bacteremia, and prosthetic valve endocarditis

Front 21

Strep. bovis

Back 21

γ-hemolytic (can sometimes be alpha), Group D

. Same as enterococcus species, but strong association w/ colon cancer

*Bovis in the Blood, Better Beware! Cancer in the Bowel!

Front 22

Staphylococci

(and their trx)

Back 22

Gm +, catalase + cocci that grow in clusters

. Differentiated based on production of coagulase (causes blood clots):

>Coag + = Staph. aureus

> Coag (-) Staph (CoNS) include Staph epidermidis and staph saprophyticus

Trx: All are resistant to penicillin (due to penicillin-binding-proteins), so either treated with Methicillin (MSSA) or Vanco if resistant to Methicillin (MRSA)

Front 23

Staphylococcus aureus

(and its virulence factors)

Back 23

Coag +, Gm +

Has a capsule, forms biofilms, MSCRAMS for surface adhesions, leukocidins to kill WBC, Protein A (finds IgG to prevent phago and comp), pyogenic, α/β a hemolysins

Front 24

Scalded Skin Syndrome

Back 24

caused by Staph. aureus exfoliative toxin

- blisters w/ no microbes or WBC

*Ritter's disease in infants

Front 25

Toxic Shock Syndrome

Back 25

Caused by TSST-1 made by Staph. aureus or Group A strep

. Super antigen reacts non-specifically with MHCII and T cells to cause mass release ofcytokines

. Symptoms = Sunburn rash, large fall in BP, fever, peeling of palms and soles

Front 26

Toxic Shock Syndrome Trx

Back 26

1) start w/ Clindamycin (stops protein synthesis of TSST-1) + Vanco (against Gm +) + Carbapenaem/Pipercillin/Tazobactam (Gm -) while waiting for blood culture results

2) When bug is IDed, continue Clinda with either Naficillin (MSSA) or Vanco (MRSA) or Penicillin (Group A Strep)

Front 27

Staph. aureus food poisoning

Back 27

due to heat stable enterotoxin

Causes vomitting, diarrhea w/in 24 hrs of eating contaminated food

B/c due to preformed toxin -> no antibiotics

Front 28

Most common cause of osteomyelitis

Back 28

Staph. aureus from wound infection

Front 29

Staph. aureus organ specific infections

(x7)

Back 29

1) Skin/soft tissue - abscess, furuncle, carbuncle

2) Impetigo - pustules on face -- also caused by group A strep

3) Bloodstream - cause + cultures, fever, decrease in BP-- require transesophageal echo to rule out endocarditis

4) Endocarditis - due to MSCRAMS attaching to valves -- unlike SBE from Strep viridans, RAPID!

5) Severe cavitous pneumonia - empyemas

6) Osteomyelitis

7) Prosthetic joint infection - due to biofilms

Front 30

Staph. epidermidis

Back 30

Coag. (-), Gm +

. Lives on normal skin flora so common blood culture contaminant

. Cause of most indwelling prosthetic devices (including IV catheters)

Trx w/ Vanco due to meth resistance

Front 31

Staph. saprophyticus

Back 31

Coag. (-), Gm +

. #2 cause of uncomplicated UTIs (2nd to E. coli) but rare in male UTI

Trx w/ TMP/SMX

Front 32

Bacillus anthracis

Back 32

Gm + rod, aerobic, spores, capsule

looks like bamboo-chains w/ curled edges ("medusa's head")

Spread via spores from herbivore hair/hides entering via skin cut, inhaled, or ingested

Front 33

3 forms of anthrax and how to trx

Back 33

1) Pulmonary (woolsorter's disease) = edema from chest up, resp distress, mediastinal widening

2) Cutaneous = malignant pustule = painless black lesion w/ rim of edema

3) GI - cramps, bloody diarrhea, vomitting. Deadly.

Trx: IV Doxy or Cipro (penicillin will work but probably resistant if used as terrorist weapon)

Front 34

Bacillus cereus

Back 34

Gm + spore forming aerobic rod

Causes food poisoning resistant to cooking (fried rice!). NO ANTIBIOTICS due to it being caused by a toxin not bacteria

Front 35

Corneybacterium diptheriae

Back 35

Gm + nonspore-forming aerobic rod that looks like Chinese characters. Grown on potassium tellurite media to ddx

. Cytotoxin ADP-ribosylates EF-2 to inhibit protein synthesis ->causes a grey pseudomembrane to form in throat that if it breaks will carry to heart and neurons

trx w/ 1) antitoxin, 2) pen or erythro, 3) DPT vaccine

(*if you see grey pseudo memb, tell your intern!)

Front 36

Listeria monocytogenes

Back 36

GM + faculatative anaerobe rod, non-spore forming. Grows at low temps (milks/cheese). Uses listerolysin O to escape vacuoles in phagos and then a actin tail to rocket to next cell

Bad in pregnant, neonates (bacterimia) and meningitis in elderly and immunocompromised

Trx w/ Amp and Gent

Front 37

Anaerobic Gm + Bacteria

Back 37

Lack Superoxide Mutase

Trx w/ Metranidazole and Clindamycin

Include: Clostridium , Bacteriodes fragilis (too fragile for O2 radicals) , Actinomyces

Front 38

Anaerobic bacteria that cause

infections above the diaphragm

Back 38

Actinomyces, Fusobacterium, Prevotella

Front 39

Anaerobic bacteria that cause infections below the diaphragm

Back 39

Clostridium, Bacteriodes fragilis (NOTE: Gm - rod),

and other Gm + cocci

Front 40

Clostridium species

Back 40

Gm +, spore-forming, anaerobic (likes to stay in closet w/out O2), box-car-like rods

Front 41

Clostridium botulinum

Back 41

. Adult botulism - Neurotoxin that blocks Ach to cause descending flacid paralysis. Food contaminated w/ spores. Trx w/ antitoxin

. Infant botulism - "floppy baby"- eat honey w/ spores. Supportive therapy only

. Wound botulism - similar to adult

Front 42

Clostridium tetani

Back 42

. Tetanospasm neurotoxin - descending spastic paralysis start w/ lockjaw

. Trx: 1) antitoxin, 2) Pen G, 3) Tetnus booster

*Vaccine via DPT - booster every 10 yr

Front 43

Clostridium perfringens

Back 43

1) Food poisoning - eat spores in meats -> watery diarrhea

2) Gas Gangrene - Lecithinase α-toxin causes rapid spread to mm w/ necrosis and gas production (crepitous) -> STAT surgery and Pen G

Front 44

Clostridium difficile

Back 44

Antibiotic-associated Pseudomembranous colitis - toxin A causes diarrhea, B = kills colon cells

Trx = Metranidazole, if this fails then Vanco, if this fails then fecal transplant

Front 45

Actinomyces

Back 45

Gm + faculatative anaerobe, filamentous (looks like fungus)

Causes "Lumpy Jaw" with draining sinuses w/ sulfur granules. May lead to brain abscess

Trx: long regime of Pen G