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38 Cards in this Set
- Front
- Back
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What is the only oxidase positive gram negative rod? |
Pseudomonas aeruginosa |
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Distinguishing features of P. aeruginosa |
Oxidase positive Catalase positive Pigments: pyocyanin (blue green), fluorescin Grape-like odor Slime layer/capsule
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Growth media for P. aeruginosa |
MacConkey EMB |
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Reservoir for P. aeruginosa |
Ubiquitous in water |
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Transmission of P. aeruginosa |
Water aerosols Raw vegetables Flowers |
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Virulence factors |
Endotoxin (LPS) Pseudomonas exotoxin A - ribosylates EF2 (elongation factor) which inhibits protein synthesis Capsule/slime layer - allows formation of pulmonary colonies |
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Diseases from P. aeruginosa |
Healthy Individuals Gastroenteritis Hot tub folliculitis Eye ulcers (contact lenses, trauma)
Burn patients Gastroenteritis Cellulitis Sepsis
Neutropenic patient Pneumonia Sepsis Ecthyma gangrenosom Chronic granulomatous disease Catheterized patient UTI Patient with Cystic Fibrosis Recurrent pneumonia |
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Diagnosis for P. aeruginosa |
GS/CS |
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Treatment for P. aeruginosa |
Anti-pseudomonal penicillin + aminoglycoside |
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Prevention of P. aeruginosa infection |
Water treatment Hand washing Prompt catheter removal No flower or raw vegetables in burn units |
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Distinguishing features of Legionella pneumophilla |
Poor gram staining Facultative intracellular |
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Reservoir for Legionella pneumophilla |
Water Air conditioning units |
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Transmission of Legionella pneumophilla |
Water aerosols No human to human transmission |
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Predisposing factors for Legionella pneumophilla |
Smoking Age over 55 High alcohol intake Immunosuppression |
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Virulence factors of Legionella pneumophilla |
Facultative intracellular Endotoxin |
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Diseases caused by Legionella pneumophilla |
Legionnaire's disease - pneumonia - mental confusion - diarrhea (but no Legionella in GI tract) Pontiac fever (usually in young and healthy individuals) - pneumonitis - no fatalities |
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Diagnosis for Legionella pneumophilla |
Direct fluorescent antibody test Antigen urine test (but for serogroup 1 only) Serology - 4x increase in titer |
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Treatment for Legionella pneumophilla |
Fluoroquinolone or macrolide Add Rifampin for immunocompromised |
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Prevention of Legionella pneumophilla |
Decontaminate waterways and AC units |
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Reservoir for Francisella |
Rabbits (hence the term Rabbit Fever) Deer Rodents |
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Transmission of Francisella tularensis |
Tick bite --> ulceroglandular disease Traumatic implantation --> ulceroglandular disease Aerosols --> pneumonia Ingestion of infected meat --> typhoidal tularemia |
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Pathogenesis of Francisella tularensis |
Facultative intracellular organism (reticuloendothelial cells) --> granulomatous response |
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Diagnosis of Francisella tularensis |
Serology Direct fluorescent antibody test |
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Treatment of Francisella tularensis |
Streptomycin |
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Prevention of Francisella tularensis |
Live, attenuated vaccine for high risk individuals |
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Reservoir for Bordetella pertussis |
Vaccinated humans |
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Transmission of Bordetella pertussis |
Respiratory droplets |
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Virulence factors of Bordetella pertussis |
Filamentous hemagglutinin - allows binding to ciliated endothelium; inhibits ciliary function Pertussis toxin - cAMP increase, influx of ions and water, causes edema; induce hypoglycemia by islet activation; blocks immune effector cells; increases histamine activity Adenylate cycle toxin - inhibits phagocytosis and causes local edema Tracheal cytotoxin - kills ciliated cells |
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Diagnosisfor Bordetella pertussis |
Sputum cultures Bordet-Gengou Regan-Lowe Direct fluorescent antibody test PCR Serology |
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Treatment for Bordetella pertussis |
Supportive care Macrolides |
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Prevention |
DTP or DTaP vaccines (5 to 7 years) |
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Reservoir of Brucella |
B. abortus - cattle B. melitensis - goats B. suis - pigs |
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Transmission of Brucella |
Direct animal contact Unpasteurized dairy products |
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Pathogenesis of Brucella |
Facultative intracellular organism --> granulomatous response with central necrosis Endotoxin |
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Diseases caused by Brucella |
Brucellosis - sepsis - evening fever - diaphoresis/profuse sweating*** - hepatomegaly - flu-like symptoms
Undulant form - milder Chronic form - B. melitensis (goat) - older people - uveitis - cyclic bouts of depression and sweating - fatigue |
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Diagnosis of Brucella |
Serology (4x increase) |
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Treatment for Brucella |
Adults: Rifampin and Doxycycline for 6 weeks Children: Rifampin and co-trimoxazole |
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Prevention of Brucella |
Vaccinated cattle, high risk humans Pasteurize dairy products |
