Gram Negative Opportunistic Infections

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part of our normal flora and the most common opportunistic pathogen

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e. coli

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four disease that E. coli can cause

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1. gastrointestinal infections
2. UTI
3. bateremia
4. maningitis

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three characteristics of E. coli that contribute to its pathogenicity

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1. K1 capsule (serum resistance)
2. Pili (UPEC)
3. shiga-like (cause of Gi symptoms)

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causes 95% of all non-hospital acquired UTIs

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E. coli

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Many UTI bacteria are capable of binding

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mannosides - common constituents of uroepithelial cells and UTI
and are either mannose sensitive or not

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an infection with UPEC is considered an infection when there is how much bacteria in urine

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10 to the 5 / ml

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a term used to describe the syndrome involving dysuria (burning feeling during urination), urgency, and occasionally suprapubic tenderness

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cystitis

usually involves lower urinary tract

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resuts from urinary tract infection that has disseminated to kidney - flank pain, tenderness, and feer, dysuria, etc

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acute pylenophritis

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binds glycolipis on uroepithelial cells and erythrocytes and encoded by the pap operon
associated with E. coli

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P pili (MR = mannonse resitant)

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stochastic switching of phenotypic trait to provide phenotypic diversity inside and outside the host

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phase variation - E. coli associated with UTI

controlled by variety of mechanism strand slippage, methylation, recombination, influenced by enviromental factos

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neo-natal meningitis

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20% - 40% of individuals care a type of E.coli that can colonize a new born via vertical transmission -
E.coli has resistance due to the KI capsule -

crosses BBB to survive in CSF, proliferate, and cause tissue damage

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E. coli associated bacteremia - often has serum resitance due to the production of

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K1 capsule

K1 capsule is made of sialic acids which are like host glycoproteins. the capsule is like that of neisseria meningitidis

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leading cause of nosocomial bacteremia

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E. coli - crosses from UT tract ot blood

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e.coli has what kind of gram stain

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Gram negative

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Klebsiella pneumoniae has what kind of gram stain

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gram neg opportunistic

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how does the klebsiella pneumoniae's capsule contribute to the increased pathogenicity

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1. reduced phagocytosis
2. reduced complement susceptibility

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what is used to help identify K. pneumoniae based on mucoid colony

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capsule


the capsule decreases phagocytosis and complement activation

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differs from Klebsiella in that it is motile and generally less heavily encapsulated

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enterbacter cloacae

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does e. cloace cause diarrhea?

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no DIARRHEA!

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the two characteristic that are known to contribute to pathogenicity of proteu vulgaris

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1. flagella
2. urease synthesis

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infections are seen secondary to broad spectrum antibiotic therapy or secondary to instrumentaiton - pneumonia is often contracted after use of contaminated respirator

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serratia marcessens

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serratia is different from the other enterobacteriaceae in that it is

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less likely to colonize GI tract and more assocaiated with respiratory and urinary tract (GI tract is imporatant reservoir among neonates)

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produces Ig-specific protease that influence pathogenicity

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serratia

also associated with septic arthritis

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three acute infections caused by p. aeruginosa

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1. bacteremia in immune compormised patients
2. eye infections
3. burn infections

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associate with Cystic fibrosis where pts are mor susceptible to a chronic bacterial infections

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p. auruginosa

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cannot ferment sugars. requires aerobic incubation. can grow via anaerobic respiration with nitrate as an electron acceptor, or ferment amino acid arginine

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p. aeruginosa

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ExoA exotoxin

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ADP-ribosylates elongation factor 2 (EF-2) which stops protein synthesis and elicits apoptosis of affected cells - P. aerugosa

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these are ADP-ribosylating enzymes that targes host regulatory proteisn and is secreted P. aeruganosa

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ExoS and ExoT

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cytotoxic exotoxin which ahs phospholipase activity; causes irreversible damage to cellular membranes and rapid necrotic death

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ExoU - P. auruginosa

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secretes elastase and phopholipases which breaks down elastin and phospholipids in lung surfactant in host cell membranes

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p. aeruginoa

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most frequently found in the water of cooling towers, resides w/in free-living amoeba

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Legionella pneumophilia

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sLegionella pneumophilia causes

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peneumonia

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Legionella pneumonia exhibits what kind of growh t

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intracellular and parasitism in amoebae

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transmission of Legionella pneumophilia

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airborn route from enviroment not from infected people

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Diagnosis of L. pneumonnia

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diret flourescnet Ab test in sputum -

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3 gram negative opportunistic pathogens which are lactose fermenting

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E. coli
K. pneumonia
E. cloacae

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why is p. aeruginosa described as obligate aerobe

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it does not ferment sugars - but can grow nitrate as an alternative alectron acceptor and grow on arginine fermentatively.

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3 surface determinants of E. coli

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LPS (O-antigen)
Flagella (H antigen)
Capsule (K antigen)

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virulence factors which are encoded on a plasmid in E. coli

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Hemolysin

Heat labile toxin (LT)
heat stable (ST)

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verotxin secreted by E.coli is also called

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shiga-like toxin

encoded on a lysogenic phage - interferes w/ protein synthesis via RNA cleavage (subunit A) and impacts cytoskeleton (subunit B)

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causes HUS (hemolytic uremic syndrome)

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seen in about 7% of E. coli infections

hemolytic anemia, thrombocytopenia, acute renal failure etc..

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E. coli O157:H7 is a serotype which what kind of diarrhea

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bloody due to the shiga-like toxin

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shows Type III secretion system

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E. coli - enterohemorrhagic ecoli

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LEE

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pathogenenicity island which encodes the T3SSS, intimin, and tir

it is the locus for enterocyte effaceement

seen in enterohemorrhagic E.coli

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locus for enterocyte efacement

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LEE

"pathogeniccity island"
EsB: pores in eukaryotic membrane
EsA: type III filmaments
TIR: E.Coli attachment
Intimin: tiR binding protien on surface
- these are effector protiens, LEE also involves a secretion apparatus

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Tir

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involved in T3SS : allows for E coli attachment

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how does the T3SS system work

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protein moves across bacterial cytoplasm and outer membrane AND across host cell membrane through a needle into host cytoplasm

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shiga-like toxin secreted by and encoded on

how does it work

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secreted by E. coli

encoded on phage

intrerferes with protein synthesis via its RNA cleavage activity (subunit A) and may impact cytoskeleton (subunity B)

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Hemolysin secreed by enterhemmorhagic E.coli does what

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nutrient acquisition by by cytotoxic-pore formation in cells

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how does Sorbitol MacConkey Agar distinguis between commensal E. coli and O157:H7

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O157:H7 is sorbitol-negative while commensal E.coli are sorbitol-positive

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are E. coli, salmonella shigella all lactose what

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E. coli is lact +
salmonella and shigella is Lac -

good diagnostic test

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what is the serologic test for O157

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direct or latex agglutination test

or H7 seology an dtoxin
analysis

send to reference library