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85 Cards in this Set
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Gram stain
Stains? Order? Gram +: color? Layers? lipid content? ABx? Gram -: color? Layers? lipid content? extra stuff? ABx? |
Crystal violet stain -> EtOH wash -> safrarin stain
+: blue; 2 - inner cytoplasmic membrane, outer thick peptidoglycan layer low lipid content vulnerable to PCN, lysozyme -: red 3 - inner cytoplasmic membrane, thin peptidoglycan layer, outer membrane High lipid content LPS/lipid A, periplasmic space, porin channel Resistant to lysozyme/PCN |
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Tetanospasmin
Organism? M/A? 2 Sx? 3 Vax? Toxin carried on? |
C. tetani
H subunit: bind neuronal gangliosides L subunit: block GABA & gly release from Renshaw to inh neurons Uncontrolled muscle contraction Lock jaw Respiratory paralysis DTP Plasmid |
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Botulinum toxin
Organism? 1 M/A? 1 Sx? 1 Toxin converted by? |
C. botilinum
Inh ACh release from NMJ endplate Flaccid paralysis Lysogenic conversion |
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HLT/choleragen
Organisms? 4 M/A? 4 Sx? 2 Mnemonic? 7 C's |
V. cholerae, E. coli, C. jejuni, B. cereus
5 B subunits bind GM1 gangliosidase on intestinal cell membrane 2 A subunits ADP-ribosylate GTP binding protein -> incr cAMP -> NaCl secretion + inh NaCl resorption Rice water stools Dehydration Cholera, coli, campylobacter, cereus, cAMP inc, Cl (w/ Na) secretion, Conversion lysogenic |
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HST
Organisms? M/A? |
E. coli, Y. enterocolitica
Bind intestinal R of guanylate cyclase -> incr cGMP -> inh NaCl resorption |
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Shiga/shiga-like toxin
Organisms? 3 M/A? 3 Sx? 4 |
Shigella dysenteriae, EHEC, EIEC
5 B subunits: bind intestinal epi cells 2 A subunits: inactivate 60S ribosomal subunit -> kill cells Sloughing dead cells Poor absorption fluid & electrolytes Bloody diarrhea Hemolytic uremic syndrome |
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Staph HST
Organism? 1 Sx? 2 From? |
S. aureus
Diarrhea Vomitting Food colonized w/ staph |
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HST
Organism? Sx? Survives? |
B. cereus
Vomiting < 24 hrs Limited diarrrhea Spores survive low temp cooking |
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Pyrogenic toxin
Organism? 1 M/A? Sx? Toxin from? |
S. pyogenes (GAS)
Activates endogenous sepsis mediators like IL-1 Scarlet fever Lysogenic conversion of temperate bacteriophage |
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TSST
Organism? M/A? Sx? 6 Also caused by? |
S. aureus
Activate endogenous sepsis mediators like IL-1 Toxic shock syndrome: fever, rash, desquamation, diarrhea, hypotensive shock -> also caused by s. pyogenes |
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S. pyogenes invasive toxins
5 toxin w/ M/A: Sx? 3 |
Hemolysins/streptolysin O & S: lyse RBC
Streptokinase: activate plasminogen -> lyse fibrin clots DNAse: hydrolyzes DNA Hyaluronidase: break down proteoglycan NADase: hydrolyzes NAD Abscess Skin inf Systemic inf |
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Staph-specific tissue invasive toxins
6 toxins w/ MA: Sx? |
Lipases: hydrolyze lipids
Penicillinases: destroy PCN Staphylokinase: activate plasminogen -> lyse fibrin clots Leukocidin: lyses WBC Exfoliatin: lyses epithelial cells Complement binding factors: cripples host complement defense Abscess Skin inf Systemic inf Scalded skin syndrome |
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Actinomyces israelli
Reservoir? 2 Morph? 2 Metab? 1 Dz? 4 Tx? 2 Dx? 3 |
Mouth, GIT
Branching chains/beaded filaments Anaerobic Cervicofacial Thoracic Abdominal Eroding abscesses PCN G Surg Gram + rod Sulfur granules in pus Anaerobic culture |
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alpha toxin
Organism? M/A? 1 Sx? 2 |
C. perfringens
lecithinase hydrolyzes lecthin -> cell death Tissue destruction Gas gangrene |
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Nocardia asteroides
Reservoir? 1 Transmission? 1 Metab? 1 Morph? 2 Dz? 2 Tx? 1 Dx? 3 |
Never part of norm flora
Resp Aerobic Partially acid-fast (mycolic acids) Branching chains or beaded filaments PA Abscesses in lung, kidney, CNS TMP/Sulfa Gram + rods Modified acid fast stain Aerobic culture |
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Anthrax toxin:
Organism? M/A? 3 Sx? Parts required? |
B. anthracis
Edema factor subunit = calmodulin-dependent adenylate cyclase -> incr cAMP -> impair neutrophils -> massive edema Lethal factor = zinc metalloprotease -> inactivates protein kinase -> macrophage release TNF-a + IL-1 -> death Protective Ag: binding subunit that allows entry of EF Inh phagocytosis, edema, death Toxin needs all 3 parts |
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Diphtheria toxin
Organism? M/A? 2 Sx? 4 Vax? Toxin from? |
C. diphtheriae
B subunit binds heart, neural tissue A subunit: ADP-ribosylates EF2 -> inh translation in protein synth Diphtheriae: myocarditis, peripheral nerve palsy, CNS fx DTP Lysogenic conversion |
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Pertussis toxins
Pertussis toxin M/A? 2 Extracytoplasmic adenylate cyclase? 2 Filamentous hemagglutinin? 1 Tracheal cytotoxin? 1 Sx? Vax? |
B subunit binds target cells
A subunit: activate Gs -> incr cAMP -> inh phagocytosis Similar to anthrax Incr CAMP -> impair chemotaxis & phagocytosis Allows binding to ciliated cells Damage resp epi cells Whooping cough DTaP |
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Toxin A/B
Organism? M/A? 2 Sx? 4 Assoc w/? |
C. difficile
A: fluid secretion & mucosal infl -> diarrhea B: cytotoxic to colonic epi cells Pseudomembranous colitis Bloody diarrhea Fever Abd pain ABx use |
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Pseudomonas exotoxin A
Organism? M/A? 1 Target organ? |
P. aeruginosa
ADP-ribosylation of EF2 -> inh protein synth Liver |
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Fx of septic shock
Vasc system? 2 Heart? 3 Kidneys? 3 Lungs? 1 Liver? 2 Brain? 1 Coag sys? 2 |
Vasodilation -> dec BP, organ hypoperfusion
Myocardial depression -> dec CO, dec BP, organ hypoperfusion Acute renal failure -> dec urine output, vol overload, toxin accumulation ARDS -> hypoxia Liver failure -> accumulation metabolic toxins, hepatic encephalopathy Encephalopathy -> altered MS DIC -> clotting, bleeding |
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Bacterial genetics
Norm bacterial state? Transformation: famous experiment? Transduction: via? Virulent v. temperate? Generalized v. specialized? Mnemonic for toxins? Conjugation: req? 3 Hfr? F'? Transposons: 2 |
Haploid
Giffith S->R pneumococci Bacteriophage Virulent = lyse bacteria immediately Temperate = stay in chromosome as lysogenic prophage Generalized = contain only bacter DNA; virulent phage Specialized = contain some bact DNA; temperate phage; lysogenic conversion ABCDE: ShigA, Botulinum, Cholera, Diph, Erythrogenic toxin F+ -> F- via F plasmid; Sex pilus formation; Cell-to-cell contact High frequency recombinant: integrated F plasmid F' = altered F plasmid that includes bact genes DNA pieces that insert themselves into DNA Leave a copy where began |
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GAS = s. pyogenes
Metabolism? 5 Virulence factors/purpose? 6 Toxins? 2 Dz? 6 Tx? 6 Dx? 3 |
Catalase neg
Microaerophilic β-hemolytic Streptolysin O: O2 labile, Ag Streptolysin S: O2 stable, non-Ag M-protein: adherence, anti-phagocytic, Ag Lipoteichoic acid: adherence Streptokinase Hyalurondiase DNAse Anti-C5a peptidase Pyrogenic toxin TSST Pharyngitis: fever, red/swollen, purulent tonsils, LAD Skin inf: folliculitis, cellulitis, impetigo, necrotizing fasciitis Scarlet fever: fever + red rash TSS Rhematic fever Acute post-streptococcal glomerulonephritis PCN G, PCN V Penicillase-resistant PCN Prophylaxis after Rheumatic fever ABx w/ dental procedure if heart valve defect Add clindamycin for invasive inf Gram + chain of cocci Inh by bacitracin Throat swab -> RADT for Ag |
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GBS = s. agalactiae
Metabolism? 3 Dz? 5 Tx? 1 Dx? 2 Part of norm flora? |
Cat neg
facultative anaerobe β-hemolytic Neonatal meningitis Neonatal PA Neonatal sepsis Sepsis in preg w/ 2o inf of fetus Sepsis & PA in elderly PCN G Gram + chain of cocci CSF, urine, blood culture Vaginal flora |
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GDS
4 species? Metabolism? 3 Virulence? 1 Dz? 3 Tx? 3 Dx? 3 Assoc w/? 1 |
Enterococci: s. faecalis, s. faecium
Non-entero: s. bovis, s. equinus Cat neg facultative anaerobe α, β, or γ-hemolytic Extracellular dextran -> helps bind to heart valve Subacute endocarditis Biliary tract inf UTI Ampicillin +/- aminoglycoside Resistant to PCN G Emerging resistance to vanco Gram + chain of cocci Enterococci: 40% bile, 6.5% Na Nonentero: only grow in bile S. bovis assoc w/ colon CA |
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S. viridans
Metabolism? 3 Virulence? 1 Dz? 3 Tx? 1 Dx? 2 Normal flora in? 2 |
Cat neg
facultative anaerobe α-hemolytic Extracellular dextran helps bind to heart valve Subacute endocarditis Dental caries Brain/liver abscess PCN G Gram + chain of cocci Resistant to optochin Oral flora & GIT |
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S. pneumonaie = pneumococcus
Metabolism? 3 Virulence? 1 Toxin? 1 Dz? 4 Tx? 2 Vax? 2 Dx? 3 |
Cat neg
Facultative anaerobe α-hemolytic Capsule Pneumolysin: bind chol in host-cell membrane PA Meningitis Sepsis Otits Media IM PCN G Erythromycin Pneumovax: against 23 capsule Ag; for elderly Heptavalent for children Gram + diplococci Culture not grow in optochin, bile + quellung test |
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S. aureus
Metabolism? 3 Virulence? 8 Toxin? 3 Dz? 11 Tx? 3 Dx? 6 |
Cat +, coag +
Facultative anaerobe Protein A: binds IgG, prevent opsinization/phagocytosis Coagulase: fibrin formation around organism Hemolysin Leukocidin PCNase Hyaluronidase Staphylokinase Lipase Exfoliatin Enterotoxin TSST Food poisoning TSS Scalded skin syndrome PA Meningitis Osteomyelitis Acute bacterial endocarditis Septic arthritis Skin inf Bacteremia/sepsis UTI PCNase-resistant PCN Vanco (IV for MRSA) Clindamycin Gram + clusters β-hemolytic Golden yellow pigment Cat + Coag + PCR detection of rRNA |
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S. epidermidis
Metabolism? 3 Virulence? 2 Dz? 5 Tx? 1 Dx? 3 |
Cat +, coag -
Faculative anaerobe Polysaccharide capsule -> biofilm Highly resistant to ABx Nosocomial: prosthetic joints, prosthetic heart valves, sepsis from IV lines, UTI Contaminate blood cultures Vanco Gram + cluster Coag neg, cat + |
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S. saprophyticus
Metabolism? 3 Dz? 1 Tx? 1 Dx? 4 |
Cat +, coag neg
Faculative anaerobe UTI in sexually active women PCN Gram + cluster γ-hemolytic Cat +, coag - |
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B. antracis
Reservoir? 3 Transmission? 3 Metabolism? 1 Virulence? 2 Toxin? 3 Dz? 3 Tx? 2 Vax? 2 Dx? 3 |
Sheeps, goats, cattle
Endospores: cutaneous, inhalation, ingestion Aerobic but facultative Protein capsule anti-phagocytic (plasmid) Non-motile Protective Ag Edema factor Lethal factor Cutaneous black vesicle (can be fatal un-Tx) Woolsorter's dz GI: abd pain/V/D (bloody) -> immunity Ciprofloxacin Doxycline High risk ind Against protective Ag Gram rod Serology Nasal swab PCR |
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B. cereus
Transmission? 1 Metabolism? 1 Virulence? 2 Toxins? 2 Dz? 1 Tx? 4 Dx? 2 |
Endospores
Aerobic No capsule Motile HLT, HST Food poisoning: N/V/D Vanco Clindamycin Resistant to β-lactams NO TX FOR FOOD POISONING Gram rod Culture from suspected food source |
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C. botulinum
Reservoir? 4 Transmission? 1 Metabolism? 1 Virulence? 1 Toxin? 1 Dz? 5 Tx? 5 Dx? 3 |
Soil
Stored veggies Smoked fish Fresh honey Heat-resistant endospores Anaerobic Motile flagella (H Ag +) Neurotoxin released on death of bact Cranial nerve palsy, muscle weakness, resp paralysis (whether food borne or wound) Constipation, flaccid paraylis in infants Antitoxin Human botulinum Ig PCN Hyperbaric O2 Supportive Gram stain rod Anaerobic culture Pt serum inject into mice -> death |
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C. tetani
Reservoir? 1 Transmission? 1 Metabolism? 1 Virulence? 1 Toxin? 1 Dz? 4 Tx? 5 Vax? 1 Dx? 2 |
Soil
Endospores: wound Anaerobic Motile flagella (H Ag +) Tetanospasmin Tetanus: muscle spasm, lock jaw, risus sardonicus, resp muscle paralysis Tetanus toxoid Antitoxin Clean wound PCN Supportive DTaP Gram + drumstick rod Anaerobic culture |
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C. perfingens
Reservoir? 2 Transmission? 1 Metabolism? 1 Virulence? 1 Toxins? 1 main Dz? 2 Tx? 2 Dx? 2 |
Soil, GIT
Endospores obligate Anaerobic Non-motile α toxin Gas gangrene, watery diarrhea if ingested Radical surgery PCN Hyperbaric O2 Gram stain rod Anaerobic culture |
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C. difficile
Reservoir? 2 Transmission? 2 Metabolism? 1 Virulence? 1 Toxins? 2 Dz? 1 Tx? 3 Dx? 2 |
GIT, Hospitals
Fecal-oral endospores Anaerobic Motile flagella (H Ag +) Toxin A/B Pseudomembranous colitis Metronidazole Oral vanco Terminate ABx Immunoassay for toxin Colonoscopy |
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C. diphtheriae
Morph? 3 Transmission? Metabolism? 2 Virulence? 1 Toxin? 1 Dz? 6 Tx? 3 Vax? 1 Dx? 3 |
Gram + rod: plemorphic, club shaped
Non-spore Non-motile Resp droplets Cat + Facultative anaerobe Pseudomembrane toxin Exotoxin A/B -> inactive EF2 (lysogenic) Sore throat Pseudomembrane on pharynx Myocarditis -> AV block Peripheral palsy Guillain-Barre like syndrome Palatal paralysis, CN palsy Antitoxin PCN/erythromycin DTaP Gram + pleomorphic clubs (Chinese letters) K tellurite culture -> dark black colonies Loeffler's medium -> stain w/ methylene blue -> reddish granules |
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L. monocytogenes
Morph? 3 Transmission? 3 Metab? 4 Virulence? 2 Toxin? 2 Dz? 2 Tx? 2 Dx? 2 |
Gram + rod
Non-spore forming Tumbling motility @ 25C Raw milk/cheese Vaginal birth Transplacental inf Facultative anaerobe Cat + β-hemolytic Intracellular Motile flagella (H Ag+) Hemolysin: Ag, heat labile Listerolysin O (lyse phagosomes) Phospholipases Meningitis: neonates, immunocompromised, elderly Septicemia in preg Ampicillin TMP/sulfa Gram + rod Cold enriched culture (2.5C) |
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N. meningitis
Reservoir? Transmission? Morph? 1 Metab? 2 Virulence? 4 Toxin? 2 Dz? 4 Tx? 3 Vax? 2 Dx? 5 High risk? |
Nasopharynx - human only
Resp Kidney bean shaped diplococci facing each other -> donut Facultative anaerobe High CO2 env Ferment maltose & glucose Capsule IgA1 protease Fe abstracting protein Pili for adherence LPS endotoxin No exotoxins Asymptomatic carriers Meningitis Septicemia Waterhouse-Friderichsen syndrome PCN G Ceftriaxone Rifampin prophylaxis Capsular Ag to A, C, Y, W-135 Not to Ag B Gram + diplococci in donut shape Choc agar @ 80C x 15 min Thayer-Martin prevent growth: Vanco, colistin, nystatin Tetramethylphenylene diamine -> colorless->pink bact DNA PCR 6-24m (low IgG) Army recruits |
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N. gonorrhea
Reservoir? Transmission? Morph? Metab? 3 Virulence? 4 Toxin? 2 Dz? 6 Tx? 4 Dx? 5 |
Humans only
STD Donut (kidney-bean diplococci facing each other) Facultative anaerobe CO2 env Ferment glucose only Pili: Adherence, antigenic, antiphagocytic IgA1 protease Outer membrane protein: dark, opaque colonies -> adherence Fe abstracting proteins LPS endotoxin No exotoxin Asymptomatic carriers Male: urethritis Female: cervical gonorrhea -> can lead to PID Both: gonococcal bacteremia, septic arthritis (most common cause in sexually active) Opthalmia neonatorum w/in 1st 5d Cephalosporin 3rd gen -> ceftriaxone 2nd line: floroquinolones, spectinomycin Erythromycin eye drops Gram + donut diplococci Choc agar Thayer Martin VCN Tetramethylphenylene diamine colorless->pink Bact PCR |
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M. catarrhalis
Reservoir? Dz? 3 Tx? 5 |
Norm resp flora
Otitis media children RTI COPD exacerbations Azithromycin/clarithromycin Amoxicillin w/ clavulanate 2nd/3rd ceph TMP/sulfa Resistant to PCN |
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Enterbacteriaceae generalities
Gram? Transmission? 3 Metab? 4 Common toxin? Dx? OKH Ag? Drug of choice? |
GNR
Fecal-oral Migration up urethra Colonization in cath Cat +, oxidase - Ferment glucose Facultative anaerobe LPS EMB agar to inh gram + bact MacConkey agar: bile salts O: Outer portion of LPS K: capsule H: Flagella Imepenem + cilastin |
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E. coli
Reservoir? Transmission? 4 Metab? 3 Virulence? 5 Toxins? 3 Dz? 9 Tx? 4 Dx? 4 |
Human GI/GU
Fecal-oral Migration up urethra Colonize cath Aspiration of oral Indole + β-hemolytic Ferments lactose Fimbriae pili = colonization factor Siderophore Adhesin Capsule Flagella HLT, HST, Shiga-like Neonatal meningitis UTI Hosp acq sepsis Hosp acq PA ETEC: LT, ST -> traveler's diarrhea EHEC: bloody diarrhea, hemorrhagic colitis, HUS (O157:H7) EIEC: blood diarrhea w/ fever Ceph Aminoglycosides TMP/sulfa Floroquinolones GNR Can grow 45.5C Deep purple-black on EMB Pink-purple on MacConkey |
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K. pneumoniae
Metab? 2 Virulence? 2 Dz? 3 Tx? 2 |
Indole neg
Ferments lactose Capsule Nonmotile PA, esp acholics Hosp acq UTI Hosp acq sepsis 3rd gen ceph (HEN PEcK) Aztreonam |
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Proteus mirabilis
Metab? 3 Virulence? 1 Toxin? 0 Dz? 3 Tx? 2 Dx? 3 |
Urease
Indole neg Doesn't ferment lactose Swarming motility No toxin UTI: high pH -> stones Sepsis Ampicillin TMP/Sulfa Swarming colonies High pH in urine Weil-Felix test to DDx from Rickettsia |
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S. dysenteriae
Reservoir? Transmission? Metab? 2 Virulence? 2 Toxin? 1 Dz? 1 Tx? 3 Dx? 1 Best Ig for immunity? |
Human
Fecal-oral No H2S Does not ferment lactose Invade GI submucosa but not lamina propria Non-motile Shiga toxin BLODDY diarrhea w/ mucus, pus (sim to EIEC) Floroquinolone Azithromycin TMP/sulfa Stool culture IgA |
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S. typhi
Human v. non human? 4 Transmission? 1 Metab? 3 Virulence? 3 Dz? 5 Tx? 4 Dx? 2 |
Typhi = human only; non-typhi: pet turtles, chickens, uncooked eggs
Fecal-oral Produce H2S Doesn't ferment lactose Intracelular Motile (H Ag +) Capsule VI Ag -> anti-phagocytic Siderophore Para/typhoid fever: fever, abd pain, HSM, rose spots on abd Chronic carrier state Gastroenteritis Sepsis Osteomyelitis Incr risk in asplenic pt Cipro Ceftriazone TMP/sulfa Azithromycin Blood/stool/urine culture Never part of norm flora |
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Y. enterocolitica
Reservoir? Transmission? 3 Metab? 2 Virulence? 3 Toxin? 1 Dz? 1 Tx? 1 Dx? 2 |
Pigs!
Ingestion: food, water, unpasteurized milk Non-lactose fermenter Can survive refrigeration V & W Ag Motile Expressed at 37C (temp sensitive) HST Acute enterocolitis: fever, diarrhea, abd pain Useless ABx Stool or blood cultures Examine terminal ileum via colonoscopy |
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V. cholerae
Transmission? 1 Morph? 2 Metab? 2 Virulence? 4 Toxin? 1 Dz? 1 Tx? 3 Dx? 2 |
Fecal-oral
Short, comma-shaped GNR Single polar flagellum Oxidase + Non-lactose fermenter Motile (H Ag +) Mucinase Fimbriae Non-invasive Choleragen Cholera - rice-water stools Replace fluids Doxycycline Floroquinolone Dark field microscopy: immobilized TCBS agar: yellow colonies |
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V. parahemolyticus
Reservoir? 1 Transmission? 1 Morph? 2 Metab? 1 Virulence? 2 Toxin? 1 Dz? 1 Tx? 2 Dx? 2 |
Fish
Raw fish consumption Short comma-shaped Single polar flagellum Halophilic H Ag + Capsule Hemolytic cytotoxin Japanese food poisoning Doxycycline Floroquinolone Req thiosulfate & bile salts Kanagawa phenomenon |
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C. jejuni
Reservoir? 3 Transmission? 3 Morph? 2 Metab? 3 Virulence? 2 Toxin? 2 Dz? 2 Tx? 2 Dx? 2 |
Poultry, wild animals, domestic animals
Uncooked meat Unpasteurized milk Fecal-oral Curved rod Single polar flagella Microaerophilic 42C Oxidase + H Ag + Invasive Enterotoxin (HLT) Cytotoxin: destroy mucosal Secretory or bloody diarrhea Floroquinolones Erythromycin Microscope: motile, curved GNR Selective media w/ ABx at 42C |
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H. pylori
Morph? 2 Metab? 2 Dz? 2 Tx? 2 |
Curved w/ tuft of polar flagellum
Microaerophilic Urease + Duodenal ulcer Chronic gastritis Bismuth amp, metro, tetracycline Clarithromycin + omeprazole |
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P. aeruginosa
Metab? 3 Virulence? 8 Toxin? 1 Dz? 8 Tx? 6 Dx? 2 |
Obligate aerobe
Oxidase + Non-lactose fermenter Polar flagellum Hemolysin Collagenase Elastase Fibrinolysin Phospholipase C DNAse +/- antiphagocytic capsule Exotoxin A (diph-like) PA: CF pt, immunocompromised Osteomyelitis: DM, IVDU, children Burn wound inf Sepsis UTI Endocarditis Malig external otitis Corneal inf in contact lens users Timentin, Piperacillin Imipenem, meropenem Aminoglycosides Aztreonam Cipro Ceftazideme, cefepime Culture: greenish-metallic colony Fruity-grape smell |
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B. fragilis
Transmission? 1 Metab? 2 Toxin? 1 Dz? 2 Tx? 4 Dx? 1 |
Part of norm intestinal flora
Anaerobic Polysaccharide capsule No Lipid A GI/pelvic/lung abscess Inf when enter peritoneal cavity Metronidazole Clindamycin Chloramphenicol Surgically drain abscess GNR Anaerobic culture |
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Fusobacterium
Metab? 1 Dz? 4 Tx? 1 Dx? 2 |
Anaerobic
Necrotizing anaerobic PA Periodontal dz Abd & pelvic abscess Otitis media PCN G Gram + Anaerobic culture |
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B. melaninogenicus
Reservoir? Metab? 2 Toxin? 1 Dz? 2 Tx? 2 Dx? 1 |
Norm gut flora
Anaerobic Polysaccharide capsule No Lipid A Necrotizing anaerobic PA Periodontal dz Metronidazole Clindamycin Produce black pigment on agar |
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H. influenzae
Reservoir? 1 Transmission? 1 Virulence? 3 Dz? 8 Tx? 1 Vax? 2 Dx? 5 |
Man only
Resp Capsule Pili (attachment) IgA1 protease Encapsulated: neonatal meningitis (#1), acute epiglottis, infant septic arthritis, sepsis (esp asplenic), PA Capsulated: otitis media, sinusitis, COPD exacerbation 2nd/3rd gen ceph Hib vax @ 2, 4, 6, 15m Passive imm Gram - Choc agar w/ X & V (can culture w/ s. aureus to release from RBCs) ELISA Latex particle agglutination Quelling + |
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H. ducreyi
Transmission? 1 Dz? 2 Tx? 3 Dx? 2 |
STD
Chancroid: painful genital ulcer Usu w/ u/l LAD -> can rupture Azithromycin/erythromycin IM ceftriaxone Cipro Gram & culture of ulcer exudate Req X factor |
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G. vaginalis
Transmission? Dz? 1 Tx? 1 Dx? 1 |
STD
Bacterial vaginitis: foul smelling d/c, pruritis, dysuria Metro Clue cells: epi cells w/ pleomorphic gram - bacilli in cytoplasm |
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B. pertussis
Reservoir? Transmission? Virulence? 3 Toxins? 4 Dz? 1 Tx? 2 Vax? 1 Dx? 4 High risk groups? 2 |
Man only; highly contagious
Resp Capsule β-lactamase Filamentous hemagglutinin (bronchial adhesion) Pertussis toxin Extracellular adenylate cyclase Filamentous hemagglutinin Tracheal cytotoxin Whopping cough: catarrhal -> paroxysmal -> convalescent phase Erythromycin (only in catarrhal phase) Prophylaxis to household contacts DTaP @ 2, 4, 6, 15m Bordet-Gengou media ELISA Direct flourescent Ab PCR of bact DNA Infants <1 yr Adults as immunity wears off |
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L. pneumophilia
Reservoir? 2 Virulence? 5 Toxins? 4 Dz? 2 Tx? 2 Dx? 3 |
AC unit, cooling towers
Facultative intracellular -> prevent phagosome/lysosome fusion Cu-Zn SOD Cat + Attachment pili Invasive flagella RNAse Phospholipase A Phospholipase C Cytotoxin Pontiac fever: HA, fever, muscle ache, self-limiting Legionnaire's dz: PA, fever, nonproductive Erythromycin Rifampin Charcoal yeast agar Serology - IFA, ELISA Serogroup 1: urinary Ag test |
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Y. pestis
Reservoir? 4 Transmission? 3 Metab? 1 Virulence? 4 Toxins? 2 Dz? 3 Tx? 2 Vax? 1 Dx? 3 |
Wild rodents,City rats, squirrels, prairie dogs
Flea bite Contact w/ inf animal Inhaled aerosolized Facultative intracellular anaerobe Temp-sensitive (@ 37C), via plasmid F1 capsular Ag: antiphagocytic V W proteins nonmotile Ca @ 37C Pesticin: kills other bact Intracellular murine toxin: lethal to mice Bubonic plague: regional LN, fever, conjunctivitis Sepsis: 75% fatal if unTx Pneumonic plague:100% fatal if unTx Streptomycin/gentamycin Doxycycline Only effective x few months GNR w/ bipolar staining Bubo aspirate culture Anti-F1 Ab |
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F. tularensis
Reservoir? 3 Transmission? 5 Metab? 3 Virulence? 2 Dz? 4 Tx? 2 Dx? 3 |
Rabbits, squirrels, ticks
Tick/deerfly bite Direct animal contact Inhaled aerosolized Ingest contaminated meat/H2O Lab personnel Obligate aerobe Intracellular Req cys Capsule Nonmotile Tularemia: ulceroglandular w/ bite PA w/ inhalation Oculoglandular w/ direct inocculation Typhoidal w/ ingestion Gentamycin/streptomycin Doxycycline Blood culture w/ cys Skin test Rise IgG |
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Brucella
4 species -> reservoir? Transmission? 3 Metab? 1 Virulence? 3 Dz? 2 Tx? 3 Dx? 3 |
Melitensis: goat
Abortus: cattle Suis: pigs Canis: dogs Direct contact w/ stock/aborted placenta Infected milk Aerosolization in lab Obligate intracellular aerobe Capsule Nonmotile Tropism for erythritol Brucellosis: undulating fever, weakness, loss of apetite Induces abortions in animals Pasteurize milk Doxy + genta/strepto/rifampin Immunize cattle Skin test for expo Blood/BM/liver/LN culture Serologic test |
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P. multocida
Reservoir? 1 Transmission? 1 Metab? 1 Virulence? 2 Dz? 1 Tx? 3 Dx? 1 |
Normal flora of domestic animals
Bite of dog, cat Facultative anaerobe (not intracellular) Capsule Nonmotile Wound inf -> can progress to nearby bones/joints PCN G Doxycycline 3rd gen ceph Culture |
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C. trachomatis
Reservoir? 1 Transmission? 2 Metab? 2 Virulence? 3 Dz? 10 Tx? 3 Dx? 5 |
Human
Direct personal contact Primarily affects: eyes, genitals, lungs Elementary body: dense infectious spherule Reticulate body: larger intracellular form; reproduces by binary fission Resistant to lysozyme Prevent phagosome-lysosome fusion Nonmotile Serotypes A-C: trachoma -> corneal scarring, blindness Serotypes D-K: inclusion conjunctivitis, infant PA, non-gono urethritis, PID, cervicitis, epididymitis, prostatis Serotype L: lymphogranuloma venereum Doxycline eyedrops (adults) Erythromycin eyedrops (infants, preg) Azithromycin Corneal scrapings PCR for urethritis Floroscent Ab Serology Frei test (rarely used) |
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C. psittaci
Reservoir? 2 Transmission? 1 Metab? 2 Dz? 1 Tx? 2 Dx? 2 |
Birds, poultry
Bird feces - dried or inhaled EB & RB Psittacosis: atypical PA, fever, dry nonproductive cough Doxycycline Erythromycin Serologic Intracytoplasmic inclusion bodies doesn't stain |
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C. pneumoniae
Reservoir? 1 Transmission? 1 Metab? 2 Dz? 1 Tx? 2 Dx? 2 |
Humans only
Human-human resp EB, RB Atypical PA in young adults Doxycycline Erythromycin Serology Intracytoplasmic not stain |
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R. rickettsii
Reservoir? 3 Transmission? 2 Metab? 2 Dz? 1 Tx? 2 Dx? 4 |
Dog, rabbit, wild rodent
Wood tick (dermacentor andersoni) Dog tick (dermacentor variabilis) Obligate intracellular parasite Grow in cytoplasm, not endosomes RMSF: fever, starts hands/feet -> spread to rest Doxycycline Chloramphenicol Direct Immunoflu Serology Weil-Felix rxn: OX-19, OX-2 |
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R. akari
Reservoir? 1 Transmission? 1 Metab? 2 Dz? 1 Tx? 2 Dx? 1 |
House mice
Mites Obligate intracellular parasite Grow in cytoplasm, not endosomes Rickettsial Pox: vesicular rash like chicken pox Doxycycline Chloramphenicol Weil-Felix neg |
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R. prowazekii
Reservoir? 2 Transmission? 1 Metab? 2 Dz? 2 Tx? 3 Dx? 2 |
Human, flying squirrels
Human body louse (pediculus corporis) Obligate intracellular parasite Grow in cytoplasm, not endosomes Louse-borne typhus: abrupt fever/HA, rash that spares palms/soles, gangrene Brill-Zinsser Dz: reactivation, mild Sx, no rash Doxycycline Chloramphenicol Eradicate lice Weil-Felix: OX-19 Serology |
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R. typhi
Reservoir? 2 Transmission? 1 Metab? 2 Dz? 1 Tx? 2 Dx? 1 |
Rats, small rodents
Rat flea (xenopsylia cheopis) Obligate intracellular parasite Grow in cytoplasm, not endosomes Endemic typhus: fever, HA, rash Doxycycline Chloramphenicol Weil-Felix: OX-19 |
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R. tsutsugamushi
Reservoir? 4 Transmission? 1 Metab? 2 Dz? 1 Tx? 2 Dx? 1 |
rats, shrew, mongoose, birds
Mite larvae (chiggers) Obligate intracellular parasite Grow in cytoplasm, not endosomes Scrub typhus: fever, HA, eschar, rash Doxycycline Chloramphenicol Weil-Felix: OX-K |
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C. burnetii
Reservoir? 3 Transmission? 1 Metab? 2 Dz? 1 Tx? 3 Dx? 1 |
Cattle, sheep, goats
Direct airborne transmission Can grow in lysosomal pH 4.5 Endospore form Q fever: HA, viral-like PA Doxycycline Erythromycin Pasteurize milk 60C Complement fixation test |
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E. chaffeensis
Reservoir? 1 Transmissions? 1 Dz? 1 Tx? 3 Dx? 2 |
Dogs
Ticks Ehrlichiosis: RMSF w/o rash Doxycycline Rifampin Resistant to chloramphenicol Ab titers Inclusion bodies on smear |
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T. pallidum
Reservoir? 1 Transmission? 1 Metab? 2 Morph? 1 Virulence? 1 Dz? 5 Tx? 4 Dx? 6 Mnemonic? |
Human only
STD Microaerophilic Sensitive to elevated temp Thick rigid spirals Motile 1o syphilis: painless chancre 2o syphilis: rash on palms/soles, condyloma latum Latent stage 3o syphilis: gummas, CVS (CVA w/o HTN), Neuro (Romberg, broad-based ataxia) -> Argyll-Robinson pupil Congenital: saber shins, saddle nose, CN VIII deafness, Hutchinson teeth, mulberry molars PCN G Erythromycin Doxycycline Jarisch-Herxheimer rxn (acute worsening after ABx) Dark-field microscopy Immunoflor ELISA VDRL FTA-ABS, MHA-TRP PCR Paresis: Personality, Affect, hyperactive Reflexes, Argyll-Robertson Eyes, Sensorium defect, Intellectual decline, Speech defect |
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T. pertenue
Reservoir? 1 Transmission? 2 Morph? 1 Virulence? 1 Dz? 1 Tx? 2 Dx? 2 |
Tropics
Person-person Flies Thick rigid spirals Motile YAWS: 1o: ulcerative skin lesion 3o: gummas PCN Plastic surg VDRL, FTA-ABS |
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T. carateum
Reservoir? 1 Transmission? 1 Morph? 1 Dz? 1 Tx? 1 Dx? 2 |
Latin America
Person-person Thick rigid spiral Pinta: flat red/blue non-ulcerating lesions PCN VDRL, FTA-ABS |
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B. burgdorferi
Reservoir? 2 Transmission? 2 Metab? 1 Dz? 1 Tx? 3 Dx? 2 |
White-footed mouse
White-tailed deer Ixodes tick: scapularis (east) pacificus (west) Microaerophilic Lyme dz: erythema migrans Complications: arthritis, encephalopathy Doxycycline Amoxicillin Ceftriaxone ELISA Ab W. blot |
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M. tuberculosis
Morph? 2 Metab? 3 Virulence? 6 Dz? 1 Tx? 5 Dx? 7 |
High lipophilic, mycolic acids
Thin rods Aerobic Cat + Slow growth rate Nonmotile Cord factor: only in virulent Sulfratides: inh fusion Wax D: adjuvant Siderophore Can grown in macrophages TB: pulm, pleura, pericardial, LN, kidney, skeletal, joints CSN, miliary 1st line: INH, rifampin, pyrazinamide, ethambutol, streptomycin Acid-fast stain Rapid culture PPD CXR PCR + DNA probes MTDT Quantiferon TB |
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M. leprae
Metab? 3 Virulence? 2 Dz? 2 Tx? 3 Dx? 4 |
Cat +
Grow best at low temp Phenolase + -> convert dopa to pigment product Nonmotile Facultative intracellular growth Lepromatous v. tuberculoid Rifampin, dapsone, clofazimine Tuberculoid: lepromin +, single lesion, none acid-fast bacilli in scraping Lepromatous: lepromin -, multiple lesion, many acid-fast bacilli in scraping |
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MAC
Dz? 3 Tx? |
Disseminated inf in AIDS pt
Norm pt: cervical lymphadenitis, pulm in Varies |
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M. pneumoniae
Morph? 3 Metab? 2 Virulence? 1 Dz? 2 Tx? 3 Dx? 5 |
No cell wall
Pleomorphic Motile (glides) Facultative aerobe Req cholesterol P1: adherence to resp tract Tracheobronchitis Walking PA Macrolides Tetracyclines Quinolones Cold agglutinins Complement fixation test 2-3 wk for culture (req chol) Dome-shaped colonies PCR of sputum |
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U. urealyticum
Morph? 2 Metab? 2 Dz? 1 Tx? 2 Dx? 2 |
No cell wall
Pleomorphic Req chol Urease + Non-gono urethritis Erythromycin Tetracycline Req chol + urea for growth Very tiny colonies (T-strain) |
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Random Bact Mnemonics:
Obligate aerobes: 4; Mnemonic? Obligate anaerobes: 3; Mnemonic? Intracellular bugs: obligate 2; Mnemonic? Facultative 7; Mnemonic? Urease + bugs: 4; Mnemonic? |
Nocardia, pseudomonas, mycobacteria, Bacillus
Nagging pests must breathe Clostridium, bacteriodes, actinomyces Can't breath air Rickettsia, Chlamydia Stay inside where it's Real Cold Salmonella, Brucella, Mycobacteria, Listeria, Legionella, Francisella, Neisseria Some Bugs May Live Life Facultatively Nside Proteus, Klebsiella, H. pylori, Ureaplasma Particular kinds have urease |
