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35 Cards in this Set
- Front
- Back
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Most common normal flora on skin
Gram + Gram - Anaerobic |
Gram +: S. epi, Strep Gram -: Enteric (E. coli, Kleb) Anaerobic: Coryebacterium, P. acnes |
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Most common normal flora in oropharynx
Gram + Gram - Anaerobic |
Gram +: S. viridans, S. pneumo Gram -: Neisseria (some people), H. flu Anaerobic: Corynebacterium spp. |
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Most common normal flora in GI tract
Gram + Gram - Anaerobic |
Gram +: Enterococcus spp. Gram -: Enteric bacilli (E. coli, Kleb) Anaerobic: Lactobacillus, Clostridium, Peptostreptococcus, Bacterioides |
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Most common normal flora in GU tract:
Gram + Gram - Anaerobic |
Gram +: Strep spp, Staph spp Gram -: Enterobacteraceae, Prevotella spp. Anaerobic: Corynebacterium, Lactobacillus |
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Enterobacteraceae family
9 genera (EKMPPSSSY) Where, depending on what? |
E. coli, Kleb, Morganella, Proteus, Providencia, Salmonella, Serratia, Shigella, Yersinia
In gut, depending on where you live and who you live with |
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S. aureus
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos cocci clusters, some with capsule
Lab ID - golden colonies, rapid growth, coag pos
Transmission - skin, nares perineum, contact
Pathogenesis - endo and exotoxins, toxic-shock toxin, protein A (inactivates complement and IgG)
Diseases - boils, skin sepsis, wound infections, scalded skin syndrome, cath-associated disease, foodborne infection, endocarditis, osteomyelitis, TSS, pneumonia
Complications - MRSA
Prevention - Handwashing, mupirocin to nares, isolation |
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S. epidermidis
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos cocci in clusters
Lab ID - golden colonies, coag neg
Transmission - skin, nares/peritoneum, contact
Pathogenesis - Extracellular slime to attach to foreign bodies
Diseases - Device related sepsis, UTI, sternal wound osteomyelitis, prosthetic valve endocarditis, artificial joint infections
Complications - MDR
Prevention - handwashing, infection control, remove devices, monitor for device infection |
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S. saprophyticus
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos cocci clusters
Lab ID - white colonies, coag neg
Transmission - Skin and GU mucosa colonizer
Pathogenesis - spreads to urinary tract
Diseases - UTI in healthy women assd with intercourse (E. coli most common for women, S. sapro most common in pregnant women)
Complications - pyelonephritis rarely
Prevention - post-coital urination |
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S. pneumoniae
Characteristics Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos diplococci (2 lungs), capsule
Transmission - colonizes URT, droplet spread
Pathogenesis - capsule evades phagocytosis
Diseases - pneumonia (#1 cause CAP), sepsis, meningitis, otitis media, sinusitis
Complications - Splenectomy predisposes to systemic infection, also antigenic-specific strains are more invasive
Prevention - vaccination, handwashing |
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S. pyogenes (GAS)
Characteristics Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - Gram pos cocci in chains
Transmission - Colonizes URT and skin, spreads by both droplets and contact
Pathogenesis - Enzymes, exotoxins
Diseases - URI, SSTI, Scarlet fever
Complications - Necrotizing fasciitis, rheumatic fever, glomerulonephritis
Prevention - No vaccine |
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Viridans group Strep
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos cocci in chains, pairs (like teeth?)
Lab ID - alpha-hemolytic, microaerophilic
Transmission - oral streptococci colonize mouth/teeth
Pathogenesis - n/a
Diseases - endocarditis
Prevention - dental care/ oral health |
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Enterococcus spp (formerly Group D Strep)
Characteristics Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram pos cocci in pairs and chains
Transmission - colonizes human gut and animals (most common gram + in gut), translocation and nosocomial acquisition
Pathogenesis - No toxins
Diseases - UTI, endocarditis, bacteremia, wound infections
Complications - more common in gut pathology, immunocompromised
Prevention - handwashing, isolation, proper sanitization |
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E. coli
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram neg rod
Transmission - gut of humans and animals, may colonize urethra and vagina, spread by contact or fecal-oral route (O157 not normal gut flora)
Pathogenesis - endotoxins (all strains), adhesins (UTI), colonization factors (GI), capsule (CNS), enterotoxins (GI)
Diseases - UTI, diarrhea, neonatal meningitis, sepsis, wound infections
Complications - increasing resistance, spread of plasmids
Prevention - proper food care, sanitization |
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Kleb, Serratia, Enterobacter spp.
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram neg rods, kleb has capsule
Lab ID - lactose-fermenting, oxidase negative
Transmission - gut of man and animals and moist inanimate environments, soil and water, spread by contact or endogenously - kleb may survive on hands for long durations
Pathogenesis - endotoxin, adhesins, capsule (Kleb)
Diseases - opportunistic infections in immunocompromised host/hospitalized host, UTI, pneumonia, bacteremia
Complications - Colonization vs infection difficult, resistance a problem (ESBL kleb), chromosomal, inducible resistance
Prevention - handwashing, isolation |
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Proteus mirabilis
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram neg rod, motile, swarms
Lab ID - odorous, non-lactose fermenter
Transmission - gut, soil, water colonizer - contact or endogenous spread
Pathogenesis - endotoxin, urease
Diseases - UTI, wound infections (nosocomial), sepsis, pneumonia (immunocompromised)
Prevention - good aseptic technique |
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Salmonella spp.
Characteristics Lab ID Transmission Diseases Complications Prevention |
Characteristics - gram neg, non motile, nonsporing rods noncapsular (except S. typhi)
Lab ID - oxidase neg, non-fermenters, serology
Transmission - NOT human gut colonizer but it is in many animals, widespread in animals and food chain, acquired through ingestion of ill prepared or contaminated food or water
Diseases - Severe diarrhea illness, sometimes bacteremia
Complications - carrier status, resistance
Prevention - proper food prep, sanitation, vaccination (S. typhi, S. paratyphi)
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Shigella spp.
Characteristics Lab ID Transmission Pathogenesis Diseases Prevention |
Characteristics - gram neg non-motile rods, no capsule
Lab ID - lactose non-fermenter, antigenic tests
Transmission - fecal-oral route
Pathogenesis - invasion of gut --> massive inflammation, shiga toxin (exotoxin), damages epithelial cells and/or glomerular epithelial cells (kidney damage)
Diseases - bacillary dysentery
Prevention - sanitation, isolation, hand hygeine |
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P. aeruginosa
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram neg rod, motile, grows in many conditions
Lab ID - smells like grapes, produces blue-green pigment, oxidase positive, non-fermenter
Transmission - colonizes some healthy human guts, many more hospitalized patients, widespread in environment (water), spread by contact from environment
Pathogenesis - endo and exotoxins, capsule and slime production, pigments may be virulence factors
Diseases - opportunistic infections of any body site, particularly skin, burns, lung, UTI, osteomyelitis, endocarditis - commonly seen in burns, AIDS, immune suppressed, cystic fibrosis
Complications - highly and variably resistant, may develop resistance on therapy
Prevention - extubation, isolation, hand washing, avoid broad spectru agents |
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H. influenzae
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - small, gram neg coccobaccillus, nonmotile, may be encapsulated at infection site
Lab ID - serological to determine invasive capsular tyes (H flu type b or "Hib")
Transmission - colonizes URT of humans and animals, airborne person-person transmission
Pathogenesis - polysaccharid capsule, endotoxin
Diseases - meningitis, pneumonia, osteomyelitis, otitis media, sinusitis
Complications - more common in children, capsule types c and f increasing in prevalence
Prevention - vaccination, rifampin prophylaxis of contacts |
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Pasturella multocida
Characteristics Lab ID Transmission Pathogenesis Diseases Prevention |
Characteristics - small gram neg coccobacilli
Lab ID - oxidase positive, grows well on blood agar
Transmission - commensal in GI tract of humans an animals, mouth commensal
Pathogenesis - capsule
Diseases - infected cat bites
Prevention - animal and human dental care |
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Vibrio spp.
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - curved gram neg rods, highly motile, salt plays a metabolic role
Lab ID - oxidase positive
Transmission - consumption of contaminated water or food
Pathogenesis - mucinase, adhesins, enterotoxin, cytotoxin
Diseases - cholera (V. cholerae), massive watery diarrhea (V. parahaemolyticus), wound infections and bacteremia (V. vulnificans)
Complications - death, necrotizing faciitis
Prevention - avoid water, oral vaccine (not in US), avoid contaminated seafood consumption |
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Campylobacter
Characteristics Lab ID Transmission Pathogenesis Diseases Prevention |
Characteristics - slender curved gram neg rods
Lab ID - require enriched media, water drop like colonies
Transmission - animal reservoirs, acquisition from contaminated food and milk
Pathogenesis - cytotoxin, local invasion and destruction of gut mucosa
Diseases - diarrhea, may invade to cause bacteremia
Prevention - proper food prep |
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Legionella pneumophila
Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - in tissue gram neg coccobacilli
Lab ID - DFA, poor gram stain test
Transmission - environmental contamination of AC cooling towers, inhalation of contaminated water from showers
Pathogenesis - intracellular survival
Diseases - pneumonia esp in elderly, immunocompromised
Complications - severe pneumonia, often requiring mechanical ventilation
Prevention - water system/HVAC maintenance |
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Moraxella catarrhalis . Characteristics Lab ID Transmission Diseases Complications Prevention |
Characteristics - gram neg cocci . Lab ID - easier to grow than Neisseria . Transmission - formerly a commensal of the RT, now mainly a pathogen . Diseases - bronchitis, pneumonia, otitis media, sinusitis . Complications - majority of strains produce beta-lacamase Prevention |
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Bordatella pertussis . Characteristics Lab ID Transmission Pathogenesis Diseases Prevention |
Characteristics - small gram neg cocco-baccillus . Lab ID - slow growing and fastidious, needs special media . Transmission - airborne person-person spread . Pathogenesis - tracheal cytotoxin, endotoxin . Diseases - whooping cough . Prevention - vaccination, now boosted, erythromycin for close contacts |
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Bacterioides fragilis . Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - small pleomorphic gram neg rod, anaerobic, non-spore forming, non-motile . Lab ID - foul odor in anaerobically grown agar . Transmission - endogenous infection from gut contamination/fecal contamination of wounds . Pathogenesis - unknown - capsule, enzymes . Diseases - intra-abdominal abscesses, aspiration pneumonia, brain abscesses, wound infection . Complications - often in polymicrobial infections . Prevention - good surgical technique and antimicrobial prophylaxis |
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Clostridium difficile . Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram + anaerobe, slender rod, spore-forming (allows it to survive in env for extended time), motile . Lab ID - difficult to culture, toxin assays of feces . Transmission - gut flora commensal, grows under antibiotic selective pressure (major risk factor), spread by contact esp with HCP . Pathogenesis - toxin-mediated gut wall damage (toxins A and B), worse with PPI (neutral stomach acid, vegetative not killed), tx is stool replacement . Diseases - Pseudomembranous colitis (antibiotic associated diarrhea), can be asymptomatic carrier --> severe fulminant disease with toxic megacolon, sepsis, death . Complications - may be rapidly fatal or need colectomy . Prevention - handwashing, isolation, avoid antibiotics or withdraw |
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Extended pathophys of C. diff - effect on colon epithelium |
Vegetative C. diff killed by stomach acid unless taking PPI Spores germinate in SMI on introduction to bile acids Vegetative C. diff produce toxins A and B which induce TNFa and proinflammatory ILs These increase vascular permeability, neutrophil and monocyte recruitment Epithelial cell junctions open, undergo apoptosis Local production of hydrolytic enzymes lead to connective tissue degredation -> colitis -> pseudomembrane formation Watery diarrhea 15-20 times a day
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Prerequisites for CDI |
Advanced age, underlying illness Antimicrobial therapy disturbing colonic microflora |
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Gardnerella vaginalis . Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - gram variable anaerobic bacilli . Lab ID - clue cells on vaginal discharge specimen . Transmission - sexual contact . Pathogenesis - unknown . Diseases - bacterial vaginosis . Prevention - safe sex |
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Treponema pallidum . Characteristics Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - regularly coiled spirochetes . Transmission - very close contact, sexually, in utero . Pathogenesis - primary, secondary, tertiary phases . Diseases - syphilis . Complications - cardiac, CNS, systemic . Prevention - contact tracing, safe sex, pregnancy screening |
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Mycoplasma spp. . Characteristics Lab ID Transmission Pathogenesis Diseases Prevention |
Characteristics - lacks cell wall . Lab ID - difficult to culture, use serology . Transmission - person to person via airborne route, some species sexually . Pathogenesis - adhesions to bind to respiratory epithelium . Diseases - pneumonia, sometimes genital infections . Prevention - difficult to interrupt spread |
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Chlamydia spp. . Characteristics Lab ID Transmission Pathogenesis Diseases Complications Prevention |
Characteristics - obligate intracellular parasite . Lab ID - serology, nucleic acid amplification . Transmission - inhalation (C. pneumoniae), sexual contact (C. trachomatis), intra-partum . Pathogenesis - unclear, intracellular environment helps evade host defense . Diseases - chlamydia, eye infection, pneumonia . Complications - PID, infertility . Prevention - safe sex |
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Antifungal spectrum (7) ABCCCHS |
Aspergillus spp. Blastomyces dermatitidis Cryptococcus neoformans Candida albicans, spp. Coccidioides immitis Histoplasma capsulatum Sporothrix schenckii |
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Viruses (17) CEEHHHHHINPPRRRVW |
Coxsackie A-16 (HFM), and A-24 EEE Epstein-Barr H5N1 - avian flu Hepatitis A, B, C Herpes simplex 1 and 2 HIV HPV Influenza viruses A, B, C Norwalk virus - viral gastroenteritis Parainfluenza virus - URI kids, LRI adults Parvovirus - fifth disease Rabies virus Rotavirus Rubella virus - German "3 day" measles Varicella zoster West Nile - mild to moderate flu like to severe encephalopathy |
