Pseudomonas/zoonotic Gram Neg Bacteria

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Pseudomonas

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-likes the water
-frequently transmitted in hot tubs and wet instruments

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yersinia general info

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-causes mesenteric adenitis(resembles appendicitis) and pseuodotuberculosis
-gram neg
-lactose -
-transmission from food milk that is contaminated w/ animal feces
-invasive organism

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yersinia pathogenesis

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-enterocolitis-similar to shigella and salmonella infections-rarely systemic
-ulcerative lesions in ileum: fever, pain, diarrhea,
-adhesions, Inv proteins, YOPs inhibit phagocytosis
-assoc with reactive arthritis and Reiter's syndrome

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treatment for helicobacteria

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-proton pump inhibitors, antacids
-acidity exacerbates the destrcutuve effects of the bacteria on the stomach wall

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Pseudomonas aeruginosa general info

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-gram neg
-very ubiquitos-found everywhere
-grows easily,
-GI tract
-forms a biofilm, due to slime layer around cell
-strictly aerobic
-oxidase positive-*** differentiates from gram neg enterics
-highly resistant to antibiotics and disinfectants
-pigmented-pyocyanin(blue/green pus)
-fruity odor

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Pseudomonas aeruginosa epidemiology

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-highly flexible-grows pretty much anywhere
-transmitted on unwashed hands, eye drops, disinfectants, pretty much anything especially wet things

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Pseudomonas aeruginosa pathogenesis

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-adherence/colonization: flagella/pili
-motile
-glycocalyx/biofilm/slime layer
-enzymes**-extracellular products; elastase, phospholipase, protease
-toxins (exo A-same as C. Dip)
-endotoxin**
-type III secretion type
-cystic fibrosis susceptible to this infection, increased number of receptors due to CF.
-quarum sensing

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Pseudomonas aeruginosa clinical presentation

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-causes just about anything
-eye infections-cont eye drops
-swimmers ear
-burn patients/CF-highly susceptible

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Pseudomonas aeruginosa lab diagnosis

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-gram neg
-green color
-antibiotic resistance testing-ie extended-spectrum penicillins testing
-No current vaccine available
-

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gram neg zoonotic bacteria general info

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-disease of animals
-brucella, francisella, yersinia pestis(black plague), bartonella, pasteurella
-acquired by bites/vectors, contact, ingestion, inhalation
-all are facultative intracellular pathogens/parasites-except pastuerella
-penetrate mucosa, and survive in cell and get carried away by phagocytes-leads to granulomatous inflammation
-not toxin secreting
-cell mediated immunity important
-antibiotics: proloned use, gentamycin, streptomycin, doxycycline
-use as agents of bioterrorism

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brucella

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-undulent fever, brucellosis, malta fever
-species specific for animal it infects, ie B. abortus=cow, B. melitensis=goat, B. suis=pig, B. canis=dog
-aerobic facultative intracellular parasite
-difficult to stain, not typically cultured in lab
-LPS major virulence factor

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brucella epidemiology

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-life long infection in animals
-organism localizes in reproductive organs
-shed in milk, urine, placental fluids
-transmitted by contact, ingestion milk/fluids, cheese-not meat, person to person is rare
-aerosols-highly infectious

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brucella pathogenesis

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-low infective dose-about 100 orgs
-enter through abrasions or GI tract
-penetrate-travel to local lymph nodes-blood and RES
-survive killing in many ways-know 3 major modes of evading destruction by immune system

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brucella clinical significance

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-incubation-several days to months
-prodromal symptoms
-mutlisystem infections-chills, weight loss, depression, osteoarticular prob
-skeletal, GI, neurologic, cardiac, pulmonary
-acute onset
-undulating fever-rise in day, down at night
-O Ag of LPS, no O, then no virulence
-

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brucella lab identification/prevention

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-requires BSL-3 lab
-pasteurize milk
-immunize animals, wear protective clothing around animals
-slaughter infected herds

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francisella tularensis general info

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-aka rabbit fever, tularemia
-small pleomorphic coccobacilli, lipid rich capsule
-strict aerobe
-capsulated
-endotoxin, no exotoxins
-facultative intracellular parasite
-inhibits phagolysosomal fusion

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francisella tularensis epidemiology

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-Arthropod vector-hard shell ticks, lice, mites, deerfly
-animal contact abrasions-inhalation, ingestion
-endemic in this area
-occupational and recreational risk-vets, hunters, trappers, meat handlers, hikers

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francisella tularensis pathogenesis

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-cutaneous-erythmatous papule, ulcerates, persists
-organism is intracellular-lymph spread to RES organs
-one of the most infectious organisms known-10orgs cause illness
-use as a bio weapon

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francisella tularensis clincial significance

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-severity-mild-fatal disease
-onset-acute
-symptoms-flu-like
-ulceroglandular: most common-punched out ulcer
-swelling of lymph nodes
-glandular, occuloglandular, pneumonic, typhoid
-typhoid tularemia-systemic but no swelling of lymph nodes swelling or ulcers
-pneumonic-from inhalation

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francisella tularensis lab diagnosis

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-clinical presentation and history
-generally not cultured
-serodiagnosis best-rise in IgG titers

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francisella tularensis prevention

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-care in handling animals
-experimental vaccine

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yersinia pestis-general info

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-causes black plague, bubonic plague
-gram neg
-oxidase neg
-like Y. enterocolitica
-safety pin shape
-LPS, capsule, and many other virulence factors
-facultative intracellular pathogen
-extremely virulent- 1 to 10 organisms cause disease*
-lose capsule=no disease
-endotoxins, exotoxins

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yersinia pestis virulence factors

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-yersinia outer proteins (YOPs):
inhibits phagocytosis, inhibits cytokine production(TNF), induce apoptosis, degrades C3b and C5a

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yersinia pestis epidemiology

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-found in southwest predominantly
-vector: fleas maintain organism; humans become reservoir when bittne
-ingestion of animal tissue
-direct exposure: via secretions from infected person
-indirect exposure: hemotagenous spread of organism to lung

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yersinia pestis toxins

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-lots of them
-YOPs
-antiphagocytic F1 envelope, protease, coagulase, exotoxin, LPS

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yersinia pestis pathogenesis

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-septic plague: initial site->Lymph nodes->organisms synthesize new protective envelopes(F1 Ag)->hemorrhagic necrosis and spread(black death), fever, shock, DIC(LPS and proinflammatory cytokines)

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yersinia pestis clinical significance

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-hungry fleas fly to humans-coag +causes blood to clot so fleas still hungry
-bubonic(septicemic)->nonspecific symptoms for few days->buboes->pustules->necrosis of extremeties->septic shock, septicemic, highly contagious-high mortality if untreated
-pneumonic-direct or indirect
-meningitis
-bio terrorist agent

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yersinia pestis lab diagnosis

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-clinical presentation
-gram stain
-culture-pus, sputum, blood
-DFA stain for F1 antigen
-serology

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yersinia pestis treatment/prevention/control

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-minimize exposure to fleas, rats, isolate patients, treat close contacts
-vaccine-experimental, only for armed forces

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bartonella general info

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-pleomorphic
-facultative intracellular pathogens
-difficult to grow
-prolonged culture needed

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B quintana info

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-relapsing fever-every 5 days
-trench fever-flu-like illness with bone pain
-bacillary angiomatosis-HIV especially
-caused by poor hygiene
-lab diagnosis with culture or serology

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B. hensale

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-cat scratch fever, also cat bites
-causes pustule at location of wound
-in a week, you get swelling of lymph nodes and in another week a granulomotous
-ID by history, serology(Ag titers)
-self-limited, no antibiotics needed

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bartonella in HIV patients

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-bacteria disseminate and cause bacillary angiomatosis-a systemic small blood vessel infection
-causes cutaneous, proliferative vascular lesions, stimulated by cytokines triggered by the bacteria, lesions bleed easily,
-resembles Kaposi's sarcoma in skin and tissue
-special silver stains to visualize in biopsy
-treat w/ erythromycin or doxycycline

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pasteurella multocida

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-not an intracellular pathogen-only one
-wound infections from animal bites
-virulence factors incude capsules and LPS
-usually softy tissue infection, polymicrobial
-colonize animals mouths

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pasteurella multocida clinical significance

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-nonintracellular parasite
-soft tissue infection
-acute celullitis in hrs->lymphdenitis(local inflammation, not swelling on lymph node)
-rapid spread from point of infection->cat bites tend to be deep due to sharp teeth, so can cause osteomyelitis/arthritis

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pasteurella multocida lab diagnosis

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-culture and biomed id
-clean/irrigate wounds; deeper infections-drainage
-do not suture these, the suturing can exacerbate the infection and inhibit antibiotic treatment