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15 Cards in this Set

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who are at risk for Staph. aureus?
-new borns
-ppl already with some underlying disease
-drug abusers
-burn patients
-trauma patients
what are the diseases caused by Staph. aureus? primary vs. severe
-primary: boils, wound infection, infection originating from prosthetic devices
-severe: sepsis, endocarditis, osteomyelitis, pneumonia, toxic shock syndrome, post-op infection
what are the potential virulence determinants of staph. aureus?
- cell associated proteins: protein A, capsular polysacc., peptidoglycan (complement --> inflammation --> damage to adjacent cells), adhesion proteins (MSCRAMMs: fibronectin-binding proteins A & B, fibrinogen-biding protein, collagen-binding protein)
- exozymes: coagulase, lipase, hyaluronate lyase, nuclease, staphylokinase, protease
- exotoxins: tss-1, epidermolytic toxin(alpha, beta, chi, gamma), leukocidin, enterotoxins (A-E)
what are the two ways in which Staphylococcus causes disease?
- inflammatory. local: boils or furuncles fuse together to form carbuncles. pus contains neutrophils, staph, host cells, DNA (gives it thickness)
- toxigenic diseases: staph scalded skin syndrome, staphylococcal food poisoning (enterotoxin)... within 1-6 hrs. toxic shock syndrome (women died ... tampon story.)
what antibiotics do you give for Staph. Aureus?
vancomycin-intermediate strains began to appear in NY 2002. so linezolid (oxazolidinones) = protein synthesis inhibitors... resistance to this is RARE. you can also do daptomycin: lipopeptide (MB active)
what are the diseases caused by GAS? (grp them based on classfication)
suppurative diseases.
-nontoxigenic strains: primary (pharyngitis), secondary: otitis, pneumonia, meningitis
-toxigenic: scarlet fever (fever, rash), necrotizing fasciitis (A=superantigen, B=systemic protease ==> pyoderma)
also, adenitis (inflammation of glands, lymph nodes), skin infections: impetigo, cellulitis, erysipelas. also, puerperal sepsis (sepsis contracted by women shortly after childbirth or abortion), lymphangitis, endocarditis
nonsuppurative disease (poststreptococcal infections):
rheumatic fever, glomerularnephritis
what are the criteria for Rheumatic fever?
carditis, polyarthritis, chorea, subcutaneous nodules, rash
what are the potential virulence determinants of GAS?
- streptolysin (hemolysin)
- streptokinase (dissolves blood clots). don't use this for heart patients. use TPA instead (tissue plasminogen activator)
- hyaluronidase
- deoxyribonuclease
-erythrogenic toxin
- hyaluronic acid
- m-protein
-peptidoglycan
- lipoteichoic acid
M-protein's role in pathogenesis. which bacteria has it?
- strep A has it.
- proteolytic cleavage of M-protein. M-protein binds to fibrinogen --> binds to neutrophil (via beta-integrin). activated MP now does 2 things:
1)releases HBP ==> vascular leakage --> shock
2) frustrated MP --> proinflammatory mediators --> tissue damage
what are the potential virulence determinants of GBS?
- SA prevents opsonization by C3b, inhibits alternate pathway activation
- C5a peptidase: prevents chemotaxis
- capsule: protects bacteria
- beta-hemolysin/cytotoxin --> damages endothelial cells
- cell damage triggers inflammation
what are the major diseases caused by Streptococcus pneumoniae?
pneumonia, otitis medea (middle ear), meningitis
what are the risk factors in streptococcal pneumoniae infection?
age: extreme age (<2 or > 60)
acute and chronic ailments: influenza, heart failure, bronchitis/emphysema/ashtma/cancer, immune suppression (AIDS)
environmental irritants: smoking; air pollution
alcoholic intoxication: decr -> cough reflec; decre -> phagocytic response
impairement of spleen does this too.
what are the virulence factors of strep. pneumoniae?
-capsule, surface protein A: protects from PC
-IgA protease
-pneumolysin: cytotoxin; damages other cells too by complement/inflammation
-hydrogen peroxide
-dif types of poly sacc. capsules (~23 dif types)
-protease sensitive surface component: binds factor H; inhibits complement activation
-murein
-neuraminidase
-adhesin
-CWPS
how is corynebacterium diphtheriae transmitted? what does it do?
by inhalation.
causes pharyngitis or bronchitis: inflammation & toxin production. Two things from here: 1) pseudomembrane --> respiratory obstruction or 2) toxemia --> CNS, heart, kidney
what is the antibiotic treatment for c. difficile
flagyl (metronidazole) ==> selective for anaerobic bacteria and protozoan. reduces its nitro grp to ferrodoxin --> damages DNA --> inhibits nucleic acid synthesis. If this doesn't work, use vancomycin.