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35 Cards in this Set

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Mycobacterium biology

1. Gram positive bacilli

2. Acid fast/waxy layer


Stages of tuberculosis

1. Latent TB: no symptoms, not contagious, walled off with calcium deposits/tubercles

2. Pulmonary TB: consumption of lungs

3. Miliary (active) TB: spreads throughout body via lymphatics and blood w development if nodules

Symptoms of tuberculosis

Coughing up blood, chills, fever, night swrsts

Epidemiology of tuberculosis


1/3 of world population infected (most are latent), spreads person to person via droplet nuclei with close and prolonged contact, virulence is low in healthy individuals

Tuberculin skin test (PPD)

Tine test is notoriously inaccurate, intracutaneous is better, wheal and flare over 10 mm is


Interferon Gamma Release Assay, blood test, relies on intact immune system, ahead of its time

Vaccination of tuberculosis

BCG (Bacille-Calmette-Guerin), isoniazid, rifampin, drug use/homelessness and economic struggle due to HIV epidemic in 80s

Mycobacterium leprae biology


Grows in cooler parts of body, armadillos, close contact with skin lesions and nasal mucus, 2-40 yr incubation period

MOTTs (mycobacterium other than tuberculosis)

Over 100 species of mycobacterium, MAC (M. avium-intracellulare complex) is most common for people with AIDS, rapid (7 days), found in soil, water, animals, milk, 25-45°C and a broad range of requirements

History of tuberculosis

-1882, caused 1/4 of adult deaths in Europe, discovered in unpasteurized milk (M. bovis)

-1946, modern TB treated with streptomycin (STM)

-1952, treated with isoniazid (INH)

-1970, rifampin (RMP)

-1985, rates increased again due to HIV, MDR tuberculosis

-1990, continues to grow

-1992, new cases have reached a maximum

-today, half of the cases in 1992


Tuberculosis is called consumption because it consumes your lungs. Walled off area in lungs composed of WBCs, calcium salts, and fibrous material

Treatment of tuberculosis

First line drugs: Isoniazid (INH), Rifampin (RMP), Ethambutol, pyrazinamide for MDR tuberculosis

Leprosy disease

Clinical manifestations confined to skin, upper respiratory system, testes, and peripheral nerves. All ages affected.

Treatment of leprosy

M. leprae is treatable and curable but disfigurations are permanent

Mycobacterium identification techniques

1.) Nucleic Acid probes/amplification: for most common mycobacterium

2.) Nucleic Acid sequencing: identifies bacteria other than M. tuberculosis and MAC

3.) MALDI-TOF MS: pattern recognition technology

4.) Analysis of fatty acids: chromatography, for all species

Enterobacteriaceae characteristics


•facultative anaerobes

•gram negative rods

•ferment glucose

•reduce nitrates to nitrites

•do not produce cytochrome oxidase

•slang name: enterics

Natural habitat of enterobacteriaceae

•ubiquitous (everywhere)

•most species are found in normal microbiome of intestinal tract of humans and animals

•some live freely in soil, water, sewer, some are known to be plant pathogens

Antigenic structure of Enterobacteriaceae

(1) Flagellar (H) - motility, protein in nature, and heat labile

(2) Capsular (K) - surface polysaccharides, heat labile

(3) Somatic (O) - associated with body of bacterial cell, polysaccharide side chain of the lipopolysaccharide in the outer membrane, heat stable, without film, nonswarming

Written like O111:H99:K2

Virulence factors/toxins

(1) Endotoxins: release of lipopolysaccharides (LPS) in outer membrane of gram negative bacteria, causes hypotension, shock, fever, intravascular coagulation, and/or death. Composed of: Lipid A, core polysaccharide, and "O" antigens. Lipid A is endotoxin component.

(2) Exotoxins: (into environment from bacteria) toxic proteins liberated from a bacterial cell into the surrounding environment, either heat labile or heat stable, can be produced by either gram- or gram+ organisms

(3) Enterotoxins: an exotoxin that acts on the intestinal tract, can be produced in food and ingested or produced by bacteria in intestine. Causes diarrhea, vomiting, can act directly on intestinal wall or can be picked up by bloodstream and act elsewhere.

Salmonella species


(1) S. typhi: causes typhoid fever, characterized by prolonged fever, bacteremia, reticuloendothelial system involvement (liver/spleen), dissemination to multiple organs.

(2) All other species besides S. typhi: cause acute gastroenteritis/food poisoning characterized by vomiting/diarrhea, common outcome of poor sewer drainage/outhouses, taxonomy based on antigenic groups.

Shigella characteristics and 4 species


(Dirty Fingers Bring Shigella)

Not part of normal microbiome

Low infective dose

Fecal-oral contact, flies, food, water, poor sanitation

All 4 species call dysentery

Can invade intestinal cell wall which causes mucusy, bloody stools.

(1) S. dysenteriae

(2) S. flexneri

(3) S. boydii

(4) S. sonnei

Shiga Toxin-Producing E. coli (STEC)


Produces toxins identical to S. dysenteriae, range: mild diarrhea to hemorrhagic colitis, hemolytic uremic syndrome, E. coli O157:H7 is most common in US

Yersinia species


Y. pestis: transmitted to humans by rodent fleas bite, bubonic or pneumonic, dogs are asymptomatic carriers, cats are symptomatic, both contagious to transmit primary pneumonic plague

Other Yersinia species:

Y. enterocolitica: is most commonly isolated, swine/dogs/cats, acute enteritis is most common infection

Y. pseudotuberculosis: primarily pathogenic to rodents/guinea pigs, clinical manifestations include septicemia accompanied by mesenteric lymphadenitis (similar presentation to appendicitis)

Escherichia coli characteristics


•major facultative inhabitant of large intestine

•opportunistic: UTIs and wound infections, pneumonia, meningitis, septicemia

•travellers diarrhea

•very virulent

•weve been co-evolving for so long so at least 165 O antigens, 100 K antigens, and 50 H antigens

Names of all common general of the family Enterobacteriaceae

1. Citrobacter

2. Edwardsiella

3. Enterobacter

4. Escherichia

5. Klebsiella

6. Morganella

7. Proteus

8. Providencia

9. Salmonella

10. Serratia

11. Shigella

12. Yersinia

Vibrio cholerae transmission, clinical manifestations, and therapy guidelines

Hurricane Katrina I think you mean hurricane tortilla

Transmission through food and water, seafood, very contagious

•Clinical manifestations: most are asymptomatic or have self limiting diarrhea, rice water stool, severe cases can produce watery diarrhea with water loss of 1 liter/hour

•Therapy: oral and IV rehydration, antibiotics decrease duration of disease/shedding of organism

Transmission and disease of Vibrio parahaemolyticus:

Transmission: raw fish, oysters, shrimp, crab, causes 50-70% of foodborne illness in Japan

Disease: acute gastroenteritis, most frequent in US, self limiting

Transmission and disease of Vibrio vulnificus

Transmission: oysters

Disease: very invasive, causes wound infections, septicemia, predisposing conditions are liver disease and increased serum iron

Transmission and disease of Aeromonas hydrophila

Transmission: fresh, brackish, or salt water, isolated from cold blooded animals, amphibians, reptiles, fish

Disease: self limiting diarrhea, wound infections

Campylobacter jejuni transmission and disease

Transmission: contaminated food, dairy products, water, in GI tract of animals

Disease: most common cause of bacterial gastroenteritis, bloody diarrhea, fever, severe abdominal pain, self limiting

Helicobacter pylori transmission and disease

Transmission: gastroenteritis, higher pH due to release of urease enzyme, peptic ulcer disease, gastric cancer risk factor

Gram stain and unique characteristics of Vibrio

Curbed, gram neg bacilli, halophiles (require or tolerate salt), oxidase positive, TCBS media

Gram stain and characteristics of Aeromonas

Non curved gram neg bacillia, no growth on TCBS, oxidase positive, nonhalophilic

Gram stain and characteristics of Campylobacter

Curved gram neg bacilli, oxidase positive, selective media, microaerophilic conditions

Gram stain and characteristics of Helicobacter

curved, gram neg bacilli