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Micro Review FA p'178181

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Lactose-fermenting enteric bacteria. Cholera and Pertussis toxins ... 'Big ... multocida Cellulitis Animal bites, cats, dogs. Cinderalla's not so cute ... – PowerPoint PPT presentation

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Title: Micro Review FA p'178181


1
Micro Review (FA p.178-181)
  • Bugs to cover
  • Anthrax
  • Actinomyces vs. Nocardia
  • Bugs that cause Food Poisoning
  • Bugs that cause Diarrhea
  • Watery vs. Bloody
  • Enterobacteriacea
  • Haemophilus influenza
  • Legionella pneumophila
  • Pseudomonas aeruginosa

2
Micro Review contd
  • Helicobacter pylori
  • Lactose-fermenting enteric bacteria
  • Cholera and Pertussis toxins
  • Zoonotic bacteria
  • (B. burgdoferi, Brucella spp., Francisella
    tularensis, Yersinia pestis, Pasteurella
    multicoda)
  • Garderella vaginalis
  • Neisseria
  • Mycobacteria
  • Primary vs. Secondary TB
  • Mycobacteria spp.
  • Leprosy

3
Anthrax
  • Description
  • Black skin lesions vesicular papules covered by
    BLACK ESCHAR (my AUNT with the nice Rack drives
    a BLACK CAR)
  • Two Forms Contact vs. Inhalation
  • Contact Painless Ulcers- bacteremia and death
  • Inhalation Woolsorters Disease
    life-threatening pneumonia

4
Actinomyces vs. Nocardia
  • Histology Gram Positive Rods- Long Branching
    filaments
  • Actinomyces israeli (normal oral flora)
  • Yellow sulfur granules-(sulfur boogers) in
    sinus tracts
  • Oral/facial abscesses with Sulfur Granules that
    may drain through sinus tracts to skin
  • Nocardia asteroides (causes nasty inf.)
  • Pulmonary infection in immunocompromised
  • Weakly acid-fast

5
Actinomyces vs Norcardia
  • Long Branches tend to SNAP
  • Sulfa for Norcadia
  • Actinomyces use Penicillin

6
Bugs in my Food- SECCondS can Be Very dangerous
  • Staph aureus Meats, mayo, custards starts and
    ends quickly
  • E. coli 0157 H7 undercooked meat
  • Clostridium perfringins- reheated meat dishes
    Id Prefer not eat that reheated leftover meat
    for dinner.
  • C. botulinum improperly canned food (Cans that
    Bulge, recall Honey/Corn Syrup infect infants)
  • Salmonella poultry, meat, and eggs

7
Bugs in my Food SECCondS can Be Very dangerous
  • Bacillus cereus Be Serious! Food poisoning
    from Reheated Fried Rice!
  • Vibrio parahaemolyticus and V. vulnifus
    transmitted in contaminated seafood (think a
    PAIR of
  • crab claws ?)

8
Diarrhea and Typical Findings
  • Campylobacter and Cholera Comma shaped (with
    Camp growth at 42 Celsius)
  • E. coli (Cole likes alcohol) -- ferments lactose
  • Yersinia enterocolitica Transmitted from pet
    feces ie. Puppies Your (yer) darn colis
    (enterocolitica) diarrhea gave me diarrhea!!!!)

9
Diarrhea and Typical Findings
  • Salmonella and Shigella dont ferment lactose
    (both salmon and sugar ray do not like alcohol),
    but both invade intestinal mucosa
  • Salmonella are motile (salmon swim and can
    disseminate ? symptoms may be prolonged with
    antibiotic treatment) Salmonella has Animal
    Reservoir
  • Shigella (think sugar ray is retired, so hes
    nonmotile now) transmission Food, Fingers,
    Feces, Flies
  • Infectious Dose Virulence
  • Shigella (10 1 org.) gt Salmonella (10 5 org.)

10
Watery Diarrhea
  • The VET PROfessor lectured on Watery Diarrhea
  • Vibrio cholera and Viruses (Rota-kids,
    Calici/Norwalk/Astro-adults)
  • Enterotoxigenic E. coli (travelers diarrhea)
  • Protozoa (Cryptosporidium HIV/AIDS and Giardia)

11
CASSEY has Bloody Diarrhea
  • Campylobacter jejuni
  • Amoebas (Entamoeba histolytica)
  • Salmonella
  • Shigella
  • Enterohemorrhagic/Enterinvasive (0157H7) E. coli
  • Yersinia enterocolitica

12
Enterobacteriaceae
  • Which bacteria are included in this group?
  • Think...a PROfessional SEEKS KOFFEe
  • PRO Proteus
  • S Salmonella
  • E E.coli
  • E Enterobacter
  • K Klebsiella
  • S Serratia

13
Enterobacteriaceae
  • KOFFEe
  • K capsular K antigen -- virulence of the bug
  • O O Antigen polysaccharide of the endotoxin
  • F Flageller (H) antigen found in motile
    species
  • F Ferment Glucose all ferment glucose and are
    oxidase negative
  • E -- Enterobacteriaceae

14
HAEMOPhilus Influenza
  • HAEMOPhilus causes
  • A IgA protease Aerosal transmission
  • E epiglottitis
  • M meningitis (the One you Tri first with
    meningitis is Ceftriaxone)
  • O otitis media
  • P pneumonia

15
HAEMOPhilus Influenza
  • Invasive disease is caused by capsular type B (B
    is Bad, so we have a vaccine that contains Type B
    polysaccharides conjugated to Dip toxoidgiven
    between 2-18 months of age)
  • Culture on Chocolate agar requires factors V
    (NAD) and X (hematin) for growthso
  • When a child has the flu mom goes to FIVE (V)
    and Dime (X) store to buy some chocolate.
  • Rifampin for prophylaxis in close contacts

16
Legionella pneumophila
  • Legionaires Disease
  • Gram neg rod that stains poorly, so use SILVER
    stain
  • Grow on charcoal yeast extract culture with iron
    and cysteine
  • Aerosol transmission from environmental water
    habitat (air conditioning, water tower, produce
    mister at the grocery store)
  • NO person-to-person transmission
  • TX Erythromycin

17
Legionella pneumophila
  • French Legionnaire (soldier) with his Silver
    (silver stain) helmet, sitting around a campfire
    (charcoal) with his Iron (with culture) dagger
    with his friends (no person-to-person
    transmission) he is no Sissy (cysteine-with
    culture)

18
Pseudomonas aeruginosa
  • Pseudomonas causes wound and burn infections
  • P Pneumonia (especially with CF)
  • S Sepsis (black lesions on skin)
  • E External Otitis (Swimmers ear)
  • U UTI and hot tub folliculitis
  • Non-lactose fermenting
  • Endotoxin - fever and shock Exotoxin A
    inactivates EF-2
  • TX Aminoglycoside and extended spectrum
    antibiotics (piperacillin, ticarcillin)

19
Pseudomonas aeruginosa
  • AERuginosa AERobic (think water connections and
    blue-green pigment)
  • Think PseudoMOANas with burn victims
    pseudomonas cause burn victims to MOAN

20
H. pylori
  • Causes gastritis and up to 90 of duodenal ulcers
  • Increased risk with PUD and Gastric Carcinoma
  • Gram Neg Rod, Urease Positive (Breath test both
    H. pylori and Proteus are urease postive)
  • Creates Alkaline environment
  • TX Triple Therapy

21
Lactose-fermenting enteric bacteria
  • Lactose is KEE
  • Bacteria grow Pink colonies on MacConkeys agar
  • Examples of Lactose-Fermenting enteric bacteria
    include
  • K Klebsiella
  • E Enterobacter
  • E E. coli and Citrobactor

22
Cholera and Pertussis toxins
  • Both toxins act via ADP ribosylation that
    activates adenyl cyclase resulting in increased
    cAMP (activating CFTR).
  • Cholera turns the on on ? activates Gs, causing
    RICE-WATER diarrhea
  • Pertussis turns the off off ? disables Gi,
    causing WHOOPING COUGH
  • Pertussis also promotes lymphocytosis by
    inhibiting chemokine receptors

23
Zoonotic bacteria --Species/Dz/Transmission and
Source
  • Big Bugs From Your Pet
  • B Borrelia burgdorferi Lyme Disease ? Tick
    bite, Ixodes Tick that live on deer and mice
  • BU Brucella spp. Undulant Fever ? Undulants,
    Unpasteurized dairy products
  • F Francisella tularensis Tularemia ? Tick
    bites, rabbits, deer
  • Y Yersinia pestis Flea bites, rodents,
    prairie dogs ? Plague
  • P Pasteurella multocida Cellulitis ? Animal
    bites, cats, dogs

24
Gardnerella vaginalis
  • Cinderallas not so cute cousin
  • Gram Variable rod that causes Vaginosis
  • Greenish (gardner) vaginal discharge with FISHY
    SMELLnon painful
  • Associated with Mobiluncus, an anaerobe
  • TX Metronidazole (get her on the Metro bus as
    fast as possible)
  • Diagnostic clue Clue Cells ? vaginal epithelial
    cell covered with bacteria

25
Gardnerella vaginalis
  • GET a
    CLUE,

  • Gardnerella!! You Smell

  • Like FISH!
  • Hurry up and get on the Metro Bus and get out of
    here!

26
Neisseria Gonococci vs. Meningococci
  • Gram Neg Cocci
  • GoNO-COC-ci
  • NO polysaccharide capsule
  • NO maltose fermentation
  • NO vaccine
  • Causes (NO-COC Mainly female associated
    diseases) Gonorrhea, septic arthritis, neonatal
    conjunctivitis, pelvic inflammatory disease

27
Neisseria Gonococci vs. Meningococci
  • Meningococci
  • Polysaccharide capsule
  • Maltose fermentation
  • Vaccine
  • Causes meningococcemia and meningitis,
    Waterhouse-Friderichsen syndrome

28
Primary and Secondary TB
29
Mycobacterium
  • Mycobacterium tuberculosis (TB-often resistant to
    multiple drugs
  • M. kanasii (pulmonary like TB symptoms
  • M. scrofulaceum (cervical lymphadenitis in kids)
  • M. avum intracellulare (resistant to multiple
    drugs, Disseminated disease in AIDS
  • ALL MYCOBACTERIUM ACID FAST ORGANISMS
  • SX Fever, Night Sweats, weight loss, Hemoptysis

30
? Horseshoe Nuclei Langhans Giant Cell
  • M. Tuberculosis red color on ACID FAST stain

Large Caseous Lesions and Miliary lesions in the
surrounding hilar node
31
Mycobacterium leprae
  • Hansons Disease (Two Forms)
  • Lepromatous
  • Tuberculoid (failed cell-mediated immunity and
    self-limited)
  • LEpromatous is LEthal
  • Likes Cool Temps
  • Infects Skin and superficial Nerves
  • Reservoir in US Armadillos

32

Leonine Facies -Loss of Eyebrows -Lumpy
Earlobe -Nasal Collapse
Treatment -Long-term oral Dapsone (Toxicity
hemolysis and methemoglobinemia) Alt. Treament -
Rifampin and combination of clofazimine and
daposone
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