Bacterial Skin Infections
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| Normal Skin Flora = ? | * Colonized by predominantly by aerobic and facultative anaerobic organisms ..... * Almost all are of G+ origin
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| What usually colonizes DRY areas of the skin ?... * WET/MOIST areas ?... Bedridden People = ? | * Dry = G+ Cocci.... * Wet = G- Rods.... * Bedridden = G- Rods...... * Biggest Culprits = Staph. Aureus and Strep. Pyo.
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| Usu cause of Abscess ? Cellulitis ? Bed Sores ? | * Staph Aureus.... * Strep Pyo.... * E.Coli
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| Staph Characteristics = ? | * G + (purple) in clusters and facultative anaerobes.... * Grow in Mannitol Agar
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| Staph Aureus Virulence Factors = ? | * Peptidoglycan thick layer and Teichoic acids that help adhere....* Fibronectin-binding protein - promotes binding to mucosal surfaces.... * Protein A = anti-opsonin effect that helps it bind to other cells
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| Toxins and Enzymes = ? | * Coagulsae, Hemolysin, and Leukocidin + (Kill WBC)..... * + for Lipase Nz, Beta-Lactamase from mecA gene (able to break Beta-Lactam rings)
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| Other Toxins = ? | * Exfoliative toxins = A and B ... * Toxic Shock Syndrome Toxin... * Enterotoxins (Most common kind of food poisoning)
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| Exfoliative Toxins Scalded Skin Syndrome has ? Bullous Impetigo ? | * A and B..... * A
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| Staph. Aureus Pathogenesis = ? | * it colonizes the external nares....* Can NOT go through skin unless it is damaged
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| Some Primary Infections caused by Stap. Aureus = ? | * Impetigo -- Scalded skin syndrome -- Toxic shock syndrome -- Folliculitis -- Abscess -- Boils -- Carbuncles -- Cellulitis
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| How to Dx and Treat a Staph. Aureus Infection ? | * aspirate abscess → Gram stain and culture ..... * TmT = IND, treat empirically to cover MRSA
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| Mechanism of resistance to pencillin = ? | * β-lactamase enzyme breaking the beta-lactam ring, rendering the anitbacterial inactive
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| Mechanism of Methicillin Resistance = ? | * MRSA expresses a PBP that is altered and does not allow Methicillin to bind
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| TmT for the 2 types of MRSA = ? | * Hospital Acquired = Vanc or Linezolid..... * Community Acquired = Trimeth-Sulf
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| How MRSA in the community is transmitted ? | * usu from direct contact with someone with MRSA.... * can be from from contaminated items too
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| General Properties of Strep. Pyo. = ? | * G+ Cocci in CHAINS (see little purple dots in chains).... * Sugar Fermenter.... * Catalase - ... * Need Enrichment to grow
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| How we classify Strep. = ? | * Based on Hemolysis Properties on Sheeps Blood .... * Alpha = incomplete hemolysis, and we see a yellow color change... * Beta = complete hemolysis and see clear all around the culture... * Gamma = NO lysis at all
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| What are the Streps. based on there Hemolysis properties = ? | * Strep. Pyo and Agalacitae = BETA .... * Faecalis = GAMMA .... * Pneumoniae = ALPHA
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| Lab Test that Strep Pyo is sensitive to = ? | * Bacitracin Test
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| Group A Streptococci (Strep Pyo.) Basics = ? | * Hyaluronic Acid Capsule... * Fibrils that have M-Proteins for attachment
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| Group A Patho = ? | * Get from ORAL secretions from another infected person.... * It spreads bc its CAPSULE is resistant to phago.
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| Some Diseases caused by Strep. Pyogenes = ? | * Pharyngitis (sore throat) - Scarlet fever - Impetigo ...... * Postinfection Diseases =
Rheumatic Fever (following a URI) and Glumerulonephritis (following a skin infection with Group A)
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| Lab Dx = ? | * Cultures to use in Hemolysis and Direct Antigen Tests... * Get a Bd Culture
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| Scarlett Fever and TmT = ? | * Caused by a strain of Group A Strep from its Erythrogenic toxin ... * See the "Strawberry Tongue"..... * TmT = Penicillins (can use them unlike S. Aureus)
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| Impetigo = ? | * From Group A Strep (Pyo.) and is usu the Non-Bullous form... * Can be mixed with Staph. Aureus
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| Erysipelas = ? | * Group A Strep.... * Looks like cellulitis on the face that makes them look like cat eyes
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| Wound infections = ? | * Group A Strep causes more Cellulitis, unlike Staph. Aureus that causes a lot of abscesses
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| Gram-Negative Nonfermenters = ? | * Opportunistic pathogens that do not ferment glucose.... * Pseudomonas Aeruginosa and Acinetobacter
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| Pseudomonas aeruginosa General characteristics = ? | * G - Rods (pink).... *Motile Flagellar Tail.... * Oxidase +... * Grow at 42 C (warm).... * Produce a FRUITY ODOR when colonizing
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| Pseudomonas Virulence Factors = ? | * Pili = Attachment... * Polysaccharid Capsule with a SLIME layer that makes it hard for ABx to kill them.... * Exotoxin-A
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| Ecthyma gangranosum = ? | * From Pseudomonas... * Looks like a red/black plug on the butt of a little kid (pic in the lecture we had)
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| Diseases caused by Pseudomonas Aeruginosa = ? | * Infect immunocompromised or those with compromised physical barriers..... * Skin after BURNS, Resp Tract in someone with CF, Conjunctivitis, Otitis Externa (Swimmers Ear), and Folliculitis from Hot Tubs
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| Pseudomonas TmT = ? | * Keep everything clean.... * For serious infections, give an AG + Extended Spec Penicillin by IV
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| Acinetobacter basics = ? | * NonFermenter, Oxidase - (aerobic), nonmotile, Short G - Rods (little pink rods)..... * Are MDRAB (multi-drug resistant AB)
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| Where we see Acinetobacter with a high prevalence ? | * Prevalent among American soldiers wounded in Iraq (grows in warmer/tropical/humid areas)
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| Acne vulgaris = ? | * The MOST COMMON skin infection... * Get HIGH sebum activity that plugs up the follicles, that then get Proprionibacterium Acnes, that causes inflammation and releases pro-inflam mediators.
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| What we usu get from a Cat or Dog Bite, or even a Human bite ? | * Pasteurella Multocida
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| How we get Erythrasma, what causes it, and how is it Dx = ? | * It looks like an solid red rash, and we get it in aresa on the body that are moist (Arm pits and Vaginal)..... * From Corynebacterium... * Dx = Wood’s Lamp (turns coral red)
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| Decubitus Ulcer MoA and what causes it ? | * Starts off as a minor skin infection and then goes deeper and deeper til it is through the fatty layer and even in to the muscle.... * It is from a MIX of Staph, Strep, and even enteric bacteria
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| Purpura Secondary to Vasculitis is what and what causes it ? | * From Neisseria Meningitidis (G - Diplococci) that invade the blood vessels and we get a endogenous skin lesion. (Bd on the inside causes the skin lesion on the outside)
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| Causes Leprosy and how we Dx it ? | * Mycobacterium Leprae... * Dx = Acid Fast Stain (see lots of white, some red and blue)
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