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MedMicro 2006 UTHSCmed

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Answer
Vibrios   Gram(-), Facultative anaerobes, Ferment Carbs, Cytochrome Oxidase(+), Highly motile (single polar flagella), Halophilic (salt-loving), Marine environment  
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V. cholarae 01 and 0139   Cholera  
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V. cholerae non-01, non-0139   gastroenteritis  
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V. parahaemolyticus   gastroenteritis(wound infections, bacteremia, rare)  
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V. vulnificus pathophysiology   wound infections, bacteremia  
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V. aliginolyticus pathophysiology   wound infections, external otitis  
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V. damsela pathophysiology   wound infections, bacteremia  
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V. cholarea reservoir   Humans carriers and hosts,  
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V. cholarea outbreaks on Gulf Coast   under cooked seafood  
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V. cholarea spread   thru contaminated food or water  
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Occurence of V. cholarea in rest of U.S. associated with   Travelers  
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V. cholerae incubation   8-72 hours  
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V cholerae colonizes   SI by adhering to surface and elaborating enterotoxin (choleragen)  
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choleragen does what   increases cAMP production which promotes fluid and electrolyte flow into the lumen  
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All clinical symptoms of V. cholerae   can be attributed to choleragen production  
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clinical symptoms for V. cholerae are:   nausea, vomiting, ab cramps and diarrhea  
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V. cholerae organisms are   non-invasive and don't damage the intestinal tract (no second sites of infection)  
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Characteristics of V. cholerae diarrhea   called rice water stool, perfuse, and watery, contains flakes of mucous (NO blood or inflamatory cells)  
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Tx for V. cholerae   Fluid Replacement (including electrolytes) very important (fluid lost is isotonic)  
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V. cholerae specific symptoms   tachycardia, slight fever or hypothermic, low( thready) or absent pulse, cyonotic, acidotic, hypokelimic, hypovolemic shock possible  
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V. cholerae Vir. Factors   cholera toxins, accesory cholera enterotoxin, zonnula occludens toxin, Neuraminidase, toxin coregulated pilus(tcp), colonization factor(cep)  
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cholera toxin (ctxA, ctxB)causes   Hypersecretion of electrolytes and water  
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accessory cholera enterotxin does what   Increases intestinal fluid secretion  
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Zonnula occludens toxin (cholera) does what   increases intestinal permeability  
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Neuraminidase (cholera) does what   increase toxin receptors  
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toxin coregulated pilus (tcp) (cholera) helps with   adherence to mucosal cells  
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colonization factor (cep) (cholera) is an   adhesion factor  
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V. cholerae diagnosis   Isolation from stool and plating on DIFFERENTIAL medium TCBS (thio-sulfate citrate salt sucrose)  
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V. cholerae produces acid yellow colonies because   it ferments sucrose  
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V. cholerae treatment   rapid replacement of fluids and electrolytes (oral)  
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V. cholerae prevention   healthy people are partially protected by normal flora and gastric acid. Improve sanitation and education  
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V. cholerae immunity is imparted by   infection with 01 provides immunity to 01 but NOT 0139. Immunity associated with IgA,Vaccine provides short term protection  
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V. cholerae NON-01 and 0139 differ how?   different LPS O antigen, non-agglutinizing, do not produce cholergen.  
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associated with eating raw seafood and can be isolated from shellfish and surface waters   V. cholerae NON-01 and 0139  
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V. parahaemolyticus is the   major cuase of Vibrio induced diarrhea  
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A common marine microbe that causes explosive, watery diarrhea, similar to cholera, but mucn less severe. Also, nausea and abdominal cramping.   V. parahaemolyticus  
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with V. parahaemolyticus what suggests invasion of intestinal tract   fever, chills, headache  
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V. parahaemolyticus pathogenic strains produce?   thermostable direct hemolysin(TDH)  
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V. parahaemolyticus virulence factors   cytotoxin, hemolysin, adhesion, mucinase  
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V. parahaemolyticus incubation time   5--72 hours  
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V. parahaemolyticus course of disease   3 days on average  
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V. parahaemolyticus attack rate   50% (generally untreated)  
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V. parahaemolyticus prevention   cook seafood for long enough time(10 minutes boiling), never return cooked seafood to original container, eat seafood rapidly(don't let it sit around)  
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V. vulnificus is an   Invasive common marine organism  
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V. vulnificus clinical presentations   primary sepsis and wound infections  
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V. vulnificus primary sepsis patients   invarialble have pre-existing liver disease and have consumed raw oysters  
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V. vulnificus wound infection patients   usually healthy but acquire thru traumatic exposure to sea water  
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V. vulnificus wound inf. characteristics   swelling erythema, and pain. Development of vessicles and bullae eventually necrosis of tissue  
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V. vulnificus identificaiton   unusual among Vibrios because it ferments lactose  
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V. vulnificus Tx   antibiotics and surgical drainage. Death rate approaches 50%  
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V. vulnificus virulence factors   Serum resistance, antiphagocytic polysaccharides, cytolysins, collagenase, protease, siderophore  
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V. alginolyticus is   normal marine flora, cause of wound infections, collagenase is virulence factor  
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V. damsela are known to   cause marine associated wound infections, these infections are cytolysin mediated and can be rapidly fatal.  
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V. vulnificus Tx   tetracycline right away  
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