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Microbiology 13
| Question | Answer |
|---|---|
| staphylococci morphology: they are | clustered cocci (staphle = grapes) |
| staphylococci are...and generally found as... | G+....commensals on skin and upper respiratory tract |
| most staph species are | harmless |
| there are about..species of staphy and most are not.. | 40...associated with humans |
| how many staph species are of clinical interest as...? | 3...opportunists |
| the three opp staphy species are | staph aureus, epidermidis and saprophyticus |
| usually you do not | distinguish between epidermidis and saprophyticus because they're so similar |
| staph species can also be... | catalase positive and facultative anaerobes |
| catalse is the enzyme to | remove reactive o2 species |
| staph species have the ability to grow in | high salt conditions |
| staph species are tolerant to | dessication, irradiation and heat |
| dessication means | drying out |
| irradiation is | uv from sun |
| heat is upt o | 60 deg C for up to 60 mins |
| some staph species are..so they can be used to distinguish between... | coagulase postive...s aureus and s epidermidis |
| coagulase is an | enzyme for clotting |
| staph species are...and the infections result when... | opportunistic pathogens...barriers (skin or mucosa) are breached, allowing entry |
| production of disease depends on the | 3 virulence factors |
| 3 virulence factors for staph species are | physical evasion of phagocytosis, production of enzymes to protect against phago and production of toxins |
| the toxins that staph produces are...so they are... | exotoxins...made and secreted by bacteria |
| aureus means | golden in latin |
| staph aureus also have..which is a... | protein a...virulence factor |
| protein a is for defense against...and is... | phagocytosis..present on surface of s aureus |
| protein a does what | binds to fc (constant) region of Ig molecules, thereby preventing opsonization |
| staph aureus can also defend against phagocytosis through | bound coagulse, glycocalyx and catalse |
| bound coagulse is when an...activates... | enzyme bound to s aureus bacteria...clotting of the serum clotting factors |
| the bound coagulase forms a | protective fibrin clot around the bacteria, protecting them from phagocytosis |
| glycocalyx is found in | most staph species |
| the glycocalyx is specifically ink both...and can... | s aureus and epidermidis...synthesize slime layers forming a biofilm to protect themselves from phagocytes |
| glycocalyx or...also allows for... | slime layer...attachment to artificial surfaces such as catheters, artificial heart valves or artificial joints |
| catalase is an..which... | enzyme..neutralizes hydrogen peroxide generated by lysosomes in phagocytes |
| catalase protects against the | killing of staph species once inside the phagocytes |
| bound coagulase, glycocalyx and catalase are all | defenses against phagocytosis |
| pyogenic staph aureus produce... | pus |
| the pus happens as a result of an...which attracts.. | inflammatory response...pms to the site of infection |
| after pmns go to site of infection, the area fills with | dead pmns, dead tissue debris, fluid and bacteria |
| puss-filled areas have | low o2 and low pH |
| what doesn't work well in the pus environment | phagocytes |
| in areas with pus...can... | bacterial populations...resurge |
| other enzymes produces by s aureaus include | cell free coagulase, hyaluronidase, staphylokinase, lipases and beta lactamase (and other antibiotic resistance factors) |
| cell0free coagulase is the ...which.. | secreted form...causes clotting |
| hyaluronidase breaks down..allowing... | intracellular matrix in the body..bacterial invasion |
| staphylokinase is releasede by..and does what... | cell-free coagulase...dissolves blood clots, allowing staph to free itself from clotted blood |
| lipases do what...allowing... | dissolves lipids in sebaceous secretions...the bacteria to live on the skin |
| beta lactamase: staph strains are known for | development of antibiotic resistance |
| toxins released by s aureus are...of.. | virulence determinants..specific staph aureus strains |
| toxins released by s aureus include | cytolytic toxins, exofoliative toxins, enterotoxins, toxic shock syndrom toxins |
| cytolytic toxins are also called...and are produced by... | exotoxins...staph aureus |
| cytolytic toxins do what | breaks open host cells |
| two types of cytolytic toxins include | leukocidin and hemolysin |
| leukocidin lyses...thus protecting against... | white blood cells...phagocytosis |
| hemolysin lyses | red blood cells (most sa strains) |
| exfoliative toxins...causing... | dissolve desmosomes...outer layers of skin to peel off |
| exfoliative toxins lead to | staphylococcal scalded skin syndrom (SSSS) |
| enterotoxins caus | food poisoning and vomitting |
| skin infections caused by staph aureus can either be | diffuse or focused |
| diffused skin infections caused by staph aureus include | impetigo |
| impetigo is a..which produces... | contagious skin infection...blisters and sores on the face mostly and sometime the hands |
| impetigo is common among | children with poor hygiene |
| focussed skin infections include | folliculitis and feruncles/carbuncles |
| folliculitis is also known as | boils or skin abcesses |
| folliculitis causes..that are.. | pus-filled lumps...tender, warm, and/or painful |
| folliculitis is caused by | localized infection of hair follicle |
| folliculitis boils should be | drained under aseptic conditions |
| folliculitis of an eyelash is a..and ususlly isnt... | sty..drained |
| feruncles/carbuncles are...and usually are found on the... | abcesses that are larger than boils...back of the neck |
| feruncles/carbuncles require | surgical draining |
| feruncles are an...that usually presents as... | acute, round, firm, tender, circumscribed, perifollicular staph infection...central pus area |
| carbuncle is | two or more confluent furuncles with sepearate heads |
| staph scalded skin syndrom is caused by | two exotoxins produced by some strains of staph aureus |
| SSSS is found in...and its thought that... | infants...bacteria may gain entry at the umbilical stump |
| SSSS involves..causing.. | large areas of the skin...large blisters that rupture |
| when large SSSS blisters rupture it causes | exfoliation of the skin |
| SSSS often resembles | third degree burns |
| no bacterial organisms from SSSS can be...indicating the.. | cultured from the blisters...action of a toxin and not the bacteria themselves causes SSSS |
| the toxins that cause SSSS are..that... | protease..digest specific proteins found in desmosomes |
| desmosomes are | special junctions which help hold the epidermal and dermal layers together |
| staph food poisoning is caused by...which are toxins produced by... | enterotoxins...some staph species which contaminate food |
| for staph food poisoning, the bacteria | die in the stomach acid but their toxins are stable int he acid and enter the blood |
| symtpoms of enterotoxins are produced by | ingesting the toxin and not by the bacterial infection |
| symtpoms of enterotoxins include | nausea, extreme vomiting, diarrhea, headache, sweating, abdominal pain |
| staph food poisoning via enterotoxins is the | most common food poisoning in US |
| enterotoxins are common in...where the food becomes contaminated by... | picnics and catering...improper hygiene of preparer |
| bacteria grow in...to cause... | improperly refrigerated foods and release toxins...enterotoxic food poisoning |
| should one use antibiotic therapy for food poisoning?..so... | no bec bacteria are not causing the problem...just treat the symptoms (fluid and ion replacement) |
| course of food poisoning takes about | 24 hours |
| enterotoxins are | heat stable so don't save and reheat the food |
| systemic staph diseasesinclude | bacteremia and endocarditis |
| bacteremia is the presence of | bacteria in the blood |
| ...is a common agent in bacteremia | staph aureus |
| in bacteremia, the bacteria enter the..from area of... | blood stream...area of infection and travel to other parts of the body which may become infected |
| what are implicated in bacteremia? | feruncles, vaginal infections, surgical wounds, contaminated medical devices, intravascular catheters |
| ...accoutn for about... | nosocomial infections...half of the cases of staph bactermeia |
| bacteremia vs. sepsis: sepsis is a...characterized by the... | whole body acute inflammatory state....release of inflammatory mediators and cytokines leading to multiple organ damage |
| bacteremia vs. sepsis: bacteremia can lead to | sepsis |
| endocarditis involves | SA colonizing the walls and valves of the heart |
| with endocarditis, heart valves recieve..so there is no protection.. | no blood suplly...from immune system |
| once colonized by...the... | bacteria..vegetation grows and valves quickly malfunction |
| patients with endocarditis start with...but condition... | flu like symptoms...rapidly deteriorates as heart output drops |
| endocarditis is fatal in about | fifty percent of cases |
| staph infection of the bone is called....and is a... | osteomyelitis..bone marrow infection |
| osteomyelitis is usually caused by | SA |
| osteomyelitis infection can be caused by | puncture or bacteremia |
| signs and symptoms of osteomyelitis include | painful limbs - especially when being moved, high fever, skin over limb may be hotter and redder than surrounding areas, there may be a break in the skin with pus discharge |
| in children, osteomyelitis is most often seen in | long bones |
| in adults, osteomyelitis is more often seen in | vertebrae |
| lung infection by staph aureus is | pneumonia |
| pneumonia is when the | alveoli (lung sacs) become filled with fluid |
| SA can cause...in lungs of the... | abscess formation..immunocompromised |
| pneumonia is | rare but fatal |
| toxic shock syndrome was very rampant in..caused by... | 1978-80...rely tampons |
| rely tampons were particularly..and were...which created... | absorbent...advertised as being long-lasting...perfect incubator for bacteria |
| certain strains of...release... | sa...toxic shock syndrome toxin 1 (tsst1) |
| tsst1 is a....which can... | superantigen...cross the mucosa, enter the bloodsream and nonspecifically bind to the tcr on t cells |
| after tsst1 binds to tcr on t cells, massive numbers of..are.. | t cells..activated simultaneously resulting in large amounts of cytokines being released |
| when large amounts of cytokines are released it results in...leading to... | septic shock with multiple organ failure...possible death |
| what has practically eliminated toxic shock syndrome | withdrawal of rly tampons and better design/testing of hygiene products |
| toxic shock syndrome is no longer listed as a | reportable disease by the cdc |
| persons with...are often... | sa infections...susceptible to reinfection |
| staph hides itself from | cells of the immune system |
| staph hides from the immune system by preventing | opsonization with protein A |
| staph prevent lysosomal killing with | catalase |
| staph prevents immune system from getting to it by | walling off the area of infection with coagulase |
| staph also evades the immune system by | releasing toxins which paralyze the immune system |
| some people are more...and there is about... | susceptible than others...30% recurrence of infection with the same strain of staph |
| an increasing n umber of...that are... | patients are being seen with skin infections caused by s aureus..reistant to multiple antibiotics |
| as new antibiotics have emerged from the...new strains of... | drug pipeline...s aureus resistant to those strains have appeared |
| staph resistance has been attributed to | the overuse of antibiotics in medicine and agriculture |
| MRSA is....and was discoveredin... | methicillin-resistant SA - superbug...1970s |
| penicillin G was introduced in..and methicillin was introduced in... | 1942...1960s |
| treatment of choice for MRSA is | vancomycin |
| VISA is...discovered in... | vancomycin intermediate SA...1997 |
| VRSA is..discovered in... | vancomycin resistant SA...2000 |
| there is no | vaccine for SA |
| ...exist but have troublesome side effects | alternative drug cocktails for multidrug resistant strains |
| new, innovative...is being investigaed | phage therapy |
| phage therapy targets | bacteria that attack bacteria |
| reports of...to clean out...have been reported | successful magot therapy..necrotic tissues of MRSA infections |
| symptoms of MRSA | minor skin problems, deep abscesses, it can reach the bone, joints, bloodstream, major organs and can lead to death |
| infections are considered...if they first appear... | nosocomial...48 hours or more after hosiptal admission or within 30 days after discharge |
| nosocomial infections are acquired by either | contact or airboen |
| contact nosocomial infections happen when | hospital personnel or devises are infected with s aureus or s epidermidis |
| common vehicle for contact nosocomial infections is | contaminated equipment (catheters) |
| contaminated equipment can cause | UTI, skin infection and lung infection |
| airborn nosocomial infections happens with | strep pneumoniae |
| iatrogenic means | brought forth by a healer |
| iatrogenic example | osteomyelitis following a bone surgery |
| risk factors for nosocomial infection with multiresistant pathogens include | old age, underlying disease, severity of illness, transplants, GI surgery, exposure to med devices, heavy exposure to antimicrobial therapy, prolonged hospital stay and interinstitutional transfer of patient |
| staph epi can form | biofilms on implant3ed medical devices |
| staph epi does not have..and is... | protein A...coag - |
| staph epi has...as a... | emerged...major nosocomial pathogen |
| one way to reduce nosocomial i nfections is to...and... | wash hands after touching patient...particularly, contaminated body fluids, secretions, excretions or objects |
| another way to reduce nososcomail is by wearing | masks and gowns to protect skin and clothing from being contaminated |
| appropriate...is important | disposal of items which came in contact w/ an infected patient and appropriate handling of laundry |
| infected patients should be | placed in isolation in a side-room to limit the spread of infection |
| staph aurues is...on.. | beta hemolytic on sheep blood agar |
| staph aureus ferments...and is often.. | mannitol...golden pigmented |
| staph aureus is...and has presense of... | coag +...protein A |
| in reference labs,...is used with staph aureus | phage typing |
| staph epi is...on | ...non hemolytic on growth or sheep agar |
| staph epi does no...and is... | ferment mannitol...non-pigmented |
| staph epi is | coag - |
| staph sapro is a significant cause of | UTI in women |
| staph sapro is...and is not usually... | coag -...differentiated from staph epi clinically |
Created by:
handrzej
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