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Bacteria (Zoonotics (Brucella (Brucella melitensis: Goats, Brucella…

- - - - spore-former
      - Anthrax
        
        cutaneous anthrax = Black eschar
      - capsule made of Glutamic Acid
      - produce EXOtoxin
    - - non-motile, non-encapsulated
      - food poisoning
      - Enterotoxin
      - spore-former
    - - only G+ ENDOTOXIN
      - V or L shaped Gram stain, tumbling
      - Meningitis, #3 in neonates
      - food-borne infections
    - - Only Exotoxin encoded by lysogenic BACTERIOPHAGE
      - Diphtheria
      - V or L shaped
      - ORAL GRAY pseudomembrane
    - - weak G+, partially acid fast
      - branching thin filaments
      - Not normal flora
      - lung abscesses & cavitations
  - - - tetanus, lockjaw (trismus)
      - Spore-forming: tennis racket
      - Tetanospasmin Exotoxin
      - blocks GABA release
      - Tetanus toxoid vaccine
      - Risus Sardonicus
    - - Botulimun neurotoxin
        
        blocks ACh: flaccid paralysis
      - spore-former
      - fatal blood poisoning
      - heat-labile, boil to inactivate
    - - Gas Gangrene: Myonecrosis
        
        Lechithinase
        
        gas production in tissues
      - Food poisoning
        
        Enterotoxin in GI
      - spore-former
      - vegetative cells: colon normal flora
    - - Antibiotic associated YELLOW GI pseudomembrane
      - Exotoxin A: diarrhea
      - Exotoxin B: damages colonic mucosa
      - no intestinal mucosa invasion
    - - filamentous
      - mouth and GI normal flora
      - Sulfur granules
      - IUD infection
      - eroding abscesses following trauma
  - - - normal flora of mouth, colon, female GU
      - mixed anaerobic infections: abd, pelvic, lungs, brain
  - - - worst staph!
      - nasal & skin normal flora
      - Toxins & Enzymes
        
        Enterotoxins
        
        food poisoning, onset 1-8 hr
        
        Protein A
        
        binds IgG: prevent complement
        
        TSST
        
        Toxic shock, desquamation
        
        Exfoliatin
        
        Scalded-skin syndrome
        
        quick recovery
        
        alpha-toxin
        
        skin necrosis & hemolysis
      - b-hemolytic, grape-like clusters
      - MRSA
      - ABE
      - Skin infections: furuncle, carbuncle, cellulitis
      - Right-sided endocarditis in IVDA's
      - Pneumonia & lung abscess
      - Osteomyelitis
      - Septicemia
      - Impetigo
    - - normal flora: skin
      - prosthetic device infection
      - frequent skin contaminant in cultures
    - - normal flora: urethra
      - 2nd MC UTI in sexually active young women
      - Lipoteichoic acid: adhere to urothelial cells
    - - b-hemolytic
      - Virulence factors
        
        M protein: adherence, anti-phagocytic
        
        Streptolysin O: ASO antibodies
        
        Erythrogenic toxin: rash in Scarlet fever
        
        Streptokinase: dissolves fibrin
        
        Hyaluronidase: spreading factor
        
        TSST toxin: causes toxic shock
      - Diseases
        
        Pharyngitis
        
        Skin infections
        
        necrotizing fasciitis
        
        Impetigo
        
        Erysipelas
        
        Scarlet Fever
        
        strawberry tongue & rash
        
        Toxic shock syndrome
        
        Rheumatic fever
        
        Glomerulonephritis
    - - b-hemolytic
      - anti-phagocytic capsule
      - 25% women carry vaginally
      - neonatal meningitis, pneumonia, sepsis
    - - green sheen, a-hemolytic
      - No lancefield group
      - normal flora: GI, nasal, gingiva
      - Infections
        
        Dental: St. mutans
        
        dental work = SBE in damaged heart
        
        Abscesses: St. intermedius
    - - Streptococcus faecium & faecalis
      - Former Group D, variably hemolytic
      - 2nd & 3rd MC nosocomial infection
    - - No lancefield group
      - Diseases
        
        otitis media in children
        
        MC adult pneumonia
        
        Major cause adult sepsis & meningitis
      - AKA pneumococcus
      - alpha hemolytic
      - Virulence Factors
        
        NO toxin
        
        IgA protease
        
        anti-phagocytic capsule
      - RUST Sputum
      - Diagnose with quelling reaction
      - Pneumovax: 23 MC capsular antigens
    - - alpha or gamma hemolytic
      - previously called non-enterococcus
      - stools of colorectal cancer pt
      - Group D Streptococci
- - - - Rodents, Squirrels, prairie dogs
      - Carried rodent to rodent by flea
        
        bitten by infected flea
        
        reproduce in histeocytes
      - Black death buboues: hemorrhages under skin
      - Tx = Gentamycin
  - - - handling infected rabbits or bites of ticks/deerflies
      - febrile, granulomatous disease
      - survives in macrophages
    - - MC Tularemia form
      - papule at inoculation site w/ black base
  - - - Cat-Scratch disease
      - small G- rods
      - Cats mouths, thorns, splinters
      - Oculoglandular syndrome
      - Tx: tetracycline
      - enlarged lymph nodes & spleen
- - - - Neisseria gonorrheae
        
        3rd MC STD
        
        Males: symptomatic
        
        dysuria, purulent discharge
        
        Females: asx
        
        PID, endometritis, salpingitis, oophoritis
        
        Sterility & ectopic pregnancy
        
        pili & IgA protease
        
        Disseminated Gonorrhea
        
        Septic arthritis
        
        GC bacteremia
        
        Ophthalmia Neonatorium
        
        tx: erythromycin drops
      - Neisseria meningitidis
        
        only known host = humans
        
        airborne droplet transmission
        
        polysaccharide capsule enhances virulence
        
        Meningitis
        
        fever, HA, stiff neck, PMNs in CSF
        
        Meningococcemia
        
        septicemia, shock, DIC: adrenal hemorrhage, purpura
      - Endotoxin in outer membranes
    - - Kingella kingae
        
        oropharynx normal flora
        
        rare opportunistic endocarditis
      - Acinetobacter calcoaceticus
        
        opportunistic respiratory equipment & urinary catheters
      - Moraxella catarrhalis
        
        sinusitis, otits, bronchitis, pneumonia
  - - - leading cause of meningitis in kids
        
        Hib most severe
        
        vaccine available
      - MC cause epiglottitis
      - adult pneumonia
      - IgA protease, capsule, endotoxin
      - H. flu orbital cellulitis
    - - STD: Chancroid, soft chancre
        
        unilateral buboes
    - - Whooping cough
        
        Catarrhal
        
        1-2 wks, URI, CONTAGIOUS
        
        Paroxysmal
        
        characteristic cough
        
        Convalescent
        
        less attacks of cough
        
        pronounced Leukocytosis
        
        Vaccine available
      - small coccobacillary, encapsulated
      - airborne droplet
    - - Legionnaires Disease
        
        older men, smokers
        
        pneumonia, high fevers, confusion, proteinuria, hematuria, cough
      - aerosolized contaminated H2O
      - Pontiac Fever
        
        No pneumonia!
        
        HA, muscle aches, fevers, chills, fatigue
        
        strikes suddenly, resolves in 1 wk
- - - - Shigella dysenteriae
        
        Shiga enterotoxin
        
        Never normal flora: always pathogen
        
        GI: GREY pseudomembrane
        
        MC Bacillary Dysentery
        
        Transmission 4 F's: fingers, flies, food, feces
      - Shigella sonnei
        
        mild diarrhea
    - - Vibrio parahaemolyticus
        
        raw sushi diarrhea
      - Vibrio cholerae
        
        choleragin enterotoxin
        
        large amt must be ingested: sensitive to HCl
        
        rice-water diarrhea
    - - risk factor for gastric adenocarcinoma
      - MC duodenal ulcers & chronic gastritis
      - produces ammonia (to neutralize HCl)
    - - Enterocolitis
  - - - Klebsiella pneumonia
        
        encapsulated, non-motile
        
        respiratory pathogen
        
        2nd MC G- sepsis
        
        pts w/ chronic disease
        
        Pneumonia: CURRANT JELLY sputum
        
        MC G- Lung abscess
      - Enterobacter cloacae
        
        motile G-
        
        opportunistic
        
        septic shock: endotoxin
      - Serratia marcescens
        
        opportunistic
        
        contaminated respiratory devices
        
        Enteric tract disease
    - - Proteus mirabilis
        
        Nephrolithiasis
        
        Triple Struvits; Staghorn calculi
      - Providencia & Morganella
        
        nosocomial UTIs
    - - opportunistic, nosocomial G- strict aerobe
      - DM foot ulcers
      - withstand disinfectants
      - Cystic Fibrosis: high risk sepsis
      - grape scent
      - indwelling foley
      - MC Otitis Externa
    - - strict anaerobe
      - Bacteroides fragilis
        
        MC Peritonitis
        
        intra-abdominal infection
        
        septic abortions, PID, IUD
      - MC organism in human colon
      - 60% vaginas
      - Bacteroides melaninogenicus
        
        oral, vaginal & intestinal normal flora
        
        aspiration pneumonia
        
        periodontal disease
  - - - Enterotoxigenic: Traveler's diarrhea
      - Enterohemorrhagic: verotoxin = hemorrhagic colitis
      - Enteroinvasive: dysentery; direct invasion of epithelial cells
      - MC UTI
      - 2nd MC Neonatal meningitis
      - MC G- sepsis
    - - Salmonella typhi
        
        Typhoid fever
        
        1st week: fever & constipation
        
        2nd week: rose spots
        
        3rd week: resolving
      - Salmonella cholerae-suis
        
        Septicemia
        
        Increased risk pt w/ Sickle Cell Anemia
        
        leads to Osteomyelitis, pneumonia, meningitis
      - Salmonella enteritidis
        
        Enterocolitis: MC diarrhea