Please enable JavaScript.
Coggle requires JavaScript to display documents.
Bacteriology, S.aureus, S.pyogenes (group A stretococci), Salmonella typhi…
Bacteriology
S.aureus
food-poisoning
short incubation(2-6hr)
preformed toxin
endotoxin is heat stable
MRSA
serious nosocomial(院内) and community-acquired infection
resistant to methicillin, nafcillin (altered penicillin binding protein)
gram+
β-hemolytic, catalase+, coagulase+
protein A binds Fc-IgG, inhibiting complement activation and phagocytosis
inflammatory disease
toxin-mediated disease(TSST-1)
TSST-1 bind to MHC2 and TCR
staphylococcal toxic shock syndrome(TSS)
S.pyogenes (group A stretococci)
β-hemolytic
hyaluronic acid capsule and M protein inhibit phagocytosis
pyogenic(化膿性) : pharyngitis(咽頭炎), cellulitis(蜂巣炎), impetigo(とびひ), erysipelas(丹毒)
pyrrolidonyl arylamidase(PYR)+
gram+ cocci
immunologic : rheumatic fever, glomerulonephritis(糸球体腎炎)
Scarlet fever
blanching, sand-paper like body rash, strawberry tongue, circumoral pallor(口囲蒼白)
toxigenic : scarlet fever(猩紅熱), toxic shock-like syndrome
ASO titer and anti-DNase B antibodies indicate recent S pyogenes infection
Salmonella typhi
gram - rod, invade GI tract via M cell of Peyer patch
endotoxin; Vi capsule
human only
H₂S production
oral vaccine---live, IM vaccine---Vi capsular
flagella
constipation, followed by diarrhea
treat with ceftriaxone or fluoroquinolon
disseminate hematogenously
Zoonotic bacteria(人畜感染症)
C.psittaci; psittacosis(オウム病); parrots(オウム)
Yersinia pestis; plague; fleas(ノミ)
Salmonella spp.; diarrhea, vomiting, fever, abdominal cramps; reptile and poultry
M.laprae; leprosy; human, armadillo
Cxiella burnetii; Q fever; aerosols of cattle/sheep
Campylobacter; bloody diarrhea; feces, contaminated meat, food and hand
B.reccurentis; relapsing fever(回帰熱); louse(シラミ)
B. burgdorferi; Lyme disease; Ixodes ticks
Bartonell spp.; cat scratch disease; cat scratch
Gram + Lab argorithm
bacilli or cocci or branching filaments
aerobic or anaerobic
catalase+→staphylococcus/ -→streptococcus
coaglase +→S.aureus/ -→S epidermidis or S saprophyticus
hemolysis α→S.pneumoniae, S.mutans, S.mitis/ β→S.pyogenes, S. agalactiae/ γ→E.faecium, E. faecalis, S. bovis
novobiocin +→S.epidermidis/ -→S.saprophyticus
optochin, bilesolubility +→S.pneumoniae / -→S.mutans, S.mitis
bacitracin +→S.pyogenes/ -→S.agalactiae
Salmonella spp.
endotoxin
poultry, egg, pet and turtle
human and animal
H₂S production
flagella
diarrhea (possibly bloody)
disseminate hematogenously
Clamydiae
Chlamydia trachomatis
reactive arthritis, conjunctivitis, nongonococcal urethritis, PID
types
D-K
urethritis, PID, ectopic pregnacy, neonatal pneumonia, neonatal conjunctivitis
L1,L2,L3
lymphogranuloma venereum(性病性リンパ肉芽腫)
swollen, painful inguinal lymph node
A,B,C
chronic infection, follicular conjunctivitis
cytoplasmic inclusion
treat with azithromycin or doxycycline
Elementary body : enter cell via endocytosis, transform into reticulate body(網状小体)
C.pneumoniae, C.psittaci : atypical pneumonia
Reticulate body : replicate in cell
intracellular (cannot make their own ATP)
cell wall lack classic peptidoglycan
Haemophilus influenzae
vaccine for capsular type b, given between 2 and 18 months
treat with amoxicillin for mucosal infection, ceftriaxone for meningitis
epiglottitis(喉頭蓋炎), cherry red endoscopic (内視鏡)appearance, thumb sign on lateral neck, meningitis, otitis media, pneumonia
gram - rod
aerosol transmission
IgA protease
mucosal infection (otitis media;中耳炎, conjuctivitis, bronchitis)
Shigella(赤痢菌)
acid stable
finger, flies, food, feces
bloody diarrhea
endotoxin, Shiga toxin(enterotoxin)
cell to cell
human
S.saprophyticus
urease+
in genital tract and perineum
coagulase-
gram+
catalase+
UTI in youn women
S.pneumoniae
meningitis, otitis media(中耳炎), pneumonia, sinusitis(副鼻腔炎)
gram+
encapsulated
IgA protease
sepsis in sickle cell and asplenic
lancet-shaped diplococci
S.agalactiae (groupB streptococci)
produce CAMP factor→enlarge area of hemolysis
intrapartum penicilin prophylaxis
gram+ cocci
β-hemolytic
screen pregnant women at 35-37 weeks
pneumonia, meningitis, sepsis (in babies)
Enterococci
cause UTI, biliary tract infection, subacute endocarditis
gram + cocci
normal colonic flora (eg. E.faecalis, E.faecium)
VRE is important for nosocomial infection
penicillin G resistant
can grow in 6.5% NaCl
B.anthracis
pulmonary anthrax
flu-like symptom, pulmonary hemorrhage, mediastinitis(縦隔炎), shock
widened mediastinum
cutaneous anthrex
painless papule surrounded by vesicles→ulcer and black eschar
polypeptide capsule
gram +
spore forming rod
anthrax toxin
C.botulinum
gram +, spore forming, anaerobic rod
honey in baby
inhibit ACh release
botulinum toxin(heat-liable)
treat with human botulinum immunoglobulin
diplopia(複視), dysarthria(構音障害), dysphagia(嚥下障害), dyspnea(呼吸障害)
Corynebacterium diphtheriae
pseudomembranous pharyngitis(偽膜性咽頭炎), lymphadenopathy, myocarditis, arrhythmias
toxic vaccine
gram+ rod
via respiratory droplet
blue and red granule, Elek test
extoxin inhibit EF-2
Mycobacteria
M.tuberculosis
TB, often resistant to multiple drug
fever, night sweat, weight loss, cough, hemoptysis(喀血)
macrophage, granulloma formation
tuberculosis
PPD, IGRA(interferon-γ release assay) (fewer false positive from BCG vaccination)
caseating granulomas(乾酪性肉芽腫), Langhans giant cell
primary tuberculosis
<10%
progressive primary tuberculosis
bacteremia, miliary tuberculosis
90%
reactivation
2°tuberculosis
localized destructive tuberculosis (caseation;乾酪化, scar, cavity)
miliary tuberculosis(粒状結核)
M.serfulaceum : cervical lymphadenitis
acid-fast organism (pink rod)
M.marinum : hand infection
M.avium : intracellular
Leprosy; Hansen disease(ハンセン病)
armadillos
treat with dapsone, rifampin(tuberculoid), clofazimine(lepromtous)
Mycobacterium laprae
like cool temperature
type
Lepromatous : skin (leonine facies), communicable, lethal
Tuberculoid : few hypoesthetic, hairless skin plaque
loss of sensation
Legionella pneumophila
treat with macrolide or quinolone
detect by presence of antigen in urine
Pontiac fever : mild flu-like syndrome
Legionnaires' disease (在郷軍人病) : severe pneumonia, fever, GI, CNS symptom
gram - rod, silver stain, charcoal yeast extract medium(with iron cysteine)
environmental water sourse habitat
Spirochetes
Syphilis(梅毒)
tertiary syphilis
gummas(ゴム腫), aortitis, neurosyphilis, Argyll Robertson pupil
congenital syphilis
facial abnormalities (rhagades; 亀裂, snuffles, saddle nose, notched teeth;切り欠き歯, mulberry molar;桑実状臼歯, short maxilla), saber shin, deafness(難聴)
occur at first trimester
secondary syphilis
disseminated, maculopapular rash(斑点状丘疹), condylomata lata, lymphadenopathy, patchy hair loss
VDRL/RPR, FTa-ABS
latent syphilis may follow
primary syphilis
painless chancre(潰瘍), VDRL + in~80%
Treponema pallidum
VLDL
false positive: pregnancy, viral infection, drug, rheumatic fever, lupus and leprosy
Lyme disease(ライム病)
borrelia burgdorferi
transmitted by Ixodes deer tick (マダニの一種)
natural reservoir is mouce
stage
1: erythema migrans (遊走性紅斑), flu-like symptom
2: secondary lesion, carditis, AV block, facial nerve palsy, migratory myalgias(移動性筋肉痛)/ transient arthritis
3: encephalopathy, chronic arthritis
treat with doxycycline, amoxicillin, cefuroxime
Leptospira interrogans
contaminated water
Leptospirosis
flu-like, myalgias, jaundice, photophobia(羞明)
Weil disease
severe, jaundice, azotemia(高窒素血症), liver and kidney dysfunction, fever, hemorrhage, anemia
eg. Borrelia, Leptospira, Treponema
visualized by aniline dye
spiral-shaped with axial filament
Gardnerella vaginalis
pleomorphic
gram-variable rod
gray vaginal discharge with fishy smell
not sexually transmitted
clue cell(糸玉状細胞)
treat with metronidazole or clindamycin
Vector-borne illness(昆虫媒介病)
treat with doxycycline
Ehrlichiosis(エールリヒア症)
tick
monocyte with morulae(桑実) in cytoplasm
Q fever
cattle/sheep amniotic fluid
arthropod(節足動物)
Anaplasmosis(アナプラズマ)
granulocyte with morulae in cytoplasm
tick
Rocky mountain spotted fever(ロッキー山紅斑熱)
rash start with wrist and ankles
then spread to trunk, palm, sole
tick(ダニ)
Typhus
fleas:R.typhi, human body louse:R.prowazekii
rash start centrally and spread out
Mycoplasma pneumoniae
headache, nonproductive cough(空咳), interstinal infiltrate
cold agglutinins (IgM)
atypical pneumonia
no cell wall, not seen on gram stain, pleomorphic
more common young people
treat with macrolides, doxycycline or fluoroquinolone
S.epidermidis
urease+
gram+
catalase+
coagulase-
normal flora of skin
Viridans group streptococci
gram+
α-hemolytic cocci
normal flora of oropharynx(中咽頭)
S.mutans, S.mitis, S.sanguinis
dental caries(虫歯)
B. cereus
cereulide(preformed toxin)
gram+ rod, spore forming
food poisoning
emetic type→nausea and vomiting within 1-5hr
diarrheal type→diarrhea and GI pain within 8-18hr
C.difficile
gram +, spore forming, anaerobic rod
diarrhea, pseudomembranous colitis
toxinA(enterotoxin), toxinB(cytotoxin)
2° to antibiotic use(PPIとかも)
metronidazole, oral vancomycin
Listeria monocytogenes
amnionitis(羊膜炎), septicemia, spontaneous abortion, granulomatosis, meningitis, gastroenteritis
gram+, facultative intracellular rod
unpasteurized(低温殺菌されていない) diary product, cold deli meat
rocket tail, tumbling motility(転倒運動)
treat with ampicillin
Pseudomonas aeruginosa(緑膿菌)
produce phospholipase C, endotoxin, exotoxin A, pigment (blue-green)
aerobic, motile, gram- rod, oxidase+
PSEUDOMONAS; pneumonia, sepsis, ecthyma gangrenosum(壊疽性膿皮症), UTI, diabetes, osteomyelitis, mucoid polysaccharide capsule(莢膜多糖), ostis externa, nosocomial infection, addict, skin infection
ecthyma gangrenosum(壊疽性膿皮症)
necrotic cutaneous lesion
treatment; CAMPFIRE drug ; carbapenem, aminoglycoside, monobactam, polymyxin, fluoroquinolone, cephalosporin (third and fourth), extended-spectrum penicillin
Escherichia coli
Enterohemorrhagic E coli; EHEC (腸管出血性大腸菌)
under cooked meat, raw leafy vegetable
O-157 is most common
hemolytic uremic syndrome; HUS(溶血尿毒素症候群) : anemia, thrombocytopenia, acute renal failure
Enteroinvasive E coli; EIEC (腸管侵入性大腸菌)
invade intestinal mucosa, cause necrosis and inflammation
Enterotoxigenic E coli; ETEC (毒素原性大腸菌)
produce heat-labile(LT) and heat-stable(ST) enterotoxin
Enteropathogenic E coli; EPEC (腸管病原性大腸菌)
adhere to spical surface and prevent absorption
gram - rod, fimbriae(線毛)---cystitis(膀胱炎) and pyelonephritis(腎盂腎炎); K capsule---pneumonia, neonatal meningitis; LPS---shock
Campylobacter jejuni
bloody diarrhea
antecedent to Guillain-Barre syndrom and reactive arthritis
poultry, meat, milk, fecal oral transmission
growth at 42℃
gram - comma and S shaped
Helicobacter pylori
by ammonia, alkaline environment is formed (in antrum (幽門洞))
treat with amoxicillin and clarithromycin and proton pump inhibitor
gastritis and peptic ulcer, risk factor for peptic ulcer, adenocarcinoma and MALT lymphoma
+: catalase, oxidase, urease
curved, flagellated, gram - rod
S.bovis
associated with colon cancer
colonize gut
gram + cocci
bacteremia(菌血症), subacute endocarditis
C.tetani
inhibitory of GABA and glycine
gram +, spore forming, anaerobic rod
tetanospasmin
spastic paralysis, trismus, risus sardonicus, opisthotonos(後弓反射)
Nocardia
treat with sulfonamide
gram+ long branching filament
aerobe, acid fast, in soil
pulmonary, cutaneous, spread to CNS
Actinomyces
treat with penicillin
abscesses, dental caries(虫歯), yellow granule, PID; pelvic inflammatory disease(骨盤内炎症性疾患)
anaerobe, not acid fast, normal flora in oral, reproductive, GI
Gram - Lab algorithm
comma-shaped rod
growth in 42℃
Campylobacter jejuni
urease
Helicobacter pylori
growth in alkaline media
Vibrio cholerae
diplococci
maltose +
N.meningitis
maltose -
N.gonorrheae(淋菌)
bacilli
lactose +
fast
citrobacter, serratia
slow
E.coli, klebsiella
lactose -
oxidase +
pseudomonas
H2S +
salmonella
H2s-
shigella, yersinia
coccobacilli
H.influenzae, Bpertussis(百日咳)
Neisseria
Meningococci
polysaccharide capsule
maltose fermentation
vaccine
transmitted via respiratory and oral secretion
peteshial hemorrhage(点状出血), gangrene(壊疽) of toe, meningitis, Waterhouse-Friderichsen syndrome)
treat with ceftriaxone or penicillin G
gonococci(淋菌)
sexually or perinatally(周産的) transmitted
gonorrhea(淋病), septic arthritis, neonatal conjunctivitis, PID, Fitz-Hugh-curtis syndrome
treat with ceftriaxone
gram - diplococci, metabolize glucose, produce IgA protease
contain lipooligosaccharides(LOS)→strong endotoxin
Vibrio cholerae
contaminated water or uncooked food
oral rehydration solution
rice-water diarrhea (enterotoxin activate Gs, ↑cAMP)
gram - flagellated(鞭毛をもつ) comma shaped
α-hemolytic bacteria
gram + cocci
greenish or brownish color
eg. S.pneumoniae, V. streptococci
β-hemolytic bacteria
gram + cocci
complete lysis of RBC, clear area on colony
eg. S.aureus, S.pyogenes, S.agalactiae
C.perfringes(ウェルシュ菌)
myonecrosis(gas gangrene), hemolysis
gram +, spore forming, anaerobic rod
αtoxin
Bordetella pertussis(百日咳)
pertussis toxin (disable Gi), cyclase toxin(↑cAMP), tracheal cytotoxin(気管細胞毒素)
stage
paroxysmal(発作) : intense cough("whooping cough"), posttussive vomiting(術後嘔吐)
convalescent(回復期) : gradual recovery
catarrhal : low fever, coryza(鼻汁)
gram -
Yersinia enterocolitica
diarrhea, pseudoappendicitis(偽性虫垂炎); mesenteric adenitis(腸間膜腺炎), terminal ileitis(回腸末端炎)
pet feces, milk, pork
gram - rod
Klebsiella
gram - rod
cause lobar pneumonia, nosocomial UTI
intestinal flora
Lactose fermenting enteric bacteria
eg. Citrobacter, Klebsiella, E.coli, Enterobacter, Serratia
pink colonies on MacConkey agar