1. How does a gram positive bacteria ce enveope di!er "rom t#at o" a gram negative bacteria ce enveope$ %e enveope& determines #ow to cassi"y bacteria 'ram positive( t#ic) ayer w. outer capsue* #ard to )i bacteria &t#ic) peptidogycan ayer so retains vioet stain &ce membrane &teic#oic acids t#at stic) up and are poymers o" gycero and p#osp#ate &water soube and ma+or sur"ace antigens* #eping cassi"y as gram positive &ce wa maintenance and enargement during ce division &moves cation in and out to stimuate immune response &poysac#arides &pressed tig#ty against ce membrane w. itte space between 'ram negative( singe s#eet peptidogycan, doesn-t absorb vioet stain, stays red &compex outer membrane &%e membrane &can #ave outer capsue and endotoxins &outer membrane& aow "or bacteria to ive in 'I tract &protects ce "rom bie sats &act as specia c#annes to aow #ydrop#iic compounds to pass &ipopoysac#arides& EN./0/1IN w. ma+or sur"ace antigens o" bacteria ce &stabii2e outer membrane and acts as barrier t Hydrop#obic moecues &composed o" ipids bound to poysacc#arides &poysacc#arides "unction by boc)ing #ost de"enses &ipoproteins&stabii2e enveope* ocated in outer membrane &anc#ors membrane to poysac##arides &toxic w#en reease during in"ection and "unctions 3s EN./0/1IN &porin* a type o" protein ocated inside /4 ®uatory contro over moecues enter5eave &structura proteins &peptidogycan( bottom t#in ayer o" /4 &rigid protective structure but t#inness gives rise to 6exibiity and sensitivity &peripasmic space& reaction site "or arge and varied poo o" substances t#at enter and eave ce &between inner and outer membrane &70&809 ce voume &contains en2ymes 7. :#y are eac# o" t#e "oowing media used by microbioogists$ Nutrient media& grows not#ing speci;c enric#ed media& basa and additives to en#ance growt# &promotes growt# to most organisms Eg. c#ocoate and bood agar basa media& suppies minima base growt# re<uirements &suppies extra nutrients transport media& maintain and preserves specimen be"ore anayses &cuturettes &acts as bu!ers5absorbant to prevent ce destruction &doesn-t support growt# seective media&aows certain bacteria to grow* in#ibits ot#ers &i" worried you #ave 1 disease* ony 1 is aow to grow so i" not#ing grows* don-t #ave 1 &in#ibits growt# o" certain microbe &di!erence "avors certain microbe to grow by se".. isoation imp. &important in primary isoation o" a speci;c microorganism "rom sampes containing mixtures o" di!. species ex. =eces* saiva* s)in* water* soi .i!erentia media& additives aow di!erentiation between organisms &visibe di!erence among microorganism &coony si2e5coor* media coor c#ange* "orm gas5bubbe Eg. dye b5c pH indicator bood agar& identi;es organism t#at #emoy2e bood &bot# enric#ed and di!erentia eg. strep test c#ocoate agar& coo)ed bee" bood powderi2ed acting as a specia nutrient :#at is 3gar$ 0ype o" S/>I. media .. most widey used and e!ective i<ue;abe soid media &6exibe and modabe and provides a basic "ramewor) &provides ;rm sur"ace to grow organism
3. .i!erentiate between endotoxins and exotoxins in terms o" w#ere and #ow t#e toxin is produced and w#at t#e toxin does to t#e in"ected #ost. Endotoxins&attac# to ce wa* reease i" ce is ysed. %annot be made into vaccine. %auses "ever* eucopenia* #ypotension* .I% & gram neg bacteria associated because wit# /uter 4embrane "aing apart* toxin is reease &toxin t#at is not secreted but it reeased ony a"ter ce is damaged5ysed Eg. ipopoysac#arides -stimulate fever and shock reactions in gram negative reactions suc# as meningitis and typ#oid "ever &ipids are #arm"u to #uman ces bc macromoecues in ce wa are "oreign to #umans?stimuate antibody production in immune system &endotoxins #ave systemic e!ects on tissues and organs &can cause "ever* in6ammation @@.I%A disease t#at is t#roug# bood causing cots* person #emorr#age to deat# Exotoxins& ce produces and excretes. Released from organism into environment &Bsed to ma)e vaccines &can cause toxic s#oc) & toxin t#at is secreted by a iving bacteria ce into t#e in"ected tissues &proteins wit# strong speci;city "or a target ce and extremey power"u and deady e!ects &a!ect ces by damaging ce membrane and initiating ysis or by disrupting intraceuar "unction &conse<uence o" ce disruption depends on t#e target &contain many speci;c exampes
8. :#ic# areas o" t#e body #ave an acid pH as a natura #ost de"ense$ &'enitas* urinary tract* 'I tract Cstomac#( uness medicated wit# antacidsD* saiva* s)in* )idneys &I" you ceave too muc# acid out o" t#e stomac#* it becomes at ris) "or c. di;cie and pneumonia S)in "ew bacteria can penetrate Csweat EpHF #eps )i someD ot#er natura de"enses( mucous membranes respiratory membraneA mucus coect* ciia beat or move bacteria up and /B0* nose #airs* coug#ing* Ig3 antibody genita5urinary tractA cervica secretions wit# yso2yme* urine 6us#ing t#roug# uret#ra 'I tractA saiva en2ymes* pH o" stomac#* norma 6ora 8. :#ic# o" t#e "oowing are capabe o" sterii2ation Ci.e. )is sporesD$ N/0E( 0#e ony way to )i spores in "ood C%. botuinumD in t#e )itc#en is wit# a pressure coo)er Cnot a #ot water bat# cannerD. 0#e temp gets muc# #ig#er C#ig#er t#an boiingD wit# a pressure coo)er* and one #as to use it "or a ong time @@acid "oods Ci)e acid tomatoes* not t#e yeow nonacid tomatoesD are sa"e to can in a #ot water bat# because the acid prevents the spores from reactivating to vegetative cells that can divide etc. spores CANNOT reactivate in acidic environment, like stomach spores love low o and low acid t#us* we need to be care"u wit# GGIs t#at destroy acid in stomac# we aso need to be care"u about canned "ood i" t#e canned "ood #as a ow acidity* be aware o" spores Sterii2ation( irreversibe destruction o" a organisms* incuding spores &removes a viabe microorganisms incuding viruses &resuts in proteins denaturing and unwinding HES& 3utocaving& saturated steam under pressure, most common met#ods in #ospitas &#eating under #ig# pressure &sterii2ation ac#ieved w#en steam condenses against t#e ob+ects in t#e c#amber and graduay raises t#eir temperature N/& =itration& used to ;ter i<uids t#at cant wit#stand #eat &;ters out impurities Ccrysta* ;bersD &disadvantage( doesn-t remove toxins t#at can cause disease N/&BI radiation& damages .N3 o" bacteria &need to te "ood distributers i" use BI except w. spices &disin"ects in some circumstances N/& aco#o #and saniti2er& denatures proteins &used as disin"ective and antiseptic?doesn-t sterii2e HES& et#yene oxide& eave toxin trace o" c#emicas in tube &ow temperatures* second most common met#od in #ospitas &boc)s .N3 repication &acts as a sporicide N/& "ood irradiation& ony reduces t#iamin and )is o" e.coi ¬ popuar in 3merica &w#en ce receive waves* moecue absorbs avaiabe energy &I/NIJIN' radiation sterii2es in absence o" #eat K. :#ic# type o" in"ectious diseases are now killing t#e most peope wordwide$ &in"ectous diarr#ea diseases &157 o" a deat#s due to tubercuosis* maaria and 3I.S L. .escribe t#e "unction and ocation o" eac# o" t#e "oowing bacteria ce structures( %apsue& "ormed "rom pat#ogenic bacteria &protects ce "rom p#agocytosis and antibiotics @encapsuated bacteria ces #ave greater pat#ogenicity because capsue boc)s mec#anism p#agocyte use to attac# and engu" bacteria &bound tig#ty t#an sime ayer Ctype o" gycoayxD and #as t#ic) consistency w#ic# gives stic)y c#aracter to coonies cytopasmic membrane& t#in* 6exibe s#eet moded competey around t#e cytopasm &ipid biayer w. proteins embedded to varying degrees &"unc( eectron transport &oxidative p#osp#oryation &seective permeabiity peptidogycan ayer& compex poymer provides strengt# and s#ape &M09 o" gram N was and M&109 o" gram & &repeating gycan cross by s#ort poypeptide &bottom t#in ayer o" /4 &rigid protective structure but t#inness gives rise to 6exibiity and sensitivity peripasmic space& ocated above and beow peptidogycan ayer &important reaction site "or arge and varied poo o" substances t#at enter5eave ce & =ound in gram ce was( E70&809 o" ce voume* contains en2ymes * extensive spaceF It is we deveoped above and beow t#e peptidogycan &!mportant rxn site for cells that enter and leave the cell &"ound in gram # cell walls$ ver% little space &etween cells and cell mem&rane -!t is ver% thin and narrow ;mbriae& bacteria sur"ace appendages invoved in interactions w. ot#er ces but don-t provide ocomotion &sma* bristei)e ;vers emerging "rom sur"aces o" bacteria ces &most contain protein &in#erent tendency to stic) to eac# ot#er 'ycocayx&coating o" macromoecues to protect ce and #ep ad#ere to its environment &di!er in t#ic)ness* organi2ation and c#emica composition in eac# types o" bacteria pii& eongated* rigid* tubuar structure made o" piin @@ 'acterial surface appendages that are involved in interactions with other cells &"ound in gram negative bacteria?utii2ing con+ugation w#ic# invoves trans"er o" .N3 "rom 1 ce to anot#er &"unction as ce connecters and trans"er agents &rigid sur"ace o" protein &ad#eres to #ost &attac#ment o" donor and recipient ces in bacteria con+ugation 6agea& ong* "rom poar regions prope ce t#roug# water &t#read i)e appendeges o" protein CH antigenD &organs o" motiity o" se" propusion &attac# by extension o" cytopasmic membrane O. .e;ne binary ;ssion. :#at is t#e signi;cance o" eac# o" t#e "oowing stages o" bacteria growt#$ >ag p#ase* stationary p#ase* exponentia p#ase* decine p#ase. &most ces rey on binary ;ssion "or propagation &it is asexua reproduction >3' GH3SE& eary 6at period on t#e grap# w#en popuation appears not to be growing or growing at ess t#an exponentia rate &newy inocuated ces re<uire period o" ad+ustment* enargement and synt#esis o" .N3* en2ymes and ribosome &ces are not yet mutipying at max. rate &popuation o" ces is so sparse or diute t#at t#e samping misses t#em Exponentia p#ase& maximum rate o" ce division* curve increases &p#ase wi continue i" ces #ave ade<uate nutrients and "avorabe environment &popuation "u;s its potentia generation time and growt# is baanced5geneticay coordinated Stationary p#ase& popuation enters a surviva mode in w#ic# ces stop growing or grow sowy &curve eves o! &rate o" ce in#ibition or deat# baances out rate o" mutipication &P o" visibe ces remain at max and constant &depetion o" nutrients and oxygen &increased ce density causes accumuation or organic acids .eat#5decine p#ase& imiting "actors intensi"t and ce begins to die* unabe to mutipy &curve dips down &speed depends on resistance o" species and #ow toxic conditions are &sower t#an exponentia rate &viabe ces remain many wee)s5mont#s a"ter p#ase begins Q. %ompare and contrast t#e "oowing terms( Gat#ogen&organism capabe o" causing disease5deat# Symbiont& organisms t#at ive toget#er in a cose partners#ip &une<ua reation* can be obigatory to one o" members i" not bot# &3 types( mutuaism* synergism* cooperation .. not becessary bene;cia 4utuaist& organisms ive in an obigatory but mutuay bene;cia reations#ip &common in nature due to surviva "actor &3 type( commensaism. Sateitism* parasitism /pportunist& organism ony causes disease w#en #ost de"enses are impaired &impaired in terms o" immune compromised* ac) o" seep &most disease &)i 3I.S patient 10. %ompare and contrast t#e "oowing terms( Racteriostatic& in#ibits bacteria growt#* can resume i" conditions are rig#t &starve nutrition &ony suppress reproduction o" bacteria &wea)ens bacteria and I= #eat#y immune* immune wi ;g#t o! bacteria but it %3N %/4E R3%S i" not #e>0HH not good "or 3I.S patient Racteriocida& irreversiby )is bacteria &troube( don-t #ave t#is "or every type o" bacteria 11. :#y are gram negative ces more diTcut to )i wit# antibiotics and disin"ectants$ &gram negative is resistant because o" toug# doube ayer outer membrane 17. :#at e!ect does eac# o" t#e "oowing virulence factors #ave on an in"ected #ost$ Iiruence "actor( ma)es organism pat#ogenic %ataase& produced by a types o" stap# &brea)s down #ydrogen peroxide into water and oygen %oaguase& produce by S. 3ureus &causes ;brin to deposit around stap# ces &prevents p#agocytosis &encourages ;brin to "orm around bacteria so p#agocytosis engu"s organism &coaguates bood pasma Hyauronidase& digests intraceuar UgueV o" connective tissue t#at #ods ce toget#er &acts as Uspreading "actorV &digests %0 o" t#e #ost Strepto)inase& bacteria )inase t#at dissoves ;brin cots and expedites t#e invasion o" damaged tissues &used to treat pumonary emboi and coronary t#rombosis eryt#rogenic toxin& a )ey toxin t#e deveopment o" scaret "ever* a)a t#e pyrogenic toxin* responsibe "or t#e brig#t red ras#* induces "ever by acting on t#e temperature reguatory center enterotoxin& exotoxins t#at act on gut C"ood poisoningD ¬ destroyed by #eat or gut en2ymes &induce nausea* vomiting* and diarr#ea Exo"oiative toxin& produce by S. 3ureus &removes s<uamous ces &cause tetanus wit# newborns w#o are paced in mud bat# a"ter birt# &causes des<uamation o" s)in in stap# scaed syndrome because toxin become ose and spread t#roug#out s)in toxic s#oc) syndrome& produced by S. 3ureus &causes symptoms o" 0SS, #ig# "ever* %I probems Geniciinase& inactivated peniciin* rendering t#e bacterium resistant Streptococca deo2yribonucease &depoymeri2es .N3
13. :#at environment is "avored by eac# o" t#e "oowing$ 3erobic bacteria* anaerobic bacteria* "acutative bacteria* microaerop#iic bacteria. 3erobic( most are t#is 0#ey i)e 07 3naerobic( % de;cie* or %ostridium OM9 N7 % de;cie is can be on t#e s)in i" peope don-t was# #ands a"ter bat#room and t#ere is ess 07 t#ere due to puncture 4icroaerop#iic C%ampyobacterD Not reay a "an o" 07* doesn-t mind it t#oug# 4ost common cause o" "ood borne iness ex. %#ic)en =acutative anaerobe 0oerates a itte 07 ma)es 30G by aerobic respiration i" oxygen is present but is aso capabe o" switc#ing to "ermentation. 18. :#ic# areas o" t#e body are normay "ree o" microorganisms$ &3 interna tissues and organs C#eart and circuatory system* iver* )idneys and badder* ungs* brain and spina cord* musces* bones* ovaries and testes* gands pancreas* saivary* t#yroid* sinuses* midde and inner ear* interna eyeD. &3 6uids wit#in an organ or tissue Cbood* urine in )idneys5uterus5badder* cerebrospina 6uid* saiva prior to entering t#e ora cavity* semen prior to entering t#e uret#ra* amniotic 6uid surrounding t#e embryo and "etusD. 1M. .e;ne t#e "oowing terms( =omite& bacteria contaminate inanimate ob+ect &indirect "orm o" in"ectious disease &assoc w. #ospita ac<uired in"ection b5c stet#oscope* nec)ties etc &stap#yococcus bioogica vector& tic)* mos<uito & deveops an in"ected organism in its body and passes it aong to its #ost & #arbor pat#ogens wit#in t#eir bodies and deiver pat#ogens to new #osts in an active manner* usuay a bite &direct "orm o" in"ectous disease &west nie virus* maaria* yme disease dropet nuceus& microscopic peets o" mucus5saiva e+ected "rom mout# and nose & remain suspended in t#e air "or severa #ours* depending on t#e environment & generated during ta)ing* coug#ing and snee2ing &cods* c#ic)en pox &direct "orm o" in"ectous disease Joonosis& contact wit# animas or anima products Endogenous( norma 6ora an advantage over ot#er 6ora &good guys &costridium diTcie spread in >0% &viridans streptococci "oowing toot# surgery 1K. .escribe #ow wounds s#oud be cutured. &irrigate wound wit# norma saine?not antiseptic soution &absorb excess saine w. sterie gau2e to remove exudates tropica antiseptics @do not put antibiotic on wound be"ore it is cutured* need to numb t#e area &cuture viabe tissue not dead &need granuation C#eaingD tissue because coagen ric# .. granuation is a good sign o" body rebuiding a"ter in+ury &0a)e a cuture w#en t#e amount5consistency5odor o" wound drainage occurs* w#en t#e patient is about to be disc#arged* and w#en a newy trans"erred patient-s wound is draining. ()T *+ &3spiration %uture &prep site w. aco#o &use 3m syringe* 77 gauge neede* ta)e 1 m 6uid &0issue Riopsy Csurgery* burn woundsD damages tissue ¬ good idea* tissue trying to #ea @@pressure ucer aso <uestionabe, organism vary as esion #eas &pressure ucer preventabe i" nouris#ed w. protein* use o" air bed* move patient care"uy* prevention is SEH &Swab cuture &diTcut to obtain wit#out contaminating specimen &prepac)aged sterie cuture tube .. use 7 cacium aginate t#e swab &i" es)ar C#ardened tissueD present* need to debride and remove es)ar to #ep #ea &avoid touc#ing swab to intact s)in at wound edges &send to ab w.in 1&7 #ours max &in"o ab needs &date time specimen coected &anatomica site* source &type o" specimen &p#armocot#erapy &exam re<uested &diagnosis 1L. :#at is t#e signi;cance o" ;nding s<uamous epit#eia ces in a ab specimen ta)en "or a bacteria cuture$ Epi ces signi"y a bad cuture 0#e specimen #as been contaminated wit# s)in >/BSH SGE%I4EN &coud be due to ta)ing a cuture "rom t#e side o" t#e wound and N/0 t#e midde Cw#ere it s#oud be ta)enD @@i" neutrop#is appear on t#e cuture* t#at is goodWW It Is a good cuture and t#e specimen is N/0 contaminatedW
1O. %ompare and contrast t#e time o" onset and symptoms o" "ood poisoning5"ood in"ection caused by( Clostridium perfringens -toxins t#at #ep spread in"ection -exotoxins produce "ood poisoning in 'I exposure %inica .iseases &'as gangrene( organisms enter wound* grow and produces gas 7 types( 1.3naerobic ceuitis& in"ections remain >/%3>IJE. in damage necrotic 0issue 7.4yonecrosis& toxins di!use into NE3XRH necrotic tissue &causes deat# in musce tissue* more widespread &%repitation( gas in tissue* ma)es sounds o" bubbing &"ou smeing disc#arge* bac)ened necrotic tissue gets in between musce ;bers and reeases exotoxin* destroying tissue &=//. G/SI/NIN'W 0ime o" onset( & incubation is K&1O #ours %ause o" "ood poisoning( &&enterotoxin Cguts o" animas used in meat productsD &most common cause o" "ood poisoning &common w. meats and c#ic)en Symptoms: &diarr#ea& usuay se" imiting deat# is extremey rare Treatment: -debridement( remoca o" necrotic tissue to expose o7 &peniciin or cep#aosporin &maggots &#yperbaric oxygen( c#amber bubbe oxygen Staphylococcus aureus 0ime o" onset( &wit# time and temp* 3ureus grows and reeases toxin &toxin ingested 1&K #ours ater &,-- hour time frame is crucial &ecause it distinguishes this from other &acteria, which have s%mptoms , hours later %ause o" "ood poisoning( &"ood preparer touc#es "ace t#en "ood .. s)in to s)in contact &It is very resistant to antibiotics and is "re<uenty caed mXS3 &Bsuay occurs wit# "ood poisoning Cdue to enterotoxinsD &wit# eapsed time and room temp* s. aureus grows* reeasing toxins Symptoms o" "ood poisoning( &vomitting* nausea "oowed by diarr#ea &Exampes( egg saad* crYme ;ings* ime pie raw "ood BotulismClostridium Botulinum &organism "rom soi gets into wound* ma)es toxin &in"ant can ingest spores in "ood i)e raw #oney t#at #as a #ig#er pH o" neonata stomac# aowing germination and production o" toxin /t#er types o" Rotuism( :ound( organism "rom soi gets into wound* ma)es toxin In"ant( ingestion o" spores in "ood Craw #oneyD #ig#er pH o" neonata stomac# aows germination w#ic# is production o" toxins %aused by(- &binds to presynaptic membrane* prevents 3c# reease &most potent microbia toxin )nown &#eat iabe &ingest "ood contain toxin Ccanned "ood w. #ig# pHD and toxin created .accid paral%sis &most cases #ome coo)ed green beans* corn* meat and ;s# &common cause o" deat# in ivestoc) and a<uatic birds Symptoms( &begins 17&L7 #ours &doube viion &cant swaow* dry mout#* cant ta) &respiratory paraysis &deat# 109 0reatment5Grevention &give botuism antitoxin immediatey &biggest t#reat is #ome canned "ood &avoid cans w. buges5ea)s &toxins is #eat iabe at 100 % and coo)ing "or 1M min New uses o" botuinism( &botox &spasmodic toricois( spasm in nec), se<ue o" pneuomonia &#yper#idrosis?xs sweing o" pam in peope wit# Gar)inson &spastic musce pain &masseter musce to decrease si2e o" ower +aw Ci" top teet# do not go over ower teet#D 1Q. :#ic# organismCsD can cause endocarditis "oowing denta wor) in individuas wit# prost#etic #eart vaves or a #istory o" r#eumatic "ever$ /!R!0AN( (T)+TOCOCC! In"ections &principa cause o" endocarditis on abnorma #eart vaves &w#en teet# are being veaned* organism goes into bood stream and increase ris) o" #eart attac) due to bad bacteria "rom gum 0reatment5Grevention &prop#yaxs o" certain patients w. abnorma #eart vaves &treat endocarditis w. peniciin and aminogycoside @@i" piercing issue and e!ect s)in* it is S03GH 3BXEBS Cdepends on porta o" entry
70. :#at is t#e most i)ey cause CorganismD o" diarr#ea in a patient w#o #as been on ong&term C1 mont#D antibiotic t#erapy$ 'ive exampes o" antibiotics t#at can cause t#is. @@broad spectrum antibiotic or narrow spectrum "or proonged times c. di;cie too muc# antibiotic use SI>>S 0HE '//. =>/X3WW 0reatment( S0/G antibiotics 3S3GWW 'ive metronida2oe C=agyD and t#en Iancomycin to avoid IXE Cstrains o" E. t#at are resistantD 71. :#at patient c#aracteristics pace t#em at ris) "or deveoping met#iciin resistant Stap#yococcus aureus and vancomycin resistant enterococcus$ 1R(A &mutipe antibiotic treatment &broad spectrum agents narrow spectrum &proonged antibiotic treatment &poor nutrition status &M09 o" cooni2ed pts deveop "unction &trauma* burns* aged* immunocompromised &now can be community ac<uired &bacteria deveops into in"ectionWWW @#eat# person #ave 4XS3 in wound* cean and body wi get rid o" it on own.. not more pat#ogenic, +ust I= gets into body* #eart to ;g#t wit# antibiotic &IXXI'30I/N is most important "or any type o" wound Iancomy resistant enterococus &transmitted between patient5sta! via 77. :#at is t#e target organ t#at is damaged by eac# o" t#e "oowing costridia species( C. botulinum, C. difcile, C. tetani, C. perfringens. -food poisoning in GI tract C di2cile 0arget organ( t#e coon Carge intestineDWW .iagnoses( &detect toxin in stoo &%auses boody diarr#ea and in6ammation o" coon 0reat( &stop antibiotics* give =agy /d c di!( &broad spectrum antibiotic )i norma 6ora aow t#at aow c. di;ci to grow & vancomyocin is now second c#oice o" drug to avoid IXE New c di!( & can contract in >0% because o" "ood borne spores &70x more toxic &give probiotic Cnorma 6oraD w#ic# contains carbs t#at reduce c. di;ci %. tetani 0arget organ( in#ibitory neurons in t#e spina coumn %aused by( &toxin tetanospasmin &in#ibits post synaptic spina neurons* boc)s reease o" in#ibitory mediator o" musce spasms %inica disease &wound puncture burns in"ected wit# spores* organisms ma)es toxin t#at permanenty binds to neurons &most cases are edery or II drug abusers &esser deveoped nations?700*000 in"ants die5yr "rom in"ected uumbiicus stump or circumcision &mudW Symptoms( &incubation 8&M days to many wee)s &convusive contractions o" vountary musces &+aw musces oc) &tetonic sei2ures 0reatment &peniciin wi #ep stop toxin production &tetanus vaccine &booster every 10 yrs Anthrax3'acillis anthracis %#aracteristics( &primariy disease o" animas* #umans rarey a!ected &spores enter via in+ured s)in or mucosa %aused by( &in#aation o" woo sorters disease #emorr#agic pneumonia &ant#rax toxin &agent o" bioogica war"are Specimens( &6uids* pus "rom esions* sputum* bood Symptoms( &necrotic ucer w. edema Cdeat# o" tissues i" e!ected in #umansD 0reatment5 %ontro &treat w. peniciin* tetracycine* cipro6oxacin &prevent by vaccinating* dispose o" anima carcass propery &vaccine is a puri;ed toxoid &K inocuations over 1.M yrs &side e!ects$ &gas #ides* #air* bone products wit# E0/ to )i SG/XES 73. :#ic# organism is t#e most common bacteria cause o" community&ac<uired Ci.e. ac<uired outside t#e #ospitaD pneumonia$ How can it be prevented$ Streptococcus (S.) pneumoniae Caso caed pneumococcusD - 'ram&positive bacterium causes 70 & K09 o" a community&ac<uired bacteria pneumonia C%3GD in aduts /nset &sudden w. "ever* c#ids and s#arp peura pain &bood or rusted coor sputum CmucousD?due to #emorr#ages &bacteremia occurs in 10&709 o" cases resuts in meningitis* endocarditis or septic art#ritis 3so* otitis and sinusitis Csinus probem or ear in"ectionD @@Streptococcus pneumonia is part o" norma 6ora and most o" us are carriers .iagnostic ab 0ests &specimens( bood* sputum* %S= &gram stain( use"u "or sputum and %S= &<ueing reaction od test &capsue sweing test &capsue swes w#en pneumococcus is mixed w. antibodies speci;c "or its type o" poysacc#aride 0reatment5 Grevention 3ntibiotics &Geniciian Cit is t#e drug o" c#oiceWWD &However* some strains are resistant Ca probem in meningitisD use %ep#treaxon Iaccine &%ontains type speci;c poysacc#arides &3ppropriate "or t#ose in day care* t#ose wit# sic)e ce* t#ose ZK0* debiitated* immunosuppressed @s#oud get vaccinated at age K0* and revaccinated at KM due to E==I%3%H 78. Snow t#e gram stains and s#ape o" eac# organism we discussed in cass. CE.g. a gram& negative dipococcus is Neisseria.D a gram N appear bue Ct#ey absorb t#e dyeD pos stap#& cocci strep& cocci costridium& bacii* protective spore baciis& rod s#aped a gram appear red Cdo not absorb t#e dyeD neg e.coi& rod s#aped* "ound in ower intestine Spiroc#etes& spira&s#aped & causes syp#iis* yme disease Neisseria& cocci & causes meningococcus* gonorr#ea 7M. :#at is t#e mec#anism o" post&streptococca acute gomeruonep#ritis$ &body produces antibody to antigen in bacteria?doesn-t )now di!erent o" antigen in body and #eart &deveop 3 wee)s a"ter untreated in"ection &causes )idneys to s#ut down because body attac)s se" and )idneys wit# antibodies against bacteria but antibodies aso attac) antigens on #eart Cantigen antibody reaction against one own antigen* body proteinsD Causes &an in"ection wit# a type o" streptococcus bacteria &does not occur in t#e )idneys* but in a di!erent part o" t#e body* suc# as t#e s)in or t#roat. &causes t#e tiny bood vesses in t#e ;tering units o" t#e )idneys CgomeruiD to become in6amed )idneys ess abe to ;ter t#e urine. &uncommon today because in"ections t#at can ead to t#e disorder are commony treated wit# antibiotic &deveop 1 & 7 wee)s a"ter an untreated t#roat in"ection* or 3 & 8 wee)s a"ter a s)in in"ection. &most o"ten occurs in c#idren ages K & 10 Xis) "actors incude( strep t#roat and s)in in"ections suc# as impetigo &impetigo, oca in"ection o" super;cia s)in ayers* #ig#y communicabe &wounded s)ins5burns resut in widespread in"ection t#at may progress to ceuitis
7K. >ist 3 organisms t#at can cause nosocomia in"ections in #ospitai2ed patients. Expain #ow eac# is ac<uired. I" transmission is possibe* #ow can transmission be prevented$ &Nosocomia in"ections are primariy caused by opportunists .. H/SGI03> 3%QBIXE. i. Enterterococci &0ransmitted between patients 5 sta! via #ands &0reatment( &can be compicated because o" resistance to cep#aosproins* peniciins and amnigycosides &must treat severe in"ections w. vacomycin pus an aminogycoside &now #ave vancomycin resistant entercocci IXE.. ive up to 11 days, not )iedby vancomyocin &use vancomycin "or %.diTcie ony w#en =agy doesn-t wor) &need mut. 3ntibiotics i" organism is transient ii. Stap#yococcus epidermidis 0 &ac<uired "rom s#unts and cat#eters 1 &causes endocarditis and B0I 7 iii. Stap#yococcus saprop#yticus &7nd most common cause B0I in sexuay active young women 0 0 b. [0#e sites o" nosocomia in"ctions* in order "rom most to east common* are as "oows( i. urinary tract ii. surgica wounds iii. respiratory tract iv. s)in Cespeciay burnsD v. bood CbacteremiaD vi. gastrointestina tract vii. centra nervous system c. Susceptibiity &t#ey dispay bro)en s)in or mucous membranes CwoundsD. &immunodepression, ess abe to ;g#t o! in"ections once ac<uired.
7L. >ist 8 diseases caused by spore "orming bacteria. :#at are t#e symptoms o" eac#$ 7O. :#at woud you expect to see in a uret#ra smear t#at is positive "or Neisseria gonorr#ea$ &smears o" uret#ra5endocervica exudates w. many gonoccadipococci w.in neutrop#is? presumptive diagnosis &smears "rom con+unctiva can aso be diagnostic 4en are Q09 sensitive* QQ9 speci;c &QQ9 speci;c means t#at 19 o" t#e time t#ere is a "ase positive &Q09 sensitive means t#at 109 o" t#e time it is "ase negative.. #ave it an you don-t )now :omen are endocervica and are M09 sensitive and QM9 speci;c 7Q. :#o s#oud be given a Streptococcus pneumoniae vaccine$ @@day care )ids* t#ose wit# sic)e ce anemia* anyone over t#e age o" K0* debiitated* immunosuppressed &t#ose wit# compromised respiratory tract* ot#er in"ections* excess mucus CaergiesD* obstruction* smo)ing &t#ose wit# aco#o* drug intoxication because #ave bad ungs &t#ose wit# abnorma circuatory dynamics Cpumonary congestion* #eart "aiureD &t#ose wit# manutrition* genera disabiity* and #ypospenism &t#ose on GGI #ave ess acid* so increase ris) "or step.. i" acid is gone t#en more i)ey to aspirate GGI into ungs 30. :#y are peope over age MM ess susceptibe to streptococca toxic s#oc) syndrome$ @reated to strain o" strep pyogene causes scaret "ever and peope deveop immunity to it earier in i"e &peope w#o #aven-t #ad scaetina strain o" strep t#roat &steptococca toxic s#oc) syndrome causes s#oc)* bateremia* respiratory "aiure* and muti organ "aiure &deat# in 309 31. :#at are t#e symptoms o" meningitis$ @Hig# "ever @Severe #eadac#e t#at isn\t easiy con"used wit# ot#er types o" #eadac#e @Sti! nec)cant touc# c#in to nec) Iomiting or nausea wit# #eadac#e %on"usion or diTcuty concentrating ? in t#e very young* t#is may appear as inabiity to 0maintain eye contact Sei2ures Seepiness or diTcuty wa)ing up Sensitivity to ig#t >ac) o" interest in drin)ing and eating S)in ras# in some cases* suc# as in vira or meningococca meningitis 37. :#at "actors increase t#e ris) o" deveoping bacteria meningitis$ &rare w. peope over M0 &peope not immuni2ed &drin) and smo)e #eaviy &"re<uent bars and s#are drin)s &#ead trauma( micro"ractures in bood brain area &repeated #ead butting @very rare, usua outbrea)s but recenty ony "ew individuas a!ected in poc)ets o" t#e word &In"ants are at #ig#er ris) "or bacteria meningitis &spread more <uic)y w#ere arger groups o" peope gat#er toget#er. %oege students iving in dormitories and &0raveers to t#e meningitis bet in sub&Sa#aran 3"rica and 4ecca may be at ris) "or meningococca meningitis* particuary during t#e dry season 33. :#at #ospita items may be reservoirs "or mutipe drug resistant stap#. aureus C4.XS3D and IXE$ & Since s. aureus is "rom s)in to s)in or contact to contact* it can be easiy transmitted "rom carrier to receiver t#roug# open S/XES /X %B0S &it is "ound on sur"aces wit#in #ospita settings* incuding sin)s* trays* towes* bedding inens * and privacy curtains &O09 o" stet#oscope aow stap# to grow @t#is usuay occurs w#en a visitor or patient #andes a contaminated sur"ace and spreads it to anot#er person &it is aso "ound in t#e #ospita air @@IXE ony ive 11 days 38. :#at are t#e eary symptoms o" necroti2ing "asciitis arising "rom a wound in"ected wit# Streptococcus pyogenes$ & Necroti2ing "asciitis a)a 6es# eating bacteria to S/=0 SSIN &G3IN out o" proportion to wound 3M. How can wounds be treated to reduce t#e ris) o" deveoping necroti2ing "asciitis$ &irrigation &Hydrogen Geroxide?wi )i strep Cnot Stap#D because no cataase to brea) it down &#owever* H707 impairs ;brobast abiity to repair wound i" too muc# 3K. :#at are t#e symptoms o" in"ections "rom Stapylococcus aureus! &>ocai2ed in"ections &pimpe* "oicuitis can go into bood and cause endocarditis &suppuration Cpus "ormD by drawing in :R% &abcess #eaed w. bood 6ow and #eat &Spread o" organism "rom ocai2ed site &Endocarditis( o"ten II drug users #ave organism trave t#roug# bood and w#en custers o" bacteria on #eart vaves become in"ected* trave to brain and cause stro)e &/steomyeitis( treatabe, need II drug &Gneumonia &:ounds in"ections* osteomyeitis &=ood Goisoning &0SS &common in women using tampons* ot#ers wit# wound in"ections &"ever* #ypotension* mut. System "aiure C)id* iver* ungs* #eart* brainD 3L. 0#e %.% estimates t#at KM9 o" c#ronic in"ections are due to bio;ms. :#ere do bio;ms occur and #ow do bio;ms contribute to c#ronic wound in"ections in oder aduts$ Rio;m& resut w#en organisms attac# to a substrate by some "orm o" extraceuar matrix t#at binds t#em toget#er in compex organi2ed ayers
&"avor microbia persistence in #abitates &on arti;cia imbsWWWWW