Bacterial Disease - Staphylococcus and Clostridium

positive; coccus; clusters

Staphylococcus aureus is a gram positive/negative _______________ (shape) found in _________________ (arrangement)

Methicillin-resistant Staphylococcus aureus (MRSA)

Type of antibiotic resistant Staphylococcus aureus

Skin and soft tissue infections, osteomyelitis, bacteremia, and meningitis

What are common infections with Staphylococcus aureus?

toxins

Staphylococcus aureus can also cause disease from...

localized erythema with induration and purulent drainage

Staphylococcus aureus skin/soft tissue infections cause (generally)...

Folliculitis, furuncles, and carbuncles

What are some common presentations of Staphyloccous aureus skin/soft tissue infections?

Folliculitis

Infection around one or more hair follicles typically caused by Staph aureus

Furuncle

Localized folliculitis (boils) caused by staphylococcus aureus

Carbuncle

Spread of folliculitis to adjacent skin and deep subcutaneous tissue often caused by Staph aureus

Osteomyelitis

Infection and inflammation of bone or bone marrow often caused by Staph aureus

60%

Staph aureus is responsible for __________ of cases of osteomyelitis

toxic shock syndrome

Staph aureus in adults is known to cause _______________ and is classically associated with tampon use

food poisoning

Enterotoxins of Staph aureus can cause _______________

fast

Does enterotoxin food poisoning from Staph aureus typically have a fast or slow onset?

Coagulase negative Staph

What kind of Staphylococci normally inhabit the skin?

infection; contamination

With coagulase negative staph, it is difficult to distinguish ______________ from _______________

Foreign body or intravascular device in place

A coagulase negative staphylococcus infection is more likely if...

Artificial joints or indwelling IV catheters

What are some foreign bodies or devices that can become infected with coagulase negative Staph aureus?

Removal of infected device and IV antibiotic

What is the typical treatment for coagulase negative Staph aureus infections?

positive rod

Clostridium is a gram positive/negative ___________ (shape)

obligate anaerobe; endospores

Clostridium is a(n) ________________ capable of producing ______________

Clostridium perfringens, Clostridium tetani, Clostridium botulinum, Clostridium sordellii, and Clostridium difficile

What 5 main types of Clostridium cause disease?

Clostridium perfringens

What clostridium species is the main cause of gas gangrene?

Clostridium tetani

What clostridium species causes tetanus?

Clostridium botulinum

What clostridium species is the main cause of botulism?

foods/wounds

Clostridium botulinum produces its toxin in...

Endometritis and toxic shock syndrome after childbirth or medical abortion

What can Clostridium sordellii cause?

Following death of normal microbiota during antibiotic therapy

When does Clostridium difficile flourish?

Pseudomembranous colitis

What can Clostridium difficile lead to?

Antibiotic-associated diarrhea

What is pseudomembranous colitis from Clostridium difficile a cause of?

Clostridium perfringens

What Clostridium most commonly causes clostridial myonecrosis?

toxins; anaerobic

In gas gangrene, ________ are produced in devitalized tissues under _____________ conditions

Anaerobic culture (positive culture = too late to help)

How is Clostridium diagnosed if gas gangrene is occurring?

Foul-smelling brown blood-tinged serous discharge and gas in tissue by palpation or radiograph (late finding)

What are some signs and symptoms of gas gangrene caused by clostridium?

Empiric therapy

If Clostridium gas gangrene is occurring, what treatment do you start immediately?

Tetanospasmin

What neurotoxin is secreted by Clostridium tetani to cause tetanus?

Neurotransmission at spinal synapses of inhibitory neurons

What does tetanospasmin interfere with?

Uncontrolled spasms and exaggerated reflexes

What does tetanospasmin cause?

Generalized disease, localized disease, and cephalic disease

What are some signs and symptoms of tetanus?

Jaw/neck stiffness, hyperreflexia, and painful tonic convulsions

What are some common generalized disease symptoms of tetanus?

Rigidity/stiffness in an extremity

What is a common localized disease symptom of tetanus?

Single or multiple cranial nerve palsies

What is a common cephalic disease symptom of tetanus?

Childhood

When is active immunization for Clostridium tetani recommended?

DTaP

Active immunization for tetanus approved for children under the age of 7

Tdap

Active immunization approved for adolescents above the age of 11 and for adults

Diphtheria and pertussis vaccines

Tdap has a reduced dosage of what?

4-6

People typically get 5 doses of DTap by age...

11-12 y/o, pregnancy, every 10 years, or if major burns/open fractures

When are Tdap boosters administered?

spore; dormant

Clostridium botulinum is __________ forming and can remain _____________ for long periods of time

Block release of acetylcholine at neuromuscular junction

What does botulinum toxin do?

soil; food

Clostridium botulinum is typically found in ________ and is inadvertently packed into ______________, where its toxin is produced and stored until ingested

home canned foods

Clostridium botulinum often is found in...

Food-borne and wound via IV drug use

What is the etiology of clostridium botulinum?

Visual changes 12-36 hours, cranial nerve palsies, dysphonia, dry mouth, and respiratory paralysis

What are neurologic signs and symptoms of clostridium botulinum?

Inoculation into mouse and ID with antiserum or a toxin assay

How is a clostridium botulinum infection diagnosed?

Antitoxin from CDC, respiratory support, and nutritional support

What is the treatment for clostridium botulinum?

Honey

What substance may contain Clostridium botulinum and if ingested by babies younger than 1 y/o, can lead to an infection due to a lack of microbiota that can outcompete the pathogen?

Cosmetically paralyze facial muscles to reduce signs of aging and certain eye diseases

What are therapeutic uses of Botox?