03 - Gram (+) Spore Forming Bacteria

F - Gram (+)
T
F - Centrally located spores
F - Non-motile
T

MTF: Bacillus Morphology

1.) Gram-negative
2.) Chains
3.) Peripherally Located Spores
4.) Motile
5.) Mostly Aerobic

Bacillus anthracis

Which specific Bacillus species has a cut glass/ground glass appearance?

Inverted fir tree appearance

Describe the appearance of bacillus species on gelatin stabs

T

T/F: Bacillus anthracis is a zoonotic disease

F

T/F: Bacillus anthracis without a capsule can still be considered virulent

Protective Antigen

This Bacillus anthracis toxin allows the entry of other toxins into the cell

Edema factor and toxin

This toxin is responsible for causing cell and tissue edema

Lethal factor and toxin

This is the major virulence factor of Bacillus anthracis that causes death in infected animals and humans

Cutaneous and Inhalation

2 ways of entry of Bacillus anthracis

Blood and Lymph nodes

2 ways of multi-organ dissemination of Bacillus anthracis

T

T/F: Woolsorter’s disease is transmitted via inhalation

Injectional Anthrax

This transmission of B. anthracis has a notable absence of central black eschar

T

T/F: When B. anthracis enter resistant animals, their capsules disintegrate and they remain localized

Pruritic Papule

This is a <1cm elevated lesion that develops 1-7 days after entry of B. anthracis

F; Develops later compared to pruritic papules

T/F: A malignant pustule can be differentiated from a pruritic papule by it’s characteristic central black eschar, greater diameter, and earlier development

6 weeks

Incubation period of inhalational anthrax

Pus, Blood, Sputum

Specimen used for B. anthracis diagnosis

T

T/F: B. anthracis on BAP will show hemolysis

Raxibacumab

This is used as treatment and prophylaxis against inhalational anthrax

Ciprofloxacin, Pen G + Gentamicin/Streptomycin, Doxycycline

Treatment for anthrax

B. cereus

This Bacillus species is commonly associated with food poisoning

Emetic Type

This type of B. cereus infection presents with vomiting after 1-5 hours and is commonly associated with fried rice

Diarrheal type

This type of B. cereus infection presents with loose stools after 24 hours and is commonly associated with meat dishes and sauces

T

T/F: Both type of B. cereus infection are self-limiting

F

T/F: Presence of B. cereus in stool is sufficient evidence for diagnosis

10⁵

Concentration of how much bacteria in stool is considered diagnostic of B. cereus infection

Vancomycin, Clindamycin, or Aminoglycoside

Treatment of B. cereus in serious or systemic infections

Ciprofloxacin

Treatment for B. cereus wound infection

F; Obligate anaerobes
T
T
F; Motile

MTF: Characteristics of Clostridium species

1.) Obligate aerobes
2.) Gram (+) Bacilli
3.) Form endospores C
4.) Non-Motile

Soil, Dust, and Feces

Source of C. tetani

Deep puncture wound

Most common portal of entry for C. tetani

F; Those with poor blood supply

T/F: C. tetani favors growth in organs with dual blood supply

Tetanospasmin

Main exotoxin that delivers the pathogenic effects of C. tetani

Synaptobrevin

Main degradation target of tetanospasmin

GABA and Glycine

Main NTs inhibited by C. tetani

T

T/F: C. tetani is characterized by spastic paralysis while C. botulinum is characterized by flaccid paralysis

T

T/F: Infection of C. tetani remains localized in the area of devitalized tissue

Risus sardonicus, Lockjaw, Opisthotonis

3 major clinical findings in C. tetani infection

Strychnine poisoning

Primary differential diagnosis for C. tetani infection

Tetanus Ig, Benzodiazepines, Metronidazole/Pen-G-Na

Treatment for tetanus infection

6, 10, and 14 weeks

When is the Tdap vaccine given according to the childhood immunization schedule

1.5 years

When is the 1st Tdap booster given according to the childhood immunization schedule

4-6 yrs old

When is the 2nd Tdap booster given according to the childhood immunization schedule

C. botulinum

This clostridium species is closely associated with canned and vacuum-packed foods w/o adequate sterilization

T

T/F: The botulinum toxin is heat-labile

A, B, and E

These types of the botulinum toxin is the most common in human illnesses

Synaptobrevin, SNAP 25, Syntaxin

Target of degradation of Botulinum toxin

ACh

Main NT affected in C. botulinum infection

Floppy baby syndrome and SIDS

This is the most common clinical finding in infant botulism

Honey

Infantile botulism is most commonly associated with what food?

Trivalent antitoxin and Ventilatory Support

Treatment of botulinum infection

C. perfringens

This Clostridium species is most commonly associated with gas gangrene and anaerobic cellulitis

T

T/F: Vegetative C. perfringens cells are normal members of the flora of the colon and vagina

Phospholipase C or Lecithinase

This is the most toxic extracellular enzyme of C. perfringens and is essential for virulence in gas gangrene

Phospholipase C or Lecithinase

C. perfringens toxin responsible for blockage of G-CSF mediated granulopoiesis

Small Intestine

What organ does the C. perfringens enterotoxin act on?

Claudin

C. perfringens enterotoxin binds to what and causes cell death?

F; High Dose = Oncosis while Low Dose = Apoptosis

T/F: High dose of CPE will cause apoptosis while Low dose will cause oncosis

DNAse

This C. perfringens enzyme degrades viscous DNA and helps with spread of infection

Hyaluronidase

This C. perfringens enzyme disrupts the ground substance and helps with spread of infection

Double zone of hemolysis

Special characteristic of C. perfringens found on BAP

Positive Lecithinase activity seen by precipitate around colonies on egg yolk media

Describe the results seen in nagler reaction in patients with C. perfringens

Surgical debridement and Penicillin

Treatment of C. perfringens

F; Large Intestine

T/F: C. difficile is a major component of the normal flora of the small intestine

Clindamycin

Most commonly implicated antibiotics causing C. difficile infection

Enterotoxin

This C. difficile toxin causes excessive fluid secretion

Cytotoxin

This C. difficile toxin causes disintegration of cytoskeleton

Raised adherent yellow plaques

Characteristic finding seen in colonic imaging

Anaerobic Stool Culture

Main diagnostic tool for C. difficile

Large, flat colonies with a barnyard smell

Explain the results seen in BAP in patients infected with C. difficile

Yellow and Ground glass-like with a filamentous edge

Explain the results seen in CCFA in patients infected with C. difficile

Oral metronidazole or Vancomycin or Fecal Transplantation

Treatment of C. difficile