patho exam 4 - new stuff

gram stain/morphology of Pasteurella

G- coccobacillus

characteristics of Pasteurella

facultative anaerobe, nonmotile, oxidase (+), catalase (+), nitrate (+), mucoid capsule, fermentative

species of Pasteurella

P. multocida

where found and transmission of P. multocida

normal flora of respiratory tract in animals

bite or scratch from infected animal

disease caused by P. multocida

wound infections, arthritis and osteomyelitis (rare)

virulence factors of P. multocida

mucoid capsule, multocida toxin

multocida toxin

affects signal transduction in host cell

treatment for P. multocida

penicillin

gram stain and morphology of Brucella

G-, single coccobacilli

characteristics of Brucella

nonmotile, strict aerobe, nonencapsulated, oxidase(+), catalase(+), facultative intracellular, grow on chocolate agar with added thiamine

requirement of Brucella

thiamine

species of Brucella

B. abortus, B. melitensis, B. suis, B. canis

transmission of Brucella

contact with infected material (infected calves), laboratory associated infection

disease and symptoms caused by Brucella

undulant fever (brucellosis)

irregular fever

virulence factors of Brucella

type iv secretion system, LPS, BvrR/BvrS, iron acquisition proteins

BvrR/BvrS

regulates expression of virulence factors in Brucella sp.

treatment for Brucella

gentamicin, streptomycin, doxycycline

gram stain and morphology of Francisella

G- single coccobacilli

characteristics of Francisella

obligate aerobe, oxidase (-), catalase (-), facultative intracellular, nonmotile

growth media for Francisella

glucose-cystine blood agar or choc

growth requirement of Francisella

cystine

species of Francisella

F. tularensis

disease and symptoms of F. tularensis

Tularemia

fever, chills, headache, malaise, swollen glands

symptoms of pneumonic Tuleremia

atypical pneumonia cough, fever, chest pain

transmission of F. tularensis

tick bite, handle/ingest infected material, inhalation

VFs of F. tularensis

type IV pili, Fsap outer membrane proteins, iron acquisition proteins, AcpA acid phosphatase

Fsap outer membrane proteins

adherence

AcpA acid phosphatase

phagosome survival

treatment of tularemia

streptomycin, gentamicin

vaccine for tularemia

LVS vaccine: reserved for military or occupations that handle organism, not known if effective for aerosol form

gram stain and morphology of Vibrio

G- straight/curved rods

characteristics of Vibrio

polar flagellum, facultative anaerobe, indole (+), oxidase (+), nitrite (+), most halophilic, found in ocean, ferment glucose

special media for Vibrio

Thiosulfate Citrate Bile Salts Sucrose (TCBS)

bile salts inhibit G+

bromthymol blue as indicator of sucrose fermentation

species of Vibrio

V. cholerae, V. parahaemolyticus, V. alginolyticus, V. vulnificus

characteristics of V. cholerae

can grow without added salt, grows in regions at interface of saltwater and freshwater

3 groupings of V. cholerae

O1 serotype, O139 Bengal serotype, non-O1/non-O139 serotype

what is the grouping of V. cholerae based on

O antigen

division of O1 serotype of V. cholerae

cholerae and El Tor

how determine O1 serotype of V. cholerae

slide agglutination

ID scheme for V. cholerae

watery diarrheal sample, plate on TCBS, look for growth and fermentation, serogroup by PCR

disease caused by V. cholerae

Asiatic Cholera

transmission and symptoms of Asiatic Cholera

fecal contamination

profuse watery diarrhea, vomiting, rapid dehydration and loss of electrolytes, extreme water loss

VFs of V. cholerae

cholera toxin, toxin co-regulated pilus (Tcp), accessory colonization factor, hemagglutinin/protease, flagella, neuraminidase, zona occuldens toxin (Zot), Accessory cholera enterotoxin (Ace)

cholera toxin

AB toxin, increase of cAMP causes fluid loss

toxin co-regulated pilus (Tcp)

binding

zona occuldens toxin (Zot)

opens tight junctions

accessory cholera enterotoxin (Ace)

contributes to diarrhea

treatment of Asiatic cholera

oral rehydration or IV rehydration with glucose-salts

doxycycline

vaccine for cholera

Vaxchora: recommended for endemic areas

characteristics of V. parahaemolyticus, V. alginolyticus, V. vulnificus

marine halophiles, need 1-3% salt to grow

transmission of V. parahaemolyticus, V. alginolyticus, V. vulnificus

ingestion of undercooked or raw seafood, contact with contaminated water

TSI rxn for V. parahaemolyticus

K/A

TSI rxn for V. alginolyticus

A/A

TSI rxn for V. vulnificus

A/A

test for V. parahaemolyticus

Kanagawa test: test for lysis of RBCs (V. p. (+))

V. parahaemolyticus disease

diarrhea

V. alginolyticus diseases

gastroenteritis, blood, wound infections

V. vulnificus diseases

gastroenteritis, blood, cellulitis, wound infections

V. parahaemolyticus VFs

hemolysin, pili, hemagglutinins, flagella

V. alginolyticus VFs

protease, flagella

V. vulnificus VFs

capsule, hemolysin, proteases, serum resistance, flagella

treatment for other Vibrio sp.

V. parahaemolyticus: self-limiting

V. alginolyticus and vulnificus: doxycycline

gram stain and morphology of Aeromonas

G- straight rods

characteristics of Aeromonas

motile, aquatic (freshwater), oxidase (+), facultative anaerobe, grows on MAC

species of Aeromonas

A. hydrophila

A. hydrophila diseases

gastroenteritis, wound infections

VFs of A. hydrophila

enterotoxin, cytotoxin

treatment of A. hydrophila

fluoroquinolone

gram stain and morphology of Campylobacter

G- pleomorphic rods

characteristics of Campylobacter

microaerophilic, motile, oxidase (+)

special media for Campylobacter

Campy BAP, Skirrow’s, Butzler’s

components of Campy BAP

vancomycin, trimethoprim, cephalothin

species of Campylobacter

C. jejuni ssp. jejuni, C. fetus ssp. fetus

C. jejuni: nalidixic acid, cephalothin, 42C growth, 25C growth

S, R, (+), (-)

C. fetus: nalidixic acid, cephalothin, 42C growth, 25C growth

R, S, (-), (+)

ID scheme for Campylobacter

stool sample, plate on Campy-BAP, put in microaerophilic conditions, gram stain, wet mount, oxidase, PCR

stool sample, wet mount, darting motility

transmission of Campylobacter

fecal oral route

C. jejuni diseases

bloody diarrhea

C. fetus diseases

blood

VFs of Campylobacter

flagella, CadF and FlpA Adhesions/Invasins, enterotoxin, cytotoxin, CiaI

CiaI

allows intracellular survival

treatment of Campylobacter

azithromycin, cipro

gram stain and morphology of Helicobacter

G- curved or straight rod

characteristics of Helicobacter

microaerophilic, oxidase (+), motile

species of Helicobacer

H. pylori

disease of H. pylori

peptic ulcers, chronic superficial gastritis, lymphoproliferative disease, chronic atrophic gastritis

ID of H. pylori

gastroscopy: culture on CHOC, rapid urease test

breath test: patient given radiolabeled urea → 14CO2

Antigen stool test

Rapid antigen trap test

PCR

lifestyle of H. pylori

stomach survival, damage and inflammation, mucosal destruction

VFs of H. pylori

urease, flagella, adhesions, vacuolating cytotoxin, LPS, heat-shock protein

treatment of H. pylori

omeprazole/ranitidine + amoxicillin + clarithro

gram stain and morphology of Legionella

G- pleomorphic rod

characteristics of Legionella

aerobic, fastidious (Fe and cystine), oxidase (V), catalase (+), motile, facultative intracellular pathogen, normal reservoirs aquatic and soil, can be found in air conditioning cooling towers, and humidifiers

special media for Legionella

BCYE-alpha

buffered charcoal yeast extract with alpha-ketoglutarate

typical specimen for Legionella

sputum

other ID of Legionella

urinary Ag test, IFA, PCR

transmission of Legionella

dust or liquid aerosol

species of Legionella

L. pneumophila, L. micdadei, L. longbeachae

diseases of Legionella

Pontiac Fever, Legionnaire’s disease

symptoms of Pontiac Fever

muscle ache, fever, lasts about a week

symptoms of Legionnaire’s disease

pneumonia