brig Human microbiota and Cardiovascular Disease/Respiratory

why is red meat bad for heart and kidneys

Red meat = carnitane

-> gut bacteria makes TMA

-> TMAO excreted from liver into blood vessels causing plaques

-> TMAO excreted from liver into kidney causes glomerular damage

TMAO bacteria

meat-loving

increase risk of atherosclerosis, HTN, HF, Afib

SCFA bacteria

fiber-loving

decreased risks of TMAO bacteria

cause of pneumococcal pneumonia

Streptococcus pneumoniae

transmission of S. pneumoniae

respiratory secretions

most susceptible population for S. pneumoniae

kids under 5

adults over 65

+diabetes and lung disease

symptoms of S. pneumo infection

cough and congestion

inflammation = chest pain, fever and chills, SOB, fluid in lungs

blood in lungs = rust-colored sputum

Dx of S. pneumo

CXR for pneumonia

Sputum culture (+ rust colored)

pathogenesis of S. pneumoniae

Capsule

Pneumolysin (pores in host cells = death)

Gram stain of S. pneumo

GPC in chains

prevention of S. pneumo

pneumococcal vaccine

-flu vaccine b/c flu and covid inc risk of pneumococcal pneumonia

cause of walking "atypical" pneumonia

Mycoplasma pneumoniae

transmission of M. pneumo

respiratory secretions

at risk population of M. pneumo

teens, YA, military recruits

sx of atypical/walking pneumonia

milder and longer than normal pneumonia - lasts weeks

fever

sore throat

nagging cough

chest soreness from coughing

incubation of pneumococcal vs. atypical/walking pneumonia

atypical/walking: 2 weeks

pneumococcal: 1-3 days

Dx of M. pneumo

Normal WBC

CXR w/o infiltrates

Detection in sputum

Pathogenesis of M. pneumo

-adhesion proteins attach to lung epithelial membranes

-hydrogen peroxide kills host cells

-ciliary inhibition

what causes prolonged cough in walking/atypical pneumonia

ciliary inhibition

ID of M. pneumo

short rod w/ no cell wall - acid fast stain (pleomorphic)

PCR on nose, throat, sputum

smallest living organism

M. pneumoniae

treatment of M. pneumo infection

self-resolution

macrolides like azithro

tetracyclines

Most common cause of HAI pneumonia

Klebsiella pneumoniae

transmission of K. pneumo

medical equipment, doorknobs, countertops

at risk population for K. pneumo

hospitalized + immunocompromised, diabetic, or alcoholic

sx of K. pneumo infection

Thick, bloody sputum due to inflammation and necrosis

normal pneumonia sx

Dx of K. pneumo

CXR for pneumonia

Sputum culture

Pathogenesis of K. pneumo

Capsule

LPS --> septic shock

ID of K. pneumo

GNR

Capsule staining

Sputum/blood culture

treatment of K. pneumo

Cephalosporins

MDR

why is K. pneumo MDR

Beta lactamase

Efflux pumps

disease caused by Chlamydia psittaci

Parrot fever/Psittacosis

Transmission of C. psittaci

aerosolized bird feces

bird bites

what does C. psittaci infect in humans

lung epithelium (+cilia)

macrophages

symptoms of C. psittaci infection

asymptomatic or mild

flu-like

dry non-productive cough

pneumonia

normal WBC count

elevated inflammatory markers

Dx of C. psittaci

h/o bird contact

dry cough

CXR for pneumonia

Chlamydia ab

pathogenesis of C. psittaci

obligate intracellular pathogen

-survive endocytosis

ID of C. psittaci

small intracellular GNC

Inclusion bodies

PCR ID from sputum

Ab detection

treatment of C. psittaci

Tetracyclines

Macrolides like erythro in pregnant women

What disease is caused by Legionella pneumophila

Legionnaire's disease/Pontiac fever

where do you find L. pneumophilia

warm, stagnant water

showers, hot tubs, AC units, drinking water

transmission of L. pneumophilia

inhalation of infected water droplets

-colonizes alveolar macrophages and epithelial cells

NOT PERSON-TO-PERSON

most at risk for L. pneumophilia

elderly

immunocompromised

smokers

Sx of L. pneumophilia infection

flu-like

typical pneumonia w/ non-productive cough

hyponatremia (brain swelling, seizures, death)

Dx of L. pneumophilia

CXR

Sputum culture + PCR

pathogenesis of L. pneumophilia

obligate intracellular pathogen

-survives endocytosis

ID of L. pneumophilia

Intracellular GNR

Inclusion bodies

PCR and Ab screen

treatment of L. pneumophilia

macrolides

other causes of pneumococcal pneumonia

H. flu

S. aureus

other cause of HAP

P. aeruginosa

transmission of TB

inhalation of respiratory droplets

infection of alveolar macrophages

most at risk for TB

immunocompromised like HIV

Sx of acute primary TB infection

granulomas --> latency

chronic cough

bloody sputum

weight loss

Sx of primary TB infection

low-grade fever

Sx of TB reactivation (chronic secondary TB)

Thick-walled lung cavities make air-filled space where pathogen proliferates

Dx of TB

CXR for tubercles or cavities

pathogenesis of TB

intracellular pathogen

mycolic acid = slow growth and long tx

MDR

ID of TB

acid fast rod

catalase negative

intracellular

PPD

CXR = tubercles in lungs

treatment of TB

rifampin + other for combo therapy over 6 months

prevention of TB

BCG vaccine in endemic areas

transmission of mycobacterium avium complex

immunocompromised/CF

southeast US

environmental

sx and dx of mycobacterium avium complex

pulmonary disease - clinically resembles TB

treatment of mycobacterium avium complex

highly resistant to TB drugs

need up to 6 diff drugs

disease caused by Bordetella pertussis

whooping cough

transmission of Bordetella pertussis

HIGHLY CONTAGIOUS

airborne droplets

only colonize cilia - damaging them

sx of first phase B. pertussis infection

flu-like, most infectious phase

sx of second phase of B. pertussis infection

whooping cough

can progress to pneumonia

sx of final phase of B. pertussis infection

chronic cough

dx of B. pertussis infection

whooping cough

PCR nasal swab

pathogenesis of B. pertussis

pertussis toxin damages nasal cilia

ID of B. pertussis

GNCB

Fastidious (PCR)

treatment of B. pertussis

erythromycin over 1 mo old

prevention of pertussis

Tdap vaccine

leading cause of death in non-immunized kids

diphtheria

transmission of diphtheria

respiratory droplets

colonizes epithelial cells of nasopharynx + skin lesions

at risk population for diphtheria

kids under 5

elderly

symptoms of diphtheria

gray pseudomembrane

sore throat

fever

paralysis from toxin

painful skin lesions

pathogenesis of C. diphtheriae

Diphtheria toxin: prevents protein synthesis = host cell death (heart, kidney, nerves)

ID of C. diphtheriae

GPR in sputum

treatment of C. diphtheriae

erythromycin

antitoxins

prevention of diphtheriae

Tdap vaccine

most common cause of OM

S. pneumo

second is H. flu

disease in adults vs. kids - M. catarrhalis

Adults: rhinosinusitis

Kids: OM

transmission of M. catarrhalis

spreads to sinuses via throat

via respiratory droplets

M. catarrhalis normal flora

ONLY IN HUMANS

Opportunistic pathogen

Dx of M. catarrhalis

PCR

Culture - GNDC and hockey pucking

pathogenesis of M. catarrhalis

biofilm formation

--> antibiotic resistance

cause of most bronchitis and infant hospitalizations

viral infections

viral pneumonia

rare in adults

-viral pneumonia from the flu = high mortality in elderly and immunocompromised

disease caused by rhinovirus

common cold

transmission of rhinovirus

highly infectious

coughing and sneezing

fomites

person-to-person

sx of rhinovirus

FEVER IS RARE

sneezing, runny nose, congestion, sore throat, malaise, cough

pathogenesis of rhinovirus

replication at low temps in epithelial cells of respiratory mucosa

increased nasal secretion due to histamine release - mucus production and leukocyte infiltration

what virus is linked to 50% of asthma flares

rhinovirus

transmission of adenoviruses

fecal-oral

aerosolized droplets

direct conjunctival inoculation

URI with adenovirus sx

pharyngitis

fever

LRI with adenovirus sx

bronchitis

atypical pneumonia

diseases caused by adenovirus

URI and LRI

eye infections

severe in babies and immunocompromised

pathogenesis of adenovirus

infects many different people

lytic infection

ID of adenovirus

DNA virus

PCR culture