Micro

  • Taxonomic classification of bacterial species is best assisted through analysis of genome.

    • Past classification techniques based on biochemical capabilities of species, morphology of a species, or other phenotype-related data of a species has led to misclassification.

  • R plasmids are plasmids that include genes conferring resistance to antimicrobial agents

  • Neubauer chamber (or hemocytometer) is a specialized, thick glass microscope slide used to manually count the concentration of cells or microorganisms in a liquid sample

    • volume of the smallest RBC counting chamber is 0.002 nL at 0.1 mm depth

    • 100 nL is the volume of WBC counting grid.

  • Nitrogen fixation: N2 to NH3

  • Denitrification: NO3 to N2

  • Ammonification: Organic N to NH4+

  • Nitrification: NH4+ to NO2 then NO2 to NO3

  • Structural flexibility of enzyme and double-stranded DNA are responsible for the incorporation of mispaired bases, known as "wobble."

    • The effect of this flexibility (wobble) allows for mispaired bases to remain.

  • DNA inversion within bacterial populations can cause Generation of variation - create successful combinations that promote fitness

  • Transient bacteremia is responsible for migration of S. viridans from the oral cavity (during dental work) to damaged heart valves and causes bacterial endocarditis

  • In medicine, a clinical picture is the complete collection of signs, symptoms, test results, and causative factors a healthcare provider uses to diagnose and treat a disease

  • flagella:

    • amphitrichous arrangement has flagella on both polar ends of the organism.

    • A lophotrichous arrangement has multiple flagella grouped on one polar end of the organism.

    • A monotrichous arrangement has one flagellum on one polar end of the organism.

    • A peritrichous arrangement has flagella all around the organism.

Hosts:

  • Primary host (definitive host): harbors a virus or parasite that is matured and is ready for reproduction

  • A secondary host (intermediate host): harbors a virus or parasite for a short period of time, just until the developmental phases are completed.

  • A reservoir host is a type of host that harbors a virus or parasite; however, it poses no health threat to the host.

Drugs:

  • acyclovir: damages nucleic acid to prevent DNA synthesis

  • metronidiazole: treats bacterial vaginosis

    • symptoms of bacterial vaginosis: grey-white discharge and fishy oder

  • fluconazole: treats yeast infections

  • doxycyline: treats cervicitis caused by clamydia

  • cefriaxone: treats cervicitis caused by gonorrhea

  • vancomycin (Vancocin): has retained activity against Gram-positive organisms, including MRSA.

  • amantidaine: treats influenza A and also useful for parkisons

    • prevents uncoating of the virus that would normally release of viral RNA into host

  • azetronam = carbapenem with antipseudomonal activity

    • last resort for multi-drug resistant bacterial infections

  • gentamicin = aminoglycoside (binds with ribosome to stop protein synthesis)

    • azetronam and gentamicin are used together to treat psudomonal skin infections with biofilm

Reguation

  • An operon is a group of genes that participate in the same metabolic activity

  • Two tryptophan molecules bind to a repressor, which binds to the operator to prevent the transcription of the trp operon.

    • This blocks RNA polymerase, which is bound to the promotor region

Bacteria:

  • Gram Positive Bacteria:

    • have Pentaglycine cross-bridges are a feature only found in Gram-positive bacteria.

    • Teichoic acid carbohydrate chains are only found in Gram-positive bacteria.

      • They may help stabilize the peptidoglycan and help the bacteria bind to host cells.

  • Gram Negative Bacteria Identification:

    • periplasmic space of the Gram-negative cell is where a small amount of peptidoglycan can be found.

    • O antigen within the lipopolysaccharide of Gram-negative cell walls is used to identify different bacterial species and strains.

    • In Gram-negative bacteria, there is a direct cross-link between tetrapeptide chains extending off of NAM molecules.

    • Lipopolysaccharide molecules are found in Gram-negative bacteria.

      • They are composed of a lipid and a polysaccharide chain and act as an endotoxin—a toxin released when the bacterial cell wall becomes damaged.

    • The outer membrane is found in Gram-negative bacteria external to the peptidoglycan cell wall.

    • Porin channels are protein channels found in Gram-negative bacteria that allow passive diffusion of molecules into the periplasmic space between the outer membrane and inner membrane.

  • Bacteria:

    • Staphylococcus aureus is a catalase- and coagulase-positive species that produces golden-yellow colonies on media.

      • They are a Gram-positive coccus occurring in clusters.

    • Clostridioides difficile: associated with heavy and frequent use of antibiotics.

      • causes loss of appetite, nausea, and persistent mucoidal liquid stools

    • Streptococcus spp is a normal host flora commonly found in the stomach.

    • streptococcus pyogenes: causes strep throat

    • clostridium botulinum: used for botox

      • causes botulinum toxin

      • source of transmission is inadequately cooked canned veggies

    • Bacteroides spp, Enterobacter spp, and Klebsiella spp are all commonly found in the colon.

    • Francisella tularensis: the causative organism of tularemia, is a zoonotic disease that can infect people through contact with ticks or deer flies commonly on rabbits and other animals.

      • People can also be exposed to tularemia from contaminated water, aerosols, and bioterrorism.

    • Mycobacterium tuberculosis has an unusually thick (waxy) lipid cell wall made up of mycolic acids, causing waxy

      • It surrounds the entire bacterial cell and hides it from the immune system/ preventing the bacteria from being attacked.

      • This cell wall also makes infection very difficult to treat with antibiotics, which cannot get through the dense lipid matrix.

    • Streptococcus pneumoniae is encapsulated, making it hard to phagocytose

      • gram positive dicocci

      • causes pneumonia in the lungs and meningitis in the meninges

    • Treponema pallidum is classified as a spirochete.

      • causes syphillis

      • Other spirochetes include Borrelia and Leptospira

    • Escherichia coli is associated with ileal tissue in patients with Crohn's disease

      • shingella and entero-invasive e.coli have common characteristics

    • Bacillus anthracis

      • infect livestock, so transmission to humans can occur through skin inoculation of spores derived from livestock or contact with contaminated bone meal fertilizer, wools, or hides

    • Clostridium tetani

      • causative agent for tetanus, a serious disease characterized by muscle stiffness and spasms

      • enters the body through abrasions, punctures, and other instances of broken skin

    • pseudomonas aeruginosa and burkholderia have similar pathology

      • cause less severe infections to burns, wounds, and lungs

    • nesseria gonorrhoeae: gram negative diplococci

      • causes dysuria and urethral discharge

    • chlamydia trachomatis: obligate intracellular aerobe

      • conjunctivitis, urethritis, and pelvic inflammation diseases

Fungi

  • candida: orgal and esophageal thrush in immunocompromised patients

  • aspergillus fumigatus: septate hyphae that branches at 45 degree angle

    • causes invasive aspergillosis in immunocompromised people with chronic granulomatous disease

    • causes aspergillomas in immunocompromised people with pre-existing lung diseases

  • Microsporidia are obligate intracellular unicellular fungi that lack centrioles, peroxisomes, and mitochondria

  • Agaricus are a group of mushrooms; some are poisonous, and some are edible. Basidiomycota are fungi that have fruiting bodies called basidiocarps; they include mushrooms, rusts, and stinkhorns.

  • Cryptococcus fungi are found as yeast; they infect people with weak immune systems.

  • Glomeromycota: consists of species of fungus that live in a close highly evolved symbiotic association with the roots of plants.

  • zygomycota: rapid growing saprobe (feeds on dead) fungi

    • lives off of decaying organic material (bread, fruit, veggies)

    • example: rhizopus stolonifer

  • Blastomyces dermatitidis: causes Acute pulmonary blastomycosis

    • Transmission of blastomycosis is usually via inhalation.

    • symptoms: non-specific symptoms of fever, cough, night sweats, loss of appetite, fatigue, chest pain, myalgias, and arthralgias, leading to potential confusion with many other pathogens.

    • Infection risk factors include travel to endemic areas in the US, such as midwestern, south-central, and southeastern states, particularly the Ohio and Mississippi River valleys and the Great Lakes.

  • Cryptococcus neoformans: round organism on microscopy, typically seen as an encapsulated yeast by India ink preparation.

    • Infection is rare without immunodeficient risk factors such as HIV or immunosuppressive therapies.

  • histoplasma capsulatum: transmitted by bat droppings

    • endemic to mississippi river valleys, ohio, and missouri

Parasites

  • trichinella spiralis = nematode parasite

    • round worm in pigs, bears, horses and humans

    • found in undercooked meat (pork)

    • causes trichinosis

      • symptoms: nausea, vommitting, diarrhea and sweating within 1st 24 hours

    • pseudomonas aeruginosa

  • ciphyllobothrium latum: tapeworm in undercooked fish

  • taenia saginata: tapeworm in undercooked beef

Viruses

  • Herpes simplex virus 1 (HSV-1) most commonly causes oral cold cores, which present as grouped or singular vesicular lesions that become pustular and then ulcerate.

    • HSV-1 is a common cause of sporadic encephalitis, which can present as altered mental status, seizures, and vesicular lesions in exposed newborns.

    • latent herpes simplex 1 virus resides in the trigeminal nerve ganglion

    • enveloped double-stranded DNA viruses.

  • Herpes simplex virus 2 (HSV-2) causes genital herpes and is transmitted through sexual contact and perinatally. HSV-2 can be transmitted perinatally.

  • Herpes simplex virus 3 (varicella-zoster virus, VZV) causes chickenpox and shingles.     

    • Primary varicella-zoster virus infection (varicella, chickenpox) is usually mild and manifests as crops of lesions appearing first on the trunk and spreading to face and extremities.

      • reactivation of varicella-zoster viral latent infection (herpes zoster, zoster). The lesions reflect the particular dermatome fed by the infected ganglion.

      • Varicella infection tends to be more severe in immunocompromised patients, such as patients receiving chemotherapy.

      • Varicella infection tends to be more severe in older patients rather than in young children,

  • Herpes simplex virus 4 (Epstein-Barr virus, EBV) causes mononucleosis, which presents as fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy. EBV remains latent in B cells.

  • Rotavirus is a virus that causes gastroenteritis.

  • influenza is an enveloped negative-sense single-stranded RNA virus.

    • It causes disease by first merging with the membrane of a host cell, then releasing its contents into the host cell cytoplasm.

      • Host ribosomes then begin translating the viral RNA into proteins and enzymes that will form viral progeny that infect more host cells.

  • Human herpesvirus 6 (HHV-6) is the cause of body rash of roseola and high fever

  • ALL VIRUSES ARE DOUBLE SRANDED DNA (EXCEPT PARVOVIRUS)

  • Parvoviruses have single-stranded DNA as their nucleic acid structure

  • severe respiratory syncytial virus (RSV) infection

    • risk factors:

      • Exposure to cigarette smoking

      • Breastfeeding for at least 6 months 

      • male sex

  • Orthomyxovirus is an enveloped single-stranded RNA virus.

    • contains the neuraminidase proteins targeted by Neuraminidase inhibitors (oseltamivir and zanamivir).

      • Neuraminidase inhibitors prevent the release of progeny influenza virus.

Diseases:

  • HIV:

    • acute phase: viral replication

      • spreads to the lymphoid tissue

      • after acute phase: depletion of CD4 cells, manifestation of opportunistic infections, development of neoplasms (tumors)

    • When untreated, the progression of HIV to AIDS is expedient.

    • With treatment, the progression of HIV to AIDS is highly variable with some patients experiencing moderate rates of progression to others experiencing prolonged progression.

    • Unprotected intercourse among males remains the highest route of transmission of HIV. 

    • Intravenous drug use, receiving a blood transfusion, and unprotected vaginal intercourse represent lesser risk

    • Antiretroviral therapy is the treatment of HIV

  • hepatitis B: infects hepatocytes

    • chronic hepatitis. B: inflammation, scarring and cancer of the liver

    • severe hepatitis B: liver failure and death

    • Cholestasis (reduction of bile flow) is associated with hepatitis B infection

    • Most cases of hepatitis B are transmitted through the action of an asymptomatic carrier

  • H. influenzae is predominately isolated within the respiratory tract

  • syphillus

    • congenital syphillus: present at birth with deformities to the bone

    • Primary syphillus: painless ulcers and rash that dissolves

    • secondary syphillus: maculopapular rash on palms and soles

    • tertiary syphillus: present 15-20 years after initial exposure

      • includes neurological, cardiovascular, or granulomatous changes

  • scurvy: disease caused by deficiency in vitamin C

  • Leprosy

    • tuberculosis leprosy: skin and nerve involvement on face, trunk, and limbs with raised edges and dry, hairless centers

    • lepromatous leprosy: characterized by widespread skin lesions and systemic involvement that often leads to significant disability if left untreated.

      • large, more severe

Immune System

  • chemokines: molecules that influence movement of cells and are effectors of leukocyte migration

  • Lipid A is part of the lipopolysaccharide component of the Gram-negative cell wall.

    • It is released during systemic Gram-negative reactions and can cause production of cytokines and toxicity. 

  • Th1 cells: play role in intracellular mediated immunity

  • Th2 cells: activated forms of helper T cells that produce multiple interleukins and promote destruction of parasites through eosinophils and mast cells

  • Th17 cells: crucial for defending mucosal barriers against extracellular bacteria and fungi.

  • complement system: uses C6, C7, C8, C9 to form membrane attack complexes

  • Antigens: activate B cells

    • Exogenous antigens enter the body from the outside (e.g., injection, vaccines, ingestion, inhalation) and include bacteria, viruses, and fungi.

    • alloantigen: only in some people (example: ABO blood type)

    • Endogenous antigens are within the body, including the body's own cells, such as blood-group antigens.

    • An autoantigen is a normal protein or protein complex that the immune system identifies as abnormal, triggering an immune response as in an autoimmune disease like rheumatic heart disease.

    • Neoantigens are newly formed antigens derived from tumor-specific mutations or viral proteins.

  • Immunoglobulins:

    • Structure:

      • Fv: Fragment variable region, which is responsible for antigen binding and determined by both heavy and light chains.

      • F(ab): arms of the Y

      • Fc: leg of the Y

      • protein A: can specifically bind to the Fc region, prevents phagocytosis

        • produced by staphylococcus aureus

    • IgE is not a common antibody, but it is mainly involved in the allergic response and anti-parasitic response to parasitic infections

    • IgM is always the first antibody to be produced in a humoral response because IgM can be expressed without isotype switching.

      • IgM circulates in the blood as a pentamer and is present on the surface of mature B cells.

Tests:

  • mannitol salt agar: selective differential media for staphylococcus species

    • staphylococcus aureus grows and produces color change

    • staphylococcus epidermis grows but doesn’t change color