Micro Bio > RTI's 1 > Flashcards

RTI's 1 Flashcards

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1
Q

What are the 3 types of Upper Tract infections

A

1.Sinusitis
2. Otitis media
3. Pharyngitis

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2
Q

What are the 2 types of Upper tract infections

A
  1. Pneumonia
  2. AE-COPD
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3
Q

What specimines can be collected for RTI’s

A

1.Sputum (not saliva)
2. BAL / bronchial washing (Invasive)
3. Nasopharyngeal aspirates / swabs (uses a suction catheter)
4. Endotracheal aspirates (needle puncture)
5. Sinus aspirates
6. Tympanocentesis (needle in typanic membrane of ear)
7. Throat swabs

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4
Q

Describe the sputum grading

A

Q0 = very poor specimen not processes
Q1 = poor quality specimen
Q3 = very good quality specimen

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5
Q

What is the most common pathogen to cause RTI’s

A

Streptococcus pneumoniae

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6
Q

What are the atypical pathogens for causing RTI’s

A

1.Mycoplasma pneumoniae
2. Chlamydia pneumoniae
3. Legionella pneumophila

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7
Q

Why cant you treat bata lactam for atypical pathogens?

A

1.Mycoplasma pneumoniae = no cell wall = beta lactam cant destroy cell wall
2. Chlamydia pneumoniae = cell wall but no peptidoglycan = beta lactam cant destroy cell wall
3. Legionella pneumophila = intracellular Beta lactams cant enter host cell

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8
Q

What is Pneumonia

A

An inflammatory condition of the lung primarily affecting the alveoli (microscopic air sacs)

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9
Q

What are the typical signs of pneumonia?

A
  1. Fever
  2. Cough (productive or dry)
  3. chest pain
  4. shortness of breath
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10
Q

Describe what CAP, HAP, and VAP mean

A
  1. Community acquired pneumonia
  2. Hospital acquired pneumonia
  3. Ventilation acquired pneumonia
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11
Q

Describe the 4 charcteristics of S. pneumoniae

A

A. Small gram-pos diplococci
B. Alpha haemolytic, bile soluble, optochin S
most are encapsulated (> 80 distinct types)
C. Colonizes the nasopharynx in 5-10%
of adults and 20-40% of children
D. Incidence increases in winter months

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12
Q

How do we test for S. pneumoniae

A

Bile soluble and optochin S

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13
Q

What is S. pneumoniaes number 1 virulence factor and describe why

A

CAPSULE
1. Aids in escape from phagocytic cells
2. Aids in adherence which essential for colonization

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14
Q

What are the two primary vaccines used for RTI’s

A
  1. Pneumococcal vaccine (Pneumovax)
  2. PREVNAR
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15
Q

Describe the charcateristics of Pneumococcal vaccine (Pneumovax)

A
  1. 23 different serotypes
  2. Account for 90% of invasive strains
    protection wanes with time and age
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16
Q

Describe the charcateristics of PREVNAR

A
  1. conjugate vaccine (a weak antigen, usually a bacterial sugar capsule is linked (conjugated) to a protein to make the immune system respond = turns a weak, short-lived response into a strong, memory-forming immune response)
  2. Indicated for use in infants < 2 years of age and adults
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17
Q

What are the 7 indicates for a vaccine

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A
  1. advanced age
  2. Myeloma (cancer of plasma cells)
  3. Splenectomy (surgical removal of the spleen)
  4. Alcoholism
  5. HIV / AIDs
  6. Diabetes
  7. lymphoma (cancer of lymphocytes_
18
Q

What can you use to treat S. pneumoniae

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A
  1. Penicillins
  2. Cephalosporins
  3. Macrolides
  4. Fluoroquinolones,
  5. Vancomycin
19
Q

What determines the choice of antibiotics for S. pneumonie

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A
  1. Site of infection
  2. Comorbidities
  3. Severity of illness
  4. Ambulatory / inpatient
20
Q

What is COPD

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A

Chronic Obstructive Pulmonary Disease (COPD)

21
Q

What are the characteristics of COPD

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A
  1. Progressive lung disease
  2. charcaterized by increasing brethlessness = problems with breathing out
22
Q

What are 4 examples of COPD

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A
  1. Emphysema
  2. Chronic bronchitis
  3. Refractory (non-
    reversible) asthma
  4. some forms of bronchiectasis.
23
Q

What is the most common cause of AE-COPD

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A

H. influenzae

24
Q

Describe the charcateristics of H.influenzae

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A
  1. small gram-negative bacilli
  2. requires X (Heme) and V (NAD) factors for growth
  3. will grow on “chocolate” agar (5% CO2) = will not grow on agar plate
  4. may be encapsulated
  5. Approx 18% produce B-lactamase
25
Describe Haemophilus influenzae type b (Hib)
1. Historically, responsible for majority of invasive disease (meningitis, epiglottitis) 2. Introduction of Hib vaccine >> very little Hib seen today 3. Majority of mucosal disease due to non-encapsulated strains (without capsule = less invasive)
26
How do you treat H. influenzae
1. Amoxicillin-clavulanate very effective 2. 2nd / 3rd generation cephalosporins effective 3. Newer macrolides have reasonable activity 4. Fluoroquinolones very active, but contraindicated in children
27
Describe the characteristocs of Moraxella catarrhalis
1. Not much of a pathogen 2. Small gram negative cocco-bacilli 3. 90% of strains resistant to ampicillin / amoxicillin = produce B-lactamase. With exception of TMP/SMX, predictably susceptible to most oral antibiotics.
28
What is Bordetella pertussis
1. The organism that causes pertussis (whooping cough).
29
Describe the charcateristics of Bordetella pertussis
1. Small gram-negative cocci-bacilli 2. Strictly aerobic, fastidious 3. Requires growth on media containing charcoal, blood, or starch 4. Bordet-Gengou(BG) or Regan Lowe (RL) medium
30
How do you identify Bordetella pertussis
1. Laboratory diagnosis though Naso-pharyngeal specimen (nose swab) 2. Swab is then tested by either: a. culture Bordet-Gengou agar (BG agar) b. PCR ✔ best way c. DFA
31
How can you treat B. purtussis
Macrolides
32
what is the number 1 cause of Bacterial Pharyngitis
S.pyogenes
33
What are the characteristics of S. Pyongenes
1. gram positive, catalase -ve (breaks down H2O2) , β-haemolytic (Kills RBC) 2. Lancefield Group A (has carbohydrates on their cell wall) 3. Pyr + (tests positive), Taxo A (bacitracin) S(killed by bacitracin in lab testing)
34
How do you treat Bacterial Pharyngitis
Penicillin / Amoxicillin
35
What are the Non-suppurative complications:
1. Rheumatic heart disease (immune reaction that damages heart valves) 2. Post-Streptococcal glomerulonephritis (Immune complexes damage the kidneys)
36
What is Arcanobacterium hemolyticum
A bacterium that can cause pharyngitis (sore throat), especially in teens and young adults.
37
What does pharyngitis look like in teens and adults
Rash (like scarlet fever), no RHD (Pheumatic heart disease) or AGN (Acute glomerulonephritis
38
How does Arcanobacterium hemolyticum respond to penicillin
May respond poorly to penicillin, but disease is self-limiting
39
How so we identify Arcanobacterium hemolyticum and what is its best conditions
1. Culture a. Best: CO2 48 hr, weak β-hemolytic b. Haemolysis best on rabbit blood c. Anaerobically: slower growth
40
Why do we treat
Disease resolution: speeds up recovery 18-24 hours ✖ - Eradication: eradicate organism and stop spread ✔ - Prevent complications: RHD ✔ a. antibiotics can prevent or significantly minimize risks b. 10 days post-onset to initiate therapy... Therefore ... no need to treat empirically, wait for culture results!!
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