N3110

Study Questions Exam I

1. How does a gram positive bacteria ce enveope di!er "rom t#at o" a gram negative
bacteria ce enveope$
%e enveope& determines #ow to cassi"y bacteria
'ram positive( t#ic) ayer w. outer capsue* #ard to )i bacteria
&t#ic) peptidogycan ayer so retains vioet stain
&ce membrane
&teic#oic acids t#at stic) up and are poymers o" gycero and p#osp#ate
&water soube and ma+or sur"ace antigens* #eping cassi"y as gram
positive
&ce wa maintenance and enargement during ce division
&moves cation in and out to stimuate immune response
&poysac#arides
&pressed tig#ty against ce membrane w. itte space between
'ram negative( singe s#eet peptidogycan, doesn-t absorb vioet stain, stays red
&compex outer membrane
&%e membrane
&can #ave outer capsue and endotoxins
&outer membrane& aow "or bacteria to ive in 'I tract
&protects ce "rom bie sats
&act as specia c#annes to aow #ydrop#iic compounds to pass
&ipopoysac#arides& EN./0/1IN w. ma+or sur"ace
antigens o" bacteria ce
&stabii2e outer membrane and acts as barrier t
Hydrop#obic moecues
&composed o" ipids bound to poysacc#arides
&poysacc#arides "unction by boc)ing #ost
de"enses
&ipoproteins&stabii2e enveope* ocated in outer membrane
&anc#ors membrane to poysac##arides
&toxic w#en reease during in"ection and "unctions
3s EN./0/1IN
&porin* a type o" protein ocated inside /4
&reguatory contro over moecues enter5eave
&structura proteins
&peptidogycan( bottom t#in ayer o" /4
&rigid protective structure but t#inness gives rise to
6exibiity and sensitivity
&peripasmic space& reaction site "or arge and varied poo
o" substances t#at enter and eave ce
&between inner and outer membrane
&70&809 ce voume
&contains en2ymes
7. :#y are eac# o" t#e "oowing media used by microbioogists$
Nutrient media& grows not#ing speci;c
enric#ed media& basa and additives to en#ance growt#
&promotes growt# to most organisms
Eg. c#ocoate and bood agar
basa media& suppies minima base growt# re<uirements
&suppies extra nutrients
transport media& maintain and preserves specimen be"ore anayses
&cuturettes
&acts as bu!ers5absorbant to prevent ce destruction
&doesn-t support growt#
seective media&aows certain bacteria to grow* in#ibits ot#ers
&i" worried you #ave 1 disease* ony 1 is aow to grow so i"
not#ing grows* don-t #ave 1
&in#ibits growt# o" certain microbe
&di!erence "avors certain microbe to grow by se".. isoation imp.
&important in primary isoation o" a speci;c microorganism "rom sampes
containing mixtures o" di!. species
ex. =eces* saiva* s)in* water* soi
.i!erentia media& additives aow di!erentiation between organisms
&visibe di!erence among microorganism
&coony si2e5coor* media coor c#ange* "orm gas5bubbe
Eg. dye b5c pH indicator
bood agar& identi;es organism t#at #emoy2e bood
&bot# enric#ed and di!erentia
eg. strep test
c#ocoate agar& coo)ed bee" bood powderi2ed acting as a specia nutrient
:#at is 3gar$ 0ype o" S/>I. media .. most widey used and e!ective
i<ue;abe soid
media
&6exibe and modabe and provides a basic "ramewor)
&provides ;rm sur"ace to grow organism

3. .i!erentiate between endotoxins and exotoxins in terms o" w#ere and #ow t#e toxin is
produced and w#at t#e toxin does to t#e in"ected #ost.
Endotoxins&attac# to ce wa* reease i" ce is ysed. %annot be made into vaccine.
%auses "ever* eucopenia* #ypotension* .I%
& gram neg bacteria associated because wit# /uter 4embrane "aing apart* toxin is
reease
&toxin t#at is not secreted but it reeased ony a"ter ce is damaged5ysed
Eg. ipopoysac#arides
-stimulate fever and shock reactions in gram negative reactions suc#
as
meningitis and typ#oid "ever
&ipids are #arm"u to #uman ces bc macromoecues in ce wa are
"oreign to #umans?stimuate antibody production in immune system
&endotoxins #ave systemic e!ects on tissues and organs
&can cause "ever* in6ammation
@@.I%A disease t#at is t#roug# bood causing cots* person #emorr#age to
deat#
Exotoxins& ce produces and excretes. Released from organism into
environment
&Bsed to ma)e vaccines
&can cause toxic s#oc)
& toxin t#at is secreted by a iving bacteria ce into t#e in"ected tissues
&proteins wit# strong speci;city "or a target ce and extremey power"u
and deady e!ects
&a!ect ces by damaging ce membrane and initiating ysis or by
disrupting intraceuar "unction
&conse<uence o" ce disruption depends on t#e target
&contain many speci;c exampes

8. :#ic# areas o" t#e body #ave an acid pH as a natura #ost de"ense$
&'enitas* urinary tract* 'I tract Cstomac#( uness medicated wit# antacidsD* saiva*
s)in* )idneys
&I" you ceave too muc# acid out o" t#e stomac#* it becomes at ris) "or c. di;cie and
pneumonia
S)in "ew bacteria can penetrate
Csweat EpHF #eps )i someD
ot#er natura de"enses(
mucous membranes
respiratory membraneA mucus coect* ciia beat or move bacteria up and
/B0*
nose #airs* coug#ing* Ig3 antibody
genita5urinary tractA cervica secretions wit# yso2yme* urine 6us#ing t#roug#
uret#ra
'I tractA saiva en2ymes* pH o" stomac#* norma 6ora
8. :#ic# o" t#e "oowing are capabe o" sterii2ation Ci.e. )is sporesD$
N/0E( 0#e ony way to )i spores in "ood C%. botuinumD in t#e )itc#en is wit# a pressure
coo)er Cnot a #ot water bat# cannerD. 0#e temp gets muc# #ig#er C#ig#er t#an boiingD wit#
a pressure coo)er* and one #as to use it "or a ong time
@@acid "oods Ci)e acid tomatoes* not t#e yeow nonacid tomatoesD are sa"e to can in a #ot
water bat# because the acid prevents the spores from reactivating to vegetative
cells that can divide etc.
spores CANNOT reactivate in acidic environment, like stomach
spores love low o and low acid
t#us* we need to be care"u wit# GGIs t#at destroy acid in stomac#
we aso need to be care"u about canned "ood
i" t#e canned "ood #as a ow acidity* be aware o" spores
Sterii2ation( irreversibe destruction o" a organisms* incuding spores
&removes a viabe microorganisms incuding viruses
&resuts in proteins denaturing and unwinding
HES& 3utocaving& saturated steam under pressure, most common met#ods in
#ospitas
&#eating under #ig# pressure
&sterii2ation ac#ieved w#en steam condenses against t#e ob+ects in t#e
c#amber and graduay raises t#eir temperature
N/& =itration& used to ;ter i<uids t#at cant wit#stand #eat
&;ters out impurities Ccrysta* ;bersD
&disadvantage( doesn-t remove toxins t#at can cause disease
N/&BI radiation& damages .N3 o" bacteria
&need to te "ood distributers i" use BI except w. spices
&disin"ects in some circumstances
N/& aco#o #and saniti2er& denatures proteins
&used as disin"ective and antiseptic?doesn-t sterii2e
HES& et#yene oxide& eave toxin trace o" c#emicas in tube
&ow temperatures* second most common met#od in #ospitas
&boc)s .N3 repication
&acts as a sporicide
N/& "ood irradiation& ony reduces t#iamin and )is o" e.coi
&not popuar in 3merica
&w#en ce receive waves* moecue absorbs avaiabe energy
&I/NIJIN' radiation sterii2es in absence o" #eat
K. :#ic# type o" in"ectious diseases are now killing t#e most peope wordwide$
&in"ectous diarr#ea diseases
&157 o" a deat#s due to tubercuosis* maaria and 3I.S
L. .escribe t#e "unction and ocation o" eac# o" t#e "oowing bacteria ce structures(
%apsue& "ormed "rom pat#ogenic bacteria
&protects ce "rom p#agocytosis and antibiotics
@encapsuated bacteria ces #ave greater pat#ogenicity because
capsue boc)s
mec#anism p#agocyte use to attac# and engu" bacteria
&bound tig#ty t#an sime ayer Ctype o" gycoayxD and #as t#ic)
consistency w#ic# gives stic)y c#aracter to coonies
cytopasmic membrane& t#in* 6exibe s#eet moded competey around t#e
cytopasm
&ipid biayer w. proteins embedded to varying degrees
&"unc( eectron transport
&oxidative p#osp#oryation
&seective permeabiity
peptidogycan ayer& compex poymer provides strengt# and s#ape
&M09 o" gram N was and M&109 o" gram &
&repeating gycan cross by s#ort poypeptide
&bottom t#in ayer o" /4
&rigid protective structure but t#inness gives rise to 6exibiity and
sensitivity
peripasmic space& ocated above and beow peptidogycan ayer
&important reaction site "or arge and varied poo o" substances t#at
enter5eave ce
& =ound in gram ce was( E70&809 o" ce voume* contains en2ymes *
extensive spaceF
It is we deveoped above and beow t#e peptidogycan
&!mportant rxn site for cells that enter and leave the cell
&"ound in gram # cell walls$ ver% little space &etween cells and cell
mem&rane
-!t is ver% thin and narrow
;mbriae& bacteria sur"ace appendages invoved in interactions w. ot#er ces but
don-t provide ocomotion
&sma* bristei)e ;vers emerging "rom sur"aces o" bacteria ces
&most contain protein
&in#erent tendency to stic) to eac# ot#er
'ycocayx&coating o" macromoecues to protect ce and #ep ad#ere to its
environment
&di!er in t#ic)ness* organi2ation and c#emica composition in eac# types
o" bacteria
pii& eongated* rigid* tubuar structure made o" piin
@@ 'acterial surface appendages that are involved in interactions with
other cells
&"ound in gram negative bacteria?utii2ing con+ugation w#ic# invoves
trans"er o" .N3 "rom 1 ce to anot#er
&"unction as ce connecters and trans"er agents
&rigid sur"ace o" protein
&ad#eres to #ost
&attac#ment o" donor and recipient ces in bacteria con+ugation
6agea& ong* "rom poar regions prope ce t#roug# water
&t#read i)e appendeges o" protein CH antigenD
&organs o" motiity o" se" propusion
&attac# by extension o" cytopasmic membrane
O. .e;ne binary ;ssion. :#at is t#e signi;cance o" eac# o" t#e "oowing stages o" bacteria
growt#$ >ag p#ase* stationary p#ase* exponentia p#ase* decine p#ase.
&most ces rey on binary ;ssion "or propagation
&it is asexua reproduction
>3' GH3SE& eary 6at period on t#e grap# w#en popuation appears not to be growing or
growing at ess t#an exponentia rate
&newy inocuated ces re<uire period o" ad+ustment* enargement and synt#esis o"
.N3* en2ymes and ribosome
&ces are not yet mutipying at max. rate
&popuation o" ces is so sparse or diute t#at t#e samping misses t#em
Exponentia p#ase& maximum rate o" ce division* curve increases
&p#ase wi continue i" ces #ave ade<uate nutrients and "avorabe environment
&popuation "u;s its potentia generation time and growt# is baanced5geneticay
coordinated
Stationary p#ase& popuation enters a surviva mode in w#ic# ces stop growing or grow
sowy
&curve eves o!
&rate o" ce in#ibition or deat# baances out rate o" mutipication
&P o" visibe ces remain at max and constant
&depetion o" nutrients and oxygen
&increased ce density causes accumuation or organic acids
.eat#5decine p#ase& imiting "actors intensi"t and ce begins to die* unabe to mutipy
&curve dips down
&speed depends on resistance o" species and #ow toxic conditions are
&sower t#an exponentia rate
&viabe ces remain many wee)s5mont#s a"ter p#ase begins
Q. %ompare and contrast t#e "oowing terms(
Gat#ogen&organism capabe o" causing disease5deat#
Symbiont& organisms t#at ive toget#er in a cose partners#ip
&une<ua reation* can be obigatory to one o" members i" not bot#
&3 types( mutuaism* synergism* cooperation .. not becessary bene;cia
4utuaist& organisms ive in an obigatory but mutuay bene;cia reations#ip
&common in nature due to surviva "actor
&3 type( commensaism. Sateitism* parasitism
/pportunist& organism ony causes disease w#en #ost de"enses are impaired
&impaired in terms o" immune compromised* ac) o" seep
&most disease
&)i 3I.S patient
10. %ompare and contrast t#e "oowing terms(
Racteriostatic& in#ibits bacteria growt#* can resume i" conditions are rig#t
&starve nutrition
&ony suppress reproduction o" bacteria
&wea)ens bacteria and I= #eat#y immune* immune wi ;g#t o! bacteria but it
%3N
%/4E R3%S i" not #e>0HH
not good "or 3I.S patient
Racteriocida& irreversiby )is bacteria
&troube( don-t #ave t#is "or every type o" bacteria
11. :#y are gram negative ces more diTcut to )i wit# antibiotics and disin"ectants$
&gram negative is resistant because o" toug# doube ayer outer membrane
17. :#at e!ect does eac# o" t#e "oowing virulence factors #ave on an in"ected #ost$
Iiruence "actor( ma)es organism pat#ogenic
%ataase& produced by a types o" stap#
&brea)s down #ydrogen peroxide into water and oygen
%oaguase& produce by S. 3ureus
&causes ;brin to deposit around stap# ces
&prevents p#agocytosis
&encourages ;brin to "orm around bacteria so p#agocytosis engu"s
organism
&coaguates bood pasma
Hyauronidase& digests intraceuar UgueV o" connective tissue t#at #ods ce
toget#er
&acts as Uspreading "actorV
&digests %0 o" t#e #ost
Strepto)inase& bacteria )inase t#at dissoves ;brin cots and expedites t#e invasion
o" damaged tissues
&used to treat pumonary emboi and coronary t#rombosis
eryt#rogenic toxin& a )ey toxin t#e deveopment o" scaret "ever* a)a t#e pyrogenic
toxin* responsibe
"or t#e brig#t red ras#* induces "ever by acting on t#e temperature reguatory
center
enterotoxin& exotoxins t#at act on gut C"ood poisoningD
&not destroyed by #eat or gut en2ymes
&induce nausea* vomiting* and diarr#ea
Exo"oiative toxin& produce by S. 3ureus
&removes s<uamous ces
&cause tetanus wit# newborns w#o are paced in mud bat# a"ter birt#
&causes des<uamation o" s)in in stap# scaed syndrome because toxin become
ose and
spread t#roug#out s)in
toxic s#oc) syndrome& produced by S. 3ureus
&causes symptoms o" 0SS, #ig# "ever* %I probems
Geniciinase& inactivated peniciin* rendering t#e bacterium resistant
Streptococca deo2yribonucease &depoymeri2es .N3

13. :#at environment is "avored by eac# o" t#e "oowing$ 3erobic bacteria* anaerobic bacteria*
"acutative bacteria* microaerop#iic bacteria.
3erobic( most are t#is
0#ey i)e 07
3naerobic( % de;cie* or %ostridium
OM9 N7
% de;cie is can be on t#e s)in i" peope don-t was# #ands a"ter bat#room and t#ere is ess
07 t#ere due to puncture
4icroaerop#iic C%ampyobacterD
Not reay a "an o" 07* doesn-t mind it t#oug#
4ost common cause o" "ood borne iness ex. %#ic)en
=acutative anaerobe
0oerates a itte 07
ma)es 30G by aerobic respiration i" oxygen is present but is aso capabe o"
switc#ing to
"ermentation.
18. :#ic# areas o" t#e body are normay "ree o" microorganisms$
&3 interna tissues and organs C#eart and circuatory system* iver* )idneys and
badder* ungs* brain
and spina cord* musces* bones* ovaries and testes* gands pancreas* saivary*
t#yroid* sinuses*
midde and inner ear* interna eyeD.
&3 6uids wit#in an organ or tissue Cbood* urine in )idneys5uterus5badder*
cerebrospina 6uid* saiva prior to entering t#e ora cavity* semen prior to entering
t#e uret#ra* amniotic 6uid surrounding t#e embryo and "etusD.
1M. .e;ne t#e "oowing terms(
=omite& bacteria contaminate inanimate ob+ect
&indirect "orm o" in"ectious disease
&assoc w. #ospita ac<uired in"ection b5c stet#oscope* nec)ties etc
&stap#yococcus
bioogica vector& tic)* mos<uito
& deveops an in"ected organism in its body and passes it aong to its #ost
& #arbor pat#ogens wit#in t#eir bodies and deiver pat#ogens to new #osts in
an active
manner* usuay a bite
&direct "orm o" in"ectous disease
&west nie virus* maaria* yme disease
dropet nuceus& microscopic peets o" mucus5saiva e+ected "rom mout# and nose
& remain suspended in t#e air "or severa #ours* depending on t#e environment
& generated during ta)ing* coug#ing and snee2ing
&cods* c#ic)en pox
&direct "orm o" in"ectous disease
Joonosis& contact wit# animas or anima products
Endogenous( norma 6ora an advantage over ot#er 6ora
&good guys
&costridium diTcie spread in >0%
&viridans streptococci "oowing toot# surgery
1K. .escribe #ow wounds s#oud be cutured.
&irrigate wound wit# norma saine?not antiseptic soution
&absorb excess saine w. sterie gau2e to remove exudates tropica antiseptics
@do not put antibiotic on wound be"ore it is cutured* need to numb t#e area
&cuture viabe tissue not dead
&need granuation C#eaingD tissue because coagen ric# .. granuation is a
good sign o"
body rebuiding a"ter in+ury
&0a)e a cuture w#en t#e amount5consistency5odor o" wound drainage occurs* w#en
t#e patient is
about to be disc#arged* and w#en a newy trans"erred patient-s wound is draining.
()T *+
&3spiration %uture
&prep site w. aco#o
&use 3m syringe* 77 gauge neede* ta)e 1 m 6uid
&0issue Riopsy Csurgery* burn woundsD damages tissue
&not good idea* tissue trying to #ea
@@pressure ucer aso <uestionabe, organism vary as esion #eas
&pressure ucer preventabe i" nouris#ed w. protein* use o" air bed* move
patient
care"uy* prevention is SEH
&Swab cuture
&diTcut to obtain wit#out contaminating specimen
&prepac)aged sterie cuture tube .. use 7 cacium aginate t#e swab
&i" es)ar C#ardened tissueD present* need to debride and remove es)ar to #ep
#ea
&avoid touc#ing swab to intact s)in at wound edges
&send to ab w.in 1&7 #ours max
&in"o ab needs
&date time specimen coected
&anatomica site* source
&type o" specimen
&p#armocot#erapy
&exam re<uested
&diagnosis
1L. :#at is t#e signi;cance o" ;nding s<uamous epit#eia ces in a ab specimen ta)en "or a
bacteria cuture$
Epi ces signi"y a bad cuture
0#e specimen #as been contaminated wit# s)in
>/BSH SGE%I4EN
&coud be due to ta)ing a cuture "rom t#e side o" t#e wound and N/0 t#e
midde Cw#ere
it s#oud be ta)enD
@@i" neutrop#is appear on t#e cuture* t#at is goodWW It Is a good cuture and t#e
specimen is N/0 contaminatedW

1O. %ompare and contrast t#e time o" onset and symptoms o" "ood poisoning5"ood in"ection
caused by(
Clostridium perfringens
-toxins t#at #ep spread in"ection
-exotoxins produce "ood poisoning in 'I exposure
%inica .iseases
&'as gangrene( organisms enter wound* grow and produces gas
7 types(
1.3naerobic ceuitis& in"ections remain >/%3>IJE. in
damage necrotic
0issue
7.4yonecrosis& toxins di!use into NE3XRH necrotic tissue
&causes deat# in musce tissue* more widespread
&%repitation( gas in tissue* ma)es sounds o" bubbing
&"ou smeing disc#arge* bac)ened necrotic tissue
gets in between musce ;bers and reeases exotoxin* destroying
tissue
&=//. G/SI/NIN'W
0ime o" onset(
& incubation is K&1O #ours
%ause o" "ood poisoning(
&&enterotoxin Cguts o" animas used in meat productsD
&most common cause o" "ood poisoning
&common w. meats and c#ic)en
Symptoms:
&diarr#ea& usuay se" imiting
deat# is extremey rare
Treatment:
-debridement( remoca o" necrotic tissue to expose o7
&peniciin or cep#aosporin
&maggots
&#yperbaric oxygen( c#amber bubbe oxygen
Staphylococcus aureus
0ime o" onset(
&wit# time and temp* 3ureus grows and reeases toxin
&toxin ingested 1&K #ours ater
&,-- hour time frame is crucial &ecause it distinguishes this
from
other &acteria, which have s%mptoms , hours later
%ause o" "ood poisoning(
&"ood preparer touc#es "ace t#en "ood .. s)in to s)in contact
&It is very resistant to antibiotics and is "re<uenty caed mXS3
&Bsuay occurs wit# "ood poisoning Cdue to enterotoxinsD
&wit# eapsed time and room temp* s. aureus grows* reeasing toxins
Symptoms o" "ood poisoning(
&vomitting* nausea "oowed by diarr#ea
&Exampes( egg saad* crYme ;ings* ime pie raw "ood
BotulismClostridium Botulinum
&organism "rom soi gets into wound* ma)es toxin
&in"ant can ingest spores in "ood i)e raw #oney t#at #as a #ig#er pH o" neonata
stomac# aowing germination and production o" toxin
/t#er types o" Rotuism(
:ound( organism "rom soi gets into wound* ma)es toxin
In"ant( ingestion o" spores in "ood Craw #oneyD #ig#er pH o" neonata stomac# aows
germination w#ic# is production o" toxins
%aused by(-
&binds to presynaptic membrane* prevents 3c# reease
&most potent microbia toxin )nown
&#eat iabe
&ingest "ood contain toxin Ccanned "ood w. #ig# pHD and toxin created .accid
paral%sis
&most cases #ome coo)ed green beans* corn* meat and ;s#
&common cause o" deat# in ivestoc) and a<uatic birds
Symptoms(
&begins 17&L7 #ours
&doube viion
&cant swaow* dry mout#* cant ta)
&respiratory paraysis
&deat# 109
0reatment5Grevention
&give botuism antitoxin immediatey
&biggest t#reat is #ome canned "ood
&avoid cans w. buges5ea)s
&toxins is #eat iabe at 100 % and coo)ing "or 1M min
New uses o" botuinism(
&botox
&spasmodic toricois( spasm in nec), se<ue o" pneuomonia
&#yper#idrosis?xs sweing o" pam in peope wit# Gar)inson
&spastic musce pain
&masseter musce to decrease si2e o" ower +aw Ci" top teet# do not go over ower
teet#D
1Q. :#ic# organismCsD can cause endocarditis "oowing denta wor) in individuas wit#
prost#etic #eart vaves or a #istory o" r#eumatic "ever$
/!R!0AN( (T)+TOCOCC!
In"ections
&principa cause o" endocarditis on abnorma #eart vaves
&w#en teet# are being veaned* organism goes into bood stream and increase ris) o" #eart
attac) due to bad bacteria "rom gum
0reatment5Grevention
&prop#yaxs o" certain patients w. abnorma #eart vaves
&treat endocarditis w. peniciin and aminogycoside
@@i" piercing issue and e!ect s)in* it is S03GH 3BXEBS Cdepends on porta o" entry

70. :#at is t#e most i)ey cause CorganismD o" diarr#ea in a patient w#o #as been on ong&term
C1 mont#D antibiotic t#erapy$ 'ive exampes o" antibiotics t#at can cause t#is.
@@broad spectrum antibiotic or narrow spectrum "or proonged times
c. di;cie
too muc# antibiotic use SI>>S 0HE '//. =>/X3WW
0reatment( S0/G antibiotics 3S3GWW
'ive metronida2oe C=agyD and t#en Iancomycin to avoid IXE Cstrains o" E. t#at are
resistantD
71. :#at patient c#aracteristics pace t#em at ris) "or deveoping met#iciin resistant
Stap#yococcus aureus and vancomycin resistant enterococcus$
1R(A
&mutipe antibiotic treatment
&broad spectrum agents narrow spectrum
&proonged antibiotic treatment
&poor nutrition status
&M09 o" cooni2ed pts deveop "unction
&trauma* burns* aged* immunocompromised
&now can be community ac<uired
&bacteria deveops into in"ectionWWW
@#eat# person #ave 4XS3 in wound* cean and body wi get rid o" it on own.. not more
pat#ogenic, +ust I= gets into body* #eart to ;g#t wit# antibiotic
&IXXI'30I/N is most important "or any type o" wound
Iancomy resistant enterococus
&transmitted between patient5sta! via
77. :#at is t#e target organ t#at is damaged by eac# o" t#e "oowing costridia species( C.
botulinum, C. difcile, C. tetani, C. perfringens.
-food poisoning in GI tract
C di2cile
0arget organ( t#e coon Carge intestineDWW
.iagnoses(
&detect toxin in stoo
&%auses boody diarr#ea and in6ammation o" coon
0reat(
&stop antibiotics* give =agy
/d c di!(
&broad spectrum antibiotic )i norma 6ora aow t#at aow c. di;ci to grow
& vancomyocin is now second c#oice o" drug to avoid IXE
New c di!(
& can contract in >0% because o" "ood borne spores
&70x more toxic
&give probiotic Cnorma 6oraD w#ic# contains carbs t#at reduce c. di;ci
%. tetani
0arget organ( in#ibitory neurons in t#e spina coumn
%aused by(
&toxin tetanospasmin
&in#ibits post synaptic spina neurons* boc)s reease o" in#ibitory mediator o" musce
spasms
%inica disease
&wound puncture burns in"ected wit# spores* organisms ma)es toxin t#at permanenty binds
to neurons
&most cases are edery or II drug abusers
&esser deveoped nations?700*000 in"ants die5yr "rom in"ected uumbiicus stump or
circumcision
&mudW
Symptoms(
&incubation 8&M days to many wee)s
&convusive contractions o" vountary musces
&+aw musces oc)
&tetonic sei2ures
0reatment
&peniciin wi #ep stop toxin production
&tetanus vaccine
&booster every 10 yrs
Anthrax3'acillis anthracis
%#aracteristics(
&primariy disease o" animas* #umans rarey a!ected
&spores enter via in+ured s)in or mucosa
%aused by(
&in#aation o" woo sorters disease #emorr#agic pneumonia
&ant#rax toxin
&agent o" bioogica war"are
Specimens(
&6uids* pus "rom esions* sputum* bood
Symptoms(
&necrotic ucer w. edema Cdeat# o" tissues i" e!ected in #umansD
0reatment5 %ontro
&treat w. peniciin* tetracycine* cipro6oxacin
&prevent by vaccinating* dispose o" anima carcass propery
&vaccine is a puri;ed toxoid
&K inocuations over 1.M yrs
&side e!ects$
&gas #ides* #air* bone products wit# E0/ to )i SG/XES
73. :#ic# organism is t#e most common bacteria cause o" community&ac<uired Ci.e. ac<uired
outside t#e #ospitaD pneumonia$ How can it be prevented$
Streptococcus (S.) pneumoniae Caso caed pneumococcusD
- 'ram&positive bacterium causes 70 & K09 o" a community&ac<uired bacteria
pneumonia C%3GD in aduts
/nset
&sudden w. "ever* c#ids and s#arp peura pain
&bood or rusted coor sputum CmucousD?due to #emorr#ages
&bacteremia occurs in 10&709 o" cases
resuts in meningitis* endocarditis or septic art#ritis
3so* otitis and sinusitis Csinus probem or ear in"ectionD
@@Streptococcus pneumonia is part o" norma 6ora and most o" us are carriers
.iagnostic ab 0ests
&specimens( bood* sputum* %S=
&gram stain( use"u "or sputum and %S=
&<ueing reaction od test
&capsue sweing test
&capsue swes w#en pneumococcus is mixed w. antibodies speci;c "or its type
o" poysacc#aride
0reatment5 Grevention
3ntibiotics
&Geniciian Cit is t#e drug o" c#oiceWWD
&However* some strains are resistant Ca probem in meningitisD use %ep#treaxon
Iaccine
&%ontains type speci;c poysacc#arides
&3ppropriate "or t#ose in day care* t#ose wit# sic)e ce* t#ose ZK0*
debiitated* immunosuppressed
@s#oud get vaccinated at age K0* and revaccinated at KM due to E==I%3%H
78. Snow t#e gram stains and s#ape o" eac# organism we discussed in cass. CE.g. a gram&
negative dipococcus is Neisseria.D
a gram N appear bue Ct#ey absorb t#e dyeD
pos
stap#& cocci
strep& cocci
costridium& bacii* protective spore
baciis& rod s#aped
a gram appear red Cdo not absorb t#e dyeD
neg
e.coi& rod s#aped* "ound in ower intestine
Spiroc#etes& spira&s#aped & causes syp#iis* yme disease
Neisseria& cocci & causes meningococcus* gonorr#ea
7M. :#at is t#e mec#anism o" post&streptococca acute gomeruonep#ritis$
&body produces antibody to antigen in bacteria?doesn-t )now di!erent o" antigen in
body and #eart
&deveop 3 wee)s a"ter untreated in"ection
&causes )idneys to s#ut down because body attac)s se" and )idneys wit# antibodies
against bacteria but antibodies aso attac) antigens on #eart Cantigen antibody reaction
against one own antigen* body proteinsD
Causes
&an in"ection wit# a type o" streptococcus bacteria
&does not occur in t#e )idneys* but in a di!erent part o" t#e body* suc# as t#e s)in or
t#roat.
&causes t#e tiny bood vesses in t#e ;tering units o" t#e )idneys CgomeruiD to become
in6amed
)idneys ess abe to ;ter t#e urine.
&uncommon today because in"ections t#at can ead to t#e disorder are commony treated
wit# antibiotic
&deveop 1 & 7 wee)s a"ter an untreated t#roat in"ection* or 3 & 8 wee)s a"ter a s)in
in"ection.
&most o"ten occurs in c#idren ages K & 10
Xis) "actors incude( strep t#roat and s)in in"ections suc# as impetigo
&impetigo, oca in"ection o" super;cia s)in ayers* #ig#y communicabe
&wounded s)ins5burns resut in widespread in"ection t#at may progress to ceuitis

7K. >ist 3 organisms t#at can cause nosocomia in"ections in #ospitai2ed patients. Expain #ow
eac# is ac<uired. I" transmission is possibe* #ow can transmission be prevented$
&Nosocomia in"ections are primariy caused by opportunists .. H/SGI03> 3%QBIXE.
i. Enterterococci
&0ransmitted between patients 5 sta! via #ands
&0reatment(
&can be compicated because o" resistance to cep#aosproins* peniciins and
amnigycosides
&must treat severe in"ections w. vacomycin pus an aminogycoside
&now #ave vancomycin resistant entercocci IXE.. ive up to 11 days, not
)iedby vancomyocin
&use vancomycin "or %.diTcie ony w#en =agy doesn-t wor)
&need mut. 3ntibiotics i" organism is transient
ii. Stap#yococcus epidermidis
0 &ac<uired "rom s#unts and cat#eters
1 &causes endocarditis and B0I
7
iii. Stap#yococcus saprop#yticus
&7nd most common cause B0I in sexuay active young women
0
0
b. [0#e sites o" nosocomia in"ctions* in order "rom most to east common* are as "oows(
i. urinary tract
ii. surgica wounds
iii. respiratory tract
iv. s)in Cespeciay burnsD
v. bood CbacteremiaD
vi. gastrointestina tract
vii. centra nervous system
c. Susceptibiity
&t#ey dispay bro)en s)in or mucous membranes CwoundsD.
&immunodepression, ess abe to ;g#t o! in"ections once ac<uired.

7L. >ist 8 diseases caused by spore "orming bacteria. :#at are t#e symptoms o" eac#$
7O. :#at woud you expect to see in a uret#ra smear t#at is positive "or Neisseria gonorr#ea$
&smears o" uret#ra5endocervica exudates w. many gonoccadipococci w.in neutrop#is?
presumptive diagnosis
&smears "rom con+unctiva can aso be diagnostic
4en are Q09 sensitive* QQ9 speci;c
&QQ9 speci;c means t#at 19 o" t#e time t#ere is a "ase positive
&Q09 sensitive means t#at 109 o" t#e time it is "ase negative.. #ave it an you don-t )now
:omen are endocervica and are M09 sensitive and QM9 speci;c
7Q. :#o s#oud be given a Streptococcus pneumoniae vaccine$
@@day care )ids* t#ose wit# sic)e ce anemia* anyone over t#e age o" K0* debiitated*
immunosuppressed
&t#ose wit# compromised respiratory tract* ot#er in"ections* excess mucus CaergiesD*
obstruction* smo)ing
&t#ose wit# aco#o* drug intoxication because #ave bad ungs
&t#ose wit# abnorma circuatory dynamics Cpumonary congestion* #eart "aiureD
&t#ose wit# manutrition* genera disabiity* and #ypospenism
&t#ose on GGI #ave ess acid* so increase ris) "or step.. i" acid is gone t#en more i)ey to
aspirate GGI into ungs
30. :#y are peope over age MM ess susceptibe to streptococca toxic s#oc) syndrome$
@reated to strain o" strep pyogene causes scaret "ever and peope deveop immunity
to it earier in i"e
&peope w#o #aven-t #ad scaetina strain o" strep t#roat
&steptococca toxic s#oc) syndrome causes s#oc)* bateremia* respiratory "aiure* and
muti organ "aiure
&deat# in 309
31. :#at are t#e symptoms o" meningitis$
@Hig# "ever
@Severe #eadac#e t#at isn\t easiy con"used wit# ot#er types o" #eadac#e
@Sti! nec)cant touc# c#in to nec)
Iomiting or nausea wit# #eadac#e
%on"usion or diTcuty concentrating ? in t#e very young* t#is may appear as
inabiity to
0maintain eye contact
Sei2ures
Seepiness or diTcuty wa)ing up
Sensitivity to ig#t
>ac) o" interest in drin)ing and eating
S)in ras# in some cases* suc# as in vira or meningococca meningitis
37. :#at "actors increase t#e ris) o" deveoping bacteria meningitis$
&rare w. peope over M0
&peope not immuni2ed
&drin) and smo)e #eaviy
&"re<uent bars and s#are drin)s
&#ead trauma( micro"ractures in bood brain area
&repeated #ead butting
@very rare, usua outbrea)s but recenty ony "ew individuas a!ected in poc)ets o" t#e word
&In"ants are at #ig#er ris) "or bacteria meningitis
&spread more <uic)y w#ere arger groups o" peope gat#er toget#er. %oege students iving
in dormitories and
&0raveers to t#e meningitis bet in sub&Sa#aran 3"rica and 4ecca may be at ris) "or
meningococca meningitis* particuary during t#e dry season
33. :#at #ospita items may be reservoirs "or mutipe drug resistant stap#. aureus C4.XS3D and
IXE$
& Since s. aureus is "rom s)in to s)in or contact to contact* it can be easiy transmitted
"rom carrier to receiver t#roug# open S/XES /X %B0S
&it is "ound on sur"aces wit#in #ospita settings* incuding sin)s* trays* towes* bedding
inens * and privacy curtains
&O09 o" stet#oscope aow stap# to grow
@t#is usuay occurs w#en a visitor or patient #andes a contaminated sur"ace and
spreads it to
anot#er person
&it is aso "ound in t#e #ospita air
@@IXE ony ive 11 days
38. :#at are t#e eary symptoms o" necroti2ing "asciitis arising "rom a wound in"ected wit#
Streptococcus pyogenes$
& Necroti2ing "asciitis a)a 6es# eating bacteria to S/=0 SSIN
&G3IN out o" proportion to wound
3M. How can wounds be treated to reduce t#e ris) o" deveoping necroti2ing "asciitis$
&irrigation
&Hydrogen Geroxide?wi )i strep Cnot Stap#D because no cataase to brea) it
down
&#owever* H707 impairs ;brobast abiity to repair wound i" too
muc#
3K. :#at are t#e symptoms o" in"ections "rom Stapylococcus aureus!
&>ocai2ed in"ections
&pimpe* "oicuitis can go into bood and cause endocarditis
&suppuration Cpus "ormD by drawing in :R%
&abcess #eaed w. bood 6ow and #eat
&Spread o" organism "rom ocai2ed site
&Endocarditis( o"ten II drug users #ave organism trave t#roug# bood and
w#en custers o" bacteria on #eart vaves become in"ected* trave to brain
and cause stro)e
&/steomyeitis( treatabe, need II drug
&Gneumonia
&:ounds in"ections* osteomyeitis
&=ood Goisoning
&0SS
&common in women using tampons* ot#ers wit# wound in"ections
&"ever* #ypotension* mut. System "aiure C)id* iver* ungs* #eart* brainD
3L. 0#e %.% estimates t#at KM9 o" c#ronic in"ections are due to bio;ms. :#ere do bio;ms
occur and #ow do bio;ms contribute to c#ronic wound in"ections in oder aduts$
Rio;m& resut w#en organisms attac# to a substrate by some "orm o" extraceuar
matrix t#at
binds t#em toget#er in compex organi2ed ayers

&"avor microbia persistence in #abitates
&on arti;cia imbsWWWWW