Bacterial Diseases - Lecture 2 - Quiz 1- ID - Spring 2022

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Gram + cocci in clusters
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Terms in this set (91)
Gram + cocci in clusters
Staphylococcus aureus
-Most virulent species- severely harmful
-identified by its production of coagulase
-part of normal flora
Staphylococcus aureus
Colonized in:
-anterior nares **
-oropharynx **
-skin
-vagina
-axilla
-perineum
reservoirs for future infections
Staphylococcus aureus
How is Staphylococcus aureus transmitted?
by direct contact of a fomite or person
What infection is most common in the hospitals?
MRSA (Methicillin-resistant Staph. Aureus)
This bacteria is a pyogenic pathogen known for its capacity to induce access formation
Staphylococcus aureus
How is Staphylococcus aureus diagnosed?
-Gram Stain and microscopic evaluation of the infected tissue
-PCR
Skin damage, injection, poor personal hygiene, predisposing skin disease. What is the most likely skin and soft tissue infection that can affect a patient with one or more of these factors?
Staphylococcus aureus
More severe than furnucles and are due to coalesced lesions extending to deeper subcutaneous tissue
Carbuncles
Lactating women can range from superficial cellulitis to abscess.
Baby suckling at the nip and it causes a skin break down. Baby has the bacteria in its mouth and goes into the mother and causes...
Mastitis
Looks like a pimple (Furuncle or Carbuncle?)FuruncleAbscess under the knee or elbow for example. Swelling and redness (Furuncle or Carbuncle?)CarbuncleMost common cause of osteomyelitis arising from either hematogenous dissection or contiguous spread from a soft tissue siteStaphylococcus aureusRubor: redness to area Calor: Warmth to area Tumor: Swelling to area Dolor: Pain to area All these are what?Signs of infectionFever Swelling Redness over area Warmth over area Pain over area Inability to weight bear Limited ROM due to pain These are S&S of?Staphylococcus aureusMost common cause of septic arthritis of native joints in adults and childrenStaphylococcus aureusCommonly affects big joints like knees, shoulders, hips and phalangesStaphylococcus aureusAn infection of SKM that is seen in tropical climates and in immunocompromised patients (usually the quads)Pyomyositis (Pus-muscle-inflammation)Newborns and infants may develop serious infections characterized by fever, dyspnea, and respiratory failure. Leading to what 3 diseases or manifestations?1) Pneumatoceles (shaggy, thin walled cavities) 2) Pneumothorax 3) Empyema (pus in lungs) Caused by Staphylococcus aureusLeading cause of infective endocarditis world wideStaphylococcus aureusThese patients have a high risk of contracting infective endocarditis-IV Drug users -Hemodialysis pts -Pts with prosthetic devices -immunosuppressed ptsWhat are the 4 clinical settings in which Staphylococcus aureus endocarditis is encountered?1) Right sided endocarditis -associated with injection drug use 2) Left sided - native valve endocarditis 3) Prosthetic valve endocarditis 4) nosocomial endocarditis (hospital acquired)How do you treat Staphylococcus aureus endocarditis?Uncomplicated: B-lactam (nafcillin; oxacillin) Complicated: VancoWhy should treatment for Staphylococcus aureus continue for 4-6 weeks?Because of the coagulation factor involvedWhat are the 2 types of MRSA?1. hospital-acquired 2. community-acquiredWhat antibiotic is used if a patient has MRSA?VancoWhat happens if a patient gets VRSA?Treatment for VRSA is Linezolid-This syndrome is often seen in newborns and children -Fragility of the skin, with tender, thick-walled, fluid bullae, can lead to exfoliation of most of the skin surfaceStaphylococcal scalded skin syndrome (SSSS)This test is positive when gentle pressure on bullae causes rupture of lesions and leaves denuded underlying skinNikolsky's SignCustards, potato salads, processed meats -S&S occur 1-6 hours after ingestion of contaminated food -N/V -Diarrhea -Hypotension -NO FEVERStaphylococcus aureusHow is Staphylococcus aureus prevented in patients undergoing surgical procedures?Mupirocin is applied to the patients anterior nares100 day coughB. pertussis (Whooping Cough)How is pertussis transmitted?respiratory dropletsWhat age group is at most risk of severe morbidity for pertussis?< 6 month oldsHow many phases does pertussis have?1) Catarrhal 2) Paroxysmal 3) Convalescentrhinorrhea, malaise, low grade fever, sneezing, anorexia, runny nose lasts 1-2 weeks What stage of pertussis is this?Catarrhal StageRepetitive cough with whoops, and leads to vomitting, cyanosis and apnea can occur with spasms, leukocytosis. Most complications occur during this phase lasts 2-4 weeks What stage of pertussis is this?Paroxysmal StageDiminished paroxysmal cough; Secondary complication (pneumonia, seizures, encephalopathy) Lasts 3-4 weeks What stage of pertussis is this?Convalescent StageWhat is the best predictor of pertussis as the cause of prolonged cough in adults?Post-tussive vomittingIncrease of WBC suggests what in young children?PertussisWhat is the gold standard for diagnosis of Pertussis?Cultures of nasopharyngeal secretionsTreatment for pertussisMacrolides (erythromycin, clarithromycin, azithromycin) Trimethoprim-sulfamethoxazole (TMP-SMX; Bactrim)what age group does rheumatic fever typically affect?Ages 5-15 years oldHow is a Dx based on with rheumatic fever?Jones criteria and lab conformation of streptococcal infectionA systemic immune process that is a sequela of B-hemolytic streptococcal infection of the pharynxRheumatic feverWhat happens if you have strep throat and you dont treat it properly?Can progress to Rheumatic FeverWhat are some things rheumatic fever can do to the heart valves?It can elongate them, shut them down, make them floppy, or fuse themWhat is the "M.A.T."?Mitral Aortic Tricuspid Valves that are damaged in order by rheumatic fever-Criteria used to diagnose Rheumatic Heart Disease -Diagnosis of RHD is made with a history of recent STREPTOCOCCAL infection and either the presence of 2 major criteria or 1 major with 2 minor criteriaJones CriteriaWhat are the major criteria for the Jones Criteria range?J: Joints (polyarthritis, hot/swollen joints) *heart emoji*: Heart (Carditis, valve damage) N: Nodules (subcutaneous, extensor surfaces) E: Erythema marginatum (painless rash) S: Sydenham chorea (flinching movement disorder)What are the minor criteria for the Jones criteria range?P: Previous rheumatic fever E: ECG with PR prolongation A: Arthralgias C: CRP and ESR elevated E: Elevated temperatureKNOW THIS:Dx of RHD is made with a Hx of recent streptococcal infection and either 2 majors or 1 major and 2 minorsThis mid diastolic mitral murmur may be present due to inflammation on the mitral valveCarey-Coombs ShortWhat is the treatment for Rheumatic Fever?First line: PCN If allergic to PCN: azithro Prednisone ASA No prophylaxis for endocarditis in rheumatic feverWhat are some complications of rheumatic valvular disease?1) Mitral valve 2) Aortic Valve 3) Tricuspid Valveprevention of rheumatic feverHand washing Treating strep throatWhat is the best preventative measurement that should be taken for a patient that is at risk for rheumatic heart disease?Early treatment of streptococcal pharyngitis with penicillinObligate anaerobe, possess both DNA and RNA, similar cell wall as a gram negative bacteriaChlamydiaWhat are the 3 forms of Chlamydia?1) Chlamydia trachomatis (Sex) 2) Chlamydia psittaci (Bird) 3) Chlamydia pneumoniae (Lungs)what test can differentiate among the three species of chlamydia?Microimmunofluorescence (MILF test)Exposure is greatest in poultry workers and in owners of pet birdsC. psittaciTransmission from person to person has never been documented, what infection is this?C. psittaciHow is C. psittaci transmitted?birds to humansWhat is the gold standard for diagnosis of C. psittaci?MILF TestTreatment for C. psittaci?Tetracycline or erythromycinAn acute eye infection occurring in adults exposed to infected genital secretions and in their newbornsAdult Inclusion Conjunctivitis (AIC)AIC is caused by sexually transmitted _______ strains, usually serovars D-K.C. trachomatisLeading cause of preventable infectious blindnessTrachomaScarring distorts the eyelids, turning eyelashes inward and abrading the eyeballAICAny damage to the eye, cornea that can lead to blindness or eye infection is?AICT/F: Chlamydial nucleic acid amplification tests are more sensitive in detecting infectionTWhat is the treatment for AIC?Azithromycin or Doxycycline (if pregnant do not take)What is very important when treating AIC?We need to make sure we treat the partner as well to prevent ocular reinfection and chlamydial genital disease.Causes ocular trachoma and urogenital infectionsTrachoma - Chlamydia trachomatiscause of lymphogranuloma venereumLGV - Chlamydia trachomatisWhat is the most prevalent of all bacterial STIs?Chlamydia trachomatisPresents as painful inguinal lymphadenopathy beginning 2-6 weeks after presumed exposureLGV - Chlamydia trachomatis-Pain or burning when peeing -pain during sex -lower belly pain -abnormal vaginal discharge -bleeding between periods -pus or watery/milky discharge from penis -swollen testicle -pain, discharge or bleeding around anusSigns and Symptoms of Chlamydia trachomatisWhat is the diagnostic test of choice for Chlamydia trachomatis?NAATs of urine or urogenital swab (identify small amounts of DNA or RNA in test samples)Treatment of Chlamydia trachomatis-azithromycin or doxycycline (if pregnant do not take) -Treat partner as wellG (-), nonmotile, non-spore-forming organism that grows singly and in pairs as diplococciN. gonorrhoeaeHow is gonorrhea transmitted?Efficiently transmitted by: Male to female via semen Female to male urethra Anal Sex Fellatio (pharyngeal infection) Perinatal transmission (mother to infant)Pain in multiple joints as well as inflammation from hematogenous spread of the bacteria. Typically affects the wrist, ankles and elbowsGonococcal arthritisAssociated with fetal lossGonorrhea, more specifically Salpingitis and PIDWhat is placed on the eye lids of babies at birth?Erythromycin gel to prevent blindness due to gonorrhea.The most common form of gonorrhea among neonates, preventable by prophylactic ophthalmic ointmentsOphthalmia neonatorumSigns and symptoms of gonorrhea in men-Great urgency of urination -pus-like discharge (white, yellow, green) -swelling or redness at the opening of the penis -swelling or pain in the testicles -persistent sore throatSigns and symptoms of gonorrhea in womenwatery, creamy discharge from vagina Pain or burning sensation while urinating need to urinate more frequently heavier periods or spotting sore throat painful sex sharp pain in lower abdomen feverDiagnose gonorrhea how?NAATs, culture, microscopic examination or urogenital samplesWhat is the best agar to grow Gonorrhea?Thayer-Martin AgarTreatment for gonorrhea?Ceftriaxone If gonorrhea + chlamydia = Ceftriaxone and azithromycin or doxycycline