MICP Exam #1 – Flashcards
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Unlock answersoften effective for treating superficial mycoses |
Topical miconazole nitrate |
Prevalent genera of dermatophytes |
Microsporum, Trichophyton and Epidermophyton |
Common subcutaneous mycoses |
lymphocutaneous sporotrichosis and chromoblastomycosis. |
Systemic mycoses are caused by primary fungal pathogens such |
Histoplasma capsulatum, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Coccidioides immitis and Cryptococcus neoformans (HBPCC) |
Pathogenicity |
Ability of an organism to infect a susceptible host genotype and cause disease |
Virulence |
The degree of disease caused by a pathogen genotype under appropriate conditions. Akin to aggressiveness. |
Nosocomial pathogens |
Hospital acquired microbes |
Koch’s Postulates |
1. isolate the suspected agent from a disease victim. 2. grow the agent in pure culture.
3. infect a healthy host and show that the organism produces the classical clinical disease. 4. Isolate the "same" organism from the new victim. |
Cytoplasmic membranes are similar to eukaryotic membranes but do not contain steroids (e.g., cholesterol).
Which are the exception to this rule? |
Mycoplasmas |
Most have signature teichoic and lipoteichoic acids in the thick peptidoglycan wall Which type of bacteria? |
Gram positive bacteria |
Characteristics of Teichoic acids |
Teichoic acids: · Strong negative charge. · Covalently linked to the peptidoglycan · Strongly antigenic Generally absent in gram-negative bacteria. · Believed to aid in concentrating metal ions from the surroundings. |
Characteristics of Lipoteichoic acids
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Lipoteichoic acids: · Attached to fatty acids and anchored in the cytoplasmic membrane. · Antigenic, cytotoxic and can be involved in adherence
|
What actions could result in Gram positive bacteria appearing to be gram negative after test |
Mechanical disruption of the cell wall of Gram-positive organisms or its enzymatic removal with lysozyme Also, old starved bacteria and those treated with antibiotics. |
_________ and _________ do not have cell wall and therefore cannot be differentiated by Gram stain. |
Mycoplasma and Ureoplasma |
__________ cannot be classified by Gram stain due to the waxy outer shell preventing the entry of the stain. An acid fast stain is used to identify them. |
Mycobacteria |
Peptidoglycan polysaccharides are made up of repeating disaccharides of ________ and _________
|
N-acetylglucosamine (NAG) and N-acetylmuramic acid |
· Cross-linking in peptidoglycans occurs between the ______ amino acid and another amino acid at the ______ position of another chain. |
Third, fourth |
In peptidoglycan synthesis passing through the membrane, activated units are attached and assembled in the _________ _________ membrane pivot.
|
undecaprenol phosphate |
3 regions of the Lipopolysaccharide |
Lipid A, Core, O-antigen |
The region of the LPS that is essential for viability of almost all gram negative bacteria
|
Lipid A region |
Which region of the LPS carries the endotoxin activity |
Lipid A region |
Which region of the LPS allows distinguishing of serotypes (strains) of a bacterial species and is the antigenic portion of the LPS?
|
O-Antigen |
Sporulation only occurs in some __________ bacteria, such as members of ______ and _____ |
gram positive Bacillus and Clostridium |
Cells that lack rigid shape, assume spherical shape. if gram-negative cell, then _________ If gram-positive, then __________ |
spheroplasts protoplasts |
Stable spheroplasts, grow indefinitely w/o wall, but derived from parents with normal walls. |
L-forms |
Group of bacteria that evolved to lack wall. Typically found in environments with high osmotic strength |
Mycoplasmas |
Cocci are what shape? |
Spherical
|
Bacilli are what shape? |
Rod-shaped |
Spirochetes are what shape? |
Helical |
The arrangements of bacteria are determined by what? |
The position of the plane of successive cell divisions. |
Chains of bacteria |
Streptococci |
Grape-like clusters of bacteria |
Staphylococci |
Angled pairs of bacteria |
Corynebacteria |
g =
give both equations |
______ t_______ 3.3 [logNt -logN0]
or
t/n |
6 major groups of microorganisms: |
1. Algae 2. Protozoa 3. Fungi 4. Bacteria 5. Archaea 6. Viruses |
The minimum requirements for bacterial growth are sources of: |
Carbon Nitrogen Energy H2O Ions |
Chemotrophs |
Organisms that obtain energy by the oxidation of electron donors in their environments. |
Bacterial pathogens are almost always _________.
This means what? |
chemoheterotrophs
they are unable to fix carbon and form their own organic compounds |
Respiration requires ___ as a terminal electron acceptor and is _____ efficient at generating energy |
O2 most |
Coenzyme A structural groups: |
acetyl group, B-mercapto-ethylamine, pantothenic acid, 3’,5’-ADP. |
Anaerobic respiration uses compounds other than oxygen (_____. _____. ______) as terminal electron acceptors, produces less ATP per mole of glucose than aerobic respiration |
sulfate, nitrate, CO2 |
NADH is worth __ ATP through ETC, FADH2 is worth __ ATP) |
3, 2 |
Glycolysis produces ___ ATP and ___ NADH for a total of ___ ATP after ETC |
2, 2 8 |
Conversion of pyruvate to Acetyl CoA yields what? |
2 NADH for a total of 6 ATP after ETC. |
The Krebs cycle produces ___ GTP, ___ NADH, and ___ FADH2 This yields a total of ___ ATP |
2 GTP, 6 NADH, 2 FADH2 Total of 24 ATP. |
Once θ (theta) DNA replication is completed, the daughter chromosomes are concatenated and must be unlinked by: |
DNA gyrase and topoisomerases |
Plasmid pTP10 is found in the clinical isolate of which bacteria |
of Corynebacterium striatum |
Term for acquisition of naked DNA from environment |
Transformation |
Only some species of bacteria have natural ability for DNA uptake, what is this ability called |
Natural competence |
Diploid for only a portion of the genome is called: |
Merodiploid |
Phage λ integration into____ chromosome to produce a |
E.coli “λ lysogen” |
When the presence of a lysogenic prophage confers a new property to the host bacterium, this is termed? |
Lysogenic conversion |
The state of being free of microorganisms. |
Asepsis |
Inactivation or elimination of ALL viable organism and their spores. |
Sterilization |
Process of removing or killing MOST microorganisms on or in a material |
Disinfection |
A cleaning process which REDUCES pathogen levels to produce a healthy clean environment. |
Sanitization |
Substance that kills vegetative bacteria and some spores |
Germicide |
Substance used on non-living objects to render them non-infectious; kills vegetative bacteria, fungi, viruses but no spores |
Disinfectant |
Substance used to prevent multiplication of microorganism when applied to living systems. An antiseptic is bacteriostatic in action but not necessarily bactericidal. |
Antiseptic |
Mask requirement |
95% filtration efficiency for 3-5 micron particles desired |
Example of a secretion pathway that is dedicated to virulence
|
type III secretion (T3S) systems |
Bacterial adherence is often mediated by adhesins: |
o Fimbrial adhesins o Afimbrial adhesins |
Streptococcus mutans Adhesin: Receptor: Attachment site: Disease: |
glycosyl transferase salivary glycoprotein pellicle of tooth dental caries |
Streptococcus salivarius Adhesin: Attachment: Disease: |
lipoteichoic acid buccal epithelium of tongue no disease |
Bacterial invasion factors:
Ex 1: Listeria invasion and cell-to-cell spread is mediated by a protein named ______. Which other bacteria has a homolog for protien? |
Internalin Porphyoromonas gingivalis (Pg) |
Bacterial invasion factors: Salmonella uses ____ to secrete effectors that induce “_______ ________” (macropinocytosis) |
T3P membrane ruffling |
Endotoxin is released upon lysis or through “_______” of outer membrane vesicles. |
blebbing |
Endotoxins bind to specific receptors and stimulate release of ________ (e.g., IFN-g, IL-1, TNF-a, IL-6, histamine, prostaglandins), stimulate growth of _______, and induce ______ followed by ________.
|
Lymphokines, B cells, leukopenia, leukocytosis. |
Broad classes of exotoxins
2 types of intracellular targets |
o A-B dimeric exotoxins (B, binding; A, active) o ADP-ribosylation of intracellular target host molecule |
Broad classes of exotoxins
Cellular targets |
Cytolytic exotoxins (usually degradative enzymes) or cytolysins |
1) Hydrolyze membrane phospholipids (phospholipases). 2) Thiol(-SH)-activated cytolysins alter membrane permeability by binding to cholesterol. ((3) Detergent-like activity on cell membranes; rapid rate of lysis.
These are types of ___________
|
Bacterial cytolysins. |
3 Examples of Two-Component A-B Exotoxins with Intracellular Targets |
· Anthrax toxin (PA, EF, LF) · Shiga toxin, A-5B · Cholera toxin, A-5B |
___________ is considered to be the initiating organism and ________ the secondary invader of dental caries. |
MS (mutans streptococci) LB (lactobacilli) |
Treatment of disseminated mycoses frequently is administration of systemic __________. |
amphotericin B |
What are the main targets of antifungal drugs? |
Ergosterols in fungal cell membranes |
_________ and ________ are active against many Gram positive and Gram negative bacteria |
Tetracycline and carbapenems |
Penicillin is effective against only _______ ______ bacteria. |
Gram positive |
The multidrug resistant Enteric bacteria, mainly ________ and ________, contain a worrisome enzyme called __________ |
E.coli & K. pneumoniae New Dehli metallo-β-lactamase (NDM) |
Films of the superficial aspects of plaque and contain non-bacterial debris. |
materia alba |
1st colonizers come from saliva: |
1) Streptococcus sanguinis and Streptococcus mitis (gram +, facultative) 2) Actinomyces (gram +, most are obligate anerobes) |
Veillonella species |
Subsequent colonizer on teeth. |
Fusobacterium species |
Subsequent colonizer |
Campylobacter species |
Subsequent colonizer on teeth. |
Main cause of Necrotizing ulcerative gingivitis (NUG) |
Spirochetes, which are members of the genus Treponema. |
In pregnancy gingivitis women often suffer from advanced gingivitis associated with high levels of an alleged opportunistic pathogen in the subgingival biofilm: Which pathogen? |
Prevotella intermedia (Pi) |
Chronic periodontitis becomes most severe when certain opportunistic pathogens become numerous. Pathogens are: |
Porphyromonas gingivalis, Treponema species and Tannerella forsythia. |
Aggregatibacter actinomycetemcomitans |
Pathogen associtated with aggressive periodontitis |
Aggregatibacter actinomycetemcomitans is the only gram negative rod associated with periodontitis that is a _________ ________.
|
Facultative anaerobe |
HIV-associated gingivitis and periodontitis: The pocket microbiota is similar to the periodontitis profile with the most distinctive microbial change being an increase |
Candida species. |
Failed endontically treated teeth usually are dominated by Gram positive facultative anaerobes, and almost always include _______ ________, a species normally found in the human gut. |
Enterococcus faecalis |
Fungi are Gram _____, mostly ______, and ____ growing |
positive, aerobic, slow |
Infection bodies of fungi Spores which are present on stalk-like projections or other |
Conidia |
Infectious bodies of fungi Septal fragments of the hyphae which separate to become reproductive entities |
arthroconidia or arthrospores |
Pathogen causing Histoplasmosis
|
Histoplasma capsulatum |
“Chicago disease”
|
Blastomycosis |
"Cave disease" |
Histoplasmosis |
Flu and pneumonia like symptoms, eventually, calcified tuberculosis-like lesions. |
Histoplasmosis |
· Pathogens remain viable in macrophages, which serve as vectors in disseminated disease to various organs
|
Histoplasmosis |
Pathogen causing Blastomycosis |
Blastomyces dermatitidis |
Organisms phagocytize alveolar macrophages |
Blastomycosis |
· Lung infection usually clears, but can form ulcerative skin and bone lesions in immunocompromised patents |
Blastomycosis |
Pathogen causing Paracoccidioidomycosis |
Paraccodioides brasiliensis |
Most prevalent in South America |
Paracoccidioidomycosis |
Affects men vs women (78:1) |
Paracoccidioidomycosis |
Primary lung infection, but can disseminate and cause mortality (16-25%) in immunodeficient. |
Paracoccidioidomycosis |
Disseminated fungus produces painful ulcers on oral, nasal, and GI muscosa |
Paracoccidioidomycosis |
Pathogen caused by Coccidioides immitis |
Coccidioidomycosis |
American southwest, airborne from soil |
Coccidioidomycosis |
Lesions on skin or meninges primarily in immunodeficient individuals |
Coccidioidomycosis |
Pathogen that causes Cryptococcosis |
Cryptococcus neoforman |
Pathogenic organism of this disease exists only in yeast form
|
Cryptococcosis |
Pulmonary symptoms and radiographic lung nodules |
Cryptococcosis |
Disseminiation via hematologic spread in healthy/unhealthy patients, often leads to Cryptococcus meningitis. |
Cryptococcosis |
Second most common fungal infection in immunosuppressed patients after candidiasis. |
Cryptococcosis |
Pathogen that causes Aspergillosis |
Aspergillus fumigatus |
Major veterinary pathogen affecting sheep and cattle |
Aspergillosis |
Conidia of the fungus are inhaled from the environment and produce localized lung infections associated with tubercular growths called mycetomas or “fungus balls” |
Aspergillosis |
The pathogen also can spread via the blood and invade blood vessles causing necrosis and thrombosis, or invade organs including the brain. |
Aspergillosis |
· Aflatoxin, an extracellular protein elaborated by A. flavus (in most cases), can contaminate foodstuff, such as peanuts, and may induce hepatocellular carcinoma. |
Aspergillosis |
· It is the most common opportunistic respiratory infection in late stage HIV patients and accounts for a 10-20% mortality rate in these individuals. |
Pneumocystis jirveci pneumonia |
The organism does not invade host cells but exists in pulmonary interstitial tissue as a sporocyst (spore case) |
Pneumocystis jirveci pneumonia |
Death occurs from asphyxiation. |
Pneumocystis jirveci pneumonia |
Treatment is administration of trimethoprim-sulfamexoxazole or pentamidine isethionate (both of which have side-effects) and oxygen administration. |
Pneumocystis jirveci pneumonia |
Drugs which impair sterols |
Polyenes |
Two examples of Polyenes |
Nystatin and amphotericin B |
This polyene binds to cholesterol in blood lipoproteins and produces a high rate of side-effects, particularly in kidneys. |
Amphotericin B |
These two drugs form large pores in fungal cell membranes, which allow leakage of vital cell constituents. |
Nystatin and amphotericin B |
Drugs which affect ergosterol synthesis Give two examples |
Azole derivatives ex:Imidazoles and Triazoles
|
________ is administered orrally and is taken up by the fungus, converted to 5-fluorouracil and then metabolized into compounds which are inhibitory to either RNA or DNA function.
What is one advantage of this drug over amphotericin B |
5-flurocytosine This drug is able to enter the CSF, whereas amphotericin B cannot |
Drug that is administered orally and is active against dermatophytes, not has no effect on systemic mycoses |
Griseofulvin |
Inhibits the enzyme UDP-GIcNAc-3-enol-pyruvyltransferase that is involved in the first phase of cell wall synthesis |
Fosfomycin |
Fairly toxic and is generally only used as a secondary treatment for tuberculosis |
Cycloserine |
Name the two drugs that act on Phase II of cell wall synthesis |
Vancomycin and Bacitracin |
Name the two drugs that act on Phase I of cell wall synthesis |
Fosfomycis and Cycloserine |
Binds to the pentapeptide terminus and inhibits both transglycosylation and transpeptidation reactions during peptidoglycan assembly |
Vancomycin |
Which drug is not effective against gram negative bacteria because of its inability to pass through the cell membrane (due to bulky size) |
Vancomycin |
Which antibiotic is used to treat gram positive infections caused by organisms that are resistant to beta-lactams |
Vancomycin |
Resistance to what antibiotic is mediated by changes in the pentapeptide terminus |
Vancomycin |
A beta-lactam ring consists of 4 atoms, what are they? |
3 carbons and 1 nitrogen. |
The enzymes involved in this final process of cell wall formation are called |
penicillin-binding proteins (PBPs) |
In cephalosporins, the beta-lactam ring is fused with a _____________ ring. |
a dihydrothiazine ring |
Beta-lactam antibiotic that is only effective against aerobic gram negative bacteria |
Monobactams |
A beta-lactam antibiotic that has broad spectrum effects but, with resistance reported in oxacillin-resistant staphylococci and Pseudomonas |
Carbapenems |
Three general mechanisms of resistance to B-lactam antibiotics |
1) Prevention of the interaction between PBP and the antiobiotic 2) Modification of the interaction between PBP and the antibiotic 3) Hydrolysis of the antibiotic by B-lactamases |
Drug that is bactericidal against actively replicating Mycobacteria by inhibiting synthesis of mycolic acid |
Isoniazid |
High-molecular-weight octapeptides that inhibit Gram-negative bacteria by interacting with the membrane and increasing cell permeability. |
Polymyxins |
Antibiotic that is only used topically since it can form potent toxins, causing damage to the kidneys and nervous system. |
Polymyxins |
What is mode of action of Polymyxins |
Interact with the cell membrane, leading to increased cell permeability. |
One of the most widely used class of antibiotics |
Quinolones |
What is the mechanism of action of quinolones |
They are a synthetic agents that inhibit gyrase (usually gram -)or topoisomerase IV (usually gram +)thereby interfering with DNA replication, recombination, and repair. |
Newer fluoroquinolones such as ________, have broader spectrum against both Gram positive and Gram negative bacteria |
Ciproflaxacin |
Nitroimidazols only inhibit _______ ________and ________ by causing breaks in strands of DNA. |
Anaerobic bacteria and protozoa |
__________ is one of the most commonly used nitroimidazols |
?Metroniadazole |
Gram negative bacteria are intrinsically resistant to the hydrophobic drug ________, because of decreased uptake of the drug |
Rifamycin |
What is the mode of action for Rifamycins? |
?Rifamycins (Rifampin, Rifabutin) bind to bacterial RNA polymerase and inhibit initiation of RNA synthesis |
_________ is bactericidal for M. tuberculosis and active against many Gram positive bacteria |
?Rifampin (a rifamycin drug) |
Streptomycin is a member of which group of drugs |
Aminoglycosides |
Which group of drugs work synergistically with B-lactams |
Aminoglycosides
B-lactams increase their uptake. |
?Aminoglycosides are effective against many _________ and some ___________ bacteria |
Gram-negative, Gram-positive |
Tetracyclines are __________ (bactericidal/bacteriostatic) because they bind __________ to the 30S subunit. |
Bacteriostatic, reversibly |
Tetracyclines block binding of __________ to the 30S ribosomal subunit |
aminoacyl-tRNA |
Which family of drugs are broad spectrum ?Used to treat a wide variety of infections caused by: ?Chlamydia ?Mycoplasma ?Rickettsia ?And a variety of other Gram positive and Gram negative bacteria |
Tetracyclines |
Which classes of drugs inhibit the 30S ribosomal subunit |
Aminoglycosides and Tetracyclines |
Which classes of drugs target the 50S ribosomal unit |
Oxazolidinones, Lincosamides, Chloramphenicol, Macrolides, Streptogramins
|
Linezolid is the most commonly used _______. |
Oxazolidinones |
Which drug is active against gram positive cocci, including those resistant to penicillins, vancomycin, and aminoglycosides. |
Oxazolidinones (linezolid)
|
What is the mechanism of action for Lincosamides |
Block protein elongation by binding to the 50S subunit of the ribosome |
Lincosamides are active against _________ and anaerobic ____________ rods. |
Staphylococci, Gram-negative |
Which antibiotics show cross-resistance with macrolides |
Lincosamides |
What are two examples of Lincosamide drugs. |
Lincomycin and its derivative Clindamycin |
What is the mechanism of action for Chloramphenicol
|
Binds reversibly to the 50S ribosomal subunit (Bacteriostatic) |
Which drug has a broad similar spectrum to tetracyclines, but is not commmonly used in America?
|
Chloramphenicol |
Enzymatic inactivation of the antibiotic (acetylation) is a resistance mechanism against which antibiotic |
Chloramphenicol |
What is the mechanism of action for the macrolides |
Binds reversibly to the 23S RNA component of the 50S ribosomal subunit (bacteriostatic) |
Most gram negative bacteria are resistant to this class of drugs that is primarily used to treat pulmonary infections
|
Macrolides |
Erythromycin, Azithromycin, Clarithromycin are drugs from which class |
Macrolides |
Macrolides show cross-resistance which group of antibiotics |
Lincosamides |
Which class of drugs are cyclic peptides that are administered as a combination of two components. Group A and Group B |
Streptogramins |
For steptogramins Group A component binds to the ______________ and facilitates binding of the _____________. Group B component inhibits _____ _______. |
50S ribosomal subunit chain elongation |
Which class of antibiotics is most commonly used against staphylococci, streptococci and Enterococcus faecium |
Steptogramins |
Folic acid is composed of which 3 components |
Pteridine, PABA, Glutamic acid |
What is the main function of antimetabolites |
Interfere with folic acid synthesis |
Two examples of antimetabolites are: |
Sulfonamides and Trimethoprims |
Sulfonamides and Trimethoprims are __________ (bactericidal/bacteriostatic) and have _______ range. |
Bacteriostatic Broad range |
The antimetabolite, ______________, p-aminosalicylic acid –is often used in combo with others (usually ________) for treatment of mycobacterial infections |
-p-aminosalicylic acid isoniazid |
Sulfonamides and Trimethoprims inhibit different steps of ____ ____ synthesis, and therefore, can be used ___________. |
folic acid synergistically |
?One form of resistance is decreased affinity of dihydrofolate reductase for the drug, ________. |
trimethoprim |
?Enterococci can use exogenous thymidine and are intrinsically resistant to which class of drugs |
Antimetabolites |
Which method would be effective on materials that would be destroyed by heat (e.g. petri dishes, gloves, syringes) |
Radiation |
Which cleaning method is used only to clean, and does NOT sterilize materials. |
Ultrasonification |
Which method cleans through cavitation bubbles which losen attached materials. |
Ultrasonification |
Which cleaning method removes microorganisms from liquids that would be destroyed by heat
What are some examples of these liquids |
Filtration ex: enzymes, vaccines, antibiotics |
What is the approximate size of pores used in filtration |
< 0.22 µm pore |
What are the 3 methods of sterilization monitoring. Give an example of each Which is most accurate? |
Mechanical, Chemical, and Biological Mechanical: monitor cycle length, pressure, or temperature Chemical: use external or internal chemical indicators Biological: Directly assess killing of known highly resistant microorganisms once per week mininimum.
Biological is only one that proves sterility |
What would be typical settings for an autoclave. |
15 lbs/sq inch pressure for 15-20 min at 121oC |
What are typical settings for hot air sterilization |
160 degrees Celcius for 1-4 hrs. |
Alcohols are not effective against __________ bacteria. |
spore-forming |
disruption of cellular membranes, solubilization of lipids, and denaturation of proteins by acting directly on S-H functional groups are modes of action for what chemical |
Alcohol |
What are the recommended vaccines for health care workers |
Influenza, MMR, VZV (live virus vaccine), HBV |
What is the change of getting HBV after a skin-puncture with a needle |
27-37% |
Which organisms/proteins can survive autoclaving and most chemical treatments |
Prions |
One time use of critical instruments Don't allow tissue to dry on instruments Completely clean instruments and autoclave at 134 degrees Celcius for 18 minutes ; These are precautions for which disease? |
Creutzfeld-Jakob Disease |
A word for the ability to cause fever. |
Pyrogenicity |
Thrombosis: Formation of blood clot (thrombus) in heart or blood vessel Thrombocytopenia: Abnormally low numbers of blood platelets; These are effects cause by what? |
Endotoxin |
The anthrax toxin contains 3 separate proteins: |
Protective antigen (PA) Edema factor (EF) Lethal factor (LF) |
For which toxin does B-subunit binds to Gb3 glycolipid receptor A -subunit;prevents binding of aminoacyl-transfer RNA by cleaving 28S rRNA from 60S ribosomal subunit resulting in inhibition of protein synthesis |
Shiga toxin, from bacterium; Shigella dysenteriae |
Which toxin has an A-subunit that migrates to the CNS pre-synaptic nerve endings, builds up in vesicles and leads to continuous stimulation of muscles |
Tetanus toxin |
Which toxin has an A-subunit that inhibits the release of acetylcholine at myoneural junctions resulting in flaccid paralysis and death |
Botulinum toxins |
Which toxins inhibits leukocyte chemotaxis and activity |
Adenylate cyclase toxin and Pertussis toxin from Bordetella sp. |
Phase variation is always ________ |
reversible |
Promoter inversions for E. coli type I pili and;Salmonella flagellar genes;are examples of what |
Site-specific recombination |