Microbiology GI – Flashcards
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| Anaerobic Normal flora of the upper respiratory tract |
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| Peptostreptococcus |
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| Anaerobic Normal flora of the upper respiratory tract |
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| Veillonella |
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| Anaerobic Normal flora of the upper respiratory tract |
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| Actinomyces |
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| Anaerobic Normal flora of the upper respiratory tract |
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| Fusobacterium |
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| Aerobic Normal flora of the upper respiratory tract |
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| Streptococcus pyogenes |
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| Aerobic Normal flora of the upper respiratory tract |
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| Streptococcus pneumoniae |
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| Aerobic Normal flora of the upper respiratory tract |
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| Staphylococcus aureus |
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| Aerobic Normal flora of the upper respiratory tract |
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| Neisseria meningitidis |
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| Aerobic Normal flora of the upper respiratory tract |
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| Haemophilus Influenzae |
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| Aerobic Normal flora of the upper respiratory tract |
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| Moraxella catarrhalis |
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| Aerobic Normal flora of the upper respiratory tract |
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| Members of enterobacteriaceae |
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| Oral cavity normal flora associated with acute endocarditis |
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| HACEK |
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| Oral cavity normal flora associated with subacute endocarditis |
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| Viridans Streptococcus |
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| Normal flora of the stomach |
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| Helicobacter |
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| Normal flora of the stomach |
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| Lactobacillus |
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| Normal flora of the stomach |
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| Streptococcus |
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| Normal flora of the small intestine |
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| Peptostreptococcus |
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| Normal flora of the small intestine |
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| Porphyromonas |
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| Normal flora of the small intestine |
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| Prevotella |
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| Major reservoir of bacteria in the body |
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| Large intestine |
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| Normal flora of the large intestine |
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| Bacteroides |
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| Normal flora of the large intestine |
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| Bifidobacterium (probiotic bacterium) |
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| Normal flora of the large intestine |
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| Clostridium |
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| Normal flora of the large intestine |
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| Eubacterium |
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| Normal flora of the large intestine |
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| Enterococcus |
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| Normal flora of the large intestine |
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| Escherichia coli |
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| Cariogenic biofilm formation and lactic acid production can lead to dissolution of tooth enamel known as a dental caries, which bacteria is mainly responsible |
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| Streptococcus mutans |
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| Swelling, erythema, gum recession, bone resorption |
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| Periodontal disease |
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| Early colonizers of periodontal biofilm formation |
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| Gram + bacteria |
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| late colonizers of periodontal biofilm formation |
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| Gram - bacteria (Tannerella forsythus, Aggregatibacter actinomycetemcomitans, Porphyromonas, Fusobacterium, Treponema) |
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| Bacterial products leading to inflammatory response in periodontal disease |
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| Endotoxins and volatile sulfur products |
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| Necrotizing ulcerative gingivitis and periodontitis (trench mouth, vincents angina)is caused by what bacteria |
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| Synergistic infection involving: Treponema vincentii, Prevotella intermedia, Fusobacterium nucleatum |
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| This bacteria causes gastritis and gastric ulcers |
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| Helicobacter pylori |
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| Sharp burning pain emanating from the abdomen |
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| Gastritis |
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| Gram (-), vibrio with 6 polar-sheathed flagella (highly motile) |
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| Helicobacter pylori |
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| Contains urease |
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| Helicobacter pylori |
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| Provides alkaline environment by converting urea into ammonia |
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| Helicobacter pylori |
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| Acting as an antigen patients show elevated levels of IgA and IgG |
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| Urease, H. pylori |
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| Uses flagella to move through mucus to stomach lining and resist effects of peristaltic flushing |
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| Helicobacter pylori |
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| Adherence to epithelial cells using an adhesin which is the same molecule found on human O type RBC |
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| Helicobacter pylori |
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| Humans are primary reservoir, person to person transmission through fecal oral or oral fecal, worldwide incidence is high |
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| Helicobacter pylori |
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| Diagnosis using endoscopic exam for lesions and biopsy specimen |
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| Helicobacter pylori |
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| Diagnosis using noninvasive urea breathe test (UBT) |
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| Helicobacter pylori |
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| Can Diagnosis through ELISA but endoscopy may be required for confirmation |
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| Helicobacter pylori |
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| Treat with antibiotics plus acid suppressors |
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| Helicobacter pylori |
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| Bacteria causing acute bacterial diarrhea |
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| Salmonella, Shigella, Escherichia, Campylobacter, Yersinia, Clostridium difficile, Vibrio cholerae, |
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| Frequent loose, watery stools, abdominal cramps and pain, fever, bleeding, dizziness from dehydration |
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| Acute bacterial diarrhea |
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| Transmitted by contaminated food, treatment is variable, most cases are self limiting |
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| Acute bacterial diarrhea |
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| Gram (-) bacilli with flagella, member of enterobacteriaceae |
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| Salmonella |
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| More than 200 serotypes based on O and H antigens |
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| Salmonella |
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| Obstruction of small intestine leads to colonization of bacterium from the large intestine |
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| Blind loop syndrome |
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| Cause most cases of salmonellosis |
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| variants Paratyphi, Hirschefeldii, Typhimurium |
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| Salmonella in reptiles |
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| Variant Arizona hinawii |
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| Salmonella responsible for typhoid fever |
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| Variant typhi |
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| Ability to grow in M cells of pyers patches and nonactivated macrophages |
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| Salmonella |
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| Pathogenicity islands contain adhesins responsible for entry and possible systemic spread, also contains an endotoxin |
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| Salmonella |
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| Ingestion of organism>absorbed to epithelial cells in terminal SI>penetrate cells and migrate to lamina propria>multiply in lymphoid follicles>PMNs confine infection to GI>inflammtion causes release of prostaglandins>hypothalamus>Inc cAMP>fluid secretion resulting in diarrhea |
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| Salmonellosis, Salmonella |
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| Spread of bacteria not confined to GI leading to prolonged disease and focal infections (osteomyelitis, pneumonia, pulmonary abscess, menigitis) |
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| Septicemia, Salmonella |
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| First week of infection contains no diarrhea>2nd week contains intracellular replication and prolonged bacteremia>Weeks 3-5 include includes infection of biliary system, rose colored spots and diarrhea |
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| Typhoid fever, Salmonella |
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| Complications include intestinal perforation, bleeding, and pneumonia |
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| Typhoid fever, Salmonella |
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| One of the more common bacterial diseases in the US, caused by contaminated food (beef, poultry, eggs, dairy) |
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| Salmonellosis, Salmonella |
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| Large animal reservoir of: cattle, chickens, rodents, reptiles |
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| Salmonellosis, Salmonella |
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| Large number of bacteria are required for symptomatic disease so person to person transmission is not common |
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| Salmonellosis, Salmonella |
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| Human carriers (gall bladder) are the only known reservoir |
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| Typhoid fever, Salmonella |
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| Major route of transmission is through water contaminated with human feces, low infectious dose so person to person spread is common, usually acquired in endemic areas of developing countries |
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| Typhoid fever, Salmonella |
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| Diagnosis from isolation of fecal matter, serological tests determines O antigen, differentiate from shigella includes: motile, bile resistant, H2S and gas production from fermentation |
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| Salmonellosis, Salmonella |
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| Blood cultures during first 2 weeks of illness |
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| Septicemia and Typhoid fever, Salmonella |
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| Treatment includes: replenish fluid loss, antibiotics are not used because they prolong the carrier state and do not shorten course of illness |
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| Salmenollosis, Salmonella |
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| Unlike salmonellosis treatment involves use of antibiotics |
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| Septicemia and Typhoid fever, Salmonella |
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| Vaccine for poultry is used and has reduced incidence |
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| Salmonella |
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| Vaccine available and effective, especially in children in locations where incidence is high |
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| Typhoid fever, Salmonella |
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| Salmonella and typhoid fever are reportable diseases |
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| True |
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| Non motile, no H2S or gas production during fermentation, inhibited by high concentrations of bile |
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| Shigella |
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| H. pylori is a member of Enterobacteriaceae |
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| False |
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| Salmonella is a member of Enterobacteriaceae |
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| True |
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| Shigella is a member of Enterobacteriaceae |
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| True |
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| Well known species of Shigella |
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| S. dysenteriae |
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| Well known species of Shigella |
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| S. flexneri |
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| Well known species of Shigella |
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| S sonnei |
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| Virulence factor contains a shiga toxin, ability to induce phagocytosis grow within and kill host |
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| Shigella |
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| Shiga toxin is an enterotoxin |
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| True |
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| Demonstrates both cytotoxic and neurotoxic activity |
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| Shiga toxin |
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| A-B toxin (A binds to ribosome inhibiting protein synthesis) damaging the mucosa and villi leading to bleeding and heavy secretion of mucus |
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| Shiga toxin |
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| Lesions develop in the intestinal tract in stages: penetrate>spread>kill>histology shows micro ulcers or gross ulcers with sloughing epithelium |
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| Shigella |
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| Symptoms vary from asymptomatic to severe with abdominal cramps, blood and pus in stool. Disease runs its course in about 10 days |
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| Shigellosis-bacillary dysentery, Shigella |
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| Humans are natural host, low infectious dose with high communicability, spread by direct fecal oral or mechanical route. Majority of cases occur in children 1-10 yoa |
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| Shigella |
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| In the US and other developed countries this is the most common spp of Shigella |
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| S. sonnei |
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| Diagnosis by loose stool containing mucus and bright red blood |
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| Shigella |
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| Fresh passed stool specimens for isolating bacterium, if stored too long, acid in feces will inhibit growth |
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| Shigella |
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| Negative Triple iron sugar test (TSI) |
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| Shigella |
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| Treat dehydration and fever, all infections treated with antibiotics |
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| Shigella |
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| Shigella is a reportable disease |
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| True |
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| Member of Enterobacteriaceae, normal flora of intestinal tract, cause many opportunistic and nosocomial infections |
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| Escherichia |
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| Small gram (-) rod with fimbriae and flagella |
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| Escherichia |
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| O, H, K antigen determined for epidemiological studies |
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| Escherichia |
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| Infects small intestine, 2 plasmid enterotoxins causing fluid and electrolyte loss, similar to cholera toxin |
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| ETEC |
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| Primary cause of travelers disease |
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| ETEC |
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| Aka shiga toxin |
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| EHEC |
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| Infects the large intestine producing 2 cytotoxins, type III secretion system introduces bacterial products directly into gut epithelial cells |
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| EHEC |
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| Verocytotoxins |
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| EHEC |
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| May cause a variety of illness including watery diarrhea followed by bloody diarrhea with little or no fever and Hemolytic uremic syndrome |
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| EHEC |
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| Most common serotype causing HUS |
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| O157:H7 |
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| Acute renal failure and thrombocytopenia with highest incidence in children <5 yoa |
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| HUS |
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| Foods of animal origin are probably the major source of human infection, mainly hamburgers |
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| EHEC |
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| Epidemic infantile diarrhea with non blood stool |
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| EPEC |
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| Dysentery with scant, blood stools with mucus and PMNs like shigella, however, does not produce a toxin |
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| EIEC |
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| Infection occurs in adults and nosocomial infections in infants |
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| Escherichia |
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| Transmission is not person to person, rather via contaminated food or water |
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| Escherichia |
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| Most common strains of Escherichia producing disease in developing countries |
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| EHEC |
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| In addition to ground beef, infection includes contaminated water, unpasteurized milk, fruit juice, uncooked vegetables, fruits |
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| EHEC |
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| If suspected diagnosis stool cultures on MacConkey-sorbitol agar |
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| HUS |
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| diagnostic test used to differentiate EHEC from normal flora Escherichia |
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| MacConkey-sorbitol agar |
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| This medium contains bile salts that inhibit growth of gram (+) bacteria, pH indicator reveals fermentation of sorbitol |
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| MacConkey-sorbitol agar |
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| Does not ferment sorbitol |
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| EHEC |
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| Assay for enterotoxins or presence of toxin genes on plasmids, serology and pulse field gel electrophoresis for epidemiology |
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| Escherichia |
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| Antibiotic resistance is a problem, spread of R factors is common among strains of species |
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| Escherichia |
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| Treatment for short term illness does not recommend antibiotics, long term illness does and infants (except for one strain) do recommend antibiotics |
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| Escherichia |
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| Antibiotics increase risk of developing HUS |
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| EHEC |
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| Most common cause of bacterial diarrhea in the US |
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| Campylobacter jejuni |
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| Gram (-), vibrio like, wings of a seagull |
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| Campylobacter |
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| Includes LPS, enterotoxin, flagella; bacteremia in some patients.ulcerated, edematous, and bloody invasion of mucosal surface, infiltration of lamina propria with neutrophils, eosinophils, and mononuclear cells |
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| Campylobacter |
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| Infection varies from asymtomatic to acute gastroenteritis with liquid and/or bloody diarrhea. In older compromised individuals disease may appear as acute bactermia with inflammatory bowel and cause death |
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| Campylobacter |
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| 20-40% of Guillain-Barre syndrome (GBS) cases are preceded by this bacteria |
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| Campylobacter |
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| Unknown mechanism causing acute paralysis |
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| Guillain-Barre syndrome |
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| Flora of mammals (pigs, cattle, dogs, cats, rabbits, and birds including poultry), contaminated water and other foods cause large outbreaks especially in developed countries |
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| Campylobacter |
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| Campylobacter is a reportable disease |
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| False |
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| Individuals at risk are those who are exposed to a large number of organisms and lack gastric acids |
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| Campylobacter |
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| Fecal oral and person to person transmission occur but it is unlikely to be transmitted by food handlers |
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| Campylobacter |
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| Diagnosis: Use dark field microscopy and Campy BAP |
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| Campylobacter |
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| Specialized media containing antibiotics to inhibit other fecal organisms |
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| Campy BAP |
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| Grow best at reduced oxygen and 42C |
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| Campylobacter |
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| Treatment includes rehydration with electrolytes for mild cases, antibiotics for more sever cases |
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| Campylobacter |
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| Causes GI tract disease found in cooler areas of the US |
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| Yersinia enterocolitica, Yersinia pseudotuberculosis |
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| Causes sever abdominal pain sometimes mistaken for appendicitis |
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| Yersinia enterocolitica, Yersinia pseudotuberculosis |
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| Gram (+), endospore forming, obligate anerobe |
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| Clostridium difficile |
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| The use can clindomycin, ampicilin, and cephalosprins may lead to pseudomembranous colitis |
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| Clostridium difficile |
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| May be resistant to antibiotic, gastric acid inhibitors may predispose over growth of bacterium |
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| Clostridium difficile |
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| 2 enterotoxins, A and B, cause necrosis in the wall of the intestine |
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| Clostridium difficile |
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| source of infecting strain can be endogenous or exogneous, risk factors include antibiotic exposure, old age, female, and impaired intestinal motility |
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| Clostridium difficile |
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| Incidence varies with degree of hospital incidence with bacterial spores |
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| Clostridium difficile |
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| Other than Clostridium difficile, this bacteria may cause antibiotic resistant colitis |
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| Staphylococcus aureus |
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| Use a combination of test for presumptive diagnosis |
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| Clostridium difficile |
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| Treatment includes avoiding drugs that slow intestinal motility or broad antibiotics and substitute antibiotics |
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| Clostridium difficile |
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| Probiotics and donor stool translplants are attempted |
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| Clostridium difficile |
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| Large number of spores shed in stool, especially in hospital environment |
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| Clostridium difficile |
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| Short, gram (-) curved rod with polar flagella |
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| Vibrio cholerae |
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| Natural habitat is marine or brackish water but can survive in fresh water |
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| Vibrio cholerae |
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| A-B type ADP ribosylating toxin with 5 B and 2 A subunits |
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| Vibrio cholerae |
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| TCBS agar |
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| Vibrio cholerae |
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| Toxin binds Gm1 gangliosides on host mucosal cells allowing A1 subunit to inhibit systhensis of G1 protein used to regulate adenylate cyclase which controlls cAMP levels. This leads to electrolyte imbalance and diarrhea |
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| Vibrio cholerae |
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| Rice water diarrhea |
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| Vibrio cholerae |
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| Fecal oral transmission, human spread is increased by the bacterias ability to survive in fresh water as well as salt water |
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| Vibrio cholerae |
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| Human caries serve as reservoirs (2 type): convalescent sheds for several months after illness, chronic carrier is usually an older individual carrying the organism in the gall bladder with intermittent shedding |
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| Vibrio cholerae |
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| Theory of permanent reservoir in estuaries and marshes in tropical and subtropical areas of the world (India, bangladesh, gulf coast of US) |
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| Vibrio cholerae |
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| Most cases involve contaminated seafood from gulf waters |
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| Vibrio cholerae |
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| killed, whole cell vaccine does not provide long term immunity but is effective for travelers |
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| Vibrio cholerae |
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| Vibrio cholerae is a reportable disease |
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| True |
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| Acute bacterial diarrhea with vomiting (food poisoning) |
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| Staphylococcus aureus, Bacillus cereus, Clostridium perfringens |
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| Found in: custards, sauces, cream pastries, processed meats, chicken salad, ham that have been contaminated and left unrefrigerated for a few hours, heating food after toxin prevention may not prevent disease |
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| Staphylococcus aureus |
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| 2 clinical forms of food poisoning producing to enterotoxins: 1 emetic form and 1 diarrheal form |
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| Bacillus cereus |
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| Incubation period of ~4 hr. Heat stable enterotoxin found in fried rice and vegetables. |
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| Emetic form, Bacillus cereus |
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| Incubation of ~16-18 hours. Heat-labile enterotoxin associated with abdominal cramps and diarrhea. Found in contaminated meat and vegetables |
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| Gram (+) spore forming, naturally present in soil |
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| Bacillus cereus |
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| Non enveloped with a double layered protein capsid resistant to drying, detergents, and pH |
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| Rotavirus |
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| Virus has a wheel like appearance |
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| Rotavirus |
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| One of the proteins contains a viral enterotoxin. Group A are the major cause of of this virus worldwide |
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| Rotavirus |
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| Viral disease severe in infants <2 yoa |
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| Rotavirus |
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| Major cause of death in children <5 yoa |
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| Rotavirus |
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| Cause of infant diarrhea (Human Infantile Gastroenteritis) |
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| Rotavirus |
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| Watery diarrhea, vomiting, fever, abdominal pain. Asymptomatic in adults |
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| Rotavirus |
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| Cell culture is not performed because it is difficult to cultivate virus from clinical specimen |
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| Rotavirus |
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| Virus spread primarily by fecal oral route. Asymptomatic shedding may occur, fomites can remain infectious at room temp for many months |
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| Rotavirus |
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| Outbreaks in N America occur in fall, winter, spring. Worldwide occur throughout the year |
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| Rotavirus |
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| Immunity after infection of this virus only lessens severity of subsequent infection. Protective immunity requires IgA in the gut lumen |
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| Rotavirus |
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| Virus is inactivated by chlorine and contains to live oral vaccines |
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| Rotavirus |
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| The initial vaccine for this virus was taken off the market due to intussesception |
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| Rotavirus |
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| No anti viral treatment available. Replenish fluid and electrolytes. Do not give fruit juices or soda due to high glucose content |
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| Rotavirus |
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| This virus has been known to bind blood group antigens in animal excretions |
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| Norovirus |
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| More data is needed to conclusively call this a zoonotic virus |
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| Norovirus |
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| Most important non bacterial cause of acute gastroenteritis for all ages, worldwide |
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| Norovirus |
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| Sometimes referred to as stomach flu, although not related to influenza |
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| Norovirus |
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| Many different strains of this virus prevent lifelong immunity. Dehydration occurs in the very young, elderly, and weakened immune systems |
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| Norovirus |
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| Cruise ships are particularly vulnerable due to crowding, frequent passenger changes, and difficult decontamination in short time periods |
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| Norovirus |
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| Highly contagious virus spread through fecal oral, fomites, inhalation, direct contact. Day cares are a major source of infection |
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| Norovirus |
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| There is a vaccine and antiviral drugs for Norovirus |
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| False |
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| Star like morphology |
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| Astroviruses |
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| Of the 8 types of this virus, Type 1 is most commonly seen worldwide |
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| Astroviruses |
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| Infection is seen primarily in children <1 yoa suggesting lack of maternal antibodies. Incidence mostly in tropical climates during winter months |
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| Astroviruses |
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| There is a vaccine and antiviral drugs for Astroviruses |
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| False |
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| Symptoms include release of liver enzymes and classic icteric symptoms: jaundince, dark urine, and clay colored stool |
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| Hepatitis |
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| Most common cause of acute hepatitis |
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| HAV |
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| Most common cause of chronic hepatitis |
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| HCV |
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| Waterborne hepatitis viruses |
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| HAV, HEV |
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| Blood borne hepatitis viruses |
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| HBV, HCV, HDV |
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| Blood borne hepatitis viruses |
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| HBV, HCV, HDV |
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| Blood borne hepatitis viruses |
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| HBV, HCV, HDV |
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| Hepatitis that persists >6 mth is termed chronic |
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| True |
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| Liver damage due to hepatitis is not due to cytopathic effect bur rather immune mediated attack on infected hepatocytes |
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| True |
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| There is only 1 serotype of HAV |
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| True |
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| Complete recovery from this form of hepatitis is seen 99% of the time |
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| HAV |
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| Complete recovery from this form of hepatitis is seen 99% of the time |
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| HAV |
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| Lab diagnosis of this virus is done by ELISA with early detection of anti___ IgM |
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| HAV |
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| Transmission of this virus is through fecal oral route (fresh or salt water in shellfish or contaminated sewage), sharing utensils, sexual, poor hygiene, and overcrowding |
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| HAV |
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| Virus causes mild disease in children, abrupt onset in adults, worldwide incidence with no seasonal incidence |
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| HAV |
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| Virus contains a protease that cleaves an important component of the IFN signaling pathyway reducing type 1 interferon respone |
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| HAV |
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| Antibody protection for HAV is lifetlong |
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| True |
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| If HAV vaccine is given within 2 weeks of exposure to illness there is an 80% efficacy in prevention |
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| True |
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| There is no antiviral treatment, however, Ig given within 2 weeks of exposure can prevent clinical illness |
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| HAV |
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| Chlorine treatment does not kill HAV |
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| False |
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| Viral core contains DNA, RT, core antigen, and a specific glycoprotein |
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| HBV |
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| Dane particle |
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| HBV |
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| Viral envelope contains an immunogenic surface antigen which binds and block the action of neutralizing antibodies |
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| HBV |
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| Serological diagnosis by profile of antibodies against core or surface antigens |
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| HBV |
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| Histological hallmark is a ground-glass hepatocyte cytopathology |
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| HBV |
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| Presence of this antigen indicates an active HBV infection |
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| HBeAg |
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| Key diagnostic test for HBV infection is detection of this antigen |
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| HBsAg |
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| Appearance of this indicates decreased HBV replication |
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| Anti-HBe |
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| Transmission for this virus includes: neonatal from mothers blood, sexual activity, IV drug use. At risk regions include China, Alaska, Africa, Pacific Islands |
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| HBV |
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| In the USA prevalence of this virus is highest in asians, african americans, and native americans |
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| HBV |
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| Single serotype, vaccine includes the surface antigen |
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| HBV |
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| Requires HBVsAg to cause infection |
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| HDV |
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| Smallest human pathogen known so far |
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| HDV |
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| Viral RNA has ribozyme activity |
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| HDV |
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| Transmission through blood, semen, vaginal secretion. May lead to chronic infection including enchephalopathy and massive hepatic necrosis |
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| HDV |
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| No Ig or vaccine available but HBV vaccine will indirectly prevent against this virus |
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| HDV |
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| Acute infection is usually asymptomatic and may go undiagnosed. This sets up a chronic infection and predisposes the liver to cirrhosis and carcinoma |
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| HCV |
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| Long term consequences are more severe than HBV |
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| HCV |
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| Transmission: blood, needles, tattoo, piercing, circumcision, less frequently sex and perinatal |
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| HCV |
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| Treat with alpha-2 interferon alone or in combination with Ribavirin for large increases in ALT serum levels |
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| HCV |
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| Hemolytic anemia is a side effect of Ribavirin, therefore Hg levels should be monitored |
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| HCV |
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| Identified as the causative agent for non-A, non-B hepatitis |
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| HCV |
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| Enteric non-A, non-B |
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| HEV |
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| Spread through fecal oral route and contaminated water, cases in Japan resulted in consumption of deer or pig meat |
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| HEV |
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| Mortality rate higher than HAV especially for pregnant women in 3rd trimester |
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| HEV |
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| Most problematic in developing countries: India, pakistan, nepal, burma, north africa, mexico |
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| HEV |
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| Infection clinically indistinguishable from HAV and self limiting. Recently there has been development of an ELISA for Igm |
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| HEV |
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| Diarrhea, cramps, fever, leukocytosis, inflammation, necrosis |
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| Clostridium difficile |
