Corynebacterium diphtheriae
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Questions and Answers

Why are pregnant women at high risk of Listeria infection?

  • Their cell-mediated immunity increases during the third trimester.
  • Their cell-mediated immunity decreases during the third trimester. (correct)
  • They are more likely to be exposed to contaminated water sources.
  • They are more likely to consume unpasteurized dairy products.

Diphtheria antitoxin can reverse damage already done to tissues by the diphtheria toxin.

False (B)

Besides pregnant women, name the third at-risk group highly susceptible to Listeria infections.

neonates

In cases of suspected diphtheria, treatment should proceed rapidly with antitoxin to neutralize circulating toxin and either penicillin or erythromycin to prevent further ______ release.

<p>exotoxin</p> Signup and view all the answers

What is a common outcome for neonates infected with Listeria?

<p>Premature birth with active infection (D)</p> Signup and view all the answers

A pediatric patient presents with a sore throat, fever, and a thick, dark exudate on their pharynx. Which organism is most likely the cause?

<p>Corynebacterium diphtheriae (C)</p> Signup and view all the answers

Listeria monocytogenes is a spore-forming bacterium.

<p>False (B)</p> Signup and view all the answers

What motility characteristic is exhibited by Listeria monocytogenes when grown at 25°C?

<p>tumbling motility</p> Signup and view all the answers

Listeria monocytogenes can grow at low temperatures and is often cultured at 4-10°C, a process called ______.

<p>cold-enrichment</p> Signup and view all the answers

Listeria monocytogenes, when isolated in blood, is often mistaken for what type of organism?

<p>Diphtheroid (D)</p> Signup and view all the answers

What is the primary mechanism by which Corynebacterium diphtheriae exotoxin damages heart and neural cells?

<p>Interfering with protein synthesis. (C)</p> Signup and view all the answers

Gram stain of a specimen from the pseudomembrane of Corynebacterium diphtheriae is always a reliable and rapid diagnostic tool.

<p>False (B)</p> Signup and view all the answers

What is the main virulence factor of Listeria monocytogenes that enables its intracellular survival?

<p>Listeriolysin O</p> Signup and view all the answers

The pseudomembrane formed in diphtheria is composed of fibrin, leukocytes, necrotic epithelial cells, and ________.

<p>Corynebacterium diphtheriae cells</p> Signup and view all the answers

Why is it strongly advised against scraping off the pseudomembrane in a diphtheria infection?

<p>It can cause bleeding and enhance systemic absorption of the exotoxin. (D)</p> Signup and view all the answers

In a pediatric emergency scenario, a child presents with a severe sore throat, fever, and a dark, thick inflammatory exudate on their pharynx reminiscent of diphtheria. Which characteristic of Listeria monocytogenes could initially mislead lab technicians, potentially delaying accurate diagnosis?

<p>Its initial misidentification as a diphtheroid due to similar morphological features in blood. (A)</p> Signup and view all the answers

The cold enrichment technique for isolating Listeria monocytogenes relies on its inability to grow at low temperatures.

<p>False (B)</p> Signup and view all the answers

What crucial motility characteristic does Listeria monocytogenes exhibit when cultured at 25 °C that aids in its identification?

<p>tumbling motility</p> Signup and view all the answers

The inflammatory exudate on a child's pharynx caused by Corynebacterium appears ______ and thicker compared to streptococcal pharyngitis.

<p>darker</p> Signup and view all the answers

Which of the following statements about gram-positive rods in pediatric infections is the MOST accurate?

<p><em>Listeria monocytogenes</em> is facultatively anaerobic, and both <em>Listeria</em> and <em>Corynebacterium</em> can infect patients in the pediatric age group. (A)</p> Signup and view all the answers

Which of the following physiological conditions in high-risk groups primarily contributes to the flourishing of Listeria monocytogenes and subsequent infection of the meninges?

<p>Inability to activate phagocytic cells in neonates. (D)</p> Signup and view all the answers

Listeria monocytogenes infections during pregnancy invariably lead to severe meningitis in all affected women.

<p>False (B)</p> Signup and view all the answers

Name two antibiotics commonly used in the treatment of Listeria monocytogenes infections.

<p>Ampicillin or trimethoprim sulfamethoxazole</p> Signup and view all the answers

Bacteria sharing morphological features with Corynebacterium diphtheriae are collectively referred to as either Coryneform bacteria or __________.

<p>diphtheroids</p> Signup and view all the answers

Match the following Coryneform bacteria with the type of infections they are commonly associated with:

<p>Corynebacterium jeikeium = Catheter-related infections Corynebacterium urealyticum = Surgical wound infections Corynebacterium amycolatum = Prosthetic device related infections Corynebacterium striatum = Native and prosthetic valve endocarditis</p> Signup and view all the answers

What immunological effect does pregnancy have that increases the risk of Listeria monocytogenes infection?

<p>Depression of cell-mediated immunity (D)</p> Signup and view all the answers

Coryneform bacteria are exclusively pathogenic and never found as normal flora on human skin.

<p>False (B)</p> Signup and view all the answers

Besides Listeria monocytogenes, which of the following bacteria is NOT commonly associated with causing infections related to implanted medical devices in hospitalized patients?

<p><em>Arcanobacterium haemolyticum</em> (B)</p> Signup and view all the answers

The ability of Listeria monocytogenes to infect the meninges in neonates is primarily attributed to the immaturity of their _______ cells.

<p>phagocytic</p> Signup and view all the answers

Name three environments where Coryneform bacteria are commonly found.

<p>Water, soil, and human skin/mucous membranes</p> Signup and view all the answers

Flashcards

Pseudomembrane

A membrane made of fibrin, leukocytes, dead cells, and Corynebacterium diphtheriae.

Diphtheria Exotoxin

It damages heart and nerve cells by stopping protein synthesis.

Listeriolysin O

Allows it to escape phagolysosomes of macrophages and avoid intracellular killing.

Diphtheria Diagnosis

Culture on potassium tellurite agar and Loeftler's coagulated blood serum media.

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Gram Stain Diphtheria

Gram-positive rods are not always seen.

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Corynebacterium & Listeria

Gram-positive rods that commonly infect pediatric age groups.

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Listeria monocytogenes

A small, facultatively anaerobic, non-spore forming gram-positive rod. May be mistaken for a diphtheroid.

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Pharyngeal Presentation of Corynebacterium

Dark inflammatory exudate on the pharynx, thicker than strep throat.

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Cold-Enrichment

Grows at low temperatures (4-10°C) to differentiate it from other bacteria.

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Listeria Motility

The bacteria has 1-5 flagella and exhibits tumbling motility (especially at 25°C).

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Listeriosis Risks

Bacterial infection particularly dangerous for pregnant women, newborns, the elderly, and immunocompromised individuals, often leading to meningitis.

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Listeria in Pregnancy

Infection typically occurs during the third trimester due to decreased cell-mediated immunity.

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Listeria Symptoms in Pregnant Women

Bacterial infection that can lead to bacteremia and sepsis in pregnant women, though meningitis is less common.

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Fetal Listeria Effects

The bacteria can infect the fetus, leading to premature birth, neonatal death (22% of cases), or active infection in surviving babies.

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Listeria Transmission

Acquired through the ingestion of contaminated food.

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Listeria Identification

A gram-positive rod that can be mistaken for a diphtheroid in blood cultures.

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Corynebacterium Colonization

Colonizes the pharynx, forming a grayish membrane.

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Listeria & Cold Temperatures

Grows at low temperatures (4-10°C), differentiating it from other bacteria.

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Listeria Lab Confusion

Often identified by labs in blood samples as a diphtheroid.

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Listeria & Immune Status

Neonates and immunosuppressed patients can't effectively activate phagocytic cells.

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Listeria in Pregnant Women

Meningitis or asymptomatic carriage.

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Listeria Treatment

Ampicillin or trimethoprim sulfamethoxazole.

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Coryneform Bacteria

Bacteria sharing morphological features with Corynebacterium diphtheriae.

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Coryneform Genera

Corynebacterium, Arcanubacterium, Breuibacterium, Microbacterium.

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Coryneform Habitats

Water, soil, human skin, and mucous membranes.

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Coryneform Infections

Surgical wound infections, catheter and prosthetic device infections, and native and prosthetic valve endocarditis.

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Common Nosocomial Corynebacterium

Corynebacterium jeikeium, Corynebacterium urealyticum, Corynebacterium amycolatum, and Corynebacterium striatum.

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Nosocomial Corynebacterium Pathogens

Corynebacterium jeikeium, Corynebacterium urealyticum, Corynebacterium amycolatum, and Corynebacterium striatum.

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Study Notes

Corynebacterium

  • Immediately send the throat and nasopharynx swabs for culture.
  • However, culture results aren't immediate.

Listeria Monocytogenes

  • Causes ~20% of all neonatal meningitis since the advent of Haemophilus influenzae vaccination.

Listeriosis High Risk Groups

  • Pregnant women should avoid soft cheeses and cold cuts because Listeria is acquired from contaminated foods.
  • Listeria monocytogenes, Escherichia coli, and Group B Streptococcus are three bacteria responsible for most meningitis acquired by the baby coming out of the birth canal (within first 3 months of age).
  • Neisseria meningitides and Haemophilus influenzae cause meningitis later in life, after the maternal antibodies passively given to fetus wane and before new antibodies develop.

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Description

This lesson covers Corynebacterium diphtheriae, a bacterium that colonizes the pharynx and releases a potent exotoxin. Diagnosis involves culturing swabs on specific media like potassium tellurite agar. Treatment includes antitoxins, antibiotics like penicillin or erythromycin, and the DPT vaccine.

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