Medical Microbiology 4th Year: Gram-Positive Rods

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Questions and Answers

What is the primary virulence factor of Listeria monocytogenes that allows it to evade immune detection?

  • Beta-hemolysin
  • Lipopolysaccharide
  • ActA protein (correct)
  • Listeriolysin O (LLO)

Which symptom is typically associated with late onset listeriosis in neonates?

  • Pyogenic granulomas in multiple organs
  • Influenza-like illness in mothers
  • Self-limiting gastrointestinal infection
  • Meningitis occurring 1-4 weeks after delivery (correct)

Which group has the highest risk of severe outcomes from Listeria monocytogenes infection?

  • Healthy adult males
  • Elderly individuals only
  • Children aged 5-12
  • Immunocompromised individuals (correct)

What is a common laboratory diagnosis method for identifying Listeria monocytogenes?

<p>Blood culture on blood agar (A)</p> Signup and view all the answers

What is a potential complication of listeriosis in pregnant women?

<p>Severe physical retardation in infants (C)</p> Signup and view all the answers

What type of movement does Listeria monocytogenes utilize to spread between host cells?

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

What is one preventive measure that could reduce the risk of listeriosis in pregnant women?

<p>Avoiding raw or undercooked meats (A)</p> Signup and view all the answers

Which of the following describes the typical clinical presentation of healthy individuals infected with Listeria monocytogenes?

<p>Self-limiting gastrointestinal infection with fever and diarrhea (D)</p> Signup and view all the answers

What indicates a positive reaction in the diphtheria skin test?

<p>A wheal of 5-10 mm diameter at the injection site (A)</p> Signup and view all the answers

Which of the following correctly describes a false positive reaction in the diphtheria test?

<p>Redness at the injection site after 3 days (B)</p> Signup and view all the answers

What is the primary mode of transmission for Listeria monocytogenes?

<p>Fecal-oral route (D)</p> Signup and view all the answers

Which characteristic is NOT true regarding Listeria monocytogenes?

<p>It is strictly anaerobic. (D)</p> Signup and view all the answers

What clinical symptom does a negative reaction in the diphtheria test indicate?

<p>Immunity against the toxin (D)</p> Signup and view all the answers

Which statement concerning the Listeria monocytogenes entry into host cells is correct?

<p>It binds to host proteins to facilitate entry. (C)</p> Signup and view all the answers

What describes a 'combined reaction' in the diphtheria skin test?

<p>Erythema fades on one arm while the other progresses. (C)</p> Signup and view all the answers

Which group is most at risk for severe infections caused by Listeria monocytogenes?

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

What type of bacteria is Corynebacterium diphtheriae?

<p>Gram-positive rod, non-spore forming (A)</p> Signup and view all the answers

What two properties determine the virulence of toxigenic strains of Corynebacterium diphtheriae?

<p>Ability to colonize the nasopharynx and produce diphtheria exotoxin (C)</p> Signup and view all the answers

How does the diphtheria exotoxin inhibit protein synthesis in eukaryotic cells?

<p>By inhibiting elongation factor 2 (B)</p> Signup and view all the answers

What is a common clinical manifestation in patients infected with Corynebacterium diphtheriae?

<p>Purulent nasal discharge and pseudo-membrane (A)</p> Signup and view all the answers

What type of transmission is primarily associated with Corynebacterium diphtheriae?

<p>Respiratory droplet transmission (D)</p> Signup and view all the answers

Which factor is least relevant in the epidemiology of Corynebacterium diphtheriae infections?

<p>Presence of their family members who are vaccinated (B)</p> Signup and view all the answers

Which of the following best describes a preventive measure against diphtheria?

<p>Vaccination with the diphtheria toxoid (D)</p> Signup and view all the answers

Which characteristic is true of non-toxigenic strains of Corynebacterium diphtheriae?

<p>They rarely cause clinical disease. (D)</p> Signup and view all the answers

Flashcards

Listeriolysin O (LLO)

A pore-forming cytotoxic protein produced by Listeria monocytogenes, responsible for beta-hemolysis.

ActA protein

A bacterial protein on the surface of Listeria monocytogenes that induces host actin polymerization enabling bacterial movement between cells.

Listeriosis

An infection caused by Listeria monocytogenes, with symptoms ranging from mild gastrointestinal issues to severe illness in vulnerable populations.

Early-onset listeriosis in adults

A severe form in immunocompromised adults, characterized by meningitis, septicemia, and endocarditis.

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Late-onset listeriosis in neonates

Mostly affects infants, characterized by meningitis following the mother's infection.

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Listeriosis in pregnant women

Infection in pregnant women may not show symptoms for the mother, but can be severe for the fetus.

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L.monocytogenes pathogenesis

Listeria monocytogenes replicates in the cytoplasm, uses ActA to move between cells, avoiding immune responses and causing infection.

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Gastrointestinal Infection (Listeriosis)

Mild infection with fever and diarrhea, generally self-limiting.

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Diphtheria toxin skin test

A test to determine if a person has antibodies against diphtheria toxin, indicating immunity to diphtheria.

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Positive reaction (skin test)

A wheal (raised mark) of 5-10mm forms at the injection site, indicating a lack of antibodies against the toxin.

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False positive reaction (skin test)

Redness at the injection site due to hypersensitivity to diphtheria toxin, rather than a lack of antibodies.

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Listeria monocytogenes

A foodborne bacterium that can grow in refrigerator temperatures, especially dangerous to immunocompromised individuals and pregnant women.

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Facultative intracellular pathogen

A microbe that can survive and multiply inside host cells, moving between cells without direct antibody exposure.

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Catalase-positive

A characteristic of certain bacteria that produce the enzyme catalase.

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Beta-hemolytic

A bacterial characteristic where the inoculated blood agar turns into a colorless zone of hemolysis.

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Important foodborne pathogen

A pathogen that can cause illness through food consumption, especially with contaminated foods.

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Gram-positive rods (Non-spore forming)

A group of bacteria characterized by a positive Gram stain, rod shape, and inability to form spores.

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Corynebacterium diphtheriae

A gram-positive, non-motile rod known for causing diphtheria, a disease often affecting children.

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Diphtheria exotoxin

A toxin produced by some strains of Corynebacterium diphtheriae that inhibits protein synthesis in eukaryotic cells.

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Toxin Fragments (A & B)

The diphtheria exotoxin is composed of two fragments. Fragment A inhibits protein synthesis, while fragment B binds to cell surface receptors.

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Gram-positive rods (Spore forming)

Gram-positive bacteria with a rod shape and the ability to create dormant structures called spores.

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Bacillus anthracis

A gram-positive, spore-forming rod that causes anthrax.

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Spore Formation

The process of creating dormant cells to ensure survival of bacteria in harsh conditions.

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Pathogenesis of Diphtheria

Infection begins in the nose, progressing to the pharynx, causing a pseudo-membrane and potentially life-threatening complications.

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Study Notes

Medical Microbiology - 4th Year

  • Gram-Positive Rods: Divided into spore-forming and non-spore-forming categories.
  • Non-spore Forming: Includes Corynebacterium diphtheriae and Listeria monocytogenes,
  • Spore-Forming: Includes Bacillus anthracis and Bacillus cereus.
  • Aerobic Non-Spore Forming: Corynebacterium diphtheriae is a gram–positive rod, non-motile, with a beaded appearance.
  • Properties: Transmitted via respiratory droplets, a disease of childhood.
  • Toxigenic Strains: Diphtheria exotoxin consists of fragment A (catalytic), inhibits elongation factor 2, and fragment B, binds to the cell surface.
  • Virulence Factors: Diphtheria exotoxin’s ability to colonize the nasopharynx and produce toxin.
  • Pathogenesis: Infection starts in the nose, spreading to the pharynx, forming a pseudo-membrane. Can lead to life-threatening systemic complications affecting the heart and nervous system.
  • 1-in Nasopharyngeal Diphtheria: Symptoms include fever, enlargement of cervical lymph nodes. Rare cases lead to pharyngeal necrosis.
  • 2-in Cutaneous Diphtheria: Skin lesions covered with a gray-brown pseudomembrane. Diagnosed by throat swab stained with Gram stain, or grown on Loffler's, and McLeod's media.
  • Laboratory Diagnosis: Elek's test (in vitro) distinguishes toxigenic from non-toxigenic varieties. Guinea pig inoculation is also part of the test.
  • Treatment: includes Antitoxin, penicillin or erythromycin, tracheotomy (laryngeal diphtheria).

Listeria monocytogenes

  • Characteristics: Facultative intracellular, catalase-positive, beta-hemolytic.
  • Epidemiology: Foodborne pathogen, grows at refrigerator temperatures. Transmitted via the fecal-oral route.
  • Virulence Factors: Ability to survive harsh environments, surface proteins (internalins A and B) to attach to host cells, and cytotoxic protein (listeriolysin O). The bacterial protein ActA is involved in host actin polymerization.
  • Pathogenesis: Can move from cell-to-cell without antibody exposure. Can infect neonates and cause meningitis.
  • Diagnosis: Blood or cerebrospinal fluid analysis, gram stain showing small gram-positive rods, motility test and culture on blood agar.

Anaerobic Non-Spore Forming Gram-Positive Bacilli

  • Propionibacterium species: Members of the normal skin flora.
  • Pathogenesis: P. acnes causes Acne vulgaris via production of lipases.
  • Important Considerations: Pregnant women and immunocompromised adults can experience severe Listeria infections.

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