Pathogenic Exam 5 Study Guide PDF

Pathogenic Exam 5 Study Guide UTI Symptoms Generally: Progression to cystitis: Frequent, painful urination Hematuria, most women Small amounts of turbid urine have pyuria, dysuria, No fever frequency, urgency,...

Pathogenic Exam 5 Study Guide UTI Symptoms Generally: Progression to cystitis: Frequent, painful urination Hematuria, most women Small amounts of turbid urine have pyuria, dysuria, No fever frequency, urgency, Sometimes blood in urine suprapubic pain Progression to pyelonephritis: Fever, flank pain, features of systemic illness, nausea and vomiting Acute Bacterial Prostatitis Spiking fever Chills Malaise Myalgia Dysuria Frequency, urgency, incontinence Pelvic pain Turbid urine Diagnoses Acute uncomplicated cystitis: Based on symptoms unless presence of risk factors (inpatient stay, use of broad-spectrum antimicrobial, travel to countries with high levels of MDR organisms) If risk factors present, culture and susceptibility test Acute complicated pyelonephritis Based on symptoms, can do dipstick for ID, Gram stain, susceptibility test Organisms E. coli P. mirabilis K. pneumoniae P. aeruginosa S. saprophyticus S. aureus Enterococcus S. marcescens Group B strep E. coli G- bacillus, facultative anaerobe, ferments lactose Indole positive, urease negative Virulence Factors: Type 1 pili: promotes periurethral colonization, attachment to bladder, phase varies P-pili: binds to Gal-Gal receptors in bladder mucosa, more often found in pathogenic than fecal flora strains K antigens: capsular, antiphagocytic Cytolytic hemolysin Multiple systems for iron acquisition K. pneumoniae Causes abscesses G- bacillus, lactose Renal (kidney) fermenter abscesses Indole negative, urease Inside from positive ascending route Capsule leads to mucoid infection, outside colonies Virulence Factors: for hematogenous Capsule is Symptoms similar antiphagocytic to pyelonephritis Endotoxin causes (fever, chills, flank fever, shock, sepsis pain) S. saprophyticus Resistant to novobiocin!! G+ cocci, catalase positive, CoNS Less pyuria than seen with G- bacilli, patients asymptomatic Often methicillin-resistant, treatment based on susceptibility testing Infection following menstruation or sex, seasonally late summer and fall Virulence Factors: UafA: adherence to uroepithelial cells Transport proteins: adjustment to osmotic and pH changes Urease E. faecalis G+ cocci in chains, non-hemolytic Salt tolerant, BEA positive Common following invasive procedures (surgeries and catheters) Causes recurrent UTIs in older men, leads to prostatitis and epididymitis Can cause pyelonephritis and perinephric abscesses Infection ID-ed by isolation of >105 CFUs Diagnosed by WBC clumps on urinalysis or abscesses Group B strep (S. agalactiae) G+ diplococci Catalase negative, narrowly β-hemolytic, bacitracin resistant Common infection in pregnant women, infants Virulence Factors: Capsule: inhibits phagocytosis, complement Group B antigen: on latex agglutination test, see beads CAMP factor: phospholipase that enhances S. aureus hemolysis P. mirabilis G- bacilli, non-lactose fermenting, swarming motility Urease positive (alkaline urine) Associated with kidney stones and catheters, recurrent UTIs UTIs more severe than E. coli Virulence Factors: MR/P fimbriae: helps bladder colonization, phase varies Urease P. aeruginosa G- bacilli, aerobic, non-fermenter Catalase positive, oxidase positive Produces pigments Symptoms can be ulcerations of bladder, ureters, renal pelvis, greenish urine Common from catheters Virulence Factors: Phospholipase C: degrades cell membranes Biofilm S. aureus G+ cocci in clusters Coagulase positive, catalase positive, β-hemolytic Often causes bacteriuria Symptoms can be fever, leukocytosis, back pain Check blood culture if no catheter (bacteremia) Causes pyogenic diseases Virulence Factors: TSST-1 S. marcescens G- bacilli, facultative anaerobe Catalase positive, DNase positive Motile, have fimbriae Can produce red pigment MDR Bacterial STIs Effects: HIV often present with Infection of newborn other STIs Infertility Ectopic pregnancy Cancers HIV transmission Death Chlamydia Trachomatis Symptoms 18 serovars Urethritis, conjunctivitis, A, B, C cause eye disease reactive arthritis, anorectal D-K cause nongonococcal infection, infertility, urethritis, conjunctivitis, lymphogranuloma venereum Women: cervicitis, neonatal pneuomonitis endometriosis, salpingitis, L1, L2, L3 cause PID (silent pelvic lymphogranuloma venereum inflammatory disease), Stage 1: painless lesion perihepatitis, ectopic Stage 2: inguinal pregnancy lymphadenopathy (swollen Men: epididymitis, prostatitis lymph nodes in groin) MOST INFECTIONS ARE Stage 3: proctitis (fever, tenesmus, bleeding, pain) ASYMPTOMATIC Endemic outside US/Europe C. Trachomatis cont. G-, lacks peptidoglycan Elementary Body Epithelial Cell Obligate intracellular pathogen, cannot be grown Transmitted with direct mucosal contact, recurrent infections common, 25-50% co-infection with GC 72 Life cycle with elementary bodies hours 12 hours (infectious extracellular, have no metabolic activity but can attach to mucosal surfaces) and 48 hours 24 hours reticulate bodies (metabolically active, divide by binary fission, form intracellular inclusion Inclusion bodies) PCR used for diagnosis Single swab or urine Neisseria Gonorrhoeae G-, always pathogenic Humans only host, transmitted via direct mucosal contact, ID=100- 1000 organisms Most are symptomatic Symptoms Virulence Factors Conjunctivitis, anorectal Pili: antigenic variation causes no infection, pharyngitis, immunity septicemia, arthritis, urethritis Por protein: intracellular survival, Women: vaginitis, prevents destruction from mucopurulent cervicitis, phagolysosome salpingitis, PID, tubo-ovarian Opa protein: mediates binding epithelial abscess, peritonitis, dysuria- cells pyuria Lipooligosaccharide Men: epididymitis IgA protease N. Gonorrhoeae cont. Disseminated Gonococcal infection: result of bacteremia, presents as arthritis-dermatitis, septic monoarticular arthritis, causes lesions Diagnosed by gram stain of urethral discharge (G- intracellular diplococci), nucleic acid amplification test (assays for GC and CT) Grow on Thayer-Martin media