Micro Test 3: Anaerobes I & II

3 Categories of Anaerobes:  What are they and what do the include?

What Gram-P spore forming anaerobe causes antibiotic-induced diarrhea, and severe colitis?

During anaerobic growth, energy is generated through (2 ways)

In fermentation, what can be used to identify molecules?

With anaerobic respiration, during transport of e- to their terminal acceptor, protons are concomitantly pumped ___ the cell.  The resulting proton and voltage gradient can then be used to do work.

True or False:  Anaerobic bacteira outnumber aerobic bacteria in the mouth.
True False

What has a major role in creating anaerobic environments?

Simultaneous infection with an anaerobic and a facultative anaerobic bacteria cause

What is a polymicrobial infection?

Hints for diagnosing Anaerobic Infections:
Adjacent to _________
________ lesion or discharge
Necrotic tissue, abscesses, "gangrenous"- promotes anoxi conditions

Perisitent infection after administration of antibiotics is characteristic of?

Anaerobic bacteria are most susceptible to what antibiotics?  The exception is?

Are anaerobic bacteria transmisible?  What is the exception?

What is the differential medium that is used to determine oxygen relationships of bacteria.

What 2 bacteria produce spores?

Process of spore production

Spore within the bacterial cell

What triggers sporulation?

Development of dormant spores into a metabolically active vegetative cell.

Clostridium:
1)  Gram-P/N
2)  Shape
3)  Aerobic/ Anaerobic
4)  Motile?
5)  Flagellua
6)Location

Which type of Clostridium is non-motile but appears motile on agar plates?

How does Clostridium conven virulence?

What Clostridium produce diarrhea and colitis?

Clostridium:
What produces intestinal damage?

Clostridium dificile disease is a 2 step process.  What are the steps?

Clostridium dificile has toxins A & B in most strains.  These toxins:
1)  Inactivates host ________
2)  Achieve cytotoxic levels when C. dificile predominates

Which C. dificile toxin is an enterotoxin that is chemotactic for neutrophils and disrupts cell-cell junctions?

Which C. dificile toxin is a cytotoxin that kills intestinal epithelial cells?

C. dificile toxin B kills ________

Which component of the C. dificile binary toxin (present in new epidemic strains) BINDS receptor and determines which cells are affected?

Which component of the C. dificile binary toxin (present in new epidemic strains) Activates the enzyme and does the damage?

C. dificile _____ aid in binding to the intestinal epithelia and concentrating toxin?

Name 2 C. dificile infetions (CDIs)

What are inciting agents for C. difile infections?

What is the primary defense against C. dificile toxins?

Pseudomembraneous colitis occurs in ________ and into ____

What disease causes small white/yellow plaques on the intestine?

Pseudomembraneous colitis (PMC) leads to _____

To diagnose C. dificle, use immunoassays to detect __________________

What bacteria will lead to a thickened colon wall seen on CT scans?

Is C. dificile acquired from exogenous source or from endogenous flora?  (Slide 25)

C. dificile treatment:

Loss of what regulatory proteins leads to higher virulence of C. dificile due to unregulation of its toxins?

Triangle of Bad Disease:
S. aureus (clindamycin)--> C. dificile (vancomycin) -> E. faecalis/faecium (horizontal gene transfer of van genes) --> S. aureus

Which type of Clostridium perfriengens causes most humain infections in USA

Which type of C. perfringens causes necrotizing enteritis?

Which type of C. perfringens is present in human intestinal tract and soil?

Which strain of bacteria has a double zone (alpha and beta hemolysis)? 

What is the basis for the type designation of C. perfringens?

Which C. perfringens toxin has lecithinase (phospholipase C) lyses RBCs, WBCs & platelets; mediates massive hemolysis and bleeding.

Which C. perfringens toxin has necrotic activity, intestinal stasis, loss of mucosa, and formation of necrotic lesions?

Which C. perfringens toxin has protoxin (activated by trypsin, that increases vascular permeability of intestinal wall?

Which C. perfringens toxin has necrotic activity, increases vascular permeability, and is produced by Type E strains?

Which type strain of C. perfringens releases enterotoxin.  Under what conditions?

Name 2 types of diseases C. perfringens causes.

Which C. perfringes toxin is associated with necrotizing enteritis?

The enterotoxin of C. perfringes is heat-labile so best way to prevent food poinsoning with it is by ____

Localized edema and erythema
Gas formation
Generally not painful
Can progress to fascitis

Spread of C. perfringens ot underlying muscle
Accumulation of pus in muscle planes
No muscle necrosis or systemic symptoms

Prominent in limbs following trauma
Rapid, extensive muscle destruction, systemic spread
Intens pain, death within 2 days of onset
Toxins causes extensive hemolysis, bleeding

Which strain and which toxin of C. perfringens produces food poisoning?
How do you prevent this toxin?
Is Ab to toxin protective?

Necrotizing enteritis:
Caused by __________ in the _________

What type bacteria, strain and toxin cause necrotizing enteritis?

What are the four symptoms of necrotizing enteritis?

Necrotizing enteritis is most common in what country and is caused by what?

What disease can lead to perforations in the intestinal wall?

Which bacteria presents with gram-P rods w/ absent leukocytes (lysed by toxins)?
What else does it have?

C. perfringens treatment:
1)  Soft tissue infections must be treated aggressively! (surgical debridement, high-dose ______)
2) Food poisoning is self-limiting
3)  Can treat myonecrosis/gas gangrene with?

C. perfringens vs. C. tetani:  Which one is motile?

Which bacteria has a terminal spore and drumstick shape?

Which bacteria forms a film, rather than colonies on a plate?

Why is it difficult to cultivate on plate?

Ubiquitous in soil, transient colonizer of human and animal GI tract.

What toxins does C. tetani produce?

C. tetani:
Tetanolysin is inhibited by _______

Which C. tetani toxin is a neurotoxin, and classic AB toxin?

Which C. tetani toxin causes the clinical manifestation of tetanus?  Is this reversible?

3 Types of Tetanus:  What type has no systemic signs, just spasm and increased muscle tone around the wound? What is the exception?

3 Types of Tetanus:  What type is systemic and produces trismus/lock jaw, risus sardonicus (rigid smile), opisthotonos (arched back)?

What type of tetanus is the most common type in adults?

What 3 things can be seen in generalized tetanus?

3 Types of Tetanus:  Begins as infection of umbilical stump, progresses to generalized tetanus.

3 types of tetanus

What is the spatula test?  What is it useful for diagnosing?

In C. tetani, why is tetanospamin antibody not detectable?

What two antibiotics can you used to treat C. tetani?  Why can't you use penicillin?

C. botulinum has ____ distinct neurotoxins.  Which ones causes human disease?

C. botulinum is found in _______ and has a _____ spore

These two bacteria closely mimic C. botulinum and produce neurotoxins.

Botulinum toxin is a _______ toxin.
B binds: ________
translocation
Effect?

Botulinum toxin ultimately results in

How does Botulinum toxin reach nerves?  Is it heat labile?

______ toxin remains at neuromuscular junction, unlike _____ toxin which has retrograde transport

What bacteria gives you spastic/rigid paralysis?

How does C. botulinum travel through the digestive tract?

Tetanus toxin:
1)  Travels to _______
2)  Inhibits release of _____ and _____
3)  Inactivates _______ neurons
4)  Muscles=
5)  What type of paralysis?

VS.

Botulinum Toxin:
1)  Stays at ____
2)  Inhibits release of ___
3)  Inhibits _________
4)  Muscles=
5)  What type of paralysis?

Symmetrical cranial nerve palsies (blurred vision, dilated pupils, slurred speech, droopy eyelids, difficulty speaking) with descending symmetric flaccid paralysis of voluntary muslces are the symptoms of?

What types of botulism can be ingested and lead to foodborn botulism?

What two types of botulinum toxin causes infant botulism?  Why can't this colonize adults?

What is the most common form of botulism in the US?

Wound botulism is caused by what type toxin?

Adult intestinal botulism resembles infant botulism except it is type ____ toxin as opposed to Types A & B toxin.

What two types of botulism are caused by Type C toxin?

What two antibiotics can be used to eliminate C. botulinum toxin from the GI tract?

Causes pneumonia, endocarditis, arthritis, peritonitis, severe tachycardia, and myonecrosis (bacteremia and sepsis occur rarely).  Can colonize vagina.

Cause of necrotizing fascitis and nontraumatic myonecrosis or spontaneous gas gangrene.

C. spticum colonizes individuals with _____

Actinomyces:
1) Gram-P/N
2) Motile?
3)  Cat-P/N
4)  Hemolysis
5) Proteolysis

Sulfur granules are clumps of cells bound by ______ that are present in the colonies of what bacteria?

Which gram-p bacteria is filamentous?
Is it acid-fast?

Chronic, granulomatous infections of face and neck, "lumpy jaw"

These Gram-N anaerobes cause opportunistic infections by endogenous spread to normally sterile sites.

A healthy 24-year-old male mountain climber fell and injured his leg. It took him 2 days to return to his car and he did not seek immediate medical treatment.  Several days later he had intense pain in his leg and went to the hospital emergency room, where he was diagnosed with myonecrosis. A gram-positive rod-shaped bacterium was recovered from the debrided tissue. Which of the following is LEAST characteristic of this bacterium and disease?



A.  The rapidly dividing bacteria in the tissue produce gas as a metabolic by-product

B.The vegetative form of the bacterium is an obligate anaerobe

C.The spore form is often present in soil

D.  The AB type toxin blocks release of neurotransmitters for inhibitory synapses

E.  The toxins include hemolysins and a phospholipase

Which of the following statements concerning clostridia is LEAST correct?

A.  Pathogenic clostridia are found both in the soil and as part of the normal flora of the colon

B.  Antibiotic-induced diarrhea and pseudomembranous colitis are due to toxins produced by Clostridium difficile

C.  Tetanus toxin blocks the release of acetylcholine, leading to flaccid paralysis

D.  Tetanus can result from infection of the umbilical stump

E.  Most pathogenic clostridia are strict anaerobes, and the vegetative cells are
readily killed by oxygen

Specific antitoxin is an important part of treatment for:

A.  necrotizing enteritis
B. Pseudomembranous colitis
C. tetanus
D. thoracic actinomycosis
E.  myonecrosis

An inciting agent for pseudomembranous colitis is

A. sporulation
B. old age
c. young age
d. Vancomycin
e.  Clindamycin

Why are anaerobic infections often treated empirically?
Select all that apply.

A.Because of the slow growth of anaerobes, antimicrobial susceptibility data that would assist therapeutic decisions are often delayed.

B.  Antimicrobial resistance is rare among anaerobes so most agents are useful.

C.All anaerobes are susceptible to penicillin.

D.Most anaerobic infections are polymicrobial,
which requires use of broad spectrum antimicrobials.

Which anaerobes are notably penicillin resistant?