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1. CELL WALL INHIBITORS
- Penicillins (beta lactams): amoxicillin, methicillin
- Cephalosporins: cefoxitin
- Vancomycin
- Bacitracin- topical only
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2. PROTEIN SYNTHESIS INHIBITORS:
- Aminoglycosides - streptomycin, gentamycin (targets ribosomes)
- Tetracycline- doxycycline, chlorotetracycline
- Erythromycin
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MEMBRANE INHIBITOR
Polymixin B
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DAN Replication Inhibitor
Quinolones- ciprofloxacin
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METABOLIC INHIBITORS
- Sulfa drugs- sulfonamides
- PABA Inhibitors Trimethoprin- sulfamethoxazole
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Mycobacterium Specific
Isoniazid- prevents waxy layers from forming
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ANAEROBIC RESPIRATION INHIBITOR
Metronidazole
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Staphylococcus aureus
natural flora (nose, skin)
disease by degrading host tissue, toxin production, inflammation
LOCALIZED INFECTION: abscesses, boils, impetigo, pimples, food poisoning, scalded skin syndrome
SYSTEMIC INFECTION: toxic shock syndrome, pneumonia
VIRULENCE FACTOR: protein A, teichoic acids, many enzymes (coagulase, protease, fibrinolysin), toxins (TSST, alpha toxin, enterotoxin, exfoliatin(sloughs off skin burning appearance))
- TREATMENT: most broad range antibacterials, quinolones, sulfa drugs,
- topical cream for skin infections
- some are b lactam resistant MRSA- use vancomycin or other antibiotics
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Staphylococcus epidermis
- natural skin flora
- commonly gets on implants such as valves, catheters = colonize
- coagulase negative
- glycocalyx for adherence
SYSTEMIC INFECTION: septicemia and endocarditis
- TREATMENT: highly resistant to many antibiotics, VANCOMYCIN + RIFAMIPICIN
- -must remove infected implant
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Streptococcus spp.
- are typed according to:
- SURFACE CARBS (A-U)
- HEMOLYSIS (alpha/partial, beta/total and gamma/no)
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Streptococcus pyogenes:
LOCALIZED INFECTION: pharygitis, strep throat, impetigo, boils, abscesses, pimples
SYSTEMIC INFECTION: septicemia, necrotizing fascitis, SCARLET FEVER
Complications/post infection disorders: rheumatoid fever, rheumatoid arthritis, glomerulonephritis
VIRULENCE FACTORS: techoic acid, M proteins, capsule, collegenase, hyaluronidase, hemolysin, toxin (exotoxin A, B and erythrogenic toxin)
TREATMENT: beta lactams, erythromycin
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RHEUMATOID FEVER/ARTHRITIS:
- autoimmune disorder
- -antibody to strep M protein cross react with joint and muscle proteins
- can detect as early as 2 weeks after S.pygenes infection, usually strep throat
- -symptoms: fever, heart murmur, heart damage, inflammation of heart tissues and joints
- -can prevent with prompt treatment
- antibiotic will not help once disorder has developed
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ACUTE GLOMERULONEPHRITIS:
- build up of antibody-antigen complexes in kidney
- onset about 2-3 weeks after skin infection
- symptoms subside and patient recovers
- prvent by treating infections promptly
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Enterococcus faecalis (streptococcus faecalis)
- VRE: vancomycin resistant enterococci
- -group D beta hemolytic
- natural flora of gut
- -associated with hospital acquired UTI by cross contamination with gut microflora on catheters
- -ENDOCARDITIS after surgery
TREATMENT: multi-drug resistant NO FAIL SAFE treatments
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Veridans Streptococci
- -flora of oral cavity
- -alpha hemolytic, no carb groupings
- mains species: S. mutans, S. sanguis & S. mitus
- -adheres to tooth enamel via glycocalys
- -metabolizes sugar in food- lactic acid produced etches tooth enamel
- plaque: combination of viridans, dextrans and food particles
- fluoride prevents adherence of strep by coating tooth enamel
-complication after dental surgery or other breach in gum tissue will allow viridans into blood stream to result in septicemia and endocarditis (infection of heat lining)
TREATMENT: beta lactams before and after dental surgery
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Streptococcus pneumoniae
VIRULENT FACTOR: capsule (major factor), pneumolysin (cytotoxin)
LOCALIZED INFECTION: upper respiratory infections, pneumococcal pneumonia, bronchitis
SYSTEMIC INFECTION: septic shock, pneumococcal meningitis
TREATMENT: beta lactams (resistant = Vancomycin), erythromycin
- ~85 different serotypes based on capsular polysaccharides
- stimulates T cell independent Ab production by passing Ab mediated pathway and triggers B cell directly to produce Ab
- -alpha hemolytic, no carb grouping
- most common cause of death due to pneumonia
- VACCINE: PneumoShot- polyvalent vaccine made up of purified capsular polysaccharides from 25 different serotypes
- -given upon request for risk groups (health care workers, immunocomp., elderly, booster shot needed every 3-5 yrs
- new children vaccine now recommended for all children - composed of 7 most common capsular polysaccharides conjugated into a carrier (diphtheria toxoid)
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Neisseria meningitis:
infection of meninges
"Epidemic meningitis"
- symptoms: fever, shock, headache, stiff neck
- -transmitted by aerosol or direct contact
- -difficult to diagnose, often asymptomatic at early stage
- 80% of adults with antibodies to N. meningitis does not have the disease
VIRULENCE FACTOR: capsule, LPS, IgA protease
TREATMENT: beta lactams, rifampicin, known resistant to sulfonamides
- VACCINE: mixture of capsular polysaccharides
- -given to risk groups
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Neisseria gonorrhoeae:
- sexually transmited disease (STD), direct contact
- causes gonorhhea, PID (pelivic inflammatory disease) in women, neonatal gonorrheal opthalmia in newborns
- -symptomatic in men
- -asymptomatic in female
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VIRULENCE FACTOR:
IgA protease
Lipooligosaccharides- similar to LPS but has shorter chain
pili (main virulence factor) - undergoes "ANTIGENIC VARIATION"
there are multiple silent pilin genes in one genetic locus but one functional promoter - genetic rearragent moves new pili genes to promoter for expression (100s of variation)
-iron binidng outer membrane proteins
tolerance of high pH
- COMPLICATION:
- PID: pelvic inflammatory disease- bacteria travels from infected cervical tiusse to reproductive tract - result in sterility
- Newborn conjunctivitis (neonatal gonococcal ophthalmia)
- -baby contract from mom leads to blindness
- TREATMENT: beta lactams and cephalosporins
- neonatal: silver nitrate or erythromycin
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