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[ ESA 3- Infection and Immunity > Infections On Surfaces > Flashcards

Infections On Surfaces Flashcards

1
Q

What is meant by a surface?

A

Any interface between a solid and either a liquid or a gas

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2
Q

What does the microbiota consist of?

A

The microorganisms that are carried on the skin and mucosal surfaces

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3
Q

What is normally true of the microbiota?

A

They are normally harmless, or even beneficial

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4
Q

When can microbiota be harmful?

A

When they transfer to other sites

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5
Q

What are the categories of normal skin flora?

A

Gram positive coccus

Gram positive bacilli

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6
Q

What are the gram positive coccus found in the skin flora?

A

Staphylococcus aureus
Staphylococcus epidermidis
Streptococcus species

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7
Q

What are the gram positive bacilli found in the skin flora?

A

Corynebacterium species

Propionibacterium species

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8
Q

What are the mucosal flora found in the eye?

A

Coagulase negative staph
Diphtheroids
Saprophytic neisseria species
Viridans group streptococci

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9
Q

What are the mucosal flora found in the nares?

A

Staph aureus

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10
Q

What are the mucosal flora found in the nasopharynx?

A

Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae

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11
Q

What are the mucosal flora found in the mouth?

A 
Viridans streptococci
Neisseria
Veillonella
Lactobacillus
Actinomyces
Bacteroides
Capnocytophaga
Eikenella
Prevotella
Fusobacteria
Clostridia
Propionibacteria
Candida
Ceotrichum species
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12
Q

What are the mucosal flora found in the stomach?

A

Helicobacter
Streptococci
Staphylococci
Lactobacilli

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13
Q

What are the mucosal flora found in the intestine?

A 
Bacteroides
Bifidobacterium
Eubacterium 
Lactobacillus
Coliforms
Aerobic and anaerobic streptococci
Clostridium 
Yeasts
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14
Q

What are the mucosal flora found in the urethra?

A 
Enterobacteriaceae
Lactobacilli
Diphtheroids
Alpha and non-haemolytic streptococci
Entercocci
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15
Q

What are the mucosal flora found in the vagina?

A 
Lactobacilli
Diphtheroids
Micrococci
Coagulase-negative staphlococci
Enterococcus faecalis
Microaerophilic and anaerobic streptococci
Mycoplasmas
Ureaplasmas
Yeasts
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16
Q

How is a coagulase test conducted?

A

By testing for coagulase in a test tube

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17
Q

How can you tell if coagulase is being produced in a coagulase test?

A

If plasma clots on addition of bacteria

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18
Q

What does a positive coagulase test indicate?

A

The staphylococcus in question is staph aureus- all other staphylococci are coagulase negative

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19
Q

What is the problem with surface infections?

A

They can be a major cause of hospital acquired infection

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20
Q

How can surface infections be acquired in hospitals?

A

Prosthetic surfaces that are implanted during surgeries

Infections of the mucosa or skin caused by procedures or invasive devices

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21
Q

What prosthetic surfaces implanted during surgery can cause a surface infection?

A

Pacemaker

Joint replacements

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22
Q

What invasive devices can result in a hospital acquired surface infection?

A

Cannulas

Catheters

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23
Q

How can the majority of hospital acquired surface infections be prevented?

A

Proper sterilisation of surfaces

Care during the procedure

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24
Q

What is the problem with HAIs?

A

Cost a large amount of money

Have a large negative impact on the outcome of treatment, and can often even cause death

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25
Q

Why do HAIs cost a large amount of money?

A

Cost of investigations
Treatments
Extended hospital stays
Loss of reputation and subsequent funding

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26
Q

Give 6 internal infections on natural surfaces

A 
Cellulitis 
Pharyngitis
Conjunctivitis 
Gastroenteritis 
UTI
Pneumonia
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27
Q

What pathogens can cause cellulitis?

A

Strep. pyogenes

Clostridium perfingens

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28
Q

What pathogens can cause pharyngitis?

A

Strep. Pyogenes
Mycoplasma pneumoniae
Adenovirus

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29
Q

What pathogens can cause conjunctivitis?

A

Adenovirus

Staphlococcus aureus

30
Q

What pathogens can cause gastroenteritis?

A

Salmonella
Norovirus
Rotavirus

31
Q

What pathogens can cause UTIs?

A

E. coli
Staph. Saphrophyticus
Klebsiella

32
Q

What pathogens can cause pneumonia?

A

Strep. Pneumoniae
Staph. Aureus
Haemophilus influenza

33
Q

Give 5 external infections on natural surfaces

A 
Endocarditis 
Vasculitis 
Septic arthritis 
Osteomyelitis 
Empyema
34
Q

What pathogens can cause endocarditis?

A

Staph. Aureus
Strep. Mutans
Pseudomonas

35
Q

What pathogens can cause vasculitis?

A

HTLV-1 (human T-cell lymphotrophic virus)

36
Q

What does HTLV-1 cause?

A

Retinal vasculitis

37
Q

What pathogens can cause septic arthritis?

A

Neisseria gonorrhoea

Haemophilus influenzae

38
Q

What pathogens can cause osteomyelitis?

A

Staph. Aureus

Aspergillus

39
Q

What is empyema?

A

Infection between pleural membranes

40
Q

What pathogens can cause empyema?

A

Strep. Pneumoniae

Staph. Aureus

41
Q

What prosthetic surfaces can get infected?

A 
Intravascular lines
Peritoneal dialysis catheters
Prosthetic joints
Cardiac valves
Pacing wires
Endovascular grafts
Ventrico-peritoneal shunts
42
Q

What pathogens cause infection on prosthetic joints?

A

Coagulase negative staphylococcus

Staph aureus

43
Q

What are the categories of infection on cardiac valves?

A

Native valves and prosthetic valve endocarditis >1 year post op
Prosthetic valve endocarditis <1 year post-op

44
Q

What pathogens can cause native valves and prosthetic valve endocarditis >1 year post op?

A

Viridans streptococci
Staph. Aureus
Candida
HACEK group

45
Q

What pathogens can cause prosthetic valve endocarditis <1 year post-op?

A

Coagulase negative staph

46
Q

What infection can occur on pacing wires?

A

Cardiac pacing wire endocarditis

47
Q

What pathogens can cause cardiac pacing wire endocarditis?

A

Coagulase negative staph

Staph. Aureus

48
Q

What are the steps in the pathogenesis of infections at a surface?

A 
Adherence to host cells or prosthetic surface
Biofilm formation 
Quorom secretion
Invasion and multiplication 
Host response
49
Q

What enhance adherence to host cells or prosthetic surface?

A

Pili or fimbriae

50
Q

How do biofilms form?

A

Bacteria excrete polymers which bind with water molecules to form a slimy matrix
The bacteria become embedded within the ‘gel’

51
Q

What polymers can bacteria excrete to produce biofilms?

A

Proteins
Lipids
Nucleotides

52
Q

Why do biofilms aid bacterial survival?

A

These bacteria have a slower turnover
Antibiotics don’t work or attach as well
Nutrients can’t diffuse into the matrix
Chemical gradients create microenvironments for different microbial species

53
Q

What is the purpose of quorom secretion?

A

Intracellular communication between bacteria

54
Q

What does intracellular communication between bacteria using quorom secretion involve?

A

Signalling molecules
Cell surface or cytoplasmic receptors
Gene expression

55
Q

What signalling molecules are involved in quorom secretion?

A

Autoinducers

56
Q

What is the purpose of gene expression in quorom secretion?

A

Co-operative behaviours and more AI production

57
Q

What does quorom secretion allow?

A

Bacteria to sense the number of nearby bacteria

58
Q

What happens if, through quorom secretion, the bacteria can sense the number of bacteria is big enough?

A

Biofilm can be formed

59
Q

What does quorum sensing control?

A

Sporulation

Virulence factor secretion

60
Q

What can the host response to infections at surfaces involve?

A

Pyogenic response

Granulomatous

61
Q

What happens in a pyogenic response?

A

Neutrophils produce pus

62
Q

What happens in a granulomatous response?

A

Fibroblasts, lymphocytes, and macrophages produce nodular inflammatory lesions

63
Q

What are the main steps in managing infected surfaces?

A

Diagnosis
Treatment
Prevention

64
Q

What is the aim of diagnosis in the management of infected surfaces?

A

Identify infecting organism and its antimicrobial susceptibilities

65
Q

How can an infected surface diagnosis be made?

A

Blood cultures

Tissue/prosthetic material sonication and culture

66
Q

What are the challenges in diagnosis of infected surfaces?

A

Adherent organisms

Low metabolic state/small colony variants

67
Q

What is the aim of treatment of infected surfaces?

A

Sterilise tissue and reduce bioburden

68
Q

How can infected surfaces be treated?

A

Antibacterials
Remove prosthetic material
Surgery to resect infected material

69
Q

What are the challenges in the treatment of infected surfaces?

A

Poor antibacterial penetration into biofilm
Low metabolic activity of biofilm microorganisms
Dangers/difficulties of surgery

70
Q

How can infection on natural surfaces be prevented?

A

Maintain surface integrity
Prevent bacterial surface colonisation
Remove colonising bacteria

71
Q

How can infection on prosthetic surfaces be prevented?

A

Prevent contamination
Inhibit surface colonisation
Remove colonising bactera

[ ESA 3- Infection and Immunity (15 decks)

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