Micro - Take 2 - Legionella

lunalovegood's version from 2016-02-05 00:28


Question Answer
The hippies and Legionella have in common1976
Gram ____negative
Acid fast? no
Similar mechanism to?mycobacterium / TB
Shape?rods or coccoid
Size?0.3-0.9 x 2 micrometers
Use what for energy?amino acids
Is their culture uniform?no (pleomorphic)
Major one?Legionella pneumophila
Not so common ones?Legionella micdadei (and "other")
Legionella pneumophila has serogroups?yes, several
Most infections?serogroup 1 (Legionella pneumophila)
"Pittsburg pneumonia"Legionella micdadei
1976 Philly incident caused by what environmental reservoir? AC systems
T/F - Pools of stagnant water, hot water towers, AC systems, and intracellular growth (protozoa)True
T/F - Facultative intracellular pathogens can go very similar to TB inside the cell.True
Donald Trump has Legionella. Nadia kissed him. Does Nadia have Legionella?no
The scary pneumonia one.Legionnaire's disease
Pneumonia, fatal if not treatedLegionnaire's disease
Treat Legionnaire's disease with?erythromycin, azithromycin, levofloxacin
Flu-like, milder, self-limiting, myalgiaPontiac fever
Define - Myalgiamuscle pain
Legionnaire's disease- resistant to treatment?yes (plus VERY FAST)
Pontiac fever - resistant to treatment?yes (plus VERY FAST, but a healthy immune system can resolve)
Easy to isolate clinical specimens?no (disease progress so fast)
In lab you use DFA. Low or high sensitive way?low (DFA = direct fluoroescent antibody)
Grows on conventional agar?no
Name two things a media must contain to get Legionella to grow.Iron and cysteine
Example of media to grow Legionella on.BCYE (buffered charcoal yeast extract agar)
A good way to detect some antigenin urine (very possible)
Name 5 lab diagnosis methods of Legionella.antigen in urine, serology, fatty acid profiling, antibody detection, nucleic acid amplification
Expensive, difficult, but good resultsNucleic acid amplification
Legionella has very distinct ___ ___ in membranefatty acid (thus fatty acid profiling works well)
Basically, you treat with _______ and for more severe forms treat with _____.microlides, fluoroquinolones


Question Answer
Gram + or - ?WAXY (neither gram + nor gram -)
Is tuberculous the first disease where some strains have become resistant to ALL antibiotics?I think so
T/F - TB kills like 1.5mil ppl a year.True
Situro ?Can be given to pts with multi-drug resistant TB
Aerobic or non? Aerobic
Size?0.2-0.6 x 1-10 micrometers
Slow or fast growth?slow (divide every 12-24 hours, 8 wks to be detectable in culture)
Acid fast?yes
Mycolic acid + Arabinogalactan + Peptidoglycan = _________MAPc (waxy)
Has high ___ and ___ in DNAcytosine and GUANINE (small error in Kiersten's notes. We talking about GC content here, not amino acids)
Name 3 things to be classified as mycobacterium.1. Acid-fast 2. Mycolic acid 3. High GC content in DNA
Classify non-tuberculoid mycoid bacterium with?Runyon classification
TB - macrophages and neutrophils accumulate - very granular/hard/calcified body called?Ghons body
T/F - The ghons body causes a granular lesion in the lung and lyse the host cell and that is when it shows in the x-ray.True
TB incubation time?2 week to 1 month (4-12 weeks also quoted)
Ligate ___ to infect macrophages.TLR-2
Ligation of TLR-2, infects macrophages, makes them produce ___.NO
NO intracellularly makes macrophages secrete ___IL-12
Macrophages present antigens to T cells + IL-12 = T cells release ___IFN-gamma (stimulates macrophage)
T/F - IFN-gamma recruits more macrophages, forming granuloma and activating them to kill intracellular bacteria.True
T/F - 1890 Robert Koch discovered Tuberculin. Diagnostic use when injected into skin.True
T/F - Selman Abraham Waksman. Nobel Prize 1952. Discovered Streptomycin. Most effective antibiotic against mycobacterium.True
T/F - 80% of TB in the world is in 22 countries.True
T/F - 1/3 of the world is infected with M tuberculosis.True
The BEST way to evidence active disease.MICROSCOPY (just a little sputum on the slide)
Name methods of microscopy.AFB staining (Ziehl Neelsen, Kinyoun or Fluorescent)
You see hilar lymphadenopathy or calcification of primary focus/LN in X-ray.Tuberculosis
That TB test we have to take every year is called?PPD (Skin test, Mantoux)
Immunodiagnosis looks at ___ release.IFN-gamma
ESAT-6 and CFP-10 are _____ things.immunodiagnosis
Diagnosis.... ____ is INSENSITIVE. PCR
____ gene is a new good target (PCR)SecA
Name 4 Anti-TB drugs.INAH, Rifampicin, Ethambutol, Pyrazinamide
T/F - DOT (direct observatory treatment) is a customized method of treatment for each pt.True
BCG was highlighted and next to it it says...positive skin test reaction (idk)


Question Answer
Isoniazidmycolic acids
Pyrazinamidemembrane acidification
RifampicinRNA polymerase (Beta-subunit)
R207910ATP synthase


Question Answer
Lowenstein-Jensenegg based
Middlebrookagar based
New culturebroth cultures
VarunIndian culture


Slow or Fast? (Runyon Classification)
Question Answer
Photochromogenslow (M kansaii, M marinum)
Scotochromogenslow (M gordonae)
Nonpigmentedslow (M avium, M intracellularae)
M kansasiislow (usually pathogenic)
M marinumslow
M gordonaeslow
M aviumslow (usually pathogenic)
M intracellularaeslow
M chelonaeFAST (sometimes pathogenic)
M fortuitumFAST (sometimes pathogenic)
M abscessusFAST (sometimes pathogenic)
Which Mycobacteria is uncommon in USA?M ulcerans and M leprae


Leprous Lemurs
Question Answer
Acid fast?yes
Are any peaceful?NO THEY ALL WANT YOU DEAD
Incubation time?like 20 years sometimes!!!!!!!!!!!
Transmission?nobody knows
Animal model?Armadillo
Low or high infectivity?low (prolonged contact required)
At what stage are we getting basically irreversible?borderline lepromatous


Non Tuberculous Mycobacteria
Question Answer
Infection of cervical lymph nodesM avium intracellulare AND M scrofulaceum
Presents as cervical lymphadenopathyM avium intracellulare AND M scrofulaceum
Severe RTI, severe GI infection, septicaemiaM avium intracellulare in immuno deficient host
Infect respiratory compromisedM kansasii
Presents like pulmonary TBM kansasii
How do you treat M avium intracellulare and M scrofulaceum?surgery
How do you treat M kansasii?not easy, it's resistant to anti TB drugs

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