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Bacterial Diseases Page 339: Table 25 – 1 & Table 25 – 2 Pathogenicity • “the state of producing or being able to produce pathological changes and disease” Staphylococcus (Page 342) • “a genus of gram-negative, nonmotile, opportunistic bacteria which tend to aggregate in irregular, grape-like clusters” • Implications for the Embalmer: page 343 Readings Question #1 • Staphylococcus aureus is the most pathogenic of the staphylococci. What are its toxins capable of doing? What enzymes does it produce, and what is their known effect? Staphylococcal Food Poisoning • Page 343 • caused by ingesting an enterotoxin • high resistance to heat, drying and radiation, and high osmotic pressures • inhabitant of nasal passages…contaminates the hands…..readily enters food • mechanical vectors • mayonnaise, cream sauces Skin and Wound Infections • Page 344 • Sty: “infected follicle of an eyelash” Skin and Wound Infections (cont’d) • Pimple: infected hair follicle • Abscess: more serious hair follicle infection – furuncle/boil: superficial – carbuncle: deeper • Risk of underlying tissues becoming infected • Toxemia: toxins circulate Scalded Skin Syndrome Toxic Shock Syndrome • Page 344 Color Plates 39 and 40 • S. aureus growth associated with the use of a new type of highly absorbent vaginal tampon • swell with menstrual fluids and adhere to the vagina • tears in the vaginal wall Streptococcus Page 345 “spherical shaped bacteria occurring in chains” What are the implications for the embalmer when dealing with saprophytes? Streptococcus pneumoniae ( pneumococcus) • gram-positive ovoid bacterium • cell pairs surrounded by capsule • common cause of: 1) lobar pneumonia 2) meningitis 3) otitis media Lobar Pneumonia • Page 346 • Readings question #2: • What is lobar pneumonia, and how is it characterized? • What are some of the predisposing conditions for this disease? • penicillin and fluoroquinolones Meningitis • • • • • • • • Figure 25-1 Page 346 70% of the population are healthy carriers Gram-positive encapsulated diplococcus Leading cause of bacterial meningitis Most cases between 1 month and 4 years Broad-spectrum cephalosporins CSF obtained by a spinal tap Vaccine: Pneumococcal Conjugated Vaccine Otitis Media • 85% before 3 years of age (Eustachian Tubes) Streptococcus pyogenes • Page 348 Color Plates 43 and 44 • Scarlet Fever: streptococcal pharyngitis • Septic Sore Throat: respiratory secretions – penicillin • Puerperal Sepsis: Childbirth/Childbed Fever • Rheumatic Fever: arthritis and fever – 50% inflammation of the heart – penicillin – Syndenham’s chorea (St. Vitus’Dance) Clostridium • Page 351 • obligate anaerobes • rod-shaped cells that contain endospores • Clostridium botulinum: botulin • Note the bullet points on page 351!! Readings Question 3 (Page 352) • Clostridium tetani causes what bacterial infection? Describe the characteristics of this microbe. Where is it found? What are its symptoms, and what causes them? Clostridium perfringens • • • • Pages 352 and 353 gram-positive, endospore-forming anaerobe saprophyte responsible for: – Gas gangrene – Tissue Gas (post-mortem) – Food Intoxication Gas Gangrene Gas Gangrene Readings Question #4 Clostridium perfringens is the causative agent of a postmortem condition known as tissue gas. What factors may result in this condition in the decedent? Food Intoxication • Clostridium perfringens Gastroenteritis: one of the more common forms of food poisoning in the United States • improper handling of meat during the slaughtering of animals • 2 main causes: 1) keeping foods warm for more than 20 minutes 2) inadequate refrigeration Clostridium difficile • • • • • Spore-forming, gram-positive, anaerobe Produces 2 exotoxins (toxin A and toxin B) Found in enterics Mode of transmission: shed in feces Reservoir: anything that can be contaminated with feces (including embalming tables!) • Healthcare workers who touch “fomites” can transmit these spores Clostridium difficile • Symptoms: watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness • Common cause of antibiotic-associated diarrhea (AAD) (15-25% of all cases) • Responsible for: psudomembranous colitis (PMC); toxic megacolon; perforations of the colon; sepsis; death (rare) • Risk factors: antibiotic exposure; G-I surgery/manipulation; lengthy stay in healthcare settings; serious underlying illness; immunocompromised; elderly