Download Anaerobic Bacteria

CLASS: 11:00-12:00
DATE: 10/20/10
PROFESSOR: MOSER
I.
ANAEROBIC BACTERIA
Scribe: ASHLEY TATE
Proof: SPENCER TERRY
Page 1 of 4
Anaerobic Bacteria [S1]
a. Intro himself
b. Going to talk about anaerobic bacteria. They are significant agents of classic diseases.
II. Reading Assignment [S2]
a. Read Chapters in book on anaerobic bacteria
III. Categories Based Upon Gaseous Requirements [S3]
a. When we talk about anaerobic bacteria this is how they get classified. Basically there is a spectrum. From
aerobic bacteria to anaerobic bacteria. Those that can grow with oxygen and those that can’t grow without it.
Then there are various in between.
b. Microaerophilic-requires oxygen to grow. Capnophilic-requires carbon dioxide to grow. Most of what you
study is Facultative bacteria-they will grow either with or without oxygen.
c. Anaerobic bacteria will grow both obligate and aerotoletant
IV. Physiology And Growth Conditions [S4]
a. This is the reasons they are Anaerobes. Both pH and oxidation-reduciton potential are important.
b. They lack cytochrome systems and lack superoxide dismutase and catalase. Which all of these things help
break down the toxic molecule radicals that are produced in oxygen metabolism. Therefore, if they lack all of
this the organism kills itself or commits suicide.
c. Obligate anaerobe - lack cytochrome, SOD and catalase. Aerotolerant anaerobe - has some SOD and or
catalase. Facultative anaerobe - grow equally well under either aerobic or anaerobic conditions.
V. NO TITLE [S5]
a. Cartoon representing the presences of oxygen. If you look at it, you have high energy radicals and if you don’t
have a detoxified pathway you kill the bacteria or it kills itself. Our cells as well as many bacteria, have all of
these things and turn it into harmless water or molecular oxygen.
b. So it is all dependent upon the presence and amount of these enzymes.
VI. Oxidation - Reduction Potential And Anatomic Site [S6]
a. Showing you the oxidation-reduction potential as it varies in different places.
b. Here the human blood, venous blood will not have anaerobes activity growing there but you will have it
growing on the periodontal pocket, dental plaque or colon.
VII. Anaerobic Bacteria Of Clinical Importance [S7]
a. Anatomic site varies some what, and this table shows that. We will break them down and talk about them.
b. Most important genera is the Gram-negative-Bactereroides gragilis group. They are below the diaphragm, a
GI organism that can caus problems in the GI tract.
c. Prevotella melaninogenica grp and Fusobacterium are found in the mouth
d. Gram-postivie vary and they are distributed throughout the body. They can all be normal flora but under
proper circumstances they can cause human disease.
e. One thing about anaerobic infectious when they do occur because of this mixture of organisms, which is
usually a polymicrobally infection, is when you will see multiple organism involved not just one.
VIII. NO TITLE [S8]
a. You can get infections based upon where they live. It is very common for anaerobes to cause chronic otitis,
mastoiditis, sinusitis, and even dental infections. Also very prominent in our oral cavity, various cellulites,
pulmonary.
b. It also can occur in the abdomen cavity, peritonitis, abscess, appendicitis, decubitus and foot ulcers
c. There are equal opportunity organisms all throughout our body.
IX. Anaerobic Bacteria in Ocular Infections [S9]
a. This is an overview of organisms that can be involved in ocular infection. Anaerobes are much less involved
in ocular infections as they would be in oral or dental infections. But there is a wide variety here.
b. But this shows a wide variety of infections in both aerobic and anaerobic organisms, with the numbers of
anaerobic being much fewer, but they are involved in various conditions.
X. Vincent Angina [S10]
a. What can happen is that you can get Vincent angina. This is from poor oral hygiene. Your gums close up and
you get massive growth, and with that massive growth that can cause tissue destruction. You
b. Right picture- you see you have mixture of long and short gram-negative rods and trepaneens (normal flora of
the oral cavity). Therefore, if you allow them to grown they become destructive.
XI. Adult Periodontitis [S11]
a. This is less acute condition of the lungs called adult periodontitis. You get a continuing growth of organism in
the gum area and a slow destruction of the gums as the recessed. At some point the teeth will not be able to
maintain their positions. Therefore, these teeth would rock around a lot.
CLASS: 11:00-12:00
Scribe: ASHLEY TATE
DATE: 10/20/10
Proof: SPENCER TERRY
PROFESSOR: MOSER
ANAEROBIC BACTERIA
Page 2 of 4
XII. Anaerobic Brain Abscess S12]
a. If they do get out of their home and find a home somewhere else then this is a possibility, and you can get
brain abscess.
b. This is the key to anaerobic infections: Abscess. The other key is that there are small gram+ organism both
cocci and rods, gram-. So there are probably 3 morphological types of bacteria in this abscess. That in itself
would indicate an anaerobic component is there.
XIII. Anaerobic Polymicrobic Cellulitis [S13]
a. Can also cause superficial things, such as this, Polymicrobic Cellulitis, which is more common in diabetics.
They are prone to infections in their extremities because of poor circulation and nervetion. When they do not
know whether they injury themselves. A portion of that is anaerobic. A portion of this is anaerobic. Organism
can find their hiding place in dead tissue. They are polymicrobic. (and may have organisms of Ecoli or staph)
They use up the oxygen, and use the oxygen route, which is a good home for them and they can go forward.
XIV.
Anaerobic Infections [S14]
a. Some of the most important groups are gram-negative bacilli. They are non-spore forming, pleomorphic,
normal flora of upper respiratory tract, intestinal and female genital tract.
b. 2 of the most important bacilli groups are- Bacteroides fragilis and Prevotella melaninogenica
c. Bacteroides fragilis and below the diaphragm Prevotella melaninogenica above the diaphragm, being oral.
d. There are also other organisms that are specific to other organisms of the body, such as colon, upper GI, and
genital tract.
e. Abscess formation is a hallmark of these kind of formation
XV. Necrotizing Fasciitis [S15]
a. Necrotizing Fasciitis (Bacteroides fragilis) is an example of flesh eating bacteria, shown here.
XVI.
Necrotizing Fasciitis [S16]
a. This is a much more extreme example. And it is showing you what you have to do if you get this. You have to
open it and get rid of all of the dead tissue. Then there become further effects, so this person will have to go
back and have this removed.
b. Regardless of what organism is doing this, this is the bad part of this particular condition.
XVII. Anaerobic Infections [S17]
a. The use of bacteria are another most common organism that we run into. That is fusobacterium. They are
non-spore forming, sometimes sole agent but usually not.
b. F. Necrophorum- It can causes Lemierre’s syndrome (which can start out as a sore throat and become
invasive and dissects down. You usually get jugular vein thrombosis which much worst and often fatal.
XVIII. Pulmonary Abscess [S18]
a. This is an abscess with an air fluid area. This is just an example of it in a child.
b. Anaerobic pulmonary abscess is usually the classic presentation of someone who is an alcoholic. They pass
out and then aspirate. You get oral flora and foreign body material, and acid from the stomach. And so when
they pass out, this is how these anaerobic abscess get formed.
XIX.
Fusobacterium S19]
a. Called this because has pointed ends. So in general they are long, fairly large organisms that come to a
tapered end. They are very distinctive if seen in gram stain.
XX. Anaerobic Infections [S20] Gram Positive Bacilli
a. Actinomyces were originally das described fungi. But then it stuck unfortunately to make it somewhat
confusing. But they are anaerobic gram-positive, non spore organisms.
b. Most common is Actinomyces israelii. They are associated in normal flora and gi tract, and oral cavity. They
are difficult to grow and grow slowly. Some are sensitive to oxygen.
c. When they do cause infection or disease they can result in destruction.
d. This organism is very unusual, it doesn't stay where it finds itself, it moves around. Also can result in draining
sinus.
e. They are more commonly Associated with oral, respiratory and female genital tract infections. Also cause
infections in the uterus.
XXI.
DACRYOCYSTITIS [S21]
a. Fairly harmless complications. This can be found in eye. If gets into tear ducts can grow and make grains of
sands and block of the tear ducts. So this is what is causing this.
b. This is what a child would look like without this certain vaccination. So this picture mimics that.
XXII. Actinomycosis [S22]
a. This is classic actinomycosis, aka ‘lumpy jaw.’ Man is swollen on one side of face. What he has is probably is
an assess tooth and now he is getting destruction of bone and root of tooth.
XXIII. Actinomycosis [S23]
CLASS: 11:00-12:00
Scribe: ASHLEY TATE
DATE: 10/20/10
Proof: SPENCER TERRY
PROFESSOR: MOSER
ANAEROBIC BACTERIA
Page 3 of 4
a. This is showing the tooth and the puss coming out of the skin, so they break it open to get capture the
granules.
XXIV. “Sulfur” Granules [S24]
a. These are “sulfur granules”, which are just a micro colony. You can crush it to a gram stain and see it. They
are gram-positive branching rods.
b. “Sulfur” granules are associated with the lumpy jaw condition.
XXV. Actinomyces israelii [S25]
a. If we do grow organism, and it is hard to grown. This is a 7-10 day old colony. It looks like a molar tooth from
the top. Usually most bacteria just divides and break apart; they make long chains of themselves. But these
actually reproduce but don’t break off
XXVI. Anaerobic Infections [S26]
a. Here are the other gram-positive bacilli. Some of these are basically just harmless. And usually part of a
mixed flora.
b. Propionibacterium—usual cause of infection, They cause ache and are normal flora of the skin, and hide in
lipid areas and follicles, and sometimes difficult to determine the role of blood if found in an infection.
c. Lactobacillus- normal flora of the vagina. They are hydrogen peroxide generating strains, that do a job good
of keeping anaerobes down. Usually occur when the flora shifts. (Ebacterium, Bifidobacterium, Arachnia)
XXVII. Anaerobic Infections [S27]
a. These are classic diseases. Should have awareness of these. They are the only genus of anaerobes to make
spores. Tetanus, botulism, gas gangrene, and food poisoning to name a few are examples
b. You get a tetanus shot usually recommended every 10 years. Can get tetanus from a rusty nail.
c. Tetanus makes in vivo toxin, and it produces tetanospasmi, which is a toxin, that blocks inhibitory
neurotransmisser. So you get clenching of muscles and switching.
d. Botulism is commonly associated with food poison; it’s the opposite of Tetanus. Therefore you cannot release
acetylchoiline (cannot fire off the muscle)
e. Botulim is preforms and tetanus is in vivo.
f. Exception to both. Tetanus exception is in infects. They can get an umbilical cord contamination and it can
cause tetanus in infants. Exception to preformed is that giving honey to infants under one year of age can
cause them to get botulism because they don’t have a ell established GI flora yet and the toxin can causes
botulism.
g. Gas gangrene-associates wth c. perfringens. It turns tissue into H2 and CO2. Most important toxin is
Phospholipase C (-toxin) –it destroys membranes. Gas gangrene also is associated with deli meats that
have not been properly handled.
h. Septcium-- Associated with when found in blood cultures.
i. Pseudomembranous colitis / antibiotic associated diarrhea. Can lead to C. difficile
XXVIII. NO TITLE [S28]
a. Cartoon showing the difference between C. tetani and C. botulinum.
XXIX. Tetanus [S29]
a. Examples of tetanus- referred to as lockjaw. His jaw is clenched and he can’t let go.
XXX. Clostridium tetani [S30]
a. In the lab, this is hard to isolate but when we do have certain characteristics. It looks like drum sticks or
Lollipops and grows anaerobically.
XXXI. Gas Gangrene [S31]
a. Example of gas gangrene. It is often post-surgical.
XXXII. Clostridium perfringens [S32]
a. Gm stain from a lesion. There is not a white cell to be seen. It makes its spores differently.
XXXIII. Clostridium perfringens [S33]
a. When we do grow it, it has double zone hemmolasis. This is the first zone and it makes about 12 different
toxins and if we think we have it we can test it in the lab. If the organism has the toxin, it becomes opaque.
XXXIV. Clostridium difficle Colitis [S34]
a. Here are examples of what the colon looks like with Clostridium difficle Colitis. It does occur but now not as
frequently.
XXXV. Pathogenesis [S35]
a. This is why anaerobes do what they do. They have synergy with facultative organisms. They function to make
the environment friendly. Many produces beta-lactamase, but there are certain restriction on what you can
use them on.
b. However, anaerobes are not at all affected by amino-glycosides. They are immune to them. They are also
toxin production
XXXVI. DIAGNOSIS OF ANAEROBIC INFECTIONS [S36]
CLASS: 11:00-12:00
Scribe: ASHLEY TATE
DATE: 10/20/10
Proof: SPENCER TERRY
PROFESSOR: MOSER
ANAEROBIC BACTERIA
Page 4 of 4
a. Characteristics of anaerobic infections: Foul smelling discharge, Proximity to a mucosal surface, gas in
tissue, and abscess formation.
b. Gram stain’s mixed look can also be helpful in identifying.
XXXVII. Gram Stain of Mixed Infection [S37]
a. Same one I should you before. This is a Gram Stain of Mixed Infection
XXXVIII.
DIAGNOSIS OF ANAEROBIC INFECTIONS [S38]
a. In order to grow anaerobic in the lab, you have to certain things.
b. How do you collect them? Require specific ways, in which you must exclude oxygen. The way they are
transported are also critical. How do you know you are interested in anaerobes, Well they have special
requirements: hemin, Vit K, and/or blood.
c. They also need to be incubation and worked up in CO2 in nitrogen and hydrogen
XXXIX. Anaerobic Containers [S39]
a. Anaerobic Containers is the simplest way to do that. Use the CampyPak and add water to it. It produces
hydrogen, and CampyPak produces less hydrogen.
XL. Anaerobic Chambers [S40]
a. More complex way is to bring them into an airlock, an anaerobe chamber. You do all the work in the chamber.
XLI.
Bacteroides fragilis [S41]
a. Bacteroides fragilis grows on bile, it is bile tolerant.
XLII.
Treatment Of Anaerobic Infections [S42]
a. Treatments include: Surgical draining, mixed infections, and certain drugs.
b. Toxin mediated diseases are antitoxin and antibiotics if active infection vs. Intoxication. Antibiotics are active
against infection.
XLIII. Etest™ Susceptibility Testing [S43]
a. Usually don’t do susceptibility testing but if you do this is something you will see in the lab. Its called the
Etest. The scale will tell you what the min concentration is. You would normally only do this if you needed to
do it just once.
XLIV. Objectives [S44]
a. Definitely know these items. But look at lecture as a skeleton and use the book to put the flesh on it.
[End 48:14 mins]