Lecture 2 Infection Control, Microbial Taxonomy, Bacterial Genetics, Host Microbe Interaction

I. Nosocomial Infections A. Nosocomial infections approximately 35 million patients http://www.cdc.gov/ncidod/hip/NNIS/@nnis.htm Reports http://www.cdc.gov/ncidod/hip/NNIS/2002NNISReport_AJIC.PDF data and definitions http://www.apic.org/pdf/cdcdefs.pdf B. Sites

C. Major Sites - organisms - risk factors 1. UTI - Gram Negatives - E.coli, GPC, & Candida - risk factors - female, age, diabetes, indwelling catheter, immune status 2. Pneumonia - GNR, S. aureus - risk factors - age, chronic lung disease, immune status, intubation,

3. Wounds - most occur after discharge - GPC, GNR, Candida - risk factors - age, obesity, invasive procedure, diabetes, extended procedures 4. Septicemia - GPC and Yeast - risk factors - immune status, invasive procedures, , indwelling devices, length of stay D. SUperbugs - the rise of resistant species http://www.fda.gov/fdac/features/795_antibio.html 1. Staph - MRSA, VRSA 2. VRE 3. Pseudomonas 4. PPNG 5. MDRTb II. Reportable diseases

Reportable Diseases
Acquired immunodeficiency syndrome (AIDS) Amebiasis * ANTHRAX * Arboviral infection * (e.g., EEE, LAC, SLV, WNV) BOTULISM * Brucellosis * Campylobacter infection * Chancroid * Chickenpox Chlamydia trachomatis infection * CHOLERA * Creutzfeldt-Jakob disease if <55 years of age Cryptosporidiosis * Cyclosporiasis * DIPHTHERIA * Ehrlichiosis Escherichia coli O157:H7 and other enterohemorrhagic E. coli infections * Giardiasis * Gonorrhea * Granuloma inguinale HAEMOPHILUS INFLUENZAE INFECTION, INVASIVE * Hantavirus pulmonary syndrome Hemolytic uremic syndrome (HUS) HEPATITIS A (IgM+) * Hepatitis B: Acute disease (IgM+) * HBsAg positive pregnant woman Hepatitis C (acute and chronic) Hepatitis, Other Acute Viral Human immunodeficiency virus (HIV) infection * Influenza * Kawasaki syndrome Lead - elevated blood levels * Legionellosis * Leprosy (Hansen disease) Listeriosis * Lyme disease Lymphogranuloma venereum Malaria * MEASLES (Rubeola) * MENINGOCOCCAL INFECTION * MONKEYPOX Mumps * Ophthalmia neonatorum OUTBREAKS, ALL (including foodborne, nosocomial, occupational, toxic substancerelated, waterborne, and other outbreaks) PERTUSSIS (Whooping cough) * PLAGUE * POLIOMYELITIS * PSITTACOSIS Q fever RABIES, HUMAN AND ANIMAL * Rabies treatment, post-exposure Rocky Mountain spotted fever Rubella (German measles), including congenital rubella syndrome * Salmonellosis * SEVERE ACUTE RESPIRATORY SYNDROME (SARS) Shigellosis * SMALLPOX Streptococcal disease, Group A, invasive * Streptococcus pneumoniae, invasive if <5 years of age Syphilis (report PRIMARY AND SECONDARY syphilis by rapid means) * Tetanus Toxic shock syndrome Toxic substance related illnesses Trichinosis * TUBERCULOSIS DISEASE (MYCOBACTERIA *~) Tuberculosis infection in children age <4 years (Mantoux skin test reaction >10 mm) Tularemia Typhoid fever Typhus Unusual occurrence of disease of public health concern VACCINIA, DISEASE AND ADVERSE EVENTS Vancomycin-resistant Staphylococcus aureus * Vibrio infection * Viral hemorrhagic fever YELLOW FEVER

* These conditions are reportable by directors of laboratories. These and all other conditions are reportable by physicians and directors of medical care facilities as well. Physicians and directors of medical care facilities should report influenza by number of cases only (and type of influenza, if known). ~ AFB on smear, speciation, and drug susceptibility Venous blood lead level > 10 ug/dl in a child under age 16 years or > 25 ug/dl in a person 16 years of age or older. III. Microbial Taxonomy Bible of Taxonomy ? Based upon?

A. Cell Wall

B. Gram Positive

C. Gram Negative

D. AFB

E .Mycoplasma and L Forms F. Bacterial Structures and Eukaryotes

Structure Cytoplasmic Membrane Cell wall

Description Phospholipid bilayer

Function Barrier, selective membrane- semipermeable

Example all bacteria

Found in Eukaryotes Yes

Gram Positive Gram Negative

all bacteria ; not L-forms & Mycoplasma

different cell wall in fungi & plants

Glycocalyx

loose,irregular, capsule

protection attachment

Streptococcus mutans

No

Capsule

like above but distinct and gelatinous whip-like structures

protection attachment

Streptococcus pneumoniae Salmonella Pseudomonas Helicobacter pylori

No - rare in yeast

Flagella

locomotion

different in eukaryotes

Pili

shorter, thinner, hair-like structures

attachment movement sex

Neisseria gonorrhea

NO

Chromosome

Single stranded circular DNA molecule RNA

inheritance

all bacteria

Eukaryotic are 2N paired chromosomes differ from Eukaryotic

Ribosomes

Work-benches for protein synthesis all bacteria Contains gas or specific substances e.g. glycogen or gas resistant, protective, survival structures Specific to species

Inclusions

Clumps of particular substaces

Endospore

Unique dormant survival capsule

Bacillus sp. Clostridium sp.

Eukaryote = reproductive spores

IV. Eukaryotic Anatomy

V. Bacterial Genetics A. Mutations 1. Spontaneous mutations - occur 1/10,000 to 1/10 trillion cell divisions, enzymes correct mistakes and damaged DNA 2. Mutagens - agents that increase the rate of mutation 3. Transposons - jumping genes 4. Induced mutations - intentional mutations to study the expression of the gene a. Chemicals - nitrous acid, alkylating agents b. base analogs - compounds that resemble the A,G,C,T or U and displace the proper base, AZT (replaces T), by attacking U we can kill some RNA only viruses c. Radiation - UV irradiation T-T dimer; X-rays delete bases causing mutations

B. Repairing damaged DNA 1. DNA polymerase proofreads for base errors 2. DNA ligase cuts out mismatched pairs 3. T-T dimers - can be repaired or removed

C. Consequences of mutation 1.Impacts cell theory 2. Most often mutations are lethal 3. Occasionally a new trait is the result 4. Impact on treatment with Tb and HIV VI. Genetic Variation in bacteria (competent = capable of uptaking DNA) A. Bacteria are haploid, contain a single circular chromosome, and plasmids

B. Conjugation - pilus transfers plasmid from one bacteria to another

C. Transformation - Pieces of DNA are absorbed into a competent cell

D. Transduction - a virus infects to bacteria carrying genetic material form one bacteria to another

What kind of genetic variation does this represent

What does this tell us about the virulence factor added by the capsule? Transformation with the Jellyfish Gene

VII. Bacterial Genetic Control

VIII. Microbe Host Relationship A. Normal Flora http://www.microbelibrary.org/FactSheet.asp? SubmissionID=559&LS=

http://www.bact.wisc.edu/Bact303/Bact303normalflora B. Disease Status & Mechanisms of Pathogenesis

1. Adhesins

2. Secretions that produce cellular changes

3. M cell conduit

4. Interference with Complement

5. Phagocytosis

a. Defeating phagocytosis

b. Capsules as anti-phagocytic approaches

6. Exotoxins

7. Exotoxins versus endotoxins

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