What is 

Staphylococcus aureus? 

Gram Positive Bacteria that is common in pus infections 

What does Staph secrete and what do they do? 

Endotoxins and digestive enzymes that breakdown tissues into nutrients 

How much percent of the population does Staph succumb and whats the location in the body it is usually found in? 

30% of the population it is colonized in and it is primarily in the skin and nose 

(50% of diabetes, IVU, HCW)

What drug is Staph resistant to that was found out in 1972? 

Methicillin

What is MRSA?

Methicillin Resistant Staph. Aureus

What were the numbers looking like for percentage of people with Staph that had MRSA in 1974? 1995? 2004? 

2%

22%

63%

What is a noscomial infection? 

An infection which is a result of a treatment in the hospital but secondary to the patient's original condition. 

How is Hospital Acquired MRSA acquired through in the hospital?

Ward Sites, IV lines, Blood, Lungs

What is CA-MRSA? 

What were the numbers in 2004 and 2006? 

Community Acquired MRSA

13% in 2004

48% in 2006

What happens if the bacteria gets into the lungs? 

25 - 30% of the people who have lung infections die from it 

What are some treatments for MRSA? 

IV, antibiotics (Oral may work) 

Surgical Debridement 

What is a surgical debridement? 

Debridement is the process of removing de-vitalized, or dead tissue from a wound bed. 

How do the young, the healthy and the adults get this disease through? 

Gyms, military, prisons, daycare facilities 

What does a typical infection with MRSA look like? 

It is aggressive, looks like spider bite, it has tenderness, it is raised, red, hot, and has a black necrotic center 

What is PVL? 

PVL is an exotoxin released by the increased virulent strains of Staphylococcus aureus 

Panton Valentine Leukocidine 

It kills white blood cells 

How can you get Staph Aureus? 

Skin to Skin 

Fomites 

How can you prevent from getting Staph? 

Basic hygeine works best: 

Washing of hands, plain soap

Don't share fomites - can result in transmission 

What are some host carriers for MRSA? 

Dogs, Horeses, Pigs, Cows, Cats 

(All Domesticated animals)

How were antibiotics discovered? 

Antibiotics are naturally occuring because they are from microbes that are trying to defend their territory when they die off - they gain ground by releasing substances that will kill other microbes 

How does resistance in naturally occuring antibiotics work? 

Microbes have a mechanism to get rid of the antibiotic that occur naturally like pencillinases 

How does the resistance gene get passed from one microbe to the next? 

Through conjugation 

What are STI's, are they different from STDs? 

Do they have immunological memory? 

Sexually transmitted infections, different from STDS

No immunological memory 

What are the primary root of infection for baterial STIs? 

Urogenital & Anal infections 

Oral infections 

What are some bacterial STI infections that get raised up? 

Most of them are gram negative 

They have no exotoxins 

How do they do damage? 

What are the #s of Chlamydia in the US?

In the World? 

What is a common occurence due to the bug and how do kids get it? 

1.1 million reported cases in the US with the actual estimate being around 30 million 

Global problem - 10 - 20% population 

6 million blindnesses resulting from the bug, kids get it from their infectious moms and infects the eye

What are the 6 crucial features of Chlamydia ? 

- small 

- no cell wall 

- complex life cycle 

- obligate energy (intercellular) parasite 

- no exotoxins (endotoxin)

- gram negative 

What percentages of the male population is Asx? 

Female population? 

1/2 of the male 

3/4 of the female 

Where are the symptoms in most male individuals when infected with Chlamydia? 

The symptoms are in the urethra, itching, burrning during urination. 

All these can occur in oral and anal passageways too. 

How are the symptoms of infected female individuals with Chlamydia different? 

what are the instances? 

Same symptoms

3x more female than males 

Chronic inflammation 

Low growing infections 

What are the long term effects of Chlamydia in males?

Females? 

Rare sterility in men 

Pelvic inflammatory diseases and may cause scarring which would lead to sterility (ectopic pregnancy) 

What is the main effect of Gonorrhea and how does it occur? 

PID - Pelvic inflammatory disease 

it is through inflammation caused by LPS

What is the most interesting thing about Gonorrhea? 

That is Asx and it is easier to infect women and are also Asx 

What are the effects of Gonorrhea on men? 

White discharge and pain on urination

What are the 3 routes that a pathogen can take to evade the immune system? 

I) Low Ag on surface - innate immune system thwarted 

II) Genomic rearrangement (antigenic variation)

     Ag genes rearrangement 

         - low immunological memory - acquired                    thwarted 

III) Specific proteases released (break up IgA Fab                                               from Fc)

What is the pathogen that causes Syphilis? 

What are the variations between what types of diseases it causes? 

Treponema Pallidium 

Some cause skin to skin infection through skin to skin contact (Pinta)

Some cause bone infection (YAWS)

How do you know if a kid has acquired syphilis from his mother?

They will have notched teeth, kids get these from infected mom (congenital syphilis)

How does Syphilis start? The Primary Syphilis stage? 

Trepnema invades into mucosal tissue 

Primary Syphilis: Ulcers form / 3 weeks later 

ooze starts coming out filled with the pathogen, it is painless, it is at the site of infection and it eventually resolves, forms a chancre (ulcer that forms at the primary site of infection 

What makes the secondary stage of Syphilis different from the primary stage? 

It is systemic because the bacteria gets into the bloodstream, this usually occurs 2 weeks to months later where rashes form on the body (usually palms and feet), there are swollen glands, fever, resolves, latent state 

What is the tertiary stage of Syphilis? And how much of the cases are in this stage? 

- This usually occurs after a year 

- Affects heart and cardiovascular system 

   (Anurism - a bubble forms in the aorta) 

- Gummas form (soft, tumor like balls of inflammation) 

- Neurosyphilis - damages nervous system 

                      - motor skills decline 

                      - dementia 

What is the treatment for Syphilis? 

Susceptible to antibiotics (Penicillin in the 1940s)

What is the one thing that is special about syphilis?

It is specially high in men. 

What is the most common STD?

What kind of virus is this? How many strains? And, how many of those are sexually transmitted? 

Can you have it for life? 

HPV - Human papilloma virus 

It is a DNA virus, 100 different strains and 30 of those strains are sexually transmitted 

No, it is not for lifetime 

What is a common effect of the HPV? 

What else that is dangerous that is common to HPV?

What two strains account for 70% of cervical cancers?

It can cause warts (genital warts) - Condylomas 

Cancer causing strains (14 of them)

Strain 16 and Strain 18

What is the percentage of women that acquire cervical cancer when introduced to Strain 16? 

What is one key note thing about Strain 18? 

100% of the women 

That the women are at more risk than men by at least 35x more

What is the treatment for HPV?

How can you prevent HPV from happening?

What are the reasons why Gardasil has tough opposition?

Removal

Vaccine: Gardasil

CDC recommends females in between 9 and 26 should get tested

It  has caused 32 deaths and mostly adverse events in women.

What is one test for HPV?

Pap - scraping of abnormal tissue -> abnormal papsmere (Cells)

What are two forms of Herpes?

What are some features of Herpes?

HSV-1 and HSV-2

It is latent (no viral production)

It attacks the dorsal root ganglia (nervous system)

It is a lytic virus

DNA virus

cause blistering & ulcers (immune sys combating)

What is a common effect of HSV-1?

What is the effect of the HSV-2?

Cold sores, rashes

HSV-2 - genital ulcers

What are treatments for Herpes?

No cures

Acyclovir (can suppress an outbreak)

What are the two common types of HIV?

Which is most common and what group has over 99% of the people with AIDS?

What are the 3 main groups for HIV-1?

HIV-1 and HIV-2

HIV-1 is the most common while group M in that category has over 99% of the people who have AIDS

HIV-1: Group M,N,O

What is HIV-2 most common to?

What are two important things to note about HIV-2?

Do monkeys (sooty mangabeys) get sick with HIV-2?

It is 40% identical to HIV-1 but it is highly identical to SIV (simmian immunodeficiency virus)

HIV-2 is less pathogenic

and it slows progression of people who are infexted with both viruses.

No

What is one interesting thing about HIV-1 M group?

Talking abut how HIV got into humans, how did it jump into humans?

It is highly identical to SIV and that chimpanzees (95%) don't get sick

Jumped into humans via contact with blood

How does HIV bind to CD4 T helper cells?

Its receptors bind to the CD4 protein which causes conformational change so it also takes in the chemokine receptors which helps it attach on to the membrane of the T cell

What are the 5 types of drugs that inhibit HIV? 

Entry inhibitors - block entrance of HIV

Fusion inhibitors - blocks the insertion of GP41

NRTI - Nucleotide Reverse Transcriptase Inhibitor

NNRTI - non-nuke " " 

PI - protease inhibitor

Integrase inhibitor  

What are some treatments that a person can follow when infected with HIV? 

There is little treatment to AIDS because of the virus resistance, but there is monotherapy and HAART

You could also try genotyping (sequence the HIV)

How long does HIV take to spread throughout the body? 

What is special about infected cells? 

What are some techniques to prevent infection with HIV? 

2 days 

all infected cells carry provirus 

safer sex and don't share needles 

If you are already infected with HIV and it is within 72 or 24 hours, what do you do? 

What if you weren't infected with HIV yet, but wanted to get it because you are a high risk individual? 

Within 24: PEP (accidental) start HAART for 6 mos. 

reduces risk of infection by 85% 

Within 72 hrs: initiate HAART

Could do PrEP - Pre-exposure prophylaxis

take HAART

As testing goes, what are the some of the tests that can be used to identify HIV infection? 

Ab test for HIV

(6 weeks - 6 months for it to actually work) 

HIV RNA test

(2 weeks)