1. FOR LECTURE 3 EXAM The whole test is matching. Be able to match the following with their description: Virulence factors/enzymes The three hemolysis patterns Disease terms Toxins Match the disease to the organism Know which diseases have which vectors (invertebrates PPT) 1

2. VIRULENCE FACTORS Adhesins (to adhere) Invasins (to get into cells) Endotoxin (LPS, LOS, and Lipid A) Exotoxins Cytotoxins (kills cells) Enterotoxin (GI upset) Neurotoxins (disrupts nerves) H Ag (flagella allows motility) K Ag (capsule) Angiotrophic ability (pulls blood vessels close) Facultative intracellular pathogens (can survive with and without O2) MDR plasmids (genetic drug resistance) PG (prostaglandins; promotes inflammation) Enzymes β lactamase (deactivates penicillins) Ribosylase (causes diarrhea) Catalase Coagulase (causes blood clots) Staphylokinase (dissolves blood clots) Streptokinase (dissolves blood clots) IgA or IgG protease (deactivates Ab’s) Hyaluronidase (can move thru tissues) SOD (superoxide dismutase; deactivates WBC lysosomes)

3. HEMOLYSIS Hemolysin Patterns:  (alpha hemolysis; partially breaks down RBC membranes. Turn blood agar green)  (beta hemolysis; completely ruptures RBCs. Turns blood agar clear)  (gamma hemolysis is no RBC lysis; no color change on blood agar) 3

4. DISEASE TERMS Furuncle (boil; infected hair follicles) Carbuncles (mass of boils) Cellulitis/ soft tissue infections. Scalded Skin Syndrome  exfolatin toxin from Staph aureus Necrotizing Faciitis: destroys muscle and fat tissue Toxic Shock: Bacteremia (bacteria in blood) and multisystem failure Enterointoxication (enterotoxin-mediated diarrhea). This is Dz, not infection. Pneumonia (fluid in the lungs) Osteomyelitis (bone infection). Requires 6-8 weeks of iv antibiotics Renal Abscess  infarcts (seeds from renal artery, forms abscess, clots blood beyond that site) Endocarditis (heart valve infection) --> destruction of valve --> blood clot forms, breaks off, travels as a septic embolism 4

5. Outer membrane Peptidoglycan GRAM NEGATIVE GRAM POSITIVE 5

6. Inner plasma membrane Outer plasma membrane ENDOTOXINS (GRAM NEGATIVE ONLY) Cell Wall LPS O Antigen Lipid A (endotoxin) LPS 6 (LOS is LPS with a smaller O antigen)

7. BACTERIA LIST Gram Positive bacteria Gram Positive Cocci Staphylococcus S. aureus S. haemolyticus S. epidermidis S. saprophyticus Streptococcus Group A (Strep. Pyogenes) Group B (Streptococcus agalactiae) Group D (Enterococcus faecalis) Viridins (Steptococcus pneumoniae) 7 Gram Positive Rods Bacillis cereus Bacillis anthracis Clostridium perfringins Clostridium difficile Clostridium botulinum Clostridium tetani Listeria Proprionibacterium acnes Corynebacterium diptheriae Nocordia asteroides Actinomyces israelii Acid-fast bacteria Mycobacterium tuburclulosis Mycobacterium leprae Non-acid-fast, non-gram staining Mycoplasma pneuomoniae

8. EXOTOXINS AND THEIR CLASSIFICATION Cytotoxins Verotoxin (Shigella-like toxin; E. coli EHEC) AB toxin (Kills colon epithelium; E. coli EHEC) Toxic Shock Syndrome toxin (Staph aureus) Exfolatin (Scalded Skin Syndrome; Staph aureus) Necrotizing Fasciitis Toxin (group A Strep) Anthrax Diphtheria Pertussis and tracheal cytotoxin Enterotoxins Neurotoxins Botulism Tetanus 8

9. Gram positive exotoxins (no endotoxins) Staphylococcus aureus Clostridium difficile Clostridium perfringens Clostridium botulinum Clostridium tetani Bacillus cereus Bacillus anthracis Corynebacterium diphtheriae 9 Cytotoxin, Enterotoxin Cytotoxins (TSS, NF, exfolatin), Neurotoxin, Enterotoxin Neurotoxin (botulism toxin) Cytotoxin, Enterotoxin Enterotoxin Cytotoxin (Anthrax toxin) Neurotoxin (Tetanus toxin) Cytotoxin (Diphtheria toxin)

10. What Diseases do these cause? Gram Positive bacteria Gram Positive Cocci Staphylococcus S. aureus S. haemolyticus S. epidermidis S. saprophyticus Streptococcus Group A (Strep. Pyogenes) Group B (Streptococcus agalactiae) Group D (Enterococcus faecalis) Viridins (Steptococcus pneumoniae) 10 Food poisoning, scalded skin syndrome, impetigo, folliculitis, furuncles, toxic shock, bacteremia, endocarditis, pneumonia, osteomyelitis, MRSA Skin infections Wound and internal fixation devices infections UTI Nosocomial infections Strep throat, Scarlet fever, Impetigo, Toxic Shock Syndrome, Necrotizing fasciitis, Rheumatic fever neonatal sepsis and meningitis in infants Pneumonia, meningitis, endocarditis, cavities, sinus and ear infections

11. What Diseases do these cause? 11 Gram Positive Rods Bacillis cereus Bacillis anthracis Clostridium perfringins Clostridium difficile Clostridium botulinum Clostridium tetani Listeria Proprionibacterium acnes Corynebacterium diptheriae Nocordia asteroides Actinomyces israelii Acid-fast bacteria Mycobacterium tuburclulosis Mycobacterium leprae Non-acid-fast, non-gram staining Mycoplasma pneuomoniae Food poisoning anthrax Food poisoning, gas gangrene Diarrhea from antibiotics, pseudomembranous colitis Botulism Tetanus Food poisoning acne Diphtheria Pneumonia, wounds, CNS infections Maxillary osteomyelitis, human bite wounds Tuberculosis Hansen’s disease Walking pneumonia