- Jun 2017
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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The sepsis rate was 1.81 per 1000 pregnant women. Escherichia coli was the predominant pathogen, followed by Group B Streptococcus.
Rate of organism causing sepsis
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www.cdc.gov www.cdc.gov
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Rarely, through infected blood In theory, the virus could be spread through a blood transfusion. To date, there are no known reports of this happening.
could happen not likely though
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www.sharinginhealth.ca www.sharinginhealth.ca
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UTIs are caused by microorganisms that typically infect the urinary tract of non-pregnant women, mainly Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae.
gram negative causes
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www.rcog.org.uk www.rcog.org.ukLayout 11
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GAS,alsoknownasStreptococcuspyogenesEscherichiacoliStaphylococcusaureusStreptococcuspneumoniaemeticillin-resistantS.aureus(MRSA),ClostridiumsepticumandMorganellamorganii.
major pathogens that cause sepsis
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academic.oup.com academic.oup.com
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G. vaginalis was isolated from the vaginal sample by streaking the specimen on a selective human blood Tween (HBT) bilayer agar medium (Becton-Dickinson).
Culturing techniques
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- May 2017
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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epithelial cells, biofilm production, surface hydrophobicity, phospholipase C and protease activity
Virulence factors of G. vaginalis
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Gardnerella vaginalis, Mycoplasma hominis and various anaerobic bacteria including Mobiluncus sp., and Prevotella sp.
Other probabe causative organism
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These are primarily anaerobic bacteria and an organism called Gardnerella vaginalis,
A possible caustative organism. No one really knows for sure.
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emedicine.medscape.com emedicine.medscape.com
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Bacterial Vaginosis Workup
Determining if there is a case
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www.medicalnewstoday.com www.medicalnewstoday.com
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Clindamyci
Alternative treatments if metronidazole does not work. If it comes back despite using clindamycin, use tinidazole.
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Metronidazole is the most common antibiotic for BV.
Most common form of treatment for bacterial vaginitis.
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www.webmd.com www.webmd.com
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fishy smell, bacterial vaginosis is a better guess
Bacterial-fishy smell while yeast overgrowth looks like cottage cheese
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www.mayoclinic.org www.mayoclinic.org
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The most common types of vaginitis are:
Bacteria, yeast, and parasite
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www.lamission.edu www.lamission.edu
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marcescensS flexneri
Test results to identify Serratia
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shodhganga.inflibnet.ac.in shodhganga.inflibnet.ac.in
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Table1.1:COLONY MORPHOLOGY OF SERRATIAMARCESCENS OF VARIOUS MEDIA
Serratia on various media.
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www.phac-aspc.gc.ca www.phac-aspc.gc.ca
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Ingestion of contaminated foods and direct contact
Mode of transmission
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They are responsible for a variety of infections, including bacteremia, pneumonia, intravenous catheter-associated infections, osteomyelitis, endocarditis, and, rarely, endogenous and exogenous endophthalmitis
Pathogenicity/toxicity
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www.who.int www.who.int
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Treatment in severe cases is electrolyte replacement (to provide electrolytes, such as sodium, potassium and chloride ions, lost through vomiting and diarrhoea) and rehydration.
Treatment option. Antibiotics not recommended unless very young, old, or immunocompromised.
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www.austincc.edu www.austincc.edu
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Virulence Factors:
possible virulence factors to note
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en.wikipedia.org en.wikipedia.org
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were recalled due to evidence of Salmonella contamination.[9]
salmonella could be in MREs
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catalog.hardydiagnostics.com catalog.hardydiagnostics.com
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Growth; red slant, yellow butt, gas positive, black butt (H 2 S produced)
biochemical test result in Triple sugar iron agar.
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www.csun.edu www.csun.edu
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Infection: occurs when live bacterial cells are ingested. These bacterial cells can then grow in the digestive tract and cause symptoms. An example of a bacterial infection is Salmonella infection.
It is an infection.
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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nternalization into host cells
Method that salmonella potentially uses to get into the host cell.
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microbeonline.com microbeonline.com
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BIOCHEMICAL TESTS
Biochemical tests we can use.
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Bismuth sulfite agar: Salmonellae produce black colonies. Blood Agar: S. typhi and S. paratyphi usually produce non-hemolytic smooth white colonies. MacConkey Agar: Non lactose fermenting smooth colonies i.e. pale colonies Deoxycholate Citrate Agar (DCA): Salmonella appear as pale colonies.
What salmonella looks like on different media.
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food.unl.edu food.unl.edu
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Temperature range: 6-46 oC (43-115 oF) Optimum Temperature: 37oC (98.6oF) pH range: 4.1-9.0 Optimum pH: 6.5 - 7.5
Growth conditions
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www.foodsafetynews.com www.foodsafetynews.com
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Salmonella Enteritidis — the most common Salmonella serotype — accounted for 36 percent of infections resistant to nalidixic acid (resistance to nalidixic acid relates to decreased susceptibility to ciprofloxacin, a widely used fluoroquinolone drug).
Antiobiotic resistence of salmonella.
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www.salmonella.org www.salmonella.org
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binds to the wall of the intestine, and through some special proteins that it makes in response to the particular conditions in the intestine it actually penetrates the barrier between us and the outside. Once it has gained access to our insides, it is taken to the liver or spleen.
A kind of vague mechanism of attachment and virulence.
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www.phac-aspc.gc.ca www.phac-aspc.gc.ca
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Susceptible to chloramphenicol, ciproflaxin, amoxicillin, co-trimoxazole, trimethprim-sulfonamid, cephalosporins and norfloxacin
Treatment for the bacteria. It does not mention if it is first line or not.
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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L pneumophila is responsible for approximately 1% to 3% of community-acquired pneumonias
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URL
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microbeonline.com microbeonline.com
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The oxidase test is used to identify bacteria that produce cytochrome c oxidase, an enzyme of the bacterial electron transport chain.
The oxidase test used to identify bacteria.
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www.odh.ohio.gov www.odh.ohio.gov
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SIGNS AND SYMPTOMSIn
other illnesses the bacteria can cause.
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www.krebs.group.shef.ac.uk www.krebs.group.shef.ac.uk
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The IgA protease, showing its teeth in red!An Arms RaceSome bacteria have developed weapons that can cut our antibodies into small pieces so that they become unable to stick the invading bacteria into clumps. These anti-antibodies are called IgA proteases and are produced inside bacteria like the ones that cause meningitis and gonorrhoea
Function of IgA protease which is to prevent antibodies from detecting invading pathogens.
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www.drugs.com www.drugs.com
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By blocking this protein enzyme it stops the release of viruses from the infected host cell and prevents new host cells from being infected.
Neuraminidase helps to release viruses produced in the host cell.
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www.drugs.com www.drugs.com
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Cephalosporins are bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to and block the activity of enzymes responsible for making peptidoglycan, an important component of the bacterial cell wall. They are called broad-spectrum antibiotics because they are effective against a wide range of bacteria.
Mechanism and also it's a broad spectrum antibiotic.
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www.emedexpert.com www.emedexpert.com
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The third generation cephalosporins have a marked activity against gram-negative bacteria due to enhanced beta-lactamase stability and the ability to penetrate the gram-negative cell wall. They have more favorable pharmacologic properties than previous generations.
First line antibiotics
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www.historyofvaccines.org www.historyofvaccines.org
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Haemophilus influenzae type b bacteria can’t survive on surfaces or in the environment. The bacterium’s only known reservoir is humans, who may carry it without becoming ill.
Where is it normally found and the way it can be transmitted
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www.microbiologyinfo.com www.microbiologyinfo.com
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Biochemical Tests
Biochemical tests we can use given that they are available to us to use.
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On Blood Agar: translucent, low, convex or flat pin point colonies, Satellitism. On Chocolate Agar: Grayish, Transparent, smooth, low, convex or flat with a slightly splayed out, entire edge, mucoid, pale
Laboratory setting to culture the bacteria.
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Slender, short, gram negative rods or coccobacillus 3-0.5 um X 0.5-1 um with rounded ends.
More cell morphology. Under a microscope, look for a rod with rounded ends. No flagella.
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emedicine.medscape.com emedicine.medscape.com
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Laboratory testing Gram staining of body fluids from various sites of infection Bacterial culture (blood, other body fluids): The most confirmatory method of establishing the diagnosis; slide agglutination with type-specific antisera is used for serotyping H influenzae Immunologic studies: Detection of the polyribosyl ribitol phosphate (PRP) polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay; important adjuncts to culturing for rapid diagnosis Cerebrospinal fluid (CSF) studies (eg, Gram stain, culture, glucose/protein levels) Blood cell counts: Assessment for anemia, leukocytosis, thrombocytosis, and/or thrombocytopenia Acute phase reactants: Characteristic elevated erythrocyte sedimentation rates (ESRs) and C-reactive protein (CRP) levels in patients with septic arthritis
Laboratory tests that we can use given that they are available for us to use.
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Haemophilus influenzae is a small (1 µm × 0.3 µm), pleomorphic, gram-negative coccobacillus.
Cell morphology.
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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blood or body fluids of a person who is sick with or has died from Ebola, coming in contact with contaminated objects like needles and touching infected animals, their blood or other body fluids, or bush meat.
Modes of transmission
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Regarding the current EBOV outbreak, it is hypothesized that the index case most likely originated via animal — human contact (e.g., ingestion of undercooked ‘bush meat’, animal bite, or inadvertent contact with body fluids or blood from an animal)
Mode of transmission: direct contact. Entry: ingestion or other entry into body. Host: human
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www.hindawi.com www.hindawi.com
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moxicillin/clavulanic acid for 14 days
treatment length
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URL
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www.antibiotics-info.org www.antibiotics-info.org
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Amoxicillin acts by inhibiting bacterial cell wall synthesis. Lack of bacterial cell wall results in death due to lysis of bacteria. So amoxicillin is useful only for actively growing and cell wall synthesizing bacteria.
Amoxcillin's mechanism
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www.microbiologyresearch.org www.microbiologyresearch.org
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necrobacillosis,
Another health concern
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www.vanderbilt.edu www.vanderbilt.edu
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10-20% Mortality
Public Health concern
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www.antibiotics-info.org www.antibiotics-info.org
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Metronidazole is reduced to disrupt energy metabolism of anaerobes by hindering the replication, transcription and repair process of DNA results in cell death. Presence of oxygen prevents reduction of metronidazole and so reduces its cytotoxicity.
Mechanism of metronidazole.
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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collagenase, neuraminidase, deoxyribonuclease, deoxyribonuclease [DNase], heparinase, and proteinases)
The bacteria can produce this to destroy surrounding tissue
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URL
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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rare emergence of penicillin-resistant strains with β-lactamase activity
resistance to antibiotics
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penicillins remain the treatment of choice in most cases of LS, cephalosporins (such as cefoxitin and cefotetan), metronidazole, or clindamycin monotherapy can sometimes be used as first-line drugs
treatment
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Fusobacterium is ubiquitous in the normal flora of the oropharyngeal, gastrointestinal, and genitourinary tracts of healthy humans.
It's usually around in the human body.
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Additional physical findings included a temperature of 38.6°C,
Fevers can present over time.
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chills and sweats
A symptom caused by the bacteria.
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www.vetbact.org www.vetbact.orgVetBact2
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-/- Other Enzymes: Esculinase -, lipase -, Tryptophanase + (= indole +).
biochemical tests
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Smells like rancid butter (or boiled cabbage).
something to consider
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catalog.hardydiagnostics.com catalog.hardydiagnostics.com
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RECOMMENDED MEDIA For culture: Brain Heart Infusion (BHI) Agar, Chocolate Agar, Brucella with H & K Agar, Cooked Meat Medium, Thioglycollate Broth with Supplements, and complex media containing peptone promotes optimum growth. For selective isolation: LKV Agar or BBE Agar. For maintenance: Cooked Meat Medium, Thioglycollate Broth with Supplements, Brucella Agar with H & K, or Brain Heart Infusion (BHI) Agar. Skim Milk Media may be used for long-term storage at -70 degrees C. INCUBATION Temperature: 35 degrees C. Time: 48 hours. Atmosphere: Anaerobic with 5% CO 2 . pH: Near 7.
How to culture the bacteria
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Catalase-variable. Lipase-negative. Indole-variable. Esculin-hydrolysis-negative. Mannose, Lactose, Fructose, and Glucose production from fermentation positive for F. mortiferum . Mannose production from fermentation positive for F. varium . Mannose, Lactose, Fructose, and Glucose production from fermentation negative for F. necrophorum and F. nucleatum . Metronidazole-sensitive.
biochemical tests
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www.consumerreports.org www.consumerreports.org
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Disease
General Guideline on how long antibiotics should be used/prescribed.
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www.drugs.com www.drugs.com
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250 to 500 mg orally 3 times a day for 7 to 10 days; alternatively, 500 to 875 mg orally twice a day may be administered
information on how long antibiotics are generally prescribed to patients.
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- Apr 2017
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journal.frontiersin.org journal.frontiersin.org
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Vancomycin resistance among enterococci is attributed to change in the d-alanyl-d-alanine portion of peptide precursor units, transmitted as Van genes, thus rendering it incapable of inhibiting peptidoglycan polymerase and transpeptidation reactions.
Mechanism bacteria use to resist vancomycin.
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Vancomycin is a tricyclic glycopeptide (Figure 1) that consists of seven membered peptide chains forming the tricyclic structure and attached disaccharide composed of vancosamine and glucose.
The structure could be imporant in how it is able to treat bacteria.
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www.uwyo.edu www.uwyo.edu
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whereas Streptococcus and Enterococcus spp. are catalase negative.
Testing results
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whereas Streptococcus species and many other organisms are inhibited by high concentrations of NaCl.
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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The attachment of S. pyogenes to the pharyngeal and skin epithelial cell surfaces represents a critical first step in establishing such infections.
Point of infection, attachment point
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human infections that involve the upper respiratory tract and skin, including acute pharyngitis and impetigo.
generally targets the respiratory tract and skin. note this for the case. Patient's point of entry was through a skin break.
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www.health.ny.gov www.health.ny.gov
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Occasionally, however, these bacteria can cause much more severe and even life threatening diseases such as necrotizing fasciitis (occasionally described as "the flesh-eating bacteria") and streptococcal toxic shock syndrome (STSS).
Again, group A can cause the symptoms seen in the patient.
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www.cdc.gov www.cdc.gov
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The skin may be warm with red or purplish areas of swelling that spread rapidly. There may be ulcers, blisters, or black spots on the skin.
symptoms
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emedicine.medscape.com emedicine.medscape.com
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Presumptive identification of a strain as a group A streptococcus can also be made on the basis of production of the enzyme L-pyrrolidonyl-beta-naphthylamide (PYRase). Among the beta-hemolytic streptococci isolated from throat culture, only group A isolates produce PYRase, which can be identified on the basis of the characteristic color change (red) after inoculation of a disk on an agar plate followed by overnight incubation.
Defining feature
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group A organisms can be identified more cost effectively by numerous latex agglutination, coagglutination, or enzyme immunoassay procedures.
Identification methods
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n addition, infection with S pyogenes has reemerged as an important cause of toxic shock syndrome (TSS) and of life-threatening skin and soft-tissue infections, especially necrotizing fasciitis
possible cause for the patient's symptoms
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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penicillin
Method of treatment
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suppurative complications such as pharyngitis, impetigo, and non-suppurative immune syndromes such as acute rheumatic fever, rheumatic heart disease, and acute post-streptococcal glomerulonephritis.
Complications as a result of contractions of a group A.
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www.webmd.com www.webmd.com
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General symptoms of brucellosis are often vague and similar to the flu. They may include: Fever (the most common symptom, with high "spikes" that usually occur in the afternoon) Back pain Body-wide aches and pains Poor appetite and weight loss Headache Night sweats Weakness Abdominal pain Cough
Do you have any flu-like symptoms and how bad have those symptoms been? Have you had vomiting or diarrhea?
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www.cdc.gov www.cdc.gov
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Bacteria can also enter wounds in the skin/mucous membranes through contact with infected animals.
Do you work in a slaughterhouse, meat-packing facility, or a veterinarian and could have been exposed to an infected animal?
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Breathing in the bacteria that causes brucellosis may also lead to infection. This risk is generally greater for people in laboratories that work with the bacteria.
Do you work in a laboratory with this bacteria?
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emedicine.medscape.com emedicine.medscape.com
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has the highest age/sex-related incidence in males in their mid-20s.
Are you a male in the mid-20s or from 13-40 years of age?
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B abortus and B suis species
Two species exist.
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www.cnn.com www.cnn.com
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Many scientists and public health officials are loath to identify those patients and avoid the term "patient zero" altogether,
It is interesting that though scientists and PH officials avoid "patient zero", the term still exists and is still used.
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