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Staphylococcus epidermidis is a coagulase negative, Gram-positive coccus. The organism uses sophisticated regulatory networks to adapt its metabolism to suit varying environmental conditions. S. epidermidis relies on biofilm formation to protect cells from the host immune system and other anti-microbial molecules.

Listeria with tumbling motility (by Pathmass)

Listeria monocytogenes

Gram+, aerobic, motile rod, facultative intracellular, beta hemolytic on blood agar

Tumbling motility in broth (as seen in video)

Jet motility in cells by actin filament formation

Listeriolysin O (Beta hemolysin): pathogenic factor, facilitates it scape from phagosome before phagolysosome formation and “jets” into another cell.

Diseases:

Lysteriosis: asymptomatic or diarrhea. 

Lysteriosis in pregnant women septicimia, crosses placenta.

Granulomatosis infantisepticum: neonatal disease, in utero transmission, sepsis, diseminated granulomas and high mortality.

Neonatal sepsis and meningitis (3° most common cause) 2-3 weeks after birth (fecal exposure)

Septicemia and meningitis in immunocompromised pts

Meningitis in renal transplant pts, cancer pts

Colon: pseudomembranous colitis due to Clostridium difficile (pseudomembranous inflammation) Note the gray-yellow pseudomembrane covering the entire mucosal surface. Damage is due to a toxin produced by C. difficile. Similar to diphtheria, the toxin produces necrosis of the mucosa and submucosa without actual invasion by the bacteria. A toxin assay of stool is the best method for diagnosing the disease. Ampicillin is the MC drug causing pseudomembranous colitis and does so by destroying colonic bacteria that normally keep C. difficile in check.

Hope it helps @shreeparn  :)

Antimicrobial Agents - Inhibition of DNA and Protein Synthesis

Bacterial chromosome replication

DNA replication

Bacterial Topoisomerases 

maintain DNA in appropriate state of supercoiling 

cut and reseal DNA

DNA gyrase (topoisomerase II) introduces negative supercoils 

Topoisomerase IV decatenates circular chromosomes 

these are the targets of the quinolone antibacterial agents 

Quinolones

bind to bacterial DNA gyrase and topoisomerase IV after DNA strand breakage 

prevent resealing of DNA 

disrupt DNA replication and repair 

bactericidal (kill bacteria)

Fluoroquinolone is particularly useful against

Gram +ves: Staphylococcus aureus, streptococci 

Gram -ves: Enterobacteriacea; Pseudomonas aeruginosa 

Anaerobes: e.g. Bacteroides fragilis 

many applications e.g. UTIs, prostatitis, gastroenteritis, STIs 

Adverse effects

Relatively well tolerated

GI upset in ~ 5% of patients 

allergic reactions (rash, photosensitivity) in 1 - 2% of patients 

Inhibition of Bacterial Protein Synthesis 

Macrolides 

in 1952: Erythromycin was isolated as the first macrolide (Streptomyces erythreus) 

Newer macrolides: clarithromycin, azithromycin 

Structurally they consist of a lactone ring (14- to 16-membered) + two attached deoxy sugars 

Mode of action 

bind reversibly to bacterial 50S ribosomal subunit 

causes growing peptide chain to dissociate from ribosome → inhibiting protein synthesis 

bacteriostatic (stops reproduction)

Macrolides’ spectrum of activity

good antistaphylococcal and antistreptococcal activity 

treatment of respiratory & soft tissue infections and sensitive intracellular pathogens • e.g. Chlamydia, Legionella 

Adverse effects

Generally well tolerated

nausea 

vomiting 

diarrhoea 

rash 

Aminoglycosides

large family of antibiotics produced by various species of Streptomyces (“mycin”) and Micromonospora (“micin”) 

include: streptomycin, neomycin, kanamycin, gentamicins, tobramycin 

Structure = linked ring system composed of aminosugars and an aminosubstituted cyclic polyalcohol 

Mode of action of aminoglycosides

Bind irreversibly to 30S ribosomal subunit 

disrupt elongation of nascent peptide chain 

translational inaccuracy → defective proteins 

bactericidal 

Spectrum of activity 

broad spectrum; mainly aerobic G-ve bacilli (e.g. P. aeruginosa) 

used to treat serious nosocomial infections (hospital acquired infections)

First TB antibiotic

Used for cystic fibrosis 

Adverse effects

all aminoglycosides have low Therapeutic Index (only a small amount needed to become toxic)

renal damage, ototoxicity, loss of balance, nausea 

Medically Important Fungi

A sample of notes from Medical Virology // I keep the margins empty so that I have space to add in relevant additional material from extra reading

Dose Dependent effects of Dopamine mnemonic

Simplified version of Dopamine’s dose-dependent MAJOR effects:

low doses - activates D1 receptors (Gs) - vasodilates renal blood vessels*

med.doses - activates B1 receptors (Gs) - increases heart rate/contractility etc..

high doses - activates A1 (Gq) - vasoconstricts,

*increased renal perfusion, GFR, also vasodilates mesenteric and coronary vessels 

source: http://reference.medscape.com/drug/intropin-dopamine-342435

ANTIBIOTICS CHEAT SHEET :)

Also, REMEMBER!!!!

* Sulfonamides compete for albumin with:

Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies

Warfarin: increases toxicity: bleeding

* Beta-lactamase (penicinillase) Suceptible:

Natural Penicillins (G, V, F, K)

Aminopenicillins (Amoxicillin, Ampicillin)

Antipseudomonal Penicillins (Ticarcillin, Piperacillin)

* Beta-lactamase (penicinillase) Resistant:

Oxacillin, Nafcillin, Dicloxacillin

3°G, 4°G Cephalosporins

Carbapenems 

Monobactams

Beta-lactamase inhibitors

* Penicillins enhanced with:

Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)

Aminoglycosides (against enterococcus and psedomonas)

* Aminoglycosides enhanced with Aztreonam

* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)

* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)

* Both inhibited by Probenecid during tubular secretion.

* 2°G Cephalosporines: none cross BBB except Cefuroxime

* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.

* Cephalosporines are "LAME“ bc they  do not cover this organisms 

L  isteria monocytogenes

A  typicals (Mycoplasma, Chlamydia)

M RSA (except Ceftaroline, 5°G)

E  nterococci

* Disulfiram-like effect: Cefotetan & Cefoperazone (mnemonic)

* Cefoperanzone: all the exceptions!!!

All 3°G cephalosporins cross the BBB except Cefoperazone.

All cephalosporins are renal cleared, except Cefoperazone.

Disulfiram-like effect

* Against Pseudomonas:

3°G Cef taz idime (taz taz taz taz)

4°G Cefepime, Cefpirome (not available in the USA)

Antipseudomonal penicillins

Aminoglycosides (synergy with beta-lactams)

Aztreonam (pseudomonal sepsis)

* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

* Covers VRSA: Linezolid, Dalfopristin/Quinupristin

* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.

* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)

* Phototoxicity: Q ue S T  ion?

Q uinolones

Sulfonamides

T etracyclines

* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides

* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis

* Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.

* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.

* Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.

* QT prolongation: macrolides, sometimes fluoroquinolones

Different anatomy notes form this semester Supplies used (not all at once, I mix and match): Faber-Castell Coloured Pencils (48 Pack) - https://amzn.to/2Kd1mUy Staedtler Triplus Fineliners - http://amzn.to/2pghonI Stabilo Point 88 Fineliner - https://amzn.to/2qU8fC9 Sharpie Pens - https://amzn.to/2HTRmP2 Uni Pin 0.1 Fineliner - https://amzn.to/2HmXp1z Crayola Supertips - https://amzn.to/2HVW1jr Bic Ballpoint Pen - https://amzn.to/2HmCjk0 Stabilo Swing Cool Highlighters - https://amzn.to/2HKxPTu