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Questions about Gram-Negative bacteria and the infectious diseases they can produce: 1.

Table comparing exotoxins and endotoxins. Type of producer bacteria Chemical composition Effect on the body Exotoxins Almost all Grampositive Polypeptide Highly specific, several types Endotoxins Almost all Gramnegative Lipopolysaccharide complex Nonspecific; local reactions, such as fever, aches, and Toxicity high or low Among the most powerful toxins known (100 to 1 million times more lethal than Fever producing Lethal dose high or low Immunology strychnine) No Low Very good, longlasting immunity confered 2. Mechanism of action of Shiga-toxin. Shiga toxins act to inhibit protein synthesis within target cells by a mechanism similar to that of ricin toxin produced by Ricinus communis. After entering a cell via a macropinosome, the protein functions as an N-glycosidase, cleaving a specific adenine nucleobase from the 28S RNA of the 60S subunit of the ribosome, thereby halting protein synthesis. 3. Classification of bacteria (Gram-positive and Gram-negative) that produce enteritis, transmitted by the oral route, according to the mechanism of action (virulence factors: preformed toxin, toxin in the intestine, invasion). a. Gram Positive: Enterococcus, Staphylococcus aureus, Bacillus cereus, b. Gram Negative: Eschericia colli, E coli O157:H7, Vibrio cholera 4. Typical complication and brief description of O157:H7 Escherichia coli infection. Yes, rapid rise to very high fever High Weak, no immunity conferred possible shock Weak, but fatal in high doses

Infection with E. coli O157:H7 follows ingestion of contaminated food or water, or oral contact with contaminated surfaces. It is highly virulent, with a low infectious dose: an inoculation of fewer than 10 to 100 CFU of E. coli O157:H7 is sufficient to cause infection, compared to over onemillion CFU for other pathogenic E. coli strains Shiga toxin–producing Escherichia coli O157:H7 is an important cause of enteric illness in developed countries.Infection typically presents as a diarrheal illness, often with bloody stools. In approximately 8% of patients,infection progresses to hemolytic uremic syndrome (HUS), a lifethreatening condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure 5. Antimicrobial treatment of O157:H7 Escherichia coli infection. 6. Amoxicillin Aztreonam Ceftriaxone Doxycycline Vibramycin

Clarify concepts: Bacteremia, SIRS, sepsis, severe sepsis, septic shock. Bacteremia  Bacteremia is the presence of viable bacteria in the blood stream. Bacteremia is different from sepsis (so-called blood poisoning or toxemia), which is a condition where bacteremia is associated with an inflammatory response from the body (causing systemic inflammatory response syndrome, characterised by rapid breathing, low blood pressure, fever, etc.). Common oral hygiene, such as brushing teeth or flossing, can cause transient but harmless bacteremia. SIRS  Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body, frequently a response of the immune system to infection, but not necessarily so. It is related to sepsis, a condition in which individuals both meet criteria for SIRS and have a known or highly suspected infection. Sepsis  Sepsis is defined as SIRS in response to an infectious process. Severe sepsis is defined as sepsis with sepsis-induced organ dysfunction or tissue hypoperfusion (manifesting as hypotension, elevated lactate, or decreased urine output. Septic shock is severe sepsis plus persistently low blood pressure following the administration of intravenous fluids