I&I organisms from infection & immunology
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- 5 live attenuated vaccines
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-MMR
-varicella
-BCG (bacille calmette-guerin)
- polio (vacinia or OPV)
- small pox - 1 vaccine from inactivated toxin
- DPT
- 2 Vaccines from purified protein
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-pertussis
-Hep B - Vaccine from polysaccharides or protein
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-meningococcal
-pneumococcal
-Haemophilus - 4 vaccines from inactivated agents
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inactivated polio
influenza
Hep A
Cholera - 3 antimicrobial peptides in extracellular immune response
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defensins
cathelicidins
protegrins (put hole in membrane) - Effector mechanism essential for Neisseria
- Complement
- How do lysozymes, cathespins, elastase function as effector mechanisms in extracellular response?
- degredation of proteins or lipids essential for pathogen integrity
- Effector enzymes in neutrophils
- Defensins & myeloperoxidase
- Effector enzymes in all phagocytes
- NADPH & phagocyte oxidase
- How do phagocytes recognize pathogens
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-C3bi
-CRP
-IgG 1 or 3
-MBL - How are macrophages activated
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Th1's express CD40L & TCR
MP binds via CD40 & MHC I
IFN gamma receptor is activated - Product of activated macrophages
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increased expression of B7 & MCH II
secrete TNF, IL-1, IL-2 IL-12
release iNOS to kill microbe - Bugs that subvert humoral immunity via antigenic variation
- Neisseria, E coli, Salmonella
- 3 ways bugs subvert humoral immunity
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antigenic variation
evasion of phagocytosis (pneumococci)
inhibit complement activation - subversion of immunity by Leishmania Major
- Th1 response gives full recovery, Th2 gives disseminated infection
- subversion of immunity by mycobacterium leprae
- Th1 response gives tuberculoid leprosy, Th2 gives lepromatous (with High bacteria count)
- prokaryote characteristics
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-cytoplasmic membrane
-nucleoid
-ribosomes: 70s (eukaryote has 80s)
-cell wall: peptidoglycan
NO: membrane bound organelles (mitochondria) - Penicillin G
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G+ strep & enterococcus
NO STAPH
N Meningitidis
***(Pen V for dentistry)*** - Amoxocillin
-
Extended spectrum PCN (skin & soft tissue, lower UTI & URI)
URI, increased G- coverage
Needs Clavulonic for ME & sinus infection - Ampicillin
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extended spectrum PCN
Listeria Monocytogenes
E Coli (UTI)& H Influenza (URI) & meningitis (HIB, S Pneumo, N Meningiditis) - Ticarcillin & Pipercillin
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extended spectrum PCN
P. Aeruginosa (w/aminoglycocide)
SE: bleeding disorder - Methcillin
- Reserved for PCNase forming staph
- Clavulonic Acid
- can be added to PCN to inhibit PCNase
- Probenicid
- decreases renal elimination of PCN- increases half life
- Cephalexin
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1st generation Cephalosporin
Proteus Mirabilus, E Coli, Klebsiella - Cefuroxime
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2nd generation Cephalosporin
Haemophilis, Enterobacter, Neisseria - Cefataxime
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3rd generation cephalosporin
crosses BBB
mostly G- coverage - Cefepine
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4th generation cephalosporin
broad spectrum G+ & G- - Imipenem
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broadest spectrum beta lactam antibiotic
nosocomial infections
P Aerugenosa