Anaerobes

Anaerobes

1. Pathogenesis of Microbial Factors

   • portal of entry: spore's from host's normal flora
   • attach to cells: polysaccharide capsule impairs phagocytosis
   • defeat / evade immune system: production of short chain fatty acids inhibit phagocytosis
   • cause damage to host cells: toxin production
   • get out and spread further

2. Clostridia *spores*

   • Clostridium tetani
     • person completely aware, muscle spasms, trismus, risus sardonicus, spontaneously or after minor stimuli (noise, light or touch)
       • laryngospasm, ANS dysfunction
       • ABC, tetanus immunoglobulin, avoid stimuli, 3 doses of DTP vaccine
   • Clostridium botulinum
     • foodborne botulism, infant botulism, wound botulism
       • symmetrical descending flaccid paralysis, bilateral cranial nerve palsies (double vision, difficulty swallowing), fever is classically absent
         • ABC, antitoxin, wound debridement and metronidazole
         • detection of toxin in stool/vomit (foodborne), organism/toxin in stool (infant), culture of organism from wound site (wound)
   • Clostridium difficile
     • new or recurrent, SIGHT, HAI/antibiotic
       • Vanc 125 mg 4x/day for 10 days; Fidaxomicin 200 mg bd for 10 days
       • 5 moments for hand hygiene!
   • Clostridium perfringens
     • food poisoning, gas gangrene, emphysematous cholecystitis
       • clinical suspicion, CT/XR (gas in tissues), wound swab/blister fluid for culture, blood cultures
       • surgical debridement, high dose penacillin / clindamycin

3. Peptostreptococcus

4. Lactobacillus

5. Propionibacterium

6. Bacteroides

7. Prevotella

8. Fusobacterium