Lecture 18: Nosocomial, Oral and Sexually Transmitted Diseases

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What diseases can you acquire during a hospital stay?: Nosocomial Diseases
Name three reasons why nosocomial diseases are acquired during a hospital stay: - patients carry lots of infections
- patients are immunocompromised
- hospital personnel and equipment
What are nosocomial diseases caused by?: blood stream infections (BSI)
burn wound infections
respiratory infections (pneumonia)
surgical site infections
urinary tract infections
Source of bacteria can be ______ (outside patient) or ______ (from patient): exogenous
endogenous
Many nosocomial diseases are caused by microbes brought with the patient at the time of admission. These organisms are generally opportunistic-that is, they do not cause disease in normal humans, but they are dangerous in compromised individuals. Name th: E. coli
Staphylococcus aureus
Pseudomonas aeruginosa
The teeth are surrounded by tissues that provide the support essential to tooth function. These tissues, called the periodontal tissues, may be the site of a periodontal disease called ____: Acute Necrotizing Ulcerative Gingivitis (ANUG)
periodontal: around tooth
gingivitis: inflammation of gums
Name four causing agents of periodontal disease: Porphyromonas gingivalis, Leptotrichia buccalis, Eikenella, Treponema vincentii
Porphyromonas gingivalis, Leptotrichia buccalis, and Eikenella are all what kind of bacteria?: Gram-negative rods
Treponema vincentii is what kind of bacteria?: Gram-negative spirochete
Process of periodontal disease. With _____ bacteria colonize periodontal pockets at gum/tooth border: plaque formation
With plaque formation bacteria colonize periodontal pockets at gum/tooth border. Bacteria produce ____ and then ____: toxins and then proteases
With plaque formation bacteria colonize periodontal pockets at gum/tooth border. Bacteria produce toxins and then proteases. Cause inflammation of gums (_____) and then ______: gingivitis
bone destruction
With plaque formation bacteria colonize periodontal pockets at gum/tooth border. Bacteria produce toxins and then proteases. Cause inflammation of gums (gingivitis) then bone destruction. Loss of _____ possible: tooth
What is ANUG (Acute Necrotizing Ulcerative Gingivitis) associated with?: poor oral hygiene, malnutrition, smoking and mental disease
How is Periodontal disease controlled?: frequent plaque removal- brushing and flossing (if you don't floss, ANUG can occur in the absence of cavities)
The acquired enamel pellicle is made up of ______: (-) charged glycoproteins which repels (-) charged bacteria
The _____ is made up of (-) charged glycoproteins which repels (-) charged bacteria: acquired enamel pellicle
What disrupts the natural repulsion of the acquired enamel pellicle repelling (-) charged bacteria?: plaque
Pellicle colonized by ______ and other bacteria: STreptococci
Coaggregation of bacteria through ______ interactions: lectin-carbohydrate receptor interactions
Pellicle colonized by Streptoccoci and other bacteria. Coaggregation of bacteria through lectin-carbohydrate receptor interactions. Streptococci produce enzyme that polymerizes _____ into ________: sucrose into glucan polymers
Pellicle colonized by Streptoccoci and other bacteria. Coaggregation of bacteria through lectin-carbohydrate receptor interactions. Streptococci produce enzyme that polymerizes sucrose into glucan polymers. Glucan cements bacteria together to form _____: plaque
Name four causing agents of Dental Caries.: Streptococcus mutans, mitis, oralis, and sanguis
Streptococcus mtans, mitis, oralis, and sanguis produce acids. What four kinds of acid?: lactic, acetic, formic, butyric
Streptococcus mutans, mitis, oralis, and sanguis produce acids (lactic, acetic, formic, butyric) after _____: metabolizing sucrose and other sugars
Plaque is not permeable to ________ so acis are not diluted or washed away: saliva

acid lowers pH and weakens tooth
Acids demineralize the _____ and _____: enamel and underlying dentin
The bacteria (Streptococcus mutans, mitis, oralis, and sanguis) produce acid that breaks down the calcium phosphate salts in ______, the major compound in the enamel and underlying dentin: hydroxyapatite
What three things do you need for caries?: 1) buildup of plaque
2) dietary carbohydrate (sucrose)
3) acidogenic bacteria
What could be done to prevent periodontal disease, plaque formation, and dental caries?: Block binding of bacteria and formation of plaque.

Fluoride
Block binding of bacteria and formation of plaque. Bacteria bind through _____: adhesin
Block binding of bacteria and formation of plaque. Bacteria bind through adhesin. FInd portion of adhesin that binds. Then synthesize a _____: peptide imposter
Block binding of bacteria and formation of plaque. Bacteria bind through adhesin. FInd portion of adhesin that binds. Then, synthesize peptide imposter, which blocks _____: sites on teeth where STreptococci would bind
HOw does fluoride work?: fluoride works by displacing the hydroxyl ions in hydroxyapatite and reducing the solubility of enamel
Sexually transmitted Diseases require person-to-person contact such as ____ or ___: intercourse
orogenital acts

Agents of STDS cannot live outside body. Fomites cannot transmit STDs
What is the #1 STD, #1 cause of sterility in young women?: Chlamydia
Chlamydia is one of several diseases collectively known as _____: nongonoccoccal urethritis (NGU)

*nongonococcal urethritis is a general term for a condition in which people without gonorrhea have a demonstrable infection of the urethra usually characterized by inflammation, and often accompanied by a discharge
What is nongonoccoccal urethritis characterized by?: inflammation of urethra accompanied by discharge
What is chlamydia caused by?: Chlamydia trachomatis, G- cocci
Chlamydia has to live in human cells to survive. In other words, it is an _______ of humans- grows only in eukaryotic cells: intracellular parasite
How long is the incubation period for chlamydia?: 1-3 weeks
What do you treat chlamydia with?: tetracycline (or erythromycin for pregnant women)

- no tetracycline for pregnant women cuz of bone formation
What are some symptoms of chlamydia for women?: - Vaginal discharge, burning w/ urination
- inflammation of cervix
- salpingitis- blockage of Fallopian tubes
- pelvic inflammatory disease (PID)
- Sterility is a possibility because some women show few symptoms or are asymptomatic
What is the blockage of Fallopian tubes called?: Salpingitis
What things should you know with pelvic inflammatory disease (PID)? (involves what? can cause what?): - involves reproductive structure
- can cause chronic pelvic pain, ectopic pregnancy, tubal infertility
What are some symptoms of chlamydia for men?: Painful urination, discharge, tingling sensation in penis
What are the symptoms of chlamydia for newborns?: diseases of eyes
chlamydial opthalmia can cause blindness
Describe the reproductive cycle of the chlamydiae: - A chlamydia enters the cytoplasm of a susceptible cell.
- It enlarges to form an initial body after about 12 hours.
- The initial body then undergoes several binary fissions to form small particles called elementary bodies.
- elementary bodies accumulate after 30 hrs.
- the elementary bodies emerge as new chlamydiae after 48 hrs.
What is the #2 STD reported?: Gonorrhea
What is the causative agent of gonorrhea?: Neisseria gonorrheae

G- diplococci, fragile organism
How long is the incubation period for gonorrhea?: 2-6 days
How can gonorrhea be treated?: a variety of antibiotics
How would you control the spread of gonorrhea?: through the use of prophylactics, rapid treatment, diagnosis of asymptomatic cases, public education
N. gonorrhea use pili to attach to mucosal cells, which prevents ____: bacteria from being washed away
What are the symptoms of gonorrhea that women have?: - symptoms similar to chlamydia, just worse
- discharge, burning pee, salpingitis, PID- can result in ectopic pregnancy or sterility
- 50% are asymptomatic (are unknowing carriers)
What are the symptoms of gonorrhea that men have?: - Painful urination, discharge, testicular pain, swelling of lymph nodes in groin
- infection of epididymis can lead to sterility
What are the symptoms of gonorrhea for newborns?: Gonococcal opthalmia prevented with silver nitrate, antibiotics
What can be prevented with silver nitrate and antibiotics?: gonococcal opthalmia
What is the one, only fatal STD?: Syphilis
What is the agent of syphilis?: Treponema pallidum
Describe Treponema pallidum: Spirochete (axial filaments)
Treponema pallidum is a spirochete (axial filaments) that enters the body through ____: mucous membranes, abrasions or hair follicles
What is the incubation period for syphilis?: ~ 3 weeks
How is syphilis transmitted?: intimate human-to-human contact
How can syphilis be treated in primary, secondary, latent, and tertiary stages?: antibiotics in primary and secondary and latent stages

can't be treated in tertiary stages
What is a characteristic of the primary stage of syphilis?: Chancre, purplish ulcer with raised margins and hard edges
Where does a chancre develop?: at site of entry
What does a chancre contain?: spirochetes
When does a chancre disappear?: Disappears spontaneously after about 2-6 weeks
secondary syphilis looks like other diseases. What are symptoms of secondary syphilis?: - fever, flu-like illness, swollen lymph nodes (mono)
- skin rash (measles or chicken pox)
- patchy hair loss, jaundice (hepatitis)
What are some of the major symptoms of syphilis?: swollen lymph nodes (mono)
jaundice (hepatitis)
measles or chicken pox
Is secondary syphilis still infectious in the latent stage?: yes
What is the tertiary stage characterized by?: gumma- soft gummy and granular lesions that will burst blood vessels
gumma leads to degeneration of ____: nervous tissues
Gumma is soft gummy and granular lesions that will burst blood vessels and leads to degeneration of nervous tissues. It then leads to ___, ____, and ___: insanity
blindness
death
Congenital syphilis is where _____ penetrate _______ after 4th month: spirochetes
placenta
What is characteristic of congenital syphilis?: skin lesions, bad bone formation, meningitis
WHat triad is associated with congenital syphilis?: Hutchinson's triad
What are the three things associated with Hutchinson's triad?: deafness
impaired vision
notched, peg shaped teeth

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