1. Bacterial Diseases Page 339: Table 25 – 1 & Table 25 – 2

2. Pathogenicity “the state of producing or being able to produce pathological changes and disease”

3. Staphylococcus (Page 342) “a genus of gram-negative, nonmotile, opportunistic bacteria which tend to aggregate in irregular, grape-like clusters” Implications for the Embalmer: page 343

4. Readings Question #1 Staphylococcus aureus is the most pathogenic of the staphylococci. What are its toxins capable of doing? What enzymes does it produce, and what is their known effect?

5. Staphylococcal Food Poisoning Page 343 caused by ingesting an enterotoxin high resistance to heat, drying and radiation, and high osmotic pressures inhabitant of nasal passages…contaminates the hands…..readily enters food mechanical vectors mayonnaise, cream sauces

6. Skin and Wound Infections Page 344 Sty: “infected follicle of an eyelash”

7. Skin and Wound Infections (cont’d) Pimple: infected hair follicle Abscess: more serious hair follicle infection – furuncle/boil: superficial – carbuncle: deeper Risk of underlying tissues becoming infected Toxemia: toxins circulate

8. Scalded Skin Syndrome

9. Toxic Shock Syndrome Page 344 Color Plates 39 and 40 S. aureus growth associated with the use of a new type of highly absorbent vaginal tampon swell with menstrual fluids and adhere to the vagina tears in the vaginal wall

10. Streptococcus Page 345 “spherical shaped bacteria occurring in chains” What are the implications for the embalmer when dealing with saprophytes?

11. Streptococcus pneumoniae ( pneumococcus) gram-positive ovoid bacterium cell pairs surrounded by capsule common cause of: 1) lobar pneumonia 2) meningitis 3) otitis media

12. Lobar Pneumonia Page 346 Readings question #2: What is lobar pneumonia, and how is it characterized? What are some of the predisposing conditions for this disease? penicillin and fluoroquinolones

13. Meningitis Figure 25-1 Page 346 70% of the population are healthy carriers Gram-positive encapsulated diplococcus Leading cause of bacterial meningitis Most cases between 1 month and 4 years Broad-spectrum cephalosporins CSF obtained by a spinal tap Vaccine: Pneumococcal Conjugated Vaccine

14. Otitis Media 85% before 3 years of age (Eustachian Tubes)

15. Streptococcus pyogenes Page 348 Color Plates 43 and 44 Scarlet Fever: streptococcal pharyngitis Septic Sore Throat: respiratory secretions – penicillin Puerperal Sepsis: Childbirth/Childbed Fever Rheumatic Fever: arthritis and fever – 50% inflammation of the heart – penicillin – Syndenham’s chorea (St. Vitus’Dance)

16. Clostridium Page 351 obligate anaerobes rod-shaped cells that contain endospores Clostridium botulinum: botulin Note the bullet points on page 351!!

17. Readings Question 3 (Page 352) Clostridium tetani causes what bacterial infection? Describe the characteristics of this microbe. Where is it found? What are its symptoms, and what causes them?

18. Clostridium perfringens Pages 352 and 353 gram-positive, endospore-forming anaerobe saprophyte responsible for: – Gas gangrene – Tissue Gas (post-mortem) – Food Intoxication

19. Gas Gangrene

21. Readings Question #4 Clostridium perfringens is the causative agent of a postmortem condition known as tissue gas. What factors may result in this condition in the decedent?

22. Food Intoxication Clostridium perfringens Gastroenteritis: one of the more common forms of food poisoning in the United States improper handling of meat during the slaughtering of animals 2 main causes: 1) keeping foods warm for more than 20 minutes 2) inadequate refrigeration

23. Clostridium difficile Spore-forming, gram-positive, anaerobe Produces 2 exotoxins (toxin A and toxin B) Found in enterics Mode of transmission: shed in feces Reservoir: anything that can be contaminated with feces (including embalming tables!) Healthcare workers who touch “fomites” can transmit these spores

24. Clostridium difficile Symptoms: watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness Common cause of antibiotic-associated diarrhea (AAD) (15-25% of all cases) Responsible for: psudomembranous colitis (PMC); toxic megacolon; perforations of the colon; sepsis; death (rare) Risk factors: antibiotic exposure; G-I surgery/manipulation; lengthy stay in healthcare settings; serious underlying illness; immunocompromised; elderly