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Part 3

After diagnosing Barbara with pneumonia, the PA writes her a prescription for amoxicillin, a commonly-prescribed type of penicillin derivative. More than a week later, despite taking the full course as directed, Barbara still feels weak and is not fully recovered, although she is still able to get through her daily activities. She returns to the health center for a follow-up visit.

Many types of bacteria, fungi, and viruses can cause pneumonia. Amoxicillin targets the peptidoglycan of bacterial cell walls. Since the amoxicillin has not resolved Barbara’s symptoms, the PA concludes that the causative agent probably lacks peptidoglycan, meaning that the pathogen could be a virus, a fungus, or a bacterium that lacks peptidoglycan. Another possibility is that the pathogen is a bacterium containing peptidoglycan but has developed resistance to amoxicillin.

  • How can the PA definitively identify the cause of Barbara’s pneumonia?
  • What form of treatment should the PA prescribe, given that the amoxicillin was ineffective?

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Filamentous appendages

Many bacterial cells have protein appendages embedded within their cell envelopes that extend outward, allowing interaction with the environment. These appendages can attach to other surfaces, transfer DNA, or provide movement. Filamentous appendages include fimbriae, pili, and flagella.

Fimbriae and pili

Fimbriae and pili are structurally similar and, because differentiation between the two is problematic, these terms are often used interchangeably. J.A. Garnetta et al. “Structural Insights Into the Biogenesis and Biofilm Formation by the Escherichia coli Common Pilus.” Proceedings of the National Academy of Sciences of the United States of America 109 no. 10 (2012):3950–3955. T. Proft, E.N. Baker. “Pili in Gram-Negative and Gram-Positive Bacteria—Structure, Assembly and Their Role in Disease.” Cellular and Molecular Life Sciences 66 (2009):613. The term fimbriae commonly refers to short bristle-like proteins projecting from the cell surface by the hundreds. Fimbriae enable a cell to attach to surfaces and to other cells. For pathogenic bacteria, adherence to host cells is important for colonization, infectivity, and virulence. Adherence to surfaces is also important in biofilm formation.

The term pili (singular: pilus) commonly refers to longer, less numerous protein appendages that aid in attachment to surfaces ( [link] ). A specific type of pilus, called the F pilus or sex pilus , is important in the transfer of DNA between bacterial cells, which occurs between members of the same generation when two cells physically transfer or exchange parts of their respective genomes (see How Asexual Prokaryotes Achieve Genetic Diversity ).

A micrograph of two cells connected by two long strings labeled pilli.
Bacteria may produce two different types of protein appendages that aid in surface attachment. Fimbriae typically are more numerous and shorter, whereas pili (shown here) are longer and less numerous per cell. (credit: modification of work by American Society for Microbiology)

Questions & Answers

Differentiation between electron, proton and neutron
Zainab Reply
what are the roles of microorganisms in human being
Buhari Reply
some causes disease, others are not disease causing
Clark
they're necessary in our digestive system+the skin,everywhere actually the number of them in the human body alone is higher(by millions)than the number of humans cells,they're indispensable in the food industry,others are fundamental to make medicines and more,what exactly are you asking about ?
BENNINI
What are the natural occurring elements found in organisms on earth?
Otu Reply
some of the naturally occurring elements found in organisms are carbon, nitrogen, hydrogen, oxygen
Yashi
thanks
Mariam
some of them are carbon, oxygen, nitrogen, hydrogen, phosphorus and sulfur
Jamal
what is Zika virus?
Somali Reply
Zika virus is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys. 
Cumar
intracellular vesicles are found in
Akshay Reply
how do i report widal slide results
Isaac Reply
how food can be used as a substrate for the growth of microorganisms
Ashi Reply
what is the importance of understanding chemistry in the field of microbiology and food technology?
Charmaine Reply
What is different between eukaryotes and prokcaryotic
Abia Reply
main difference is that eukaryotic cells possess membrane bound organelles
Iqra
prokaryotes are primitive organisms that doesn't contain membrane bound nucleus or any orgenelle while in eukaryotes membrane bound orgenelles and nucleus is present
Yashi
what s anatomy
jane Reply
its mean body structure, function, and systems
gazi
study of internal structure of living things
Falere
anatomy is the study structure of the made human
isir
anotomy is the actual study of body internally and externally Which include how itis made. for what and what is need of this
Iqra
la science anatomie c'est la science qui nous aide à étudier l'homme
Baraka
okay
Baraka
Ancestor are they real
Rapheal Reply
yes of course
David
yes please
Clark
50 50, depending on the accuracy of the clan records.
Vincent
okay
Baraka
Why protist is not a kingdom of Linnaeus 'S taxonomy?
Neha Reply
I dont know
Jeewraj
Linnaeus used Aristotle's criteria for dividing living organisms into kingdoms. Plants are immobile and insensitive, while animals are mobile and sensitive. the creatures he saw through the microscope were mobile, so he attributed them to animals.
Lad
name the different types of media use in lab to detect the micro organisms
Shehzadi Reply
The different types of media used in the lab to detect the microorganisms is known as cell culture..
Tean
solid media or broth is used to grow and detect microorganisms
Pohor
what is microbiology
Baraka
the study of large living organisms
Pratibha
the study of organisms which are micro in range
Vency
what is autoclaving?
Yashi
process for sterilization
Vency
is a machine used on the process of sterilisation
Clark
what is difference between hot air oven and autoclave as they both are used for sterilization ?
Vency
autoclave basically do moist heat sterilization while hot air oven do sterilization by dry heat.....
Yashi
what is the microbe
HUSSAIN
which method out of these two is best?
Yashi
why human have microbe
HUSSAIN
Hi
Sadam
hi to all
Sadam
depends on what to sterilize
Vency
microbes
Md
what is knowledge
HUSSAIN
well idea
Daniel
what are the importance of microbiologe to a nurse
Enny Reply
it enable a nurse to know the weight and height of a patient
Abotu
it helps the nurse in way as to give first aid to patient on which basis doctor will take diagonos
Iqra
disagree with both of you
Akhtar
ok
Abotu
Your Own idea
Abotu
it helps a nurse to be able to counsel a patient /client
Abotu
cell culture
Tean
Types of micro organisms
Jennifer Reply
Who discovered plant and animal cell
Jennifer
Robert Hooke
Martha

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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