Gram (+) Cocci:

Bacteria Distinguishing/ Reservoir Transmission/ Pathogenesis Diseases Treatment/

important predisposing prevention
features factor

Staph. - beta- hemolytic normal flora: - hands - protein A binds Fc Inflammatory/ - gastroenteritis
aureus - coagulase (+) - nasal - sneezing components of pyogenic: is self-limiting
- ferments mucosa - surgical IgG, inhibits - furunculus
mannitol on - skin wounds phagocytosis - impetigo - for MRSA:
mannitol salt - contaminated - enterotoxin: fast - foliculitis vancomycin
agar food acting, heat stable
- lecitinase + - TSST-1: Toxin mediated: - for VRSA:
predisposing superantigen - food poisoning quinupristin/
* protein A on factors: - TSS dalfopristin
surface wounds/ - plasmid that - Scalded skin s.
surgery/ encodes beta- (exfoliatin toxin) - oxacillin
tampoons lactamase (degrade
penicillin) - osteomyelitis
- pneumonia

Staph. - Novobiocin normal flora: predisposing pyogenic infections infection of prosthetic

epidermidis sensitive skin and factor: heart valves and hips;
- lecitinase + mucous infection of common member of
membranes intravenous opportunistic normal flora
- gamma- catheter sites pathogen
hemolysis and prosthetic
devices

staph. - Novobiocin predisposing pyogenic infections, urinary tract

saprophyticus resistant factor: urinary tract mainly infections- mainly
- gamma- urinary tract cystitis
hemolysis infection
 Bacteria Distinguishing/ Reservoir Transmission/ Pathogenesis Diseases Treatment/
important predisposing prevention
features factor

Strep. - beta-hemolytic - human - direct contact - M-protein Pyogenic: penicillin-G

pyogenes - Bacitracin throat, - respiratory (antiphagocytic) - impetigo
sensitive upper droplets - Streptokinase - cellulitis
resp. tract - Hyaluronidase - myositis
- skin - DNase - pharyngitis
Group A - Streptolyzin O Toxic:
toxin (antigenic, - scarlet fever
oxygen labile)) - TSS
- Sreptolysin S toxin Immunogenic:
(non-antigenic, - PSGN
oxygen stable) - rheumatic fever

Strept. - beta- hemolytic - female - newborn - capsule neonatal septicemia

agalactiae - Bacitracin vagina infected during Diagnosis: CAMP and meningitis
resistant - GI tract birth test (beta-hemolysin
Group B - hydrolyze from staph. aureus
hyppurate on sheep blood agar)

Strep. - alpha-hemolytic human respiratory - polysaccharide Respiratory tract: vaccine:

pneumoniae - Optochin upper droplets capsule is the major - pneumonia capsular
sensitive respiratory virulence factor - sinusitis polysaccharide
- lancet-shaped tract, - otitis media vaccine
diplococci normal - COPD
- bile soluble flora Invasive:
- meningitis

Strep. - alpha-hemolytic human - endocarditis

mutans - Optochin oropharynx - dental varies
(viridans resistant normal
family) - not bile soluble flora
Gram (+) Rods:
Bacteria Distinguishing Reservoir Transmission/ Pathogenesis Disease Treatment/
features Predisposing Prevention
factors

B. - G(+) rod found - spores in soil 1. cutaneous anthrax toxin: Anthrax - ciprofloxacin
antracis in chains anthrax: 1. Edema factor - doxycyline
- spore formation zoonosis spores in soil (adenylate cyclase) --> edema
enter wound 2. Lethal factor (protease)
2. pulmonary --> cleavage of phosphokinase (MAPK
anthrax: activator)--> inhibition of cell growth vaccine:
spores are purified
inhaled into the 2 exotoxins composed of: antigen
lung 1. B (binding) subunit- protective
antigen
2. A (active) subunit- enzymatic activity

B. spores on portal entry: GI 2 exotoxins: food

cereus grains such as tract 1. similar to cholera toxin, it increase poisoning
rice survive cAMP
steaming and 2. similar to staphylococcal
rapid frying enterotoxin, it is a superantigen
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features prevention

C. tetani - large G(+) soil - puncture - spores germinate in the Tetanus - hyperimmun
spore forming wounds/trauma tissue, producing tetanus e humane
rod (human bites) toxin specific features: globulin to
neurotoxic - obligate - carried intra-axonally to CNS - lockjaw neutralize
clostridia anaerobe - binds to ganglioside (trismus) toxin
- produces receptors - rhisus
tetanus toxin - blocks release of inhibitory sardonicus vaccine:
mediators: GABA and - opisthotonus toxoid vaccine
Glycine - spastic paralysis
--> extreme muscle spasm

C. - large G(+) spore in: exotoxin in food the exotoxin is absorbed from Botulism: respiratory
botulinum spore forming - soil is ingested the gut and carried by to blood 1. wound support+
rod - contaminated to peripheral nerves synapse botulism trivalent
- anaerobe vegetables --> blocks the release of Ach 2. infant botulism antitoxin
neurotoxic - produces - contaminated --> descending weakness (made in
clostridia botulinum toxin meat and paralysis horses)
- home made - weakness and
cans paralysis
- accumulation 2 forms of botulism: - diplopia - no honey
in conserved 1. wound botulism- the spores - dysphagia below 1 year
food contaminate the wound - respiratory of age
2. infant botulism- the muscle failure
organism grow in the gut
and produce the toxin there
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features prevention

C. - large G(+) - soil - spores in soil - spores germinate under 1. Gas gangrene - debridement
perfringens spore-forming - human colon enter wound anaerobic conditions in - contamination of of wounds
rod - exotoxin in tissue wound with - cook food
- anaerobe food is soil.feces
- identified by ingested - toxin production: - acute and Gas
Nagler 1. lecithinase (alpha-toxin) increasing pain gangrene:
histotoxic reaction- egg --> damage cell membranes at wound site - penicillin
clostridia yolk agar plate 2. superantigen - clindmycin
is used to 2. food
demonstrate poisoning
the presence enterotoxin produced in - enterotoxin no vaccine
of lecithinase intestines in food poisoning: production in gut;
disrupt ion transport --> watery self limiting
diarrhea, cramps noninflammatory,
watery diarrhea

C. dificille - cant culture normal flora antibiotic - evade the immune response - antibiotic- caution in
because (colonization suppress and multiplies, producing associated over-
organism is part inhibited by normal flora toxins A and B diarrhea, prescribing
of normal flora normal flora) pseudo- broad-
opportunistic membraneous spectrum
pathogen! colitis antibiotics

- vancomycin
- metronidazol
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features /Diagnosis prevention

Coryne- - gray-to-black - throat bacterium or Toxigenic: diphteria toxin: Diphteria: - antitoxin

bacterium colonies of club- - nasopharynx phage via inhibits protein synthesis - local - macrolides
diphteriae shaped G(+) rods respiratory by ADP- ribosylation of inflammation in
arranged in V or L droplets elongation factor 2 (EF-2) the throat,
shapes formation of gray vaccine:
- Granule produced - Toxin- lysogenic phage pseudo- diphteria
on Loeffer’s encoded membrane toxoid
coagulated serum --> extension into vaccine
medium Diagnosis: larynx/trachea --> ( part of the
- aerobic throat swab should be obstruction DTP)
- Neisser stain cultured on Loeffler’s
medium or tellurite
medium; toxin production
must be demonstrated by
agar precipitation (ELEK-
test)
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Listeria - small G(+) rod - animals -ingestion of the pathogenesis of listeriosis: - ampicilin
mono- arranged in V or (livestock, unpasteurized milk Listeria depends on the - meningitis - gentamycin
cytogenes L-shaped like cattle) products, organism’s ability to invade - sepsis
corynebacteria - unpateurized undercooked meat and survive within cells. - Intrauterine
- exhibit an unusual milk and raw vegetables Invasion of cells is or cervical
tumbling - plants - contact with farm mediated by internalin infections in
movement that - soil animals and their and E-cadherin on the pregnant
distinguishes it feces surface of human cells. women
from -
corynebacterim 2 clinical setting: *Upon entering the cell --> - intestinal
- narrow zone of 1. in the fetus- as a listeriolysin production --> infections
beta-hemolysis result of escape from the
on blood agar transmission phagosome into the cyto.
- Listeria grows across the --> escape destruction.
well at cold temp. placenta or
during delivery *actin rockets- filaments
2. in pregnant of actin polymerize and
women/ propel the bacteria through
immunosuppresse the membrane of one
d adults, human cell to another.
especially renal
transplant patient
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Prevention
features

Actinomyces - anaerobic human; endogenous invasive growth Actinomycosis: penicillin G

israelii - G (+) normal flora of in tissue with - chronic infection
branching rod gingival compromised - commonly in the face and
- non-acid fast crevices and oxygen supply neck
female genital - generally not painful but
tract very invasive, penetrating
Diagnosis: all tissues, including bone
identify G(+) - tissue swelling -->
branching bacilli draining abscesses
in “sulfur (sinus tracts) with
granules” “sulfur granules” (hard
yellow microcolonies) in
exudate that can be used
for microscopy or culture

Nocordia - aerobic soil and dust airborne or Aerobe bacteria Nocordiosis: trimethoprim-
asteroids - G(+) traumatic found in the abscesses in brain and sulfamethoxazole
branching transplantation environment. In kidney in immunodeficient
rods immunocomprom patient, pneumonia
- partially acid- ised individuals
fast they can produce
lung infection and
may disseminate
in tissues.
Gram (-) Cocci:
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease/ Diagnosis Prevention/
features Treatment

N. - kidney-bean human respiratory tract - polysaccharide - Meningitis - penicilin-G

meningitidis shaped nasopharynx capsule - Meningococcemia - 3rd generation
diplococci - IgA protease cephalosporin
- large capsule - LPS: fever, vaccine: capsular
- grows on septic shock polysaccharide of
chocolate agar - pilli Diagnosis: strains A, C, Y,
- ferments - gram stain of the CSF W135
maltose - Latex agglutination (no vaccine
against type B)

N. - G(-), kidney human sexual contact, - pilli- mediate -Gonorrhea: - ciprofloxacin

gonorrhea bean-shaped genital tract birth attachment and STD: - ceftriaxone
diplococci are - Male: urethritis, proctitis
- oxidase + antiphagocytic - Female: purulent dischrge, newborn: silver
- LOS cervicitis acetate eye
- IgA protease - arthritis drops or
- Ophtalmia neonatorum erythromycin
- skin eruptions ointment

Diagnosis:
intracellular G(-) diplococci
in PMNs from urethral smear
from symptomatic male

Moraxella G(-) diplococcus normal respiratory endotoxin - otitis media

catarrhalis upper droplets - sinusitis
respiratory - bronchitis
tract flora
Gram (-) Bacilli:
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Prevention/
features Treatment

Pseudomonas - flagella ubiquitous water aerosols, - endotoxin - sepsis - pasteurization

aeruginosa - strict aerobe in soil and raw - pseudomonas - UTI of water-related
- oxidase (+) water vegetables, exotoxin A: ADP - pneumonia equipment
- non-lactose flowers ribosylates EF-2 - meningitis
fermenter inhibiting burn patients: drugs:
- pigments: normal flora, protein GI tract colonization - piperacillin
pyocyanin opportunistic, synthesis --> skin -->colonization of +tazobactam
(blue-green) nosocomial - liver is primary eschar --> cellulitis combination
and fluorescein pathogen target (blue-green pus) --> - tobramycin
- grape-like odor septicemia - imipenem

Burkholderia horses malleus disease of - tetracyclins

mallei zoonotic horses, transmissible to -
humans: ulcers, aminoglycosides
lymphangitis, sepsis

Burkholderia - flagella soil, water, zoonotic melioidisis: skin - tetracyclins

pseudomallei rice, infection, pneumonia -chloramphenocil
vegetables, (inhaled), bacteremia,
rodents abscess

Legionella - facultative rivers/ aerosols from - facultative - Legionnaires’ disease: Macrolides

pneumophila intracellular streams contaminated intracellular pneumonia, diarrhea (erythromycin,
- atypical air-conditioning pathogen - Pontiac fever: azithromycin)
pneumonia - MIP (macrophage pneumonitis drug must
infectivity penetrate human
potentiator) Diagnosis: urine antigen cells
/rapid microagglutination
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Francisella - zoonosis many - tick bite - facultative intracellular Tularemia streptomycin

tularensis species of - mucous pathogen
wild membrane - granulomatous response Diagnosis:
animals, - respiratory - agglutination test
especially tract - fluorescent-antibody
rabbits, - GI tract
deer

Bordetella - aerobe G(-) human respiratory - filamentous Whooping cough - supportive

pertusis coccobacillus droplets hemagglutinin (pertussis) care+
- encapsulated - pertussis toxin- erythromycin
stimulates adenylate- Tracheobronchitis
cyclase
- adenylate cyclase toxin vaccine:
- endotoxin Diagnosis: DTaP
- pilli- aid with attachment - isolation from (acellular;
to ciliated epithelium --> nasopharyngeal swab inactivated
decreased cilia activity --> and inoculate on Bordet- pertusis toxin)
death of the ciliated cells Gengou

Brucella - aerobic domestic - unpasteurized - endotoxin Brucellosis: - milk

- abortus livestock dairy products - O antigen - acute septicemias pasteurization
- suis - through the - facultative intracellular - influenza-like symptoms
- melitensis B. abortus- zoonosis skin- by direct parasite- localize in the - sweating (profuse) - tetraciclin+
A antigen contact with RES (LN, liver, spleen) - osteomyelitis rifampin
B. melitensis- animal tissue - granulomatous response B. abortus- Bang disease
M antigen (slaughterhous with central necrosis B. melitensis- Malta fever
B. suis- e) *B. melitensis infections B. suis- Undulant fever
A, M antigens tend to be more severe Diagnosis: rise in
and prolonged antibody titer
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Campyelo- - curved rods with intestinal fecal-oral - enterotoxin - Gastroenteritis/ Most infected
bacter polar flagella tracts of primarily from - low infectious dose enterocolitis persons with
jejuni (“gulls wings”) humans, poultry (as few as 500) Campylobact
- oxidase (+) cattle, - invades mucosa - in pregnancy --> abortion er will recover
- microaerophilic sheep, of the colon, - in immunocompetent --> without any
- grows well at dogs, cats, destroying sepsis, meningitis, specific
42’C on selective poultry mucosal surfaces; endocarditis treatment.
media: Skirrow (zoonotic) blood and pus in
agar (blood agar stools complications:
with antibiotics) (inflammatory -Guillain-Barre syndrome
diarrhea) (GBS): there is antigenic severe:
cross-reactivity between -erythromycin
Campyelobacter
oligosaccharides and
glycosphingolipids on
neural tissues-->
ascending paralysis
- Reactive arthritis

Helicobacter - flagella humans - fecal-oral - endotoxin Chronic gastritis and amoxicillin

pylori - microaerophilic - oral-fecal - cytotoxins (cagA) duodenal ulcers: (tetracyclin)
- grow on Skirrow - urease associated with several metronidazole
agar - catalase forms of stomach cancer: and bismuth
- oxidase (+) - invasive into gastric adenocarcinoma, salts + proton
- Urease (+) stomach lining MALT lymphoma pump
- catalase (+) where pH is neutral inhibitors
- inflammation is
prominent Diagnosis:
- urea-breath test
- biopsy with culture
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Vibrio - flagella human - fecal-oral - motility, mucinase Cholera: - fluid and

cholera - oxidase (+) colon - requires high and toxin co- - rice-water stools, electrolytes
- growth on (no animal dose regulated pili tremendous fluid loss replacement
alkaline but not carriers) (TCP) aid in - hypovolemic shock if not - severe
acidic media attachment to the treated cases:
(TCBS= intestinal mucosa tetracycline
thiosulfate- - cholera Food poisoning
citrate-bile-salt- enterotoxin vaccine:
sucrose medium) - ADP ribosylates killed; live
- A-B type toxins activating Diagnosis: attenuated
encoded by adenylate cyclase - oxidase +
phage --> increase cAMP - culture on TCBS
(lysogenic --> efflux of Na, K,
conversion) Cl- and H2O

Vibrio - halophilic (thrive marine life consumption - enterotoxin food poisoning; mild to self limited
parahemo- in salty of production (similar severe watery diarrhea,
liticus environment) undercooked to cholera toxin nausea, abdominal cramps
seafood

Vibrio - halophilic (thrive salt water, consumption - cellulitis doxyciline

vulnificus in salty oysters of - sepsis
environment) undercooked
seafood
Gram (-) Rods:

Entrobacteriacea family: Pathogenesis: Lab diagnosis:

- facultative anaerobes - endotoxin - blood agar

- ferment glucose - some also produce exotoxins antigens: - EMB or MacConkey agar
- catalase-positive O= cell envelope or O antigen (differentiate lactose fermentation)
H= flagellar - lactose fermenters --> colored
K= capsular polysaccharide colonies
V= virulence, salmonella capsular antigen - non-lactose fermenters -->
colorless colonies
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

E. coli - facultative - human - endogenous Virulence factors: - UTI mainly

anaerobes colon - fecal-oral - capsular antigens K1, - Neonatal meningitis supportive:
- ETEC - oxidase (-) - EHEC: bovine K5 --> neonatal - nosocomial wound replacement of
- EHEC - lactose fecal meningitis infection water and
- EIEC fermenter: contamination - P-fimbria, alpha- - enteritis electrolytes
- EPEC iridescent green - O157:H7 hemolysin, aerobactin
- EAEC sheen colonies strains are --> UTI, Pyelonephritis ETEC: fluoroquinolons
on EMB associated with - watery diarrhea or sulfonamides
- capsule, flagella, ingestion of ETEC: (“travelers diarrhea”) for UTI
fimbria undercooked - CFA (colonization
hamburger factor antigen) EHEC:
(fast food - toxins (LT, ST) - bloody diarrhea
restaurants) EHEC: - abdominal cramping
- shiga-like toxin - fever (similar to shigella)
- damages b.vessels *complications: HUS
and endothelial cells (toxin enters the blood)-
EIEC: most common in kids
invasion plasmid--> (kidney failure, hemolytic
invades large bowel anemia) & hemmorhagic
similar to shigellosis colitis
including the formation EIEC:
of actin “jet trails” - dysentery like diarrhea
EPEC: - purulent, bloody stool
- pili - ulcers in the large
- attaching-effacing intestine.
EAEC: EPEC:
- endotoxin prolonged watery diarrhea
- capsule (K1, K5) EAEC:
- O antigen - chronic watery diarrhea
- P fimbria - 80% of UTI
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Klebsiella - large -human endogenous - capsule: antiphagocytic in hospital patients: extended-

pneumoniae polysaccharide colon - endotoxin: causes fever, - Pneumonia
spectrum b-
capsule - upper resp. inflammation and shock - nosocomial UTI
- lactose- tract - septicemia lactamases
fermenting Diagnosis: - sinusitis (ESBLs)
colonies on - sputum culture - otitis media
MacConkey - lactose fermenter - gallbladder
agar inflammation
- oxidase - wound infections
- (-)

Shigella - non-lactose human fecal-oral - endotoxin triggers Bacillary dysantery fluid and
fermenters colon spread, person- inflammation = a form of electrolyte
- Sonnei (colorless (no animal to-person - invasion plasmid: shigellosis: replacement
- flexneri colonies on carriers) shigella invade M cells,
- boydii EMB/ get into the cytoplasm, -most severe form
- dysenteriae MacConkey) replicate and then of dysentery severe:
- non-motile polymerize actin jet - organisms invade, antibiotics
- few (1-10) trails to go laterally--> producing bloody
organism are enter neighboring cells diarrhea
enough to start - fever, abdominal
infection! * invasion is the critical cramps
factor of pathogenesis - mucous (pus)
diarrhea
- Shiga-toxin: produced
by S. dysenteriae: Diagnosis:
1. neurotoxic - EMB/Mac.
2. cytotoxic - TSI
3. enterotoxic
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Yersinia - zoonosis fleas, rats - bite of rat flea - endotoxin 1. Bubonic plague: tetracylin (&
pestis - small rods with - human-to- - exotoxin flea bites infected rat streptomycin)
bipolar staining human by - envelope antigen (F-1) and then uninfected
(“safety pin” respiratory inhibits phagocytosis humans
- facultative droplets symptoms:
intracellular - fever
parasites Diagnosis: - regional buboes
- coagulase - EMB/Mac. - conjunctivis
positive - TSI
- rise in antibody titer 2. Pneumonic
plague
highly contagious,
high lethality

Yersinia - zoonosis cattle, deer, - unpasteurized - enterotoxin Enterocolitis

enterolitica - motile at 25 pigs, and milk, pork - endotoxin
deg., non-motile birds
at 37 deg.
- cold growth!

Proteus - flagella, highly human endogenous - Urease raises urine pH nosocomial

mirabilis/ motile; colon and to cause kidney stones infections:
vulgaris “swarming environment - motility may aid entry UTI
motility” (water and into bladder sepsis
- non-lactose soil) - endotoxin --> fever and wound infections
fermenter shock when septicemia
- Urease (+) occur
- facultative
anaerobe Diagnosis:
- oxidase (-) - EMB/Mac.
- H2S producer - TSI
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Salmonella - highly motile humans fecal-oral Typhoid fever Typhoid fever - fluoro-
enterica sub - Vi antigens only; no - organism ingested quinolons
species: on capsule animal - Salmonella reach basolateral (Rose spots are
- facultative reservoirs side of M cells, then mesenteric seen on the skin) - 3rd
- typhi anaerobe LN and blood--> bacteremia generation
- paratyphi - non-lactose - liver and spleen are infected with less milder: cephalo.
fermenting additional release of bacteria to Paratyphoid
- produce H2S bloodstream --> signs of fever
septicemia (mainly fever) vaccine:
- S. typhi survives killed
intracellularly & replicates in Diagnosis: S.typhi
macrophages; no macrophage - 1-2 weeks:
killing due to decreased fusion of blood/b.m
phagosome with lysosome sample
- invasion of the gallbladder--> - 2-3 weeks:
establishment of carrier state urine/stool
and excretion of the bacteria in culture
the feces for long period

Salmonella - facultative enteric chicken Enterocolitis: Enterocolitis/ extraintestin.

enterica sub anaerobe tracts of products - endotoxin in cell wall gastroenteritis infection:
species: - non-lactose human and - invade the mucosa--> - gentamycin
fermenting domestic inflammation --> increased PG Septicemia - ampicilin
- entritidis - produce H2S animals; --> increased cAMP --> loose (S. choleraesus - sulfamet.
- choleraesuis - serotyped with e.g., diarrhea (containing mainly) - cipro.
- typhimurium O, H and Vi chickens lymphocytes) - trimetop.
antigens Osteomyelitis
(sickle cell
disease
predisposes)
 Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Haemophilus - encapsulated human respiratory - polysaccharide - purulent antibiotics:

influenza G(-) cocobacillus nasopharynx droplets capsule most meningitis - ceftriaxone (for
- 95% of invasive important virulence - epiglotitis meningitis)
disease caused factor - otitis media - amoxyciline-
by capsular type - IgA protease--> - sinusitis clavulanate
b facilitate - pneumonia - trimetophrim-
attachment to sulfamethoxazole
resp. mucosa (TMP-SMX)

Diagnosis: vaccine:
- blood or CSF on capsular
chocolate agar polysaccharide b
- antigen detection conjugated to
of capsule by latex diphteria toxoid/other
agglutination carrier protein

Haemophilus STD human sexual STD: Cephalosporins

ducreyi genitals transmission - Chancroid
- Genital ulcers

Bacteroides - anaerobic human colon, endogenous - endotoxin: - abscess - metronidzole

fragilis - prominent normal flora from bowel modified LPS - septicemia - clindamycin
capsule defects (e.g., - capsule- - peritonitis
- highest number from cytotoxic antiphagocytic
in the colon drug use,
cancer),
surgery,
trauma
Non-Gram stained bacteria:
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

M, - obligate human respiratory - exsudative lesions - Pulmunary tuberculosis multiple

tuberculosis aerobe droplets from - granulomatous - Extrapulmunary drug
- acid-fast rods human-to- lesions; giant cells infection therapy:
- high lipid human surrounded by - Ghon’s complex - isoniazid
content (60%) fibrous tissue - rifampin
in the cell wall - central caseous Diagnosis: - pyrazin.
- resistant to dry necrosis and - acid-fast staining - ethambu.
and chemicals calcification (LOWENSTEIN-JENSEN
but sensitive to - multidrug resistant medium vaccine:
UV (MDR) due to - Bac-Tec medium BCG
chromosomal mutation - PCR

M. leprae - cannot be human prolonged - replicates Lepromatous leprosy:

cultured in contact with intracellularly (skin - malignant, nodular
vitro patient with histiocytes, endothelial skin lesions,
- acid fast leprom. leprosy; cells, Scwann cells) - negative lepromin skin
- obligate nasal discharge test
intercellular from untreated
leprom. leprousy Tuberculoid leprosy:
patient - benign, macular skin
lesion
- positive lepromin skin test

M. kansasii - atypical myco. - soil -Respiratory - AIDS patient pulmonary GI

M. Avium - noncontagious - water - ingestion - cancer Disseminated
intracellulare - cigarettes - chronic lung disease

M. marinum same abrasion soft tissue infections INH, Rif

Mycoplasma, Spirochetes, Chlamydiae, Rickettsiae

Mycoplasma: smallest free living bacteria, wall-less organisms, Culture: special media, slow, „fried-egg” colonies
Bacteria Distinguishing Reservoir Transmission Pathogenesis Disease Treatment/
features Prevention

Mycoplama - smallest free human respiratory - tapered tip that contain - Pneumonia - most - macrolides
pneumoniae living organisms droplets specific proteins that frequent cause in (erythromycin,
(0.3 micrometer) serve as the point of young adults (5-10% azithromycin)
attachment to the resp. of all community-
- absence of cell epithelium acquired pneumonia)
wall!! - inhibition of cilliary - the disease resolves no cell wall
movement and necrosis spontaneously in inhibitors!!
- only bacteria of the epithelium 10-14 days
that its - autoantibodies are - extra-pulmonary
membrane produced against manifestations
contains RBC’s’ => cold include:
cholesterol agglutinins. Stevens-Johnson
- auto-antibodies are also syndrome, erythema
produced agains the multiforme
brain, lung and liver cells
Diagnosis:
serologic testing: a
cold-agglutinin titer of
1:128 or higher is
indicative of recent
infection

Ureaplasma - urease human, direct sexual - STD - 20 % of NGU

urealyticum normal conact (non-gonococcal
genital flora urethritis)
Spirochetes: thin walled, flexible, spiral rods
Bacteria Distinguishin Reservoir Trans. Pathogenesis Disease Treatment/
g features Prevention

Treponema - flexible, spiral human 1. STD - the organism infects the endothelium - Syphilis penicillin G
pallidum bacteria of small b.v, causing endarteritis. This - congenital
- no growth on occurs during all the stages of syphilis: syphilis (abortion/
bacteriologic 1. Primary syphilis: 14-21 days after Late manifes.:
media/cell 2. Placenta incubation, multiplication of the Hutchinson teeth,
culture bacteria at the site of inoculation saddle nose,
- grows very creating chancre (nontender ulcer) keratitis)
slowly that usually heals spontaneously but
(antibiotics the bacteria spread to the blood Diagnosis:
must be stream. - darkfield
present at an 2. Secondary syphilis: 3-8 wks after microscopy-
effective level appearance of chancre, (the spirochetes
for several maculopapular rash on the palms from the chancre or
weeks to kill and soles. Condylomata lata- moist condylomata-lata)
the organism) lesions on the genitals, rich in - serologic tests
spirochetes, may also seen at this (reagin- Ab against
stage (highly infectious!) syphilis)
associated symptoms: low-grade fever, - Complement
malaise, anorexia fixation test
*early stages (primary and (Wassermann test
secondary) may “cure” themselves for syphilis)
without treatment. - biopsy (obtained
3. Latent stage- no lesions appear but from gummas)
serologic tests are positive (divided - Wasserman test
into early and late stages) for syphilis-
4. Tertiary syphilis: may show Cardiolipin from
granulomma (gummas) especially of a cow heart is
skin and bones, CNS- tabes dorsalis used as an
cardiovascular involve. - aneurysm antigen
 Bacteria Distinguishing Reservoi Trans. Pathogenesis Disease Treatment/
features r Prevention

Borrelia the most white- tick bite bite site--> bacteremia --> to various Lyme disease tetracycline
burgdofreri common footed (Ixodes organs: heart, joints and CNS or
vector-borne mouse, scapilaris) - virulence factors: Outer surface amoxicillin
disease in the deers protein A (OspA), OspB ,OspC Diagnosis: for acute;
U.S. - Lipoprotein variable major protein- - Erythema penicillin G
like sequence --> immune evasion migrans for chronic
- zoonosis clinical findings: 3 stages (clinically)
1. erythema chronicum migrans- - serological
expanding erythematous, macular tests mainly
rash (“bull’s eye” appearance) seen (culturing are
b.w 3-30 days after the tick bite. less effective)
2. cardiac and neurologic
involvement - seen weeks to * Both stages 2
months later and 3: arthritis
3. arthritis of large joints

Borrelia - Tick-born human human body- - arthropod bite --> spirochete into the Relapsing fever tetracycline
recurrentis & relapsing recurrentis louse blood --> multiplication
Borrelia fever (B. - during infection, the antigens of Diagnosis:
hermsii hermsii ) rodents these organisms undergo variation seeing the large
zoonosis hermsii (antigenic switching) --> relapses of spirochetes in
- Louse-born Tick illness (as Ab develop against one stained smears
relapsing antigen, variants emerge) of peripheral
fever (B. recu.) blood

Leptospira - zoonosis dogs animals excrete leptospiras are ingested/pass through Leptospirosis penicillin G
interrogans - obligate domestic leptospiras in mucous membrane/skin --> (biphasic illness:
aerobe livestock the urine which bacteremia -->multiplication in various acute vs.
- oxidase+ contaminates organs --> fever and liver dysfunction immune phase)
- catalase+ water and soil (jaundice), kidneys (uremia) and CNS Diagnosis:
(aseptic meningitis) microscopy
Chlamydiae: obligate intracellular bacteria (cell-cycle: use elementary body to invade and formation of reticulate body to multiply)
Bacteria Distinguishing Reservoir Trans. Pathogenesis Disease Treatment/
features Prevention

Chlamydia - most common human - sexual exist in more than 15 immunotypes (A-L): - urethritis doxycycline
trachomatis cause of STD contact- - A, B, C types => trachoma (chronic - pneumonia , erythro-
in the U.S STD conjunctivitis, endemic to Asia & Africa) - conjunctivitis mycin
- obligate - D-K types => STD -genital tract - lympho-
intracellular - perinatal infections (can occasionally transmitted to granuloma
- rigid cell wall, the eyes- inclusion conjunctivitis, and venerum
not typical respiratory tract). In men- its a common - trachoma
peptydoglycan cause of NGU (nongonococcal urethritis) (the bacteria is
characterized by urethral discharge and transmitted by
may progress to other genital finger-to-eye)
inflammations (prostatitis).
women- may develop cervicitis, Diagnosis:
endometritis, PID and salpingitis. inclusions in
- L1-L3 types => lymphogranuloma epithelial cells
venerum (STD) seen with
* patient with genital tract infections Giemsa stain /
have high incidence of Reiter’s syndrome immnofluor.
(autoimmune disease)

Chlamydia - obligate human aerosol upper and lower respiratory tract infections Atypical doxycycline
pneumoniae intracellular pneumonia;
- most common
atypical Diagnosis:
pneumoniae serologic test

Chlamydia - obligate birds inhaling epithelial cells of the lungs --> lung infection psittacosis doxycycline
psittaci intracellular organism (Atypical
- zoonosis s in dry pneumonia)
bird feces
Rickettsiae: obligate intracellular parasites. very short rods that barely visible in light microscope. stained poorly with gram stain
Diagnosis: in the past- Weil-Felix test (based on cross-reaction with proteus vulgaris O antigen), stain: Giemsa or Gimenez

Bacteria Distinguishing Reservoir Trans. Pathogenesis Disease Treatment/

features Prevention

Rickettsia - zoonosis dogs, ticks typical lesion- Rocky mountain spotted fever tetracycline
ricketsii - obligate rodents (exhibit vasculitis, (RMSF): and
intracellular trans- particularly in the - starts with acute onset non-specific chloram-
parasites ovarial endothelial lining of symptoms ( fever, headache. rash is phenicol
passage the vessel wall rarely seen (3%) )
from an where the - sudden onset of fever (>38-39°C) doxycycline
infected organism is found is the drug of
female tick - significant malaise, and severe choice
to her headache (patients often
progeny) describe the headache as the worst
endothelial cell
infection --> they have ever had)
phagocytosis of - typical rash starts 2-6 days later: starts on
the infected cell --> the wrists + ankles with subsequent
escape from centrifugal progression to the palms and
phagosome --> soles. Then the rash spreads
filopodium focal centripetally to the arms leg, and trunk
lysis of the cell
- Diagnosis:
Difficult: based on physical examination of
the patient and epidemiological data.

- clinical manifestations:
- the eruption becomes maculopapular with
central petechiae
- skin necrosis and gangrene (amputation)
- cough and pneumonia
- hepatomegaly (12–25%)
Bacteria Distinguishing Reservoir Trans. Pathogenesis Disease Treatment/
features Prevention

Coxiella - zoonosis cattle, aerosol main organ involved- lungs Q fever doxycycline
burnetii - the only sheep, - sporelike stage - acute disease, recovery
ricketssial goats is spontaneous Prevention:
infection Antigenic variation: - starts with influenza-like killed vaccine
which is not C burnetii exhibits an antigenic symptoms
transmitted variation that exist in 2 phases: - hepatitis may combine
by an 1. phase 1- organism is isolated with the pneumonia
arthopod from the patient, virulent - Q fever–associated
- has a (synthesize surface antigens). chronic fatigue
sporelike High levels of phase 1 syndrome may exist as
stage- highly antibodies are detected well. -
resistant, during chronic Q fever 10%–30% of all patients
infectious 2. phase 2- produced by with acute disease
- obligate repeated passage in culture, report persistent
intracellular not virulent, is the first to be symptoms (e.g.,
parasites detectable during acute Q fatigue, myalgia, night
fever. sweats) more than a
year after acute
- C. burnetii targets monocytes/ infection occurred
macrophages, multiplies in the
host monocyte or macrophage Diagnosis:
- The survival and multiplication indirect fluorescence is
of C burnetii in an acidic vacuole the gold standard:
prevents antibiotics from killing - acute disease: phase II
the bacteria antibodies are high
-chronic disease: phase I
antibodies are high

Rickettsia - zoonosis rodents fleas endemic Typhus tetracycline and

typhi - obligate (murine typhus) chloram-phenicol
intracellular
Bacteria Distinguishing Reservoir Trans. Pathogenesis Disease Treatment/
features Prevention

Rickettsia - human human human bite --> spreading through blood - Epidemic Typhus - Early antibiotic -
prowazekii infection is an body and lymph --> entire body. before
obligatory louse Attachment occurs through the confirmation of
stage in the adhesin protein. the diagnosis.
cycle (1st - Brill-Zinsser disease-
infected - Cellular injury leads to a recurrent form - tetracycline,
person-> generalised vasculitis with (the bacteria survive doxycycline
tick-> 2nd) increased vascular within adipose tissue)
-Delousing
permeability, oedema,
methods: by
- obligate hypovolemia, virtually all
Diagnosis: bathing the
intracellular organs can be involved
plate microagglutination patient, and
parasites
- Activation of humoral and indirect changing and
inflammatory and coagulation immunofluorescence test boiling infested
mechanisms (DIC) clothes.

- Eradication of
- progressive endothelial louse with an
damage leads to vascular insecticide (10%
dysfunction, microscopic and DDT, 1%
macroscopic foci of malathion, or 1%
hemorrhages, thrombi in small permethrin) is
vessels also an effective
method
-brain lesions with seizures and
coma, damage to the pulmonary
microcirculation with non-
cardiogenic pulmonary edema,
and rashes on the skin