Download Gram Negative Rods

Gram Negative
Bacterial Diseases
Proteobacteria

Alpha: Parasitic bacteria




Beta: GNC
Gamma



Largest group
Enterics
Delta



Tick borne diseases
Flea vector
Sulfur reducing bacteria in
soil/water
Predatory (attack other
bacteria)
Epsilon : GI
Gram Negative Cell Wall
Neisseria

Characteristics





GNC, diplococci
Capnophile
Nonmotile
Oxidase (+)
Pathogenicity




Fimbria
Capsule
Protease (inhibit IgA)
LOS (oligosaccharide)

Lipid A endotoxin
Neisseria meningitidis

Epidemiology


Pathogenicity







Various strains
Capsule
LOS: lipid A
Disease


Normal microbiotica (resp)
meningitis
Septicemia/death
Dx: CNS, Ab
Tx: AB
Prevention


Vaccination
Prophylactic AB to exposed
Neisseria gonorrhoeae



Gonococci

Eye

Pharynx

Uritogenital

Rectum
Pathogenicity

Adhesins

Pili

Protein II

Replicate in WBCs
Disease

STD “Clap”

PID  scar tissue

Neonatal conjunctivitis

Inflammation

Urinary

Repro

Oral Cavity
Neisseria gonorrhoeae

Dx



Culture/Isolation
Symptoms
Tx:

AB
Cepha
quinolones

Iodine/Silver Nitrate (eye)
Prevention:

Screen/Detection

Tx infected individuals

Condom use

Public education


Enterobacteriaceae


Characteristics

GNR

Motile = flagella

Capsule/slime layer

Nitrate reduction

FA

Oxidase (-)
Epidemiology

Source

GI

Water

Soil

Decaying vegetation
Gamma Proteobacteria
Enterobacteriaceae

Groups
 Gammaproteobacteria:
Enterics
 Coliforms
 Noncoliforms
 Pathogens
 FA
 Oxidase (-)
 Reduce nitrate
 (cocco)bacilli
Enterobacteriaceae

Pathogenicity

LPS




Antigens



Core polysaccharide
O polysaccharide
Lipid A endotoxin
Capsular (K)
Flagellar (H)
Virulence factors

Immune evasion







Capsule
Fimbriae
Type III secretion system
Adhesins
Exotoxins
Hemolysins
Iron-binding compounds
Enterobacteriaceae

Dx

Culture/Isolation




Location
Tx



MAC
EMB
Supportive
AB
Prevention


Hand washing
Sewage control
Coliforms


Normal GI microbiotica
Groups







Escherichia
Klebsiella
Serratia
Enterobacter
Hafnia
Citrobacter
Biochemical tests

Ferment lactose
Enteric Bacteria

Pathogenicity


Glycocalyx
LPS












Core polysaccharide
O antigen
Lipid A endotoxin
K (capsular) antigens
H (flagellar) antigens
Fimbria
Adhesins
Exotoxins
Hemolysins
Bacteriocins
Iron binding proteins
Sex Pili  AB resistance
Enteric Bacteria

Diagnosis



Treatment



Culture
Biochemical tests
AB
Toxin neutralization
Prevention


Hygiene
Clean water supply
Esherichia coli



Coliform

E. coli O157:H7
Pathogenicity

O, H, K antigens

Plasmids for virulence

Shiga-like Toxin

Type III secretion system

Disrupt PM

Receptors for attachment
Diseases

Gastroenteritis

Food-fecal contamination

UTI

Uremic syndrome

Pyelonephritis

Septicemia

Neonatal meningitis
Klebsiella

Epidemiology


Nosocomial
Reservior




Pathogenicity


Polysaccharide capsules
Diseases




UTI
Bacteremia
Meningitis
Pneumonia





Soil, water
GI
Respiratory tract
Cherry red sputum
Lung abscess
Empyema
Dx: Culture
Tx: AB
Serratia

Characteristics




Red pigment
coliform
Agent: S. marcescens
Epidemiology

Nosocomial





GI
Soil, water
Pathogenicity



Opportunistic
Fomites (catheters, saline solutions)
AB resistance
Endotoxin
Diseases


UTI
URTI
Enterobacter





Agents

E. aerogenes

E. cloacae
Location

Coliform

Water, sewage

Soil
Epidemiology

Opportunistic

Blood

Wounds/incisions

Nosocomial
Pathogenicity

Endotoxin

AB resistance
Disease

Dairy contaminant

UTI

Pneumonia
Hafnia (formerly Enterobacter sp)







Characteristics

GNR, FA

motile
Agent: H. alvei (2 biogroups)
Epidemiology

GI micorbiotica (HARF)

Opportunistic, nosocomial
Pathogenesis

Attach and efface enterocyte mucosa
(LEE)
Disease

Diarrhea

Gastroenteritis

Peritinitis

Septecemia

Liver Abscesses

UTI

Endocarditis

Meningitis

Pneumonia
Dx: Culture fluids
Tx: AB
Citrobacter







Characteristics

GNR, FA

Ferment lactose
Agent: C. freundii
Epidemiology

GI microbiotica (HARF)

Soil, water

Decaying vegetation
Pathogenesis

Opportunistic

Lipid A endotoxin
Disease

UTI

Cholecystitis

Meningitis

OM
Dx: Culture fluids
Tx: AB
Noncoliform





Opportunistic
Nosocomial
Diseases

UTI

Kidney stones
Groups

Proteus

Morganella

Providencia

Edwardsiella
Biochemical

Non lactose fomenters
Proteus

Characteristics




Agent








Urease
Motility
Endotoxin
Disease


Colon, soil & water
Opportunistic
Pathogenicity


P. mirabilis
P. vulgaris
Epidemiology


GNR, FA
Flagella (polar), swarms
Urease (+)
UTI (catheter)
Kidney stones
Dx: Culture
Tx: AB, resistance is developing
Morganella (formerly Proteus sp.)

Characteristics



Agents








GI microbiotica (HAR)
Nosocomial
Pathogenesis: Lipid A endotoxin
Disease


M. morganii
Epidemiology


GNR, FA, motile
Only glucose fermentation
UTI
GI diarrhea
CNS infection
Ear and Sinus infections
Dx: Culture
Tx: AB
Providencia



Characteristics

GNR

Motile

FA
Agents:

P. stuartii

P. rettgeri

P. alcalifaciens
Epidemiology

Normal GI microbiotica


Nosocomial

Catheter

Endotracheal tubes
Pathogenesis: plasmid codes for urease
Disease

GU: UTI, prostatitis, kidney stones

Pneumonia

Bacteremia
Dx: Culture fluids, feces
Tx: AB, but developing resistance





animals
humans
Edwardsiella

Characteristics



Agents








Opportunistic
GI tract (HARF)
Pathogenesis
Disease


E. hoshinae
E. tarda
Epidemiology


GNR, FA
+/- motility
Gastroenteritis
UTI
Wound infections
Dx: Culture fluids
Tx: AB
Pathogenic Enteric Bacteria

Characteristics


NLF
Virulence



Type III secretion
Toxins
Groups



Salmonella
Shigella
Yersinia
Salmonella



Characteristic

GNR

Motile (peritrichous)

Gas production

H2S production

Urease (-)

Oxidase (-)
Location

GI (S. enterica)

2,000 serovars
Examples

S. typhi

S. paratyphi

S. typhimurium
Salmonella pathogenicity



Epidemiology

Fecal contamination

Poultry products

Milk
Pathogenicity

Many serotypes

Proteins  endocytosis

Invade intestinal mucosa

Toxins

Enterotoxin

Cytotoxin
Diseases

Salmonellosis

N/V/D

Bacteremia

Typhoid fever

Gastroenteritis

Bacteremia

Peritonitis
Salmonella

Dx




Tx
Supportive

AB

Cholecystectomy
Prevention

Hygiene

Proper food handling

Cooking

Refrigeration

Vaccination


Culture
Isolation
Symptoms
Salmonella typhi






Epidemiology

Source

Carrier’s feces

Transmission

Contaminated food/H2O
Pathogenesis

Invade GI spread to LN, Liver, GB

Shed bacteria in feces: 3mos

Abdominal pain, anorexia
Disease

Typhoid fever
Dx: Culture blood, feces; Serology
Tx: AB
Prevention:

Food handling

Isolation of infected individuals

Vaccine for high risk individuals
Shigella

Characteristics





GNR
Nonmotile
FA
(-): urease, oxidase
Examples




S. dysenteriae
S. flexneri
S. boydii
S. sonnei
Shigella

Location

GI pathogen

Epidemiology

Source: food/water
contamination with feces

Transmission

Fecal-oral

4 F’s




food
fingers
feces
flies
Shigella





Pathogenesis

Multiply in colon mucosa

Disrupt phagosome membrane and
invade

Toxins

Exotoxin: Shiga Toxin

Endotoxin
Disease

Diarrhea:

water, blood, mucus

Shigellosis dysentery

Ulcerate colon
Dx: Isolates, biochemical tests, serology
Tx: fluid support, AB
Prevention

Hygiene

Sewage treatment
Yersinia

Characteristics


Location



GNR
GI of animals
Endemic (in West Texas)
Epidemiology

Food/H20 contamination with
feces




Direct contact
Indirect: inhalation
Vector: flea bite
Agents



Y. enterocolitica
Y. pseudotuberculosis
Y. pestis
Yersinia

Pathogenicity



Pathogen
YOPS
 outer membrane
proteins
 Prevent phagocytosis
Plasmid virulence factors


Adhesins
Type III secretion systems

Trigger apoptosis
 PMN
 MO
Yersinia

Diseases

Gastroenteritis (Y. enterocolitica)

SI

Mesenteric LN

Plague (Y. pestis)

Bubonic (LN)

Pneumonic (Lungs)

Dx: Blood ID, culture, PCR
Tx: AB
Prevention: control

Rodent

Flea

Vaccination

Isolation of infected persons


Plague life cycle

Reservoir





Rats
Mice
Voles
Vector: Flea
Hosts

Amplify





Prairie dogs
Rabbits
Deer
Dogs/Cats
Cycle


Flea bite
Exposure to infected animals
Bubonic Plague






Lymphadenopathy
Bacteremia
DIC
S.C. Hemorrhage
Gangrene
“Black” Death
Pneumonic Plague

Lungs



Bloody sputum
Dyspnea
Respiratory droplet
Alpha, Beta, & other Gamma proteobacteria



Aerobic
GNR
Groups



Alpha

Bartonella

Brucella
Beta

Bordetella

Burkholderia
Gamma

Pseudomonads

Pseudomonas

Moraxella

Acinetobacter

Francisella

Legionella

Coxiella
Alpha Proteobacteria
Bartonella

Characteristics




Aerobic
Location: animals
Vectors: insects
Examples



B. bacilliformis
B. quintana
B. henselae
Bartonella Diseases

Bartonellosis



Trench fever



Lice
Bone pain
Bacillary



Sand flies
RBCs invaded
Angiomatosis
Peliosis hepatitis
Cat-Scratch fever



fleas
Cat nails, teeth
LN and abscesses
Brucella

Characteristics


Location



Intracellular parasite
Animal hosts
Pathogenicity


coccobacillus
Prevent phagolysosome
Examples




B. melitensis
B. abortus
B. suis
B. canis
Brucella

Epidemiology




Disease



Unpasteurized dairy
Animal blood / urine
Reproductive organs
Undulant fever (Bangs)
Tx: AB
Prevention

Animal vaccination
Beta Proteobacteria
Bordetella

Characteristics




Aerobic
GN coccobacillus
Location
Examples



B. pertussis
B. parapertussis
B. bronchiseptica
Bordetella

Epidemiology



Inhaled aerosols
Inhibit ciliary action
Pathogenicity


Adhesins
Toxins






Pertussis
Adenylate cyclase
Dermonecrotic
Tracheal
Disease: whooping cough
Prevention


Hygiene
Vaccination (DPT)
Burkholderia




Characteristics

Aerobic

Flagella
Location

environmental

Opportunistic:

Lungs

Joints

Skin
Diseases

Meliodosis

Glanders
Example

Burk. cepacia

Burk. mallei

Burk. pseuodomallei
Gamma Proteobacteria
Pseudomonads

Characteristics



Location




GNR
aerobic
Environment: soil
Moist areas
opportunistic
Examples



Pseudomonas
Moraxella
Actinobacter
Pseudomonas aeruginosa

Pathogenicity



Fimbria= biofilms
Adhesins
Enzymes






Neuraminidase
elastase
Capsule
ROS
Drug Antiports
Toxins


Endotoxin: Lipid A
Exotoxin


Exotoxin A
Exoenzyme S
Pseudomonas aeruginosa

Diseases








Bacteremia
Endocarditis
UTI
CNS
GI
M/SK
Burn
Resp
Moraxella catarrhalis
(formerly Branhamella sp)

Characteristics



Aerobic
Short bacilli
Disease




Opportunistic
URTI
Ears
Sinusitis
Acinetobacter

Characteristics



Location




Aerobic
Short bacillus
Soil
Water
Sewage
Diseases





Opportunistic
URTI
UTI
CNS
Endocarditis
Francisella





Characteristics: GNR
Agent: F. tularensis
Epidemiology

Animal reservoirs (rabbits)

Transmission

Vector bite (tick, fly, mosq)

Direct contact with infected
tissue

Inhalation
Pathogenesis

Ulcer

Enlarged LN
Disease




Tuleremia
Dx: Culture, PCR, FlorescentAb/Agglut
Tx: AB
Prevention

Vector control

Vaccination
Francisella tularensis





Characteristics

Aerobic

Coccobacillus
Location

Water

Intracellular parasite
Epidemiology

Zoonotic

Bite mosquito, fly

Tick feces

Infected animal

Rabbit

muskrat

Tularemia
Pathogenicity

Capsule

Beta lactamase
Disease

LN buboes

Resp: cough, pain

Death
Legionella

Source: environment



Epidemiology






Cytotoxic protease
Diseases


Airborne
Chronic illness susceptible
Path


Soil
Water (A/C, showers)
Severe bronchopneumonia
Pontiac fever
Dx : Isolation, urine Ag
Tx: AB
Prevention


clean environment
Water chlorination
Legionella pneumophila

Characteristic




Location: water
Epidemiology



Intracellular parasite
Inhalation of aerosols
Pathogenicity



Aerobic
Pleomorphic
Protozoa carry
Exit pores
Disease


Pneumonia
2nd: GI, Urinary
Coxiella burnetii

Characteristic


Location



aerobe
Intracellular parasite
phagolysosome
Epidemiology

Hosts




Vector: Tick
Pathogenicity


Avian
Mammals
Spore like infective body
Human Disease


Inhale infective body
Q fever


Acute
Chronic
Pasteurellaceae

Gammaproteobacteria





GNR
Oxidase (+)
FA
Nonmotile
Groups


Pasteurella
Haemophilus
Bovine pneumonia
Pasteurella






Characteristics

GNR
Agent: P. multocida
Location

Normal microbiotica in animals

Oral

Resp
Exposure

Animal bite

Aerosol
Pathogenesis

Zoonotic
Disease

Humans

Abscess

Arthritis

Animals


Pneumonia
Sepsis
Haemophilus

Characteristics



Location


GNR
Pleomorphic
MM parasite
Examples





H. influenza
H. ducreyi
H. aphrophilus
H. parainfluenza
H. aegyptius
Haemophilus influenzae

Pathogenicity




Disease









Capsule
K antigen
Various strains
Meningitis
Infantile arthritis
Cellulitis
Epiglottitis
Ocular and Aural (OM)
Sinusitis
URTI (bronchitis. Pneumonia)
Tx: AB
Prevention

vaccination
Haemophilus parainfluenza


Characteristics
Epidemiology



Pathogenesis
Disease



Component of dental
plaque
POD
Valvular endocarditis
Dx
Haemophilus aegyptius

Purpuric Fever



South America
Children
Disease




Conjunctivitis 
N/V/D 
Shock 
Death
Haemophilus ducreyi


STD
Pathogenicity


toxin
Disease

Genital ulcer (chancroid)
Vibrios



Vibrio
Campylobacter
Helicobacter
Vibrio








Characteristics

GNR
Agent: V. cholera
Epidemiology

carriers

Fecal contamination

Water

Food
Pathogenesis

Serotypes: O1 and O139

Adhere to intestinal mucosa

Toxin: Choleragen (from bacteriophage)

Subunit A

Activates adenylate cyclase

Hypersecretion of Cl- and H20

Subunit B

Binds to intestinal receptors
Disease

Muscle cramps

Profuse diarrhea

Circulatory shock and collapse
Dx: culture of feces, Agglutination Rxn
Tx: supportive; AB
Prevention: water sanitation
Proteobacteria

Epsilon


Campylobacter
Helicobacter
Campylobacter



Characteristics

GNR, curved

Capnophile
Agent: C. jejuni
Epidemiology

Source

GI animals

Birds

Cattle

Water

Transmission

Contaminated water

Undercooked food

Contact with infected
animals
Campylobacter





Pathogenesis

Invades SI

Exotoxin (similar to cholera
toxin)
Disease

Gastroenteritis and ulceration

Bloody watery diarrhea

Endocarditis

Septic arthritis

Meningitis
Dx: Culture and Isolation
Tx: Supportive, AB: erythromycin
Prevention:

Hygiene

Proper food handling

Pasteurization

Cooking of meat
Helicobacter (Campylobacter)







Characteristics

GNR
Agent: H. pylori
Epidemiology

Gastric mucosa (mucus)

Food-water: person-person
Pathogenesis

Adhesins: Fimbria

Enzymes

Urease

Proteases

Phospholipidase

Cytokines

Toxins: cytoxins
Diseases

Gastritis

Peptic ulcers

Gastric cancer
Dx: Gastric biopsy  culture
Tx:

Peptobismol

Metronidizole

Beta lactam AB

Prevacid
Anaerobic GNR


Bacteroides
Prevotella
Bacteroides fragilis

Characteristics




Location


85% of GI disease
Pathogenicity




Normal GI microbiotica
Epidemiology


GNR
Pleomorphic
anaerobic
Fimbria
Capsule
Inhibit lysosomes
Disease



Peritonitis (ruptured GI)
Pelvic Abscesses
Wound necrosis
Provotella

Characteristic



Location: normal flora




Urogenital
Respiratory
Epidemiology: opportunistic
Pathogenicity




GNR
anaerobic
Adhesins
Antiphagocytic capsules
Proteases
Disease




Sinusitis
OM
POD
PID
Questions?