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Gram Positive Cocci Bacteria Staphylococcus aureus Diagnosis Diseases Caused morphology /physiology - catalase pos - coag pos - beta hemolytic - yellow pigment - endocarditis - scalded skin syn - septic embolism - TSS - food poisoning - pneumonia - Bacteremia -UTI -Wound infections - grape like clusters - facultative anaerobe epidermidis - catalase pos - coag neg -grape like clusters - facultative anaerobe saprophyticus - catalase pos - coag neg - β hemolytic - PRY pos - catalase neg - Medical device related infections - IV line sepsis - UTI -UTI in sexually active women Streptococcus pyogenes agalactiae pneumoniae mutans Enterococcus faecalis & faecium - β hemolytic - catalase neg - CAMP pos (staph a inc hemolysis) - bile sensitive - - catalase neg - PYR pos - bile e. pos (black plate) Acute: -Phyryngitis (strep throat) - Scarlet fever - Skin infections - necrotising faciitis - Strep TSS Antibody Mediated - Rhematic Fever (classI) - glomerulonephritis (M12) - neonatal septicemia, meningitis & pneumonia (during birth) -grape like clusters - facultative anaerobe - long chains - not quite round - cocci in chain - facultative anaerobe - Pneumonia (opportunistic) - Meningitis - URI - Otitis Media - Bacteremia - TSS - Dental caries - Endocarditis - lancet-shaped (diplococci) - UTI - Baceteremia - Endocarditis - Local trauma infections - nosocomial (hs) - facultative anaerobe - facultative anaerobe Virulence Protective Proteins -Protein A -coagulase -hemolysins -leukocidins -penicillinase Tissue Destroying -hyaluronidase -staphlyokinase -lipase - Exfoliative toxins - enterotoxins - TSST-1 -polysacch capsule - highly antibiotic resistant Epidemiology Treatment - normal flora Penicillinase – resistent PNCs Vacomycin Clindamycin - normal flora - Vancomycin - hand washing -normal flora -PCN - phage encoded - Capsule - Lipoteichoid acid (adherence) - M-protein (70 types) & F - Pyrogenic exotoxins - Streptolysin S and O - Streptokinase - DNAase - anti-C5a peptidase - Capsule - Lancefield Group A -Bacitracin - Group B - normal flora of URT & female genital - Bacitracin resistent - PCN G - Capsule (quellung rxn, specific antibodies for this cap) - IgA protease - Teichoic Acid - Pneumolysin O - Hydrogen Peroxide - Thick polysacch capsule - adherence and acid production during fermentatio - some have no antibiotic susceptibilities - Pili - surface polysacch - VRE - Viridans Group - highly communicable - droplets - risk factors: COPD and alcoholism - PCN - Vancomycin - vaccine - Viridans Group - normal flora Gu & GI - optochin resistant - Group D - normal flora colon & GU - can survive for weeks on dry surface - PCN - ampicillin ~ Lancefield group antigens - categorized by Group-Specific Carbohydrates ( C carb in cell envelope, A-S) Bacteria Bacillus cereus anthracis Clostridium botulinum Diagnosis - gram pos - β hemolytic - gram pos - nonhemolytic - gram pos Diseases Caused morphology /physiology - gastroenteritis Emetic- if you ate, growing in food, vomit Diarrheal- diarrhea -Anthrax cutaneous –edema & necrotic lesion GI/orophary – internal sores Inhalation – cp, high fever & mortality -Biowarfare Botulism - foodborne - infant, spores grow Virulence Epidemiology Treatment - rods - spore forming - aerobic - NO capsule - motle - Enterotoxin - heat stable – emetic - heat labile – dirrheal - endospores - β lactam resistant - large “box-car” rods - spore forming - facultative anaerobe - 2 plasmids one encodes toxin, other colonization - capsule of poly-D-glutamic acid - Exotoxin: protective antigen, edema & lethal factor -protective antigen B - lethal factor, kills cells - edema factor - zoonotic (sheep, goats, cattle) - endospores - PCN - vaccine - rods - anerobe - motile (flagella) - disease associated c Type A, B, E, F - A/B neurotoxin (inhibits - toxin released upon death of bacteria - antitoxin - hyperbaric Gram Positive Endosporous Bacilli difficile Bacteria Corynebacterium perfringens diphtheriae - gram pos Diagnosis - gram pos gramacid posfast test -- neg - reduces tellurite (black) - Elek test (test toxin) tetani mycobacterium tuberculosis -- gram gram pos pos - catalase pos - pos acid fast test - wound - A mediated secretion - B breakdown of Caused colonic Diseases epithelium - rod - anaerobe morphology - Diptheria - Gangrene - Necrotising fasciitis - Food poisoning - club shaped lg rectangular rods -- aerobe -- non motile nonsporing - anaerobes -- Tetanus: general, cephalic, TB local, neonatal -- banjo / drumstick thin rods -shaped aerobe -- spores cord (in virulant) - anaerobe /physiology acetylcholine) - Enterotoxin (A) - Cytotoxin (B) Virulence - Adhesion Factor (binds to colon) -- Sporulation psuedomembrane formation in - binds to motor neurons, blocks pharnyx acetylcholine - A/B-like exotoxin of toxins --huge A inh#prot syn by ADP-ribosylation -ofToxin EF-2 A most common in US - toxin on phage -- inhibition of efferent BCG is vaccine strainneuron, in fibrous continuous musclein -resulting TB makes tubercules constriction lungs - Tetanospasmin – inhibits GABA & gly - Tetanolysin Gram Positive Non-sporing Bacilli - overgrowth during antibiotic use Epidemiology - 5%of people normal flora -- spores can live in soil aerosolized replicates rapidly -- noninvasive -- normal flora GI V or L form - soil - stop other antibiotics Treatment -- soil slow growth endospores through -- opportunistic wound - only found in humans -Isoniazid give Botulism -toxin TB shows inc -resistance DPT vaccine - antitoxin wound cleaning -- DPT vaccine - antibiotics - hyperbaric Bacteria leprae Neisseria gonorrhoeae other than tb (MOTTs) - Lowenstein-Jensen agar - PPD test Diagnosis - gram pos -- catalse pos gram neg - oxidase pos - grow on Choc agar, but not reg - gram pos Nocardia asteroides - gram pos - part acid fast Lysteria monocytogenes - gram pos - waxy lipids cell wall Diseases Caused - Leprosy = Hansen’s disease tuberculoid - Gonorrhea (TT) – tram in sex & -granuloma formation birth -* loss of sensation human only few lesions -- sterility lepromatous (LL) - Fitz-Huge-Curtis - nerve damage (perihepatitis) -- loss of sensation Proctitis - numerous lesions -hair loss - M. avium - M. kansasii - brochopulmonary infection - wound, cu, subcu - diarrhea in healthy - sepsis & meningitis in neonates and imm comp morphology /physiology - diplococci, bean shaped - mostly aerobic - non motile - produces niacin Virulence - facultative intracellular Epidemiology - skin -- armadillo pads no maltosefoot fermentation - obligate intracellular organism - intracell growth - pili - por proteins (prevent phage fusion - opa proteins (adherence - Rmp proteins -lipopolysacch - IgA1 protease - travels c Chlamydia - like CO2 Treatment - PCNresistant - silver nitrate - opportunistic - filamentous - branching rods - aerobe - flagella - actin after infect - can grow at 4ºC - escapes phagosome and enters cytoplasm Gram Negative Cocci - frequently misdiagnosed as TB - aerosolized - facultative intracell growth - food born - can cross placental -PCN Bacteria meningitididis Diagnosis largest group of gram neg rods - gram neg - oxidase pos - gram neg - grow on Choc - oxidase neg agar Moraxella catarrhalis - gram neg - oxidase pos - pharyngitis - arthritis Diseases Caused - conjunctivitis Meningococcus - Waterhouse-Friderichsen syn (adrenal hemorr) - Pneumonia - Arthritis - Urethritis - otitis media - bronchitis - sinusitis morphology - mostly aerobic /physiology non motile -- rods - peritrichous flagella -diplococci - short rods - resitance: PCN binding mutation, cell surface prot,β lactamase (protein Virulence on plasmid, cleaves PCN) - maltose fermentation - large capsule A,B, C -endotoxin pili -- Capsule endotoxin outer mem -- antimicrobial resis. - vaccine against A,C,Y, W135, (B = -serum resistence cases) Growth F -50% sequester -phase variation (change antigen presented) Enterobacteriaceae - Gram Negative Bacilli Epidemiology - intracellular survival - -ferment like CO2 glucose (& some others) - bind Fe - normal flora UR Treatment - PCN - vaccine high risk - PCN resistant Escherichia Coli Bacteria Vibrio Cholera - black on EMG agar Diagnosis - pink MacConkey - fast lactose fermenter Salmonella typhi - UTI - Septicemia Diseases Caused - Neonatal Meningitis - Gastroenteritis Cholera watery diarrhea (no - medical– cath pus) - rod morphology /physiology - curved rod - single polar flagella -Typhoid Fever -gastroenteritis -septicemia -osteomyelitis in sickle cell pt - gastroenteritis paratyphi typhimurium enteritidis Shigella Plague - buobonic -pneumonic enterocolitica - gastroenteritis pseudotuberculosis Klebsiella pneumoniae -indole neg Proteus mirabilis - indole neg -gastro enteritis -pneumonia -UTI (hs) -wound infection (hs) -septicemia (hs) - septicemia -UTI, can precipitate kidney stones - human colon - contaminated crops Epidemiology - fecal-oral - A/B toxin - causes extreme water loss (1L/hr) -carried on phage - contaminated water sources -humans sole known reservoir (gall bladder) -fecal-oral route -poultry, egg, dairy - antibiotics Treatment - treat typhoid Mary - usually don’t treat dysenteriae (severe) -bloody diarrhea flexneri (3rd world boydii sonnei (US) Yersinia pestis Strains: ETEC, EPEC, EIEC, EHEC, EAEC, DAEC Virulence Adhesions -P-phili binds to uroepithelium --Colonization Toxin coregulated Factorpili Ag -Exotoxins accessory cholera enterotoxin -- zonnula occludens heat stable or labiletoxin -- mucinase hemolysis -- motility Shiga-like toxins (food --Vi seriotyped capsule by O antigen O1 and - glucose (no lactose) fermenter -initial colonization in Mcells small intestine - rod - Shiga toxin- inhibits protein syn - binds GB3 glycolipid - IpaA-D proteins - actin based motility - non mobile - fecal oral transmission - glucose fermentation - antiphagocytic Capsule - serum resistance - plasmid-encoded virulence genes Bubonic - urban plague –rats/flea -sylvatic plague – squirrels, etc Pulmonary-aerosolized - growth in terminal ileum -mimic appendici. - affects northern populations - can multiple in cold - can grow in blood products - large mucoid polysacch capsule - lactose fermenter - Capsule - nonmotile - strong urease rxn - non lactose fermenter Other Gram Negative Bacteria - normal flora URT, colon - enviro or human origin parahaemolyticus - likes salt - seafood poisoning Campylobacter jejuni - oxidase pos - Guillain-Barre Syn - most common cause infectious diarrhea Helicobacter pylori - oxidase pos - chronic gastritis - Duodenal ulcers -stomach cancer - motile, curve -microaerophilic Pseudomonas aeruginosa - oxidase pos - fruity grape like odor -aerobe Bordetella pertussis Bordet-Gengou (potato) agar - 10% nosocomial infection - septic shock - resp tract CF - burn/wound infection - UTI from cath - swimmers ear - endocarditis IV drug use - pertussis - parapertussis -rabbit fever -zoonosis - Ulceroglandular - Ocularglandular -Pneumonic B. melitensis -fever, flulike Undulant form Chronic -inc treatment - children meningitis -aerobe -Pontiac Fever -Legionnares Disease pleomorphic rods Fracisella tularensis Brucella Haemophilus influenzae Legionella - Chocolate agar c factors V (NAD) and X (hematin) - Charcoal yeast extract c Fe and Cysteine - silver stain Anerobic Rods - curved rod - single polar flagella - motile, curve slight spiral --microaerophilic - small rods -aerobes O139 cholera toxin strains - beta-hemolysis Kanagawa - low infectious dose - 25% food poisoning in Japan - zoonotic infections - chickens - grows at 42ºC - motility - urease - cytotoxin - req oxidative stress - non fermenter - mucoid capsule - tons of endotoxins - exotoxin A - modified porins in outer mem, blocks antibiotics - human natural reservior - only treat if causing prob - found everywhere - some GI colonization - notorious antibiotic resistence - filamentous hemagglutinin - pertussis toxin - adenylate cyclase/hemolysin toxin - other cytotoxins & LPS - non fermenter -fastidious -antiphagocytic capsule -can survive a while in water - sensitive, hard to grow - childhood vaccine -capsule -IgA protease -needs X and V factor to grow -flora nasopharynx - natural source - water sys -HVAC systems -facultative intracellular - inhalation of airborn bac - tick bite - from dead/sick animals -no person to person trans -potential for bioterr childhood vaccine for B Hib Bacteroides fragilis -Prevotella melaninogenicus -Fusobacterium nucleatum - porphymonas gingivalis Obligate Intracellular Organisms (cannot make ATP) Bacteria Rickettsia prowazekii Diagnosis Diseases Caused Typhus -Epidemic -Recrudescent (Brill-Zinsser) reactivation many yrs later morphology /physiology Virulence Epidemiology - unsanitary conditions - body louse -(S) flying squirrels Treatment -Sporadic Rocky Mountain Spotted Fever - rash rickettsii Orentia Ehrlichia chaffeenis Coxiella - morula formation Chlamydia trachomatis - replication in endothelial cells Scrub typhus - monosytic er Sennetsu fever - Q fever acute – ha, fever, chills, musc chronic – heart, liver, pulmo - replicates in vacuoles - prevents fusion of phagosome - multiply in phagolysosomes - antigenic variation I acute, mix I and II for chronic - stable outside host - elementary bodies- infectious element - reticulite body – non infectious - no peptidoglycan - serovars D-K Chlamydia Trachoma – A,B,Ba,C PID, urethritis - conjunctivitis, proctitis Lyhphogranuloma venereum -L - URI Chlamydophilia psiticci pneumonia - quick onset, fever, chills - Southeast US - hard ticks - reservior rats - reproduction in vacuoles - Lone Star ticks - deer and pets - livestock - aerosolized - humans - nonciliated epithelial cells of UG, Resp, conjunctiva - often asymptomatic - travels c gonorrhea - birds - condoms - URI Cell Wall-less Bacteria Bacteria Diagnosis Diseases Caused Mycoplasm pneumoniae - Atypical pneumonia (walking) Ureaplasma urealyticum Urethritis Prostatisis Renal calculi morphology /physiology - fried egg Virulence - no cell wal, no peptidoglycan - sterols, rigidity - binds to resp epitheliam via P1 adhesion, inhibits ciliary action - no cell wal, no peptidoglycan - sterols, rigidity - urease production Epidemiology - free living - human resp, droplets - free living - STD Treatment Gram Negative Cocci Bacteria Diagnosis Neisseria gonorrhoeae - gram neg - oxidase pos - grow on Choc agar, but not reg -Thayer-Martin (VCN) media - ferments glucose meningitididis - gram neg - oxidase pos - grow on Choc agar - ferments maltose Moraxella catarrhalis - gram neg - oxidase pos Diseases Caused - Gonorrhea – tran in sex & birth * human only - sterility - Fitz-Huge-Curtis (perihepatitis) - Proctitis - pharyngitis - arthritis - conjunctivitis Meningococcus - Waterhouse-Friderichsen syn (adrenal hemorr) - Pneumonia - Arthritis - Urethritis - otitis media in kids - bronchitis - sinusitis morphology /physiology - diplococci, bean/ doughnut shape - no true capsule - mostly aerobic - non motile - mostly aerobic - non motile -diplococci - short rods Virulence Epidemiology Treatment - no maltose fermentation - pili - por proteins (prevent phage fusion) - opa proteins (adherence) - Rmp proteins (block bacteriacide) -lipooligosacch - IgA1 protease - resitance: PCN binding mutation, cell surface prot,β lactamase (protein on plasmid, cleaves PCN) - maltose fermentation - large capsule A,B, C - pili, lipooligosacch - endotoxin outer mem - vaccine against A,C,Y, W135, (B = 50% cases) - pili - β lactamase - human is only host - no immunity from repeat infections - intracell growth - travels c Chlamydia - like CO2 - PCNresistant - silver nitrate - human only host - intracellular survival - respiratory transmission - like CO2 - PCN - vaccine high risk - normal flora UR - risk, smoking - PCN resistant Spirochetes Bacteria Treponema pallidum endemicum, pertenue, carateum Borellia burgdorferi Diagnosis - cannot culture - dark-field microscophy - RPR, VDRL - difficult to culture - gram neg recurrentis Leptospira interrogans - dark-field microscophy Diseases Caused Syphilis 1º- chancre, painless 2º- flulike sx, rash, wartlike, mucous mem lesion, hairloss 3º- gummas – granulomatous lesions, CNS -Bejel - Yaws -Pinta Lyme Disease -Early – erythema migrans (at site of bite) -Late – I neuro/cardio, II joint, arthritis Relapsing Fever- sharp, chills - epidemic – louse, human - endedmic – tick, zoonosis Leptospirosis – flu-like, GI - Weil’s disease – hepatic/renal morphology /physiology - microaerophilic Virulence - 1 and 2 reesolve spontaneously - 1/3 of people progress to 3 Epidemiology - human pathogen, STD - cross placenta - children in poor areas - direct contact - microaerophilic - large - immune complexes - tick - reservior mice, deer - microaerophilic - arthropods - aerobic - thin, question mark shape - zoonoic, spread animal urine Treatment -PCN