a.)     Gram positive

b.)     Cocci in clusters

c.)      Lives in anterior nares in healthy people, skin and mucous membranes, hospital environment

d.)     Reduces phagocyte killing (Catalase), clots plasma (coagulase), destroys connective tissue (Hyaluronidase), destroys beta lactam drugs (Beta lactamase), lyse WBCs and release lysosomal enzymes (cytotoxins and leukocidins), interrupts intercellular skin junctions—“Scalded Skin Syndrome” (Exfoliatin), stimulates T cells and endothelial damage and TSS (Toxic Shock Toxin)

e.)      ??

f.)      ??

g.)      Aerobic culture, beta-hemolytic, Mannitol fermentation, Catalase positive, and Coagulase positive

h.)     ??

i.)       Increase in oscucillin-resistant organisms that are resistant to most other antibiotics except Vancomycin (MRSA).

Staphylococcus epidermis

a.)  Gram +

b.)  Coccus

c.)  Resident skin flora, gut, upper respiratory tract

d.)  Adhesion, capsule, slime, biofilm

e.)  Common colonizer of skin but also is an important nosocomial pathogen; most common microorganism causing infections after implantation of orthopedic devices, etc.

f.)  Well adapted for causing shunt and catheter infections because they produce a polysaccharide slime that bonds them to catheters and shunts and protects them from antibiotics and inflammatory cells; hydrophobic nature of the organism’s cell surface facilitates its adherence to synthetic devices; many isolates are resistant to multiple antibiotics

g.)  Growth on blood agar

h.)  Catalase +; coagulase negative; gamma hemolytic, susceptible to Novobicin

i.)  Removal of catheters and prosthetic devices, antibiotics

a.)  Gram +

b.)  Coccus

c.)  Pathogenic in bladder, urinary tract of sexually active young females

d.)  Unknown

e.)  Causative agent in 10-20% of UTIs in sexually active yound women.  Little is known about its pathogenesis

f.)  UTI in sexually active young women

g.)  Growth on blood agar

h.)  Gamma hemolysis, catalase +, coagulase negative, Novobicin resistant

i.)  antibiotics

a.)  Gram +

b.)  Cell Morph: Cocci

c.)  Reservoir: Humans- not in normal flora

d.)  Virulence Factors: Hyaluronic Acid capsule that is antiphagocytic. Hyaluronidase can eat up the HA and penetrate through the tissue, Beta hemolytic, M protein that is present on the pilus with teichoic acid and prevents opsonization, binds fibrinogen and fibrin to form a dense coating to block it from complement. Streptokinase forms the fibrin clots.

e.)  Epidemiology: person to person, mainly in kids in the winter

f.)  Disease type and spectrum: Scarlet fever, Erysipelas, Bacteriemias

Erythrogenic toxin- scarlet fever – toxin carried on bacteriophage

g.)  Means of detection and diagnosis: culture, catalase -, Beta Hemolytic, Bacitricin Sensitive

h.)  Unique features: None

i.)  Ab to M protein but repeated infections can occur, Bacitracin sensitive, no vaccine.

Group B - beta hemolytic

A)      Gram stain rxn:  gram + 

B)      Cell morphology:  cocci in chains

C)      Natural habitat or reservoir:  GI tract (importantly in pregnant women as a part of their normal flora)

D)      Major virulence factors:  hyaluronic acid capsule (produces hyaluronidase)

E)      Epidemiology:  transmitted at time of delivery from mother to newborn infant; also seen in older debilitated adults

F)       Disease type & spectrum:  causes severe pneumonia and meningitis

G)      Means of detection or diagnosis:  identified by hemolytic pattern; catalase neg. rxn; positive CAMP test (streak Staph aureus on blood Agar and take strain of b strep and streak it perpendicular to it, group B strep secrete a protein (CAMP factor) which enhances the hemolytic action of the staph b-lysin on blood agar); can also use Hippurate Hydrolysis to distinguish

H)     Unique features:  capnophile (like increased levels of CO2)

I)        Prevention:  pregnant women are screen for vaginal and rectal caries of group B strep

alpha hemolytic

A)      Gram stain rxn:  gram +

B)      Cell morphology:  cocci in PAIRS

C)      Natural habitat or reservoir:  respiratory tract

D)      Major virulence factors:  (all are listed, but some were not discussed in class)

hyaluronic acid capsule (produces hyaluronidase)

PspA (a surface protein that inhibits opsonization)

autolysin (releases cell components)

pneumolysin (cytotoxic-inhibits cilia function, lyses RBC, activates classical complement pathway, stimulates cytokines…tissue damage and purulent inflammation)

Hydrogen Peroxide (tissue damage)

Surface protein adhesions (CbpA)

Neuraminidase

IgA protease

Peptidoglycan (activates alternate complement pathway, cytokine release)

Transformation (antibiotic resistane-uptake of new DNA)

Intracellular Invasion (invade cell and hide form immune system)

E)      Epidemiology:  colonization preceeds disease; spreads by droplets

F)      Disease type & spectrum:  causes ear infections in kids; cause of meningitis; common cause of community acquired pneumonia…results in bacteremia

G)     Means of detection or diagnosis:  culture on sheep blood agar; catalase neg; Optochin Test ( optochin susceptible = Ab-type compound selectively inhibits pneumococcus, but not other a hemolytic streps); bile solubile

H)     Unique features:  capnophile, 90 capsular serotypes; no Lancefield Ag; has species-specific C polysaccharide

I)        Prevention:  adults: esp people over 65, those with functional asplenia and sickle cell disease (23 valent polysaccharide vaccine); children: given during infancy and could have better memory and has reduced the antibiotic resistant pneumococci carriage in kids (7 valent conjugate vaccine)

alpha hemolytic

A)      Gram stain rxn:  gram +

B)      Cell morphology:  cocci in long or short chains

C)      Natural habitat or reservoir:  commensals of the mouth, upper resp. tract

D)      Major virulence factors:  hyaluronic acid capsule (produces hyaluronidase)

E)      Epidemiology:  not mentioned

F)      Disease type & spectrum:  cause of endocarditis (affects the heart valve); cause of dental caries (Strep mutans-polymerizes dextran from glucose)

G)     Means of detection or diagnosis:  culture on sheep blood agar, catalase neg; a hemolytic; can be differentiated biochemically

H)     Unique features:  capnophiles; no Lancefield Ag; low pathogenicity

I) Prevention: not mentioned

• gram (+)
• usually non-hemolytic
• enteric flora
• opportunist - nosocomial pathogen
• intrinsic antimicrobial resistance (ex. E. faecium --> vancomycin resistance
• abscesse, urinary tract, endocarditis, abdominal/pelvic, bacteremia, wound infection

• most common: E. faecalis

• distinguish from streptococci by: esculin hydrolysis, growth in 6.5% NaCl, PYR hydrolysis (Group A beta strep. are +)

a. Gram stain reaction

Gram-positive

b. Cell morphology (rod, coccus, etc.)

                Curved pleomorphic rods (“Chinese letters”)

c. Natural habitat or reservoir (humans, animals, water, soil, etc.)

                Throat

d. Major virulence factors (how it causes disease)

Toxin acts locally on mucous

membranes of respiratory tract

e. Epidemiology (life cycle, how infection is contracted, transmissibility, etc.)

Spreads by droplet

• Adherent pseudomembrane of

fibrin, bacteria, epithelial and

phagocytic cells impairs breathing

• Toxin spreads hematogenously

to heart, CNS, and adrenals

• Cytotoxic effect mediated by

interfering with protein

biosynthesis by inactivating EF-2

f. Disease type & spectrum (relate virulence factors to manifestations)

Causes Diphtheria

g. Means of detection or diagnosis (culture, serology, biopsy, PCR, etc.)

– Loeffler's serum medium: C. diphtheriae

grows rapidly, faster than other upper

respiratory tract bacteria and its cellular

morphology is enhanced

– Potassium tellurite medium inhibits normal

flora, selects for corynebacteria.

– Elek plates containing antitoxin on paper

strips to confirm toxin production

– Limited to public health labs.

h. Unique features to distinguish from others (structure, biochemicals, etc.)

                Curved pleomorphic rods (“Chinese letters”)

i. Prevention (public health measures, vaccines, antibiotics, etc.)

• Protect by vaccination (toxoid)

a. Gram stain reaction

                Gram positive

b. Cell morphology (rod, coccus, etc.)

                Rods..often in chains, usually with spores

c. Natural habitat or reservoir (humans, animals, water, soil, etc.)

                Animal products

d. Major virulence factors (how it causes disease)

                Cutaneous inoculation or respiratory

e. Epidemiology (life cycle, how infection is contracted, transmissibility, etc.)

Usually cutaneous inoculation of anthrax spores- slow healing ulcer, bacilli spread to lymphatics and bloodstream

f. Disease type & spectrum (relate virulence factors to manifestations)

Cutaneous = 20% mortality if untreated

Respiratory anthrax usually fatal even with treatment

g. Means of detection or diagnosis (culture, serology, biopsy, PCR, etc.)

Nonmotile, May be identified with FA staining and susceptibility to specific (“gamma”) bacteriophage

h. Unique features to distinguish from others (structure, biochemicals, etc.)

                Poly-D-glutamic acid (protein) capsule

                Three component exotoxin

i. Prevention (public health measures, vaccines, antibiotics, etc.)

Made from avirulent, nonencapsulated B. anthracis strain

Requires series of injections and annual boosters

Used in military

a. Gram stain reaction

                Gram positive

b. Cell morphology (rod, coccus, etc.)

                Rods, usually with spores

c. Natural habitat or reservoir (humans, animals, water, soil, etc.)

d. Major virulence factors (how it causes disease)

                Endospores

e. Epidemiology (life cycle, how infection is contracted, transmissibility, etc.)

                Contracted through endospores found in infected food (usually canned goods)

f. Disease type & spectrum (relate virulence factors to manifestations)

                Food poisoning

g. Means of detection or diagnosis (culture, serology, biopsy, PCR, etc.)

                β-hemalytic, catalase positive

h. Unique features to distinguish from others (structure, biochemicals, etc.)

                Endospore forming

i. Prevention (public health measures, vaccines, antibiotics, etc.)

                Proper packaging of food products

a. Gram stain reaction

                Gram positive

b. Cell morphology (rod, coccus, etc.)

                Rods with straight parallel sides

c. Natural habitat or reservoir (humans, animals, water, soil, etc.)

Animal products 

d. Major virulence factors (how it causes disease)

                ~food borne (dairy products)

~meningitis

~neonatal infections

e. Epidemiology (life cycle, how infection is contracted, transmissibility, etc.)

                ~food

                ~neonatally

f. Disease type & spectrum (relate virulence factors to manifestations)

~food borne (dairy products)

~meningitis

~neonatal infections

g. Means of detection or diagnosis (culture, serology, biopsy, PCR, etc.)

Catalase-positive

Motile (positive motility test)

Esculin positive

β hemolytic

h. Unique features to distinguish from others (structure, biochemicals, etc.)

i. Prevention (public health measures, vaccines, antibiotics, etc.)

a. Gram stain reaction

                Gram positive

b. Cell morphology (rod, coccus, etc.)

                Branching rod

c. Natural habitat or reservoir (humans, animals, water, soil, etc.)

d. Major virulence factors (how it causes disease)

e. Epidemiology (life cycle, how infection is contracted, transmissibility, etc.)

f. Disease type & spectrum (relate virulence factors to manifestations)

g. Means of detection or diagnosis (culture, serology, biopsy, PCR, etc.)

                ~partially acid fast (so sometimes confused with the truly acidfast myco bacteria)

h. Unique features to distinguish from others (structure, biochemicals, etc.)

i. Prevention (public health measures, vaccines, antibiotics, etc.)

Enterobacteriaceae

a.)  gram negative bacilli (pink to red color).

b.)  Cell morphology:  rod

c.)  Normal flora of mammals and birds.  Most common Enterobacteriaceae is in the gut.

d.)  Most strains are harmless and common in humans.  However all pathogenic strains have fimbriae that allow them to bind to certain intestinal epithelial cells.  They also produce toxins that cause gastrointestinal disturbances (diarrhea).  It has large virulence plasmid related to Shigella virulence plasmid.

e.)  E. coli is present in fecal matter and can be transmitted through uncooked meat, contaminated water, and from person to person if hygiene or hand washing habits are inadequate.  The life cycle of E. coli in infected humans is 5-10 days in those with a healthy immune system.

f.)  E. coli is one of the Enterobacteriaceae.  It is motile with peritrichous flagella and is a facultative anaerobe.  One of the most common and easily cultured bacteria.

g.)  E. coli is a facultative anaerobe that is easily cultured on an agar gel.  E. coli is oxidase negative, nitrate positive, Catalase positive, lactose positive, indole positive, and is motile.

h.)  indole positive test distinguishes E. coli from other Enterobacteriaceae.

i.)  Contracting E. coli is best prevented by thoroughly cooking meat, drinking treated water, washing hands, and good personal hygiene.  Antibiotics are used to treat pathogenic E. coli after symptoms appear. 

Enterobacteriaceae

a.)  Gram Stain: gram –

b.)  Cell Morphology: rod

c.)  Natural Habitat: humans GI tract

d.)  Major Virulence Factors: Capsule, nonmotile, b lacatamase

e.)  Epidemiology: Predisposing factors include: hospitalization, respirator, increased age, aspiration of oral secretions, alcoholism, Diabetes mellitus, Chronic bronchopulmonary disease

f.)  Disease Type and Spectrum:  Pneumonia (non-purulent bloody sputum, necrosis/abscess) septicemia, UTI, meningitis

g.)  Means of Detection or Ds: Lactose + (MacConkey and XLD agar), resistant to ampicillin/carbenicillin, sensitive to cephalosporins

i.)  Prevention: 

Enterobacteriaceae

a.)  Gram Stain: gram –

b.)  Cell Morphology: bacillus

c.)  Natural habitat: Human intestinal tract, soil, water, plants

d.)  Major Virulence Factors: tetracycline, ampicillin, & cephalosporin resistant

e.)  Epidemiology: Community acquired infection

f.)  Disease Type & Spectrum: UTI, wound infections, pneumonia, septicemia

g.)  Means of Detection or Ds: Urease +, H2S +, Lactase –

h.)  Unique Features:  Highly MotileàSwarm

i.)  Prevention:

Enterobacteriaceae

a.)  Gram Stain: gram –

b.)  Cell Morphology: rod

c.)  Natural Habitat: humans GI tract, animals (meat & dairy), water

d.)  Major Virulence Factors: adhesions, endotoxins

e.)  Epidemiology: Fecal-Oral, Sanitary Food preparation

f.)  Disease Type and Spectrum: Typhoid fever (enteric fever), Food poisoning (entercolitis), bacteremia

g.)  Means of Detection or Ds: lactose -, most H2S +

i.)  Prevention: proper food preparation

Enterobacteriaceae

4 Named species: Shigella Dysentery, Shigella Flexneri. Shigella Boydii, Shigella Sonnei

a.)  Gram Stain: gram –

b.)  Cell Morphology: rod

c.)  Natural Habitat: intestinal tract of humans

d.)  Major Virulence Factors: endotoxins, cytotoxin, Shiga toxin

e.)  Epidemiology: Fecal-Oral, Sanitary Food preparation

4 F’s of transmission: feces, fingers, food, flies, water

f.)  Disease Type and Spectrum: Dysentery

h.)  Unique Features: nonmotile

g.)  Means of Detection or Ds: lactose-, no gas formed from glucose, H2S -

i.)  Prevention: Sanitation, hand washing, antibiotics: ampicillin & bactrim

Enterobacteriacea

a.)  Gram Stain: gram –

b.)  Cell Morphology: bacillus

c.)  Natural habitat: rodents

d.)  Major Virulence Factors: Ca2+ dependent, endotoxin, capsule

e.)  Epidemiology: Pneumonic transmission person to person, or cat to person

Bubonic transmission is from the bite of a flea

f.)  Disease Type & Spectrum: Bubonic & Pneumonic Plague

g.)  Means of Detection or Ds: Fluorescent Ab

i.)  Prevention:  rodent and flea control

Enterobacteriaceae

a.)  Gram Stain: gram –

b.)  Cell Morphology: bacillus

c.)  Natural habitat: soil, water, GI tract of animals

d.)  Major Virulence Factors: Ca2+ dependent, endotoxin, capsule

e.)  Epidemiology: transmission through food, water, and person to person contact

Fecal-oral route

f.)  Disease Type & Spectrum: Enteric Infection, Mucosal ulcerations in ilium, inflamed mesenteric nodes, abdominal pain, diarreha

g.)  Means of Detection or Ds: stool sample

i.)  Prevention:  Sanitary Food Preparation, antibiotics: penicillin & tetracyclines

1. gram negative     
2. bacillus
3. no natural habitat
4. 1. motile  2. hemolysin 3. collagenase 4. elastase 5. main virulence factor is that p.a. has endotoxin A which blocks protein synthesis
5. Patients must be IMMUNOCOMPROMISED TO GET THIS INFECTION
6. Pneumonia: CYSTIC FIBROSIS

Sepsis: bandages on BURN PATIENTS

Endocarditis:  IV DRUG USERS

Corneal infections:  Contact lens wearers

7. detect with culture
8. smells like GRAPES, is beta hemolytic on Blood agar, and produces bluish-green pigmented colonies
9. broad spectrum antibiotics are used to treat

Not a lot on this organism, causes some lung infections if I remember right.  Rods appear to branch on gram stain.

1. gram negative
2. short COMMA looking bacillus
3. no natural habitat
4. fecal-oral transmission, drinking water with sewage in it
5. 1. motile  2. mucinase 3. fimbriae 4. NONINVASE
6. CHOLERAGEN:  an enterotoxin increases levels of cAMP which leads to electrolyte secretion into the GI which causes water to follow
7. Grows as flat, YELLOW COLONIES, on TCBS agar
8. Causes RICE WATER STOOLS (aka severe diarrhea
9. Treat with doxy. and quinolones.  Proper sewage treatment prevents outbreaks

1. gram negative
2. bacillus
3. habitat is wild and domestic animals, poultry
4. 1. motile 2.invasive 3. main virulence factor is an enterotoxin which acts the same way as choleragen  4. cytotoxin which destroys cells
5. 1.  uncooked meat  2. unpasteurized  milk  3. fecal oral 
6. Causes bloody or secretory diarrhea
7. KEY way differentiate from salmonella typhi is that campy grows at 42 degrees Celsius, and salmonella does not
8. Culture with a CAMPY plate
9. Proper food preparation and sewage treatment are preventative, treat with erythromycin

a.       gram negative    

b.       curved bacillus

c.        no natural habitat

d.       no virulence factors or toxins

e.        people whom regularly insult there stomach with EtOH, and smoke are prone to infections

f.        causes PEPTIC ULCERS, chronic gastritis, and PROSTATE CANCERS

g.        detect with dark field microscopy or a breath test which functions similar to a PCR

h.       know PEPTIC ULCER

i.   treat with antibiotics

a.       gram negative    

b.       curved bacillus

c.        no natural habitat

d.       no virulence factors or toxins

e.        people whom regularly insult there stomach with EtOH, and smoke are prone to infections

f.        causes PEPTIC ULCERS, chronic gastritis, and PROSTATE CANCERS

g.        detect with dark field microscopy or a breath test which functions similar to a PCR

h.       know PEPTIC ULCER

i.         treat with antibiotics

a.         gram negative

b.         bacillus (coccobacillus, almost looks like diplococci)

c.          found in HUMANS only

d.         has 1 of 6 capsules, b capsule is the most virulent;  pilli for attachment; and IgA protease

e.          transmitted thru respiratory drops

f.          major cause of MENINGITIS in young kids between 6 mo and 3 y/o, also causes Acute EPIGLOTTITIS in infant, and sepsis which can lead to SEPTIC ARTHRITIS in infants

g.          detected with cultures on CHOCOLATE AGARS, only grows in the presence of NAD+ and HEMIN (X and V), does not grow on Blood Agar

h.         the capsule b (b=bad) is tough for infants to make antibodies against thus as people get older and their immune system matures Haemophilus inf. Becomes less of a problem

i.           in 1991 they came out with a vaccine against the capsule b strain and thus have dramatically reduced the number of infections

1. bacillus, spore forming
2. reservoir is man
3. 1. capsule 2. beta-lactamase 3. FHA: a pilli that allows the org. to attach to ciliated epithelial in bronchi
4. Pertussis exotoxin cause increased G proteins which leads to increased cAMP resulting in increased sensitivity to histamine, release of insulin, and number of wbcs;  the org also has cytotoxic effect on epis and weakens wbcs
5. Culture on BORDET-GENGOU media (has penicillin in the agar), also can detect with an ELISA assay, or direct microscopy
6. WHOOPING COUGH is the main manifestation, we get a PPT vaccine which has made bp a mute point. Infants before the age of one can’t get the vaccine so they are at risk.  Adults can get whooping cough   from the vaccine

1. gram negative
2. bacillus
3. reservoirs are man, cooling systems, hot tubs, and water fountains
4. 1.  capsule  2. motile  3. hemolysin
5. Immunocompromised people are at risk, likes to invade alveolar cells
6. Causes PONTIAC FEVER which is acute and has flu like symptoms, and a chronic condition called LEGIONAIRES’ disease which manifests as pneumonia
7. Detect with CHARCOAL YEAST EXTRACT AGAR
8. L-cysteine is critical for growth
9. Regular chlorination of pools, and testing of cooling systems in hospitals is preventative of an outbreak

1. gram stain- not the best, identified by acid fast staining
2. cell morphology-red rods with acid fast stain

M. Tuberculosis flaky white dry colonies

M. avium non-pig colonies

3. natural habitat-obligate aerobes

M. tuberculosis humans are the only natural host

M. avium soil and water

M. leprae- humans and armadillos

4. virulence factor- mycolic acids
5. epidemiology- slow growing

M. tuberculosis- 90% of infected persons will not develop TB, survives drying, susceptible to UV radiation, resistant to many disinfectants need to use chlorine to kill, killed by pasteurization, transmitted by infectious droplets 5-200.

M. avium transmission respiratory or GI tract

M. leprae transmitted by inhalation or skin contact with contaminated respiratory secretions

6. disease type and spectrum

M. leprae- leprosy or Hansen’s disease, organism lives in nerves in cooler parts of the body

7. means of detection and diagnosis

M. tuberculosis diagnosed with AFB smear, TB skin test, Cehst radiograph, AFB culture

M. leprae detection AFB stain of nasal secretions, lepromin skin test, prevention vaccine under development

8. unique features mycobacteria are acid fast stained!
9. prevention-M. tuberculosis decrease exposure, chemoprophylaxis, BCG vaccine

Diagnosis:

     Clinical signs

1.       foul smelling discharge (because of short chain fatty acids as an end product)

2.       proximity to a mucosal surface

3.       gas in tissue

4.       abscess formation 

     Gram stain (may be helpful in the establishment of a mixed infection or the presence of closdtricia in wounds

      Culture – sample collections and transport are critical; require complex medium supplemented with hemin, Vit. K, and/or blood;  media should include antibiotics(aminoglycoside) to suppress facultative anaerobes;  incubation and work up performed in CO2 in nitrogen/hydrogen mix

Treatment:

       Surgical drainage of closed abscess

       Mixed infections – cover for both aerobic and anaerobic component

       Metronidazole, penicillin G, Clindamycin (B. fragilis and P. melaninogenica are penicillin resistant);  Aminoglycoside are not effective

        Toxin mediated diseases – antitoxin and antibiotics if active infection vs. intoxification

Pathogenesis:

         Synergy with facultative organisms

                      Facultative bacteria such as Enterobacteriaceae function to reduce the oxygen content in the tissue

                       Beta-lactamase production

Diseases:

                Vincent Agina – synergistic infection of Fusobacterium, Bacteroides, and Treponeme (gums receding away from teeth)

                Necrotizing Fasciitis – usually associated with Streptococcal dz, but sometimes caused by anaerobes

a.)  Gram-negative bacilli (rods),  non-sporeforming pleomorphic rods (take on different appearances)

c.)  Natural habitat is normal human floral, mainly associated with the colon

d.)  Causes disease by -

f.)  Diseases – Necrotizing Fasciitis:

g.)  Means of Detection or Diagnoses – bile(+) and esculin (+)

h.)  Unique features – capsule is antiphagocytic, resistant to penicillin, pleomorphic

i.)  Prevention – antibiotic therapy with surgical inervention

a.)  Gram-positive bacilli, sporeforming; looks like lollipops because of the terminal spores larger than vegetative cell

c.)  Natural habitat – ubiquoitus, found in soil

d.)  Causes disease by – toxin production

f.)  Diseases – Tetanospasmin (causes continuous firing of motor neurons); “Lock Jaw” (masseter muscles are clenched)

g.)  Means of Detection or Diagnoses – presence of toxin

h.)  Unique features – “lollipop” appearance

i.)  Prevention – vaccine (DPT-given when young)

a.)  Gram- positive bacilli,  sporeforming; “boxcar” like

c.)  Natural habitat – in humans intestinal tract and in the soil

d.)  Causes disease by – Phospholipace C (alpha-toxin):gas gangrene, destrpys WBCs, platelets, and a bunch of other host cells;  enterotoxin:Food poisoning

f.)  Diseases – Gas gangrene, food poisoning

g.)  Means of Detection or Diagnoses – Etest Susceptibility Testing, on agar the colony will be surrounded by a hazy circle – double zone of hemolysis (due to all the toxins made); Nagler Test (has antitoxin only on one side of the agar plate)

h.)  Unique features – “boxcar”

i.)  Prevention –

a.)  Gram- positive bacilli,  sporeforming

c.)  Natural habitat – ubiquoitus, found in soil worldwide

d.)  Causes disease by – ingestion of preformed neurotoxin except for wound and infant botulism; mostly food-borne dz 

f.)  Diseases – neurotoxin blocks muscle contraction, infant botulism (most common form of botulism in US, form ingestion of environmental material i.e. honey)

g.)  Means of Detection or Diagnoses – find toxins in food or patient feces or serum

h.)  Unique features –

i.)  Prevention – no vaccine, metrodiazole, antitoxin

a.)  Gram- positive bacilli, sporeforming

c.)  Natural habitat – human intestinal tract

d.)  Causes disease by – antibiotics for another disease wipes out all of the normal flora, except C. difficile (which is typically resistant); toxin

f.)  Diseases – Pseudomombranous colitis/antibiotic related diahrea

g.)  Means of Detection or Diagnoses –

h.)  Unique features –

i.)  Prevention –   

a.)  Gram-positive bacilli

c.)  Natural habitat – in humans associated with oral, respiratory and female genital tract infections (IUD); common in soil as well

d.)  Causes disease by –

f.)  Diseases – causes extensive soft tissue involvement, crosses tissue plane and involving multiple organ systems; form sulfur granules (clumps of organisms that have host material deposited on them, 1-2 mm, if crushed and gram stain (-) filamentous branching structures)

                      Dacrocryocystitis – blockage of tear ducts, must remove sulfur granules

                      Actinomycosis (“Lumpy Jaw”) – poor hygiene, allowing abscess formation on the roots of teeth, destruction of root and bone, if left alone will it will make its way exterior

g.)  Means of Detection or Diagnoses – slow growing and are difficult to isolate; presence of sulfur granules

h.)  Unique features – sulfur granules, not aerotolerant

i.)  Prevention –

a.)  Gram-negative bacilli, pleomorphic nonspore forming rods; long, thin, some with pointed ends

c.)  Natural habitat – present in the human upper respiratory tract and intestinal tract (mouth, colon)

d.)  Causes disease by – usually present in mixed infections but may be the sole agent

f.)  Diseases – pulmonary abscesses

g.)  Means of Detection or Diagnoses –

h.)  Unique features – rods with pointed ends

i.)  Prevention –

• aerobic - obligate or facultative
• eukaryotic: membrane bound nucleus and cytoplasmic organelles (may be multinucleate
• achlorophyllous
• morphology - unicellular or multicellular
• cell wal: multilayered polysacchardie (cellulose, glucan, mannans, chitin, polypeptides. absence of teichoic acids, peptidoglycan, LPS)
• cell membrance: phospholipid bilayer, ergosterol (relate to chemotherapy)
• cytoplasm - typical eukaryotic organelles
• nuleus - either uninucleate or multinucleate
• capsule - present in some species. functions: antiphagocytic and antigenic
• Grow in form of yeast or mold
• asexual reproduction - fungi usually exist as haploid, 2 haploid organisms and fuse and multiply by meiosis

• 1st organism shown to cause disease using Koch's postulates
• infects zoo animals and nonhuman primates

• causes leprosy (aka Hansen's disease)
• cutaneous loss of sensation - nerve damage due to CMI
• organisms incdae nerves and form granulomas
• inact cell mediated response

Gram (-)

Diplococci

Non-motile

Have LPS, endotocin effect, Pili help attach

Polysaccharide capsule to help it not be phagocytized

Uses an IgA protease to escape?

Epidemiology - leading cause of bacterial meningitis in older children and young adults (community-sporadic, institutional-outbreaks)

10-15% mortality, 11-19% have permanent sequelae. Invasive disease and can be fatal within HOURS

Only infects humans and spread by respiratory droplets or oral secretions

Oxidase positive, Grows on chocolate & sheep blood agar

Capnophilic (5-7% CO2)

Neisseria gonorrhoeae

·         Gram (-)

·         Diplococci

·         Require specialized medium & incubation conditions for growth

·         Non-motile

·         Kidney-shaped

·         Venereal or vertical transmission

·         Pili enhance attachment to cells

·         Endotoxin

·         Intracellular location

·         IgA protease

·         Antigenic variation – no permanent immunity following infection

·         Penicillin resistance – plasmid & chromosomal

·         Detection/Culture: Oxidase positive, growh on chocolate agar * antibiotics (Thayer Martin), susceptible to cold stress & drying, glucose utilization, requires CO2

·         Gram (-)

·         Obligate intracellular pathogens

·         Lacks peptidoglycan

·         Unique intracytoplasmic growth cycle

·         Depend on host for ATP

·         Stain with Giemsa

·         Ocular infections, Genital infections

·         Detection – culture/stain, nucleic acid amplification(preferred), antigen detection

Chlamydia psittaci

·         Gram (-)

·         Disease of birds sometimes transmitted to humans as respiratory infection from their droppings

·         Acute lower respiratory illness, pharyngitis, sinusitis

·         Similar to mycoplasma

·         Frequently asymptomatic

·         Detected by PCR, cell culture, serology. Diagnotic testing not widely available.

·         Relation to other chronic inflammatory conditions (such as atherosclerosis and coronary artery disease)

·         Smallest free-living organisms

·         Lack cell wall – pleomorphic

·         Specialized cell membrane

·         Evolved from gram (+)

·         Extracellular on mucosal surfaces

·         Pathogenesis- cytadherence (P1 & other proteins, immunogenic), induction of inflammation, cytokine cascade, antigenic variation, autoimmunity, superoxide anions inhibit host catalase increasing oxidative damage

·         Detection – enriched agar medium, slow growth (5-20 days), glucose hydrolysis, ID colonies by PCR.

·         Tracheobronchitis

·         Atypical interstitial “walking” pneumonia

·         All ages affects but more common in younger persons

·         Reinfection common – no protective immunity

·         Spirochete

·         Syphillis!

·         Motile spirals (5-15microns)

·         Hasn’t been successfully cultured or subcultures on artificial media. But can multiply in rabbits

·         Very susceptible to environmental condition

·         Does not stain with aniline dyes

·         Diagnosis- useful only if lesion is present, not useful for oral lesions. Positive sooner than serology tests

·         Fluorescent Treponemal Antigen (FTA) Test

·         Spirochetes, large (20-30 microns in length)

·         Lyme Disease!

·         Motile

·         Stainable with aniline dyes

·         May be observed with conventional microscopy

·         Cultivable in artificial media

·         Transmitted mainly by Ixodes ticks, reservoir in mice

·         Clinical – bloodstream invasion seeds tissues (nerves, heart, joints), three distinct stages (1. Erythema chronicum migrans rash at site of tick bite, 2. Neural and heart problems – months, 3. Joints – arthritis – years)

·         Diagnosis – antibody production

·         Spirochetes

·         Sprals, thin, tightly coiled, 10-20 microns

·         Obligate anaerobes

·         Grow in artificial media supplemeted by rabbit serum

·         May require 4 weeks

·         Epidemiology – parasitize animals, carry them in kidney, occasionally infect humans who come in contact with soil or water contaminated with urine.

·         Pathogenesis= entrhy through mucous membranes or breaks in skin, gain access to bloodstream, kidney, liver, CNS

·         Clinical – FUO, aseptic meningitis, jaundice, nephritis, Weil’s disease

·         Diagnosis- culture(blood, CSF, urine), serology, darkfield examination

Rickettsiae in general

·         Obligate intracellular organisms

·         Most transmitted to humans by arthropods

·         Contain both RNA and DNA

·         Cell walls similar to Gram (-) fission

·         Quickly destroyed by heat, drying and bactericidal chemicals

·         Use serology for diagnosis

·         Multiply in endothelium of small vessels and become necrotis

·         Vector – tick

·         Reservoir – dogs, rabbits, rodents

·         Disease – rocky mountain spotted fever

·         Vector – louse, flea

·         Resevoir- flying squirrel

·         Disease – louse-bone typhus

·         Vector – flea

·         Resevoir – Rodents

·         Disease – Murine Typhus

·         Vector-none

·         Resevoir – Deer, dogs

·         Disease – monocytic ehrlichiosis