Peptidoglycan-B-linked NAG/NAM; protection/strength

Teichoic Acids-glycerol Phosphate or ribitol phosphate polymer; promotes adhesion to epithelium

Lipoteichoic acids-polyglycerol phosphate; holds together PM and PG; promotes adhesion

plasma membrane

Outer Membrane (lipopolysaccharide; OM proteins (porins/porin-like proteins));

 peptidoglycan;

 periplasmic space; plasma membrane

OM proteins involved in hydrolysis, antibiotic inactivation, adhesion, chemotaxis, transport

Outer leaflet has LPS (endotoxin)

PG in inter membrane space

Gives bug negative overall charge for evasion of complement and phagocytosis

In cytosol, sequential addition of amino acids to UDP-NAM to form NAM-pentapeptide. (requires ATP)

In inner leaflet, UMP is released leaving a di-P linkage; NAM pentapeptide is now attached to bactoprenol (membrane bound lipid like carrier); NAG is added to complex as well as amino acids; Complex crosses membrane; This disaccharide unit is attached to the end of the growing chain; transpeptidases crosslink adjacent glycan chains to form single NAM-NAG chain

Stain purple with crystal violet/iodine

Decolorization

Counterstain with Safranin (red)

All spores are Gram + rods

Exosporium, spore coat, cortex, core

Dipicolinic Acid is unique to spores and aids in resistance

Sterilize in autoclave 120 > 20 minutes

70% EtOH, 10% bleach, water

Hydrophillic

network of polysaccharides

Called slime layer if amorphous

Common or Somatic: attach to epithelial cells

Sex-only one per cell; involved in gene transfer

Composed of pilin which form a tube with a small hollow core

Rotating helical structures anchored to PM for locomotion

Monotrichous (at one pole)

Lophotrichous->1 at a pole

Amphitrichous-at both poles

Peritrichous-all around the bacteria

Has basal body in which central rod rotates; hook like joint, and flagellin filament

Sec proteins serve as chaperones

ATP dependent

Gram +/-

Extends across both membranes

Proteins exported w/o use of GSP

ATP dependent

No chaperones

From periplasm into ECM

ATP dependent

Only provides second step for proteins already found in periplasm using sec proteins of GSP and Tat proteins

Uses GSP or Tat

Transports across outer membrane

UNIQUE: ATP INDEPENDENT

Similar to Type 2

Extends across both membranes

has syringe like apparatus

directly injects proteins across a 3rd membrane (toxins into host cells)

Utilizes a chaperone and is ATP Dependent

Notable use in Yersenia pestis (bubonic plague)

Extends across both membranes

ATP dependent

Syringe like apparatus (like Type III) but can transport protein AND DNA (toxins and plasmids)

waxy material in outer wall of Mycobacterium (tb and leprae) and Nocardia species

Stain with Carbol fuschin dye/destain with acid alcohol

Acid fast wall is rich in mycolic acids which resist lysozyme and leads to fastidious slow growing bacteria

Mycolic acids/polypeptides in outer layer consisting of free lipids, glycolipids and peptidoglycolipids

Surface proteins are species specific

Also, cord factor, trehalose mycolates and sulfolipids, arabinogalactan, lipoarainomannan, arabinomannan and Wax D

Binds CD14 to drive toxic shock sydrome, a cytokine storm of IL I and TNF-alpha that induces fever and can lead to MTOF and death

Comprised of Lipid A, core polysaccharide and O side chain; Lipd A contains glucosamine and is highly toxic; core polysacch is fairly conserved; O side chain is major surface antigen that shows most variability

LPS assembly uses bactoprenol carrier

H2O2 and O2-

Bacteria use catalase and superoxide dismutase to counteract these; bacteria that lack these enzymes are likely anaerobic

Mutation

Recombination

Transposition

Genetic Exchange

recombination used for this; mechanism for immune evasion and ability to change surface antigens;

genetic unit that can modulate its own relocation using Transposase and the 2 elements: insertion sequences and transposons;

IS-use unzymes for site-specific recombination and have inverted repeats and direct repeats; only genes involved in transposition are encouded here

Transposons: Have more enzymes that are involved in antibiotic resistance, toxins, etc. and transposition may be replicative

Transfer of genetic material from donor to recipient cell;

Uses Transformation, Transduction, or Conjugation

Direct interaction between 2 bacteria with transfer of a plasmid (conjugative plasmid has genes to drive own transfer; non-conjugative lack these genes);

Can occur between different species; varies between Gram +/- ; many plasmids carry virulence genes

Diffusion tests (Kirby Bauer and E test)

Macro dilution (test tubes)

Microdilution (plates)

Determine Min. Inhibitory comcentration or minimum bactericidal concentration

Block Cell Wall synthesis

Penicillins, cephalosporins, monobactam, carbapenems

Inhibit transpeptidation and activate autocatalytic enzymes (NOTE: Gram- bacteria make B-lactamases)

Natural Pen G & V

Penicillinase -resistant: Oxacillin, nafcillin, cloxacillin, methicillin

Amino Penicillins: ampicillin, amoxacillin

Anti-pseudomonas: ticarcillin

Extended spectrum: pepercillin

cephalexin, cefazolin

for non-life threatening infections/surgical prophylaxis

cefuroxime, cefoxitin

Increased activity against Gram-, more resistant to B-lactamases

ceftriaxone, cefoperazone

broad spectrum; CNS penetration

cefepime

broadest spectrum of activity against Gram +/-

Aztreonam

Resistant to B-lactamases

Effective against Gram- but NOT Gram +

imipenem, meropenem, ertapenem

resistant to most b-lactamases

used for Gram+/-

TOXIC

glycopeptide AB, blocks transglycosylation

Kills Gram + (especially pen-resistant Staph)

Some bacteria have Van-A for resistance

Blocks dephosphorylation of bactoprenol

Kills Gram +

Administered topically

Cycloserine: D-alanine analog blocks cell wall synthesis

Isoniazid: inhibits mycolic acid synthesis

Ethambutol: inhibits arabinogalactan synthesis

Ethionamide: inhibits mycolic acid synthesis

Disrupt plasma membrane

Bactericidal against Gram-

Cubicin

bactericidal lipopeptide depolarizes membrane

Use against Gram + cocci

Sulfonamides (Sulfmethoxazole, dapsone): inhibits PAPA incorporation into dihydropteroic acid so inhibits folate synthesis; Bacteriostatic against Gram+/- but a lot of resistance so now used for UTI's from E.coli. Allergies common

Trimethoprim (inhibits dihydrofolate reductase)

Two are used synergistically against aerobes, Gram +/- cocci, bacilli

Inhibit DNA gyrase and DNA synthesis

Ciprofloxacin, moxifloxicin, gatifloxicin

Bactericidal against aerobes and fac. aerobes

Inhibits DNA synthesis by inhibiting RNA polymerase

rifampin, rifabutin, rifaximin

Bactericidal for Gram +/some -

Uses: mycobacterium tb, and prophylaxis for N. meningitis, and H. influenza type B

metronidazole, tinidazole

Damages DNA, not an inhibitor of synthesis

Kills anaerobic bacteria, fungi, parasites

Given with B-lactam to broaden spectrum

streptomycin, gentamicin, amikacin

Binds 30S, blocks initiation

uses against aerobes

TOXIC

resistance slowly develops

tetracycline, doxycycline, tigercycline

Binds 30S, stops elongation

Bacteriostatic against some Gram + and Gram - rods and cocci, aerobes and anaerobes, cell wall deficient

TOXIC to bones and teeth, GI

Resistance via efflux; resistant to one, resistant to all

Binds 50S, inhibits peptide bond formation

Bacteriostatic against some Gram +/-

TOXIC-aplastic anemia; bone marrow transplant needed

erythromycin, azithromycin, telithromycin

Binds 50S, blocks translocation and/or inhibits peptide bond formation

Bacteriostatic against some Gram +/- and some intracellular pathogens

Resistance to one, resistance to all

clindamycin

Binds 50S, inhibits peptide bond formation

Bacteriostatic against Gram+/-

topical for gram + cocci

inhibits synthesis of isoleucyl-tRNA

Quinupristin+Dalfopristin

FDA approved to treat vancomycin resistant E. faecium; also effective against vano-resistant staph; Binds 30S

an oxazolidinone

Binds 50S site

Treats VREF, MRSA, MSSA

Methenamine and Nitrofurantoin (UTI's)

Pyrazinamide (Mycobacterium)

Used to reduce the number of microbes on skin surfaces

ex) alcohols, iodophors, chlorhexidine, PCMX, triclosan

high level disinfectants used for items involved with invasive procedures that can't withstand sterilization

ex) glutaraldehyde, hydrogen peroxide, peracetic acid, chlorine

Intermediate level cleans surfaces without spores

ex) alcohols, iodophores

Low level for blood pressure cuffs, etc

ex) quaternary ammonium

Alcohols: spores, some viruses and fungi

halogens: some spores

aldehydes: bacteriostatic at low conc

phenols: spores, some viruses

gases:

cationic detergents:

iodines: must clean off organic matter

chlorhexidine: kills slowly

hexachlorphene: only kills Gram +

S. epidermidis, Micrococcus sp., Corynebacterium sp.,

P. acnes

Major: S. epidermidis, Corynebacterium sp.,

Minor: S. aureus, Haemophilus sp., Streptococcus sp., Branhamella sp

Major: S. mitis, S. sanguis, S. salivarius,

S. mutans (plaques and caries)

Other: S. epidermidis, peptostreptococcus sp., Lactobacillus sp, Treponema sp. Actinomyces sp. Bacteroides sp., Fusobacterium sp., Veillonella sp

Distal: Candida albicans, Enterobacteriaceae,

Gram-anaerobes

Strict anaerobes: Bacteroides sp., Fusobacterium sp., Eubacterium sp., Peptostreptococcus sp., Bifidobacterium sp.,

Minor: Enterococcus sp., Staphylococcus sp., Enterobacteriaceae, C. albicans

Urethra sterile except distal part which has flora like skin

Vagina, cervix: Lactobacillus sp., Bacteriodes sp., Corynebacterium sp., Sp. epidermidis, Enterococcus sp.

In carriers: C. albicans, T. vaginalis

Pili/Fimbriae: adherence; resist phagocytosis

Capsules/slime layers: resist phagocytosis; inhibit C3b deposition

Exotoxins: AB (diptheria), non-AB(pore forming LLO),

Gram+, filamentous, fac/strict anaerobes

inhabit mucosal surfaces

Infection: pyogenic abscesses connected by sinus tracts; "sulfur granules" form in tissues; opp. infections; cervicofacial infections most common (assoc w poor oral hygiene or trauma)

Control: penicillin, tetracycline, macrolide

Gram+, filamentous, partially acid fast, aerobic, fragment, common in soil

Infections: survive/replicate in macrophages; cause exogenous bronchopulmonary infections in immunocompromised that disseminates to CNS; also cause primary cutaneous and lymphocutaneous infections and brain abscess

Control: TMP-SMX, 3rd gen ceph.

Gram+ cocci, anaerobes, non-spore forming, no cytochromes; predisposing conditions, proinflammatory cell walls

Infections: brain abscess, pulmonary infection, intra-abdominal infection, female pelvic inf, skin and soft tissue infections

Control: penicillin, clindamycin, imipenem

Gram-rods, anaerobes, non-spore forming, lack cytochromes

60% of intra-abdominal infections and 70% of anaerobic bacteremias

enterotoxin

Infections: brain, oral, URT, dental, sinuses, LRT, female genital tract inf.,

Control: drain, debride, metronidazole, clindamycin, chloramphenicol, imipenem

Gram-rods, anaerobes, non-spore forming, lack cytochromes

capsule, adhesins, enzymes=virulence factors

Infections: brain, oral, URT, dental, sinuses, LRT, female genital tract inf.,

Control: drain, debride, metronidazole, clindamycin, chloramphenicol, imipenem

Gram+ rods, anaerobes, non-spore forming, lack cytochromes

Infections: associated with acne

Non-motile, Gram+rods, endospores, fac anaerobes, catalase +

Virulence factors: zoonosis, polyglutamic acid capsule; toxins(PA-EF (calmodulin-dep adenylate cyclase to increase intracellular cAMP), PA-LF(protease that induces apoptosis/disrupts endothelial barrier

Infections: Sx associated with toxin/route of entry; intestinal, inhalation, cutaneous all assoc w/ toxemia

Control: Vaccine, penicillin, oxycycline, quinolone

Gram+rods, endospores, fac anaerobes, catalase+, motile

Virulence factors: Heat labile (HL) and heat stable(HS) enterotoxins, cereolysin, lectithinase

Infections: emetic (HS toxin) and diarrheal (HL toxin) diseases (food borne); other: bacteremia, pneumonia, ophthalmitis, osteomyelitis

Control: proper food storage, supportive care, serious infections use Vancomycin or clindamycin

Gram+rods, spores, fac anaerobes, catalase +

emetic gastroenteritis, sepsis

Gram +rods, spores, fac anaerobes, catalase+

diarrheal gastroenteritis

Gram-coccobacilli, aerobe, capsule, pili

Virulence factors: human reservoir, aerosol transmission, LPS, capsule, sol PG, pertussis toxin, invasive adenylate cyclase, adhesins (pertactin, filamentous hemagglutinin, pili, pertussis toxin, type 3 secretion

Infections: pertussis in children, persistent cough in adults

Control: vaccine, macrolide

Motile, microaerophilic, Gram-spirochete, no LPS, pro-inflammatory lipoprotein in OM, changes antigenic strux, zoonotic diseases, difficult to culture

lice vector, humans only host

Virulence: highly invasive, intracellular growth

Infections: relapsing fever

Control: avoid vectors, tetracyclines, macrolides

Motile, microaerophilic, Gram-spirochete, no LPS, pro-inflammatory lipoprotein in OM, changes antigenic strux, zoonotic diseases, difficult to culture

tick vector, rodents, small mammals are natural hosts

Virulence: highly invasive, intracellular growth

Infections: relapsing fever

Control: avoid vectors, tetracyclines, macrolides

Motile, microaerophilic, Gram-spirochete, no LPS, pro-inflammatory lipoprotein in OM, changes antigenic strux, zoonotic diseases, difficult to culture

Virulence: highly invasive, tick vector, mice, deer, & birds are resevoir; adhesins,

Infections: Lyme disease (early localized-erythema chronicum migrans); (early disseminated-secondary skin lesions, facial nerve palsy, meningitis, carditis); late disease (arthritis)

Control: avoid vectors; vaccine, doxycycline, amoxicillin, cefuroxime, cetriaxomne for serious infection

Gram-, non-motile coccobacilli, aerobe, catalase +, oxidase +, urease+

Virulence factors: animal resevoir,, transmit by direct contact or ingestion; LPS, fac. intracellular pathogen

Infections: brucellosis, sepsis, granulomas or abscesses in reticuloendothelial tissue (LN, bone marrow, spleen, liver)

Control: doxycycline+rifampin

Gram-, curved bacilli, microaerophilic, motile at 37C, oxidase and catalase+

grows at 25C but not 42C

Virulence factors: zoonotic with many animal reservoirs, transmit by direct contact, food, water; LPS, capsule (S protein that inhibits C3b binding)

Infections: common in immune compromised , sepsis following gastroenteritis

Control: avoid undercooked food/contaminated water, tetracyclines, macrolides, quinolones

Gram-, curved bacilli, microaerophilic, motile at 37C, oxidase and catalase+

Grows at 42 NOT 25C

Virulence factors: many animal reservoirs (esp food animals), transmit by contaminated food/water; LPS, invasive, enterotoxin?,, cytotoxin?

Infections: leading cause of bacterial food-borne gastroenteritis (inflammatory), disseminated disease in immunocompromised; secondary complication with GBS and arthritis

Control: avoid undercooked food or contaminated water tetracyclines, macrolides, quinolones

strict intracellular bacteria, 2 form-life cycle: elementary bodies(infectious form) and reticulate bodies (replicative form); Gram- like envelope w/o PG

Virulence: intracellular pathogen, human reservoir, transmission route depends on dyndrome

Infections: Trachoma (seros A, B, Ba, C; transmitted by direct contact or flies, keratitis); inclusion conjunctivitis (seros B,Ba,D-K; transmitted by direct contact), STD (seros B,Ba,D-K; urethritis, cervicitis; PID, epididymitis, prostatitis), lymphogranuloma venereum (seros L1-3, STD)

Control: doxycycline or macrolides

strict intracellular bacteria, 2 form-life cycle: elementary bodies(infectious form) and reticulate bodies (replicative form); Gram- like envelope w/o PG

Virulence: intracellular pathogen, bird reservoir, transmit by bite or inhalation

Infections: atypical pneumonia

Control: tetracyclines

strict intracellular bacteria, 2 form-life cycle: elementary bodies(infectious form) and reticulate bodies (replicative form); Gram- like envelope w/o PG

Virulence: intracellular pathogen, human reservoir, transmit by aerosols

Infections: (long incubation pd) pneumonia, bronchitis, sinusitis, pharyngitis, atherosclerosis

Control: tetracyclines or macrolides

Gram+rods, strict anaerobes, spores, soil and GIT inhabitant

histotoxic, aerotolerant and non-motile, 5 strains based on exotoxin profile (A-E); target hemolysis associated with alpha and theta toxins

Virulence: exotoxins, alpha (most impt) and beta toxin (enteritis necroticans); enterotoxin Superantigen, heat labile; infection initiated by traumatic entry of endospores or inoculation of ischemic tissue or consumption of contaminated food (gastroenteritis)

Infections: most assoc with A; sepsis, intra-abdominal, biliary tract, genital, pleuropulmonary, cellulits, fascitis, myonecrosis, gastroenteritis  (food poisoning from A), enteritis necroticans (C strain)

Control: debridement + penicillin, clindamycin or metronidazole

C. septicum (myonecrosis, neutropenic colitis)

C. novyi, Csordellii, C. histolyticum (myonecrosis)

C. difficile

Gram+rods, strict anaerobes, spores, soil inhabitant;

Virulence: human reservoir, survival of spores in hospitals, adhesins, enterotoxin (toxin A); cytotoxin (toxin B)

Infections: self limiting diarrhea, pseudomembranous enterocolitis (antibiotic assoc/non-assoc)

Control: Vancomycin or metronidazole

Gram+rods, strict anaerobes, spores, soil inhabitant

very oxygen sensitive, motile

Virulence: traumatic entry of endospores, tetanolysin (hemolysin), tetanospasmin (neurotoxin)

Infections: tetanus (spastic paralysis); generalized, localized, cephalic, neonatal

Control: vaccine, would management, TIG, Td, penicillin or metronidazole

Gram+rods, strict anaerobes, spores, soil inhabitant

motile, very resistant endospores

Virulence: strain classification: group 1 (proteolytic, neurotoxins A,B, or F), group II (non-proteolytic, toxins B,E, or F)

Infections: food, wound, infant botulism

Control: anti-toxin (A,B,E), penicillin or metronidazole

Gram+pleomorphic bacillus, aerobe, black colonies on tellurite agar

Virulence: human reservoir, transmit by respiratory droplets; diphtheria toxin (ADP-ribosylates EF2 and inhibits protein synthesis)

Infections: signs and symptoms related to toxin (myocarditis, neuritis); cutaneous and pharyngeal

Control: vaccine (DPT, Tdap); anti-toxin (only from CDC) + penicillin, macrolide, or tetracycline

enterobacter; lactose fermented

Virulence: animal and human reservoir; transmit by contaminated food/water, direct contact, fecal-oral; adhesins, type III secretion, quorum sensing, cytotoxins, LPS, enterotoxins, capsule/biofilm

Infections: GIT/non-GIT

Control: avoid contaminated food/water/animals; symptomatic, TMP-SMX, quinolone, azithromycin or rifaxmin (no antibiotics for EHEC)

UTI (adhesins, cytotoxin, LPS; TMP-SMX, floroquinolone, azithromycin

Pneumonia (LPS; 3rd gen ceph.+aminoglycoside)

Sepsis (LPS; 3rd gen ceph+aminoglycoside)

Meningitis (neonatal; LPS, K1 strains; 3rd gen ceph+aminoglycoside)

EPEC (bundle-forming pili, type 3 secretion, intimin-mediated attachment; loss of microvilli in sm intestine/ absorption inhibited; infant diarrhea)

ETEC (adhere to sm intestine via pili, secret HL toxin +/or HS enterotoxins; fluid and electrolyte loss; traveler's diarrhea)

EIEC (attaches and invades lg intestine; absorption inhibited; inflammatory diarrhea that is watery to bloody; adult infection)

EHEC (adheres to lg intestine epithelial cells via pili; spreads cell to cell via actin tails; secrete Shiga-like toxins I & II; absorption inhibited; watery diarrhea; O157:H7 & SLT-II causes hemolytic uremic syndrome)

EAggEC/EAEC (adheres in stacked-brick pattern known as the aggregative adherence, non-inflam diarrhea)

Enterobacter; non-motile; capsule

Virulence: animal reservoir; transmit by aerosol; LPS, capsule

Infections: lobar pneumonia; UTI, sepsis, meningitis

Control: 3rd gen ceph+aminoglycoside

Other species: K. Oxytoca, pneumoniae spp ozaenae, pneumoniae spp rhinoscleromatis

Enterobacter; swarming motility; urease pos, H2S produced

Virulence: animal reservoir; transmit by direct contact; LPS, motility, urease

Infections: UTI, stones (in compromised: pneumonia and sepsis)

Control: 3rd gen ceph + aminoglycoside for life-threatening infections; quinolone, ampicillin, or amoxicillin for UTI

Shigella sonnei

other species: S. dysenteriae, flexneri, boydii)

enterobacter; non-motile, no lactose fermentation, no H2S produced

Virulence: human reservoir; transmit by direct contact, perrson-to-person, food or water; adherence, LPS, type III secretion, intracellular growth; Shiga toxin actin tails mediate cell to cell spread

Infections: inflammatory diarrhea that is watery or classic dysentery

Control: avoid contaminated food/water; quinolone, TMP-SMX, or rifaximin

Salmonella enterica

(serotypes choleraesuis, paratyphi, enteritidis, typhimurium, newport, heidelberg)

enterobacter; motile, no lactose ferm; produces H2S;

Virulence: human (typhi and paratyphi) and numerous animal reservoirs; transmit by direct contact, person to person, food or water; adherence, LPS, type III secretion; intracellular growth, actin rearrangement

Infections: typhoid fever, inflammatory diarrhea that is watery and mucoid; sepsis

Control: vaccine for typoid fever; avoid contaminated food/water; quinolone or TMP-SMX for GIT, ceftriaxone or chloramphemicol for sepsi

Enterobacter, Serratia, Citrobacter

Infections: nosocomial UTI & sepsis in immunocompromised

Increased AB resistance from R-plasmid spread within whole family

Gram-, pleomorphic coccobacillus, aerobe, catalase +, oxidase-, requires cysteine for growth, capsule

Virulence: many animal reservoirs (esp rabbits); transmit via ticks, biting flies, direct, ingestion, or inhalation; LPS, capsule, fac. intracellular pathogen; very infectious

Infections: (zoonosis) ulceroglandular, glandular, oculoglandular, pharyngeal, typhoidal, pneumonic

Control: avoid infected animals; doxycycline, quinolone or gentamicin

Gram- coccobacilli, fac anaerobe, catalase +

requires hematin (X factor) & NAD or NADP (V factor) for growth, capsule (a-f)

Virulence: human reservoir, aerosol transmission; LOS, capsule, OM proteins (adherence, invasion, intracellular growth), sol PG, IgA peptidase

Infections: pharyngitis, sinusitis, pneumonia, bronchitis, otitis media, conjunctivitis, epiglottis, sepsis, meningitis (rare w/ vaccine)

Control: vaccine; cefuroxime, ceftriaxone, amox for non-life threatening; rifampin prophylaxis

non-typable/unencapsulated H. influenzae (assoc with otitis media, pneumonia, sinusitis, neonatal & post partum sepsis; treat with macrolide, TMP-SMX, quinolone)

H. aphrophilus (assoc w endocarditis; treat w macrolide or quinolone)

H. ducreyi (STD; chancroid, treat w macrolide)

Gram- spiral rod, microaerophilic, motile at 37C, urease, oxidase and catalase+

Virulence: human reservoir; transmit via fecal/oral or direct contact; LPS, urease, acid inhibitory protein, motility, mucinase, cytotoxin, adhesins (hemagglutin, sialic acid-binding protein, Lewis blood group adhesin)

Infections: chronic gastritis leading to peptic ulcers; predisposes to carcinoma

Control: macrolide or tetracycline+metronidazole+ bismuth subsalicylate+proton pump inhibitor

Characteristics: gram neg rod, aerobe, catalase pos, oxidase neg, hydrolyzes hippurate, motile, fastidious

(requires high cysteine and iron levels), facultative psychro-thermophile

Virulence factors: aquatic environment the natural reservoir (parasitizes amoebas and ciliated

protozoans); transmission by aerosols (point-source); LPS (OM blebs), type II & IV secretion,

intracellular growth (internalized by coiling phagocytosis), pili, Th1 response needed

Infections: Pontiac fever (high attack rate, self limiting febrile disease), Legionnaires’ disease (low

attack rate, predisposing condition, bronchopneumonia with dry cough that becomes productive; GIT,

CNS, and kidneys may be involved)

Control: macrolide, quinolone, or doxycycline

Characteristics: gram-negative tightly coiled spirochete, hook shaped at one or both ends; motile, aerobe

Virulence factors: many animals are reservoirs; usually transmitted to humans by direct contact with

contaminated water; LPS, invasive, intracellular growth

Infections: anicteric leptospirosis (mild syndrome to systemic disease involving aseptic meningitis);

icteric leptospirosis (Weil’s disease) with liver and kidney failure and vascular collapse

Control: macrolide, doxycycline, or ceftriaxone

Characteristics: gram + bacillus, fac anaerobe, catalase pos, oxidase neg, fac psychrophile, hydrolyzes esculin, motile at room temp

Virulence factors: zoonotic, widespread in nature, many foods contaminated; transmitted by ingestion,

transplacental (in utero), vaginal; facultative intracellular pathogen (Th1 needed to recover),

lysteriolysin, internalin, actin tails, Act A

Infections: pregnancy (sepsis, infection of fetus), neonatal (early and late onset diseases), adults

(meningitis and sepsis most important; also gastroenteritis)

Control: avoid processed meats; sulfameth-trimeth prophylaxis; treat with beta-lactam or betalactam+

aminoglycoside

Pasteurella multocida

Characteristics: gram neg diplococcus, aerobe, oxidase pos, catalase pos, grows on most media (not

fastidious)

Virulence factors: human reservoir (5-50% colonization); aerosol transmission; LOS (no somatic Opolysacch),

adhesins (pili and OM proteins),

Infections: important cause of otitis media, sinusitis, bronchitis, pneumonia

Control: cefaclor, marcrolides, quinolones, trimeth-sulfameth

Characteristics: gram neg rod

Infections: cat scratch disease; bacillary angiomatosis in immunocompromised

Control: rifampin, quinolone, or azithromycin

(gram-positive cytology with high glycolipid [mycolic acids,

arabinogalactan, lipoarabinomannan] content in cell wall responsible for acid-fast staining,

proinflammatory activities, and resistance to detergents and disinfectants; most slow growing and form

serpentine cords; aerobic)

Characteristics: produces niacin

Virulence factors: human reservoir; aerosol transmission (prolonged contact needed); facultative

intracellular pathogen (Th1 needed to control infection but also responsible for tissue damage); wall

gycolipids promote resistance to intracellular killing, inhibit interferon-activation of macrophages,

grows in the cytoplasm, and stimulate cell-mediated inflammatory injury

Infections: Primary TB (first exposure), Secondary TB (reactivation), Progressive primary and

secondary TB, and Miliary TB (disseminated disease involving the bone marrow, nodes, CNS, etc);

infection converts to PPD+

Control: vaccine (limited use in USA); rifampin, isoniazid, pyrazinamide, ethambutol first-line drugs

M. bovis causes similar disease. It doesn’t produce niacin and many animals serve as reservoirs;

transmission by ingestion.

Characteristics: intracellular bacterium (no growth on lab media)

Virulence factors: human and armadillo reservoirs; transmission by nasal secretions; intracellular

pathogen (Th1 needed but also mediates tissue damage), proinflammatory wall, phenolic glycolipid

capsule, phenolase

Infections: Hansen’s disease (leprosy): chronic disease of skin, peripheral nerves, & URT; tuberculoid

(paucibacillary), borderline, lepromatous (multibacillary); infection converts to lepromin+

Control: dapsone + rifampin

M. kansasii, M. marinum, M. scrofulaceum, M. ulcerans, M. fortuitum, M. avium, intracellulare

(no cell wall results in pleomorphic morphology; have

sterols in plasma membrane and require exogenous sterols for growth; smallest free-living procaryotes;

all extracellular pathogens; membrane induces inflammation)

Characteristics: prefers anaerobic growth

Virulence factors: human reservoir; transmission by direct contact

Infections: urethritis (prominent cause of NGU in men and women), cervicitis, and PID

Control: doxycycline or quinolone

Characteristics: aerobic

Virulence factors: human reservoir; transmission by aerosols; adheres to cilitated epithelial cells (kills

2O2), induces cytokines (IL-1, 6 & TNF) and inflammatory infiltrate

Infections: pneumonia, tracheobronchitis, pharyngitis, otitis, Stevens-Johnson syndrome

Control: doxycycline or azithromycin

(gram-negative, oxidase-positive diplococci; fastidious, requires extra CO

2;

poor survival on environmental surfaces; human reservoir; high turnover of envelope components (LOS

Virulence factors: aerosol transmission; LOS (blebs, no somatic O-polysacch), capsule (12 serogroups

with B, C, and Y most common; A associated with epidemics), adhesins (OM proteins & pili), sol PG,

IgA peptidase

Infections: sepsis, meningitis, Waterhouse-Friderichsen syndrome

Control: Vaccine; penicillin, chloramphenicol, or ceftriaxone

Virulence factors: sexual transmission (neonatal infection in utero or during birth); LOS (blebs, no

somatic O-polysacch), adhesins (OM proteins [Por mediates complement resistance and intracellular

survival, Opa associated with attachment] pili [pili antiphagocytic]), sol PG, beta-lactamase, IgA

peptidase

Infections: urethritis in men, urethritis and cervicitis in women (~30% symptomatic); PID, disseminated

gonococcal infection (arthritis w/ or w/o skin lesions), gonococcal opthalmia

infection suspected

Characteristics: gram negative rod, aerobic (anaerobic with nitrate), motile, oxidase & catalase pos, nonfermenter,

wide temp range, nutritionally versatile, fluorescein pigment (pyocyanin) produced by most

Virulence factors: many environmental reservoirs (including hospitals); transmission by direct contact,

food, water; LPS, pili, capsule or biofilm, proteases, cytotoxin, heat stable and labile hemolysins,

exotoxin A, exoenzyme (exotoxin) S, Type III secretion, quorum sensing, antibiotic resistance

Infections: mostly opportunistic and nosocomial; endocarditis, respiratory tract infections, pneumonia in

cystic fibrosis, sepsis (ecthyma gangrenosum), meningitis, otitis, keratitis, bone and joint infections,

UTI, skin (burn infections, generalized folliculitis)

Control: aminoglycoside + anti-Pseudomonas beta-lactam

Infections: (colonizes many moist environments) nosocomial pneumonia, sepsis, and soft tissue

infections

Infections: RT infections in cystic fibrosis, catheter-associated UTI & sepsis

Control: trimeth-sulfmeth

Infections: nosocomial sepsis, meningitis, UTI, wound infections

Control: trimeth-sulfmeth

Characteristics: gram neg coccobacilli, strict intracellular pathogen, grows in cytoplasm of host cells,

utilizes host ATP, NAD, and intermediates

Virulence factors: animal reservoir; transmission by hard ticks (wood or dog; tick progeny infected);

strict intracellular pathogen, weak endotoxin, phospholipase A destroys host membranes, actin tails

mediate cell to cell spread

Infections: RMSF (vasculitis, rash)

Control: avoid tick contact; doxycycline or chloramphenicol

Characteristics: gram negative cytology, no peptidoglycan or LPS, intracellular pathogen (grows in

phagosome=morula), life cycle involves reticulate and elementary - like bodies

Virulence factors: animal reservoir; transmission by tick; strict intracellular pathogen of monocytes;

immune response (gamma-interferon and activation of macrophages) associated with pathology

Infections: human monocytic ehrlichiosis

Control: avoid tick contact; doxycycline

Characteristics: similar to Ehrlichia

Virulence factors: animal reservoir; transmission by tick; strict intracellular pathogen of myeloid

precursors (neutrophils); pathogenesis related to immune response

Infections: human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis)

Control: avoid tick contact; doxycycline

Characteristics: gram negative pleomorphic bacillus that produces resistant endospore-like structures;

obligate intracellular pathogen

Virulence factors: animal reservoir; transmission by tick to animals, to humans by inhalation or

ingestion; strict intracellular pathogen of reticuloendothelial cells; antigenic variation of LPS during

infection

Infections: Q-fever (acute febrile disease, atypical pneumonia most common; chronic with subacute

endocarditis, hepatitis, CNS, and/or pulmonary involvement)

(gram-positive cocci that grow in clusters; facultative anaerobes,

catalase positive, salt-tolerant)

Characteristics: coagulase positive, ferments mannitol

Virulence factors: human reservoir (carriers); transmission by direct contact; capsule and biofilm,

quorum sensing; alpha, beta, delta, gamma-toxins; leukocidin (panton-Valentine); enterotoxins (super

antigens), pyrogenic exotoxins (TSST-1), exfoliatins (super antigens), facultative intracellular parasite,

proinflammatory cell wall components (induces IL1, TNF alpha), beta-lactamases, cell wall-bound

adhesion molecules (fibrinogen, collagen, & fibronectin-binding proteins), Protein A, extracellular

hydrolases

Infections: folliculitis, furuncle, carbuncle, cellulitis, impetigo, scalded skin syndrome, sepsis,

endocarditis, pneumonia, osteomyelitis, septic arthritis, purulent meningitis, food poisoning, toxic shock

Control: hand washing; mupirocin, clindamycin for MRSA, beta-lactam (e.g. oxacillin, nafcillin) w/ or

w/o aminoglycoside, or vancomycin;

Characteristics: coagulase negative

Virulence factors: human reservoir, commensal and pathogenic strains; transmission by direct contact;

biofilm, quorum sensing, proinflammatory cell wall components (induces IL1, TNF alpha), alpha and

delta toxins, beta-lactamases

Infections: neonatal bacteremia, nosocomial bacteremia, prosthetic devise infection, surgical infections,

infections associated with peritoneal dialysis, urinary tract infection

Control: hand washing; beta-lactams, vancomycin+rifampin or gentamicin

Characteristics: resistant to novobiocin, coagulase negative

Virulence factors: human reservoir; transmission by direct contact; specific adherence to urinary tract

epithelial cells; proinflammatory cell wall components

Infections: community-acquired UTI (mostly women)

Control: trimeth-sulfmeth, quinolone, amox+clavulanic acid

(gram-positive cocci occurring in pairs and/or chains;

facultative anaerobes; ferment lactic acid; catalase negative; alpha, beta, or gamma-hemolysis)

Characteristics: grows in chains, Group A carbohydrate, beta-hemolytic, sensitive to bacitracin

Virulence factors: human reservoir; transmission by aerosols, food, water and direct contact;

M-proteins, fimbriae, proinflammatory cell wall components, hyaluronic acid capsule, Streptolysin O &

S, Streptococcal pyrogenic exotoxins (super antigens), intracellular invasion, adhesins (LTA, Protein F,

fibrinogen binding protein, collagen binding protein, plasmin binding protein), C5a peptidase

Infections: pharyngitis, scarlet fever, streptococcal toxic shock syndrome, impetigo, cellulitis, erysipela,

necrotizing fasciitis, puerperal sepsis, rheumatic fever (antigenic mimicry), postinfectious

glomerulonephritis

Control: penicillin, macrolide, penicillin+clindamycin for invasive disease

Characteristics: grows in chains, Group B carb, weakly beta-hemolytic or gamma hemolytic, hydrolyzes

hippurate, posituve CAMP test

Virulence factors: human reservoir; transmitted by direct contact, person to person, transplacental;

proinflammatory wall components, capsule, intracellular invasion, C5a peptidase

Infections: neonatal infections (early and late onset); adult infections (sepsis, meningitis, respiratory and

urinary tracts)

Control: hand washing, hospital control policies; penicillin, vancomycin, penicillin or

S. mutans, mitis, sanguis

Characteristics: Group D carb

Virulence factors: animal reservoir or endogenous source (GIT); transmitted by contaminated food or

water; proinflammatory wall components

Infections: endocarditis, bacteremia (assoc. with GI malignancy)

Control: penicillin

Characteristics: grows in pairs, optochin sensitive, large capsule

Virulence factors: human reservoir; transmitted by aerosols or endogenous; capsule, proinflammatory

wall components, adhesins (capsule, choline-binding protein, neuraminidase), pneumococcal surface

protein A & C, autolysin, pneomolysin O, hyaluronate lyase, antibiotic resistance

Infections: pneumonia, otitis media, meningitis, sinusitis

Control: Vaccines (adult & child); CAP: macrolide, quinolone (e.g. gemifloxacin, moxafloxacin),

ceftriaxone, cefotaxime; OM, sinusitis: amox+clav; Invasive disease: vanco+ceftriaxone or cefotaxime

Characteristics: grows in chains, Group D carbohydrate, hydrolyze esculin, tolerates high salt and bile

concentrations

Virulence factors: endogenous (GIT & vagina) or nosocomial source; transmitted by direct contact or

person to person; proinflammatory wall components, adhesins, cytolysin (bacteriocin), antibiotic

resistance

Infections: catheter-associated UTI, sepsis, endocarditis

Control: hand washing, vancomycin, vanco + aminoglyside, quinupristin/dalfopristin, linezolid,

Characteristics: thin gram negative spirochete (special microscopy needed to observe), microaerophilic,

motile, no growth on lab media, cardiolipin in OM

Virulence factors: human reservoir; sexual transmission; highly invasive, intracellular growth,

hyaluronidase, OM proteins associated with adherence, fibronectin coats outer membrane (antiphagocytic);

tissue damage associated with immune/inflammatory response

Infections: Syphilis (primary, secondary, latent, tertiary, congenital)

Control: penicillin or doxycycline

(curved gram-negative bacilli, inhabit marine environments, motile by single

polar flagellum, facultative anaerobes, oxidase positive)

Characteristics: killed by stomach acid; only seotypes O1 and O139 are associated with cholera

Virulence factors: transmission by food or water; pili, cholera toxin (increases intracellular cAMP)

Infections: noninflammatory watery diarrhea (potentially life threatening)

Control: avoid contaminated food/water; tetracycline or erythromycin; rehydration

Characteristics: halophilic

Virulence factors: transmission by food or water; LPS, pili, cytotoxin/hemolysin (has enterotoxin

activity)

Infections: noninflammatory watery diarrhea to inflammatory dysentery-like gastroenteritis

Control: avoid raw or undercooked seafood; doxycycline or ciprofloxacin

Characteristics: halophilic

Virulence factors: transmission by food or water; LPS, pili, proteases, cytotoxin, antiphagocytic capsule

(resistance to complement)

Infections: wound infections (rapidly progressive cellulitis), invasive gastroenteritis, sepsis

Control: avoid raw or undercooked seafood; doxycycline or ciprofloxacin

(zoonotic, gram negative coccobacilli, facultative anaerobes; common virulence

factors: LPS, facultative intracellular parasite, type III secretion, yadA gene products (adhesins and antiphagocytic proteins), yop/lcr gene products (OM proteins, toxic secreted proteins), V and W antigens

(intracellular growth))

Characteristics: bipolar staining, capsule (fraction 1 antigen)

Virulence factors: animal reservoir; transmission by flea bite or aerosols; antiphagocytic capsule

(fraction 1 Ag)

Infections: bubonic, pneumonic, septicemic plague

Control: vaccine; gentamycin or doxycycline