Professional Documents
Culture Documents
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Staphylococcus:gram+cocci,grapelikeclusters,catalase+,faculatativelyanaerobic,S.aureus coagulase+,
Streptococcus:gram+cocci,chainsorpairs,allcatalase,mostarefacultativeanaerobes
coagulase+
S.Aureus
Staphylococcus Catalase+
Staphylococcalscaledskinsyndrome(SSSSRitter ds)/bullousimpetigo:exfoliativetoxin(ETAheatstable andchromosomal,ETBheatlabileandplasmid),serine Cytotoxins: proteasessplitsdesomosomesthatholdstratum :disruptssmoothmuscleinblood granulosumepidermis(toxinmediatesonostaphorPMNs vesselsandistoxictoRBCs,WBCs, ProteinA:bindstoFcreceptorof attissuelevel),noscarformation,children,onsetwith hepatocytes,plts;importantcauseof goldpigment(atroomtemp) IgG1/2/4thereforeblockingantibody perioralerythema. sx. mediatedimmuneresponse coagulase+, Foodpoisoning:enterotoxinA(mcfoodpoisoning),B :(sphingomyelinaseC)hasspecificitiy mannitolsaltagar(halophiles), Coagulase:allowsfibrinformation (staphpseudomembranouscolitis),C/D(milkproducts) forsphingomyelinand aroundorganism(clumpsorganism) hemolytic(2*totoxin), resistanttogastricacidandjejunalenzymes,stableto lysophosphotidylcholine,killsRBCs, nutritionallyenrichedsheep Catalase:removalofH2O2 heating100Cx30mins,actsassuperantigen,severe fibroblasts,WBCs,macrophages;lyses N/V/nonbloodydiarrhea/abdpain;processed(salted bloodagar, Pencillinase: hydrolyzespcn cellmembranes. meats),custard,potatosalad,icecream,rapidonset<4hr, Staphylokinase:dissolvesfibrinclots :hasSlow&Fastelutingproteins,lyse rapidcourse<24h neutrophilsandmacrophages;caues Toxicshocksyndrome:TSST1(formensturatingFand poreformationthereforelyses enterotoxinBfornonmesturatingFandM),superatigen, death2*hypovolemicshockandmultiorganfailure,diffuse maculareryrash,fever,hypotensive
Disease2*directorganinvasion (infectious): commoninnasopharynx,doesnot capsule:PNA,empyema requireanimalcontact coagulase:impetigo,folliculitis, Neonates:colonizationofthe furncules,carbuncles umbilicalstump,skin,andperineal adhesion:endocarditis areaisalsocommon other:meninigits,bacteremia,osteomyelitis Sheddingofbacteriacauses (Brodieabscess),septicarthritis infectiontospread MecA:codesforNPBP2'willnotbindto NOTE:staphylococciare PCNbutstillfunctional;locatedon susceptibletohightemp., staphylococcalcassettechromosomemec disinfectants,andantiseptics,but (SCCMEC)responsibleforhospital cansurviveondrysurfacesforlong acquiredMRSA periodsoftime canacquireSSSfromcutting umbilicus Note:bloodculturesnegativeintoxin mediatedillnesses! Abxnotcurative,willkillbacteriabutnot exotoxins
Novobiocinsensitive S.Epidermidis
Novobiocinresistant S.Saprohyticus
Family Gram+cocci
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Staphylococcus:gram+cocci,grapelikeclusters,catalase+,faculatativelyanaerobic,S.aureus coagulase+,
Streptococcus:gram+cocci,chainsorpairs,allcatalase,mostarefacultativeanaerobes
S.Pyogens
hemolytic BBRAS
PyrogenicexotoxinStreptocococcal pyrogenicexotoxin(Spes):causes Suppurative: Scarletfeverrash,necrotizingfascitis, pharyngitis, Mprotein:responsiblefor streptococcalTSS;producedby 1)adhesion, scarletfever;("sandpaperrash,strawberrytongue,"desaq lysogenicstrains,actsassuperantigen. ofhandsandfeet) 2)mediatinginternalizationbyhost GroupA;bacitracinsensitive; cell;bindstheserumglobulinfactor Streptokinase:A/Bcleavesfibrinand pyoderma, fibrinogen=lysisofclotsandfibrin microaerophilic; erysipelas, H,whichisregulatoryproteinfor deposits;resultsinrapidspreadof PYRpositive; cellulitis, alternativecomplementpathway inhibitedbyelevatedglucose degradesC3bandinhibitsphagocytosis S.pyogens necrotizingfascitis, DNase:reduceviscosityofabscess antiDnases streptococcaltoxicshock (needtomakeantibodiesagainstM materialandfaciliatesspreadof protein),fibrinogenalsobindstoM orgaism NonSuppurative(antibodymediated): protein C5apepitdase:inactivatesC5awhich RFs/ppharyngitis pili mediatesinflammation acuteglomerulonephritiss/pskin/pharyngitis StreptolysinO/S:destroyRBCandWBC, Oisantigenic
ASOtesttestsantibodiesagainst streptolysinO(oxygenlabilehemolysin), documentsrecentgroupAstrepinfection, normallylivesonskin,soskin samplesneedPMNstobepositive forRFandAG,willbenegativeinptswith skininfections pharyngitisP2Pviaresp Anteriortotonsils,normalflorainhibitS. skintraumainoculatesbacteriain pyogens sodon'tcontaminateswab skin AntiDNasesmarkersforskininfections(b/c ASOnegative); AntiDNABfor?glomerulonephiritis
S.agalactiae
StreptococcusCatalase
Earlyonsetneonatalds(acquiredinuteroorbirthcanal): onset<7dold,bactermia,pna,meningitis(CSFtesting) Lateonsetneonatalds (acquiredfrommomorotherbaby): colonizelowerGIand onset1wk3m,bacteremiawithmeningitis genitourinarytract;transient PregnantF:postpartumendometritis,woundinfection, vaginalcarriagein1030%ofF UTIss/ppreg MenandnonpregF(withunderlyingconditions): bactermia,pna,bone/jtinfections,skin/STinfections
polysaccharidecapsule
S.viridans
secretoryIgAproteaseblocks usuallyhaveantecedentviralillnessorotherconditionthat secretoryIgAwhichnormallybindsto interfereswithbacterialclearance; bacteriaandtomucinatFcregion MCC: trappingbacteriainmucus, normallylivesinoropharynx adults:pna(aspiration),bacterialmeningitis; Pneumolysinbindstocholesterolin respiratorydroplets children:otitismedia hostcellmembraneandcreatespores asplenicpatientsathigherrisk,alsocausesbacterial thatdestroyciliatedepithelialcellsand sinusitis phagocyticcells,stopsphagocyticcell oxidativeburst S.mutans:dentalcariesandbacteremia S.viridans:subacutebacterialendocarditis colonizeoropharynx,GItract,GU tract,rarelyonskin(fattyacidsare S.angionosus:deepabscessformation S.bovis:GImalignancies(invadesbloodstreamthroughGI toxictothem) lesions)
ManyPCNresistantstrains
GroupD//non/ rarely
enterococcus facealis
Family Gram+rods
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
B.anthracis
Nonmotile,encapsulated
Bacillus catalase+
Cutaneous:inoculationfrominfectedanimals,20%death, pXO1 painlesspurpleulcersurroundedbyvesiclesnecrotic EdemaFactor(EF);activeAsubunit; eschar calmodulindependentadenylate Gastrointestinal: pXO2 cyclase,cAMP Upper:ulcersinmouth/esophaguswithregional Capulse:inhibitsphagocytosisof LethalFactor(LF):zincmetalloprotease, lymphadenopathy,edema,sepsis; replicatingcells**onlybacteriawith inactivatesproteinkinase,stimulates Lower:N/V/malaiseprogressestosystemicsx,upto100% capsulemadeofprotein(polyD macrophagetoreleaseTNFandIN1 death glutamicacid) =death Inhalation:prolongedlatentperiod(>2months),initial: Protectiveantigen(PA):activeB nonspecificfever,myalgias,drycough,malaisefollowedby subunit,mostimmunogenic,bothEF rapidonsetofsepsis;alveolarmacrophagesingestinhaled andLFrequirePA,bindstocellandhas sporesandtraveltomediastinallymphnodes(widened threecompetitivebindingsites mediastinum)
Epidemiology:anthraxisdsof herbivores,formsresilientspores, contaminatedsoilsoranimal productscanbeinfectiousfor years;nopersontopersoncontact (becausereplicationisin mediastinallymphnodesandno bronchopulmonarytree) 1.Skin:95%ofhumancases inoculationofsporesthrough exposedskinfromcontaminated soilorinfectedanimalproducts 2.GIingestion(MCroutefor herbivores) 3.inhalation:uncommon,unless bioterrorism
B.cereus
Motile,lackscapsule
Enterotoxin: heatstable,proteloysisresistant:MOA unclear,B.cereusmultipliesinleftout riceandformsheatstabletoxinthatis resistanttoreheating heatlabile:stimulatesadenylate cyclase,cAMP,profusewatery diarrhea(similartoe.coliandvibrio) Oculartoxins: necrotictoxin(heatlabile) cereolysin(hemolysin) phospholipaseC(lecithinase)
Foodpoisoning: Emeticform:heatstableenterotoxin,reheatedrice,onset <6h Diarrhealform:heatlabiletoxin,haslongerincubation becauseactuallyinfectedwithB.cereus(>6hrs) Ocularinfection:s/ppenetratingeyeinjurywithsoil contaminatedFB,rapiddestructionofeye Other: IVcatheterrelatedsepsis Severepna(rareanthraxlike)
C.perfringens SporeForming
Nonmotile
softtissueinfection:cellulitis,suppurative,myositis, myonecrosisgasgangrene foodpoisoning enteritis septicemia botulinum:toxinresultsinflaccidparalysis(blocksAch releaseatNMJ) A/Btoxin:A:zincendopepitdasewhich adult(foodborne):ingestionofpreformedneurotoxin; inactivatesproteinsthatregulateAch diplopia,drymouth,constipation,abdpain,dizziness,b/l release;similartotetanusbutstaysat weaknessandflaccidparalysis NMJ,irreversible,protectedbynontoxic infant"floppybaby":ingestionofsporesinhoney wound:similartoonestasfoodbornebutlessGIsxand proteinsduringGIpassage longerincubation inhalation:rapidonsetandhighmortalitiy
C.botulinum
Motile
C.Septicum ;gasgangrene,septicemia
C.tetani
Motile
C.difficle
Motile
Enterotoxin(toxinA):chemotacticfor neutrophilsstimulatinginfiltrationof PMNsintoileumwithreleaseof cytokines;cytopathiceffect:resultingin antibitoicassociateddiarrhea:510days/pabxtx Surfacelayerproteins(SLPs):binding disruptionoftightcellcelljxn, pseudomembranouscolitis:profusediarrheaabd permeabilityofintes nalwall ofC.difftoepithelium cramping,fever,whitishplaquesoverintactcolonictissue resultingindiarrhea Cytotoxin(toxinB):causesactinto depolymerizeresultingindestructionof cellularcytoskeleton
Family Gram+rods
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Primarysource:soilanddecaying vegetablematter;contaminated Earlyonsetdisease(granulomatosisinfantiseptica): milk,softcheese(goatcheese), acquiredtransplacentallyinutero,disseminatedabscesses undercookedmeat(turkeyfranks, andgranulomasinmultipleorgans;highmortalityrateif coldcuts,microwavedbeef), nottreated unwashedrawveggies,cabbage; Lateonsetdisease:acquiredatorshortlyafterbirth(23 cangrowinwidepHrangeand weeks);presentsasmeningitisormeningoencephalitiswith coldtemps(cangrowduring septicemia prolongedrefrigation);15%of peoplearefecalcarriers
Erysipelothrix rhospathrae
Catalase+aerobic
faculativeanaerobe
Occupational:mostlyonwildand domesticanimals:butchers,meat processors,farmers,poultry workers,fishhandlers,vets; Cutaneousinfectionsdevelopafter organismisinoculated subcutaenouslythroughand abrasionorpuncturewound duringhandlingofcontaminated animalproductsorsoil
Nonsporeforming pleomorphicrod, cysteinetelluritebloodagar Cornyebacterium (characteristicgraytoblack diptheriae color), Tinsdale colistinnalidixicagar(CNA), PCR(testsfortoxgene)
diphtheriatoxin:(exotoxin)produced atsiteofinfectionandspreads;tox Respiratorydiphtheria:24dayincubationperiod, geneintroducedvialysogenic organismsmultiplylocallyinpharynxandcauselocalized bacteriophage damage2*toexotoxin;suddenonsetofmalaise,sore A/Bsubunits:B:bindstoheparin bindingepidermalgrowthfactor(MCon throat,exudativepharyngitis,lowgradefever pseudomembrane:composedofbacteria,lymphocytes, heartandnervecells);A:catalytic regionterminatesproteinsynthesisby plasmacells,fibrin,deadcells,*bleedswhenremoved inactivatingelongationfactor2(EF2) recoveryinoneweek Diptheriatoxinrepressor(DTxR):binds sequelea:myocarditis,neurotoxicity toandpreventstoxinproductionin presenceofhighiron
Nocardia
pulmonarynocardia
Actinomyces Anerobic,filamentous
commonlycausestransient,insignificant bacteremiafromoropharynxorGItract
Family
Organism Gramdiplococci
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Hasoutermembrane,LPS:LipidAisendotoxincomponentthatcausesfeverandshock,polysaccharide,Oantigenisimportantsurfaceantigen;periplasmicspacesiteoflactamases
Maltoseandglucose oxidizer
N.meningitis
capsule:antiphagocytic(calssifiedinto serogroupsbasedondifferent capsules) LOS:causeshemorrhage,sepsis,and encapsulated, petechiae,andTNF(lacksOantigen) maltoseandglucoseoxidizer, releasesmembraneblebs nonmotile IgA1protease:cleavesIgAinhalf intracellulardiplococci, Pili:allowsattachmenttohuman oxidase+, nasopharyngealcells,undergoes catalase+, antigenicvariationtoavoidimmune chocolateagarorThayer system;pilinsmediateattachmentto MartinVCN, nonciliatedepithelialcells,interfers keepmoistandwarm withneutrophilkilling;lackof immunitytoreinfection2*toantigenic variation. PorAandPorB:antigenicvariation; porinproteinsthatallowsfornutrients inandwastesout nasopharyngealcells,undergoes antigenicvariationtoavoidimmune system;pilinsmediateattachmentto nonciliatedepithelialcells,interfers withneutrophilkilling;lackof immunitytoreinfection2*toantigenic variation. IgA1protease:cleavesIgAinhalf LOS:causeshemorrhage,sepsis,and petechiae,andTNF(lacksOantigen) releasesmembraneblebs PorB:promotesinvasioninto epithelialcells;interfereswith degranulationofneutrophils;resistant tocomplementmediatedserumkilling Opaprotein:(opaticyproteins) membraneproteinsthatmediatefirm bindingtoepithelialandphagocytic cells;integraltocelltocellsignaling, appearopaquewheninculture (opaqueinlocalizeddiseases& transparentinPIDordisseminatedds) Rmpproteins(reductionmodifable proteins):stimulateantibodiesthat blockserumbactericidalactivity receptorsfortransferrin/lactoferrin/ hemoglobin
N.gonorrhoea Glucoseonlyoxidizer
Family Grambacilli
Organism
Physiology/Metabolism/Dx ENTERICS
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Escherichiacoli Indole+
Lactosefermenter
LipidA(LPS) Capsule(Kantigen):protectsfrom facultativeanaerobic, phagocytosis glucoseandlactose TypeIIIsecretionsystems:facilitates fermenting, secretionofbacterialvirulencefactors hemolytic siderophores:ironchelating oxidasenegative, compounds catalasepositive, Oantigen:extpartofLPS indole+, Hantigen:flagella motile P.Pili:adhesinsthatallowsE.coli to greenmetallicsheenonEMB, remaininurinary/GItract;Ppili=P lightpurpleonMacConkey) bloodgroupantigens Other:frimbriae,bundleformingpili, Serology:OandHantigens intimin,Ipaprotein,Drfrimbriae
ETEC(enterotoxigenicE.coli) Colonizationfactorantigens
Traveler'sDiarrhea:smallintestine,watery(secretory) diarrhea("ricewater"), N/V/cramps,lowgradetonofever; hypersecretionoffliudsandelectrolytes fecaloral,infantdiarrheaindev Heatlabiletoxin(LT):plasmidmediated;similartocholera countries toxinincreasewaterandNaClsecretion);(cAMP) Heatstabiletoxin(ST):similartoY.enterocoliticatoxin( cGMP),decreasesNaClabsorption
EHEC(enterohemorrhagicE.coli) bundleformingpili,intimin
EIEC(enteroinvasiveE.coli) invasiveplasmidantigen
adheretocolonicepitheliuminvademucosallayerand secretes: diseaseindevelopingcountries hemolysinA(HlyA) SLT1andSLT2whichleadstoinflammation,fever,watery diarrheadystenterywithleukocytesinstool Notoxin,waterydiarrheaandvomiting;plasmidmediated persontoperson,PEDS A/Ehistopathologywithdisruptionofnmlmicrovillus majorcauseofinfantdiarrheain impoverishedcountries structuremalabsorptionanddiarrhea lobarpneumonia:andcommunityandnosocomial"currant jelly"sputum,verycommoninalcoholicsanddiabetics hospitalacquiredgramnegative nosocomialUTI(hospitaladministeredabx,urinarytractis rod blockedbystoneorcatheter);sepsis2ndtoe.coli
Indole
Klebsiella pneumoniae
Capsule
Salmonellatyphi
PathogenicitiyislandI:invasion proteinsandtypeIIIsecretionsystems PathogenicitiyislandII:evadeshost immunesystemandtypeIIIsecretion system PathogenicitiyislandII:evadeshost immunesystemandtypeIIIsecretion system Pathogenesis:ingestion,attachedto mucosaandinvadeM(microfold)cells inPeyer'spatchesandenterocytes; remaininendocyticvacuoleand replicate;transportedandreleased intobloodorlymp
Septicemia:bacteremia,increasedriskinpeds,elderly,
andimmunosuppressed; Entericfever(Typhoidfever):leavesintestineinside macrophagestoliver,spleen,andmarrow,1014 incubation;nonspecificsx(GI:constipation;fever,malaise, myalgias,anorexia);persistx1week redmacules(rosespots) Carrierstate:canliveingallbladderforyears! survivesonlyinhumans commoninothercountries(Asia) fecaloral higherriskinasplenicpatients
Zoonotic:infectsbothanimalsand EIEC,shigella,salmonellaenteritidis Gastroenteritis:MCform;sxonset648hours;intialsx: humans Invasionofintestinalepithelialcells:cell N/V/nonbloodydiarrhrea,F,cramps,myalgias,HA;sx acquiredfromreptiles(turtles, penetrationresultsinsystemicimmune persist2daysto1weekwithspontaneousresolution;no snakes),poultry,eggs,anddairy; responsewithbloodydiarrhea+leuks+ abx(prolongscarrierstate);moresusceptiblewithimpaired consumptionofcontaminated fever gastricacidsecretion foodandwater;fecaloral
Family
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Shigllea dysenteriae
TypeIIIsecretionsystem
HumansonlyreservoirforShigella; epidemicsoccurinAfricaand CentralAmerica; Shigellosis:(pedsandMSM);initialwaterydiarrheathat EIEC,shigella,salmonellaenteritidis Endemicdiseaseiscommonin progressestoabdominalcrampsandtenesmusandbloody Invasionofintestinalepithelialcells:cell adultmalehomosexualsandin diarrhea(2*toinflamedcolonandunabletoreabsorb penetrationresultsinsystemicimmune householdcontactsofinfected fluids);fever,abdominalpain, responsewithbloodydiarrhea+leuks+ children Bacterialdysentery fever Persontopersonviafecaloral Neverconsideredpartofnormalflora route requireslessthan200bacteriato causedisease UTIandrenalcalculiStruvitestones(urease+),causes alkalineurine P.Vulgaris
Proteusmirabilis
urease+, swarminggrowth
fimbriae
Vibriocholerae
epidemiology:growsinesturaine andmarineenvironment; Cholerae:60%mortaliltyunreated,and<1%iftreated; flourishesinwaterswithshellfish contaminatedfood/water;abruptonsetofwaterydiarrhea (oysters,clams,mussels);canbe andvomiting23daysafteringestion;"ricewaterstool:" carriedonasxpts stoolbecomescolorless/odorless,freeofprotein,speckled spreadbycontaminatedwater withmucusandfecesstreaked;severefluidandlytesloss andfood,nopersontoperson leadingtodehydration spread;poorsanitation; highinoculationrequired
Vibriovulnificus Oxidase+
Pseudomonas aeruginosa
Lactosenonfermenter
gramrodsarrangedsingly andinpairs,withbluegreen coloniesandfruity(sweet grapelike)odor,requires aerobicincubation, oxidase+, growsrapidlywithflat coloniesandspreading border, hemolytic
1)flagellaand2)piliactasadhesion andhelpwithmotility 3)LPSendotoxin 4)capsuleformedbyalginate mutationofporinproteinsmajor mechansimofresistance ExotoxinA;(mostimportant):disrupts lacmtamses proteinsynthesisbydisablingEF2 TypeIIISecretorysystem (dermatonecorsis,cornealdamage, Pyocyanin:bluepigmentthatcatalyzes pulmtissuedamage) productionofsuperoxideandH2O2and ExoenzymesS/T:causesactin rearrangementthatleadstoepithelial attractsneutrophils Pyoverdin:yellowgreenpigmentthat celldamagethatfacilitatesbacteral spread,tissueinvasion,andnecrosis regulatessecretionofotherfactors PhospholipaseC:heatlabilehemolysin thatbreaksdownlipidsandlecithin tissuedescruction LasA(serineprotease)andLasB(zinc metalloprotease):degradeselastin Alkalineprotease:
Burkholderiacepacia :respiratorytract infectionscommoninpatientswithcystic fibrosisorchronicgranulomatousdisease Stenotrophomonasmaltophilia: occursin debilatedpatientswithimpairedhost defenses;resistanttolactamand aminoglycosideantibitoics;patientsonlong termabxtherapyatrisk;commonlyfoundin hopsitaldisinfectantsolutions,respiratory machines,monitoringequipment,ice machines Acinetobacter :growsonmoistanddry surfaces,partofnormalfloraof oropharyngealregion;atrisk:onbroad spectrumabx,recoveringfromsurgeryor onrespiratoryventilation
motileat25C,notat 37C
Yersinia enterocolitica
nonmotile,cansurvive refrigeration
VandW
Family
Organism
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Yersiniapestis Bipolarstaining
VandWantigens
Reservoir:rats Urbanplague:rats Vector:fleas/rats Reservoir:squirrels,rabbits,field Sylvaticplague:mammals rats,domesticcats Vector:fleas flea Bubonicplague:incubationperiodupto7days;highfever contaminatedanimalsandanimal NewMexicoandArizona andlargebubo(lymphadenopathyingroinoraxilla) tissue Pneumonicplague:(90%mortality)incubation23days;F, malaise,andpulmonarysxwithinoneday;highlyinfectious fleas
persontopersonvia
respiratorydroplet Pathogenesis:initialcolonizationfaciliated byblockageofacidproducingbybacterial acidinhibitoryprotein;neutralizationof gastricacidbyammoniaproducedby ureaseactivity(enhancedbyheadshock protein);highlymotilehelicobacterscan thenpassthroughthegastricmucusand adheretoepithelialcells Localizedtissuedamagemediatedbyurease byproducts,mucinase,phospholipase, vacuolatingcytotoxin protectedfromphagocytosisand intracellularkillingbyproductionof superoxidedismuatseandcatalase
curved,smallgrowthon Urease Campyagar,urease+,urea Heatshockprotein breathtest,WarthinStarry Acidinhibitoryprotein silverstainmostsensitive, Flagella gastricbx,antigendetection Adhesins Helicobacterpylori viastoolsample,Serologycan mucinaseandphospholipase demonstrateexposure,culturesuperoxidedismutase organismisadherentanddoes catalase notappearinstoolorblood; vaculotatingcytotoxin microaerophilic,catalase+, highlymotile
humansprimaryreservoir,fecal oral
Curved Microaerophilic AcuteenteritiswithD,malaise,fever,abdominalpain; mayhave>10BMperday,maybebloody MCCofgastroenteritisinUS producteshistologicdamagetomucosalsurfaeofjejunum, poultry,cattle,sheep ileum,colon;appearsulcerated,edematous,bloody,with cryptabscessesinepithelialglands AssociatedwithGBS 25%ofgastroenteritisinUSbutisMCCofgastroenteritis indevelopingcountries pigs,poultry,sheep,birds AssociatedwithGBS gastroenteritis,extraintestinalinfections dogs,cats systemicsxincludingsepticemia,septicthrombophlebitis, arthritis,septicabortion,meningitis;morecommonin cattle,sheep debiliatedandimmunocompromised
C.jejuni thin,curved(commashaped), gramrod, oxidize+ unabletoferment carbohydrates. Microaerophilicgrowth, motileviapolarflagellum acquiredfromingestionof contaminatedfood/water, unpasteurizedmilk persontopersonuncommon infectiousdoseishighunless decreasedgastricacid worldwidedistribution
Campylobacter
Capsuleantiphagocytic polysacchariderichcapsule producesblackpigmenton fimbriaeadherence Bacteroidesfragilis bileesculinagar,growsrapidly shortchainfattyacidproduced (<2days); duringmetabolsimandinhibits largecapsulegivesthatgives phagocytosisandintracellularkilling mucoidappearance;catalase+ catalaseandsuperoxidedismutase Onlygramwithoutendotoxin(NO LipidA)
Strictanaerobe
varietyofcytotoxicenzymescause tissuedestruction,inactivate immunoglobulins,andresistoxygen toxiciity B.fragilistoxin(BFT)somestrains majorityofintrabdominalinfections createheatlabilezincmetalloprotease diarrhealdiseasesomestrains toxincausesdiarrhealdisease (changesofintestinalepitheliumand stimulationofClsecretionandfluid loss;IL8inducedinflammation
normalGIflora,mouth,vagina, skin,softtissue
Family
Organism Gramcoccobacilli,pleomorphic
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Hasoutermembrane,LPS:LipidAisendotoxincomponentthatcausesfeverandshock,polysaccharide,Oantigenisimportantsurfaceantigen;periplasmicspacesiteoflactamases small,gramrod,facultative anaerobe,hemophilus, requireshemin(X)andNAD(V) LPSendotoxin factors,chocolateorlevinthal polysaccharidecapsulesixantigen agar,satellitephenomenon serotypeswithBmostcommon (cangrowarounds.aureuson unheatedagar),growsbetter anaerobically Vaccine:firstpolysaccharidevaccinenot epidemiology:colonizedin protectiveforchildrenyoungerthan18 Morelabstuff: mucosalmembranesofrespiratory months;Purifiedpolyribosephosphate H.aegyptius :chocolateagarwith1%isoVitaleXandCO2 tract (PRP)antigenconjugatedwithprotein incubationx24d nonencapsulatedstraincommonly carrierselicitsresponseininfants2months H.ducreyi :bestongonococcalagarwith12%hemoglobin, foundinupperresptract,earand andolder 5%fetalbovineserum,IsoVitaleX,andvancomycin, sinusinfectionscommoninpeds, infectionsnowoccurinnonimmunechildren incubatedat33degreesCin510%CO2for7days andelderlyadults;innonvaccinated pulmdiseasecommoninelderly countriesstillverycommon
X&Vfactorsrequired
Haemophilus influenzae
Legionella pneumophila
Pathogenesis;bindtoC3bon mononuclearphagocytes Foundinmoistenvironmentsandcan endocytosis;phagolysosomefusion surviveinhightempsandchlorine;canlive isinhibited;chemokinesand inbiofilm cytokinesstimulatesevere capableofsporadic,epidemic,and inflammatoryresponserequires nosocomialinfections cellmediatedimmunityand inferferongamma
BordetGengou
Filamentoushemagglutinin(FHA): verysmall,strictaerobe, Pertusistoxin:A/Bsubunit;inactivates bindstosulfatedglycoproteinson oxidizeAA,nonmotile,does Giproteinsuninhibitedadenylate membranesofciliatedrespiratorycells notferment,collectonCalcium cyclasecAMPlymphocytosis, intraches;initiatesphagocytosis phagocytosis Bordetellapertusis alginateordacronswabs, withoutinitiatinganoxidativeburst; Reganlowemedium,room Trachealcytotoxin:lowlevelsresultsin protectsagainsthumoralantibodies; c temp,prolongedincubation, ciliostasisandhighlevelsdestroy AntiFHAantibodiesaregeneratedby PCRmostsensitive(negative: ciliatedcellsdecreasesmucus vaccine clearanceandresultsinwhooping urease,growthonsheepblood Extraadenylatecyclase:cAMPand cough orMacConkey) decreasesphagocytosis
Whoopingcough: 1)Catarrhalstage;mostcontagious,mostbacteria,similar toURI,lasts12weeks 2)Paroxysmalstage:repetitivecoughsfollowedby inspiratorywhoop;lasts24weekslciliatedepithelialcells areextrudedfromresptractandmucusclearanceis impaired,havemarkedlymphocytosis 3)Convalescentstage:paroxysmdiminish,secondary complicationoccurincludingpna,sz,encephaolopathy,no longercontagious
Family
Organism Gramcoccobacilli,pleomorphic
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Hasoutermembrane,LPS:LipidAisendotoxincomponentthatcausesfeverandshock,polysaccharide,Oantigenisimportantsurfaceantigen;periplasmicspacesiteoflactamases
Brucella Aerobic
B.melitenis: goatsandsheep; severediseasewithsevere Undulantfever:temperaturerisesduringthedayandfalls complications atnight;fever,malaise,chills,sweats,fatigue,weakness, B.abortus: cattleandamerican myalgias,anorexia,arthralgias,drycough,backache,HA, bison;milddisease(rarepus) B.suis: swine,reindeer,caribou; lympahadenopathy formationofdestructivelesions; Zoonotic:meatpackers,vets,farmers,travelers, prolongedcourse unpasteurizeddairyproducts(importedgoatcheese) B.Canis: dogs,foxes,coyotes;mild disease(rarepus)
requirescysteine
Francisella tularensis
Zoonotic
Capsuleantiphagocytic polysacchariderichcapsule
Epidemiology:rabbits,cats,hardticks, Pathogenesis; bitingflies Handlinginfectedrabbitsandcats reservoir:wildmammals,domesticanimals, andfrombitesofticksordeerflies; birds,fish,bloodsuckingarthropods intracellularpathogencansurvive subsptularensis restrictedtoNorthAmerica forprolongedperiodsin TypeAEast:Oklahoma,Missouri,Arkansas macrophagesof TypeAWest:aridregionfromRockyto reticuloendothelialsystembecause SierraNevadamountains itinhibitsphagosomelysosome subspholarctica inNorthernHemisphere fusion (rodentsandcats)
oxidase+,catalase+
Pasteurella multocida
cellulitiss/pcatbite
B.bacilliformis:
Bartoenlla silverstains
B.quintana:
Carriondisease:acutefebrileillnesswithsevereanemia (Oroyafever)followedbychronic,cutaneous,bloodfilled nodules(verrugaperuana) Trenchfever:severeHA,F,weakness,paininlongbones; feverrecursq5days Bacillaryangiomatossis:vascularproliferativediseasein immunocompromisedpatients;bodyaches,malaise, fatigue,weightloss,HA,fevers Subactueendocarditis:mildbutprogressive Catscratchdisease:chronicregionallymphadenopathy Bacillaryangiomatosis Subacuteendocarditis
fecesofhumanbodylouse
spreadfromcolonizedanimalsviadirect contactofinsectvectors
B.hensalae
catsandtheirfleas;carriedin felineoropharynx
Family
Physiology/Metabolism/Dx
VirulenceFactorsStructural
VirulenceFactorsToxins
Disease
Transmission/reservoir
Notes
Hasoutermembrane,LPS:LipidAisendotoxincomponentthatcausesfeverandshock,polysaccharide,Oantigenisimportantsurfaceantigen;periplasmicspacesiteoflactamases presentin~70%ofhealthypeople; sxdevelopifpatienthas Subacuteendocarditis:mildprogressiveinfectionof preexistingheartdiseaseororal endocardium;fatigue,malaise,lowgradefever diease Dysgonicfermenter(DF1): colonizehumanoropharynx Dysgonicfermenter(DF2): colonizeoralcavitiesofdogsand cats;associatedwithbitewounds
Streptobacillusmonoliformis
Opportunisiticinfections:peridonitis,septicemia, bacteremia,endocarditis
Porphyromonas
Ratbitefever:irregularfever,HA,chills,myalgia,arthralgia associatedwithrodentbite;maculopapularrashextending tohandsandfeet foundinnasopharynxofrats,small Haverhillfever:pharyngitisandvomitingassociatedwithh rodents,andinanimalsthatfeed bacteriainfoodandwater ontheserodents proteases:degradeimmunoglobulins pigmented,asaccharolyticrods fimbriae:adhesin capsule proteases:degradeimmunoglobulins Brainabscess:typicallyfromchronicsinusitisorOM,if bacteremicspreadfrompulmthenmultipleabsceses;ALL THREE Intraabdominalinfections;MCCB.fragilis; B. thetaiotaomicron,Prevotellamelaninogenica Bacteremia:B.fragilis 13%ofinfxns periodontaldisease,aspirationpna,abdominalandpelvic abscess,andOM oralcavity,GItract,respiratory tract,colon difficultyinlabdxofanaerobes: stainfaintlyandirregularly mustbecollectedinoxygenfreesystem keepmoist lysedbloodenrichedmediastimulate pigmentproductioninPorphyromonas and Prevotella
Prevotella AnaerobicGramBacilli
Fusobacterium
verysmall
respiratorytract;femalegenitalia
elongatedrods
respiratorytract