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Microbe Chlamydia

Gram Neg -tiny

Species Chlamydia trachomatis Chamydophila pneumonia Chamydophila psittacci

Location eyes, genitals, lungs lungs lungs lung genitals genitals genitals (tiny colony)

Mycoplasma

smallest bac Mycoplasma pneumoniae no cell wall Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Pos clusters Staph aureus Staph epidermidis Staph saprophyticus

Gram Positives Staphylococci

skin bladder

Streptococci

chains B-hemo A-hemo

Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone GI, upper resp infants Strep pneumoniae- lancet Viridans Strep mouth and gut

Clostridium

Positive Bascilli Anaerobe

C. Tetani C. Botulinum C. Perfringens C. Diff pairs or short chains E.faecalis E.faecium

GI tract from rust/splinter Soil, canned food, honey GI spores Nosocomial Spread gut

Enterococcus Pos anaerobe (like strep)

Gram Negatives Peptostreptococci Non-spore Neisseria Negative diplococci Aerobes Bacteroides Fragilis N. Meningitidis N. Gonnorhea mouth, GI, vagina GI tract, Vagina Brain In your Vajay/Schlong

Enterobacteriaceae anaerobes

Neg Pathovars

All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis

All GI small bowel Large bowel small bowel Large bowel Large Bowel Small bowel blood stream, bladder, kid bloodstream identical to E.coli

capsule, Inhabits gut

M-SPICE

S E C

Serratia marcescens Enterobacter Citerobacter

not normal flora capsule citrate as sole source

I Proteus Indole pos+ P.mirabilis P.vulgaris P Pseudomonus aergunosa

Morganella M.morganii Salmonella S.typhi

S.paratyphi nontyphoidal Non-Enterobacterace Urease -ve Urease +ve Campylobacter Jejuni Heliobacter pylori Animals --> our gut Stomach Intestinal Tract Commensal in Pharynx Genitals

Oxidase +ve Vibrio Cholerae Haemophilus Negative H. Influenzae Coccobascilis H. Ducreyi Aerobe Legionella Pneumophilia Bordotella Pertussis Pseudomonas aerobic Neg rod curved P.aeruginosa

Lungs, aerosolized water Pharynx; one of few airborns

colon

Plasmodium

parasite P.falciparum P.vivax P.malariae P.ovale P.knowlesi

Non-Bacteria Protozoa

parasite

Giardia intestinalis

cysts- infected form trophozoites- active form

Fungi opportunistic

yeast, Pos

Candida

mouth, eso, vagina, skin Mucosal & Cutaneous Deep-seeded Candidemia usually inhaled as spores

mold

Aspergillus A.fumigatus

A.flavus A. niger yeast-encap. Cryptococcus C.neoformans var neoformans (birds) var gattii no pseudohyphae! effects immunocomp. effects all

Diseases A,B,C- trachoma (blindness), D-K- conjunctivitis, infant pneu, cerviciti, PID, urethritis, L- LGV walking pneumonia birds walking pneumonia (with target rash or stevens-johnson syndrome)

Skin and soft tissue infections, osteo, endocard, and septic arthritis Mainly found coating heart valves and prosthetics, biofilm UTI's

Pharyngitis (cobblestone), Scarlet fever, glomerulonephritis, rheumatic fever, necrotizing fasc. UTI, endometritis, bacteremia, skin and soft tissue infections, early/late onset disease in infants pulmonary infections and a million others Endocarditis

tetanus blocks Gaba and causes rigid paralysis Floppy paralysis, Ach blockage caused by endospores Food poisoning, soft tissue infection (necro fasci, uterine infection) Diarrhea caused by antibiotics #1 disease is UTI. Also causes bacteremia, endocarditis, meningitis, skin and soft tissue endocarditis most common

sinusitis, stomach lung and brain abscesses, post partum endometriosis Surgery, trauma, chronic disease leads to this commensal causing pneumonia and pleural abscesses Pili for adhesion, LPS for epithelial cell damage, and MENINGITIS DUH. Urethritis, Cervicits. Ophthalmic problems in neonates

UTI, blood, peritoneum, resp tract infections all common diarrheal outbreaks in neonates hemorrhagic colitis and HUS- Shiga toxin- bloody diarrhea travelers diarrhea illness similar to shigella travelers diarrhea diarrhea in developing nations UTI

UTI, abscesses, pneumonia alcoholics more suseptable

Associated with IVDUs, UTI and endocarditis

UTI sometimes resp infections severe UTI with possible stone formation - swarming motility

UTI and wound infection

typhoid fever

typhoid fever gastroenteritis - foodborne outbreaks gastroenteritis leading to guilamme barre due to enterotoxins urease allows it to survive in stomach acid. Causes stomach and duodenal ulcers Enterotoxin A and B causes secretion of fluid to gut. Firehose Diarrhea = 20L. 1-3L/day Capsule and IgA protease. Meningitis, pneumonia in COPD and alcoholics Chancroid ulcer

Legionaires disease and Pontiac fever. Whooping cough (cough of 100 days) Low grade fever progresses to vomitting and cyanosis Hot tub Folliculitis, smells like grapes Bacteremia, acute pneumonia, chronic resp infections (in CF), bone and joint, swimmers ear, eye, UTI

Malaria most severe form

beaver fever

Thrush and Esophagitis (nystatin not effective here), Vaginitis (no statin) & Diaper rash, intertrigo (skin folds) CNS, endocarditis, osteomyelitis, septic arthritis, blood stream -> can disemminate to organs

Allergic bronchopulmonary aspergillosis (asthma/CF produce lung infiltrates

Invasive pulmonary and sinus infection - in immunosupp. Pulmonary aspergilloma (fungus ball)- TB cavity required

pneumonia and meningitis

Treatments tracoma-azithromycin, conju-erythromycin, pneu-macrolides, the rest are doxycycline

macrolides, quin azithromycin or doxycycline

cefazolin (ceph), cloxacillin (penicillin), Erythromycin (macrolide), Clindmycin, sulfa, and vanco (for MRSA)

Penicillin, Erythromycin Penicillin, Vancomycin Penicillin, Erythromycin - pneumococcal conjugate vaccine Penicillin-gentamycin

Clean wound, Tetanus Ig, benzo's, tetanus vaccine series on discharge Penicillin for wound infection, Horse made anti-toxin Pen G + Clindamycin Remove antibiotic, metranidazole, fluids. Avoid anti-motility agents! All have intrinsic and extrinsic resistance - to B-lactams and Aminoglycosides Use ampicillin + gentamicin for synergy, vanco + genta if allergic Linezolid for VRE

penicillin or clindamycin Metronidazole, drain abscess Penicillin, 3rd Gen Ceph. Quinolone given prophylactically to close contacts Erythromycin eye drops to EVERY baby. Doxycycline or azithromycin

ALL can use peniciilin, most cephalosporin, ALL quin, ALL sulfa B-lactams use depends on: 1) AB in contact with target 2) affinity of AB for target 3) production of B-lactamases Resistance: 1) porin channel mutations 2) Efflux system mutations (more AB pumped out) 3) PBP mutations 4) B-lactamase production (MOST COMMON)

ALL ampicillin/amoxicillin resistant - non-MDR use 1st gen cephalosporins

ONLY 4th gen cephalosporins and Carbapenems can used used on M-SPICE have AmpC cephalosporinases therefore can't use 1,2,or 3 gen

Chromosomally-inducible beta-lactamases (AmpC)

Treat between 2-50, immunocompromised and very severe cases macrolides or quinolones, replenish fluids OAC = Omeprazole, Amoxicillin, Clarithromycin. Check for cure with urease breath test Replenish fluids like a mofo, Doxycycline, Quinolone Vaccinate, Macrolide, 2/3 gen ceph, Rifampin to close contacts Quinolone, 3rd gen ceph, macrolide

Macrolides or quinolone. Pip/tazo would probs also be a good choice IMO Erythromycin or macrolides for patient and contacts.

Pip/Tazo, Serious infection = B-lactam + quinolone

Chloroquine (but has resistance), Doxycycline (not in kids), Primaquine (no G6PD) Mefloquine (good drug)

metronidazole

topical nystatin (fungicidal-attacks cell mem) or oral fluconazole (fungistatic) CNS treated with IV AF fluconazole or newer gen voriconazole

AF, bronchodilators/inhaled corticosteroids

CT shows "halo sign" or "air-cresent" infiltrates - use Amphotericin B or voriconazole surgery to remove fungus ball

Amphotericin B and Fluctosine, Fluconazole

Extra Cannot be cultured, no pep wall - no beta lactams

Cannot be cultured, no pep wall - no beta lactams

All Catalase + Coagulase + Coag Coag -

All Catalase All have capsule All have C protein (antigenic component)

Catalase -, Alpha hemolytic

All ferment glucose, all reduce nitrate to nitrite All catalase +, All oxidase - (except pseudo) Do not prescribe AB, will cause HUS

Oxidase + grows at 42 degrees, water associated

Extra Extras

Staph Aureus #1 cause of endocarditis in IVDU 1) Disable IS- coagulase, leukocidins, penicillinase, PBP 2 (meth) 2) Tissue destroying enzymes- protease, lipase, 3) Exotoxins- exfoliation (scalded skin syndrome), Heat stable (food poisoning), TSST-1

Has M protein (rheumatic and superantigen TSS) Has M and F antigen, produces A hemolytic colonies

virulent factors: extracellular protein and aggregation substances

Microbe Chlamydia

Species Chlamydia trachomatis Chamydophila pneumonia Chamydophila psittacci Mycoplasma pneumoniae Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Staph aureus Staph epidermidis Staph saprophyticus

Where to Find Them eyes, genitals, lungs lungs lungs lung genitals genitals genitals (tiny colony) skin/joints/diabetic foot skin bladder

Mycoplasma

Gram Positives Staphylococci

Streptococci Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone Strep pneumoniae- lancet Viridans Strep Clostridium C. Tetani C. Botulinum C. Perfringens C. Diff Enterococcus anaerobe (like strep) pairs or short chains E.faecalis E.faecium GI tract from rust/splinter Soil, canned food, honey GI spores Nosocomial Spread Throat GI, upper resp infants, Genitals Brain, Lungs mouth, gut, heart

Gut Gut

Gram Negatives Peptostreptococci Bacteroides Fragilis Neisseria N. Meningitidis N. Gonnorhea mouth, GI, vagina GI tract, Vagina Brain Urinary tract

Enterobacteriaceae anaerobes

All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis

All GI small bowel Large bowel small bowel Large bowel Large Bowel Small bowel blood stream, bladder, kid bloodstream GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI

M-SPICE

Serratia marcescens Enterobacter Citerobacter Proteus P.mirabilis P.vulgaris Pseudomonus aergunosa

Morganella M.morganii Salmonella S.typhi

S.paratyphi nontyphoidal Non-Enterobacterace Campylobacter Jejuni Heliobacter pylori Vibrio Cholerae Haemophilus H. Influenzae H. Ducreyi

GI GI Animals --> our gut Stomach Intestinal Tract Commensal in Pharynx Genitals

Legionella Pneumophilia Bordotella Pertussis Pseudomonas aerobic rod curved P.aeruginosa

Lungs, aerosolized water Pharynx; one of few airborns

Resp, Urinary, Gi

Plasmodium P.falciparum P.vivax P.malariae P.ovale P.knowlesi Non-Bacteria Protozoa

Giardia intestinalis

cysts- infected form trophozoites- active form

Fungi opportunistic

Candida

mouth, eso, vagina, skin Mucosal & Cutaneous Deep-seeded Candidemia usually inhaled as spores

Aspergillus A.fumigatus

A.flavus A. niger Cryptococcus C.neoformans var neoformans (birds) var gattii Respiratory tract effects immunocomp. effects all

Microbe Chlamydia

Species Chlamydia trachomatis Chamydophila pneumonia Chamydophila psittacci Mycoplasma pneumoniae Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Staph aureus Staph epidermidis Staph saprophyticus

Mycoplasma

Gram Positives Staphylococci

Streptococci Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone Strep pneumoniae- lancet Viridans Strep Clostridium C. Tetani C. Botulinum C. Perfringens C. Diff Enterococcus anaerobe (like strep) pairs or short chains E.faecalis E.faecium

Gram Negatives Peptostreptococci Bacteroides Fragilis Neisseria N. Meningitidis N. Gonnorhea

Enterobacteriaceae anaerobes

All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis

M-SPICE

Serratia marcescens Enterobacter Citerobacter Proteus P.mirabilis P.vulgaris Pseudomonus aergunosa

Morganella M.morganii Salmonella S.typhi

S.paratyphi nontyphoidal Non-Enterobacterace Campylobacter Jejuni Heliobacter pylori Vibrio Cholerae Haemophilus H. Influenzae H. Ducreyi

Legionella Pneumophilia Bordotella Pertussis Pseudomonas aerobic rod curved P.aeruginosa

Plasmodium P.falciparum P.vivax P.malariae P.ovale P.knowlesi Non-Bacteria Protozoa

Giardia intestinalis

Fungi opportunistic

Candida

Aspergillus A.fumigatus

A.flavus A. niger Cryptococcus C.neoformans var neoformans (birds) var gattii

Treatments Azithromycin. Erythromycin given to babies Doxycycline Doxycycline Macrolides or Quinolones azithromycin or doxycycline. Maybe Quinolone in resistance azithromycin or doxycycline azithromycin or doxycycline Cloxacillin Vancomycin (MRSA vanco as well) Penicillin

Penicillin, Erythromycin Penicillin, Vancomycin Penicillin, Erythromycin - pneumococcal conjugate vaccine Penicillin-gentamycin

Clean wound, Tetanus Ig, benzo's, tetanus vaccine series on discharge Penicillin for wound infection, Horse made anti-toxin Pen G + Clindamycin Remove antibiotic, metranidazole, fluids. Avoid anti-motility agents! All have intrinsic and extrinsic resistance - to B-lactams and Aminoglycosides Use ampicillin + gentamicin for synergy, vanco + genta if allergic Linezolid for VRE

penicillin or clindamycin Metronidazole, drain abscess Penicillin, 3rd Gen Ceph. Quinolone given prophylactically to close contacts Erythromycin eye drops to EVERY baby. Doxycycline or azithromycin

ALL can use peniciilin, most cephalosporin, ALL quin, ALL sulfa B-lactams use depends on: 1) AB in contact with target 2) affinity of AB for target 3) production of B-lactamases

ALL ampicillin/amoxicillin resistant - non-MDR use 1st gen cephalosporins

ONLY 4th gen cephalosporins and Carbapenems can used used on M-SPICE have AmpC cephalosporinases therefore can't use 1,2,or 3 gen

Chromosomally-inducible beta-lactamases (AmpC)

3rd generation Cephalosporin

Treat between 2-50, immunocompromised and very severe cases macrolides or quinolones, replenish fluids OAC = Omeprazole, Amoxicillin, Clarithromycin. Check for cure with urease breath test Replenish fluids like a mofo, Doxycycline, Quinolone Vaccinate, Macrolide, 2/3 gen ceph, Rifampin to close contacts Quinolone, 3rd gen ceph, macrolide

Macrolides or quinolone. Pip/tazo would probs also be a good choice IMO Erythromycin or macrolides for patient and contacts.

Pip/Tazo, Serious infection = B-lactam + quinolone

Chloroquine (but has resistance), Doxycycline (not in kids), Primaquine (no G6PD) Mefloquine (good drug)

Metranidazole

topical nystatin (fungicidal-attacks cell mem) or oral fluconazole (fungistatic) CNS treated with IV AF fluconazole or newer gen voriconazole

AF, bronchodilators/inhaled corticosteroids

CT shows "halo sign" or "air-cresent" infiltrates - use Amphotericin B or voriconazole surgery to remove fungus ball

Amphotericin B and Fluctosine, Fluconazole

Resistance: 1) porin channel mutations 2) Efflux system mutations (more AB pumped out) 3) PBP mutations 4) B-lactamase production (MOST COMMON)