Bacte Must-Knows!

COMPILED BY: SHIRIN KAY O. BUTA, RMT |

Ribosome major antimicrobial target; 30s subunit targeted by tetracycline and aminoglycosides; 50s subunit
by chloramphenicol and macrolides, ketolides, and azalides.
Flagellin, lipopolysaccharide, are pathogen-associated molecular patterns (PaMPs) that stimulate toll-like receptors (tLRs).
lipoteichoic acid, and peptidoglycan
Capsule Is a major virulence factor, is antiphagocytic, and extends the bacteria’s time in the bloodstream.
Pili are the major virulence factor providing adherence to especially in urinary tract infections
obligate aerobes Mycobacterium tuberculosis, Neisseria, Nocardia species, and Pseudomonas aeruginosa
obligate anaerobes Bacteroides, Actinomyces, Treponema, and Propionibacterium. PS- Some Clostridium species are
aerotolerant anaerobes.
Facultative anaerobes Escherichia coli and Staphylococcus aureus.
Facultative intracellular bacteria N. meningitidis, N. gonorrhoeae, B. pertussis, and L. pneumophila
Aminoglycoside antibiotics ineffective against anaerobic bacteria. (e.g., streptomycin and gentamicin)
Spores Some gram-positive bacteria can sporulate; gram-negative bacteria cannot sporulate.
are resistant to boiling and many chemicals (including common disinfectants) and can survive in soil for long
times. Spores are inactivated by autoclaving for 15 minutes and by aldehydecontaining disinfectants
Transformation: uptake of a segment of naked DNA and its incorporation into the bacterial chromosome
Transduction uptake of DNA packaged in phage particles and its incorporation into the bacterial chromosome
Conjugation direct transfer of DNA from a donor (male) cell to a recipient (female) cell through sex (F) pilus, which is
encoded by F plasmid in donor cell
Transposition movement of a transposon (nonreplicable DNA segment) from one DNA site to another, resulting in
inactivation of the recipient gene into which it inserts
Sterile sites blood, cerebrospinal fluid, brain, organ parenchyma, lower lung airways, joint spaces, bone
endotoxin Produces by all gram-negative bacteria, the lipid A portion of LPS. Endotoxin causes fever, shock,
disseminated intravascular coagulation, and possibly death.
capsule Produced by certain gram-positive and gram-negative bacteria is a significant virulence factor that helps
bacteria avoid immune detection, phagocytosis, and intracellular killing. Patients lacking a spleen are more
susceptible to encapsulated bacteria.
Gram stain Purple is positive; red is negative. Gram variability occurs with old culture and β-lactam–treated bacteria.
MacConkey agar distinguishes normal flora enterobacteria (lactose positive—purple colonies) from Salmonella, Shigella,
Pseudomonas and other genera (lactose negative— gray colonies)
Neisseria species fermentation meningitidis has an m and a g for maltose and glucose. Gonorrhoeae has only a g for glucose.
MIC lowest concentration that inhibits growth
MBC lowest concentration that kills.
Kirby-Bauer only for achievable blood levels of antibiotic. Is not useful for infections of central nervous system or bone
E-test uses a graduated diffusion method to give MIC values for bacteria grown on agar plates.
Bactericidal drugs kill bacteria penicillins, cephalosporins, vancomycin, polymyxins, aminoglycosides, quinolones, and metronidazole.
β-Lactam drugs inhibit cross-linking of peptidoglycan.
Staphylococci salt tolerant and grow on picnic meats and other foods.
Most staphylococci are resistant to penicillin (produce a β-lactamase). Resistance to methicillin means
resistance to all β-lactams.
Staphylococci and streptococci cause pusforming (suppurative) infections.
S. aureus catalase, coagulase, grape-like clusters, MRSA, pus, 3-hour gastroenteritis, toxins, TSST. Major cause of
nosocomial and wound infections. Ferment mannose, other staph don’t.
S. epidermidis catalase, catheters, coagulase negative, shunts
S. pyogenes Bacitracin (A disk-group A) sensitivity, β hemolysis, gram-positive cocci in chains, necrotizing fasciitis, pus,
streptolysin O and S
causes pharyngitis, scarlet fever, toxic shock, rheumatic fever, acute glomerulonephritis. Must be treated to
prevent sequelae, sensitive to penicillin.
Group B streptococci acquired at birth cause bacteremia, pneumonia, and meningitis within first week.
Penicillin G alone or in combination with aminoglycosides
Viridans streptococci cause dental plaque, caries. Dental caries are caused primarily by S. mutans
Damaged heart valves are a risk factor for viridans strep endocarditis.
α-Hemolytic , resistant to Optochin, no Lancefield antigens
S. pneumoniae α-hemolytic, capsule, gram-positive diplococci, meningitis, otitis media, P disk (Optochin) sensitive,
polysaccharide vaccine, pneumonia
Optichin sensitive (P-disk; pneumoniae)
Quellung reaction indicates capsule on S. pneumoniae.
S. pneumoniae and H. influenzae most common bacterial causes of acute otitis media and sinusitis
Enterococci grow in bowel and resistant to bowel conditions: bile and salt.
are inherently resistant to many antibiotics.
Bacillus anthracis bioterror; eschar; fur; Medusa’s head colonies; sheep, goat, goat hair; spore; toxin; wool-sorters’ disease
only organism with a polypeptide capsule
Anthrax contact with B. anthracis spores or bacteria → painless ulcer; possible progression to septicemia and death.
Inhalation of spores → life-threatening pulmonary illness
Cutaneous anthrax occupational hazard for goat and sheep fur handlers.
B. cereus heat-labile toxin—diarrhea; heatstable toxin—vomiting; rice, preformed toxin; 3-hour gastroenteritis
Clostridium versus Bacillus both clostridia and bacilli are grampositive, spore-forming rods that produce potent exotoxins. Clostridia are
anaerobes; bacilli are aerobes.
C. perfringens boxcar shaped, diarrhea, double zone of hemolysis, gas gangrene, lecithinase, toxins
destroys tissues with many degradative enzymes, e.g., alpha toxin.
Gangrene combination of tissue degradation and gas production in anaerobic tissue.
C. tetani A-B toxin, diphtheria, lockjaw, sardonic grin, twitching spasms
Tetanus toxin inhibits release of inhibitory neurotransmitters in the central nervous system → spastic paralysis.
C. botulinum A-B toxin, botulism, floppy baby, food-borne, honey, spores, strict anaerobe
Botulinum toxin blocks release of acetylcholine at neuromuscular junction → flaccid paralysis.
Floppy baby syndrome results from ingestion of honey containing botulinum spores.
C. difficile antibiotic associated (Antibiotic treatment eliminates competing bacterial growth in the gut and allows C.
difficile to grow.), pseudomembranous colitis, spores, toxins A and B
resistant to alcohol hand cleaners.
common nosocomial infection, especially for patients taking broad-spectrum antibiotics.
C. diphtheriae A-B toxin; DPT vaccine; pseudomembrane.
the only significant human pathogen in the genus Corynebacterium.
Small, club-shaped, gram-positive, non–spore-forming rods with metachromatic granules
Black colonies on tellurite agar
Diphtheria toxin inhibits protein synthesis by adenosine diphosphate ribosylation of EF-2, which inactivates the elongation
factor.
Adhesins on fimbriae prevent bacteria from being washed away and promote urinary tract infections.
salmonella, shigella, and Yersini cannot ferment lactose, are not normal flora and always cause disease and must be treated.
E. coli diarrhea; EIEC, EHEC, ETEC, EAEC, EPEC; gram-negative rod; lactose positive; neonatal meningitis; O157:H7;
oxidase negative; urinary tract infection (UTI)
Lactose-fermenting, strain-specific virulence factors
enterotoxigenic strains (ETEC) Heat-labile enterotoxin- Mechanism similar to that of cholera toxin.
Heat-stabile enterotoxin- fluid loss and diarrhea.
Enterohemorrhagic strains (EHEC) Verotoxin is the same as Shiga toxin
Enteroinvasive strains (EIEC) Invasion and destruction of colonic epithelial cells
Enteropathogenic strains (EPEC) Adherence to mucosa of small intestine and disruption of microvilli structure.
Uropathogenic stains (UPEC) fimbriae–mediated adherence to uroepithelium, primary cause of UTIs
E. coli and group B streptococci most common causes of neonatal meningitis.
O157:H7 O-antigen serotype of the LPS that is on the bacteria that carry the plasmid for the verotoxin Shiga toxin.
K. pneumoniae aspiration, capsule, currant jelly (blood) sputum, pneumonia
lung infection most common in alcoholic patients and those with poor pulmonary function
Can also cause Bacteremia and UTI
Salmonella species dairy foods, motile, nonbloody diarrhea, nonlactose fermenter, raw eggs and chicken
recovery from typhoid confers immunity, whereas that from salmonellal enteritis does not.
Enteritis most common form of salmonellosis
excessive fluid and electrolyte loss may be life threatening, especially for infants, elderly people, and
immunocompromised patients
s. typhi only infects humans.
more likely to be isolated from blood than stool during first 2 weeks.
shigella always spreads from human source through food, fingers, feces, flies, or fomites.
Y. pestis transmitted by flea bite or aerosol.
plague, rodent and animal host, fleas, buboes
Y. enterocolitica carried in livestock, rabbits, and rodents and transmitted to humans in contaminated food, water, or blood
products
P. mirabilis elevated urine pH, swarmer, urease, UTI
Marked by elevated urine pH due to urease action and often by formation of renal stones (magnesium
ammonium phosphate; “staghorn calculus”)
Ammonia smell of urine
Neisseria often seen as gram-negative intracellular diploids within phagocytes.
Deficiency in C5-C9 is risk factor for neisserial infections.
N. meningitidis has an m and a g and ferments maltose and glucose.
chocolate agar, endotoxin, gram-negative diplococci in cerebrospinal fluid, lipooligosaccharide, meningitis,
oxidase positive, petechiae, purpura, septic shock, Thayer-Martin agar, Waterhouse-Friderichsen syndrome
N. gonorrhoeae only have g, therefore ferments glucose only
chocolate agar, gramnegative diplococci, oxidase positive, STD, Thayer-Martin medium, urethritis
virulence factors include pili, OMPII, immunoglobulin A (IgA) protease, antigenic variation, and endotoxin r
elease.
causes sexually transmitted diseases, PID; conjunctivitis in newborns
B. pertussis BordetGengou agar, DPT vaccine, whooping cough
virulence factors are adherence and toxins.
H. influenzae capsule, epiglottitis, Hib, meningitis, otitis, X and V factors
Haemophilus ducreyi chancroid, STD. Must exclude other diseases marked by genital ulcers, such as primary syphilis and herpes
simplex disease.
L. pneumophila air-conditioning, atypical pneumonia, charcoal yeast agar (BCYE agar), warm mist, shower and other
lukewarm water sources
grow intracellularly in phagocytes and even ameba
atypical pneumonia, particularly in individuals older than 55 years, smokers, and patients with chronic
obstructive pulmonary disease
spread by aerosols from water sources, such as showers and air-conditioning cooling towers.
P. aeruginosa burn patient, cystic fibrosis, fruity smell, hot tub folliculitis, nosocomial infection, opportunistic, oxidase
positive
Virulence factors of P. aeruginosa are pili, capsule, exotoxin, biofilm, toxins, and antibiotic and disinfectant
resistance.
ubiquitous and may be spread in contaminated soap.
Burkholderia chronic granulomatous disease (CGD), cystic fibrosis, Pseudomonaslike
Vibrio cholerae comma (S) shaped, rice-water diarrhea, shellfish
causes severe diarrhea (by secretory mechanism) with rice-water stools, high mortality rate
Contaminated water is usually the source of a cholera outbreak.
C. jejuni bloody diarrhea; thin, curved gram negative; undercooked poultry
primary cause of bloody diarrhea in the US- Disease is usually self-limited, but symptoms usually last for at
least 1 week
H. pylori gastric or duodenal ulcer, urease, urease breath test
Virulence factors of H. pylori: urease production of ammonia neutralizes stomach acid, flagella, mucinase,
cytotoxin.
ubiquitous and acquired by ingestion, poor sanitation, and person to person
Mycoplasma no cell wall, naturally resistant to β-lactam antibiotics due to lack of cell wall.
smallest free-living bacteria and lack a peptidoglycan
only bacteria with sterols in their cell membrane
Virulence factors: P1 adhesin, cytolytic enzymes, superantigen stimulation of cytokine storm
causes mild, hard to resolve respiratory infections.
M. pneumoniae outbreaks of “walking pneumonia” are common in military barracks and prisons.
M. hominis and U. urealyticum sexually transmitted diseases
Facultatively anaerobic organisms that form colonies with a fried-egg appearance
Nocardia abscess, acid fast, aerobe, filamentous, slow growing
Bronchopulmonary disease- Inhaled organisms (primarily Nocardia asteroides) colonize the oropharynx and
then are aspirated into the lower airways
May disseminate to the central nervous system, forming brain abscesses, or to skin
Actinomyces anaerobe, draining sinus tracts, filamentous, mycetoma, sulfur granules
Actinomyces infection of the fallopian tube (salpingitis): risk factor is the use of an intrauterine device.
Cervicofacial disease is marked by tissue swelling, fibrosis, and scarring along draining sinus tracts at the
angle of the jaw and neck. Poor oral hygiene, dental surgery, and oral trauma are risk factors.
Bacteroides fragilis abscess, foul-smelling, mixed infection
most clinically significant of the numerous gram-negative, nonsporulating, anaerobic colonizers of the
respiratory, gastrointestinal, and genitourinary tracts
disease associated with surgery and trauma affecting colonic mucosa
Syphilis Treponema pallidum
Yaws Treponema pallidum pertenue
This granulomatous disease is marked early by elevated papilloma-like skin lesions and later by destructive
lesions of the skin, lymph nodes, and bones.
Pinta Treponema carateum
Small pruritic papules develop initially and then enlarge into recurrent lesions that cause scarring and
depigmentation
Lyme disease Borrelia burgdorferi
Louse-borne relapsing fever Borrelia recurrentis
Tick-borne relapsing fever Borrelia species
Leptospirosis Leptospira interrogans
FTA-ABS and MHA-TP are specific for antitreponemal antibody but are more expensive than nontreponemal tests and are
commonly used to confirm infection
Nontreponemal tests false positive acute or chronic illness, collagen-vascular disease, heroin addiction, leprosy, malaria, pregnancy, recent
reaction immunization, and viral infection
Treponemal tests acne vulgaris, crural ulceration, drug addiction, herpes genitalis, mycoses, pregnancy, psoriasis, pyoderma,
rheumatoid arthritis, skin neoplasm, and systemic lupus erythematosus
T. pallidum gumma, painless ulcer (chancre), palm and sole rash, RPR and VDRL tests, spirochete, STD, strict anaerobe,
syphilis, unculturable
only sexually transmitted treponemal disease
B. burgdorferi deer tick, erythema chronicum migrans, high grass, Lyme disease
Leptospira interrogans small spirochete with curled end; only aerobic spirochete that infects humans; no insect vector; mild flu-like
disease without jaundice
Weil syndrome, a severe form of leptospirosis, develops in about 10% of infected patients. Manifestations
include headache, rash, jaundice, azotemia, hemorrhages, and vascular collapse
Urine is an excellent body fluid to identify the organisms
M. tuberculosis acid fast, caseation, Ghon complexes, granuloma, isoniazid, LöwensteinJensen medium, Mantoux reaction,
opportunistic disease, PPD
Humans are the only natural reservoir of M. tuberculosis
Tuberculin skin test Intradermal injection of purified protein derivative (PPD)
Positive reaction is indicated by an area of induration (>15 mm for healthy adults) 48 to 72 hours after PPD
injection
False-positive results occur in individuals vaccinated with bacille Calmette-Guérin (BCG)
Tuberculosis therapy RIPES = rifampin, isoniazid, pyrazinamide, ethambutol, streptomycin
Mycobacterium avium-intracellulare common opportunistic disease of AIDS patients in terminal stages (CD4 T cells < 50/ mL)
complex (MAC)
MAC are resistant to anti-TB drugs and are treated with clarithromycin or azithromycin plus ethambutol and
rifampin
M. leprae anesthetic skin lesion, lepromatous leprosy
Chlamydia cannot make adenosine triphosphate (ATP) and lack peptidoglycan
existing in two forms: Elementary body: Enters cells; Reticulate body: Replicates within cells.
C. trachomatis most common cause of neonatal blindness worldwide
Lymphogranuloma venereum initially causes small painless lesion at infection site with possible fever, headache, and myalgia but can
progress to swollen draining lymph nodes.
C. psittaci birds, parrots , only chlamydial species that causes zoonotic disease
Rickettsia Obligate intracellular growth, Southeastern Atlantic and south central states, tick, Weil-Felix reaction
Rickettsia, Coxiella, Ehrlichia species zoonotic disease, insect vectors
• Bartonella species (cat-scratch fever)
• Brucella species (undulant fever)
• Chlamydophila psittaci (psittacosis-parrot fever)
 • Coxiella burnetii (Q fever)
• Francisella tularensis (tularemia)
• Listeria monocytogenes (meningitis, sepsis)
• Rickettsia species (Rocky Mountain spotted fever, typhus)
Brucella goats and sheep, intracellular growth, undulant fever, unpasteurized milk and cheese
brucellosis marked by intermittent (undulating) fever and granulomas in advanced stages
F. tularensis intracellular, rabbit, tularemia, ulcer
Hunters, animal skinners, taxidermists, and rabbit owners are at risk for tularemia.
L. monocytogenes baby, cold enrichment, intracellular growth, meningitis, milk products, motility, undercooked meat
Contaminated food is common source of Listeria species infection.