Listeria monocytogenes

Genus Features Distinguishing Features Reservoir

● Gram-positive, non–spore ● Small gram-positive rods ● Widespread: animals

forming rods ● Beta hemolytic, nonspore-forming rod (gastrointestinal and genital
● Facultative intracellular on blood agar, CAMP positive tracts), unpasteurized milk
● Tumbling motility ● Tumbling motility in broth; actin jet products, plants, and soil

motility in cells
● Cold growth: soft cheeses,
● Facultative intracellular parasite
Transmission⎯foodborne, vertical, or deli meats, cabbages
● Cold growth

across the placenta (coleslaw), hotdogs

Pathogenesis :
● Listeriolysin O, a b-hemolysin:
facilitates rapid egress from phagosome
into cytoplasm, thus evading killing
when lysosomal contents are dumped
into phagosome; “jets” directly (by
actin filament formation) from
cytoplasm to another cell
Disease(s)
● Immunologic immaturity predisposes
Listeriosis (human, peaks in summer)
to serious infection.
●

Granulomatosis infantisepticum

Meningitis with septicemia

Diagnosis

● Blood or CSF culture

● CSF wet mount or Gram stain

Treatment⎯ampicillin with gentamicin added

for immunocompromised patients

Prevention⎯pregnant women or
immunocompromised patients should not eat
cold deli foods
 Bacillus anthracis

Genus Features Pathogenesis

Capsule⎯polypeptide, antiphagocytic,
Gram-positive rods
●
●
immunogenic
● Spore forming
● Aerobic
● Anthrax toxin includes 3 protein components:

Species of Medical Importance

Protective antigen
● Bacillus anthracis
● Bacillus cereus
Lethalfactor—kills cells

Edemafactor is an adenylate cyclase(calmodulin-

activated like pertussis adenylate cyclase)

Diseases

● Cutaneous anthrax⎯papule

● Pulmonary (wool sorter’s disease)

Life-threatening pneumonia;
mediastinal haemorrhagic lymphadenitis

● Gastrointestinal anthrax

Diagnosis

● Gram stain and culture of blood, respiratory

secretions or lesions ● Serology
● PCR

Treatment⎯ciprofloxacin or doxycycline. (Genes

encoding resistance to penicillin and doxycycline
have been transferred to B. anthracis.)
 Corynebacterium diphtheriae

Distinguishing Features Pathogenesis

● club-shaped gram-positive rods arranged in ● Organism not invasive; colonizes

V or L shapes on Gram stain epithelium of oropharynx or skin in
cutaneous diphtheria
● Granules (volutin) produced on Loeffler
coagulated serum medium stain ● Extension into larynx/trachea →
metachromatically obstruction

● Aerobic, non−spore forming ● Effect of systemic circulation →

heart and nerve damage
Reservoir ⎯ throat and nasopharynx

Transmission ⎯ bacterium or phage via

Disease: diphtheria (sore throat with
respiratory droplets
pseudomembrane, bull neck, potential respira-
tory obstruction, myocarditis, cardiac
dysfunction, recurrent laryngeal nerve palsy,
and lower limb polyneuritis)

Diagnosis

● Elek test to document toxin production

(ELISA for toxin is now the frontline)

● Toxin produced by toxin-producing strains

diffuses away from growth.

● Antitoxin diffuses away from the strip of

filter paper.

● Precipitin lines form at zone of equivalence.

Treatment

● Erythromycin and antitoxin

● For endocarditis, intravenous penicillin and

aminoglycosides for 4–6 weeks

Prevention: toxoid vaccine (formaldehyde-

modified toxin is still immunogenic but with
reduced toxicity), part of DTaP, DTP, or Td,
boosters 10-year intervals
 Erysipelothrix

A catalase negative, non spore forming, non-motile

facultatively anaerobic gram positive bacillus that has
a worldwide distribution.

Appearance: Appear as short rods with rounded ends.

Occurring singly, in short chains, or non-branching
filaments.

Clinical manifestations

two species have been identified: - rhusiopthiae and E-

tonsillarium

transmitted to humans from animals by means of skin

wounds produced by contaminated objects or in contact with
blood , flesh, viscera, or feces of infected animals.

Eryselpeloid: causes local cutaneous infection systemic

infections are rare.
Laboratory diagnosis.
Biopsy and tissue separates best for culture.
Grows on blood or chocolate agar, may require 7
days, non-hemolytic.
Oxidase and catalase negative
 Nocardia asteroides and Nocardia
brasiliensis

Genus Features Distinguishing Features

Aerobic
Gram-positive filaments breaking up into rods
●
●
Gram-positive branching rods
Aerobic
●
●
Partially acid fast
Partially acid fast (some areas of smear will be
●
●

blue and some red)

Reservoir⎯soil and dust

Species of Medical Importance

● N. asteroides
● N. brasiliensis
Transmission⎯airborne or traumatic
transplantation
Pathogenesis
● No toxins or virulence factors known
● Immunosuppression and cancer predispose to
pulmonary infection

Disease(s)

Nocardiosis

Cutaneous/subcutaneous nocardiosis

Symptoms: cellulitis with swelling→draining

subcutaneous abscesses with granules
(mycetoma)
Diagnosis: culture of sputum or pus from
cutaneous lesion

Treatment: sulfonamides (high dose) or

trimethoprim/sulfamethoxazole (TMP-
SMX)