Class 5. Gram-positive rods: Listeria, Erysipelothrix, Cutibacterium and Corynebacterium.
1. Diseases caused by Listeria monocytogenes:
Early-onset disease (neonatal): (granulomatosis infantiseptica),
disseminated abscesses / granulomas in multiple organs.
Late- onset disease (neonatal): meningitis, meningoencephalitis w/
septicemia
Disease in healthy adults: influenza-like illness with or w/o
gastroenteritis
Disease in pregnant women/ Pat. w/ cell-med. immune defects: primary
febrile bacteremia /disseminated disease w/ hypotension + meningitis
2. Trojan Horse mechanism based on
phagocyte-facilitated invasion/phagolysosome lysis, bacterial replication
and directional movement in repeating order. Bacteria replicates in
macrophages and moves within cells, thus avoiding antibody-mediated
clearance
3. Virulence factors produced by L. monocytogenes:
- Internalins – internalin A: adhesion to hostcell, other internalins
recognize receptors on a wider range of host cells
- ActA – movement of bacterium towards cell membrane, coordinates
assembly of actin (1 part fixed, at the other assembly occurs)
- Listeriolysin O (LLO) - activated by acidic pH of surr.
phagolysosome, bacterial pore forming cytolysin -> entry into cell
- Phospholipases – making the phospholipid layer permeable to L.
monocytogenes (2x diff. phospholipase C)
4. Process of cell invasion and intracellular survival of L. monocytogenes
(complete using virulence factors from the exercise 3):
Entry: bacteria adheres to host-cell via internalin A , other internalins
(B)recognize receptors on a wider range of host cells: InIA, InIB.
Vacuolar lysis: via LLO: Listeriolysin O: release of bacteria into
cytosol. Replication: ActA: bacteria replicated and move to cell
membrane mediated via ActA. Vacuolar lysis II: LLO + PlcA, PlcB
/prfA
This is only scientific help, it is necessary to broaden the knowledge from the book.
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5. Diseases caused by Erysipelothrix rhusiopathiae:
Most commonly localized cutaneous infections or septicemia associated
with endocarditis
Erysipeloid – inflamm. Skin lesion, after 2-7 days incubation at site of
trauma, appears violaceous w/ raised edge, at hands/fingers
Generalized cutaneous form - slowly spreads peripherally (discoloration
at central area fades), pruritic / burning or throbbing sensation, lesions
either at initial lesion or other skin locations, systemic signs: fever
/arthralgias
Sepsis – uncommon, frequently associated w/ endocarditis, acute onset but
usually subacute, involvement of heart valves common
6. Virulence factors produced by E. rhusiopathiae:
Production of neuraminidase: attachment/penetration into epithelial cells
Polysaccharide-like capsule: protects bacteria from phagocytosis
7. Cutibacterium colonize mainly skin, but can be also find in conjunctiva,
external ear, oropharynx, female genital tract
8. Diseases caused by Cutibacterium acnes:
1. Acne vulgaris, in teenagers, young adults
2. Opportunistic infections, patients w/ prosthetic devices, intravascular
lines
Class 5. Gram-positive rods: Listeria, Erysipelothrix, Cutibacterium and Corynebacterium.
9. Factors contributing to the development of C. acnes-related acne
vulgaris:
- Production of a low-molecular weight peptide by bacteria, residing in
sebaceous follicles, attracting leukocytes

- bacteria phagocytized, release of hydrolytic enzymes (lipases,

proteases, neuraminidase, hyaluronidase)

- stimulate localized inflammatory reponse

à cellular damage, metabolic byproducts, bacterial debris produced
by rapid growth
10. Potentially toxinogenic species within genus Corynebacterium include:
Corynebacterium diphteriae, C. Pseudotuberculosis, C. ulcerans (can
carry diphtheria exotoxin genes)
These species have the ability to produce diphtheria

Beta-phage is responsible for the transformation of non-toxinogenic

strains of corynebacteria to toxinogenic, during the process of proteolytic
cleavage + cleavage of the toxin molecule into 2 polypeptides = A-B
exotoxin (coded by diphtheria toxin)

11. Diseases associated with production of diphtheria toxin:

Respiratory diphtheria - sudden onset with malaise, sore throat, exudative

pharyngitis, low-grade fever. Exudate evolves into pseudomembrane (difficult to
dislodge), systemic complications: myocarditis, neuropathies
cutaneous diphtheria - skin contact —> papule, evolves into chronic, non-healing
ulcer

12. The most important aspect of prevention of diphtheria is administration of

DPT vaccine (book says diphtheria antitoxin though) abbreviation:
diphtheria, pertussis, tetanus vaccine
This protects against three infections: diphtheria, pertussis, tetanus
Toxoid means: after diphtheria recovery, patient has to to receive
immunization with a toxoid, as there are not sufficiently enough
antibodies (= inactivated toxin)
This is only scientific help, it is necessary to broaden the knowledge from the book.