PHARMACEUTICAL MICROBIOLOGY AND PARASITOLOGY SLU-PHARMACY

COMMON INFECTIOUS DISEASES Haemophilus influenzae

• Small uniform coccobacillus Foodborne and Waterborne Bacterial Diseases
Pathogenicity • Aerobic or facultative anaerobe
ability of a pathogen to produce disease by overcoming defenses of • Encapsulated Clostridium botulinum
the host • 6 distinct antigenic types • Normal flora of animals
• Growth factors (X,Y) • Inh. Release of Ach in skeletal muscles
Virulence • Causes meningitis, epiglottitis, septic arthritis, sepsis • Acquired by humans through:
degree of pathology caused by the organism • Lab diagnosis: Chocolate agar o Deep wound infection
usually correlated with the pathogen’s ability to multiply within the o Consumption of vacuum packed or canned
host Mycobacterium tuberculosis foods
• Intracellular organism o Consumption of honey by infants
Virulence Factors • Slow growing (12-20hr) • S/S:
molecules expressed and secreted by pathogens which may • Weakly G(+) cell wall o Flaccid Paralysis
promote: • Resist drying  Lack of muscle tone, “Flappy baby
o Colonization of a niche in the host • Sensitive to UV, phenol, hypochlorite, heat syndrome”
o Immunoevasion • Virulence factor: cord factor, intracellular survival  Starts with facial muscles
o Immunosuppression • Growth: Lowenstein-Jensten medium o Diaphragmatic paralysis – respiratory arrest
o Entry into and exit out of cells • Aka Koch’s bacillus o Diplopia, slurred speech, swallowing difficulty
o Obtain nutrition from the host • CM: • Used in dermatology – Botox
• Pulmonary Tuberculosis (PTB) • Rx: Trivalent antitoxin
• Extrapulmonary tuberculosis (EPTB)
Airborne Bacterial Diseases • Tb of the skin, bones, kidney, and other organs
• s/s: afternoon fatigue, pm fever, loss of appetite and weight Staphylococcus aureus
Streptococcus pyogenes (rapid), cough, hemoptysis (bloody sputum) -G(+) cocci
• Most virulent, important human pathogen • DIagnosis -Catalase (+), Coagulase (+)
• CM: o Mantoux test (told) – tuberculin
o Scarlet Fever o Purified protein derivative (new) Hidradenitis suppurativa
 Aka. Scarletina, erysipelas • Treatment: Recurrent pyogenic abscess of apocrine sweat glands
 ID: Dick’s test o TB Directly Observed Treatment, Short-course (TB-
o Impetigo DOTS) Toxic Shock Syndrome
 Aka pyoderma
Occurs in young women
 s/s: yellow crusted lesions (face) Klebsiella pneumoniae Caused by TSST 1
o Sepsis • Present in respiratory trace and feces of about 5% of normal S/Sx:
o Infectious endocarditis individuals Fever
o Tonsilitis, Strep throat (3-5x/yr = • 2nd most common cause of G(-) sepsis Hypotension
complications) • Pneumonia Erythoderma wit desquamation
o Pharyngitis
Profuse diarrhea
• Complications (1-4 weeks after infection) Mycoplasma pneumoniae Multi-organ involvement
o Acute Rheumatic Fever • Plastic, pleomorphic shape
 Heart murmurs • Lacks peptidoglycan cell wall Scarlatiniform rash
 Aschoff’s nodule formation in the • Enclosed by lipid bilayer membrane Red rash of STSS
heart valves • Can’t synthesize sterol
o Acute Glomerulonephritis • Smallest known free-living self-replicating prokaryotic cell Staphylococcal Scalded Skin Syndrome
o Rx: Penicillin V • Produces “walking pneumonia” Commonly occurs in children and neonates
• Resistant to Penicillin, Cephalosporin, Vancomycin S/Sx:
Corynebacterium diphtheriae
Perioral erythema with sunburn like rash rapidly turning bright red then
• V-shaped or palisades Bordatella pertussis spreading to bullae which later on desquamates
• “Chinese lettering” • Fastidious coccobacilli
• Pleomorphic; aerobic/facultative anaerobic • (+) capsule in virulent strains Scalding of skin
• Non-motile, non encapsulated • Strict aerobe Exfoliative toxin causes reddened patches of the epidermis to slough
• Screening test: Schick Test • Oxidase(+), urease (-) off
• Lab Dx: Loeffler’s • Agglutination property

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PHARMACEUTICAL MICROBIOLOGY AND PARASITOLOGY SLU-PHARMACY

Staphylococcal Food Poisoning • UTI • Cutaneous: exotoxin causes localized tissue necrosis “black
Caused by ingestion of enterotoxin • Sepsis eschar lesions”
Second most common cause of acute food poisoning • Meningitis • Respiratory: “Woolsorter’s” disease
S/Sx: • GI: rare but fatal
Acute salivation • Normal flora of sheep, goat, cattle
Nausea Listeria monocytogenes • Encapsulated (with D-glutamic acid in capsule)
Vomiting • Has tumbling end-over-end motility at 22C but not at 37C • ID test: MacFaydean reaction test
Abdominal cramps • Facultative anaerobe • Medusa head colony appearance
Watery diarrhea • Catalase ( )
• Produces hemolysin Clostridium tetani
• Only G(+) with endotoxin • Normal flora of horses, dogs
Septicemia • Common cause of meningitis in neonates (L. meningitides) • CM: Tetanus
Associated with age extremes, CVD, decompensated diabetes, and • S/S:
heroin addicts Bacillus cereus o Spastic paralysis
May complicate to endocarditis • Non-encapsulated, motile o Ricus sardonicus – sardonic smile/”devil’s grin”
• Produces exotoxin o Opisthotonus – hyperarching of back muscles –
Other infections caused by S. aureus • Causes food poisoning: emetic/diarrhea spine may break
Sty, boil, cellulitis, impetigo, osteomyelitis o Lock jaw
Legionella pneumophila
Salmonella sp • Facultative intracellular Clostridium perfringens
• Mostly motile; non-lactose fermenter • Aerobic, fastidious • CM: Gas Gangrene
• Most produce H2S • Natural habitat is water • S/S: Myonecrosis – liberation of foul smelling gas
• Form acid in glucose and mannose • Causes Legionnaire’s disease and Pontiac fever • ID Test: Nagler’s Test
• Lives in GI of animals • Tx Options:
Shigella dysenteriae o Amputation
1. Typhoid fever – S. typhi • Non-motile; non-lactose fermenter o Maggots – eat necrotic tissue
DOC: Chloramphenicol, Ciprofloxacin, Ceftriaxone • Highly adapted to humans o Hyperbaric chambers – allows O2 to penetrate for
2. Sepsis – S. choleraesius • Acid resistant blood flow
3. Diarrhea/Gastroenteritis – S. enteritidis • Shiga toxin: inactivates 60s ribosomes
Leptospira interrogans
Vibrionaceae Family Helicobacter pylori • Tightly coiled, thin, flexible
• Small, curved bacilli • Spiral shaped, highly motile, microaerophilic • Culture: ____________ media
• Oxidase (+); have polar flagella • Produce large amounts of urease • Causes Leptospirosis
• Require alkaline and salinecontaining media for growth in • Adherence factors, motility, mucinase • CM: Leptospirosis / Weil’s Dse
lab • Gastritis, gastric/duodenal ulcers o Commonly from rodents but may be from dogs,
• MDT: Metronidazole, Tetracycline, Amoxicillin bats, squirrels
V. cholera: gastroenteritis o Acquired by humans from contaminated water
V. parahemolyticus: gastroenteritis Clostridium difficile • S/s: nephritis, meningitis, conjunctivitis, splenomegaly,
V. vulnificus: septicemia, wound infection • Normal flora of colon jaundice
V. alginolyticus: wound infection; external otitis • CM: Pseodomembranous colitis • Rx: Doxycycline
o S/S: bloody diarrhea, abdominal cramps
Vibrio cholerae o Associated with use of broad spectrum antibiotics Yersinia pestis
• Exotoxin: cholera toxin • CM: Bubonic plague aka black death, black plague
• Watery diarrhea: “rice watery” stools • S/S: buboes (wound)
• Not an invasive infection • Rodents – rat flea (vector) – humans
Soilborne and Arthropod-borne Bacterial Diseases
Escherichia coli Francisella tularensis
• Normally found in GI Bacillus subtilis • CM: Tularemia aka rabbit fever, deer fly fever
• Become pathogenic only when they reach tissues outside • CM: UTI
of their normal intestinal sites • Source of Bacitracin (wound of Margaret Tracey) Borrelia recurrentis
• EPEC: infant and children’s diarrhea • Highl flexible
• ETEC: traveler’s diarrhea (Montezuma’s revenge) Bacillus anthracis • Can be cultured in fluid media (blood serum and tissue)
• EIEC: similar to shigellosis • Only bacteria with amino acid capsule • Causes Relapsing fever
• EHEC: verotoxin; bloody diarrhea • Causes anthrax

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PHARMACEUTICAL MICROBIOLOGY AND PARASITOLOGY SLU-PHARMACY

Borrelia burgdorferi  3rd Stage: gummas characterized by Miscellaneous Bacteria

• CM: Lyme’s disease CNS problems
• Vector: Ixodes tick  ID test: venereal dse research lab test Streptococcus viridans
• S/s: erythema chronicum migrans (VDRL), Rapid plasma regain • “green”
 Rx: Pen G (DOC) – administer at gluteus • Normal flora of the oral cavity
maximuss Streptocccus mutans
Rickettsia • Causes bad breath, dental carries
• Pleomorphic coccobacilli Neisseria gonnorhoeae • CHO to lactic acid
• Peptidoglycan-ctg muraminic acid and diaminopimelic • Gonorrhea, STD • Complication: brain abscess
acid • PID
• Growth enhanced by Sulfonamides • Gonococcal ophthalmia neonatorum Streptococcus agalactiae
• Vector: transmitted via ticks, mites, louse, fleas • Normal flora of female genitalia
• ID test: Weil-Felix Test Chlamydia • CM: neonatal sepsis/meningitis (from mother)
• s/s: diffused rashes from arthropod bite • Elementary Bodies (EB): infectious form
• Rx: TCN, Chloramphenicol, increased resistance to • Reticulate Bodies (RB): non-infectious form Enterococcus (faecalis, faecium, durans)
sulfonamides • Causes conjunctivitis, cervicitis, pneumonia • CM:
• C. trachomatis, C. pneumoniae, C. psittaci o liver, intestinal abscess
Rickettsia rickettsii o UTI
• Vector: wood tick or dog tick
• Rocky Mountain Spotted Fever Haemophilus ducreyi Streptococcus bovis
• Fever, conjunctival redness, severe headache, rash • CM: soft chancre known as chancroid (hard chancre – CM • Normal flora of the colon
of syphilis) • Common org. isolated among patients with colon cancer
Rickettsia prowazekii • S/S:
• CM: Brill-Zinser’s Dse/epidemic typhus (vector = louse) o ulcerative lesions in genitalia Propionibacterium acnes
o Lymphadenitis in the groin area • More common in males due to inc. testosterone and sebum
Orientia tsutsugamushi • CM: Acne
• CM: Scrub Typhus (vector = mite) Haemophilus aegyptius • S/S: comedone (black, whiteheads)
• Aka Koch-Week’s bacillus, H.infuenzae biotype III
Rickettsia akari • CM: Conjunctivitis Brucella
• CM: Rickettsial Pox (vector = mite) • B. abortus (cow)
Mycobacterium leprae • B. suis (swine)
Rickettsia australis • Causes Hansen’s disease aka Leprosy • B. cannis (dog)
• CM: Queensland Tick Fever (vector = tick) • Found in scrapings from skin or mucous membrane in • B. miletensis (goat)
lepromatous leprosy • CM: Brucellosis aka Malta fever, undulant fever, Bang’s
• Attacks colder tissues of the body (ears, nose, cheeks, dse
Sexually Transmitted and Contact Infectious Bacterial scrotum)
• Two types of Leprae
Diseases Neisseria meningitides
o A. Tuberculoid (TL) • Meningococcus
 Benign type • Glucose and maltose fermenter
Treponema pallidum
 CM: blotchy, flat lesions • Piliated
• Microaerophilic
 (+) in lepromin skin test • Meningitis, meningococcemia
• Darkfield microscopy, immunofluorescence, silver stains
o B. Lepromatous (LL)
• Causes syphilis
 CM: disfiguring appearance Pseudomonas aeruginosa
• CM: Syphilis
(leonine/lion like), thickening of • Motile, obligate aerobic rods
o 1. Congenital (newborn, during 4th month)
eyebrows, lips, cheeks • Occurs as single bacterium, in pairs in short chains
 s/s: keratoconjunctivitis, perforated
 Disintegration of boy parts, malignant • Oxidase ( )
palate, saddle nose, patchy mucus
type • (+) ferment CHO
membrane, Hutchinson’s teeth
 (-) in lepromin skin test • UTI, pneumonia
 ID test: Flruoresent Treponema test
• Rx: Dapsone (DOC)
o 2. Acquired/STD
o SE: erythema nodosum leprosum Pigments produced:
 1st Stage: hard chancre
 2nd Stage: condylema – macupapular Pyocyanin
Proteus mirabilis Pyoverdin
rash with cigar butt like burn
• Very motile, alkaline urine Pyorubin
 Latent: Several years
• Common cause of UTI and nosocomial infections Pyomelanin

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