BACTERIOLOGY

• Study of bacteria
• a branch of microbiology dealing with the 
identification, study, and cultivation of bacteria 
and with their applications in medicine, agricul-
ture, industry, and biotechnology.
 Special Bacteriology
Staphylococcus aureus:
Staph. aureus is a Gram-positive coccus. The cocci
are mainly arranged in grape-like clusters, but
some may occur as a single cell or pairs of cells.
Pathogenesis: Staph. aureus is present in the nose
of 30% of healthy people and may be found on the
skin. It causes infection most commonly at sites of
lowered host resistance, e.g. damaged skin or
mucous membranes.
Staphylococcal toxins:

1. ENTEROTOXINS: enterotoxins, types A-E, G, H,

I and J are commonly produced by up to 65%
of strains of Staph. aureus. When ingested as
preformed toxins in contaminated food, can
induce within a few hours the symptoms of
staphylococcal food poisoning: nausea,
vomiting and diarrhoea.
2. TOXIC SHOCK SYNDROME TOXIN (TSST-1): a multisystem
disease caused by staphylococcal TSST-1 or enterotoxin,
or both -> established with the use of highly absorbent
tampons.

3. EPIDERMOLYTIC TOXINS: two kinds of epidermolytic

toxins (A and B) -> cause blistering diseases.
Epidemiology: the sources of infection are infected
lesions -> large numbers of staphylococci are
disseminated in pus and dried exudate discharged from
large infected wounds, burns, secondarily infected skin
lesions, and in sputum coughed from the lung of a
patient with bronchopneumonia. Direct contact is the
most important mode of spread.
• Diseases:
- in skin : furuncle, carbuncle, impetigo,
cellulitis, wound infection, folliculitis
- Musculoskeletal: osteomyelitis, arthritis
- Genitourinary: renal carbuncle, UTI (lower
part)
- Cardiovascular: endocarditis
Streptococcus pneumoniae
• Str. pneumoniae, commonly called the
pneumococcus, is a member of the oropharyngeal
flora of 5-70% of the population.
• They are G+. Str. pneumonia generally occurs as
characteristic diplococci.
• Str. pneumoniae is an important pathogen, which is
largely ascribed to its capsular polysaccharide.
• It primarily causes disease of the middle ear,
paranasal sinuses, mastoids and the lung
paranchyma, but may spread to other sites, such as
the joints, peritoneum, endocardium and biliary
tract and, in particularly, the meninges.
• Str. pneumoniae is the most frequent cause of
PNEUMONIA
• OTITIS MEDIA: middle ear infections:
approximately 1/3 of cases are caused by Str.
penumoniae.
• MENINGITIS: Str. pneumoniae is among the
leading causes of bacterial meningitis. It is
assumed that invasion arises from the pharynx to
the meninges via the bloodstream.
• person-to-person spread is common.
• Treatment: Penicillin. When resistance to
penicillin is developed, vancomycin is used -
Vaccines
• Streptococcus agalactiae
Str. agalactiae is a primary habitant of human
colon. It may be carried in the throat and
importantly, 10-40% of women intermitently carry
in the vagina. Str. agalactiae has become the leading
cause of neonatal infections in industrialized
countries and is also an important cause of
morbility among peripartum women and non-
pregnant adults with chronic medical conditions.
• EARLY ONSET: this results from ascending
spread of Str. agalactiae from the vagina into
the amniotic fluid, which is then aspirated by
the infant, and results in septicaemia in the
infant or the mother or both. Infants borne by
mothers carrying Str. agalactiae may also
become colonized during passage through the
vagina
• The clinical symptoms include lethargy,
cyanosis and apnoea, when septicaemia
progresses, shock ensues and death will occur
if treatment is not quickly instituted.
Meningitis and pulmonary infection may be
associated
• Risk factors for neonatal colonization and
infection are:
• premature rupture of membranes
• prolonged labour
• premature delivery
• low birth weight
• intrapartum fever
• LATE-ONSET DISEASE: purulent meningitis is
the most cmmon manifestation, but septic
arthritis, osteomyelitis, conjunctivitis, sinusitis,
otitis media, endocarditis and peritonitis also
occurs.
• Many cases are acquired in hospitals. Mastitis
in the mother has also been described as a
source of infection
• - Infections in the adult: disease may manifest
as sepsis, pneumonia, soft tissue infections
such as cellulitis and arthritis, and urinary
tract infections complicated by bacteraemia.
The risk factors in these patients are diabetes
mellitus, liver cirrhosis, renal failure, stroke
and cancer.
• Treatment:
G+ penicillin and ampicilin sensitive
 Streptococcus pyogenes
• This species, which consists of Lancefield
group A streptococci, is among the most
prevalent of human bacterial pathogens. It
causes a wide range of suppurative infections
in the respiratory tract and skin, life
threatening soft tissue infections, and certain
types of toxin-associated reactions
• Clinical features:
• The most common route of entry of Str.
pyogenes is the upper respiratory tract.
Spread from person to person is by respiratory
droplets or by direct contact with infected
wounds or sores on the skin.
• Pharyngitis: clinical signs such as abrupt onset
of sore throat, fever, malaise and headache
generally develop 2-4 days after exposure to
the pathogen. The posterior pharynx is usually
diffusely reddened, with enlarged tonsils that
may show patches of gray-white exudate on
their surface and, sometimes, accumulations
of pus in the crypts. The local inflammation
results in swelling of cervical lymph nodes.
• Scarlet fever: pharyngitis caused by certain
pyrogenic exotoxin-producing strains of Str.
pyogenes may be associated with a diffuse
erythematous rash of the skin and mucous
membranes.
• Skin infections: Str. pyogenes may cause several
types of skin infection, sometimes in association
with Str. aureus.
• It primarily affects exposed areas on the face, arms
or legs. The skin becomes colonized after contact
with an infected person and the bacteria enter the
skin through small defects. Initially, clear vesicles
develop, which within a few days become pus-filled.
• Rheumatic fever: this manifest as an
inflammation of the joints (arthritis), heart
(carditis), central nervous system (chorea),
skin (erythema marginatum), and/or
subcutaneous nodules. Polyarticular arthritis is
the most common manifestation, whereas
carditis is the most serious as it leads to
permanent damage, particularly of the heart
valves.
• Acute post-streptococcal glomerulonephritis:
the clinical manifestations include:
• coffee-coloured urine caused by haematuria
• oedema of the face and extremities
• circulatory congestion caused by renal
impairment
• Treatment
• penicillin (either G-penicillin for parenteral
use or V-penicillin for oral use)
• macrolides - in penicillin allergic persons only
• vancomycin - is a reserve, 100% effective
 Neisseria meningitidis
• Often referred to as meningococcus, is a
Gram-negative bacterium that can
cause meningitis and other forms of
meningococcal disease such as
meningococcemia, a life-threatening sepsis.
• is a contagious infection spread by close
contact, such as living with or kissing an
infected person.
• People spread meningococcal bacteria to
other people by sharing respiratory and throat
secretions (saliva or spit). Generally, it takes
close (for example, coughing or kissing) or
lengthy contact to spread these bacteria.
• The first symptoms are usually fever, vomiting,
headache and feeling unwell. Limb pain, pale
skin, and cold hands and feet often appear
earlier than the rash, neck stiffness, dislike of
bright lights and confusion.
• a fastidious bacterium, is a Gram-negative
kidney-bean-shaped diplococcal obligate
aerobe