cory ne bacterium

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Bacteria GPR or Gram Var. Peptiglycan in cell wall of bacteria Bacteria doesn’t contain chitin or cellulose Acid fast bacilli 1. Microbacterium 2. Nocardia Non-Acid fast 1. Corynebacterium 2. Listeria 3. Erysipelothrix 4. Bacillus 5. Atinomyces 6. Gardenella 7. Lactobacillus Corynebacterium 1. “Coryne” → Greek for Club → Club shaped cells 2. Ferments glucose & maltose 3. Reduces Nitrate to nitrite (Nitrate +) C. diptheria 1. A.k.a Respiratory dip. a. Spread by droplet or hand to mouth contact b. Incubation period → 2-5 days c. Treatment → horse serum w/ antitoxins 2. Manifestation a. Pharyngitis b. Dysphagia c. Low fever

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Page 1: Cory Ne Bacterium

BacteriaGPR or Gram Var.

Peptiglycan in cell wall of bacteria

Bacteria doesn’t contain chitin or cellulose

Acid fast bacilli

1. Microbacterium2. Nocardia

Non-Acid fast

1. Corynebacterium

2. Listeria

3. Erysipelothrix

4. Bacillus

5. Atinomyces

6. Gardenella

7. Lactobacillus

Corynebacterium

1. “Coryne” → Greek for Club → Club shaped cells2. Ferments glucose & maltose3. Reduces Nitrate to nitrite (Nitrate +)

C. diptheria

1. A.k.a Respiratory dip.a. Spread by droplet or hand to mouth contactb. Incubation period → 2-5 daysc. Treatment → horse serum w/ antitoxins

2. Manifestationa. Pharyngitisb. Dysphagiac. Low feverd. Malaisee. Lymphenditisf. Headache

3. Systemic effect

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a. Myocarditisb. Neuritisc. Kidney damage

4. Removal of the systemic membrane would cause suffocation5. Virulence factors

a. Caused by diphtheria toxinb. Bacteriophage gene → Tox gene

i. Strains that make it → toxigenic1. Blocks synthesis of Eukaryotic cells2. C. ulcers & C. pseudo tuberculosis can also become toxigenic when infec.

6. Cellsa. Curvedb. Chinese letters (when in clusters)c. Pickett fences (when in a line)d. “V”e. Non-Motile & Non capsulatedf. “Metachromasia” when stained with methylene blue

7. Mediaa. Loeffler serum media

i. Contains beef, serum, & eggsb. Phosphomycin makes BAP selective for corynebacteriumc. To ID

i. Tinsdale media1. Most preferred2. Black (↓ telluride) w/ brown halo (↓ cystinase)

a. Nontoxic strains don’t have the “halo”ii. CTBA (cysteine tellurite)

1. Blacka. Staph and Strep also grow black (differentiated by gram stain)

iii. CNA1. Least preferred

iv. Main ID items1. Reduced cystinase2. Absence of pyrazinamidase3. Most important → demonstration of toxin

8. Testsa. ELEK (diffusion test)b. PCR

9. Polypeptidesa. Frag. A

i. responsible for Toxicityb. Frag B

i. for mediation

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c. NAD is involved

C. Jeikeium

1. A.k.a → Prosthetic Valve disease2. Susceptible only to Vancomycin

a. May also be sus. to terramycin or erythromycin

C. Urealyticum

1. In urinary track2. Needs 48hr incubation before growth3. Mac → NLF4. Use cysteine urea slant5. Resistant to aminoglycosides & macrolides 6. Tests

a. Urease → Pos (within mins)

C. ulserum

1. Causes mastitis in cows & other animalsa. Human infec. → animal contact

2. C. dip like illnessa. Many produce dip. Toxins

3. Causes skin ulcers or exudative pharyngitis4. BAP → Narrow hem.5. Tests

a. Gelatin → Pos (at RT)

C. pseudo tuberculosis

1. Produces dermal nephrotic toxin2. Sus. → Penicillin & erythromycin3. Tests

a. Urease → Posb. Gelatin → Neg

Rhodococcus Equi

1. Found in soil2. GPR w/ Filaments & branching3. Looks like Klebsiella on BAP4. Salmon pink pigment5. NOT differentiated with Bio-chemical tests

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Listeria

L. monocytogenes

1. Caused by contaminated foods2. Only animal & human pathogen in listeria3. Growth

a. Best growth → cold enrichment ( 4° C )b. Optimal → 30-35° Cc. Can grow → 0-40° Cd. Aerobice. Non-sporulatingf. Grows on BAP, Choc, Thio, & brain-heart infusiong. Beta hem.

i. Confused w/ Beta strep B (A.k.a S. agalactiae)1. Differed by Catalase

h. Likes up to 10% NaCL (Salt)i. Needs a carbohydrate source

4. Virulence factorsa. Hemolystin

i. Listeria lysine Ob. Protein P 60

i. Induces phagocytosis ↑ adhesions5. Clinical Infec.

a. Found in blood or spinal fluid6. Drugs

a. Penicillin, macrolides, & aminoglycosides7. Most serious in Preg. Women, neonates, & immunocomp. Ppl.

a. In Preg. Womeni. Seen in 3rd trimester

ii. Causes spontaneous abortions & still births1. Takes 3-7 days

b. Neonatal Listeriai. when baby lives (50% do)

ii. types1. early onset

a. right after birthb. sepsis

2. Late onseta. Days-weeks after birthb. Meningitis

c. In immunocomp. Ppl.i. Known as Invasive Listeria

ii. Manifestations

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1. Central nervous system infec. (most common)2. Endocarditis3. Meningitis4. Sepsis

Erysipelothrix Rhusiopathiae

1. Mainly in domestic Swine (pigs)2. Human infec. → Occupational exposure (threw cuts)3. Resistant to salting, pickling, & smoking ( pig feet )4. Incubation → 1-4 days5. Growth

l. vary long filamentsm. Non-sporulating

6. Motility → pipe cleaner or test tube brush looka. Differs from listeria

7. Types in humansa. Septicemiab. Erysipeloid (skin)c. Endocarditis (mostly in valve replacements)

8. Infectiona. Swollen, painful (looks like a pimple)b. Red-purple zonec. Zone spreads as the color fades

9. Manifestsa. Last 2-4 weeksb. Lymphadenopathyc. Low feverd. Relapses are common

10. Treatmenta. Penicillinb. Clindamycinc. Erythromycind. Cephalosporin

11. Gram stain → little short chains, or “V” shape12. Specimen

a. Tissueb. Skin aspiratesc. Inoculate in broth w/ 1% glucose, incubate, subculture to BAP Daily

13. Coloniesa. Non-Hem or Alphab. 24hr → Pinpointc. 48hr → 2 distinct colonies

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i. 1 → small, smooth, transparent, glysiningii. 2 → large, rough, irregular edges

14. Testsa. Acid from glucose → +b. Nitrate → =c. Urease → =d. Res. to neomycin → = (Listeria is sus)

Bacillus

1. Organisma. Pink to black-blue pigmentb. Aerobicc. From Endosporesd. In all climatese. Grow at 5-75˚C (org. dependent)

2. Classified based on spore locationa. Group 1

i. Oval, located Centrally or Terminallyb. Group 2

i. Same as 1 but w/ Swollen Cellsc. Group 3

i. Round, terminal, Swollen spores

B. anthracis

1. Causes Anthrax2. Lestinace +3. Grows in high salt4. Sus. To penicillin (B. cereus is not)5. Virulence

a. Depends on glutamic acid capsulei. Protects from phagocytosis

ii. The Capsule IS necessary6. 3 factors

a. EF (Edema factor)i. EF + PA → Swelling

ii. EF + LF → Nothingb. PA (Protective antigen)

i. Is needed for activation of these factorsc. LF (Lethal factor)

i. LF + PA → Death, toxin ↑ in vascular permeability interfering w/ phagocytosis

Anthrax

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1. Spread → animals eat plants, we eat animals2. Forms in humans

a. Cutaneous (Wound)i. Steps

1. 2-3 day incubation2. “Pimple” like lesion forms

a. Usually 1-3 m in diameterb. Called malignant puscual

3. Vessels form around the pimple4. Eschar forms

a. black ring in center of infectionb. Puss present → A pyrogenic organism is present

5. Heals in 1-2 weeksii. Manifest

1. Lymphangitis2. Malaise3. Lymphadenopathy

b. GI (ingestion)i. Organism

1. Gram Posa. Only young cultures are gram Pos

2. Square endsa. Single or in chainsb. Look like bamboo rods

3. On BAP → Medusa Head4. Look like “string of pearls” on agar5. Non-hem6. Non-motile7. Produces lithinase on egg yolk

ii. Symptoms1. Abdominal pain2. Bloody diarrhea3. 5% produce meningitis4. …

iii. Mortality1. ↑ than in cutaneous (it’s usually misdiagnosed)2. May occur 1-6 days after exposure

iv. Treatment1. Penicillin (drug of choice)

v. Sensitive to1. Gentamycin2. Erythromycin3. Tetracycline

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4. Chloramphenicolc. Pulmonary (inhalation)

i. Alternate names1. Wool sorters disease

a. Most common2. Rag pickers disease

ii. Symptoms1. Resemble cold & flu2. Last 2-5 days after inhaled

iii. Sever Phase1. Dyspnea

a. trouble breathing2. Stenosis

a. Vessels narrowing3. Plural infusion

a. Fluid in lungs4. Onset of respiratory distress till death → about 24 hrs

B. cereus

1. Causes food poisoning2. 2 types

a. Diarrheai. Ass. w/ Meat & Poultry

ii. Incubation → 8-16 hrsiii. 25% experience vomitingiv. Fever is uncommonv. Lasts 24 hrs

vi. Indistinguishable from Clostridium perfringensb. Emetic (vomiting)

i. Ass w/ fried riceii. 1/3 ppl. Experience diarrhea

iii. Lasts 9 hrs3. 2 distinct enterotoxins4. Res → penicillin5. Ferments …6. Part of normal fecal flora

a. ≥ 10⁵/g confirms it’s the cause of the disease7. Opportunistic infec

a. Eye infec. (Most common)8. Are contaminants of enlisted drugs9. Treatment

a. A Clindamycin / Gentamycin combination

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B. subtilis

1. Mostly pigmented2. Usually a contaminant3. GI illness

Actinomyces

1. A fungus like bacteria2. Branches out (like hyphea)3. reproduces by spores, fragmenting of conidia, & …

Nocardia

1. Characteristicsa. Aerobicb. Branched Hyphaec. Easily disrupted into rods & coccid. Stains Gram Variablee. Weak acid fastf. Slow growers

2. Speciesa. N. asteroidesb. N. brasiliensisc. N. canidae

3. Samplesa. Sputum or wound

4. 25-30˚C5. Produces a superoxide dismutase & catalase → gives resistance to oxidative killing. And a

nocobactin6. Routes

a. Pulmonaryi. Cause → Broncho Pneumonitis

ii. Fatal in ppl w/ SS disease & SC traitiii. Rapid progressioniv. Initial lesion in lung → pneumonitis advances to necrosisv. Little encapsulation, granuloma formation

vi. Disseminates to brain & other organsvii. Sputum → thick & sticky

viii. No sulfur granulesb. Cutaneous (inoculation)

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i. Cause → N. Brasiliensisii. Seen in hands/feet

iii. Destructive to tissue & bone1. Called “mycetoma”

iv. Puss → pigmented, contains sulfur granulesv. Granules → white/cream color

1. Eumycotic gran → Fungal Granules2. Atinogranules → Actinomyce Granules

vi. Treatment1. Drain it2. Surgery3. Antimicrobials

a. Res to Penicillinb. Sus to sulfonamides

vii. Sample1. Tissue2. Puss

viii. Best isolation → Paraffi-bate techniquec. Aerobic

i. A. pelletieri1. Was part of Nocardia

a. Most everything is the same2. Only diff → it’s Cellulose & Xylose Pos

ii. Streptomyces1. S. Griseus

a. 3rd most common aerobic Actinomycei. After A. Bracillis & Streptomyces

b. Doesn’t show aerial filamentsc. Chain of sporesd. Is a soil mycosis

Mycobacterium

1. Bio-chemicalsa. Septi-check AFB

i. Is for Recovery time & Growth rateii. Recovery → 3-60 days

1. Rapid growers → < 7 days2. Slow → > 7 days

iii. Temp → 30-32˚C1. Up to 35˚C2. Only 42˚C mycobacterium → Xenopi

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MTB (M. tuberculosis)

1. Organisma. Is inhaledb. Consists of MTB, M. bovis, M. canidi, M. africanum, M. microti, M. canettii, M. leprea, MOT

(M. Other Than TB)i. M. bovis & MTB → the main cause of TB

ii. M. canettii → cause lymphadenitis & TB in aids patientc. All are a strong acid fastd. Have waxes and lipids in cell walle. GS → ghost cellsf. Optimal growth → 30-45˚C

i. Best → 37˚Cg. Target organ → lungsh. Specimen of choice → bronchial lavage

i. Fecal spec. → M. avium → Aids patientsi. Generation time → 3-6 weeksj. Patient must stay in isolation for 72hrsk. All tests are Pos except Catalasel. Cat → = at 68˚C

2. Runyon classificationa. Photochromogens

i. Bright yellow pigment in presence of lightii. M. marinum, M. kansasii, M. samyii, M. asiaticum

b. Schotochromogensi. Deep yellow color in presence of light or dark

1. The longer it’s in light the deeper the yellowii. M. scrofulaceum, M. gordonae, M. szulgai

c. Non-Photochromogensi. No pigment in light or dark

ii. Usually light yellow or tan coloriii. MTB, M. avium, and all the rest

3. Staining techniquesa. Ziehl-Neelsen

i. Carbol fusion stainii. Heat at 68˚C

1. Allows die to penetrate cell walliii. Acid-alcohol decolorizeriv. Malachite & methylene blue…

1. Non-acid fast → blue-green2. Acid fast → pink

b. Kinyouni. A.k.a → Cold acid fast stain

ii. Primary stain → ↑fusion & phenol than in Neelsen

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1. Dissolves cell wall allowing for penetrationiii. No heativ. Modified kinyoun

1. Weaker decolorizer2. Sulfuric acid

c. Auraminei. The mycobacterium fluoresce bright yellow

ii. Need a florescent microscope4. Classification

a. Primary Pulmonary TBi. Usually asymptomatic

ii. May have a non-productive cough, fever, or shortness of breathb. Chronic pulmonary TB

i. Fever, chills, fatigue, night sweats, weight loss, chest pain, sputum productionc. Advanced chronic TB

i. Hemoptysis (spitting up blood)d. Systemic

i. A.k.a → Miliary-TBii. Hemoginase dissemination via blood stream

iii. Organs involved → spleen, liver, lungs, BM, kidney, adrenal gland, eyes1. May also include central nervous system, GI track, pericardial

5. To get ready for processinga. NACL

i. A TB based digestion1. Contains sodium Hydroxide

a. A decontaminate agent (helps isolate)ii. 50 ml conical tube

iii. Add sterile distilled water or 0.067 M Phosphate buffer w/ a PH of 6.8iv. Use the sediment at the bottom for staining

6. mediaa. Back-tech bottleb. Lorestine-jenstinc. Middle-brookd. Middle-brook 7H9 (or 7H11)

i. 7H11 → serpentine quarting seen when it’s TB7. To ID

a. Lives in tissue cells i. Macrophages or monocytes

1. Means it inhibits phagocytosisii. Mycolic acid in MTB → A.k.a cord factor

1. is cytotoxic2. inhibits WBC migration

8. Treatment

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a. INH (Isoniazid)b. Etham brutalc. Pyrazamide (PSA)d. Rifampin

Niacin accumulation

NitrateRed.

Growth on TCH

Pyrazinamidase(4 day)

MTB + + + [ +M. africanum V V V =

M. bovis = = = [ =M. canetti + + + +

Notes: → a = nitrate red. → Confirmed by “zinc dust” (a heat tolerance test to see if Catalase can be detected (MTB is all Cat = at 68˚C))

→ Growth on TCH → Is + in 7-H11 (NOT H9)

MOTs

1. Usually from environmenta. Soil, aquarium, bio-film of ….

2. Infects lungs, skin, soft tissue, bones, lymph nodes

Slow Growers

Species Clinical sig.Pigment

productionOther

characteristics

M. avium & M. intracellular

-Most common MTM in humans-cause infections in AIDS pat.

Non-photo

M. Kansasii -2nd to M. avium as a cause of MTM -Cause chronic pneumonia & cervical lympintitis, cutaneous abscesses,Cellulitis, arthritis, fasciitis, osteomyelitis

Photo * -Long beaded bacilli on acid fast stain

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M. Marinum(marina)

-Chronic skin lesions,-Corticoid mycobacteriosis

Photo * -Requires 30-32°C Incubation to recover In-vitro

M ulcerins -Chronic deforming skin ulcers, buruli ulcer(in Africa)

Non-photo

Xenopi -Pulmonary dis.,Disseminated infec.

Non-photo -Pale pigment (may change) *is Thermophilic (42-45C)-Recovered from hot water systems

RAPID Growers

Species Clinical sig.Pigment

productionOther

characteristics

M. Fortuitum -Everything but pulmonary disease

Non-photo

M. abscess -Chronic lung dis, Post traumatic wound infec, Otitis medium cutaneous infec, Catheter associated bacteremia

Non-photo

M. chelonae -Disseminated nodular dis,Post fram. Skin infec,Catheter infec.

Non-photo

M. mucogemicum

-Soft tissue infec,Catheter associated septicemia pulmonary

Non-photo -Only one that affects lungs

M. Lepra Non-photo

All → Non-Photochromogens

Skin → affected most

Lungs → least

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Gardenella vaginalis

1. Founded the vagina and rectal area of male and female2. Causes bacteria vaginalis3. A synergetic bacteria (uses many bacteria to make infection worse)4. Can cause premature rupture of membranes, preterm delivery, chorioamnionitis, neonatal

infections5. Clue cells seen

a. Squamish epithelial cells6. Absence of lactobacillus seen in smear 7. Diagnosis

a. BD panelb. Amsel & Nugent criteria

i. Age, sexual history, reset STDs, vaginal discharge (anal rectal discharge in men)8. Media

a. V agari. 37°C

ii. 5% CO₂b. If its human or rabbit blood → beta hemolyticc. If not → Non-hemolytic

9. Cat → =10. Inhibited by 50mg of metronidazole or 5mg of trimethoprim

Lactobacillus

1. In every body site. Mainly:a. Oral cavityb. GIc. Vagina

i. Called “good guys”1. Makes hydrogen peroxide (H₂O₂) which helps keep pathogenic bacteria in check

2. Probiotics …..3. GS → square ends4. Microaerophilic or obligate anaerobes5. Non-spore6. Non-motile7. Alpha-hem8. Cat, Ox, Nit, H₂S → =9. Vancomycin resistant

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GNRs

Enterobacteriaceae

1. Organismsa. E. Colib. Klebsiella c. Citrobacterd. Serratiae. Salmonellaf. Shigellag. Proteush. Morganellai. Providenciaj. Yersiniak. Enterobacterl. Edwardsiella

2. Klebsiella & Enterobacter are encapsulateda. So is Pantoea but it’s no longer an Enterobacteriaceae

E. coli

1. Most common cause of the UTI 2. 2ND most common and nosocomial infection & septicemia3. Not encapsulated

1. If it is → has an O Ag, H Ag, & a K Aga. O → lipopolysaccharideb. H → Figgeliumc. K → capsule

Klebsiella

1. All Kleb.a. Hodge test ??

2. K. pneumoniaa. Usually lower respiratoryb. Lung disease, UTI, nosocomial infection, ENT infection (ear, nose, throat)

3. K. oxytoca a. Isolated from blood, urine, respiratory tract infections, school

Pantoea

1. used to be an Enterobacteriaceae (Isn’t anymore)2. nosocomial infects (hosp. required)

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3. Isolated from urine, blood…

Citrobacter

1. Intestinal flora2. Cause disease to debilitate patient3. Urinary tract, ….., meningitis

Serratia

1. Soil & water2. Nosocomial infects.3. Non-pig or bright red

Salmonella

1. 2 speciesa. S. entericab. S. bongori

2. S. enterica

a. S. typhi i. Causes typhoid fever

1. Death usually from septic shock2. Transmitted → p-p, & fecal cont. food and water3. Serotype- S. paratyphi A, B, & C4. Antigen → VI antigen (capsule)

3. S. typhimurium, S. enteritidis4. Characteristics

a. Aerobic or facultative anaerobe b. Typhi → orthinine = …..

5. Virulence factora. Pilib. endotoxin—cause of death

6. Based on O Ag, VI Ag 1 & H ag (H is the same )a. O → somaticb. Vi → capsulec. H → Flagellum

Shigella

1. Most Bio-chemically Non-reactive 2. Serogroups

a. A → S. dysenteriai. doesn’t ferments mannitol (the rest do)

b. B → S. flexner

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c. C → S. bongorid. D → S. sonnei

i. Most diarrhea commonly caused by A & B1. In the US → B & D

3. Causes shigellosisa. A.k.a bacillary dysenteryb. Bloody or non-bloody diarrheac. common in “developing countries” (is an epidemic)

4. Trans → P - P or fecal cont. H2O5. Virulence factors

a. Surface proteins i. Invasive plasmid Agsii. Adherence & phagocytes of epithelial cellsiii. Where the shiga toxins are produced

1. Cause Huss.

Proteus

1. Found in G.I, soil, H₂O & sewage2. Nosocomial 3. If indole = & ampicillin sens. → P. Mirabilis

a. If ampicillin is res. → more tests → maltose & ornithine → M =, O+, → P. Mirabilis

Morganella

1. Used to belong to proteus 2. Nosocomial

Providencia

1. Nosocomial

Yersinia

1. virulence factors a. possess adhesions b. anti-phagocytic proteins and capsules c. produces coagulase & fibrinolysisd. can bind or store hemine. motile at 22˚C

2. Mediaa. Cin → target colonies

i. Aeromonas also grows, but is OX +

GNRs that are NLFs

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1. Usually cause hospital infection, swimmers ear, UTI, burns and pneumonia2. Differentiate from Enterobacteriaceae

a. Oxidase → Vb. Mac → Vc. Glucose → =

3. OF glucose testa. Helps see if the organism breaks down carbohydrateb. O → Oxidativec. F → Fermentatived. Sugars used → glucose, maltose, lactose and mannitole. Tubes start green

Open tube Closed tube Interp.

Yellow Green Glucose Oxidizer

Yellow Yellow Glucose Fermenter

Green Green Glucose Non-oxidizer

Pseudomonas

1. Most common aerobic organisma. most isolated spp. P. aeruginosa and Acinetobacter

2. Testsa. Motileb. Non-spore formingc. Cat +d. Ox +e. Nitrate +

3. 2 groups separated by colorsa. Pyoverdin

i. Yellow/Greenii. Yellow/Brown

b. Pyocyanini. Yellow/Blue

ii. Blue/Brown

4. P. aeruginosa a. Colonizer

i. can survive in soap & weak disinfectant

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b. Not normal florac. Cause community acquired infection

i. Folliculitisii. Eye infection

iii. Burnsiv. Endocarditis

d. Virulence factori. Pilli

ii. Exopolysaccarides (slime)iii. Exotoxins and exoenzyme (hemalycin and protease)

e. Treatment → Gentamicinf. Test

i. TSI: K/Kii. Growth: 42˚C

iii. Spot indole =1. Differs Pseudomonas & Aeromonas

Burkholderia

1. Characteristics

a. non-spore formingb. motile (except B. malei)c. catalase +

2. B. cepaciaa. affect people with indwelling catheters, surgical and burn woundsb. causes lower resp. infec. in patients with Cystic Fibrosisc. CGD → deficiency in PMN’s i.e. neutrophilsd. Drug resistant

i. only one tested for SXTii. weak Ox+

e. resemble pseudomonasf. Dark pink to red colonies after 4-7 days (ferment lactose)g. Dirt-like odor

3. B. pseudomalleia. cause Melioidosisb. Pneumonia is the most common symptom

c. Resp. infection resembles TBd. can lay dormant for years then become reactivee. Geographic locations

i. SE Asia ii. North Australia

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f. potential bio warfare agentsg. Treatment → SXT & Fluoroquinolonesh. Tests

i. Ox+ii. Produce gas from nitrate

iii. Arginine dehydroxinase =iv. Motilev. Gram stain → safety pin

i. Earthy odor (dirt-like)

S. maltophilia

1. Most common opportunistic infectiona. Conjunctivitisb. Parativitis

2. Susceptible to SXT (read at 24hr)3. Tests/Media

a. BAP → yellow, tan or green (smell like ammonia)b. DNase +

i. pink coloniesc. glucose Oxidative → = or Lated. Lysine decarb +e. Maltose +

Alcaligenes

1. Isolated more from clinical spp.2. Water, soil, moist areas of hospital3. Nosocomial4. Has CDC Alcaligenes (they don’t have official names yet )5. Isolated from: blood, urine, knee joint, brain abscess and bronchial washing6. Drug resistant

a. Aztreonamb. Genemycinec. amplicillin,

7. testsa. BAP → greenish discolorationb. Oxidase +c. Indole =d. Is a Asaccharolytic Non-fermenter e. Reduce nitrate and nitrite

Chryseobacterium

1. Soil, vegetation, water (including tap water)

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2. C. Indologenesa. causes septicemia in people with indwelling devices

3. C. meningosepticuma. causes septicemia in neonatesb. resistant `to Gram negative antibioticc. Susceptible to Gram positive antibiotics

i. Rifampinii. Clindamycin

iii. Erythromyciniv. SXTv. Vancomycin

4. Testsa. Motility

i. M. septicum =ii. Indologenes +

b. BAP: yellowc. MAC: poorly grown or not at alld. Indole +e. Cat +f. Ox +g. Esculin +h. Gelatinase +i. H₂s +

Fastidious GNRs

1. Organismsa. The HACEK group

i. Haemophilusii. Actinobacillus

iii. Cardiobacteriumiv. Eikenella

v. Kingella

b. Pasteurella

c. Bartonella

d. Legionella

e. Francisella

f. Capnocytophaga

g. Mis.

i. Aeromonas

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ii. Plesiomonas

iii. Brucella

h. Pretty much all the “ellas”

The HACEK group

1. In Oral cavity 2. Cause endocarditis3. Very slow growers

a. 6-10 days

Haemophilus

1. Characteristisca. Coccobacillus (kidney bean shape)b. Non motilec. Non-spored. Requires either:

i. X → Heminii. V → NAD

e. Nitrate +2. H. influenza

a. Cause Bacterial Meningitisb. Vaccine → HIBc. Has capsular-Bd. Causes Pink eye, conjunctivitis, meningitis in kids, & acute epiglottitise. 2nd most common of otitis media

i. Strep pneumonia is #1f. Virulence factor

i. Polysaccuride capsuleii. Res to

1. Ampicillin2. Chloramphenicol3. Tetracycline4. B- Lactamase

iii. BAP → satellitism in presence of staph aureusiv. Also Require X & V → H. aegyptius & H. hemolyticusv. Porphyrin test

1. Organisms that require X &V can’t break down porphyrin2. H. hem → porphyrin =

a. H. parainfluenza is the only +vi. Grows in 5% CO₂

3. H. parainfluenza4. H. aegyptius

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5. H. hemolyticus6. H. para hemolyticus

a. Lower respiratory infecs.i. Is upper res. Normal flora

7. H. ducreyi a. An STD

i. chancroid b. mostly Asia, Africa, & Latin Americac. Grows best 33°Cd. GS school of fish

Pasteurella

1. In gingiva (gums) & nasopharynx of animals 2. P. multocida most common human isolate 3. Transmitted infect. dog/cat into wound or scratch 4. Peritonitis in home care dialysis pat. 5. Small, coccoid, non-motile 6. GS bi polar

a. So is Yersinia, burkholderia 7. Encapsulated8. Musty odor9. Bap Glisten 10. MAC NG ( still WB) 11. Ox, Cat, Indole, Nitrate +12. Use ornithine decarboxylase to differ

Actinobacillus

1. Animal pathogen2. In humans urea hominis, actinomyces chromatins 3. Isolated from blood, CSF, peroneal fluid4. Virulence factor

a. Leukotoxins, endotoxins, b- lactamase producedb. Res penicillin, macrolides,…c. GS → coccoidd. Non motilee. don’t grow on MACf. OX → Vg. Cat +h. Urease, nitrate, indole =i. Confused with Pasteurella, Yersinia, …

Bartonella

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1. Causes trench fever & cat scratch disease a. B. quintana → Trench feverb. B. henselae → Cat scratch

2. Cephalitis (brain)3. Hepatitis 4. Antibiotics help liver and spleen infec.5. GS slightly curved6. Aerobic 7. Grow on Bap & Choc.8. Produces two colonies

a. Irregular, rough, molar tooth lookb. Small, tan, pits into agar, Carmel smell

9. ox =10. Cat =11. Urease=12. Indole =

Bordetella

1. Cause of whooping cough a. Cause cyanosis, hernias, mid ear infection, pneumonia, CNS dysfunctions, … b. Virulence Factors

i. Has adhesionsii. Protein toxins ??

iii. Piliiv. Endotoxins v. Survives within macrophages

2. Treatment erythromycin, clarithromycin, azithromycin 3. Don’t use cotton swabs to collect

a. Cotton inhibits it4. Strictly aerobic5. Media

a. Bordet-Gengou (preferred)b. Reagan lowc. potato diffusion mediad. charcoal horse blood → mercury droplets

Capnocytophaga

1. Dog/cat bite infecs2. Usually isolate with Act. israelii 3. Res astrininame, aminoglycosides, vancomycin …4. GS fusiform with thin pointed ends 5. … pleomorphic or

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6. Falcutalive anerobes a. 5-10 % Co₂

7. MAC =8. if org is moved yellow pigment9. Sliding/ gliding motility on plate

a. Looks like sweating10. Indole, urease = 11. Decarb =12. Cat, ox +

Cardiobacterium

1. Cause endocarditis2. C. Hominis

a. GS → Rosette Clustersi. Appears GP but is a pleomorphic GNR

b. Cultured on Media with yeast extract c. Requires 5-10% Co₂d. Pits into agare. Hold blood cultures 2-3 weeks

Francella

1. Cause tularensisa. Cause tularemia

2. In small mammals and arthropods3. Transmitted air, H₂O, soil, vegetation, handling ill or dead animals, or infec. Insect bites 4. Mechanical & biological vector animals5. Subspecies

a. F. tularensisi. A.k.a → Bio vars

ii. Most virulentiii. Hunters get it from tick/ deer tick bite, rabbitsiv. Common names tick fever, deer fly fever, rabbit feverv. A facultative intracellular (lives & multiples in macrophage)

vi. Symptoms chills, fever, generalized malaise vii. 6 forms

1. Ulcerglandular ( ulcer and lymph’s) 2. Glandular ( lymph’s) 3. Oculoglandular ( eyes, lymph’s ) 4. Pneumonic5. Typhoidal

6. Is a bio ware fare agent a. Yersinia

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b. B. anthrosisc. Burkholder

7. Vurulance a. Encapsulatedb. Can live in phagocytes

8. Res penicillin and cephalosporin’s 9. SES. strepitnomycine10. Tests

a. Non motileb. GNBc. Media cysteine thio sulfate infused media d. Choc. raised, butyraceous (fat) after 10-14 days e. Produces sheen from utilizationf. weak Cat +g. Ox =h. Uses glucose, maltose, sucrose…i. Doesn’t produce gas

Legionella

1. L. pneumophiliaa. Most common one in humansb. In soil & H₂O (including chlorinated H₂O)

i. Mostly likes hot H₂O tanks (40-50°C)c. Primary Cause of Legionellosis

i. A.k.a legionnaries diseasesii. A flu like illness (Pontiac fever)

d. Survives in temps from 0-60°C & PH from 5-8.5e. Reservoir → Aquatic and soil dwelling ameba’sf. Virulence factors

i. Piliii. Endotoxin

iii. Cytotoxiciv. Long filamentsv. …

vi. Facultative intracellularvii. Stimulates phagocytosis & replicates within ovular macrophages & epithial cells

viii. Drugs of choice1. Erythromycin2. Rifampin3. Tetracycline All used together4. fluoroquinolone5. Imacruli azilites???

ix. Tests

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1. Urinary antigen test2. Motile3. GS → faint GNR

a. Use carbol fuchsin or crystal violate stainx. Media

1. BCYE (Buffered Charcoal Yeast Extract)xi. To ID

1. requires Cysteine2. Doesn’t ferment anything3. Slide agglutination

Bacteria w/o cell walls

Mycoplasma & Ureaplasma

1. Grow on enriched mediaa. Fried egg appearance

2. Mediaa. Shepherds A-7b differential agar

i. Extreamly small colonies1. Must examine under microscope

3. Can pass through pores & effect the mucus membranes of the genital & upper res. Track4. Cause cell damage by releasing H₂O₂5. M. genitalium & U. urealyticum

a. Cause NGU (Non-gonococcal urethritis)i. Treatment → Doxycycline

6. M. pneumonia a. Sus to

i. Chloroquinilonesii. Tetracyclines

7. Ureaplasmaa. Common in genital urinary trackb. Ass w BV (bacterial vaginosis) & PID (pelvic inflammatory disease)c. Sus to

i. Doxycyclineii. Tetracycline

8. Distinguished by Urea (release of ammonia)

Glucose Arginine(only for These 2 &

Plesiomonas )

Urea

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M. pneumonia + = =M. hominis = + =

M. genitalium + = =U. urealyticum = = +

Misc. GNRs

Aeromonas

1. Found in fresh H₂O2. Transmitted → Food, meat, dairy3. A. caviae

a. Ass w diarrhea & dysenteryb. Symptoms

i. Fever, vomiting, Ab. Pain, nauseac. Don’t “fit” into any specific groupd. Tests

i. Ox, nitrate, indole, VP, Lysine, + (+ or most anything )ii. Ferment w or w/o gas

e. Mediai. Bap → hemolytic

ii. CIN → Pink center1. Look like Yersinia

Plesiomonas Shigelloides

1. Part of Enterobacteriaceaea. Only diff → its OX +

2. Cause diarrehea, fever, dehydration3. Media

a. NLF & Non-sucrose fermentorb. CIN → Clear

4. Testsa. Lysine, ornithine, arginine +’

Brucella

1. Causes Brucellosis

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2. 4 Speciesa. B. abortus

i. Cows ii. Only one in humans

b. B. melitensisc. B. suis

i. swined. B. canis

i. Dogs3. Transmitted → Food, contact4. Potential bio-warfare agent5. Ass w granulomas

a. WBC abscesses in the primary lymphoid organs 6. A common lab acquired infection7. Intracellular8. Resist destruction within the phagocyte9. Virulence factors

a. Facultative aerobic i. So is pseudomonas

b. Growth → 37°C, CO₂c. Slow growersd. Nitrate, Ox, Urease, Cat, H₂S +e. Indole =

GN Curved & Spiral shaped Bacilli

Curved

1. Vibrio2. Campylobacter

Spiral

1. Treponema2. Borrelia3. Leptospira

Curved

Vibrio

1. Found in salt water

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a. On & in marine animals, plankton & Sea foods2. Causes Cholera

a. An acute diarrhea disease b. Produces Rice water stoolsc. Usually shows in natural disasters

3. Virulence factorsa. Flagellab. Pilic. Cholera toxind. Adhesionse. Motilef. Lactose =g. Facultative anaerobeh. Mac → NLFi. Halophilic

i. Loves salt j. Treatment → tetracycline

4. 2 strainsa. V. cholera 0139b. V. cholera Non-01 & Non-0139c. All 3 on Bap → Beta hem

i. Other Vibrio → Alphad. Have capsules

5. Put in Cary Blair bottlea. Enhances bacterial survival

i. Has sodium thioglycollate & a ↑ PH6. New Orleans has the highest Report in the US7. Media

a. TCBSi. Best for V. cholera & V. parahaemolyticus

ii. Produce smooth green colonies8. Ox, Nitrate +9. String Test +

a. V. cholera +, other Vibrios =

Campylobacter

1. In cattle, sheep, pigs, poultry, plants2. Transmitted → Contaminated food

a. Primarily chicken & unpasteurized milk or water 3. C. jejuni & C. coli

a. most common cause of food borne illness in the USb. also cause HUS

i. So does E. coli

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4. C. jejuni → most common cause of bacterial diarrhea & sporadic enteritis5. C. fetus

a. Human infec. Is rareb. Cause abortions in cattle & sheepc. Campy

i. Growth at 25°Cii. Vary at 42°C

iii. HIPP =d. Treatment → erythromycin, azithromycin, clarithromycine. Sus → cephalosporin

6. Testsa. Thermophilicb. Motilec. Adherenced. GS → Seagull Wingse. Bap → Non hemf. Mac → NGg. Ox, Cat, Nitrate +h. Urease =i. HIPP

i. C. jejuni → +ii. C. coli → =

j. CNA → V7. Virulence factors

a. Microaerophilic, capnophilici. 3-5% O₂

ii. 10% CO₂iii. 85% Nitrogen

8. Mediaa. Campy

i. 42°Cii. Grey

iii. Mucoid

Spirochetes

Leptospira

1. L. interrogans2. Cause leptospirosis (A.k.a Weils disease)3. Transmitted → Contact with infec animal urine4. Occupational hazard for ppl in contact with animal urine

a. Such as ppl. In rice or sugarcane fields5. Entry → abrasions, cuts, or the eye

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6. Symptoms look like aseptic meningitis7. Enteric biceric infec8. Treatment penicillin, doxycycline9. GS → tightly coiled spirals with pointed ends (shepherds hook, or crook)10. Motile

a. In blood, urine, CSF, peritoneal fluid11. Obligated aerobe12. 28˚-30˚C13. Media

a. EMJH (ellen-hausen, mccullen Johnson, harris) b. PLM – 5c. Both → .1% Agar olaic acid, albumin, 5 flouracil d. Sealed in darke. Growth → dingers ring ( a band)f. Incubated for 13 weeks

i. Looked at once a week under darkfield mircroscopy14. Anti- enterogans are detected by Pat. Serum with suspension of live or killed bacteria

a. +→ seen→ agglutination aka microagglutination test

Borrelia

1. Causes Lyme disease2. Flagella lie between cell membrane and outer membrane 3. Motility → cork screw or oscillating4. Trans → IXODEX deer tick 5. Babesia (Maltese cross)6. Human infection→ called Borrelia

Species Disease Arthropod vector Animal reservoir

B. burgdorferi Lyme dis. Hard ticks RodentsB. recurrentis Louse-borne relapse

fever Human body lice Humans

B. duttonii Tick-borne relapse fever

Soft ticks Humans

B. hermsii,B. venezuelensis,B. mazzottii

American tick-borne relapse fever

Soft ticks Rodents

Other Tick-borne relapse fever (in countries other than N & S

Soft ticks Rodents

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America

Burgdorferi

... Left room for a min…

1. Lyme disease mostly in NA2. 2 IV injection3. Drugs → chephlosporin4. B. Bodorfif → res to trymephyl , sulfur, refambin, aminoglycocydes5. Cause Relapse fevers, treat →tetramycin, & erythromycin6. Loosely coiled7. Gs→ pale pink8. Use dark field microspy

a. Acradine orange9. Media

a. Modified Kelly i. Inc. in dark at 30-33˚C

10. Rotational motility

11.To detect Ab → anti… procedure

Treponema

1. Cause of syphilis 2. + poladium3. Some cause gingivitis4. Virulence factors

a. Can coat itself with host proteins to protect itself from the immune system b. Attach endotheial cells that line blood cells c. Can pass through placenta causing congenital syphilisd. Treat → penicillin e. Very thinf. Used dark field or phase contrast

Species Disease Location

T. Pallidum Venereal Syphilis World wide

T. Pertenue Yaws Caribbean, Indonesia, SA

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(Cutaneous lesions) (Tropical regions )T. endemicum Bejel

(oral Pharyngeal & cutaneous lesions)

ARID regions

T. carroteum Pinta(Skin lesions)

Central & South America

Obligate intracellular bacteria

Chlamydia

1. Sexually transmitted 2. Have elemtary bodies ( EB) → metabolicly inactive and infectious 3. Ritic bodies (RBs)

a. Active and non-infectious4. Biphacic elements

EB

1. Survive in extracellular environment (RBs cant)

Stages

a. EB is taken up in the host cellb. EB → RBc. RB combined by bionary fusion forming inclusion bodies d. After 48 hours the multiplication stops and they combine together to form new EBse. Ebs are released from cell by cytolysis

ID’d by

a. Transport media → keep coldb. Cell culture (hella, cell cult)c. PCR → does clam. & gonorreha → uses urine d. Considered energy parasites e. Cause trichimona, inclusion conjunctivitis non gonnicoccal urethritisf. C. pneumonia

a. Cause pneminioa and res dis.

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g. C. psittacia. Cause siciosis ( a res. Dis)