GramPositiveCocci:StrepandStaph

Organism Physiology/Structure Virulence Epidemiology Diseases Tx

StaphAureus Gram(+)cocciformed
inclusters

FacultativeAnaerobes

Catalase(+)

Coagulase(+)

Hemolytic
Aproteinevadesphagocytosis

Coagulaseformsfibrinclotaround
organism,protectingitfrom
phagocytosis

ToxicShockSyndromeToxin
producesthesuperantigenTSST1
thatleadstotoxicshock.

Exfoliatincausestheskintoslough
off,disruptsdesmosomes.

Enterotoxincausesgastroenteritis
Isnormalflorafoundinmucous
membranesandskin.Transmission
caneitherbeendogenousor
exogenous.

Commoncontaminationisfoundin
foodworkersthatsneezeontheir
hands,thendontwash.Foundon
foodthathasbeenleftout,likepotatoe
salid.
Gastroenteritisusuallyselflimiting.Can
becausedbyingestionofbacteria(then
subsequentproductionoftoxin)orby
ingestionofheatstabiletoxinproduced
beforeorganismwaskilledbycooking.

ScaldedSkinSyndromelocalinfection
producesatoxindistally.Causesmild
epidermaltears,withasunburnlike
rash

ToxicShockassociatedwithtampons
leftintoolong,toxinisasuperantigen
thatcausesfever,hypotension,anddeath

InfectiveEndocarditisacuteonset
endocarditiswithfever,malaise,anda
heartmurmur.Causedbycytolytic
toxins
Gastroenteritisisselflimiting,
andtheorganismispassed
withstool

Itisgram(+)with
penicillinaseactivity,soBeta
Lactamsdontwork.

MethacillinandNafcillinwere
drugsofchoicebecauseof
theirresistanceto
penicillinase.MRSA
(methicillinresistantstaph
aureus)hasmadetreatment
moredifficulty.

Vancomycinisnowthedrug
ofchoice,thoughresistant
strainsarebeingidentified.
Enterrococcus
(Fecalisand
Fecium)
Gram(+)Coccus,itis
oneoftheStrep
Species

LancefieldGroupD

CangrowninBileor
inHighSalt(6.5%)

Hemolytic

PYR(+)
SurvivesBileandSaltsocan
colonizeinthegallbladder.

Theyarepartofthenormalfloraofthe
GIandGUtract.Duringaprocedure,
theycanbedislodgedordisplacedand
presentedtowheretheyshouldnobe.

NormalFlora

MostprevalentbacteriaofGItract

EndogenousTransmission
UTIGIGU

Cholecystitisinfectionofthe
gallbladder.

Penicillin
StrepPyogenes Gram(+)Coccus

LancelfieldGroupA

Hemolytic

BacitracinSensitive
toseparateitfrom
StrepAgalactiae
Themeisescapeorspread
Mproteinantiphagocyticprotein.
M12isassociatedwithglomerular
nephritis

StreptolysinOOxygenLabile,
antigeniccytolysinthatcauseslysis
ofcells.

StreptolysinSOxygenStabile,
nonantigeniccytolysinthatcauses
lysisofcells.

ASEsStreptokinase,DNAase,
Hyalurindase,allmakesiteasierto
spreadintissue.

ExotoxinACthataresuperantigens
andcausesymptomsofscarletfever

Humanthroat,transmittedbyaerosol
dropletsorendogenousinfection.

SequellaeofDisease(tofitbetter)

RheumaticFeverpossiblesequella
ofuntreatedpharyngitisONLY.Thisis
atypeIIhypersensitivityreaction,
whereantibodiestothestrepcross
reactwithhearttissue.Causes
endocartitis,achorea,fever,and
arthralgia.

PoststreptococcalGlomerular
Nephritispossiblesequellaof
untreatedstreppharyngitisorskin
infection.TypeIIIhypersensitivity
reaction.Immunecomplexesare
depositedinthekidney,causing
damage.AssociatedwithM12serotype
Pharyngitiswhite,purulentlesionson
theoropharynx.

Scarletfeverifstrepthroatis
untreateditcanthenbeaccompaniedby
scarletfever.Itisdescribedasasand
paperrash,alsocalledasunburnlike
rash,inthattheskinisred.Thepalms
andsolesarespared.Thereisalsoa
strawberrytonguethatpresentsbright
redwithmanybumps.

Impetigojustlikestaphaureus

NecrotizingFasciitisinfectionthat
causesflesheatingbacteria.Rapid
spreadthroughfasciallayercaninvolve
largeamountsoftissuerequiring
debreidmentoramputation.

Cultureallnegativesonarapid
test.

Lactamsworkwell.

Inthosewithallergies,use
macrolides.

Organism Physiology/Structure Virulence Epidemiology Diseases Tx

StrepPneumoniae Gram(+)Coccus

LancetShaped
Diplococci

NoLancelfieldGroup

Hemolytic

OptochinSensitiveto
separateitfrom
Viridansgroup
Capsulemostimportantvirulence
factor

IgAproteasecleavesIgAthat
allowscolonizationofmucosa.

PneumolysinOwhatis
responsiblefortherustcolored
sputumassociatedwiththedisease.
Destroysciliatedcellsbyinducing
classiccomplement.
Normalfloraoftheupperrespiratory
tract.Theycanbecolonized,butnotbe
infected.Anyimmunocompromise
(chronicpulmonarydisease,viral
infection,spleenectomy)canleadto
pathogenesis
AcutePneumoniarapidonsetoffever
andchills,painoninspiration,andanX
raywithinfilitrates

OtitisMediamostcommoncauseof
otitismediainchildren,despitevaccine.

Sinusitussameasotitismedia,
commonlycausessinusitisinkids

AdultMeningitissincethevaccinefor
H.Influenzaeb(later),nowisleading
causeofmeningitisinneonates.
Macrolidesforadultbacterial
pneumonia

ThirdGeneration
Cephalosporinformeningitis

Vaccinesareavailable.The
pediatricvaccinecovers7
commonserotypesprotecting
againstmeningitis.

Theadultvaccinecovers23
commonserotypestoprotect
againstpneumonia

Viridansgroup Gram(+)Coccus

NoLancelfieldGroup

Hemolytic

OptochinResistantto
separateitfromS.
Penuemo
DextranBioslimethatbothprotect
theorganismfromtheimmune
systemandincreasesadherenceto
teethorheartvalves
Thisisavarietyoforganismssuchas
S.Mutans.

S.Mutansispartofthenormalfloraof
dentalcaries.Thesebuggerscause
plaque.Plaquethenallowsother
Viridansgrouptocolonizeandcause
cavities
SubacuteEndocarditisdentalsurgery
givesS.Mutansaccesstotheblood
streamwhereitcolonizesthemitral
valve.

Thisiswhypeoplewithprostethicvalves
orpreviousvalveproblemsget
prophylacticantibioticsbeforedental
procedures.
Penicillinoftenprophylactic
forendocarditis.

Inpharm,youlearnyoutreat
withClindamycinora
combinationofVancomycin+
Gentamycin.

GramPositiveRods:BCCLANLMSendanEmail(BCC)overthenetwork(LAN)toLincolnMartin(LM)
Bacillus,Corynebacterium,Clostridium,Lactobacillus,Actinomyces,Nocardia,Listeria,Mycobacteria;youknowNisNOTneisseriabecauseMycobacteriaandNocardiaaresimilar.
Organism Physiology/Structure Virulence Epidemiology Diseases Diagnosis
BacillusAnthracis Gram(+)Rod

Formsspores

Isuniqueforits
polypeptidecapsule
(mostothersare
polysaccharide)

Facultatively
Anaerobic
SporeFormingsotheyarehighly
resistanttodrying,desiccation,
heating,etc.

AntiphagocyticCapsuleevades
phagocytosis

Exotoxins
EdemaFactorcalmodulin
dependentincreaseincAMPleading
tofluidextrusion.
LethalFactorcausestissue
necrosis.
ProtectiveFactorallowsentryof
toxinsintotargetcells.Calledthis
becauseitistargetofvaccine.
Foundinsoil,water,andonanimals
(particularlysheep).

Canbeinoculatedintoacutaneous
woundorinhaledintothelungs.

Possibleagentofbioterrorism(note
thepostalscare).
CutaneousAnthraxis95%ofall
anthraxcases.Sporesgetintowound
causingblackpainlessswollen
postulescalledeschars.Theycrustover
andresolvespontaneously.Theycan
rarelyentercirculationandcausefatal
septicemia.

PulmonaryAnthrax(Woolsorters
Disease).Inhaledsporescause
hemorrhagiclymphedemitiswith
mediastinalwidening.Itresembles
manypulmonarydiseasesinitially,andis
rapidlyfatalwithouttreatement.
Normallytransmittedbysheep,itisnow
ariskofbioterrorism.
FormerlyPenicillin(which
maystillwork).

Currentlyusedoxycylineor
cirpofloxain
BacillusCereus Gram(+)Rod

Formsspores

SameasBacillus
Anthracis
SimilarvirulencetoAnthracis,has
differenttoxins

Exotoxins
EmeticToxincausesN/V/D16hrs
afteringestion
DiarrhealToxincausesacAMP
dependentsecretorydiarrhea
similartoCholeraorETEC
Foundonfoodthatwascookedand
reheated.Thinkbuffetlineata
Chinesefoodrestaurant.

Theclassicpresentationisfriedrice
ataChinesebuffet.
Gastroenteritislikesymptoms SelfLimiting
Corynebacterium
Diphtheriae
Gram(+)Rod

Aerobic

Nonsporeformers

FormChineseLetters
ongramstain,VorL
shape.

GrowGreyorBlack
coloniesonTellurite

LoefflersMedia
causesgranule
formation
Toxininhibitsproteinsynthesis.It
isaclassicABtoxinthatinhibitsEF
2

Whileitcolonizesthenasoor
oropharynx,itisnotinvasive
Throatandnasopharynx,usually
transmittedbyrespiratorydroplets.

DiphtheriaGreypseudomembrane
thatisonthepharynx.Itiswellattached
andwillcausehemorrhageifremoved.
Itisherethatnecrotictissue,leukocytes,
andthecorynebacteriumare.Ifthe
membranegetstolarge,itcancause
respiratoryobstruction.

BullNeckswellingoftheneckout
Elektestwillconfirmtoxin
producingstrains.Inthistest,
bacteriaarestreakedacrossa
plate,withaelekstripplaced
acrossallstreaks.Itcontains
anantitoxinthatcauses
precipitation

Antitoxinistoppriorityto
neutralizetoxin

Antibioticswillkillbacteria,
andstopthetoxinproduction

DPTvaccine

Organism Physiology/Structure Virulence Epidemiology Diseases Diagnosis

Clostridium
Tetani
Sameasother
clostridiumspecies,no
doublezoneof
hemolysis
TetanusToxin(tetanospasmin)
causesspasticparalysisknownas
Tetanus.

ClassicABtoxinthattargetsthe
centralnervoussystem,inhibiting
inhibitoryneuronsbypreventing
vesicletransportandfusion.

Nofusion=norelease.Norelease=
disinhibitionofskeletalmuscles=
contraction.

TargetsGABAandglycine.
Foundindirt,soil,ordust.

Commonpresentationisa
penetratingwound(suchasarusty
nail).
Tetanus
Bacteriacolonizealocalinfection,
housedinnecrotictissue(anaerobic
space).

Secreteexotoxinthattravels
everywhere,targetstheCNSinhibitory
neurons.

Symptomsbeginwithtrismus
(lockjaw)andrisussardonicus(a
smilethatcannotbestopped)

Progressestoaspasticparalysiswith
deathresultingfromspasmofdiaphragm
Antitoxinbindsand
neutralizesfreetoxinin
circulation

Toxoid(akathevaccine)
conveyslongterm
neutralizationoftoxinand
activeimmunity.Survival
DOESNOTconveyimmunity.

Giveinjectionsatseparate
sites

MuscleRelaxants(benzos)
toalleviatecontractions
Clostridium
Botulinum
Sameasother
clostridiumspecies,no
doublezoneof
hemolysis
BotulismToxincausesspastic
paralysisknownasBotulism.

ClassicABtoxinthattargetsthe
peripheralnerves,inhibitingNMJ
neuronsbypreventingvesicle
transportandfusion.

Nofusion=norelease.Norelease=
inhibitionofskeletalmuscles=
flaccid.

TargetsACh
Itisalsofoundindirt,soil,ordust,
thatcancausethelowyieldwound
botulism.

Foundinhomecannedfoodsthatare
notcookedwellenough.

Foundinhoneygiventonewborns.
AdultBotulismfoodcontaminated
withbotulismisnotcookedorprepared
wellenough.Beginswithdipoliaand
dysphagia,progressingtoflaccid
paralysisanddeathfromflaccid
diaphragm

InfantBotulismhoneycontaminated
withbotulisminaninfantlessthanone
yearold.Beginswithconstipationand
feedingproblemsprogressingtofloppy
babysyndrome.
Palliativecaretoprovide
ventilatorsupport

Antitoxintoalleviate
circulatingtoxin(anytoxinin
cellshasalreadytakeneffect).

Penicillintokillbacteria
Clostridium
Difficle
Sameasother
clostridiumspecies,no
doublezoneof
hemolysis
ToxinA=Enterotoxin
Causesinflammationandsecretory
diarrhea

ToxinB=Cytotoxin
Disruptsproteinsynthesisand
causesdisorganizationofthe
cytoskeleton.

PartofthenormalGIFlora.

Whenonbroadspectrumantibiotics
thenormalfloraiseliminated.Thisis
highlyresistant,sothengrowsinthe
spaceleftbythepreviousflora.
PsuedomembranousColitiswatery,
secretorydiarrheathatresultsfromthe
enterotoxin.Ulcerationscanbe
visualizedonendoscopyresultingfrom
Cytotoxin.Cultureswillbepositive
(normalflora),butatoxscreenofstool
willconfirmdiagnosis.
Discontinueantibiotictherapy.

Giveoralvancomycin(oneof
thefewdrugsitisNOT
resistantto).Youmustgiveit
orallybecausevancomycin
cannotpenetrateGIbarrier,
andtheinfectionisintheGI
tract.
Lactobacillus Lowyieldorganism KnowthatitmaintainsthevaginalpH
topreventexogenousinfection.When
givingbroadspectrumantibiotics,you
cankilllactobacillus,andallow
overgrowthofotherorganisms(like
candida)

Actinomyces
Israelii
Facultatively
anaerobic/strictly
anaerobic

NOTacidfast(contrast
toNocardia)

Growslowly

Filamentoushyphae

Resemblegrainsof
sand>sulfurgranules

NOTfoundonskin
ColonizeURT,GI,femalegenitaltracts

Actinomycosischronic
granulomatouslesions>suppurative
andformabscesses

Nopersontopersonspread

Diseasefromsoilorwater

Cervicofacialinfections>poororalhygiene;
invasivedentalprocedure

Thoracicinfections>Hxofaspiration>
spreadstolungadjoiningtissues

Abdominalinfections>GIsurgery;traumato
bowel

Pelvicinfections>secondarymanifestation
ofabdominalactinomycosis;primaryinfection
ofwomanwithIUD

CNS>hematogenousspreadfromother
tissues
Mostcases:Cervicofacial>drainingsinus
tractsalongangleofjaw/neck

Difficult

Culturingisslow

Sulfurgranules>tin,gram
positive,branchingrodsaround
periphery
Nocardia
Asteroides
Gram(+)branching
rods.

PartiallyAcidFast

Aerobic
Illdefinedpathogenesis ReservoirisSoilandDust,thusthereis
anexogenousinoculationviatrauma
orinhalation.

(Inhalation)Cavitary
BroncholpulmonaryNocardosis
oftenassociatedwithimmune
compromisedpatients.Symptomsare
fever,cough,diffusepneumoniawith
cavitationofthelungs.

Spreadviathebloodtothebrain.

(TraumaticImplantation)Subcutaneous
nocardosistrainingtypeofsinustracts
andgranules.Thisissimilarto
actinomycesonlywithatraumatic
implantation.
Sulfonamides
Listeria
monocytogenes
G+vecoccobacili>
arrangedinpairs
resembling
enterococci

Faculativeanaerobes

Motileatroomtemp,
weaklyhemolytic,
capableofgrowthat
4Candhighsalt
concentration
Facultativeintracellularpathogen
thatcanavoidAbmediatedclearance

VirulentStrainsproducecell
attachmentfactors(internallins),
hemolysins(listeriolysinO,two
phospholipaseCs),andaprotein
thatmediatesactindirectedmotility
(ActA)

Actinrocketscelltocell
movement

Isolatedinsoil,water,andvegetation

Diseaseassoc.withconsumptionof
contaminatedfoodproducts
(unpasteurizedmilk)

Transplacentalspreadfrommotherto
neonate
(vaginaltransmission)

HIGHRISK:Young,elderly,Pregnant,
ptswithdefectivecellularimmunity
NeonatalDiseaseAmnionitis:
1. Earlyonsetdisease:
granulomatosisinfantiseptica>
disseminatedascessesand
granulomasinmultipleorgans
2. Lateonsetdisease:acquiredator
shortlyafterbirth.Presentsas
meningitisormeningoencephalitis
w/septicemia

HealthyAdults:
Influenzalike(withorwithout
gastroenteritis)

Pregnantwomen/cellmediated
immunedefects:
Primarybacteremiaordisseminated
disease(hypotensionandmeningitis)

Microscopy>insensitive

Culture23daysorcold
enrichment
Mycobacteria
Tuberculosis
Gram(+)Weakly

ObligateAerobes

AcidFastcellwall
hasalotoflipidinit,
whichmakesitpoorly
gramstaining

Facultatively
Intracellular(causes
granuloma)
CordFactorserpentinegrowthin
cultureandinhibitsPMNmigration.
Itisthemycolicacid

MycolicAcidTBismadeof
primarilyfatinitscellwall.Thefat
happenstobemycolicacid.

PeptidoglycanLayeritispartially
gram+andthisisbecauseofits
peptidoglycanlayerbeneathitsfatty
cellwall

Tuberculinproteinsecretedused
todothePPDtest.

Sulfatidesglycolipidsincellwall
thatinhibitphagolysomalfusion,
increasinglongevityinmacrophages

ReactiveO2andN2speciessurvives
theoxidativeburst
Humansaretheonlyknownreservoir.
Aerosolizedparticlesarereleasedby
aninfectedpatientonlyintheactive
formofTB.Therefore,mostinfections
aregenerallyreinfections.

Requiresalargeinfectiousdoseovera
prolongedexposure

PPDTest:assessexposuretoTBby
givingtheproteinTuberculinina
Subdermalinjection.ItisaTypeIV
hypersensitivity
Highrisk:(AIDS)>5mm
ModerateRisk(healthcareworker
/inmate/regularexposure)>10mm
LowRisk:(generalpopulation)
>15mm
TBthereisnoexotoxin,thereisno
endotoxin,thedamagethatTBdoesis
thedamagetheimmunesystemcausesin
anattempttogetridofthedisease.
Macrophageswallitoffinagranuloma.

PrimaryTBrecentexposure,currently
active,transmittable,growingin
macrophage
ActiveTBLungDisease,XrayChanges,
LiquefactiveGranulomas(with
hemoptysis)
LatentTBNoncontagious,calcified
granulomas.Whenimmunocompromised
itwillreverttoPrimaryTB.
ReactivationLatenttoActive.

Theseareatype1immuneresponse
mediatedbyTh1cells(compareto
leprosy)
SensitivetoUVLight

AuramineRhodamineisa
rapidtesttoseeifthereare
mycobacteria.Thisstainturns
TBbrightapplegreen.

BCGvaccineisalive
attenuatedvaccinegivenin
thirdworldcountriesthat
protectagainstsystemicTB,
notsomuchthePulmonary
TB.

Treatedwithacombinationof
IsoniazidandRifampin.

CautionwhentreatingRA
patientswithTNF
antagonists;TNFkeepsthe
TBcontained.
Mycobacteria
Leprae
Obligate
Intracellular

Growsonlyatcooler
temperature(which
iswhyiteffectsthe
skinandnotthe
internalorgans)

SlowestGrowing
Bacteria(doubling
timeof2weeks)
NonelistedinClassnorKaplan ArmadilloshaveLeprae.

Humansaretheusualreservoir,which
requiressignificantlyprolonged
exposure.

Thelapromintestistheanalogous
testtothetuberculintest(PPD)of
tuberculosis.Itwillbepositiveonlyfor
thetuberculoidleprosybecauseit
showsanactiveimmuneresponse.
TuberculoidLeprosystrongimmune
system.ThisisaTh1response.It
containsthediseasebyforming
granulomasinthenervoustissue.It
causespatchesofanesthesiaasthe
immunesystemwallsofthelepraeinthe
nerves.

LepromatousLeprosyweakimmune
system.ThisisaTh2responseandisa
wilddissemination.Therewillbe
nodularskinlesionswithmultiple
organinvolvement.Thiscausesthe
lionlikefaciallesionsthatare
associatedwiththesevereform.
DapsoneandRifampinthat
hastobetakenover2yearsto
eliminatethedisease.

Closehouseholdcontactswill
receiveprohphylactic
Dapsone.

Isolationisnotrequired(leper
coloniesarearchaic)

GramNegativeCocci:NeisseriaandMoraxella

Organism Physiology/Structure Virulence Epidemiology Diseases Diagnosis

Neisseria
Meningitidis
Gram()Cocci

Diplococciwith
flattenedsides

Oxidase(+)

Glu+,Maltose+

Facultative
Intrallecular

Foundinrespiratory
tractandcauses
meningitis
Capsule5differentserotypesof
capsule.Bisthemostcommonfound
intheUS.ItisNOTcoveredinthe
vaccine,butallothersare.

IgAProteasehelpscolonizethe
respiratoryepithelium

Endotoxin=LPS

Piliforattachment

Foundinthehumannasopharynx.
About510%arecarriersofthe
organism.

Usuallytransmittedthrough
respiratorydropletsthatcolonizes
thepharynxandspreadstothe
menignese.

CollegeDorms,MilitaryRecruits
otherclosequarters
AdultMeningitis
BeginswithaStiffNeck,Photophobia

PetechialRash.Oncetherashstarts,the
patientdeclinesrapidly.

Fulminantcasesdevelopbruising,DIC,
anddeath.Thiscanhappeninhours.

FormerlyPenicillin(which
maystillwork).

Currentlyusedoxycylineor
cirpofloxain.

Vaccineisavailablethatisa
thepolysaccharidecapsular
vaccinecoveringalltypesnot
B.
Neiserria
Gonorrhea

HighYieldimage
isagramstainof
exudatefrom
someonewith
gonnorheawith
thegramnegative
diplococciINSIDE
thePMNs
Gram()Cocci

Diplococciwith
flattenedsides

Oxidase(+)

Glu+Maltose

Facultative
Intracellular

Foundinthe
urogenitaltractand
causesgonorrhea

NoCapsule

AntigenicVariationchangesits
antigentoavoiddetection

OuterMembraneProteins(OMP)
OMP1=PorProteinthatdecreases
phagolysosomefusioninPMNsand
increasestranscytosis
OMP2=Opa=adhesionmolecule

IgAProteaseevadesmucosal
epitheliumdefenses.

Piliincreaseadhesion
Humangenitaltractandistransmitted
asanSTDortoachildinbirth.
Gonorrhea
Males=urethritisandproctitis.
Purulentyellowdischargewith
painfulurination.
Females=variablesymptoms
includingPelvicInflammatory
Disease,Salpingitis,and
IntramenstrualBleeding.Itmay
gounnoticed,andfemalesareoften
thecarriers
Infantsopthalmiaandblindness
ifuntreated
BetaLactamasesare
abundant,sowenowuse
cephalosporins.

Thereisaspecialagarcalled
ThayerMartinAgarthatisa
chocolateagar+antibiotics
thatgrowsonlygonorrhea
Moraxella
Catarrhalis

Previouslow
yieldorganism,
thathasbeen
cominguponthe
boards
Gram()Cocci

Diplococcus
Normalfloraoftheupperrespiratory
tract

Transmitedthroughtherespiratory
droplets
OtitisMediastreppneumoisthemost
commoncause,butMoraxellacancause
earaches

SinusitissamethingasOtitisMedia

Bronchitisespeciallyintheolder
population
Augementinorthird
generationcephalosporing

GramNegativeRodsallgramnegativebacteriahaveLPS,theendotoxin,whichposesariskofsepsis,shock,anddeath
Organism Physiology/Structure Virulence Epidemiology Diseases Diagnosis Tx
YersiniaPestis Gram()Rod

BipolarStaining,theylook
likeasafetypinora
dumbbell.Thereisstaining
ateitherend,butclearin
themiddle.

FacultativeIntracellular
producesgranulomas

Coagulase(+)

F1Antigencaninhibit
phagocytosis

TypeIIISecretionSystem
molecularsyringethat
allowsfortoxinstobe
injectedintohostcell.
Causeoftheplague,the
blackdeath.

Commoninthedesert
southwest.

Transmittedbythebite
ofafleaorbyhuman
humancontactvia
respiratorydroplets
PneumonicPlague=septicpulmonary
embolusfromthebubonicplague,or
inhalation.Thisishighlycontagious,highly
fatal,andisatargetofbioterrorism

Cutaneous=BubonicPlaque=BlackDeath.
Thisisfromthefleabitesthatgeneratethe
axillarybubosandconjunctivitis.Itscalled
theBlackdeathbecauseyougetDICandthe
extremities,withoutanadequateblood
supply,necrose,turnblack,andfalloff.
Aminoglycosides

Controltheanimals,thevector(the
rats).Killingrodentsisabadidea,the
fleaswillallgotohumans!
Enterobacteriaciae
family
Gram()Rods
Catalase(+)
FermentersatleastGlu+
Endotoxinallgram
negativebacteriapossess
LPSorLOS.

Antigens:
O=CellWall
K=Kapsular
H=Flagella

EscherlichiaColi
(E.Coli)
SameAsEnterobacteriaciae
family.
Piliattachandestablish
infectioninthemucosaof
theGItractortheurinary
tract.

Capsule
Normalfloraofthe
humanGut.

Therecanbean
engodenousdisplacement
fromtheGI(suchasin
UTI)orcanbeexogenous
(suchasfecaloral)

MostcommoncauseofUTI.

Neonatalmeningitis.Thisisthesecondmost
commoncauseofneonatalmeningitidesafter
StrepAgalactiae.K1serotypeimplicated.

Fluroquinolone

Thirdgenerationcephalosporin
ETEC
Enterotoxigenic
E.Coli

SameAsEnterobacteriaciae
family.
Enterotoxinstheyare
cyclicsomethinginducers.
OneiscAMP,theotheris
cGMP.Regardlessofthe
mechanism,theybothcause
waterydiarrhea.

HeatLabileToxin(LT)
causesADPRibosylationof
GsthatstimulatesAC
cAMP
HeatStabileToxin(ST)
causesADPRibosylationof
GuanineCyclaseincreasing
cGMP.
SameasE.Coli

MontezumasRevenge.ETECcausesTravlers
Diarrhea.Thisisawaterydiarrheabecause
itisnoninvasive.
UsuallySelfLimiting.Replacefluids
eitherIVorOral.
EHEC
EnteroHemorrhagic
E.Coli

SameAsEnterobacteriaciae
family.

KnowtheO157:H7
serotypeisthemost
implicated.

NonSorbitolfermenter
(mostE.Coliaresorbitol
ShiggaLikeToxina
classicABtoxinthatcauses
ADPRobsylationofthe
60sribosomereducing
affinityforEF1.Called
verotoxin.
SameasE.Coli,butcan
alsobefrombovinefeces
orunpasteurizedmilk.

EHECcanberemembered
asHamburger(theJack
intheBoxE.Coli
outbreak).
Dysentery.EHECcausesHemorrhagic
diarrhea.Thisisanexceptiontotherule.
Normallybloodydiarrheameansinvasive
organisms.Thisisnoninvasive.Therefore,
therewillbe(+)Blood()Pus.

HemolyticUremicSyndrome(HUS).A
sequellaofEHECisrenalfailure.
DONOTGIVEANTIBIOTICS.Deathof
EHECwillreleaseitstoxinandLPSthat
increasestheriskofHUS.
fermenter)
EIEC&EPEC Lowyieldwithoutdetail Theyareinheretomakeyouawarethatitexists.DontknowthemforTulaneexams.
Salmonella
Enteriticus

Gram()Rods

Motile(likeasalmon)

Lac
FacultativeIntracellular

AcidToleranceResponse

Pili

LPS
Doeshaveananimal
reservoir.Foundoneggs,
poultry,reptiles,
includingreptilefeces.

Thisistheundercooked
chickendisease

Salmonellosis=Gastroenteritispotentially
causesbloodydiarrhea(itisinvasive),but
usuallycausesawaterydiarrhea.Causes
diarrheabyanincreaseincAMPasaresultof
inflammationNOTaresultofexotoxin.
Osteomyletismostcommoncauseof
osteomyletisinthosewithsicklecell.
Withoutsicklecell,themostcommoncauseis
StaphAureus.
Invasivediseasefluroquinolone
SalmonellaTyphi Gram()Rods

Motile(likeasalmon)

Lac

FacultativeIntracellular

AcidToleranceResponse
Gene.DecreasesinpHcause
thegenetoturnon,
increasingdefense,
decreasingvirulence(it
survivesin,butdoesnot
infect,thestomach).
IncreasesinpHcausethe
genetoturnoff,decreasing
defense,increasing
virulence(itcolonizesthe
intestines).Thisisalsohow
itliveswithinthelysosome.

ViAntigen(Typhionly).It
istheKapsularantigen,but
givenaspecialnamein
salmonella.Withstands
phagocytosisand
complementdestruction.

Adhesins/Piliallow
adhesiontothemucosal
epithelium
Hasnoanimalreservoir,
thusvaccinesare
available.

HumanshaveitintheirGI
tract,orsurvivorsof
TyphoidFevercontainit
within
TyphoidFevertyphoid=typhuslike.
Organismisingestedwithinfectioninthe
ileocecalregion.Thiscausesconstipation.
Travel+Constipation=Typhoid.

Mcellstakeupthecellsviaphagocytosis.Itis
presentedtomacrophageswhereitsurvives
withinthephagolysosome.Themacrophage
transportsittolymphnodesandtothe
spleen,whereitenterscirculation.

ItcanreentertheGItractthroughtheGall
Bladder,whereitcantakeuppermanent
infectionandcreateacarrierstate.

Systemicinfectionscauserosepedallesions
whicharepinpointerythmatouslesionson
thetrunkorabdomen.

Septecemiaispossible.
IfitisonlylocalintheGItract,dont
treatit.

Iftheygosystemic,useBetaLactams
andFluorquinolones.

Therearevaccinesavailable
ViCPS=capsularvaccine,
administeredparenterally
Ty2a1=attenuatedbacteria
ingestedmanytimestodevelop
adequateresistance
Eitheraregiventopeople
travelingtoendemicareas.
Shigella Gram()Rods

Nonmotile

NoH2S

NonLactoseFermenters
FacultativeIntracellular
ShiggaToxinClassicAB
toxin.ADPRibosylatesthe
60sribosomereducingthe
affinityforEF1

InvadesMcellsby
phagocytosis,thenmigrates
intoneighboringcells
intracellularly.Itcanalso
livewithinthemacrophage
byescapingthe
phagolysosome.Whenthe
macrophagefinallylyses,
shigellaisabletogetinto
epithelialcellsviathebasal
surface

Hugelypathogenic,
incrediblylowinfectious
dose(110organisms)
ShigellaSoneiiisthemost
commoninUSandisthe
leastvirulent.

ShigellaDysenteriaeis
theworstoftheshigellas,
butisuncommoninthe
US
Therearenoanimal
carriers.Thehumancolon
istheonlyreservoir.
Transmissionisfecaloral,
suchasatdaycare
DysenteryaptlynamedDysenteriae.Causes
abloodydiarrhea.Itisinvasiveandkillscells
leadingtotheblood.Theinflammation
responsecausesthemalabsorptionand
diarrhea.

CanleadtoHemolyticUremicSyndrome,
whichisnormallyassociatedwithEHEC.
However,sincethetoxinsaresosimilar,the
possibilityforHUSispresent.
Usuallyselflimiting.

Antibioticscanbeused,butmultiple
drugresistancesmakeitchallengingto
eradicate.
Klebsiella
Pneumoniae
Gram()rod,partofthe
enterobacteriacae
Capsuleantiphagocytic
andantigenic.
Foundincolonandupper
respiratorytract.
Numberonecauseofaspirationpneumonia
inalcoholics.
Fluroquiniloneor

Inculturewillhaveahalo
aroundcells,becauseof
theircapsule.

Lac+

EndotoxinLPSfromit
beingGram()

Usuallyanendogenous
transmission

Communityacquiredpneumonia.Common
causeofcommunityacquired.StrepPneumo
isthemostcommoncause,butKlebsiellais
stillrightthere.Usethegramstainto
separate.

Causesathicklikejelly,redsputumwithout
apungentodor(suchasinthecaseofa
aspirationpneumonia).
ThirdgenerationCephalosporin
Pasturella
Multocida

thinkCATSandCAT
BITES
SmallGram()Rods

FacultativeIntracellular

facultativeAnaerobe
Reservoiristhemouthsof
cats,transmittedfrom
bitesorlicks.Dont
confusethiswithCat
Scratchfever,whichis
causedbyascratch,nota
lickorabitelike
Pasturella
RapidlySpreadingCellulitisfromthesiteof
thelickorbite,therewillbeacellulitisthat
willspreadwithinhours.
AmoxyclinandAugmentin

Becauseitissorapidspreading,they
giveanIMinjectionofantibiotics.
BordetellaPertussis Smallgram()rod

Nonmitile

StrictlyAerobic

GrowSinglyorinpairs

Encapsulated

Requiresalonggrowth
periodonaspecialagar,
calledthe
BordetGengou

Bordet=Bordetella
PertussisToxinclassic
ABtoxinthattargetsthe
ciliarycells.ItisacAMP
toxin,causingedemaand
fluid.Thiscausesincreasein
histaminesensitivity,
leukocytosisandanincrease
ininsulin,leadingto
hypoglycemia.

DermonecroticToxin

AdenylateCyclaseToxin
secretedACthatistakenup

TrachealCytotoxin

FilamentousHemagglutin

Endotoxin
Colonizestherespiratory
epitheliumandcabbe
spreadviarespiratory
droplets(thecoughing,
sneezing,andhandto
handcontact)
WhoopingCoughcomesin3phasesaftera
weekofincubation.
CatarrhalStagethehighly
infectiousstagewithnonspecific
symptomssuchaslowgradefever,
malaise,rhinitis.Weeks23
ParoxysmalStagethisisthe
noninfectious,butstereotypical
phase.Thisstagehasfrequentbouts
thatcomeandgo(paroxysmal)of
severefitsofcoughingfollowedbya
stronginspirationagainstanarrowed
glottiscausingthewhoop.Theycan
becomecyanoticorvomit.Weeks36
ConvalescenceStagethedisease
diesout,withlesseningparoxysmal
stagesymptoms.Weeks6on
Erythromycinisdrugofchoicetogive
tohouseholdcontactsandthoseinthe
catarrhalphase.

Isolatethecatarrhalandearly
paroxysmalphases

VaccinatewiththeDPTvaccine.
VibrioCholera Curved,Gram()Rodwith
polarflagella

Oxidase(+)

GrowonAlkalinebutnot
Acidic

Motile
PilustheTcpPilusallows
foradhesiontomucosal
epithelium

Flagellamakesitmotile

Toxincholeratoxinisa
classicABtoxin.Itactivates
GsviaADPRibosylation.It
causescAMPincreasesthat
leadstotremendousfluid
extrusion
Thereservoirforcholera
isthehumancolon.Itis
transmittedfecaloral,but
oftenbycontaminated
water.Itrequiresavery
highinfectiousdose.

ElTorstraincauses
epidemics

Theclassicstrainhasnot
beensobad
Choleraexcessivediarrheaupto20L/day.
Causesricewaterstools,lookingwhite/clear
likewaterwhilecookingrice.
Treatwithfluidandelectrolyte
replacement,bothoralandIV.

Preventcholerabyboilingwaterand
vegetables,cookingyourfood
HelicobacterPylori Gram()curvedrodwith
aSinglepolarflagella
(soundslikeCholera)

Onlyorganismthatcan
growandreplicateinthe
stomach
Ureaseconvertsureaand
acidintobicarbonateand
ammonia,whichneutralizes
theacid,allowingittolivein
thestomach

Adhesinsallowcolonization
andpreventdislodgement
fromgastricmucosa

Mucinasedegradesthe
mucinprotectivebarrier

VacuolatingCytotoxin
inducesvacuolesinhuman
cells.

CytoxinAssociatedGene
encodesanothercytotoxin.
TheseHParemorevirulent

Humansaretheonly
knownreservoiranditis
thoughtthatitis
transmitablefecaltooral
ororaltooral.

Themodeoftransmission
hasnotyetbeen
established,despiteits
prominenceinGIdisease.
Gastric/DuodenalUlcertheureaseand
mucinasedegradestheprotectiveliningofthe
stomach,allowingacidtoreachthemucosal
surface.

Inaddition,thecytotoxinscauseautolysisof
macrophagesandneutrophilsinducinga
stronginflammatoryreaction,also
contributingtothedisease.

Canleadtocancer.Eitherthereactive
oxygenspeciesdamagingDNApostlysisand
inflammationorthroughviralinfectionof
theepitheliumfromthecompromisedbarrier,
gastrictumorsmayresult.

ThisisaType1CarcinogenicAgent,ahighly
boardrelevantpoint.
Serologycandetectantibodies,butwill
onlytellyouifthereeverwasan
infection.

Goldenstandardisthebiopsywith
culture.

UsetheUreaBreathTesttodetermine
ifsomeonehasHP.Youfeedthepatient
radioactiveurea,and,ifthereisHP,they
willexpireradioactiveCO2(converted
fromthebicarbtheHPmade)

Endoscopycanbemadetoidentify
gastriculcers.

TreattheulcerswithProtonPump
Inhibitorstreatingthesymptoms.

TreatthebugwithAmoxicillin+
Clarithromycin
ProteusMirabillis
andVulgaris

Mirabillis=90%of
infection
SmallGram()Rodsthat
arepartofthe
enterobacteriacaefamily

SwarmingMotilityfrom
itsperitrichousflagella

Urease+

NonlactoseFermenting
ExtremeMotility

Urease

EndotoxinLPSfromgram()
Prettymuchubiquitousin
theenvironmentand
withinthenormalflora
oftheGItract.

Mostcasesinhumansare
endogenous.

UTIifthereisaUTIviaproteus(EColimost
common),thereisanincreasedriskofkidney
stonesbyreducingthepHoftheurine.
Fluroquinilone

Treatkidneystoneswithpainmeds(for
passing)orsonicdisruptiontoremove
stones.
Legionella Slender,pleomorphic,
Gverods

Stainspoorlyw/common
reagentsUseSilverStain

Nutritionallyfastidious>
Lcysteineandenhanced
growthwithironsalts

Nonfermentative

Capableofreplicationin
ALVEOLAR
MACROPHAGES(and
amoebaeinnature)

Preventsphagolysosome
fusion
Sporadic,epidemic,
nosocomialinfections

AerosolTransmission
(Airconditioningunits,
butnopersonto
person)

Commonlyfoundin
naturalbodiesofwater
(riversandstreams)

Estimatedbtw10kto20k
casesinUSannually

Highrisk:compromised
pulmonaryfunction,pts
withdecreasedcellular
immunity(transplant)
1.Legionnairesdisease(legionellosis)
incubationperiodof210days
systemicsignsofacuteillnessappearabrupt
Multiorgandisease(GI,CNS,liver,Kidneys)
Primarymanifestationpneumonia(severe)

2.Pontiacfever
Selflimiting,febrileillness
Fevers,chills,myalgia,malaise,headache
Symptomsdevelopover12hrs,last25days

Microscopy:insensitive
DFAfluorescence

Culture:
Bufferedcharcoalyeastextract(BCYE)
andFe+Cys

Antigentests:sensitiveforL.
pneumophilaserogroup1

Seroconversion:mustbedemonstrated
>6mo.Todevelop

PCR:
Sensitivityandspecificityapproaching
culture
Chlamydia Gram()Rods

ObligateIntracellular
Bacteria

Energyparasites

Reallysmall,obligate
intracellular=cannotsee
onagramstain

ReticulateBodyvs
ElementaryBodies

Elementarybodiesarethe
metabolicallyinactiveform
thatinfectscells.

Reticulatebodiesarethe
metabolicallyactiveform
withininfectedcells.

Chlamydia
Trachomatis
Gram()rod

ObligateIntracellular
(granulomaformation)
Reservoiristhegenitalia
andtheeyes.Itiscanbe
transmittedviasexual
intercourse,handtoface,
orevenviaflies.
SexualTransmittedDiseases.Mostcommon
bacterialSTDintheUS.Urethritis,cervicitis,
anddamagetothefallopiantubes.Thiscauses
sterility.SerotypesDK

LymphogranulomaVenereumbeginswith
L,sodotheseroptypes.Notcommoninthe
US,butindevelopingcountries.ItisanSTD
thatcausesswollenlymphnodesthat
eventuallyresultsinblockageoflymph
drainageandgenitleelephantiasis.

TrachomaSerotypesAC.Resultsin
conjunctivalscarringandblindness.Itisthe
mostcommoncauseofpreventable
blindness.
Doxycylineto
treatdisease

Erythromycincan
begiven
prophylatically.
Primary:Newer
macrolidesor
fluoroquinolones

ie.Azithromycin,
clarithromycinor
ciprofloxacin,
levoloxacin

Decreased
environmental
exposureto
reduceriskof
disease

Water:treatwith
hyperchlorination,
superheating,
coppersilver
ionization

Decontaminateair
conditioning
units.
ChlamydiaPneumo
Treponema
pallidum
Gram()Spirochete

Reallyhadtofindona
gramstain.

ObligatePathogen(we
cannotcultureit).ItisNOT
anobligateintracellular
pathogen.

Humangenitaltractisthe
reservoir.Itisasexually
transmitteddiseasethat
canbepassedtothefetus.
Syphillushas3stages
(1) Primarynontenderchancer.There
isnopain,thelesionisthere,aftera
fewweeksgoesaway.Ifyoubiopsythe
lesionyoucouldseethetreponema.
Serologictestswillstaynegative.
(2) Secondarymaculopapulocopper
coloredrashthatisdiffusethat
includespalmsandsoles,withpatchy
alopecia.Thisrashiscapableof
transmittingdisease.Condylamata
lookslikeHPVwithwartsgrowingin
theperianalregion.Serologycomes
backpositive.
(3) Tertiarysyphiliticgranunlomas
(aortictitus,TabesDorsalis,andaltered
Twotypesofteststodotodiagnosis:
(1)Screening:crossactingantibodies
tocardiolipin.nonspecific,cardiolipin,
VDRL(cautionSLEwhichmayyield
falsenegative)

(2)Specific:immunofluorescence
FTAABS

Penicillinisthetreatment.Evenif
allergic,thetreatmentispenicillin.
mentalstates).

Borrelia
Burgdorferi
Gram()Spirochete Itisinvasive,andwillinfect
theheart,joint,andCNS.
Nymphs(onmice)and
Ticks(ondeer).

Weusuallyhereabout
thisdiseasewithdeer
ticksfromLymeCT.
Ixodesisthegenusoftick
thatspreadsthe
organism.
LymeDisease
Thisisthenumber1vectorbornedisease.
Yougetabullseyerashatthebitesite.It
startsoutwithflulikesymptomswithswollen
lymph.

Oncetheorganismdisseminates,thenyousee
nerveeffects(suchasbellspalsy).

MigratoryArthralgiadevelopsfromTypeIII
hypersentivityreactionsdepositingintothe
joints.

CardiacArrythmiasmayresultfromthe
diseaseaswell.
Serology
diagnosesthe
problemviaELISA
orPCR.

Treatmentis
doxycycline

Leptospira
interrogans

Lowyield
Spirochete
Gram()Spirochete,with
littlehooksattheend
Unknownpathogenesis Zoonoticdiseasewith
transmissionthrough
watercontaminatedwith
animalurine.Youwillsee
thisinpatientswhojetski
orwhoworkinsewers.
SwineherdsDiseaseorMudFever
gastrointestinalsymptoms+flulike
symptomsthatmayprogresstohepaticor
liverfailure.

Rickettsia
RickettsiaRicketsii Energyparasite.Theyneed
yourATP,andarean
obligateintracellular
parasitewithleaky
epithelium

Verytiny,soyouwouldnt
seethemonagramstain,
eventhoughtheyare
consideredGram()rods
Invadethevascular
endothelialcellscausing
vasculitisandpermitting
themtomovethroughthe
bloodstrea,
Reservoiristicks.The
vectorisatickbite.

Requiresalongfeeding
timeinordertotransmit
thebacteria.Thebacteria
maybepassedto
progeny.
RockyMountainSpottedFever.Rashis
criticalforthediagnosis.Whennotpresent,
thediseaseisusuallymisseduntiltoolate,as
thisdiseaseisrapidlyfatal.

Confusion,N/V/D+headache.Itlookslike
meningitis,butthentherashcomeson.The
rashisamaculopapularthatturns
petechialthatstartsonthehandsandfeet
andmovestothetrunk.Includespalms
andsoles
Starttreatment
without
confirmationfrom
serological
indirectantibody
test.

WeilFelixisan
oldtest,thatmight
creeponthe
boards.
Doxyclcineand
protectionagainst
thevector.
Rickettsia
Prowazekii

Consideredlow
yieldforBoards
SameasRicketsii EndemicTyphus
RickettsiaTyphi

Consideredlow
yieldforBoards
SameasRicketsii
Haemophilus(and
relatedbacteria)
Small,pleomorphic,Gve
rodsorcoccobacili

Facultativeanaerobes,
fermentative

MostspeciesrequireX
(heme)and/orV(NAD)
factorforgrowth

H.influenzaesubdivided
serologically(atof),
biochemically(biotypesIto
H.influenzetypebis
clinicallymostvirulent(PRP
polyribitolphosphate
incapsule)

PRPribose,ribitol,
phosphate

Haemophilusadheretohost
cellsviapiliandnonpilus
structures

IgAProtease
NoncapsularHaemophilis
commonlycolonizedin
humans;encapsulated
Haemophilis(H.influenze
typeb)UNCOMMON
membersofnormalflora

DiseasecausedbyH.
influenzetypebwas
primaryapediatric
problem>eliminatedin
immunizedpopulations

Haemophilisinfluenzae
Meningitis:unimmunizedchildren>fever,
severeheadache,systemicsigns
Epiglottitis:unimmunizedchildren>initial
pharyngitis,fever,difficultybreathing,
progressestocellulitisandswellingof
supraglottictissues>obstructionofairway
Pneumonia:inflammationandconsolidation
oflungsobservedprimarilyintheELDERLY
withunderlyingchronicpulmonarydisease;
typicallycausedbynontypeablestrains

Haemophilusducreyi
Microscopy
sensitivetestin
CSF,synovialfluid,
lowerrespiratory
specimens

Culture>
chocolateagar

Antigentests>
lessusefulforH.
influenzaetypeb
infections

VIII),andclinically
(biogroupaegypticus)

SatellitePhenomenayou
cangrowHaemophilus
nexttostaphbecauseitis
betahemolyticand
releasesthehemeandNAD
intothemediumonablood
agar.
H.ducreyidiseaseis
uncommonintheUS

WiththeexceptionofH.
ducreyi,whichisspread
bysexualcontact,most
Haemophilusinfections
arecasedbyptsbacterial
flora(endogenous
infections)
Chancroid:STD>tenderpapulewithan
erythematousbase>progressestopainful
ulcerationandlympathadenopathy.Thisisa
distractorwithSyphilis(treponema)because
theyarebothspirochetes,andbothcausea
chancer.Yoyudocrywithducreyimeaning
thatitisapainfulchancer.

followingvaccine

BacteroidesFragilis Gram()Rod ReducedEndotoxin

Capsule
NormalpartoftheGI
flora.Traumatic
displacement(surgery)
canpermitmovement
intoothercompartments.
Sepsis:weak,becausetheendotoxinis
modified.

Peritonitis:Thisisntterriblyhighyield,but
manyoudontwantthiskindofperitonitis.It
willcausemassivenecrosisoftheperitoneum
andtheintrabdominalcontents

Francisella
Tularensis

(potentiallylow
yieldacceptitisa
Bioterroragent)
Zoonotic

SmallGram()Rod

FacultativeIntracellular
pathogens(cause
granulomas)
Tickbite(theulcero
glandularform)

Associatedwithhunting
andskinningWabbits.
Thiscancausea
traumaticimplanationor
inhalationwhileyou
shreditsflesh
everywhere.

Ifyoueattherabbit
withoutcookingitwell,
youcouldingestitaswell
Tuleremia:

Ulceratbitesiteandregionallymphswelling
fromtick.TraumaticImplantationfrom
wabbitskinningcancauseitaswell.

Ifyouinhaleitoreatit,youwilldevelop
tularemiaintheGItract.
LiveAttenuated
Vaccine
broadspectrum
cephalosporins,
azithromycin,or
fluoroquinolones

Manystrainsare
resistantto
ampicillin

Active
immunization
withconjugated
PRPvaccines
preventsmostH.
influenzaetypeb
infections

Rifampin
prophylaxis>
childrenathigh
riskfordisease
Brucella
(potentiallylow
yieldacceptitisa
Bioterroragent)
Zoonotic

SmallGram()Rod

FacultativeIntracellular
pathogens(cause
granulomas)
EndotoxinLPSingram()

Passesreadilybetween
animalsandhumans.
Usuallycontainedin
domesticlivestock(large
animalveterinarians)

Speciesdependsonthe
animalitinfects.

Abrotus=cattle
Sewis=pigs
Malatensis=goats
Brucellosisundulantfeverbecauseitgoes
upanddown.Theyareflulikesymptomswith
profusesweating.

Serum
Agglutination
testispretty
muchallyoucan
do.

Rifampin&
Doxycyclinefor6
weeks(facultative
intracellularare
tough)

Wecanvaccinate
cattleorhighrisk
individuals.

Pasturization
helpsspread.

GramPositiveCocci
Staph=Aureus,Epidermis,
Strep=Pyogenes,Agalactiae,Mutans(Viridansgroup),Pneumonia,Enterococcus

GramNegativeCocciNevermindaboutMoraxellaNM,TheNandMthatarentintheRamPositiveRods.
Neisseria=Gonorrhea,Meningitidis
Moraxella=Catarrhalis

GramPositiveRodsBCC:LAN,LM,Sendanemail(BCC)overthenetwork(LAN)toLincolnMartin(LM)
Bacillus=Anthracis,Cereus BofBCC
Corynebacterium=Diphtheriae CofBCC
Clostridium=Tetani,Botulinum,Perfringes,Difficile CofBCC
Lactobacillus=Lactobacillus LaofLAN
Actinomyces=Israelii AofLAN
Nocardia=Nocardia NofLAN
Listeria=Monocytogenes LiofLincoln,alsothinklistserv
Mycobacteria=Tuberculosis,Leprae MofMartin

GramNegativeRods
Everythingelse.Yep,thatsright.Everything.Ihatememorizinglists(likeallbacteriaabove),soheresomecategorizationstohelpyoukeepthebugsstraight

Respiratory Zoontic Opportunistic

NonEntericGram
NegativeRods
HaemophilusInfluenzae
LegionellaPneumophilia
BordetellaPertussis
FrancisellaTularensis
PasturellaMultocida
BrucellaSpp.
YersiniaPestis
RickettsiaRickettsii
RickettsiaProwazekki
Coxiella
Bartonella
PseudomonasAeruginosa
KlebsiellaPneumoniae
ToxinSecreting
cAMP
VibrioCholera
ETEC
BacillusAnthracis
BordertellaPertussis
ProteinSynthesis
Inhibition
Neurotoxins
Corynebacterium
Diphtheria
EHEC
Pseudomonas
Shigella
ClostridiumTetanii
ClostridiumBotulinum

Enterobacteriaciae

NonlactoseFermentersShYPS LactoseFermentersCEEK
Shigella CitrobacterTulanedoesntdiscussit
Yersinia EscherichiaEColi
Proteus Enterobacter
Salmonella Klebsiella

SporeFormersStartofftheGramPositiveRods
Bacillus
Clostridium

Capsules:SomeKillersHavePrettyNiceCapsules
SS.Pyogenes
KKlebsiellaPneumoniae
HHaemophilusInfluenza
PPseudomonasAeruginosa
NNeisseria(Meningiditisonly)
CCryptococcus(fungus)

Motile,H
2
Sproducing
Nonmotile,nonH2Sproducing
UreasePositive
KlebsiellaPneumoniae
HelicobacterPylori
Proteus

Toxins

IntracellularGrowth

Facultative Obligate
ListeriaMonocytogenes MycobacteriaLeprae
SalmonellaGenus RickettsiaRickettsii
ShigellaGenus CoxiellaBurnetti
MycobacteriaTB Erlichia
BrucellaGenus ChlamydiaSpecies
Bartonella

TheABCsofAnaerobicbacteria
AActinomyces(gram+)
BBacteroides
CClostridium(gram+)
AcidFastBacteria
Mycobacteria(TBandLeprosy)
Nocardia