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I.

Infections Caused by Gram-Positive Bacteria

Name of Bacteria Disease(s) Caused Type of Pathogenesis Medication Used to Treat Common Characteristics

Boils, abscesses, Daptomycin

Toxic shock infection, Vancomycin


More than 90% contain beta
Staphylococcus aureus Wound infection, Toxigenic and pyogenic Gentamycin lactamases and they perform
coagulase production.
Skin infections, Clindamycin

Food poisoning Cefazoline Fosamil

Vancomycin
Staphylococcus It does not produce mannitol,
Endocarditis and joint infection Pyogenic Rifampin
epidermidis It is harmless.
Aminoglycosides

Staphylococcus Ciprofloxacin or any other It does not produce mannitol,


Urinary tract infection Pyogenic
saprophyticus Quinolone It is harmless.

Pharyngitis,

Cellulitis, Pyogenic, toxigenic and Ciprofloxacin These are catalase negative.


Streptococcus pyogenes
Scarlet fever, immune mediated Augmentin It is beta-hemolytic

Rheumatic fever

Streptococcus agalactiae Meningitis in neonates Pyogenic Penicillin Bacitracin resistant

Ceftriaxone Related to group D and it is alpha


Streptococcus bovis endocarditis pyogenic
Gentamycin hemolytic

Streptococcus Penicillin G
Pneumonia Pyogenic Alpha hemolytic, Catalase negative
pneumoniae Penicillin V
Ciprofloxacin

Viridians streptococci Endocarditis Pyogenic Erythromycin Alpha hemolytic

Ciprofloxacin Rod shaped gram positive,


Bacillus anthracis Anthrax Pathogenic
Doxycycline Non-motile

Omeprazole and sodium Motile, rod-shaped gram-positive


Bacillus cereus Food poisoning Exotoxin
bicarbonate bacteria

Clostridium tetani Tetanus Exotoxin Tetanus immunoglobulin Anaerobic, spore forming

Trivalent antitoxin made from Spore forming, Block the secretion


Clostridium botulinum Botulism Toxin
horse. of acetylcholine

Gas gangrene and food It damages the cell membrane


Clostridium perfringens Toxin Penicillin G
poisoning including erythrocytes

Metronidazole It mostly occurs in hospitalized


Clostridium difficile Colitis and diarrhea Exotoxin
Vancomycin patients by hands

Corynebacterium Toxigenic and non- Erythromycin


Diphtheriae It is easily separable
diphtheriae toxigenic Penicillin G

Ampicillin It is L shaped and it causes beta-


Listeria monocytogenes Meningitis
Gentamycin hemolysis
II. Infections Caused by Gram-Negative Bacteria

Name of Bacteria Disease(s) Caused Type of Pathogenesis Medication Used to Treat Common Characteristics

Mostly enters from the upper


Neisseria meningitis Meningitis Endotoxin, pyogenic Penicillin G respiratory tract, Beta lactamases
is absent

Ceftriaxone
Neisseria gonorrhea Gonorrhea Pyogenic Virulence is less
Doxycycline

Ampicillin Straight rod shape bacteria,


Escherichia coil Urinary tract infection Enterotoxins
Cefotaxime anaerobic, ferment lactose

Ceftriaxone
Salmonella typhi Typhoid fever Pathogenicity Curved-shaped
Ciprofloxacin

Shigella (bacillary Non-lactose fermenting, non-


Enterocolitis Pathogenic Ciprofloxacin
dysentery) motile

Tetracycline
Vibrio cholerae Cholera Enterotoxin Also known as Rice water stool.
Electrolytes and Glucose

Erythromycin
Campylobacter jejuni Enterocolitis Inflammatory May be curved or S-shaped.
Ciprofloxacin
Bismuth Tricyclate

Helicobacter pylori Gastric peptic ulcer Inflammatory Amoxicillin, Curved gram-negative bacteria

Metronidazole

References:

 Microbiology: An Introduction by Gerard J. Tortura, Beredell R. Funke, Christine Case. 8th edition, part no. 4 Page no. 620-771.

 Microbiology, Michael J.Pelczar.Jr, 5th edition, Chapter no. 14, page no. 288-294.

 Concise & conceptual Microbiology by Dr. Tariq Javaid, Irfan Bashir, Talha Javaid, Edition 1st, Section no. 3 page no. 121, Section no. 4 page no. 162.

 Review of medical microbiology and immunology by Warren levinson, 12thedition, published year 2012, Chapter no. 15, and page no. 113,116, 120, 137.

 Clinical microbiology by Patrick R. Murray, Yvonne R. Shea Section no. 2 page no. 54-60.

III. Main Classes of Antibiotics

Although there are well over 100 antibiotics, the majority come from only a few types of drugs. These are the main classes of antibiotics.

 Penicillins such as penicillin and amoxicillin


 Cephalosporins such as cephalexin (Keflex)
 Macrolides such as erythromycin (E-Mycin), clarithromycin (Biaxin), and azithromycin (Zithromax)
 Fluoroquinolones such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
 Sulfonamides such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim)
 Tetracyclines such as tetracycline (Sumycin, Panmycin) and doxycycline (Vibramycin)
 Aminoglycosides such as gentamicin (Garamycin) and tobramycin (Tobrex)
IV. Mechanisms of Action of Antibacterial Drugs: A: Inhibit Bacterial Cell Wall Biosynthesis; B: Inhibit Bacterial Protein Synthesis;
C: Inhibit Bacterial Membrane Function; D: Inhibit Nucleic Acid Synthesis; and E: Inhibit Metabolic Pathways (Antimetabolite)

Common Antibacterial Drugs by Mode of Action

Mode of Action Target Drug Class


Inhibit cell wall biosynthesis Penicillin-binding proteins β-lactams: penicillins, cephalosporins, monobactams,
Peptidoglycan subunits carbapenems
Peptidoglycan subunit transport Glycopeptides
Bacitracin
Inhibit biosynthesis of proteins 30S ribosomal subunit Aminoglycosides, tetracyclines
50S ribosomal subunit Macrolides, lincosamides, chloramphenicol,
oxazolidinones
Disrupt membranes Lipopolysaccharide, inner and outer membranes Polymyxin B, colistin, daptomycin
Inhibit nucleic acid synthesis RNA Rifamycin
DNA Fluoroquinolones
Antimetabolites Folic acid synthesis enzyme Sulfonamides, trimethoprim
Mycolic acid synthesis enzyme Isonicotinic acid hydrazide
Mycobacterial adenosine triphosphate (ATP) Mycobacterial ATP synthase Diarylquinoline
synthase inhibitor
Table A. Drugs that Inhibit Bacterial Cell Wall Synthesis

Mechanism of Action Drug Class Specific Drugs Natural or Spectrum of Activity


Semisynthetic
Interact directly with PBPs Penicillins Penicillin G, penicillin V Natural Narrow-spectrum against gram-positive and a few gram-
and inhibit transpeptidase negative bacteria
activity Ampicillin, amoxicillin Semisynthetic Narrow-spectrum against gram-positive bacteria but with
increased gram-negative spectrum
Methicillin Semisynthetic Narrow-spectrum against gram-positive bacteria only,
including strains producing penicillinase
Cephalosporins Cephalosporin C Natural Narrow-spectrum similar to penicillin but with increased
gram-negative spectrum
First-generation Semisynthetic Narrow-spectrum similar to cephalosporin C
cephalosporins
Second-generation Semisynthetic Narrow-spectrum but with increased gram-negative
cephalosporins spectrum compared with first generation
Third- and fourth- Semisynthetic Broad-spectrum against gram-positive and gram-negative
generation cephalosporins bacteria, including some β-lactamase producers
Fifth-generation Semisynthetic Broad-spectrum against gram-positive and gram-negative
cephalosporins bacteria, including MRSA
Monobactams Aztreonam Semisynthetic Narrow-spectrum against gram-negative bacteria, including
some β-lactamase producers
Carbapenems Imipenem, meropenem, Semisynthetic Broadest spectrum of the β-lactams against gram-positive
doripenem and gram-negative bacteria, including many β-lactamase
producers
Large molecules that bind Glycopeptides Vancomycin Natural Narrow spectrum against gram-positive bacteria only,
to the peptide chain of including multidrug-resistant strains
peptidoglycan subunits,
blocking transglycosylation
and transpeptidation
Block transport of Bacitracin Bacitracin Natural Broad-spectrum against gram-positive and gram-negative
peptidoglycan subunits bacteria
across cytoplasmic
membrane
Table B. Drugs That Inhibit Bacterial Protein Synthesis

Molecular Mechanism of Action Drug Class Specific Drugs Bacteriostatic Spectrum of


Target or Bactericidal Activity
30S subunit Causes mismatches between codons and anticodons, Aminoglycosides Streptomycin, gentamicin, Bactericidal Broad
leading to faulty proteins that insert into and disrupt neomycin, kanamycin spectrum
cytoplasmic membrane
Blocks association of tRNAs with ribosome Tetracyclines Tetracycline, doxycycline, Bacteriostatic Broad
tigecycline spectrum
50S subunit Blocks peptide bond formation between amino acids Macrolides Erythromycin, azithromycin, Bacteriostatic Broad
telithromycin spectrum
Lincosamides Lincomycin, clindamycin Bacteriostatic Narrow
spectrum
Not applicable Chloramphenicol Bacteriostatic Broad
spectrum
Interferes with the formation of the initiation complex Oxazolidinones Linezolid Bacteriostatic Broad
between 50S and 30S subunits and other factors. spectrum

Table C. Drugs That Inhibit Bacterial Membrane Function

Mechanism of Action Drug Class Specific Spectrum of Activity Clinical Use


Drugs
Interacts with lipopolysaccharide in the outer Polymyxins Polymyxin B Narrow spectrum against Topical preparations to prevent infections in
membrane of gram-negative bacteria, killing the gram-negative bacteria, wounds
cell through the eventual disruption of the outer including multidrug-
membrane and cytoplasmic membrane resistant strains
Polymyxin E Narrow spectrum against Oral dosing to decontaminate bowels to
(colistin) gram-negative bacteria, prevent infections in immunocompromised
including multidrug- patients or patients undergoing invasive
resistant strains surgery/procedures.
Intravenous dosing to treat serious systemic
infections caused by multidrug-resistant
pathogens
Inserts into the cytoplasmic membrane of gram- Lipopeptide Daptomycin Narrow spectrum against Complicated skin and skin-structure infections
positive bacteria, disrupting the membrane and gram-positive bacteria, and bacteremia caused by gram-positive
killing the cell including multidrug- pathogens, including MRSA
resistant strains
Table D. Drugs That Inhibit Bacterial Nucleic Acid Synthesis

Mechanisms of Action Drug Class Specific Drugs Spectrum of activity Clinical Use
Inhibits bacterial RNA Rifamycin Rifampin Narrow spectrum with activity against gram-positive Combination therapy
polymerase activity and blocks and limited numbers of gram-negative bacteria. Also for treatment of
transcription, killing the cell active against Mycobacterium tuberculosis. tuberculosis
Inhibits the activity of DNA Fluoroquinolones Ciprofloxacin, Broad spectrum against gram-positive and gram- Wide variety of skin
gyrase and blocks DNA ofloxacin, negative bacteria and systemic
replication, killing the cell moxifloxacin infections

Table E. Antimetabolite Drugs

Metabolic Mechanism of Action Drug Class Specific Drugs Spectrum of Activity


Pathway Target
Folic acid Inhibits the enzyme involved in production Sulfonamides Sulfamethoxazole Broad spectrum against gram-positive and gram-
synthesis of dihydrofolic acid Sulfones Dapsone negative bacteria
Inhibits the enzyme involved in the Not applicable Trimethoprim Broad spectrum against gram-positive and gram-
production of tetrahydrofolic acid negative bacteria
Mycolic acid Interferes with the synthesis of mycolic acid Not applicable Isoniazid Narrow spectrum against Mycobacteriums,
synthesis including M. tuberculosis

Source: Mechanisms of Antibacterial Drugs. Lumen. Microbiology. Accessed September 22, 2018:
https://courses.lumenlearning.com/microbiology/chapter/mechanisms-of-antibacterial-drugs/
V. Major Types of Infections Common Across the Lifespan

Acute Bacterial Meningitis

Neonates (0-2 weeks old)

 Streptococcus agalactiae (Group b streptococcus)

 Escherichia coli

 Listeria monocytogenes

Neonates (0-3 months)

 Streptococcus agalactiae

 Escherichia coli

 Listeria monocytogenes

 Streptococcus pneumoniae

 Haemophilus influenzae

3 months to 50 years of age

 Streptococcus pneumoniae

 Neisseria meningitidis

 Haemophilus influenzae

Over 50 years of age

 Streptococcus pneumoniae

 Listeria monocytogenes

 As the population ages, Haemophilus influenzae will become more prevalent in this age group
Nosocomial (Hospital-Acquired) and Immunocompromised Patients

 Escherichia coli

 Klebsiella spp.

 Staphylococcus aureus

 Streptococcus pneumoniae

Viral (Aseptic) Meningitis and Encephalitis (90% of cases in patients under 30 years old)

 Enteroviruses (70%; late summer and early fall)

 Arboviral meningoencephalitis (summer via tick or mosquito; West Nile virus, Eastern Equine Encephalitis virus, Western Equine Encephalitis virus, St.
Louis Encephalitis virus, California group Encephalitis viruses, Powassan Encephalitis virus)- are the most common cause of episodic encephalitis in the
US.

 Mumps (late winter and early spring)

 Herpes simplex virus (sporadic)

 HIV (sporadic)

 Rabies virus (rare)

Granulomatous Meningitis (Chronic meningitis)

 Mycobacterium tuberculosis

 Cryptococcus neoformans

Spinal Cord

 Clostridium tetanus*

 Polio virus
Skin (Integument) Infections

There are a huge number of infectious diseases of this the largest organ of the human anatomy. Therefore, only the more common bacterial, viral and fungal
microbes are mentioned here.

Common Bacterial Infections:

 Staphylococcus aureus - impetigo, bullous impetigo, scalded skin syndrome, folliculitis, furuncles, carbuncles, cellulitis, myositis and toxic shock
syndrome.

 Streptococcus pyogenes - impetigo, scarlet fever, erysipelas, necrotizing fasciitis, and streptococcal toxic shock syndrome.

 Propionibacterium acne - acne

Common Viral Infections:

 Herpes Simplex 1 and 2 viruses- oral and genital herpes

 Papilloma viruses – warts, genital warts, cervical dysplasia and cervical carcinoma

 Common childhood rashes (exanthems) are caused by

o Coxsackie viruses and Echoviruses (enteroviral rashes),

o Erythrovirus B19 (formerly Parvovirus B19; Erythema Infectiosum)

o Human Herpes virus 6B (Exanthem subitum or Roseola)

o Human Herpes Virus-7 (Exanthem subitum or Roseola)

o Varicella-Zoster virus (Chickenpox)

o Measles virus (Rubeola)

o Rubella virus (Rubella).

Common Fungal Infections:

 Malassezia furfur- Tinea versicolor

 The dermatophytes (Microsporum, Trichophyton and Epidermophyton) - Tinea pedis, Tinea corporis, Tinea capitis, Tinea manus and Tinea cruris.

 Candida albicans - intertrigo, folliculitis, paronchyia and onychomycosis.


Ear Infections

Otitis Media

 Streptococcus pneumoniae

 Moraxella catarrhalis

 Haemophilus influenzae (nontypable)

Otitis externa

 Pseudomonas aeruginosa*

 Staphylococcus aureus

Eye and Eyelid Infections

Anterior Blepharitis

 Staphylococcus aureus or Staphylococcus epidermidis

Hordeola (stye)

 Staphylococcus aureus

Periorbital (Preseptal) Cellulitis

 Streptococcus pneumoniae in young children

 Staphylococcus aureus or Streptococcus pyogenes post-traumatic

Orbital (Postseptal) Cellulitis

 Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Enterobacteriaceae

Dacryocystitis

 Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pyogenes, and Pseudomonas aeruginosa

Conjunctivitis

 Viral- Adenoviruses*, Herpes Simplex viruses’ types 1 and 2 (less common but more serious infection)
 Bacterial (pinkeye)- Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa,
Neisseria gonorrhoeae and Neisseria meningitidis

 Chlamydial- Chlamydia trachomatis

Keratitis

 Bacteria*

o Gram positive bacteria (Streptococcus pneumoniae, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus viridans, enterococci
and Peptostreptococcus) are most frequently obtained with the most common of them being Staphylococcus aureus.

o Gram positive bacilli that cause keratitis include Corynebacterium diphtheriae, Bacillus and Clostridium

o Gram negative bacilli that cause keratitis include Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Serratia marcescens,
Escherichia coli and Aeromonas hydrophila. Pseudomonas aeruginosa is one of the most destructive of the bacterial causes of keratitis.

o Gram negative cocci or coccobacilli that cause keratitis include Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella, Pasteurella
multocida andAcinetobacter.

o Ocular lymphogranuloma venereum is more serious than simple chlamydial conjunctivitis because corneal scars, conjunctival scars, and
micropannus formation can occur (serotypes L1-L3 of Chlamydia trachomatis).

 Viruses

o Herpes Simplex 1 and 2*- most common of viruses

o Adenoviruses- epidemic keratoconjunctivitis

o Varicella Zoster virus

Respiratory Tract Infections

Acute Rhinosinusitis

 Usually caused by various respiratory viruses.

Acute Bacterial Rhinosinusitis

 Streptococcus pneumoniae

 Haemophilus influenzae (nontypable)


Common cold (Rhinitis)

 Rhinoviruses*

 Coronaviruses

Pharyngitis

 Adenovirus

 Herpes Simplex virus

 Epstein Barr Virus

 Coxsackie viruses

 Remember Streptococcus pyogenes (group A streptococcus is important because of the complications that can result (rheumatic fever).

Viral Croup

 Parainfluenza virus

 Influenza virus

 Respiratory syncytial virus (most common cause of bronchiolitis in children under 1 year of age).

Bacterial tracheitis

 Staphylococcus aureus

Epiglottitis

 Haemophilus influenzae type b (very rare now due to the Hib vaccine)

Bronchitis

 Respiratory viruses that infect the upper respiratory tract: influenza viruses A and B, parainfluenza viruses, adenovirus, respiratory syncytial virus, herpes
simplex virus, rhinovirus, coxsackievirus A and B, and echovirus.

 Mycoplasma pneumoniae

 Chlamydophila pneumoniae (TWAR agent)- 5% of cases

 Streptococcus pyogenes
Bronchiolitis

 Respiratory Syncytial virus (RSV)

Pneumonia:

Neonatal (0-1 month)

 Escherichia coli

 Streptococcus agalactiae (group B streptococcus)

Infants (1-6 month)

 Chlamydia trachomatis (afebrile pneumonia with staccato cough)

 RSV

Children (6month-5 year)

 RSV

 Parainfluenza virus

Children (5-15 year)

 Mycoplasma pneumoniae

 Influenza virus type A

Young Adults (16-30 yr)

 Mycoplasma pneumoniae

Older Adults

 Streptococcus pneumoniae*

 Haemophilus influenzae
Gastrointestinal Tract Infections

Infections of the Teeth

 Dental caries- Streptococcus mutans, Streptococcus sobrinus, low-pH tolerant Streptococcus spp., Lactobacillus casei, Actinomyces spp.,
and Bifidobacterium spp.

 Gingivitis- The more dental plaque that accumulates on the teeth the more likely a patient will develop gingivitis. The plaque leading to gingivitis
contains higher numbers of Gram negative anaerobic bacilli and spirochetes.

 Necrotizing ulcerative gingivitis (NUG: trench mouth)- the dental biofilm/plague usually contains a lot of Fusobacterium spp., Prevotella intermedia, and
especially spirochetes (Treponema denticola).

 Chronic periodontitis- is a polymicrobial process; biofilms (plaque) containing higher numbers of Gram negative anaerobic bacilli and spirochetes.
Certain organisms, when present in plaque will increase the risk of chronic periodontitis developing.

 Red complex organisms (high risk): Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola.

 Orange complex organisms (moderate risk): Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescens, Parviomonas micra,
Eubacterium nodatum, and various Camplylobacter species (e.g., C. rectus).

 Yellow complex organisms (low risk): Streptococcus intermedius, Streptococcus sanquinis, Streptococcus oralis, Streptococcus
mitis, and Streptococcus gordonii.

 Aggressive periodontitis- The plaque microflora in aggressive periodontitis is similar to chronic periodontitis. However, the presence of certain bacteria
in the plaque increases the risk for this disease to develop (Aggregatibacter actinomycetemcomitans or Eikenella corrodens in concert
with Fusobacterium nucleatum). Sparse amounts of biofilm/plaque are generally found relative to degree of periodontal destruction.

Ludwig’s Angina

 Streptococcus, Bacteroides, Fusobacterium and/or Staphylococcus aureus

Infections of the Mouth and Tongue

 Herpes Simplex viruses 1 and 2 (gingivostomatitis or cold sores)

 Candida albicans (oral candidiasis)

Angular Cheilitis

 Candida albicans

Parotitis

 Mumps virus- benign viral parotitis


 Staphylococcus aureus- acute bacterial parotitis

Esophagitis- usually only seen in immunocompromised patients

 Candida albicans*

 Cytomegalovirus (CMV) Herpes Simplex Virus (HSV), Human Immunodeficiency virus (HIV), Varicella Zoster Virus (VZV)

Peptic Ulcer Disease

 Helicobacter pylori

Intestinal Infections- Bacterial (can be inflammatory [blood and mucus small volume; fecal wbc's present] or noninflammatory [large volume watery stools; fecal
wbc's NOT present]

Inflammatory ones

 Campylobacter jejuni

 Escherichia coli (EIEC)

 Escherichia coli (EHEC)

 Salmonella typhimurium

 Salmonella typhi (get also fever and headache; sometimes no diarrhea)

 Shigella dysenteriae type 1 (lots of PMN's)

 Shigella sonnei/flexneri

 Yersinia enterocolitica

 Clostridium difficile (can be both inflammatory and non-inflammatory)

Non-inflammatory ones

 Escherichia coli (EPEC)

 Escherichia coli (ETEC)

 Escherichia coli (EAEC)

 Vibrio cholerae

 Clostridium difficile (can be both inflammatory and non-inflammatory)


Parasitic infections of the intestine

 Giardia lamblia*

 Entamoeba histolytica

 Cryptosporidium parvum

 Cyclospora cayetanensis

 Enterobius vermicularis

 Taenia saginata

 Taenia solium

 Hymenolepis nana

 Ascaris lumbricoides

 Necator americanus

 Strongyloides stercoralis

Viral Gastroenteritis

 Noroviruses* (winter vomiting disease- most common in industrialized countries for all age groups)

 Rotavirus (winter infant diarrhea- next most common in infants and children; after Norovirus)

 Adenoviruses

 Astroviruses

Food poisoning- intoxications

 Staphylococcus aureus*

 Bacillus cereus

 Clostridium perfringens

 Clostridium botulinum

Viral Hepatitis- Infections of the Liver

 Hepatitis A virus
 Hepatitis C virus

 Hepatitis B virus

 Hepatitis D virus

 Hepatitis E virus

Infections of the Bones and Joints

Osteomyelitis

 Staphylococcus aureus*

 Streptococcus sp.

 Members of the Enterobacteriaceae

Septic arthritis

 Neisseria gonorrhoeae (most common in sexually active young adults)

 Staphylococcus aureus*

Infections of the Heart

Pericarditis

 Viral pericarditis*- Enteroviruses [Coxsackieviruses (A and B) and Echovirus (type 8)]

 Purulent pericarditis- rare- Staphylococcus aureus, Streptococcus pneumoniae and other streptococci

 Chronic pericarditis- rare- Mycobacterium tuberculosis and various fungi (Candida sp.)

Myocarditis

 Enteroviruses (Coxsackievirus B is the most common)


Endocarditis

 Native valve- Streptococcus sp. (60-80%, viridans streptococci (30-40%), Streptococcus bovis (10%), Enterococci (S. faecalis and S. faecium; 5-18%)
and Staphylococci (20-35%, usually Staphylococcus aureus)
 Intravenous drug users- Staphylococcus aureus (50%) and gram-negative bacilli (15%; Pseudomonas aeruginosa is most the common gram-negative).
 Prosthetic valve infections

o Early (within 2 months of surgery) - Staphylococcus (50%; coagulase positive and coagulase negative), gram-negative aerobic bacilli (20%) and
fungi (5%).

o Late (more than 2 months post surgery) - viridans Streptococcus sp. (35%), coagulase negative staphylococci (20%), and Staphylococcus
aureus (10%).

Rheumatic Heart Disease

 Streptococcus pyogenes

Hematopoietic/Lymphoreticular Infections

Infections of the Lymphocytes

 Acquired Immunodeficiency Syndrome (HIV/AIDS)- T-lymphocytes

 Infectious Mononucleosis- B-lymphocytes

 Cytomegalovirus Infections- T-lymphocytes and macrophages

Infections of the Phagocytic Cells

 Cat-scratch disease – Bartonella henselae

 Tularemia – Francisella tularensis

 Ehrlichiosis/Anaplasmosis - Ehrlichia chaffeensis, Ehrlichia ewingii and Anaplasma phagocytophilum

 Q fever- Coxiella burnetii

 Brucellosis- Brucella sp. Plague- Yersinia pestis

Infection of the Erythrocytes

 Babesia- Babesia microti

 Malaria- Plasmodium sp.


Infection of the Endothelial Cells

 Bacillary Angiomatosis/Hepatica peliosis- Bartonella henselae or Bartonella quintana

 Endemic relapsing fever- Borrelia sp. (15 different species; B. hermsii, B. parkeri)

 Epidemic Hemorrhagic fever- Sin Nombre virus (Hantavirus- hantavirus pulmonary syndrome)

 Rocky Mountain Spotted Fever- Rickettsia rickettsii

Bacterial Sepsis

Neonates

 E.coli*

 Streptococcus agalactiae (group b strep.)

Adults (Systemic Inflammatory Response Syndrome, Sepsis, Septic Shock)

 Most are due to bacterial infections. 50% due to Gram negative bacteria; 50% due to Gram positive bacteria. It depends on the location of the site of the
initial infection. Most common sites of infection leading to sepsis are lungs, abdomen, and urinary tract (ex. urinary tract think Escherichia coli;
community acquired pneumonia think Streptococcus pneumoniae).

Infections of the Genitourinary Tract

Cystitis and Pyelonephritis

 Escherichia coli*

Acute bacterial Prostatitis

 Escherichia coli*

Vaginitis

 Bacterial Vaginosis* (BV) due to Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and various anaerobic bacteria
including Mobiluncus sp., and Prevotella sp.

 Candida albicans

 Trichomonas vaginalis
Sexually Transmitted Infections (STI’s) of the Genitourinary Tract

Genital Ulcerative Diseases

 Genital Herpes- HSV-2* (80%),

 HSV-1 (20%) Syphilis- Treponema pallidum

 Chancroid- Haemophilus ducreyi

 Granuloma Inguinale- Klebsiella granulomatis (formerly Calymmatobacterium granulomatis)

 Lymphogranuloma Venereum- Chlamydia trachomatis

Urethritis

 Chlamydia trachomatis*

 Neisseria gonorrhoeae

Cervicitis

 Chlamydia trachomatis*

 Neisseria gonorrhoeae

Other STI’s

Acute Pelvic Inflammatory Disease

 Chlamydia trachomatis*

 Neisseria gonorrhoeae

Genital Warts

 Human Papilloma virus (HPV types 6 and 11 most common for wart-like lesions; HPV types 16 and 18 most common for with cervical dysplasia and
carcinoma.)

Epididymitis

 Sexually active men aged <35 years- Chlamydia trachomatis or Neisseria gonorrhoeae

 Men >35 years of age- gram-negative enteric bacteria


Ectoparasitic Infections

Scabies

 Sarcoptes scabiei var hominis

Pediculosis

 Pediculus humanus capitis (head louse)

 Pediculus humanus corporis (body louse)

 Pthirus pubis (pubic louse)

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