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BACTERIA PART 1
BRIAN SAMEER C. BAILE, RMT, MMPA, MMHA
2
3
• B. pseudomallei – generally
acquired through penetrating
injury or inhalation from
environmental reservoir;
wound infections, bronchitis
and pneumonia, septicemia
• MOTILE WITH LOPHOTRICHOUS
FLAGELLA
• CAUSES MELIOIDOSIS:
SEPTICIMAL GLANDER’S LIKE
DISEASE
Burkholderia 17
• B. mallei
• NON-MOTILE
• CAUSE GLANDER’S DISEASE
• (STRAUS TEST POSITIVE)
Acinetobacter 18
• LYMPHADENOPATHY
• CONTACT IN ANIMAL THROUGH INHALATION
• REQUIRES CYSTEINE FOR GROWTH
• NON-MOTILE, ENCAPSULATED
• INTRACELLULAR BACTERIA (RESIDES IN R-E-C)
• MEDIA: GCBA: GLUCOSE CYSTEIN BLOOD AGAR
• PCA: PEPTONE CYSTEIN AGAR
• CHA: CYSTEINE HEART AGAR
Francisella tularensis and Tularemia 26
Bordetella pertussis 27
• Virulence factors
• receptors that recognize and bind to ciliated respiratory
epithelial cells
• toxins that destroy and dislodge ciliated cells
• Loss of ciliary mechanism leads to buildup of mucus
and blockage of the airways.
• Vaccine – DTaP- acellular vaccine contains toxoid and
other Ags
Bordetella pertussis 29
• OXIDASE POSITIVE; UREASE NEGATIVE
• BIPOLAR METACHROMATIC GRANULES (TOLUIDINE BLUE)
• WHOOPING COUGH (PERTUSIS)
• SPECIMEN: NASOPHARYNGEAL SWAB
• DIAGNOSIS: PCR (BEST) CULTURE
• CULTURE MEDIUM:
• BORDET-GENGOU(POTATO BLOOD GLYCEROL AGAR) “MERCURY
DROPS”
• REGAN LOWE
• JONES KENDRICK CHARCOAL AGAR
• STEINER-SCHOLTE AGAR
• NASOPHARYNGEAL ASPIRATE
• TRANSPORT MEDIUM: CASEIN MEDIUM AND CAUSAMINO ACID
BROTH
30
Bordetella spp. 31
• Bordetella parapertusis
• OXIDASE NEGATIVE; UREASE POSITIVE
• Bordetella bronchiseptica
• MOTILE, OXIDASE POSITIVE, UREASE POSITIVE
Alcaligenes 32
• Live primarily in soil and water
• May become normal flora
• A. faecalis (ODORANS) – most common clinical species
• isolated from feces, sputum, and urine
• occasionally associated with opportunistic infections –
pneumonia, septicemia, and meningitis
• “FRESH APPLE ODOR”
• OXIDASE POSITIVE, CATALASE POSITIVE
• MOTILE WITH PERITRICHOUS FLAGELLA
• BAP: GREEN ZONE
• SELLERS: B/B
Legionella pneumophila and 33
Legionellosis
• Widely distributed in water
• Live in close association with amebas
• 1976 epidemic of pneumonia afflicted 200
American Legion members attending a
convention in Philadelphia and killed 29
• Legionnaires disease and Pontiac fever
• Prevalent in males over 50
• Nosocomial disease in elderly patients
• Fever, cough, diarrhea, abdominal pain,
pneumonia fatality rate of 3-30%
• Azithromycin
Legionella pneumophila and 34
Legionellosis
• PLEOMORPHIC, WEAKLY GRAM NEGATIVE ROD
• REQUIRES “CYSTEINE” AND IRON FOR GROWTH
• AIR CONDITIONING (AEROSOL), WATER COOLER TANKS, RIVERS
• FACULTATIVE INTRACELLULAR PATHOGEN
• DISEASE: LEGIONNAIRE’S DISEASE(ATYPICAL PNEUMONIA)
• “CUT GLASS” COLONY
• BROAD STREET PNEUMONIA
• PONTIAC FEVER
• DIAGNOSIS: DIETERLE STAIN: POSITIVE
• CULTURE: BUFFER CHARCOAL YEAST EXTRACT (BCYE) WITH ALPHA
KETO GLUTARATE
• FEELY GORMAN MEDIUM
35
Enterobacteriaceae Family 36
• Enterics
• Large family of small, non-spore-forming Gram-negative
rods
• Many members inhabit soil, water, decaying matter, and
are common occupants of large bowel of animals
including humans.
• Most frequent cause of diarrhea through enterotoxins
• Enterics, along with Pseudomonas sp., account for
almost 50% of nosocomial infections.
Enterobacteriaceae Family 37
• MAJOR GROUPS:
• LACTOSE FERMENTERS:
• RAPID LACTOSE FERMENTERS: DUE TO BETA
GALACTOSIDASE AND PERMEASE
• E. coli
• KLEBSIELLA
• ENTEROBACTER
• SLOW LACTOSE FERMENTERS/LATE LACTOSE FERMENTERS
(LLF) ONLY BETA GALACTOSIDASE IS PRESENT
• ARIZONA SP., CITROBACTER, SERRATIA AND S. sonnei
Enterobacteriaceae Family 42
• Klebsiella oxytoca:
• INDOLE TEST POSITIVE
• Klebsiella ozonae
• CAUSE DISEASE OF NASAL MUCOSA “CHRONIC ATROPHIC
RHINITIS”
• Klebsiella rhinoscleromatis
• NOSE & PHARYNX “RHINOSCLEROMA DISEASE”
KLEBSIELLA 55
• SERRATIA
• DNAse, LIPASE, GELATINASE
• RESISTANT TO COLISTIN AND CEPHALOTIN
• Serratia marcescens – produces a red pigment; causes
pneumonia, burn and wound infections, septicemia and
meningitis
• UREASE PRODUCER (K-E-S) GROUP
• NON LACTOSE FERMENTER (TSI: K/A)
• PRODIGIOSIN: (RED PIGMENT)
• ARABINOSE NEGATIVE
Other Coliforms 58
• Serritia liquifaciens
• PINK TO RED PIGMENT
• KCN, GELATIN, ARABINOSE POSITIVE
Other Coliforms 59
• CITROBACTER: ASSOC. W/GASTROENTERITIS, UTI,
NEONATAL MENINGITIS, BRAIN ABSCESS, DIARRHEA
• LATE LACTOSE FERMENTER: ONPG POSITIVE (YELLOW)
• TSI: A/A +GAS+H2S
• LYSINE DECARBOXYLASE: (LDC) NEGATIVE
• KCN: POSITIVE
• BIOCHEMICAL SAME AS SALMONELLA, MORPHOLOGY SAME
AS E. coli
• C. freundii: INDOLE (-); H2S(+); KCN(+); MALONATE (+)
• C. diversus: INDOLE (+); H2S(-) KCN(-); MALONATE (+/-)
• C. amalonaticus: INDOLE (+); H2S(-), KCN(+), MALONATE(-)
Citrobacter 60
Other Coliforms 61
• Arizona hinshawii
• LATE LACTOSE FERMENTER: ONPG POSITIVE (YELLOW
• GROWS ON NA MALONATE
• GELATIN LIQUIFACTION (+)
• LYSINE DECARBOXYLASE
• CAUSE GASTROENTERITIS
• INTESTINAL CONTENT (REPTILES)
Other Coliforms 62
• Edwardsiella tarda
• NON LACTOSE FERMENTER: TSI: K/A+GAS+H2S
• LYSINE DECARBOXYLASE POSITIVE
• IMViC: +,+,-,-
ENTEROBACTERIACEAE 63
Noncoliform Lactose-Negative 64
Enterics
• Proteus, Morganella, Providencia
• Salmonella and Shigella
Opportunists: Proteus and Its
65
Relatives
Proteus, Morganella, Providencia – ordinarily
harmless saprobes in soil, manure, sewage,
polluted water, commensals of humans and
animals
• Proteus sp. - swarm on surface of moist agar in a
concentric pattern
• involved in UTI, wound infections, pneumonia,
septicemia, and infant diarrhea
• Morganella morganii and Providencia sp. involved in
similar infections
• All demonstrate resistance to several
antimicrobials.
Opportunists: Proteus and Its
66
Relatives
• PROTEAE: PROTEUS
• UTI, SEPTICIMIA, STAG-HORN CALCULI
• UREASE (FUSCHIA PINK) AND PAD (GREEN) POSITIVE
• DEAMINATES LYSINE: LIA: R/A
• NON LACTOSE FERMENTERS: TSI: K/A+H2S+GAS
• BURNT GUN POWDER
• SWARMING MOTILITY
• DIENES PHENOMENON
• GELATINASE (+)
Opportunists: Proteus and Its
Relatives 67
• MEMBERS:
• S. typhi (S. typhosa): “Vi”Ag is exclusive
• EBERTH’S BACILLUS
• S. cholera suis
• S. enteritidis
• BIOTYPE: A. S. paratyphi A,B,C D. S. gallinarum
• B. S. sendari E. S. pullorum
• C. S. typhimurium F. S. darby
Typhoid Fever and Other Salmonelloses74
• NON MOTILE
• AEROGENIC
• CAUSE BACILLARY DYSENTERY (INVASIVE)
• NON LACTOSE FERMENTERS (EXCEPT S.sonnei)
• TSI: K/A
• LYSINE DECARBOXYLASE NEGATIVE: LIA: K/A
• IMViC VARIABLE (SEROTYPING)
Shigella and Bacillary Dysentery 81
• SPECIES:
• S. dysenteriae (S. shiga): GROUP A
• S. flexnerri (STRONG’S BACILLUS): GROUP B
• S. boydii (S. ambigua): GROUP C
• S. sonnei: (COMMON ISOLATES) GROUP D
82
The Enteric Yersinia Pathogens 83
• ID 3-50 bacilli
• Bubonic – bacillus multiplies in flea bite, enters
lymph, causes necrosis and swelling called a bubo
in groin or axilla
• Septicemic – progression to massive bacterial
growth; virulence factors cause intravascular
coagulation subcutaneous hemorrhage and purpura
– black plague
• Pneumonic – infection localized to lungs, highly
contagious; fatal without treatment
90
• Pasteurella multocida
• Haemophilus influenzae
• H. aegyptius
• H. ducreyi
• H. parainfluenzae
• H. aphrophilus
Pasteurella multocida 93
• BLOOD LOVING
• REQUIRES X & V FACTOR EXCEPT:
• H. ducreyi: X FACTOR ONLY
• H. parainfluenza: V FACTOR ONLY
• H. paraphrophilus: V FACTOR ONLY (SBE)
• PORPHYRIN (ALA) TEST (X FACTOR): RED COLOR (=)
Haemophilus 98
• H. influenzae (PFEIFFER’S BACILLUS)
• acute bacterial meningitis, epiglottitis, otitis media, sinusitis,
pneumonia, and bronchitis
• subunit vaccine Hib
• POLYRIBITOL CAPSULE: IgA PROTEASE
• MOUSY ODOR
• X (HEMIN) & V (NICOTINAMIDE ADENINE DINUCLEOTIDE) FACTOR
• NASOPHARYNX
• OTITIS MEDIA (MAJOR CAUSE)
• BRONCHITIS
• PNEUMONIA
• EPIGLOTTIS
• B-LACTAMASE
• NO GROWTH ON MacCONKEY
Haemophilus 99
• MENINGITIS: (TYPE b H. influenza)
• LATEX AGGLUTINATION TEST (ANTIGEN SCREEN ON CSF)
• SEROTYPE BY QUELLUNG TEST
• CULTURE MEDIA: BAP WITH S. aureus “SATELLITE
PHENOMENON”
• CAP: (X&V)
• FILDES ENRICHMENT
• LEVINTHAL AGAR
Haemophilus 100
• H. aegypticus –
conjunctivitis, pink eye
• “KOCH WEEK’S BACILLUS”
• REQUIRES X&V FACTOR
• H. parainfluenzae and H.
aphrophilus – normal oral
and nasopharyngeal flora;
infective endocarditis
Haemophilus 102