Bacilli

Gram (+) non-spore forming Gram (+) spore forming Gram (-) bacilli
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Taxonomical Classification:
Gram

(+) non-spore formers Mycobacterium Corynebacterium gravis mitis Intermedius Lactobacillus Erysipelothrix Listeria

Gram

(+) spore formers: Aerobic - Bacillus B. anthracis B. subtilis Anaerobic-Clostridium C. tetani C. botulinum C. perfringens

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Taxonomical Classification: (2)

Gram

(-) bacilli Enterics Escherichia Salmonella Shigella Klebsiella Arizona Providencia Vibrio

Citrobacter Edwardsiella Serratia

Proteus
Morganella

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Small gram (-) bacilli

Bordatella Hemophilus Brucella

Pasteurella

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Mycobacterium: (1)
M.

tuberculosis (Kochs bacilli) long, slender, granular curved or rounded end AFS (+), Gm (+) *glycerine Lowenstein, Petroffs, Dorsets , Corpers
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Types:

-man Bovine - hogs & cattle Avian - birds Pathogenecity: no toxins produced Productive Lesions Exudative Lesion

Human

AFS property of Mycobacterium:

Due

to the presence of mycolic acid. Mycolic acid gives M. tuberculosis many characteristics that defy medical treatment. They lend the organisms increased resistance to chemical damage & dehydration. Prevent the effective activity of hydrophobic antibiotics Allows it to grow within macrophages which makes it resistant to the immune system action
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Mycobacterium (2)
Types

of tuberclosis Primary infection Reactivation TB Millary TB Diagnosis: microscopic exam chest x-ray tuberculin test culture of sputum
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M.

leprae ( Leprae bacilli, Hansens bacilli) long, slender, usually straight, non-motile, grouped like cigarette packets Pathognesis: Leprosy Acute nodular Anesthetic or nerve

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Mycobacterium (3)
M.

leprae ( Leprae bacilli, Hansens bacilli) grouped like packet of cigarettes leprosy: acute nodular leproma anesthetic - nerve leprosy
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transmission:

prolonged contact organisms found in mucous membrane diagnosis: Mitsuda, Lepromin test Stains: Ziehl Neelsen Baumgarten Papenheims

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Corynebacterium: (1)
C.diptheriae:

Kleb Loeflers bacilli pleomorphic, globular, club shaped, bard-shaped, irregular swelling & staining ---Babe Ernst bodies Gram (+), AFS (-) Culture: BAP, Pais Tellurite
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more

in children Pathogenesis: toxin is absorbed -destruction of cells -inflammatory response -- formation of pseudomembrane -- bleeding -- edema Specimen : nose & throat swabs

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Corynebacterium: (2)
Diagnosis: direct

Methods

microscopic exam culture virulence test -in vivo & in vitro DPT vaccine: Diptheria Pertussis & Tetanus combination
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of Acquired immunity fetal transfer attack or infection Artificial immunization from infection

Corynebacterium: (3)
gravis short in tellurite (-) hemolysis mitis intermedius long , granular long , barred in tellurite in tellurite (+) hemolysis (-) hemolysis

large colonies small colonies small colonies forms pellicle grows in broth diffusely
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granular sediments

LACTOBACILLUS
-Most species of this non-spore-forming bacterium ferment glucose into lactose, hence the name Lactobacillus. -The most common application of Lactobacillus is industrial, i.e. for dairy production. -This genus also contains several bacteria that make up part of the natural flora of the human vagina..
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 Because

of their ability to derive lactic acid from glucose, these bacteria create an acidic environment which inhibits growth of many bacterial species which can lead to urogenital infections. Lactobacillus is generally harmless to humans, rarely inciting harmful infections or diseases. Treatment of this vancomycin-resistant microbe usually consists of high doses of penicillin in combination with gentamicin
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ERYSIPELOTHRIX
E.

rhusiopathiae, the only species of this genus, is better known as a veterinary pathogen than as a human pathogen. When cultured on blood agar or some other nutrient medium, Erysipelothrix forms notably large colonies. This ubiquitous microbe has been found in many farm animals such as pigs, horses, and turkeys.
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 Occasionaly,

though, it can infect a human host and cause an inflammatory skin disease, Erysipeloid.
Treatment usually consists of penicillin G, ampicillin, or cephalothin. Most clinical strains have been found to be resistant to the super-antibiotic, vancomycin.

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LISTERIA:
Gram-positive

rod which is not capable of forming endospores. Although several species of this bacterium exist, our discussion will focus only on the two species of human pathogenic significance: L. monocytogenes and L. ivanovii. In particular, L. monocytogenes has been implicated in several food poisoning epidemics. This is a normal inhabitant of the gastrointestinal tract and of animal feces
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 Infected

suffers from vomiting, nausea, and

diarrhea. Those at high risk include newborns, pregnant women and their fetuses, the elderly, and persons lacking a healthy immune system. The bacterium usually causes septicema and meningitis in patients with supressed immune function. Causes Listeriosis, an inflammation of the brain. Antibiotics are recommended for treatment of infection because most strains of Listeria are sensitive to ampicillin and gentamicin.
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Bacillus : (1)
char.: B. anthracis (anthrax medusa head colonies bacillus) inverted fir tree in stab Gram (+) , aerobic, Biochemical char.: central spore, motile, ferment dextrose non-pathogenic except anthracis, thermophilic indole is not produced ends are concave or gelatin is liquefied square, forms long Note: Find differences chains, jointed bamboo with B. subtilis
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cultural

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Bacillus : (2)
Anthrax

- lesion like carbuncle, large , black, necrotic death due to mechanical clogging of capillaries Types: Bacteremia blood Cutaneous - skin
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- wool sorters disease Intestinal Specimen - blood, swab w/ pus, sputum, feces Diagnosis: direct microscopic culture animal inoculation

Pulmonary

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Clostridium : (1)
C.

tetani (tetanus or drumstick bacillus) motile medium in length terminal spore Thioglycolate broth pathogenesis: fever, pain , Lockjaw, sardonic smile, spasm
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Diagnosis: culture

from lesion - BAP, Thioglycolate Prevention: active immunity with toxoid

secretion

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Clostridium: (2)
C.

botulinum (Von Ermengens bacilli) motile long subterminal spore Culture: Chopped meat BA medium
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Pathogenesis:

intoxication food infection food poisoning Culture of leftover food or stool History of patient

food

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Clostridium: (3)
C.

perfringens (C.welchii, Frankels or gas gangrene) non-motile short central spore Culture media: same as C. botulinum
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pathogenesis

gangrene food infection Diagnosis: swab from lesion & culture microscopic exam culture of pus

gas

Clostridium: (4)
Clostridium difficile: Causes pseudomembrane colitis Relatively resistant to most antibiotics Produces cytopathic toxins and enterotoxin
Diarrhea,

to marked diarrhea to necrosis of mucosa Diagnosis

Demonstrate

neutralizeable toxin in stool Detecting enterotoxin by immunoassay

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Actinomyces israelii
Causes

actinomycosis Vary considerably in length Maybe branched or un branched Grows slowly, on agar some strains produce colonies similar to molar teeth Sometimes confused with corynebacterium Sensitive to penicillin & erythromycin
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Propionibacterium acne:
Normal

flora of the skin but can cause disease when they infect shunt and appliances On gram stain, highly pleomorphic Participates in the genesis of acne May contaminate blood and CSF once it penetrates the skin
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Eubacterium, Bifidobacterium & Arachnia:

These

3 genera are made up of anaerobic, pleomorphic, gram positive rods There are several species Are found in mixed infections associated with oropharyngeal or bowel flora

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Gram - Bacilli
Enteric

Bacteria (Enterobacter family) found in intestines of man & animals, parasitic & saprophytic, mostly pathogenic causes intestinal diseases & septicemic infections produce Hydrogen sulfide
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Media:

Selenite

broth Tetrathionate broth Peptone Tryptone

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Gram (-) bacilli

Plating

media: Desoxycholate, Citrate SSA, EMB, BAP McConkey, Brilliant green

Indicators: Neutral

red: Red/colorless Phenol red: yellow/red Andrades: pink/ colorless

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Escherichia
Escherichia

coli found in the normal flora of GIT, outside the GIT it causes cystitis, peritonitis index for food & water pollution IMViC - ++- A.aerogenes - --++
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 Qualitative

analysis of

water:
Organolytic

- physical Presumptive - lactose broth for gas Confirmatory - EMB Completed - RDS, TSI, KIA

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Salmonella

Salmonella

typhosa

circular,

small, smooth surface w/ even edge colonies Indole (-), Citrate (+), no lactose fermentation, ferments glucose, maltose
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Antigenic Structure: H-flagellar O-somatic Vi-capsular Widals Test: ^titer O - active infection ^titer H - post vaccination ^Vi -carrier
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Salmonella

Resistance:

at 60 degrees for 15 - 20 minutes can survive whole winter, 7 days in well water Typhoid & enteric fever- S.typhosa, S. para A, S. para B
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killed

Salmonella
Paratyphoid

fever S. paratyphosa Gastroenteritis & food poisoning - S. derby, S. enteritidis Bacteremia, septicemia- S. Cholrasuis
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Characteristics

in food poisoning: no taste or smell, grow rapidly in meat, toxins resistant over 100 degrees, not destroyed with ordinary cooking Sources: water, milk & dairy products, frozen eggs, meat

Salmonella Motility Hydrogen sulfide Indol Citrate Mannitol

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Shigella motile negative variable negative

non-motile positive negative positive

non fermenter fermenter

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Shigella
Shigella

dysenteriae: small, convex, circular, colorless, glistening colonies non-lactose fermenter, body temp. , aerobic ferment glucose, mannitol, citrate (-)
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 Mannitol

fermentation (-) Indole (-) S. dysenteriae (+) S. ambigua (+) Lactose (-) Indole (-) S. flexner (+) S. boydii (+) Indole (-) S. sonnei

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Diagnosis : Stool exam, rectal swab -culture in McConkey, SSA or EMB Pathogenesis: bacillary dysentery- abdominal pain, cramps, diarrhea, fever
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Arizona
Arizona

SPACE FOR RENT!!!

hinshawii Gram (-) , motile, similar to Salmonella Slow lactose fermenter, sucrose & Indole (-) IMViC - -+-+ Pathogenesis: causes gastroenteritis or sepsis

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Klebsiella
Klebsiella

pneumoniae (K. oxytoca or Friedlanders bacilli) short, Gram (-) , nonmotile, posess thick capsule of polysaccharide, facultative anaerobes, killed at 55 degrees
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 Cultural

char.: large, mucoid colonies, tenaceous colonies, repeated culture loses capsule Biochemical: ferment lactose, sucrose, maltose, mannitol & salicin IMViC - --++
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 Pathogenesis:

causes bacterial pneumonia, enteritis, Pharyngitis, sinusitis, septicemia, meningitis, peritonitis, UTI Antigenic structure: 72 capsular types Type 1&2 respiratory Type 8,9,10 - UTI
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Diagnosis: culture of stool, blood, urine, pus, CSF other members: K.ozanae-produce fetid odor & progressive atrophy K.rhinoscleromatis granuloma in nose & fever

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Providencia
Providencia

( morgani, retgerii, vulgaris & mirabilis) Gram (-), pleomorphic, motile at 25 degrees, weak & non-motile at 31 Biochem: urea (+), non lactose fermenter
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 Antigenic

structure: OxK Ag - Weil Felix Test -- (+) Ox2, Ox19 Pathogenesis: (+) in stool, pneumonia & bacteremia, nosocomial infection Diagnosis: culture urine, stool, lesion & sputum
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Vibrio
Vibrio

cholera: small curved bacilli, commashaped, monotrichous, motile, aerobic, alkaline pH pinpoint black glistening colonies Biochem: ferment sugars, Indole (+), Greigs Test (-)

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 Pathogenesis:

Asiatic cholera - incubation 25 days Symptoms: preliminary diarrhea intense LBM,dehydrate exhaustion face & skin shrinks rice watery stool coma
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 Strains Diagnosis

: symptoms Rice watery stool culture of stool Agglutination test Gram stain Biochemical test Greigs Test

of Cholera: El tor Celebes strain Camphylobacter fetus

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EDWARDSIELLA
Edwardsiella

tarda is the only species in this genus of enteric bacteria which is important to our discussion. E. tarda is biochemically similar to E. coli with the exception that E. tarda produces hydrogen sulfide. This bacterium is usually found in aquatic animals and reptiles. However, it has been known to cause gastroenteritis and wound infections in humans.
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LABORATORY INDICATIONS
Lysine

+ Hydrogen sulfide + -/+ TSI reaction (with gas) Indole + Citrate -

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CITROBACTER
Citrobacter

is not considered to be an enteric pathogen because it is normal gut flora. When plated, Citrobacter colonies bare a strong resemblance to E. coli colonies. C. freundii is suspected to cause diarrhea and possibly extraintestinal infections. C. diversus has been linked to a few cases of meningitis in newborns
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LABORATORY INDICATIONS:
Lysine Hydrogen sulfide + (C. freundii) +/+ TSI reaction (with gas) Citrate + Slow urease

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SERRATIA
Members

of the Serratia genus were once known as harmless organisms that produced a characteristic red pigment. Today, Serratia marcescens is considered a harmful human pathogen which has been known to cause urinary tract infections, wound infections, and pneumonia.

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 Serratia

bacteria also have many antibiotic resistance properties which may become important if the incidence of Serratia infections dramatically increases.
can be distinguished from other genera belonging to Enterobacteriaceae by its production of three special enzymes: DNase, lipase, and gelatinase.

Serratia

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LABORATORY INDICATIONS:
Lysine + Citrate + Indol +/+ TSI (No gas) DNase +

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PROTEUS
Proteus,

like almost every other bacterium in this family, can cause urinary tract infections and hospital-acquired infections. Proteus is unique, however, because it is highly motile and does not form regular colonies.

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 Proteus

forms what are known as "swarming colonies" when plated on non-inhibitory media. The most important member of this genus is considered to be P.mirabilis, a cause of wound and urinary tract infections. Fortunately, most strains of P. mirabilis are sensitive to ampicillin and cephalosporins.

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 Unlike

its relative, P. vulgaris is not sensitive to these antibiotics. However, this organism is isolated less often in the laboratory and usually only targets immunosuppressed individuals. P. mirabilis and P. vulgaris can be differentiated by an indole test for which only P. vulgaris tests positive.

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LABORATORY INDICATIONS:
Lysine

Hydrogen sulfide + Motile Urease

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MORGANELLA
Not much exciting going on here. Morganella morganii is the only important species of this genus. It can cause urinary tract and wound infections, as well as diarrhea. Chloramphenicol is a good choice for treating Morganella infections. Indole + , Ornithine + Citrate +

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Pleomorphic Small Gram (-) bacilli:

group

of short bacilli, Gram (-) , bipolar staining, safety pin Bordatella pertussis (Bordet Gengon bacilli) Bordatella parapertussis (Whooping cough)
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 small,

plump coccobacilli, non motile, possess capsule Cultural char: Potato glycerol agar, acid pH, easily die when exposed to outside factors ( sunlight, drying)

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 Pathogenesis:

incubation- 2 weeks, caterrhal stage, explosive cough, lymphocytes (1630000) Symptoms: spasmodic cough, bulging eyes, red conjunctiva, emaciated child
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Hemophilus
Hemophilus influenza (Pfeiffers bacilli) 8-9 species small aerobic, nonmotile, non-spore former media requires blood & derivatives seen in pairs or singly

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 satellite

phenomenon in BAP Pathogenesis: capsulated forms produce suppurative respiratory infections: sinusitis laryngitis epiglotitis meningitis

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 H.

ducreyi (chancroid bacilli) aerobic, 37 degrees, non-motile, seen in chains no satellite phenomenon Transmisssion: direct contact w/ lesion

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 Pathogenesis:

chancroid angry hyperemia pustule--ulcer-bubo Diagnosis: smear pus from lesion Dmelcos test Ducreyis skin test
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cause

Brucella
Brucella

(abortus, melitensis, suis, canis) non-motile, aerobic , obligate parasites to man, located intracellularly Biochemical char: ferments CHO, Hydrogen sulfide (+)
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 Resistance:

sensitive to heat & acids , killed in milk by pasteurization Pathogenesis: port of entry -- lymphatic channels -- thoracic duct -- blood streams - parenchymatous organ
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 Diseases: Brucellosis

fever Undulent fever Diagnosis: Clinical findings: specimen - acute Incubation period phase - 1-6 weeks -blood culture onset is incidious TSB w/ fever, aches & biopsy sweating, Agglutination Test splenomegaly, Skin test jaundice
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Malta

Pasteurella, Yersinia & Francisella

Pasteurella

, Yersinia & Francisella ( pestis, tularemia, multocida, enteritis) short ovoid, plump, nonmotile, prolonged incubation, pleomorphic enrich- blood, tissue fluid, yolk sac
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 Biochemical

char.: ferment CHO, w/out gas, catalase activity Pathogenesis: rodentrodent, rodent-man ---fleas Types of plague: bubonic, pneumonic septicemic, cutaneous

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 Tularemia:
Oculoglandular ulceroglandular

pneumonic

systemic Diagnosis: culture staining serological test

febrile

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