Bacteria

GPR or Gram Var.

Peptiglycan in cell wall of bacteria

Bacteria doesnt contain chitin or cellulose

Acid fast bacilli

1. Microbacterium
2. Nocardia

Non-Acid fast
1. Corynebacterium
2. Listeria
3. Erysipelothrix
4. Bacillus
5. Atinomyces
6. Gardenella
7. Lactobacillus

Corynebacterium

1.
2.
3.

Coryne Greek for Club Club shaped cells

Ferments glucose & maltose
Reduces Nitrate to nitrite (Nitrate +)

C. diptheria
1. A.k.a Respiratory dip.
a. Spread by droplet or hand to mouth contact
b. Incubation period 2-5 days
c. Treatment horse serum w/ antitoxins
2. Manifestation
a. Pharyngitis
b. Dysphagia
c. Low fever
d. Malaise
e. Lymphenditis
f. Headache
3. Systemic effect
a. Myocarditis

4.
5.

6.

7.

8.
9.

b. Neuritis
c. Kidney damage
Removal of the systemic membrane would cause suffocation
Virulence factors
a. Caused by diphtheria toxin
b. Bacteriophage gene Tox gene
i.
Strains that make it toxigenic
1. Blocks synthesis of Eukaryotic cells
2. C. ulcers & C. pseudo tuberculosis can also become
toxigenic when infec.
Cells
a. Curved
b. Chinese letters (when in clusters)
c. Pickett fences (when in a line)
d. V
e. Non-Motile & Non capsulated
f. Metachromasia when stained with methylene blue
Media
a. Loeffler serum media
i.
Contains beef, serum, & eggs
b. Phosphomycin makes BAP selective for corynebacterium
c. To ID
i.
Tinsdale media
1. Most preferred
2. Black ( telluride) w/ brown halo ( cystinase)
a. Nontoxic strains dont have the halo
ii.
CTBA (cysteine tellurite)
1. Black
a. Staph and Strep also grow black (differentiated by gram
stain)
iii.
CNA
1. Least preferred
iv.
Main ID items
1. Reduced cystinase
2. Absence of pyrazinamidase
3. Most important demonstration of toxin
Tests
a. ELEK (diffusion test)
b. PCR
Polypeptides
a. Frag. A
i.
responsible for Toxicity
b. Frag B
i.
for mediation
c. NAD is involved

C. Jeikeium
1. A.k.a Prosthetic Valve disease
2. Susceptible only to Vancomycin
a. May also be sus. to terramycin or erythromycin

C. Urealyticum
1.
2.
3.
4.
5.
6.

In urinary track
Needs 48hr incubation before growth
Mac NLF
Use cysteine urea slant
Resistant to aminoglycosides & macrolides
Tests
a. Urease Pos (within mins)

C. ulserum
1. Causes mastitis in cows & other animals
a. Human infec. animal contact
2. C. dip like illness
a. Many produce dip. Toxins
3. Causes skin ulcers or exudative pharyngitis
4. BAP Narrow hem.
5. Tests
a. Gelatin Pos (at RT)

C. pseudo tuberculosis
1. Produces dermal nephrotic toxin
2. Sus. Penicillin & erythromycin
3. Tests
a. Urease Pos
b. Gelatin Neg

Rhodococcus Equi
1.
2.
3.
4.
5.

Found in soil
GPR w/ Filaments & branching
Looks like Klebsiella on BAP
Salmon pink pigment
NOT differentiated with Bio-chemical tests

Listeria
L. monocytogenes
1. Caused by contaminated foods
2. Only animal & human pathogen in listeria
3. Growth
a. Best growth cold enrichment ( 4 C )
b. Optimal 30-35 C
c. Can grow 0-40 C
d. Aerobic
e. Non-sporulating

4.

5.
6.
7.

f. Grows on BAP, Choc, Thio, & brain-heart infusion

g. Beta hem.
i.
Confused w/ Beta strep B (A.k.a S. agalactiae)
1. Differed by Catalase
. Likes up to 10% NaCL (Salt)
i. Needs a carbohydrate source
Virulence factors
a. Hemolystin
i.
Listeria lysine O
b. Protein P 60
i.
Induces phagocytosis adhesions
Clinical Infec.
a. Found in blood or spinal fluid
Drugs
a. Penicillin, macrolides, & aminoglycosides
Most serious in Preg. Women, neonates, & immunocomp. Ppl.
a. In Preg. Women
i.
Seen in 3rd trimester
ii.
Causes spontaneous abortions & still births
1. Takes 3-7 days
b. Neonatal Listeria
i.
when baby lives (50% do)
ii.
types
1. early onset
a.
right after birth
b.
sepsis
2. Late onset
a.
Days-weeks after birth
b.
Meningitis
c. In immunocomp. Ppl.
i.
Known as Invasive Listeria
ii.
Manifestations
1. Central nervous system infec.
(most common)
2. Endocarditis
3. Meningitis
4. Sepsis

Erysipelothrix Rhusiopathiae
1.
1.
2.
3.
4.

Mainly in domestic Swine (pigs)

Human infec. Occupational exposure (threw cuts)
Resistant to salting, pickling, & smoking ( pig feet )
Incubation 1-4 days
Growth
l. vary long filaments
m. Non-sporulating
5. Motility pipe cleaner or test tube brush look
a. Differs from listeria
7. Types in humans
a. Septicemia
b. Erysipeloid (skin)
c. Endocarditis (mostly in valve replacements)

8. Infection
a. Swollen, painful (looks like a pimple)
b. Red-purple zone
c. Zone spreads as the color fades
9. Manifests
a. Last 2-4 weeks
b. Lymphadenopathy
c. Low fever
d. Relapses are common
10.
Treatment
a. Penicillin
b. Clindamycin
c. Erythromycin
d. Cephalosporin
11.
Gram stain little short chains, or V shape
12.
Specimen
a. Tissue
b. Skin aspirates
c. Inoculate in broth w/ 1% glucose, incubate, subculture to BAP Daily
13.
Colonies
a. Non-Hem or Alpha
b. 24hr Pinpoint
c. 48hr 2 distinct colonies
i.
1 small, smooth, transparent, glysining
ii.
2 large, rough, irregular edges
14.
Tests
a. Acid from glucose +
b. Nitrate =
c. Urease =
d. Res. to neomycin = (Listeria is sus)

Bacillus
1. Organism
a. Pink to black-blue pigment
b. Aerobic
c. From Endospores
d. In all climates
e. Grow at 5-75C (org. dependent)
2. Classified based on spore location
a. Group 1
i.
Oval, located Centrally or Terminally
b. Group 2
i.
Same as 1 but w/ Swollen Cells
c. Group 3
i.
Round, terminal, Swollen spores

B. anthracis
1. Causes Anthrax
2. Lestinace +
3. Grows in high salt

4. Sus. To penicillin (B. cereus is not)

5. Virulence
a. Depends on glutamic acid capsule
i.
Protects from phagocytosis
ii.
The Capsule IS necessary
6. 3 factors
a. EF (Edema factor)
i.
EF + PA Swelling
ii.
EF + LF Nothing
b. PA (Protective antigen)
i.
Is needed for activation of these factors
c. LF (Lethal factor)
i.
LF + PA Death, toxin in vascular permeability interfering w/
phagocytosis

Anthrax
1. Spread animals eat plants, we eat animals
2. Forms in humans
a. Cutaneous (Wound)
i.
Steps
1. 2-3 day incubation
2. Pimple like lesion forms
a. Usually 1-3 m in diameter
b. Called malignant puscual
3. Vessels form around the pimple
4. Eschar forms
a. black ring in center of infection
b. Puss present A pyrogenic organism is present
5. Heals in 1-2 weeks
ii.
Manifest
1. Lymphangitis
2. Malaise
3. Lymphadenopathy
b. GI (ingestion)
i.
Organism
1. Gram Pos
a. Only young cultures are gram Pos
2. Square ends
a. Single or in chains
b. Look like bamboo rods
3. On BAP Medusa Head
4. Look like string of pearls on agar
5. Non-hem
6. Non-motile
7. Produces lithinase on egg yolk
ii.
Symptoms
1. Abdominal pain
2. Bloody diarrhea
3. 5% produce meningitis
4.
iii.
Mortality

1. than in cutaneous (its usually misdiagnosed)

2. May occur 1-6 days after exposure
iv.
Treatment
1. Penicillin (drug of choice)
v.
Sensitive to
1. Gentamycin
2. Erythromycin
3. Tetracycline
4. Chloramphenicol
c. Pulmonary (inhalation)
i.
Alternate names
1. Wool sorters disease
a. Most common
2. Rag pickers disease
ii.
Symptoms
1. Resemble cold & flu
2. Last 2-5 days after inhaled
iii.
Sever Phase
1. Dyspnea
a. trouble breathing
2. Stenosis
a. Vessels narrowing
3. Plural infusion
a. Fluid in lungs
4. Onset of respiratory distress till death about 24 hrs

B. cereus
1. Causes food poisoning
2. 2 types
a. Diarrhea
i.
Ass. w/ Meat & Poultry
ii.
Incubation 8-16 hrs
iii.
25% experience vomiting
iv.
Fever is uncommon
v.
Lasts 24 hrs
vi.
Indistinguishable from Clostridium perfringens
b. Emetic (vomiting)
i.
Ass w/ fried rice
ii.
1/3 ppl. Experience diarrhea
iii.
Lasts 9 hrs
3. 2 distinct enterotoxins
4. Res penicillin
5. Ferments
6. Part of normal fecal flora
a. 10/g confirms its the cause of the disease
7. Opportunistic infec
a. Eye infec. (Most common)
8. Are contaminants of enlisted drugs
9. Treatment
a. A Clindamycin / Gentamycin combination

B. subtilis
1. Mostly pigmented
2. Usually a contaminant
3. GI illness

Actinomyces
1. A fungus like bacteria
2. Branches out (like hyphea)
3. reproduces by spores, fragmenting of conidia, &

Nocardia
1. Characteristics
a. Aerobic
b. Branched Hyphae
c. Easily disrupted into rods & cocci
d. Stains Gram Variable
e. Weak acid fast
f. Slow growers
2. Species
a. N. asteroides
b. N. brasiliensis
c. N. canidae
3. Samples
a. Sputum or wound
4. 25-30C
5. Produces a superoxide dismutase & catalase gives resistance to oxidative
killing. And a nocobactin
6. Routes
a. Pulmonary
i.
Cause Broncho Pneumonitis
ii.
Fatal in ppl w/ SS disease & SC trait
iii.
Rapid progression
iv.
Initial lesion in lung pneumonitis advances to necrosis
v.
Little encapsulation, granuloma formation
vi.
Disseminates to brain & other organs
vii.
Sputum thick & sticky
viii.
No sulfur granules
b. Cutaneous (inoculation)
i.
Cause N. Brasiliensis
ii.
Seen in hands/feet
iii.
Destructive to tissue & bone
1. Called mycetoma
iv.
Puss pigmented, contains sulfur granules
v.
Granules white/cream color
1. Eumycotic gran Fungal Granules

2. Atinogranules Actinomyce Granules

vi.
Treatment
1. Drain it
2. Surgery
3. Antimicrobials
a. Res to Penicillin
b. Sus to sulfonamides
vii.
Sample
1. Tissue
2. Puss
viii.
Best isolation Paraffi-bate technique
c. Aerobic
i.
A. pelletieri
1. Was part of Nocardia
a. Most everything is the same
2. Only diff its Cellulose & Xylose Pos
ii.
Streptomyces
1. S. Griseus
a. 3rd most common aerobic Actinomyce
i.
After A. Bracillis & Streptomyces
b. Doesnt show aerial filaments
c. Chain of spores
d. Is a soil mycosis

Mycobacterium
1. Bio-chemicals
a. Septi-check AFB
i.
Is for Recovery time & Growth rate
ii.
Recovery 3-60 days
1. Rapid growers < 7 days
2. Slow > 7 days
iii.
Temp 30-32C
1. Up to 35C
2. Only 42C mycobacterium Xenopi

MTB (M. tuberculosis)

1. Organism
a. Is inhaled
b. Consists of MTB, M. bovis, M. canidi, M. africanum, M. microti, M. canettii,
M. leprea, MOT (M. Other Than TB)
i.
M. bovis & MTB the main cause of TB
ii.
M. canettii cause lymphadenitis & TB in aids patient
c. All are a strong acid fast
d. Have waxes and lipids in cell wall
e. GS ghost cells
f. Optimal growth 30-45C
i.
Best 37C
g. Target organ lungs

h. Specimen of choice bronchial lavage

i.
Fecal spec. M. avium Aids patients
i. Generation time 3-6 weeks
j. Patient must stay in isolation for 72hrs
k. All tests are Pos except Catalase
l. Cat = at 68C
2. Runyon classification
a. Photochromogens
i.
Bright yellow pigment in presence of light
ii.
M. marinum, M. kansasii, M. samyii, M. asiaticum
b. Schotochromogens
i.
Deep yellow color in presence of light or dark
1. The longer its in light the deeper the yellow
ii.
M. scrofulaceum, M. gordonae, M. szulgai
c. Non-Photochromogens
i.
No pigment in light or dark
ii.
Usually light yellow or tan color
iii.
MTB, M. avium, and all the rest
3. Staining techniques
a. Ziehl-Neelsen
i.
Carbol fusion stain
ii.
Heat at 68C
1. Allows die to penetrate cell wall
iii.
Acid-alcohol decolorizer
iv.
Malachite & methylene blue
1. Non-acid fast blue-green
2. Acid fast pink
b. Kinyoun
i.
A.k.a Cold acid fast stain
ii.
Primary stain fusion & phenol than in Neelsen
1. Dissolves cell wall allowing for penetration
iii.
No heat
iv.
Modified kinyoun
1. Weaker decolorizer
2. Sulfuric acid
c. Auramine
i.
The mycobacterium fluoresce bright yellow
ii.
Need a florescent microscope
4. Classification
a. Primary Pulmonary TB
i.
Usually asymptomatic
ii.
May have a non-productive cough, fever, or shortness of breath
b. Chronic pulmonary TB
i.
Fever, chills, fatigue, night sweats, weight loss, chest pain, sputum
production
c. Advanced chronic TB
i.
Hemoptysis (spitting up blood)
d. Systemic
i.
A.k.a Miliary-TB
ii.
Hemoginase dissemination via blood stream
iii.
Organs involved spleen, liver, lungs, BM, kidney, adrenal gland,
eyes

5.

6.

7.

8.

1. May also include central nervous system, GI track, pericardial

To get ready for processing
a. NACL
i.
A TB based digestion
1. Contains sodium Hydroxide
a. A decontaminate agent (helps isolate)
ii.
50 ml conical tube
iii.
Add sterile distilled water or 0.067 M Phosphate buffer w/ a PH of
6.8
iv.
Use the sediment at the bottom for staining
media
a. Back-tech bottle
b. Lorestine-jenstin
c. Middle-brook
d. Middle-brook 7H9 (or 7H11)
i.
7H11 serpentine quarting seen when its TB
To ID
a. Lives in tissue cells
i.
Macrophages or monocytes
1. Means it inhibits phagocytosis
ii.
Mycolic acid in MTB A.k.a cord factor
1. is cytotoxic
2. inhibits WBC migration
Treatment
a. INH (Isoniazid)
b. Etham brutal
c. Pyrazamide (PSA)
d. Rifampin

MTB
M.
africanum
M. bovis
M. canetti

Niacin
accumulatio
n
+
V

Nitrate
Red.

Growth on
TCH

+
V

+
V

Pyrazinamid
ase
(4 day)
+
=

=
+

=
+

=
+

=
+

Notes: a = nitrate red. Confirmed by zinc dust (a heat tolerance test to see if
Catalase can be detected (MTB is all Cat = at 68C))
Growth on TCH Is + in 7-H11 (NOT H9)

MOTs
1.
2.

Usually from environment

a. Soil, aquarium, bio-film of .
Infects lungs, skin, soft tissue, bones, lymph nodes

Slow Growers
Species

Clinical sig.

Pigmen
t
product
ion

Other
characteristics

M. avium &
M.
intracellula
r

-Most common MTM

in humans
-cause infections in
AIDS pat.

Non-photo

M. Kansasii

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

Photo *

-Long beaded bacilli on

acid fast
stain

M. Marinum
(marina)

-Chronic skin lesions,

-Corticoid
mycobacteriosis

Photo *

-Requires 30-32C
Incubation to recover
In-vitro

M ulcerins

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

Non-photo

Xenopi

-Pulmonary dis.,
Disseminated infec.

Non-photo

-Pale pigment (may

change)
*is Thermophilic (4245C)
-Recovered from hot water
systems

RAPID Growers

Pigment
production

Species

Clinical sig.

M.
Fortuitum

-Everything but
pulmonary disease

Non-photo

M. abscess

-Chronic lung dis,

Post traumatic
wound infec, Otitis
medium cutaneous
infec, Catheter
associated
bacteremia
-Disseminated
nodular dis,
Post fram. Skin infec,
Catheter infec.

Non-photo

-Soft tissue infec,

Catheter
associated
septicemia
pulmonary

Non-photo

M.
chelonae

M.
mucogemic
um

M. Lepra

Other
characteristics

Non-photo

-Only one that affects

lungs

Non-photo

All Non-Photochromogens
Skin affected most
Lungs least

Gardenella vaginalis
1.
2.
3.
4.

Founded the vagina and rectal area of male and female

Causes bacteria vaginalis
A synergetic bacteria (uses many bacteria to make infection worse)
Can cause premature rupture of membranes, preterm delivery,
chorioamnionitis, neonatal infections
5. Clue cells seen
a. Squamish epithelial cells
6. Absence of lactobacillus seen in smear
7. Diagnosis
a. BD panel

b. Amsel & Nugent criteria

i.
Age, sexual history, reset STDs, vaginal discharge (anal rectal
discharge in men)
8. Media
a. V agar
i.
37C
ii.
5% CO
b. If its human or rabbit blood beta hemolytic
c. If not Non-hemolytic
9. Cat =
10.
Inhibited by 50mg of metronidazole or 5mg of trimethoprim

Lactobacillus
1. In every body site. Mainly:
a. Oral cavity
b. GI
c. Vagina
i.
Called good guys
1. Makes hydrogen peroxide (HO) which helps keep pathogenic
bacteria in check
2. Probiotics ..
3. GS square ends
4. Microaerophilic or obligate anaerobes
5. Non-spore
6. Non-motile
7. Alpha-hem
8. Cat, Ox, Nit, HS =
9. Vancomycin resistant

GNRs
Enterobacteriaceae
1. Organisms
a. E. Coli
b. Klebsiella
c. Citrobacter
d. Serratia
e. Salmonella
f. Shigella
g. Proteus
h. Morganella
i. Providencia
j. Yersinia
k. Enterobacter
l. Edwardsiella
2. Klebsiella & Enterobacter are encapsulated
a. So is Pantoea but its no longer an Enterobacteriaceae

E. coli
1.
2.

Most common cause of the UTI

2ND most common and nosocomial infection & septicemia
3. Not encapsulated
1. If it is has an O Ag, H Ag, & a K Ag
a. O lipopolysaccharide
b. H Figgelium
c. K capsule

Klebsiella
1. All Kleb.
a. Hodge test ??
2. K. pneumonia
a. Usually lower respiratory
b. Lung disease, UTI, nosocomial infection, ENT infection
3. K. oxytoca

(ear, nose, throat)

a. Isolated from blood, urine, respiratory tract infections, school

Pantoea
1. used to be an Enterobacteriaceae (Isnt anymore)
2. nosocomial infects (hosp. required)
3. Isolated from urine, blood

Citrobacter
1. Intestinal flora
2. Cause disease to debilitate patient
3. Urinary tract, .., meningitis

Serratia
1.
2.

Soil & water

Nosocomial infects.
3. Non-pig or bright red

Salmonella
1.
2.

2 species
a. S. enterica
b. S. bongori
S. enterica
a. S. typhi
i. Causes typhoid fever
1. Death usually from septic shock

2.
3.
4.

Transmitted p-p, & fecal cont. food and water

Serotype- S. paratyphi A, B, & C
Antigen VI antigen (capsule)
3. S. typhimurium, S. enteritidis
4. Characteristics
a. Aerobic or facultative anaerobe
b. Typhi orthinine = ..
5. Virulence factor
a. Pili
b. endotoxincause of death
6. Based on O Ag, VI Ag 1 & H ag (H is the same )
a. O somatic
b. Vi capsule
c. H Flagellum

Shigella
1. Most Bio-chemically Non-reactive
2. Serogroups
a. A S. dysenteria
i. doesnt ferments mannitol (the rest do)
b. B S. flexner
c. C S. bongori
d. D S. sonnei
i. Most diarrhea commonly caused by A & B
1. In the US B & D
3. Causes shigellosis
a. A.k.a bacillary dysentery
b. Bloody or non-bloody diarrhea
c. common in developing countries (is an epidemic)
4. Trans P - P or fecal cont. H2O
5. Virulence factors
a. Surface proteins
i. Invasive plasmid Ags
ii. Adherence & phagocytes of epithelial cells
iii. Where the shiga toxins are produced
1. Cause Huss.

Proteus
1. Found in G.I, soil, HO & sewage
2. Nosocomial
3. If indole = & ampicillin sens. P. Mirabilis
a. If ampicillin is res. more tests maltose & ornithine M =, O+, P.
Mirabilis

Morganella
1. Used to belong to proteus
2. Nosocomial

Providencia
1. Nosocomial

Yersinia
1. virulence factors
a. possess adhesions
b. anti-phagocytic proteins and capsules
c. produces coagulase & fibrinolysis
d. can bind or store hemin
e. motile at 22C
2. Media
a. Cin target colonies
i.
Aeromonas also grows, but is OX +

GNRs that are NLFs

1. Usually cause hospital infection, swimmers ear, UTI, burns and pneumonia
2. Differentiate from Enterobacteriaceae
a. Oxidase V
b. Mac V
c. Glucose =
3. OF glucose test
a. Helps see if the organism breaks down carbohydrate
b. O Oxidative
c. F Fermentative
d. Sugars used glucose, maltose, lactose and mannitol
e. Tubes start green

Open tube

Closed tube
Interp.

Yellow

Green

Glucose Oxidizer

Yellow

Yellow

Glucose Fermenter

Green

Green

Glucose Non-oxidizer

Pseudomonas
1. Most common aerobic organism
a. most isolated spp. P. aeruginosa and Acinetobacter
2. Tests
a. Motile
b. Non-spore forming
c. Cat +
d. Ox +
e. Nitrate +

3. 2 groups separated by colors

a. Pyoverdin
i.
Yellow/Green
ii.
Yellow/Brown
b. Pyocyanin
i.
Yellow/Blue
ii.
Blue/Brown

4. P. aeruginosa
a. Colonizer
i.
can survive in soap & weak disinfectant
b. Not normal flora
c. Cause community acquired infection
i.
Folliculitis
ii.
Eye infection
iii.
Burns
iv.
Endocarditis
d. Virulence factor
i.
Pilli
ii.
Exopolysaccarides (slime)
iii.
Exotoxins and exoenzyme (hemalycin and protease)
e. Treatment Gentamicin
f. Test
i.
TSI: K/K
ii.
Growth: 42C
iii.
Spot indole =
1. Differs Pseudomonas & Aeromonas

Burkholderia
1.

Characteristics
a. non-spore forming
b. motile (except B. malei)
c. catalase +
2. B. cepacia
a. affect people with indwelling catheters, surgical and burn wounds
b. causes lower resp. infec. in patients with Cystic Fibrosis
c. CGD deficiency in PMNs i.e. neutrophils
d. Drug resistant
i.
only one tested for SXT
ii.
weak Ox+
e. resemble pseudomonas
f. Dark pink to red colonies after 4-7 days (ferment lactose)
g. Dirt-like odor
3. B. pseudomallei
a. cause Melioidosis
b. Pneumonia is the most common symptom

c. Resp. infection resembles TB

d. can lay dormant for years then become reactive
e. Geographic locations
i.
SE Asia
ii.
North Australia
f. potential bio warfare agents
g. Treatment SXT & Fluoroquinolones
h. Tests
i.
Ox+
ii.
Produce gas from nitrate
iii.
Arginine dehydroxinase =
iv.
Motile
v.
Gram stain safety pin
i. Earthy odor (dirt-like)

S. maltophilia
1.

Most common opportunistic infection

a. Conjunctivitis
b. Parativitis
2. Susceptible to SXT (read at 24hr)
3. Tests/Media
a. BAP yellow, tan or green (smell like ammonia)
b. DNase +
i.
pink colonies
c. glucose Oxidative = or Late
d. Lysine decarb +
e. Maltose +

Alcaligenes
1.
2.
3.
4.
5.
6.

7.

Isolated more from clinical spp.

Water, soil, moist areas of hospital
Nosocomial
Has CDC Alcaligenes (they dont have official names yet )
Isolated from: blood, urine, knee joint, brain abscess and bronchial washing
Drug resistant
a. Aztreonam
b. Genemycine
c. amplicillin,
tests
a. BAP greenish discoloration
b. Oxidase +
c. Indole =
d. Is a Asaccharolytic Non-fermenter
e. Reduce nitrate and nitrite

Chryseobacterium
1. Soil, vegetation, water (including tap water)
2. C. Indologenes
a. causes septicemia in people with indwelling devices
3. C. meningosepticum
a. causes septicemia in neonates
b. resistant `to Gram negative antibiotic
c. Susceptible to Gram positive antibiotics
i.
Rifampin
ii.
Clindamycin
iii.
Erythromycin
iv.
SXT
v.
Vancomycin
4. Tests
a. Motility
i.
M. septicum =
ii.
Indologenes +
b. BAP: yellow
c. MAC: poorly grown or not at all
d. Indole +
e. Cat +
f. Ox +
g. Esculin +
h. Gelatinase +
i. Hs +

Fastidious GNRs

1. Organisms
a. The HACEK group
i.
Haemophilus
ii.
Actinobacillus
iii.
Cardiobacterium
iv.
Eikenella
v.
Kingella
b. Pasteurella
c. Bartonella
d. Legionella
e. Francisella
f. Capnocytophaga
g. Mis.
i.
Aeromonas
ii.
Plesiomonas
iii.
Brucella
h. Pretty much all the ellas

The HACEK group

1. In Oral cavity
2. Cause endocarditis
3. Very slow growers
a. 6-10 days

Haemophilus
1. Characteristisc
a. Coccobacillus (kidney bean shape)
b. Non motile
c. Non-spore
d. Requires either:
i.
X Hemin
ii.
V NAD
e. Nitrate +
2. H. influenza
a. Cause Bacterial Meningitis
b. Vaccine HIB
c. Has capsular-B
d. Causes Pink eye, conjunctivitis, meningitis in kids, & acute epiglottitis
e. 2nd most common of otitis media
i.
Strep pneumonia is #1
f. Virulence factor
i.
Polysaccuride capsule
ii.
Res to
1. Ampicillin
2. Chloramphenicol
3. Tetracycline
4. B- Lactamase
iii.
BAP satellitism in presence of staph aureus
iv.
Also Require X & V H. aegyptius & H. hemolyticus
v.
Porphyrin test
1. Organisms that require X &V cant break down porphyrin
2. H. hem porphyrin =
a. H. parainfluenza is the only +
vi.
Grows in 5% CO
3. H. parainfluenza
4. H. aegyptius
5. H. hemolyticus
6. H. para hemolyticus
a. Lower respiratory infecs.
i.
Is upper res. Normal flora
7. H. ducreyi
a. An STD
i.
chancroid
b. mostly Asia, Africa, & Latin America
c. Grows best 33C
d. GS school of fish

Pasteurella
1. In gingiva (gums) & nasopharynx of animals

P. multocida most common human isolate

Transmitted infect. dog/cat into wound or scratch
Peritonitis in home care dialysis pat.
Small, coccoid, non-motile
GS bi polar
a. So is Yersinia, burkholderia
7. Encapsulated
8. Musty odor
9. Bap Glisten
10.MAC NG ( still WB)
11.Ox, Cat, Indole, Nitrate +
12.Use ornithine decarboxylase to differ
2.
3.
4.
5.
6.

Actinobacillus
1.
2.
3.
4.

Animal pathogen
In humans urea hominis, actinomyces chromatins
Isolated from blood, CSF, peroneal fluid
Virulence factor
a. Leukotoxins, endotoxins, b- lactamase produced
b. Res penicillin, macrolides,
c. GS coccoid
d. Non motile
e. dont grow on MAC
f. OX V
g. Cat +
h. Urease, nitrate, indole =
i. Confused with Pasteurella, Yersinia,

Bartonella
1. Causes trench fever & cat scratch disease
a. B. quintana Trench fever
b. B. henselae Cat scratch
2. Cephalitis (brain)
3. Hepatitis
4. Antibiotics help liver and spleen infec.
5. GS slightly curved
6. Aerobic
7. Grow on Bap & Choc.
8. Produces two colonies
a. Irregular, rough, molar tooth look
b. Small, tan, pits into agar, Carmel smell
9. ox =
10.Cat =
11.Urease=
12.Indole =

Bordetella
1. Cause of whooping cough

2.
3.
4.
5.

a. Cause cyanosis, hernias, mid ear infection, pneumonia, CNS dysfunctions,

b. Virulence Factors
i. Has adhesions
ii. Protein toxins ??
iii. Pili
iv. Endotoxins
v. Survives within macrophages
Treatment erythromycin, clarithromycin, azithromycin
Dont use cotton swabs to collect
a. Cotton inhibits it
Strictly aerobic
Media
a. Bordet-Gengou (preferred)
b. Reagan low
c. potato diffusion media
d. charcoal horse blood mercury droplets

Capnocytophaga
1.
2.
3.
4.
5.
6.

Dog/cat bite infecs

Usually isolate with Act. israelii
Res astrininame, aminoglycosides, vancomycin
GS fusiform with thin pointed ends
pleomorphic or
Falcutalive anerobes
a. 5-10 % Co
7. MAC =
8. if org is moved yellow pigment
9. Sliding/ gliding motility on plate
a. Looks like sweating
10.Indole, urease =
11.Decarb =
12.Cat, ox +

Cardiobacterium
1.
2.

Cause endocarditis
C. Hominis
a. GS Rosette Clusters
i. Appears GP but is a pleomorphic GNR
b. Cultured on Media with yeast extract
c. Requires 5-10% Co
d. Pits into agar
e. Hold blood cultures 2-3 weeks

Francella
1. Cause tularensis
a. Cause tularemia

2. In small mammals and arthropods

3. Transmitted air, HO, soil, vegetation, handling ill or dead animals, or infec.
Insect bites
4. Mechanical & biological vector animals
5. Subspecies
a. F. tularensis
i. A.k.a Bio vars
ii. Most virulent
iii. Hunters get it from tick/ deer tick bite, rabbits
iv. Common names tick fever, deer fly fever, rabbit fever
v. A facultative intracellular (lives & multiples in macrophage)
vi. Symptoms chills, fever, generalized malaise
vii. 6 forms
1. Ulcerglandular ( ulcer and lymphs)
2. Glandular ( lymphs)
3. Oculoglandular ( eyes, lymphs )
4. Pneumonic
5. Typhoidal
6. Is a bio ware fare agent
a. Yersinia
b. B. anthrosis
c. Burkholder
7. Vurulance
a. Encapsulated
b. Can live in phagocytes
8. Res penicillin and cephalosporins
9. SES. strepitnomycine
10.Tests
a. Non motile
b. GNB
c. Media cysteine thio sulfate infused media
d. Choc. raised, butyraceous (fat) after 10-14 days
e. Produces sheen from utilization
f. weak Cat +
g. Ox =
h. Uses glucose, maltose, sucrose
i. Doesnt produce gas

Legionella
1

L. pneumophilia
a Most common one in humans
b In soil &
HO (including chlorinated HO)
i
Mostly likes hot HO tanks (40-50C)
c Primary Cause of Legionellosis
i
A.k.a legionnaries diseases
ii
A flu like illness (Pontiac fever)
d Survives in temps from 0-60C & PH from 5-8.5
e Reservoir Aquatic and soil dwelling amebas
f Virulence factors
i
Pili
ii
Endotoxin

iii
iv
v
vi
vii
viii

ix

x
xi

Cytotoxic
Long filaments

Facultative intracellular
Stimulates phagocytosis & replicates within ovular macrophages &
epithial cells
Drugs of choice
1 Erythromycin
2 Rifampin
3 Tetracycline
All used together
4 fluoroquinolone
5 Imacruli azilites???
Tests
1 Urinary antigen test
2 Motile
3 GS faint GNR
a Use carbol fuchsin or crystal violate stain
Media
1 BCYE (Buffered Charcoal Yeast Extract)
To ID
1 requires Cysteine
2 Doesnt ferment anything
3 Slide agglutination

Bacteria w/o cell walls

Mycoplasma & Ureaplasma
1
2

3
4
5

Grow on enriched media

a Fried egg appearance
Media
a Shepherds A-7b differential agar
i Extreamly small colonies
1 Must examine under microscope
Can pass through pores & effect the mucus membranes of the genital & upper
res. Track
Cause cell damage by releasing HO
M. genitalium & U. urealyticum
a Cause NGU (Non-gonococcal urethritis)
i Treatment Doxycycline

6 M. pneumonia
a Sus to
i Chloroquinilones
ii Tetracyclines
7 Ureaplasma
a Common in genital urinary track
b Ass w BV (bacterial vaginosis) & PID (pelvic inflammatory disease)
c Sus to

i Doxycycline
ii Tetracycline
8 Distinguished by Urea (release of ammonia)

Glucose

Arginine

Urea

(only for These 2

& Plesiomonas
)
M. pneumonia
M. hominis
M. genitalium
U. urealyticum

+
=
+
=

=
+
=
=

=
=
=
+

Misc. GNRs
Aeromonas
1
2
3

Found in fresh HO
Transmitted Food, meat, dairy
A. caviae
a Ass w diarrhea & dysentery
b Symptoms
i Fever, vomiting, Ab. Pain, nausea
c Dont fit into any specific group
d Tests
i Ox, nitrate, indole, VP, Lysine, + (+ or most anything )
ii Ferment w or w/o gas
e Media
i Bap hemolytic
ii CIN Pink center
1Look like Yersinia

Plesiomonas Shigelloides
1
2
3
4

Part of Enterobacteriaceae
a Only diff its OX +
Cause diarrehea, fever, dehydration
Media
a NLF & Non-sucrose fermentor
b CIN Clear
Tests
a Lysine, ornithine, arginine +

Brucella
1
2

3
4
5
6
7
8
9

Causes Brucellosis
4 Species
a B. abortus
i Cows
ii Only one in humans
b B. melitensis
c B. suis
i swine
d B. canis
i Dogs
Transmitted Food, contact
Potential bio-warfare agent
Ass w granulomas
a WBC abscesses in the primary lymphoid organs
A common lab acquired infection
Intracellular
Resist destruction within the phagocyte
Virulence factors
a Facultative aerobic
i So is pseudomonas
b Growth 37C, CO
c Slow growers
d Nitrate, Ox, Urease, Cat, HS +
e Indole =

GN Curved & Spiral shaped Bacilli

Curved
1. Vibrio
2. Campylobacter

Spiral
1. Treponema
2. Borrelia
3. Leptospira

Curved
Vibrio
1. Found in salt water
a. On & in marine animals, plankton & Sea foods
2. Causes Cholera
a. An acute diarrhea disease

3.

4.

5.
6.
7.

8.
9.

b. Produces Rice water stools

c. Usually shows in natural disasters
Virulence factors
a. Flagella
b. Pili
c. Cholera toxin
d. Adhesions
e. Motile
f. Lactose =
g. Facultative anaerobe
h. Mac NLF
i. Halophilic
i. Loves salt
j. Treatment tetracycline
2 strains
a. V. cholera 0139
b. V. cholera Non-01 & Non-0139
c. All 3 on Bap Beta hem
i. Other Vibrio Alpha
d. Have capsules
Put in Cary Blair bottle
a. Enhances bacterial survival
i. Has sodium thioglycollate & a PH
New Orleans has the highest Report in the US
Media
a. TCBS
i. Best for V. cholera & V. parahaemolyticus
ii. Produce smooth green colonies
Ox, Nitrate +
String Test +
a. V. cholera +, other Vibrios =

Campylobacter
1. In cattle, sheep, pigs, poultry, plants
2. Transmitted Contaminated food
a. Primarily chicken & unpasteurized milk or water
3. C. jejuni & C. coli
a. most common cause of food borne illness in the US
b. also cause HUS
i. So does E. coli
4. C. jejuni most common cause of bacterial diarrhea & sporadic enteritis
5. C. fetus
a. Human infec. Is rare
b. Cause abortions in cattle & sheep
c. Campy
i. Growth at 25C
ii. Vary at 42C
iii. HIPP =
d. Treatment erythromycin, azithromycin, clarithromycin
e. Sus cephalosporin
6. Tests

a.
b.
c.
d.
e.
f.
g.
h.
i.

Thermophilic
Motile
Adherence
GS Seagull Wings
Bap Non hem
Mac NG
Ox, Cat, Nitrate +
Urease =
HIPP
i. C. jejuni +
ii. C. coli =
j. CNA V
7. Virulence factors
a. Microaerophilic, capnophilic
i. 3-5% O
ii. 10% CO
iii. 85% Nitrogen
8. Media
a. Campy
i. 42C
ii. Grey
iii. Mucoid

Spirochetes
Leptospira
1.
2.
3.
4.

L. interrogans
Cause leptospirosis (A.k.a Weils disease)
Transmitted Contact with infec animal urine
Occupational hazard for ppl in contact with animal urine
a. Such as ppl. In rice or sugarcane fields
5. Entry abrasions, cuts, or the eye
6. Symptoms look like aseptic meningitis
7. Enteric biceric infec
8. Treatment penicillin, doxycycline
9. GS tightly coiled spirals with pointed ends (shepherds hook, or crook)
10.Motile
a. In blood, urine, CSF, peritoneal fluid
11.Obligated aerobe
12.28-30C
13.Media
a. EMJH (ellen-hausen, mccullen Johnson, harris)
b. PLM 5
c. Both .1% Agar olaic acid, albumin, 5 flouracil
d. Sealed in dark
e. Growth dingers ring ( a band)
f. Incubated for 13 weeks
i. Looked at once a week under darkfield mircroscopy
14.Anti- enterogans are detected by Pat. Serum with suspension of live or killed
bacteria

a. + seen agglutination aka microagglutination test

Borrelia
1.
2.
3.
4.
5.
6.

Causes Lyme disease

Flagella lie between cell membrane and outer membrane
Motility cork screw or oscillating
Trans IXODEX deer tick
Babesia (Maltese cross)
Human infection called Borrelia

Species

Disease

B. burgdorferi
B. recurrentis

Lyme dis.
Louse-borne
relapse fever
B. duttonii
Tick-borne
relapse fever
B. hermsii,
American tickB. venezuelensis, borne relapse
B. mazzottii
fever
Other
Tick-borne
relapse fever (in
countries other
than N & S
America

Arthropod
vector

Animal
reservoir

Hard ticks
Human body
lice
Soft ticks

Rodents
Humans

Soft ticks

Rodents

Soft ticks

Rodents

Humans

Burgdorferi
... Left room for a min
1.
2.
3.
4.
5.

Lyme disease mostly in NA

2 IV injection
Drugs chephlosporin
B. Bodorfif res to trymephyl , sulfur, refambin, aminoglycocydes
Cause Relapse fevers, treat tetramycin, & erythromycin

6. Loosely coiled
7. Gs pale pink
8. Use dark field microspy
a. Acradine orange
9. Media
a. Modified Kelly
i. Inc. in dark at 30-33C
10.
Rotational motility
11.
To detect Ab anti procedure

Treponema
1.
2.
3.
4.

Cause of syphilis
+ poladium
Some cause gingivitis
Virulence factors
a. Can coat itself with host proteins to protect itself from the immune
system
b. Attach endotheial cells that line blood cells
c. Can pass through placenta causing congenital syphilis
d. Treat penicillin
e. Very thin
f. Used dark field or phase contrast

Species

Disease

Location

T. Pallidum

Venereal Syphilis

World wide

T. Pertenue

Yaws
(Cutaneous lesions)
Bejel
(oral Pharyngeal &
cutaneous lesions)
Pinta
(Skin lesions)

Caribbean, Indonesia, SA
(Tropical regions )

T. endemicum

T. carroteum

ARID regions
Central & South America

Obligate intracellular bacteria

Chlamydia
1. Sexually transmitted
2. Have elemtary bodies ( EB) metabolicly inactive and infectious
3. Ritic bodies (RBs)
a. Active and non-infectious
4. Biphacic elements
EB
1. Survive in extracellular environment (RBs cant)
Stages
a.
b.
c.
d.

EB is taken up in the host cell

EB RB
RB combined by bionary fusion forming inclusion bodies
After 48 hours the multiplication stops and they combine together to form
new EBs
e. Ebs are released from cell by cytolysis

IDd by
a.
b.
c.
d.
e.
f.

Transport media keep cold

Cell culture (hella, cell cult)
PCR does clam. & gonorreha uses urine
Considered energy parasites
Cause trichimona, inclusion conjunctivitis non gonnicoccal urethritis
C. pneumonia
a. Cause pneminioa and res dis.
g. C. psittaci
a. Cause siciosis ( a res. Dis)