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Speci es S. aureu s
Properties Gram +ve cocci Grapelike (cluster s) Goldenyellow appear ance in culture
Virulence factors Has B-lactamase = therefore ressistant to some penicillin (meticilin) Protein A = prevent compliment binding with Ab Capsule = poorly immunogenic. Therefore hard to produce vaccine. Peptidoglycan has endotoxinlike properties = stimulate microphage to produce cytokines. Exotoxin 1. Enterotoxin = causing food poisoning 2. Toxic shock syndrome toxin = causes toxic shock
Disease Due to toxin 1. Abcess 2. Food poisoning 3. Toxic shock syndrome Skin 1. Scalded skin 2. Impetigo (bullous) 3. Surgical site sepsis 4. Osteomyelitis 5. Pneumonia 6. Endocarditis 7. Carbuncle
Treatment vancomycin, to which gentamicin is sometimes added daptomycin Trimethopri msulfamethox azole or clindamycin For TSS = using fluids, pressor drugs, and inotropic drugs
Diagnosis Using smear from lession. Will reveal clusters of cocci. Golden yellow in colour. Mannitol -salt agar is a commonl y used screenin g device for Sta. aureu as it is coagulas epositive.
3. Exofoliative toxin = causes scalded skin Enzymes 1. Catalase = degrade H2O2. Therefore neutrophil to kill. 2. Coagulase = cause blood to clot by converting prothrombin to thrombin 3. Haemlysin = lyse RBC 4. Leucocidin = kill leucocytes 1
Species S. pyogen es -
Properties Gram +ve cocci Appear in pairs or chains Catalase negative Have differed haemolytic properties 1. Alpha haemolyric = form green zone around colonies due to incomplete haemolysis 2. Beta haemolytic = form clear zone around colonies due to complete haemolysis of RBC. 3. Gamma haemolysis = no haemolysis . -
Virulence Factors Capsule = antiphagocytotic M protein = antiphagocytotic and has many serotypes that cause different diseases. Also for attachment Enzymes 1. Hyaluronidase = degrades hyaluronic acid and causing strep to spread. 2. Streptokinase = causing plasminogen to form plasmin (dissolve clot) 3. DNAse = degrade DNA in exudates of necrotic tissues. 4. Haemolysin Streptolysin O = inactivated by oxidation and antigenic. Streptolysin S = not inactivated by oxygen. 5. Erythrogenic toxin = causing rash of scarlet fever. Mechanism same as Toxin Shock Syndrome. 6. Exotoxin A = causes strep toxic shock syndrome 7. Exotoxin B = potease -
Disease Pyogenic infection (inflammation induced locally) 1. Pharyngitis 2. Tonsillitis 3. Sore throat 4. Cellulitis 5. Nacrotising fascilitis Exotoxin production 1. Scarlrt fever 2. Toxic shock syndrome Immunologic (antibody against a component of the organism cross-reacts with normal tissue) 1. Rheumatic fever 2. Acute glumerulonep hritis
Diagnosis Rapid test uses swab from throat. Enzyme reacts with antibody and bind to latex particles. Agglutinati on of latex will occur. Stained smear from wound. In culture, if inhibited by bacitracin, they are group A streptococ cus.
Genus Streptococc us
Species S. pneumoni ae
Properties Gram +ve cocci Diplococcic Alpha haemolytic lysed by bile or deoxychola te growth inhibited by optochin
Virulence factors - polysaccharide capsule = antiphagocytotic - lipotechoic acid = causes toxic shock syndrome-like disease - Pneumolysin, the hemolysin that causes alpha hemolysis ~ not so important to know
Disease - Bronchopneumo nia - Lobar pneumonia - Bacteraemia (presence of bacteria in blood) - Meningitis
Treatments penicillins and erythromycin in severe, penicilin G. fluoroquinolone with good antipneumococc al activity, such as levofloxacin
Diagnosis In sputum. Lancetshaped diplococcic. Growth inhibited by optochin. CSF is positive for meningitis.
Genus Baccilus
Species B. cereus
Bacillus
B. anthracis
Gram +ve bacilli Aerobic growth Spore forming In chains Have antiphago cytotic capsule
Virulence Factors - 2 exotoxins Similar to cholera toxin, it increases cyclic AMP Similar to staphylococcal enterotoxin, it is a superantigen - Exotoxin has 3 components protective antigen binds to cells edema factor is an adenylate cyclase lethal factor is a protease that inhibits cell growth
Anthrax
Smears show large, grampositive rods in chains Spores not seen as it formed when nutrients insufficient
Genus
Clostridiu m
Species
C. tetani -
Properties
Gram +ve bacilli Anaerobic growth Spore forming Tennis racket shape or drumstick Gram +ve bacilli Anaerobic growth Spore forming
Virulence Factor
Tetanus toxin (tetanospas min) blocks release of inhibitory transmitters -
Disease
Tetanus -
Treatments
Tetanus immune globulin (tetanus antitoxin) metronidazole or penicillin G can be given -
Diagnosis
rarely isolated has terminal spore
Clostridiu m
C. botulinum
Clostridiu m
C. perfringen s
Botulinum toxin blocks the release of acetylcholine Has 8 serotypes Type A for botox alpha toxin (lecithinase), which damages cell membranes, including
Botulism
Penicillin G
2.then identified by sugar fermentatio n reactions and organic acid production colonies exhibit a double zone of hemolysis presence of exotoxins in the filtrate of a patient's stool
Clostridiu m
C. difficile
Pseudomembranous colitis
Genus Corynebacteriu m
Species C. diphtria e
Properties Gram +ve bacilli Aerobic growth Non-spore forming Arranged in palisade/ Chinese letter Has granules that stain metachromat ically (a dye that stains the rest of the cell blue will stain the granules red)
Virulence factor - ADPribosylati on of elongatio n factor 2 (EF-2) inhibits protein synthesis of eukaryot es. - It must be infected with bacteriop hage to be pathogen ic. If not, toxin cant be produced
Disease - Diphtheria (thick, gray, adherent pseudo membrane over tonsils and throat.
Treatment Antitoxin (preferred, will bind to toxin) Penicillin G and erythromycin Treatment should be given without delay
Diagnosis Isolating the organisms and investigate toxin production. It will be cultured on Lffler's medium, a tellurite plate, and a blood agar plate. typical gray-black color of tellurium will be formed. Can also be stained with methyline blue (granules)
Genus Listeri a
Species L. monocytogene s
Properties - Gram +ve bacilli - Aerobic growth - Non-spore forming - Shape almost similar to corynebacte rium but has tumbling movement. - Colonies on blood agar produce narrow Bhemolytic region (like streptococc us)
Virulence factors - Listeriolysin allows it to escape phagosome - Its ability to invade placenta, pass meninges and GIT is due to interaction of internalin and E-cadherin
Treatments trimethoprimsulfamethoxazol e (meningitis and sepsis) ampicillin and gentamicin ampicillin and trimethoprimsulfamethoxazol e
Diagnosis - Gram stain and culture. Culture will show narrow Bhemolyti c region and motile organis ms.
Genus Neisseri a
Species N. gonorrhoea e
Properties - Gram ve diplococc i - No capsule - Kidneybean shaped diplococc i with neutroph ils - Some produce Blactamas e - Has three outer membran e protein - Has many serotypes - Has endotoxi n in its outer membran e
Virulence factors
Disease
Treatments
Pilli. Attachment to mucosal surface and antiphagocytot ic. LOS, lipooligosacch arides (in cell wall) IgA protease hydrolyses IgA that prevent attachment to mucosa.
Local = gonorrhea Ascending = pelvic inflammatory disease Disseminated = disseminated gonococcal infection Neonatal = conjunctivitis
Diagnosis - Growth inhibited by toxic trace metals and fatty acids in certain media (blood agar plate) - Oxidase +ve as they have cytochrome c. cause phenylenedi amine turn purple or black
Genus Neisser ia
Properties Gram ve diplococci Polysaccharide capsule that is antiphagocytot ic Has many serotypes
Virulence factors
Disease
Treatments
Diagnosis procedure same as gonococci. Meningococci To differentiate, meningitidis ferment maltose, whereas gonococci do not (both organisms ferment glucose).
Lipopolysaccharid e capsule that is antiphagocytotic and ressist polymorphonuclea r leukocytes (PMNs). Endotoxin LPS which causes fever and shock IgA protease that hydrolyse IgA that prevent attachment to mucosa
penicillin G
Genus Salmonell a
Properties Gram ve bacillus Produce H2S Live both within and outside enteric tract Ferment glucose Facultative anaerobes Oxidase negative (no cytochrome) Reduce nitrate to nitrites
Virulence factors
Disease
Treatments
Capsular Vi (antiphagocy totic) O antigen which divide salmonella into group A to I Also has H antigen
Typhoid fever Paratyphoid fever A Paratyphoid fever B Paratyphoid fever C Enterocolitis (inflammation of small intestine and colon)
Typhoid fever = ceftriaxon e or ciprofloxa cin Typhoid carrier = Ampicillin or ciprofloxa cin
Diagnosis - Colourless colonies on MacConkeys agar and EMB(eosin methyline blue)agar that indicates no lactose fermenting - On TSI (triple sugar iron) agar, an alkaline slant and an acid butt, frequently with both gas and H2S (black color in the butt), are produced
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Genus Shigell a
Properties Gram ve bacillus Can be distinguished from salmonella by: Non motile Do not produce H2S
Virulence factors
Disease
Treatments
Also has O antigen which divides it into groups Disease exclusive in GIT Invades mucosa of distal ileum and colon
Diagnosis - Colourless colonies on MacConkey s and EMB agar (no lactose fermentatio n) - On TSI agar, they cause an alkaline slant and an acid butt, with no gas and no H2S.
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Genus Bordetella
Species B. pertussis -
Properties
Virulence factors
Disease
Treatments
Diagnosis -
Haemophil us
H. influenza
Yersinia Legionella
Gram ve bacilli Opportunisti c pathogens Vary similar features K. has large capsule S. produces red colonies
Opportunisti c pathogens
Produced coloured colonies in MacConk yes and EMB agar due to lactose fermenta tion
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Genus Pseudomon as
Species P. aerugino sa
Properties - Gram ve bacilli - Aerobic growth (differs from other enteroba cteria) - Oxidase +ve (has cytochro me c) - Has pyocyani n that colour the pus blue - Has pyoverdi n that (fluoresc ent greenyellow pigment)
Virulence factors
Disease
Treatments
Opportunistic hospitals pathogens Endotoxin causes sepsis (presence of toxins in blood) and septic shock Exotoxin A causes tissues necrosis (death of cells or tissues) Enzymes like elastase and protease are histotoxic and help invasion in bloodstream
Diagnosis - colourless colonies on MacConke ys and EMB agar (no fermentati on) - metallic sheen of the growth on TSI agar (oxidase +ve) - blue-green on agar
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Genus Bacteroide s
Species B. fragilis
Virulence factors
Disease
Treatments
Part of normal flora Has capsule Hyalurunidase, collagenase and phospolipase causes tissue damage Also has O antigen that divides them into groups The exotoxin is called choleragen causes the loss of water and ions from the cell
Vibrio
V. cholera e
penicillin resistant Metronidazole (preferred) cefoxitin, clindamycin, and chloramphenico l (alternatives) Water and electrolyte replacement Antibiotics not necessary
On TSI agar, an acid slant and an acid butt without gas or H2S are seen
Colonies from the stool will be colorless as lactose is fermented slowly They differs from other enterobact eria as they are oxidase +ve
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Genus
Properties Gram ve bacilli Spiral shaped Has same comma or S shape as vibrio microaerophilic, growing best in 5% oxygen rather than normal atmosphere Gram ve bacilli Spiral shape Same as campylobacter appearance Differs in that it is urease +ve and C. otherwise
Virulence factors
Disease
Treatments
Diagnosis Grown in microaeropjili c condition (5% O2) Characteristic comma shape, motile and resistant to nalidixic acid specimen taken from gastric mucosa. Appearance same as campylobacte r except Helicobacter is urease +ve
pathogenesis is unclear
Helicobacter
H. pylori
Attaches to mucus secreting cells of mucosa Production of ammonia from urea by the organism's urease, coupled with an inflammatory response, leads to damage to the mucosa (stomach)
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Properties - Walless and smallest free-living organism - Poor on gram stain and antibiotic is ineffective
Virulence factors
Disease
Treatments
Pathogen only for human In lungs, rod shape with tapered tips for attachment
Atypical pneumonia
Mycoplasma M. hominis
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Genus Mycobacteri a
Species M. tubercolosi s
Properties - Acid-fast bacilli - Not gram +ve nor ve - able to retain the carbolfuchsi n stain despite treatment with ethanol hydrochloric acid mixture - grows slow - obligate aerobe - virulent strain grows in cord-like pattern - resistant to most antimycoba cterial drugs
Virulence factors
Disease
Treatments
survive within phagoso me of macroph ages can dissemin ate via bloodstre am to many organs The parenchy mal exudative lesion and the draining lymph nodes together are called a Ghon complex
tuberculosis
isoniazid
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Genus
Species -
Properties same acidfast property as M. tuberculosis grows very slowly grows with low temp
Virulence factors
Disease
Treatments
Mycobacteria M. leprae
replicates intracellularl y
dapsone
Mycobacteria M. bovis
Tuberculosis
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Genus Spirochete s
Properties - Thin wall, flexible, spiral rods - Seen by darkfield illuminat ion, silver impregn ation or fluoresc ence stain
Virulence factors
Disease
Treatments
Transmitted by sexual contact or to fetus Very slow to grow In primary, local and nontender ulcer is formed Secondary, spread to many organs, maculopapular rash and pastules occur Tertiary shows granuloma and CNS involved
Syphilis
Penicillin G
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Genus Spirochet e
Properties - large and loosely coiled - stain with Gemsa stain - +ve growth in media thin, tight spirals can only be seen by dark illumina tion +ve growth on media
Virulence factors
Disease
Treatments
Tetracycline
Spirochet e
Leptospira interrogan s
Leptospirosis
Penicillin G
Serological test
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