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					Bug Name            Fam/Genus/Spec    Classification           Metabolism                Virulence                                             Normal Flora?        Toxins                                       Diseases (1)                                   Diseases (2)                             Lab Diagnosis

                                                                                                                                                                                                                 Algorithm for identification of G+ bugs:
                                                                                         6 main G+ Genus: 2 cocci - (Streptococcus,                                                                              (1) Gram stain - either cocci or bacilli.
                                                                                         Staphylococcus), 2 spore formers - (Bacillus,                                                                           (2) If cocci - do catalase test. Catalase
                                                                                         Clostridium), 2 others - Listeria,                                                                                      + = Staph - do coagulase test. Catalase
Gram + organisms                                                                         Corynebacterium.                                                                                                        negative = Strep - do hemolysis test.
                                                                                                                                                                    (1) Erythrogenic (pyogenic) toxin -
                                                                                                                                                                    responsible for scarlet fever and Toxic                                                                                              (1) Beta hemolytic, bacitracin
                                                                                         (1) M-protein (>80 types) - inhibits activation of                         Shock Like syndrome. 3 serotypes:            3 types. (1) Inflammatory/invasive -                                                    sensitive colonies on a sheep
                                                                                         complement, protects organism from                                         SpeA (like TSST-1 - a Superantigen),         pharyngitis, impetigo, cellulitis, fascitis,   3% of untreated streptococcus            BAG (blood agar plate), with
                                                                                         phagocytosis, but antibodies can opsonize by                               SpeB, SpeC (2) Exoenzymes -                  gangrene, erisypelas. (2) Toxigenic -          pyogenes phayngitis results in post-     bacteria taken from throat swab.
                                                                                         binding M protein. (2) Beta-hemolytic due to                               hyaluronidase, streptokinase, DNase,         scarlet fever, toxic shock-like syndrome.      streptococcal sequela (Rheumatic         (2) Agglutination of latex beads
                                                             Catalase negative,          enzymes that destroy RBC and WBC.                                          NADase, C5a peptidase. (3)                   (3) Immunological sequelae - acute             fever, APGN). In USA, most               carrying antibodies to group A
                    Streptococcus     Gram+, Beta hemolytic, oxidase negative,           Streptolysin-O: oxygen labile, antigenic.                                  Streptolysin O - a hemolysin, main toxin     rheumatic fever, APGN (Acute                   streptococcal pharyngitis caused by      carbohydrate. (C carbohydrate,
Strep. pyogenes     pyogenes (GAS)    Lancefield group A.    microaerophilic             Streptolysin-S: Oxygen stable, non-antigenic.                              released in Rheumatic fever.                 Proliferative Glomerulonephritis).             non-rheumatic M types 2, 4, 12.          Lancefield group A)
                                                                                                                                                                                                                                                                (1) Early onset disease - acute          (1) Gram stain of CSF or blood.
                                                                                                                                               GI and lower GU                                                                                                  respiratory infection, pneumonia,        (2) Culture of CSF, blood, or
                                                               Catalase negative,                                                              tract. 25% of                                                                                                    bacteremia, beginning w/in 2 days of     urine. (3) Narrow zone of beta-
                    Streptococcus     Gram+, Beta hemolytic,   oxidase negative,         Capsule type III causes most neonatal                 Pregnant women                                                    B (Group B) for Baby: meningitis,              birth. (2) Late onset disease -          hemolysis, which synergizes with
Strep. agalactiae   agalactiae        Lancefield group B.      microaerophilic           meningitis, type II most adult meningitis             carry in vagina.                                                  pneumonia, sepsis.                             meningitis w/in 3-8 weeks after birth.   Staph lysin (cAMP test).
                                      Gram+, Alpha (partial)
                                      hemolytic, no C          Catalase negative,                                                              nasopharynx,                                                      EDA: Endocarditis (SBE), Dental
                    Viridans          carbohydrate for         oxidase negative,                                                               oropharynx, mouth,                                                caries, Abscesses. Viridans                                                             (1) Gram stain (2) Culture (3)
Strep. salivarius   Streptococci      Lancefield typing        microaerophilic           Extracellular dextran to bind to heart valves         GI                                                                Streptococci are #1 cause of SBE.                                                       Optochin resistant
                                      Gram+, Alpha (partial)
                                      hemolytic, no C          Catalase negative,                                                              nasopharynx,                                                      EDA: Endocarditis (SBE), Dental
                    Viridans          carbohydrate for         oxidase negative,                                                               oropharynx, mouth,                                                caries, Abscesses. Viridans                                                             (1) Gram stain (2) Culture (3)
Strep. sanguis      Streptococci      Lancefield typing        microaerophilic           Extracellular dextran to bind to heart valves         GI                                                                Streptococci are #1 cause of SBE.                                                       Optochin resistant
                                      Gram+, Alpha (partial)
                                      hemolytic, no C          Catalase negative,                                                              nasopharynx,                                                      EDA: Endocarditis (SBE), Dental
                   Viridans           carbohydrate for         oxidase negative,                                                               oropharynx, mouth,                                                caries, Abscesses. Viridans                    IMMEDIATELY ASSESS for                   (1) Gram stain (2) Culture (3)
Strep. intermedius Streptococci       Lancefield typing        microaerophilic           Extracellular dextran to bind to heart valves         GI                                                                Streptococci are #1 cause of SBE.              ABSCESS.                                 Optochin resistant
                                      Gram+, Alpha (partial)                                                                                                                                                                                                    Binds to teeth, ferments sugars, makes
                                      hemolytic, no C          Catalase negative,                                                              nasopharynx,                                                      EDA: Endocarditis (SBE), Dental                acid which destroys enamel and
                    Viridans          carbohydrate for         oxidase negative,                                                               oropharynx, mouth,                                                caries, Abscesses. Viridans                    dentin. S. mutans is major cause of      (1) Gram stain (2) Culture (3)
Strep. mutans       Streptococci      Lancefield typing        microaerophilic           Extracellular dextran to bind to heart valves         GI                                                                Streptococci are #1 cause of SBE.              dental caries.                           Optochin resistant
                                      Gram+, Alpha (partial)
                                      hemolytic, no C          Catalase negative,                                                              nasopharynx,                                                      EDA: Endocarditis (SBE), Dental
                    Viridans          carbohydrate for         oxidase negative,                                                               oropharynx, mouth,                                                caries, Abscesses. Viridans                                                             (1) Gram stain (2) Culture (3)
Strep. mitis        Streptococci      Lancefield typing        microaerophilic           Extracellular dextran to bind to heart valves         GI                                                                Streptococci are #1 cause of SBE.                                                       Optochin resistant



                                                                                                                                                                                                                 (1) Subacute bacterial endocarditis (2)
                                                                                                                                                                                                                 Biliary tract infection. (3) Urinary tract
                                                               Catalase negative,                                                                                                                                infection. (4) Bacteremia (5)
                                      Gram +, Lancefield       oxidase negative,                                                                                                                                 Abdominal infection (6) Neonatal                                                        (1) Gram stain (2) Grows in
Entero. faecium     Enterococcus      group D, non-hemolytic   microaerophilic                                                                 mouth, GI                                                         meningitis                                                                              40% bile, 6.5% NaCl



                                                                                                                                                                                                                 (1) Subacute bacterial endocarditis (2)
                                                                                                                                                                                                                 Biliary tract infection. (3) Urinary tract
                                                               Catalase negative,                                                                                                                                infection. (4) Bacteremia (5)
                                      Gram +, Lancefield       oxidase negative,                                                                                                                                 Abdominal infection (6) Neonatal                                                        (1) Gram stain (2) Grows in
Entero. faecalis    Enterococcus      group D, non-hemolytic   microaerophilic                                                                 mouth, GI                                                         meningitis                                     #2 nosocomial pathogen                   40% bile, 6.5% NaCl
                                                                                                                                                                                                                 (1) Subacute bacterial endocarditis (2)
                                                                                                                                                                                                                 Biliary tract infection. (3) Urinary tract
                                                               Catalase negative,                                                                                                                                infection. (4) Bacteremia (5)
                                      Gram +, Lancefield       oxidase negative,                                                                                                                                 Abdominal infection (6) Neonatal               BOVIS in BLOOD = CANCER in               (1) Gram stain (2) Grows in
Strep. bovis        Non-enterococci   group D, non-hemolytic   microaerophilic                                                                 mouth, GI                                                         meningitis                                     BOWEL                                    40% bile, but not 6.5% NaCl
                                                                                                                                                                                                                 (1) Subacute bacterial endocarditis (2)
                                                                                                                                                                                                                 Biliary tract infection. (3) Urinary tract
                                                               Catalase negative,                                                                                                                                infection. (4) Bacteremia (5)
                                      Gram +, Lancefield       oxidase negative,                                                                                                                                 Abdominal infection (6) Neonatal                                                        (1) Gram stain (2) Grows in
Strep. equinus      Non-enterococci   group D, non-hemolytic   microaerophilic                                                                 mouth, GI                                                         meningitis                                                                              40% bile, but not 6.5% NaCl

                                                                                                                                                                                                                 (1) Adults - Sinusitis, Pneumonia,                                                      (1) Gram stain (2) Optochin
                                                                                                                                                                                                                 meningitis, sepsis 75% of community                                                     sensitive (3) Bile soluble (4)
                                                                                                                                                                                                                 acquired pneumonia is pneumococcus.                                                     Positive Quellung test - mix
                                      Gram+ lancet-shaped                                (1) Protective Capsule - 83 serotypes, fortunately                                                                      "Old man's friend" - 60% fatal over age                                                 antiserum (serum w/Ab to
                                      diplococci, Alpha                                  capsule is antigenic. Capsule 1,3,4,7,8,12 most                                                                         70. #1 cause of adult bacterial                                                         pneumococcus capsule),
                                      (partial) Hemolytic, No C Catalase negative,       virulent in adults, type 14,18,19,23 in kids. Type                         Pneumolysin - binds to cholesterol in        meningitis. (2) Children - otitis media.                                                pneumococcus, and methylene
                    Streptococcus     carbohydrate for          oxidase negative,        3 most virulent of all. (2) IgA protease - to                              host-cell membranes, and kills               #1 cause of otitis media in kids, #2     Pneumococcus is to Parents what                blue, and capsule appears to
Pneumococcus        pneumonia         Lancefield typing         microaerophilic          colonize mucosal surfaces.                         URT                     phagocytic cells.                            cause of bacterial meningitis in kids    group B is to Babies                           swell.

                                                                                         [1] Proteins which attack the immune system:                               3 Exotoxins: (1) Exfoliatin - diffusable
                                                                                         (HL PCP) (1a) Protein A - binds Fc portion of                              exotoxin, causes skin to slough off due
                                                                                         IgG, prevents opsonization and phagocytosis.                               to proteolysis of intracellular junctions.
                                                                                         (1b) Coagulase - leads to protective fibrin clot                           Also superantigen. Causes scalded skin
                                                                                         around bacteria. (1c) Hemolysin - 4 types                                  syndrome. (2) Enterotoxin - heat             (1) Inflammatory/Invasive Diseases -
                                                                                         (alpha, beta, gamma, delta) - destroy RBC,                                 stable, major cause of food poisoning in     ("U ME Bar SOAP?") -
                                                                                         PMN, M0, platelets. (1d) Leukocidins - destroy                             USA. 7 serotypes                             Bacteremia/sepsis, Pyoderma (pustules,
                                                                                         leukocytes. (1e) Penicillinase - secreted form of                          (SEA,B,C1,C2,C3,D,E). Also                   furuncles, carbuncles), Acute bacterial
                                                                                         beta-lactamase, destroys penicillin's beta-lactam                          superantigen. (3) Pyrogenic exotoxin:        endocarditis (#1 cause), Osteomyelitis,
                                                                                         ring. [2] Tissue-Destroying proteins: (2a)            Anterior nares and   Types A, B, and TSST-1 (Toxic Shock          Septic arthritis, Pneumonia, Meningitis,
                                                               (1) Catalase positive,    Hyaluronidase - spreading factor - degrades           skin of 20-30% of    Syndrome Toxin). Superantigens -             UTI. (2) Exotoxin mediated disease -                                                    (1) Gram stain (2) Culture -
                                                               Facultative anaerobes     proteoglycans in CT. (2b) Staphylokinase - lyses      healthy humans,      cross links TCR V-beta with MHC-II,          Acute Gastroenteritis (food poisoning),                                                 catalase positive, coagulase
                    Staphylococcus                             (2) Coagulase positive,   fibrin clots. (2c) Lipase - degrades fats and oils,   90% of health care   leading to massive production of IL-1,       Scalded Skin Syndrome, Toxic Shock                                                      positive (3) Produces yellow
Staph. aureus       aureus            Gram +, grow in clusters beta-hemolytic            allows colonization of sebaceous glands.              workers.             TNF.                                         Syndrome, Kawasaki disease.                                                             pigment (aureus = gold in Latin).
                                                              (1) Catalase positive,                                                                                                                             (1) Commonly infects catheters, heart
                                                              Facultative anaerobes                                                                                                                              valves, prostheses. (2) Contaminates       Bacteremia, Endocarditis, Meningitis,         (1) Gram stain (2) Culture -
                   Staphylococcus                             (2) Coagulase negative,     Polysaccharide capsule is antiphagocytic and                                                                           blood cultures from skin during blood      Joint destruction. Septicemia w/30%           Catalase positive, coagulase
Staph. epidermidis epidermidis       Gram +, grow in clusters non-hemolytic               promotes formation of viscous biofilm.              Skin                                                               draw.                                      mortality.                                    negative
                                                              (1) Catalase positive,
                                                              Facultative anaerobes                                                                                                                              #2 cause of community acquired UTI,                                                      (1) Gram stain (2) Culture -
Staph.             Staphylococcus                             (2) Coagulase negative,                                                                                                                            causes 10-20% of UTI in children and                                                     Catalase positive, coagulase
saprophyticus      saprophyticus     Gram +, grow in clusters non-hemolytic                                                                                                                                      young women.                                                                             negative
                                                                                                                                                                                                                 PMC - Pseudomembranous Colitis.
                                                                                                                                                                                                                 Caused by any condition which
                                                                                                                                                                                                                 removes normal flora (antibiotics -
                                                                                                                                                                                                                 clindamycin or beta-lactams,
                                                                                                                                              colon - 3% in                                                      chemotheraputics, etc.). Abdominal
                                                                                                                                              community, 20% in                                                  pain, fever, leukocytosis, bloody,
                                                              Obligate Anaerobe.                                                              hospital, 65% in    Enterotoxin (A), cytotoxin (B) - disrupt       explosive diarrhea, pseudomembrane                                                       Can use ELISA, Agglutination
                                     Gram +, rods, forms      Grows when normal flora                                                         neonates (no normal intracellular junctions, cause massive         formation in colon. Appears in 4-9                                                       test, or colonoscopy. Usually
Clost. difficile   Clostridium       spores                   are removed.                Adhesin (to colonic cells), Hyaluronidase           flora)              fluid leak (secretion) into colon.             days, lethal for 20%.                                                                    diagnosed by history.

                                                                                                                                                                    (1) Diarrhea: Heat Labile Enterotoxin,
                                                                                                                                                                    inhibits glucose transport and damages       (1) Secretory diarrhea - due to
                                                                                                                                                                    intestinal epithelium. (2) Gas               colonization and toxin production.         (2) Gas gangrene - usually occurs in
                                                                                                                                                                    Gangrene - alpha toxin, a phospholipase      Onset in 8-24 hours, lasts for 24 hours.   anaerobic areas, C. perfringens
                                                                                                                                                                    which (a) destroys cell membranes, (b)       Precooked and reheated foods are           produces gas (CO2, H2) from alpha
                                     Gram +, rods, forms                                                                                                            alters capillary permeability, and (c)       biggest risk. Seasonal - mostly fall,      toxin. Results in cellulitis or Clostridial
Clost. perfringens Clostridium       spores                   Obligate Anaerobe                                                                                     causes hemolytic anemia.                     winter.                                    myonecrosis


                                                                                                                                                                                                                 Tetanus - toxin produced at infection
                                                                                                                                                                                                                 site and is transported to CNS, where it
                                     Gram +, rods, forms                                                                                                                                                         blocks GABA and Glycine inhibitory       Often grows on rust - thus don't step
Clost. tetani      Clostridium       spores                   Obligate Anaerobe                                                                                     Tetanus toxin - tetanospasmin                neurons, resulting in tetany.            on rusty nail.

                                                                                                                                                                                                               Botulism - Toxin ingested from food
                                                                                                                                                                                                               (canned food or smoked fish), or spores      Symptoms begin w/ diplopia and
                                                                                                                                                                                                               from honey. Spores are canned and            dysphagia and end with flaccid
                                     Gram +, rod, forms                                                                                                             Produces botulinum toxin (neurotoxin) - then proliferate in anaerobic                   paralysis. Babies become "floppy
Clost. botulinum   Clostridium       spores                   Obligate Anaerobe                                                                                     inhibits release of ACh.                   environment.                                 baby".
                                                                                                                                                                                                               Spores can be ingested (GI), inhaled
                                                                                                                                                                                                               (lung), or absorbed through breaks in
                                     Gram +, rod, forms                                                                                                             One of its toxins is an adenylate          skin. Round black lesions appear on
Bacillus anthracis Bacillus          spores                   Aerobe                      Amino acid capsule                                                        cyclase.                                   skin. Fever, myalgia, death.
                                                                                                                                                                                                               (1) Vomiting - Preformed toxigenic
                                                                                                                                                                                                               gastroenteritis from fried rice. Onset in
                                                                                                                                                                                                               1-6 hours, lasts 8-10 hours. (2)
                                                                                                                                                                                                               Diarrhea - Colonization and toxin
                                                                                                                                                                    (1) Heat stable toxin - emetic disease.    production from sausage, beef, chicken,
                                     Gram +, rod, forms                                                                                                             (2) Heat labile toxin - causes increase in or heavy cream sauce foods. Onset in
Bacillus cereus    Bacillus          spores                   Aerobe                                                                                                cAMP and secretory diarrhea.               10-12 hours, lasts 24 hours.
                                                                                                                                                                                                               Diptheria - usually in children.
                                                                                                                                                                                                               Pharyngitis, fever, dark inflammatory
                                                                                                                                                                                                               exudate on pharynx. This                                                                   "TELL yoUR InTErn not to
                                                                                                                                              We all carry the non-                                            pseudomembrane is a launching                                                              LOAF" - Potassium tellurite
                                     Gram +, rod, some                                                                                        toxigenic form. The Diptheria toxin - phosphorylates EF-2        platform for exotoxin rockets which                                                        agar, Loeffler's coagulated blood
                                     curved or "club" shaped.                                                                                 toxic form has        (Elongation Factor), preventing protein affect heart, kidney (acute nephritis),                                                       serum media. Treat from history
                                     Chinese letter shaped,                                                                                   undergone             synthesis in humans - a Anti-Human         and CNS (cranial and peripheral nerve                                                      and clinical presentation as
Coryn. dipthreriae Corynebacterium   pleomorphic.             Aerobe                                                                          transduction.         Antibiotic!                                degeneration).                                                                             these take too long.
                                                                                                                                                                                                               Food-borne - uncooked foods
                                                                                                                                                                                                               (contaminated milk, soft cheeses,
                                                                                                                                                                                                               veggies, coleslaw). Listeria can
                                                                                                                                                                                                               multiply slowly even at refrigerated
                                                                                                                                                                                                               temperatures (4C). At risk are pregnant      Asymptomatic or mild intestinal
List.                                Gram +, rod, has lipid A                                                                                                       Lipid A endotoxin (only gram + that does women, neonates (can cross placenta),          distress in adults. Meningitis in
monocytogenes      Listeria          endotoxin                Aerobe, beta-hemolytic                                                                                this).                                     and immunocompromised.                       neonates and immunocompromised.

                                                                                          [A] Gram stain: (A.1) Cocci (Neisseria). (A.2)
                                                                                          "Coccoid Rods" - H. flu, Pasturella, Brucella,
                                                                                          Bordetella. (A.3) Rods. If Rods, then [B]
                                                                                          Lactose fermentation test. (B.1) Fast lactose
                                                                                          fermentation - E. Coli, Enterobacter, Klebsiella.
                                                                                          (B.2) Slow lactose fermentation - Serratia,
                                                                                          Citrobacter. (B.3) Lactose non-fermenter. If non
                                                                                          fermenter, then [C] Oxidase test. (C.1) Oxidase
Gram neg                                                                                  positive - Pseudomonas. (C.2) Oxidase
organisms                                                                                 negative - Shigella, Salmonella, Proteus.
                                                                                                                                                                                                                                                            Incubation period is 2-5 days, but can
                                                                                                                                                                                                                 Urethritis (gonorrhea), PID (Pelvic        be as long as 2-3 weeks. (1) MEN -
                                                                                                                                                                                                                 Inflammatory Disease), Disseminated        usually presents as urethritis.
                                                                                                                                                                                                                 gonococcal infection, septic arthritis,    Symptoms include: Meatal irritation,
                                                                                                                                                                                                                 neonatal conjunctivitis. Most common       Dysuria, Increased urinary frequency,
                                                                                                                                                                                                                 cause of septic arthritis in young         Penile Discharge - initially thin and
                                                                                                                                                                                                                 sexually active individuals. Transfer by   mucoid, later grossly purulent. If not
                                                                                                                                                                                                                 sexual contact. 50-80% of women will       treated, epididymitis, prostatitis, and
                                                                                                                                                                                                                 be asymptomatic. Disseminated              disseminated gonococcal infection can
                                                              (1) Aerobe/facultative                                                                                                                             gonococcus: Occurs in 1% of all cases.     occur. (2) WOMEN: Urethritis,
                                                              anaerobe. Catalase and                                                                                                                             HX includes: Fever, Polyarthralgia,        Cervicitis, and Pelvic Inflammatory           (1) In men, Gram stain of
                                                              cyto c oxidase positive.    (1) Suface structures: Pili and Opa (opacity                                                                           Rash - usually <20 petechial, papular,     disease are most common. Symptoms             urethral swab is 90% sensitive.
                                                              (2) Prefers elevated CO2,   protein, aka protein II) confer adherence to                                                                           hemorrhagic, or necrotic lesions on        include: Dysuria, Frequent urination,         (2) In women, culture of cervical
                                                              temp=35-37C, and is         epithelial cells and anti-phagocytic properties.                                                                       distal extremities. Arthritis: (1) 2/3     Cervical-vaginal discharge,                   swab on Thayer Martin VCN
                                     Gram -, diplococci w/    fastidious (chocolate       Considerable antigenic variation yielding poor                            Endotoxin - LPS (aka LOS - Lipo              develop wrists, ankles, or knees without   Dyspareunia - pain on dunking,                medium is 90% sensitive.
Neiss.             Neisseria         each cocci shaped like   Blood agar) (3) Ferments    long-term immunity. (2) IgA proteases - allow       No, but obligate      Oligosaccharide), toxic for ciliated cells   frank arthritis. (2) 1/3 develop           Abnormal menstrual flow, Pelvic               (Vancomycin - G+, Colostin - G-,
gonorrhoeae        gonorrhea         kidney bean.             glucose.                    colonization of mucosal surfaces.                   human pathogen        and fallopian tube cells.                    monoarthritis                              pain/discomfort.                              Nystatin - Fungi)
                                                                  (1) Aerobe/facultative                                                                                                                            (1) Acute purulent meningitis - 20% of
                                                                  anaerobe. Catalase and                                                         5-15% of healthy                                                   meningitis - HA, fever, stiff neck,
                                                                  cyto c oxidase positive.     16 serotypes of antiphagocytic polysaccharide     adults and children   Endotoxin - LPS (aka LOS - Lipo              petechiae, stupor (2)
                                                                  (2) Prefers elevated CO2,    capsule, w/ polysialic acid residues. B, C are    are carriers. Much    Oligosaccharide). Neisseria shed large       Meningococcemia - purpura fulminans,                                                 (1) Gram - (2) Catalase,
                                                                  temp=35-37C, and is          major groups. (B is non-immunogenic, and          higher in closed      amounts of LOS and outer membrane            DIC, w/ or w/out meningitis, death in                                                oxidase positive. (3) Grows on
                                       Gram -, diplococci w/      fastidious (chocolate        causes 50% of meningitis). Y, W135 are not as     environments - Army   during growth. LOS toxin can lead to         hours. (3) Chronic meningococcemia - Acquired by respiratory route                   Thayer-Martin medium (VCN,
                    Neisseria          each cocci shaped like     Blood agar) (3) Ferments     prevalent. A occurs in large epidemics every 8-   recruits, boarding    fever, fibrin in small vessels (DIC), and    transient bacteremia, low fever, sterile (aerosolized droplets), grow in             V=Vancomycin, G+; C=Colistin,
Neiss. meningitidis meningitidis       kidney bean.               glucose and maltose.         12 years.                                         schools               vascular collapse.                           arthritis, pustular skin lesions.        nasopharynx.                                G-; N=Nystatin, Fungi)
                                                                  (1) Aerobe/facultative
                   Moraxella                                      anaerobe. Catalase and
                   catarrhalis.                                   cyto c oxidase positive.
                   Formerly Neisseria                             (2) Prefers elevated CO2,
                   catarrhalis,                                   temp=35-37C, and is
                   Branhamella                                    fastidious (chocolate                                                                                                                             Otitis media (one of big 3), sinusitis,
Morax. catarrhalis catarrhalis        Gram -                      Blood agar)                                                                    RT                                                                 bronchitis, pneumonia


                                                                                                                                                                                                                    (1) Gastritis (burping, distention,
                                                                                                                                                                                                                    halitosis) - inflammation of gastric
                                                                                               (1) Urease - may damage gastric epithelium.                             (1) VacA (RTX cytotoxin), causes             epithelium and lamina propria (2)
                                                                                               (2) Adheres to gastric epithelium (fucose-                              vacuolization of gastric epithelial cells.   Gastric and duodenal ulcers, dyspepsia                                               (1) Serum ELISA for antibodies
                                                                                               containing carbohydrates), causing leukocytosis   Not normal, but 50-   (2) LOS - Lipo oligosaccharide contains      (esophagitis). Most stomach                                                          (2) Urease breath test (3) EGD -
                                       Gram -, curved (spiral),   Microaerophilic, urease      and gastritis (3) Flagella - necessary to swim    60% colonization by   Lewis-x, Lewis-y antigens, can trigger       ulcers/gastritis in the antrum on lesser                                             Esophago-duodenoscopy w/
H. pylori           Helicobacter       peritrichous flagella      positive, slow growing.      through gastric mucosa.                           age 60 in USA.        autoimmune response (to RBC?)                curvature. (3) Gastric carcinoma                                                     biopsy
                                                                                                                                                                       Choleragen (AB toxin) - 5 B (binding)
                                                                                                                                                                       subunits bind to GM1 ganglioside on
                                                                                                                                                                       intestinal epithelial surface. A (action)
                                                                                                                                                                       subunit covalently modifies the alpha
                                                                                                                                                                       subunit of the Gs receptor G protein,
                                                                                                                                                                       preveting its natural GTPase feedback        Secretory, non-inflammatory diarrhea -
                                                                                                                                                                       activity. Since the G protein is stuck in    rice water stool. Abrupt onset of
                                       Gram -, curved, single                                                                                                          the cAMP synthesis state, cAMP               diarrhea, N/V, massive fluid loss (10-
                                       polar flagellum, aquatic   Facultative anaerobes,                                                                               concentration is high, and cAMP              20L/day) leading to hypovolemic shock,                                               Microscopic stool exam reveals
                                       bacteria, salt or fresh    catalase positive, oxidase (1) Attach to intestinal mucosa using Tcp pilus.                          activates secretion of Na+, Cl-, and         metabolic acidosis. 60% mortality if                                                 numerous curved rods with fast
Vibrio cholerae     Vibrionaceae       water                      positive                   (2) Flagella for motility                                                 water, via CFTR.                             untreated.                                                                           darting movements.
                                       Gram -, curved, single
                                       polar flagellum, aquatic   Facultative anaerobes,                                                                                                                            Gastroenteritis after eating undercooked
Vibrio                                 bacteria, salt or fresh    catalase positive, oxidase                                                                                                                        seafood. Marine bacterium. Explosive
parahaemolyticus Vibrionaceae          water                      positive                                                                                                                                          secretory diarrhea.
                                       Gram -, curved, single
                                       polar flagellum, aquatic   Facultative anaerobes,                                                                                                                            Gastroenteritis after eating undercooked
                                       bacteria, salt or fresh    catalase positive, oxidase                                                                                                                        seafood. Marine bacterium. Explosive
Vibrio vulnificus   Vibrionaceae       water                      positive                                                                                                                                          secretory diarrhea.
                                                                                                                                                                                                                    One of 3 main causes of diarrhea in
                                                                                                                                                                                                                    world (ETEC, Rotavirus, C. jejuni).
                                                                                                                                                                                                                    Prodrome of fever, HA, followed in 12      Large animal reservoir (poultry, sheep,
                                                                                                                                                                                                                    hours by Loose, bloody diarrhea and        etc.) acquired by consumption of
                    Vibrionaceae -     Gram -, rod, single polar                                                                                                                                                    abdominal pain. May last for 1 week or     contaminated food (poultry, water,
Camp. jejuni        Campylobacter      flagellum                 Facultative anaerobe                                                                                                                               more.                                      milk).

                                                                                                                                                                                                                                                               Disease is inflammatory/invasive, but
                                                                                                                                                                                                                  (1) Bacillary dysentery (cramps,             only epithelial cell invasive - not
                                                                Facultative anaerobe,          IPA proteins (Invasion Plasmid Antigens): (1)                                                                      tenesmus, frequent small-volume              lymph/blood. Highly infectious - as few
                                      Gram -, rod, Shigella     catalase positive, oxidase     Invasion of epithelial cells (2) Escape from                                                                       bloody mucoid stools). (2) Hemolytic         as 100 bacteria can cause disease.        Culture from stool.
                                      NO flagella, nonmotile, negative, lactose and H2S        phagocytic vacuoles (3) Apoptosis of M0 (4)                                                                        Uremic Syndrome (HUS - hemolytic             Xmission is fecal-oral (please wash       PMN/lactoferrin is indicative of
                    Enterobacteriacea replicate in cytoplasm of negative, produce lactic       Actin polymerization and passage into adjacent                          Shiga toxin - kills cells by attacking 60S anemia, glomerular capillary                 hands!!). Often seen in conditions of     inflammatory invasion of bowel,
Shig. dysenteriae   e - Shigella      intestinal epithelium     acid but no gas                cells                                                                   ribosome                                   thrombosis, thrombocytopenia)                crowding or poverty - day care.           but not necessarily shigella.

                                                                                                                                                                                                                                                               Major cause of diarrhea in male
                                                                                                                                                                                                                                                               homosexuals. Disease is
                                                                                                                                                                                                                                                               inflammatory/invasive, but only
                                                                                                                                                                                                                  (1) Bacillary dysentery (cramps,             epithelial cell invasive - not
                                                                  Facultative anaerobe,        IPA proteins (Invasion Plasmid Antigens): (1)                                                                      tenesmus, frequent small-volume              lymph/blood. Highly infectious - as few
                                      Gram -, rod, Shigella       catalase positive, oxidase   Invasion of epithelial cells (2) Escape from                                                                       bloody mucoid stools). (2) Hemolytic         as 100 bacteria can cause disease.        Culture from stool.
                                      NO flagella, nonmotile,     negative, lactose and H2S    phagocytic vacuoles (3) Apoptosis of M0 (4)                                                                        Uremic Syndrome (HUS - hemolytic             Xmission is fecal-oral (please wash       PMN/lactoferrin is indicative of
                    Enterobacteriacea replicate in cytoplasm of   negative, produce lactic     Actin polymerization and passage into adjacent                          Shiga toxin - kills cells by attacking 60S anemia, glomerular capillary                 hands!!). Often seen in conditions of     inflammatory invasion of bowel,
Shig. flexneri      e - Shigella      intestinal epithelium       acid but no gas              cells                                                                   ribosome                                   thrombosis, thrombocytopenia)                crowding or poverty - day care.           but not necessarily shigella.

                                                                                                                                                                                                                                                               Disease is inflammatory/invasive, but
                                                                                                                                                                                                                  (1) Bacillary dysentery (cramps,             only epithelial cell invasive - not
                                                                  Facultative anaerobe,        IPA proteins (Invasion Plasmid Antigens): (1)                                                                      tenesmus, frequent small-volume              lymph/blood. Highly infectious - as few
                                      Gram -, rod, Shigella       catalase positive, oxidase   Invasion of epithelial cells (2) Escape from                                                                       bloody mucoid stools). (2) Hemolytic         as 100 bacteria can cause disease.        Culture from stool.
                                      NO flagella, nonmotile,     negative, lactose and H2S    phagocytic vacuoles (3) Apoptosis of M0 (4)                                                                        Uremic Syndrome (HUS - hemolytic             Xmission is fecal-oral (please wash       PMN/lactoferrin is indicative of
                    Enterobacteriacea replicate in cytoplasm of   negative, produce lactic     Actin polymerization and passage into adjacent                          Shiga toxin - kills cells by attacking 60S anemia, glomerular capillary                 hands!!). Often seen in conditions of     inflammatory invasion of bowel,
Shig. boydii        e - Shigella      intestinal epithelium       acid but no gas              cells                                                                   ribosome                                   thrombosis, thrombocytopenia)                crowding or poverty - day care.           but not necessarily shigella.

                                                                                                                                                                                                                                                               Most common shigella in USA.
                                                                                                                                                                                                                                                               Disease is inflammatory/invasive, but
                                                                                                                                                                                                                  (1) Bacillary dysentery (cramps,             only epithelial cell invasive - not
                                                                  Facultative anaerobe,        IPA proteins (Invasion Plasmid Antigens): (1)                                                                      tenesmus, frequent small-volume              lymph/blood. Highly infectious - as few
                                      Gram -, rod, Shigella       catalase positive, oxidase   Invasion of epithelial cells (2) Escape from                                                                       bloody mucoid stools). (2) Hemolytic         as 100 bacteria can cause disease.        Culture from stool.
                                      NO flagella, nonmotile,     negative, lactose and H2S    phagocytic vacuoles (3) Apoptosis of M0 (4)                                                                        Uremic Syndrome (HUS - hemolytic             Xmission is fecal-oral (please wash       PMN/lactoferrin is indicative of
                    Enterobacteriacea replicate in cytoplasm of   negative, produce lactic     Actin polymerization and passage into adjacent                          Shiga toxin - kills cells by attacking 60S anemia, glomerular capillary                 hands!!). Often seen in conditions of     inflammatory invasion of bowel,
Shig. sonnei        e - Shigella      intestinal epithelium       acid but no gas              cells                                                                   ribosome                                   thrombosis, thrombocytopenia)                crowding or poverty - day care.           but not necessarily shigella.
                                                                                                                                                                                                      "MUD PANS": (M) Meningitis in
                                                                                                                                                                                                      neonates - E. coli has K1 capsule w/
                                                                                                                                                                                                      poly sialic acid groups like Neisseria
                                                                                                                                                                                                      meningitidis. (U) UTI - Most
                                                                                                                                                                                                      community acquired UTI. (D) Diarrhea -
                                                                                                                                                                                                      Secretory and inflammatory diarrheas -
                                                                                                                                                                                                      one of big 3 (rotavirus, E. coli, campyl.
                                                                 (1) Facultative Anaerobe,                                                                                                            jejunum). (P) Pneumonia - rare. (A)
                                                                 Catalase positive, oxidase KOH antigens: O - LPS outer O-antigen (155), K                                                            Abscess - abdominal and pelvic. (N)
                   Enterobacteriacea - Gram -, rod, peritrichous negative. (2) Lactose-     -capsule Antigen (100), H - FlagHella antigen                                                             Nosocomial infections - 40% are E. coli.
Escherichia coli   Escherichia         flagella, motile          fermenting, H2S negative. (50)                                            colon                                                      (S) Septicemia - 25% fatal.
                                                                                                                                                                                                      (1) Secretory diarrhea - profuse, non-
                                                                                                                                                                                                      inflammatory, watery. Milder than
                                                                                              (1) KOH antigens: O - LPS outer O-antigen                     (1) LT - Labile Toxin, like cholera toxin cholera but can be life-threatening in
                                                                 (1) Facultative Anaerobe,    (155), K -capsule Antigen (100), H - FlagHella                stimulates Gs --> cAMP --> CFTR -->       young children. Transmitted via raw
                   Enterobacteriacea -                           Catalase positive, oxidase   antigen (50) (2) CFA pili - Colonization Factor               secretes Cl-, Na+ and water into lumen. veggies or water. E. coli resides in
                   Escherichia,        Gram -, rod, peritrichous negative. (2) Lactose-       Antigen pili - allows adherence of E. Coli to                 (2) ST - Stable Toxin, non-immunogenic ileum. No fever, no RBC, WBC in
ETEC               Enterotoxigenic     flagella, motile          fermenting, H2S negative.    intestinal epithelium                                 colon   peptide that activates guanylyl cyclase. stool.
                                                                                                                                                                                                      Like a mild shigellosis. E. Coli invades
                                                                                                                                                                                                      colonic epithelium, verotoxin (SLT)
                                                                                                                                                                                                      produces necrosis, death, and
                                                                 (1) Facultative Anaerobe,                                                                                                            ulceration of colonic epithelium. Fever,
                   Enterobacteriacea -                           Catalase positive, oxidase KOH antigens: O - LPS outer O-antigen (155), K                  Mild amounts of verotoxin (shiga-like     and mild dysentery (cramps, tenesmus,
                   Escherichia,        Gram -, rod, peritrichous negative. (2) Lactose-     -capsule Antigen (100), H - FlagHella antigen                   toxin) - kill 60S ribosome, leading to    frequent, small volume bloody, purulent
EIEC               Enteroinvasive      flagella, motile          fermenting, H2S negative. (50)                                            colon            death of colonic epithelium.              stools)

                                                                                                                                                                                                                                                  EHEC Diarrhea - Copious bloody
                                                                                                                                                                                                      (1) EHEC attach and efface microvilli in    diarrhea (the E. coli of newspapers).
                                                                                                                                                                                                      distal ileum, colonize cecum and colon,     Begins as watery diarrhea with intense
                   Enterobacteriacea -                          (1) Facultative Anaerobe,                                                                                                             causing severe diarrhea. (2) HUS -          abdominal pain and cramps. Followed
                   Escherichia,                                 Catalase positive, oxidase KOH antigens: O - LPS outer O-antigen (155), K                   Verotoxin (SLT - Shiga-Like Toxin) -      Hemolytic Uremic Syndrome (Hemolytic        in 1-2 days by hemorrhagic colitis,
                   Enterohemorrhagi Gram -, rod, peritrichous   negative. (2) Lactose-     -capsule Antigen (100), H - FlagHella antigen                    kills 60S ribosome, leading to death of   anemia, Glomerular capillary                copious bloody diarrhea, WBC (pus) in
EHEC               c                   flagella, motile         fermenting, H2S negative. (50)                                            colon             colonic epithelium.                       Thrombosis, Thrombocytopenia)               stool. Little or no fever.

                                                                 (1) Facultative Anaerobe,
                   Enterobacteriacea -                           Catalase positive, oxidase KOH antigens: O - LPS outer O-antigen (155), K
                   Escherichia,        Gram -, rod, peritrichous negative. (2) Lactose-     -capsule Antigen (100), H - FlagHella antigen                                                             Secretory (Rice water) diarrhea in
EPEC               Enteropathogenic flagella, motile             fermenting, H2S negative. (50).                                           colon                                                      infants.

                                                                 (1) Facultative Anaerobe,
                   Enterobacteriacea -                           Catalase positive, oxidase KOH antigens: O - LPS outer O-antigen (155), K
                   Escherichia,        Gram -, rod, peritrichous negative. (2) Lactose-     -capsule Antigen (100), H - FlagHella antigen
EAgEC              EnteroAggregative flagella, motile            fermenting, H2S negative. (50)                                            colon

                                                                 (1) Facultative Anaerobe,    KOH antigens: O - LPS outer O-antigen (155), K
                   Enterobacteriacea -                           Catalase positive, oxidase   -capsule Antigen (100), H - FlagHella antigen
                   Escherichia,        Gram -, rod, peritrichous negative. (2) Lactose-       (50). Makes Pap or P pilus, allows adherence to                                                         UPEC accounts for 75-90% of cystitis
UPEC               Urethrapathogenic flagella, motile            fermenting, H2S negative.    UT cells.                                                                                               (bladder) and pyelonephritis infections.
                                                                                                                                                                                                      (1) Enterocolitis (gastroenteritis) - 15%
                                                                (1) Facultative Anaerobe,                                                                                                             of food borne infections in USA, eggs,   According to "Clinical Micro Made
                                                                Catalase positive, oxidase                                                                                                            poultry, milk. N/V, secretory diarrhea.  simple", 3 groups of Salmonella:
                   Enterobacteriacea -                          negative. (2) Non-lactose                                                                                                             (2) Typhoid fever (3) Septicemia (4)     Salmonella typhi, Salmonella cholera-
Salmonella         Salmonella          Gram -, motile           fermenting, H2S positive                                                                                                              Enteric fever                            suis, Salmonella enteritidis
                                                                                                                                                                                                                                               Typhoid fever - Incubation for 1-4
                                                                                                                                                                                                                                               weeks, slow onset of fever, malaise,
                                                                                                                                                                                                                                               constipation, myalgia, HA, delirium,
                                                                                                                                                                                                                                               tender abdomen, rose spots on trunk.
                                                                                                                                                                                                                                               Progresses to N/V, secretory diarrhea,
                                                                                                                                                                                                      Typhoid fever - enter intestines through dark urine. Complications if not
                                                                                                                                                                                                      M cells, invade M0 in Peyer's patch,     treated include myocarditis,
                                                                                                                                                                                                      spread to reticuloendothelial system     encephalopathy, DIC (Diffuse                Stool and urine. Some may be
                                                                (1) Facultative Anaerobe,     Salmonella typhi has a capsular Vi antigen.                                                             (liver and spleen). Disseminate          Intravascular Coagulation), intestinal      chronic carriers (S. typhi likes to
                                                                Catalase positive, oxidase    Similar to K antigen for E. coli, but called Vi for                                                     throughout body causing lesions in       hemorrhage from ulceration of Peyer's       reside in gall bladder) and
                   Enterobacteriacea -                          negative. (2) Non-lactose     "virulence". Serotypes A,B,C highly adapted to                                                          lungs, bone marrow, gall bladder, etc.   patches, UTI, metastatic lesions in         excrete Salmonella typhi for
Salm. typhi        Salmonella          Gram -, motile           fermenting, H2S positive      humans                                                                                                  Symptoms often mimic appendicitis!       joints, liver, meninges.                    months.

                                                                (1) Facultative Anaerobe,                                                                                                             Enteric fever - high fever, bacteremia,
                                                                Catalase positive, oxidase                                                                                                            metastatic spread to structural
                   Enterobacteriacea -                          negative. (2) Non-lactose                                                                                                             abnormalities (plaque, prosthesis,          Enteric fever can lead to pneumonia,
Salm. paratyphi    Salmonella          Gram -, motile           fermenting, H2S positive Serotypes A,B,C highly adapted to humans                                                                     trauma), and no GI symptoms.                osteomyelitis, and meningitis
                                                                                                                                                                                                      (1) Gastroenteritis - Most common
                                                                                                                                                                                                      salmonella infection is S. typhinurium.
                                                                                                                                                                                                      N/V, abdominal cramping, non-bloody
                                                                                                                                                                                                      diarrhea (inflammatory response, not
                                                                                                                                                                                                      invasive). 3-4 day diarrhea w/
                                                                                                                                                                                                      spontaneous resolution of symptoms.
                                                                                                                                                                                                      (2) Enteric fever - high fever,
                                                                (1) Facultative Anaerobe,                                                                                                             bacteremia, metastatic spread to
                                                                Catalase positive, oxidase                                                                                                            structural abnormality (plaque,
                  Enterobacteriacea -                           negative. (2) Non-lactose                                                                                                             prosthesis, trauma), and no GI              Enteric fever can lead to pneumonia,
Salm. typhinurium Salmonella          Gram -, motile            fermenting, H2S positive                                                                                                              symptoms                                    osteomyelitis, and meningitis

                                                                (1) Facultative Anaerobe,
                                                                Catalase positive, oxidase                                                                                                            Current nomenclature is that S. typhi
                   Enterobacteriacea -                          negative. (2) Non-lactose                                                                                                             and S. Minnesota are serotypes of
Salm. enterica     Salmonella          Gram -, motile           fermenting, H2S positive                                                                                                              Salmonella enterica

                                                                (1) Facultative Anaerobe,
                                                                Catalase positive, oxidase
                   Enterobacteriacea -                          negative. (2) Non-lactose
Salm. pullorum     Salmonella          Gram -, motile           fermenting, H2S positive                                                                                                              Avian is normal host, can infect humans
                                                                 (1) Facultative Anaerobe,
                                                                 Catalase positive, oxidase
                    Enterobacteriacea -                          negative. (2) Non-lactose                                                                                                                      Bovine is normal host, can infect
Salm. dublin        Salmonella          Gram -, motile           fermenting, H2S positive                                                                                                                       humans

                                                                 (1) Facultative Anaerobe,                                                                                                                      Enteric fever - high fever, bacteremia,
                                                                 Catalase positive, oxidase                                                                                                                     metastatic spread to structure
                  Enterobacteriacea -                            negative. (2) Non-lactose                                                                                                                      abnormalities (plaque, prosthesis,          Enteric fever can lead to pneumonia,
Salm. cholerasuis Salmonella          Gram -, motile             fermenting, H2S positive                                                                                                                       trauma), and no GI distress.                osteomyelitis, and meningitis
                                                                                                                                                                                                                (1) Opportunistic (hospital or
                                                                                                                                                                                                                immunocompromised) pneumonias.
                                                                                                                                                                                                                Violent, cavitary pneumonia, thick
                                                                                                                                                  Carried in URT and                                            bloody sputum coughed up. High
                    Enterobacteraciae - Gram -, non-motile (no                                O antigen, K antigen in capsule, no H antigen       GI of 5% of                                                   mortality. (2) UTI in patients with
Kleb. pneumonia     Klebsiella          flagella)                Lactose fermenting           (non-motile). Capsule inhibits phagocytosis.        population.                                                   catheters. (3) Sepsis.
                                                                                                                                                                                                                (1) Brain abscesses (2) UTI -
                                                                                                                                                                                                                especially with catheters, cystitis and
                                                                                                                                                                                                                pyelonephritis. (3) Urease alkalinizes
                    Enterobacteraciae -                          Contains urease, splits      Shares 3 common antigens with Rickettsia: OX-                                                                     urine and precipitates Mg2+ and Ca2+                                                  Weil-Felix test for Antigens
Proteus mirabilis   Proteus             Gram -, rod, very motile urea into NH3 and CO2        19, OX-2, OX-K. Also has antigenic LPS, pili. GI                                                                  to form stones.                                                                       (used for Rickettsia too)
                    Enterobacteriacea
Serratia            e - Serratia        Gram -                                                                                                                                                                  UTI, wound infections, or pneumonia.                                                  Produces bright red pigment.
                                                                                                                                                                                                                Yersinia passes through M cells,
                                                                                                                                                                                                                replicate in mesenteric lymph nodes.
                                                                                                                                                                                                                Infection requires high dose. Bloody        Can replicate at 4 celcius (in the
Yers.               Enterobacteraciae -                                                                                                                                Produces toxin which causes rise in      diarrhea and systemic appendicitis-like     refrigerator), contaminated milk is
enterocolitica      Yersinia            Gram -, rod                                                                                                                    cGMP.                                    symptoms ensue.                             often the culprit.

                                                                                                                                                                                                                 Bubonic plague - Enlarged regional
                                                                                                                                                                                                                 lymph nodes (Buboes), hematogenous
                    Enterobacteraciae -                                                                                                                                                                          spread to other organs, bacteremia,        Spread in rats and flea bites (fleas
Yers. pestis        Yersinia            Gram -, rod                                                                                                                                                              septic shock, death.                       hang out on rats)
                                                                                                                                                                                                                 (1) Opportunistic pneumonia in patients
                                                                                                                                                                       (1) Exotoxin A - phosphorylates eEF2      with respiratory clearing. (2)
                                                                                                                                                                       (Eukaryotic Elongation Factor 2) -        Opportunistic in patients with loss of
                                                                                                                                                                       prevents translation, thus it is an anti- physical defense barriers (burns) (3)
Pseudo.                                                                                                                                                                human antibiotic. (2) Endotoxin - Fever, Patients with defective phagocytic                                                    Produces pyocyanin, a blue-
aeruginosa          Pseudomonas         Gram -, rod              Obligate aerobe                                                                                       hypotension, DIC.                         function.                                                                            green pigment.
Bacter. fragilis    Bacteroides         Gram -, rod              Anaerobic                                                                                                                                       Abscesses in GI, pelvis, and lungs
                                                                                                                                                                                                                 (1) Epiglottitis - fever, pharyngitis,
                                                                                                                                                                                                                 laryngitis, barking cough in young         Meningitis from H. influenza has very
                                                                                              (1) Antiphagocytic polysaccharide capsule, type                                                                    children - do NOT examine throat. (2)      serious sequelae: Hearing loss,           Requires factor V (NAD) and
                                        Gram negative                                         b refers to capsular antigen. (2) IgA protease -                                                                   Meningitis (3) Septic arthritis (4)        delayed language development, MR,         factor X (hemin) for growth on
Haem. influenza b Haemophilus           coccobacillus                                         allows it to colonize mucosal surfaces.                                                                            Sepsis                                     seizures                                  chocolate blood agar plate.
                                                                                                                                                                                                                 (1) Otitis media (2) Bronchitis (3)                                                  Requires factor V (NAD) and
                                        Gram negative                                         (1) No capsule - only locally invasive. (2) IgA                                                                    Rhinitis/sinusitis (4) Pneumonia -                                                   factor X (hemin) for growth on
Haem. influenza     Haemophilus         coccobacillus                                         protease - allows it to colonize mucosal surfaces. RT                                                              community                                                                            chocolate blood agar plate.
Haem. ducreyi       Haemophilus         Gram negative bacillus   needs heme                                                                                                                                      Chancroid - painful ragged ulcers
                                                                                                                                                                                                                 Whooping cough - Airborne
                                                                                                                                                                                                                 transmission. (1) Catarrhal stage - mild
                                                                                                                                                                                                                 cough, sneezing. (2) Paroxysmal stage
                                        Gram negative                                         Infects respiratory epithelium (ciliated columnar                                                                  - violent coughing followed by
Bord. pertussis     Bordetella          coccobacillus                                         cells)                                                                   Pertussis toxin                           inspiratory "whoop"

                                        Gram negative            Grows intracellularly in                                                                                                                       Pneumonia - often fatal (20%). Causes
                                        pleomorphic rod - poor   macrophages - prevents                                                                                                                         big immune response and lots of        Loves water, supermarket misting
                                        gram stain, use silver   phagosome/lysosome                                                                                                                             damage. Only pneumonia bug which       machines, air conditioning units, etc.         Grow on charcoal yeast with Fe
Leg. pneumonia      Legionella          stain.                   fusion.                                                                                                                                        presents with lots of GI symptoms.     Heat resistant, chlorine resistant.            and cysteine.
                                                                                                                                                                                                                Acne - bacteria secretes organic acids
                                                                                                                                                                                                                which damage skin. Bacteria also
Prop. acnes         Propionibacterium                            Anaerobe                                                                         Skin                                                          triggers inflammatory response.


                                                                                                                                                                                                                (1) Trachoma - caused by serotypes A-       (3) NGU - Non-Gonococcal Urethritis -
                                                                                                                                                                                                                C. Aka chronic follicular conjunctivitis,   caused by Chlamydia trachomatis or
                                                                                                                                                                                                                leading cause of infectious blindness.      Ureaplasma Urealyticum. NGU is
                                                                                                                                                                                                                Conjunctivitis leads to corneal             most common urethritis in USA, infects
                                                                                              Life cycle has 2 forms: EB - Elementary body,                                                                     vascularization, scarring, and blindness.   5% of sexually active teen males and
                                                                                              small dense particle which is endocytosed by                                                                      Lymphoid follicles of upper eyelid swell,   10% of sexually active teen females.
                                                                 Steals ATP from host,        cells. In 8 hours changes to RB - Reticulate                                                                      eyelashes are turned in (entropion) and     (4) Mucopurulent cervicitis - twice as
                                                                 can't make energy by         body, a fragile intracellular form. RB divides by                                                                 rub against cornea. (2) Inclusion           frequent with oral contraceptive use.
                                                                 itself. Replicates in        fission, in 24-72 hours some RB change back to                                                                    conjunctivitis - caused by Serotypes D-     (5) Lyphogranuloma venereum -
                                        Gram -, rod, very small, endosomes (inclusions).      EB and are released to kill other cells.                                                                          K, neonatal conjunctivitis aquired from     primary lesion on genitalia followed by
Chlam.                                  obligate intracellular   Tropism for columnar         Chlamydia is smart because it does not kill its                                                                   cervical secretions at birth. Causes        enlargement and rupture of inguinal
trachomatis         Chlamydia           parasite.                epithelium.                  host (usually), but it is HIGHLY infectious.                                                                      copious mucopurulent discharge.             lymph nodes.

                                                                                              Life cycle has 2 forms: EB - Elementary body,
                                                                                              small dense particle which is endocytosed by
                                                                 Steals ATP from host,        cells. In 8 hours changes to RB - Reticulate
                                                                 can't make energy by         body, a fragile intracellular form. RB divides by
                                                                 itself. Replicates in        fission, in 24-72 hours some RB change back to                                                                    Ornithosis - disease acquired by
                                        Gram -, rod, very small, endosomes (inclusions).      EB and are released to kill other cells.                                                                          inhalation of infected bird droppings.
                                        obligate intracellular   Tropism for columnar         Chlamydia is smart because it does not kill its                                                                   Acute LRT infection, 20-40% fatal if not
Chlam. psittaci     Chlamydia           parasite.                epithelium.                  host (usually), but it is HIGHLY infectious.                                                                      treated.
                                                                                           Life cycle has 2 forms: EB - Elementary body,
                                                                                           small dense particle which is endocytosed by
                                                                Steals ATP from host,      cells. In 8 hours changes to RB - Reticulate
                                                                can't make energy by       body, a fragile intracellular form. RB divides by    (1) Atypical pneumonia - dry hacking
                                                                itself. Replicates in      fission, in 24-72 hours some RB change back to       cough instead of yellow purulent
                                       Gram -, rod, very small, endosomes (inclusions).    EB and are released to kill other cells.             productive cough, milder fever, slower
Chlam.                                 obligate intracellular   Tropism for columnar       Chlamydia is smart because it does not kill its      onset, etc. (2) Possible causative
pneumoniae          Chlamydia          parasite.                epithelium.                host (usually), but it is HIGHLY infectious.         agent of atherosclerosis

                                                                                                                                                Rocky Mountain Spotted Fever -                Organism proliferates in endothelial
                                                                Steals ATP from host,                                                           "Rickettsia Rickettsii, the story of a        lining of small blood vessels and
                                                                can't make energy by                                                            gram neg, wood tick riding, obligate          capillaries, causing small hemorrhages   Weil-Felix test. Latex beads
                                                                itself. Requires arthropod                                                      intracellular parasite; how he caused         and thrombi. It takes 6-10 hours for     with OX-2, OX-19, OX-K are
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are               fever, HA, and conjunctivitis as his          tick to transfer Rickettsia, so tick     mixed with serum from patient.
                    Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        maculopapular rash spread from the            checks help! Diseases more prevalent     If agglutination, patient has
Rick. rickettsii    Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   palms to the trunk.                           in Appalachain Mts than Rockies.         Rickettsial infection.

                                                                Steals ATP from host,
                                                                can't make energy by                                                            Rickettsialpox - mild, self-limited febrile
                                                                itself. Requires arthropod                                                      disease. Papule at original mite bite
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are               site, becomes vescicle, w/ fever, HA,
                    Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        and vesicles all over body (like chicken
Rick. akari         Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   pox).

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
                    Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used
Rick. conorii       Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   Mediterranean spotted fever

                                                                Steals ATP from host,
                                                                can't make energy by                                                                                                          1/3 of Napoleon's army was killed with
                                                                itself. Requires arthropod                                                      Epidemic typhus - Abrupt onset of fever       R. prowazekii in 1812 as he advanced
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are               and HA following 2 week incubation.           upon Russia. Prowazekki is PRO-
                    Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        Macules covering body. May resolve in         WAR. Hygeine in army is good
Rick. prowazekii    Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   3 weeks, or may be fatal.                     (transferred by lice).

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
                    Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        Endemic typhus - fever, HA,
Rick. typhi         Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   maculopapular rash.

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
Rick.               Rickettsiaceae -   Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        Scrub typhus - fever, HA,
tsutsugamushi       Rickettsia         parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   maculopapular rash.

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
                                       Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        Q fever - Carol Burnetti forms a spore.       Atypical Rickettsia due to aerosol
Coxiella burnetti   Rickettsiaceae     parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   Fever, diaphoresis, pneumonia                 transmission.

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
Bartonella                             Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used
quintana            Rickettsiaceae     parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   Trench fever

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are               Cat-scratch fever - fever, malaise,
Bartonella                             Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        lymphadenopathy, skin and eye rash,
henselae            Rickettsiaceae     parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   granulomas in lymph nodes.

                                                                Steals ATP from host,
                                                                can't make energy by
                                                                itself. Requires arthropod
                                       Gram -, rod/coccoid,     vector. Cytoplasmic        OX-2, OX-19, OX-K - these antigens are
Ehrlichia                              Obligate intracellular   replication. Tropism for coincidentally shared by Proteus vulgaris. Used        HME - Human Monocytic Ehrlichiosis -
chafeensis          Rickettsiaceae     parasite.                vascular endothelium.      for Weil-Felix diagnosis of Rickettsial infection.   High fever, HA, rash in 20%
                                                                                                                                                                                 Syphilis - (0) incubation for 3-6 weeks       Neurosyphilis: (1) Meningovascular
                                                                                                                                                                                 (1) chancre - painless, highly infectious,    meningitis - infects base of cerebrum,   (1) VDRL (Venereal Disease
                                                                                                                                                                                 hard based genital ulcers for 4-6 weeks,      plasma and lymphocyte infiltrate,        Research Lab) or RPR (Rapid
                                         Spirochete - tightly                                                                                                                    remission for 6 weeks. (2) Secondary          causes obliterative endarteritis,        Plasma Reagin) test. Both
                                         wound spiral. Note, a                                                                                                                   syphilis - Bacteremia, Hair loss, fever,      thickened meninges, and abscess          measure antibodies to reaginic,
                                         spirochete is a long,                                                                                                                   weight loss, lymphadenopathy, red             formation. (2) Tabes dorsalis - 10       non-treponemal antigen. 100%
                                         thin, spiral bacteria                                                                                                                   maculopapular rash often on palms and         years later, degeneration of posterior   sensitive during stage 2, 70%
                                         wrapped around an axial                                                                                                                 soles of feet, condyloma latum - flat,        columns in spinal cord, spinal roots,    sensitive during all other stages.
                                         filament, with tufts of                                                                                                                 wart like lesions, endarteritis occurs 2-     and dorsal root ganglion inflammation.   (2) FTA (Flurescent Treponemal
                                         periplasmic flagella                                                                                                                    10 weeks later. (3) Tertiary syphilis - in    (3) Paretic neurosyphilis - dementia,    Antibody-Absorption test) -
                                         extending from each                                                                                                                     1/3 of people, of whom 25% die.               tremor, weakness, speech disturbance,    detects antibody to T. palladium.
                    Treponema            pole, meeting in middle, Commensal organisms,                                                            Not normal, but                Gummas (granulomatous lesions in              delusions of grandeur (4) Argyll-        91% sensitive during stage 1,
                    palladium =          covered by outer         cause persistent, chronic                                                       humans are only                skin, bones, joints, liver, URT), Aortitis,   Robertson pupil - reactive to            nearly 100% sensitive in all
Trep. palladium     syphilis             membrane.                infections.                    Penetrates mucus membranes during sex.           host.                          neurosyphilis.                                accomodation but night light.            other stages.
                    Treponema                                     Commensal organisms,
                    Palladium            Spirochete - tightly     cause persistent, chronic
Yaws                pertenue             wound spiral             infections.                                                                                                    Ulcers on face - picture jaws biting face.
                                                                                                                                                                                 Pinta - "Por favor, no pinta mi cabeza" -
                                                                                                                                                                                 Rural Latin America - Red papule
                    Treponema                                        Commensal organisms,                                                                                        lesions on face and skin which turn blue
                    Palladium            Spirochete - tightly        cause persistent, chronic                                                                                   in sun, and white after about a year.
Pinta               carateum             wound spiral                infections.                                                                                                 Lesions look painted on.
                                                                                                                                                                                 Lyme Disease - 3 stages. (1)
                                                                                                                                                                                 Summertime flu (HA, fever, myalgia,
                                                                                                                                                                                 arthralga, etc.) w/ Bullseye rash - small
                                                                                                                                                                                 papule at site of tick bite, expands to
                                                                                                                                                                                 large annular lesion with central
                                                                                                                                                                                 clearing. Develops into ECM
                                                                                                                                                                                 (Erythema Chronica Migrans). Stage 1
                                                                                                                                                                                 lasts 1 month. (2) Stage 2 = CNS              Xmitted by deer tick (Ixodes
                                                                                                                                                                                 (15%) and cardiac (10%) involvement.          scapularis) mostly in spring through
                                                                                                                                                                                 (3) Stage 3 begins weeks to years later -     fall. It takes 24 hours for tick to
                                                                                                                                                                                 synovitis and migratory or episodic           transfer Borrelia, so prompt tick checks
                                         Spirochete - large,         Commensal organisms,                                                                                        arthritis predominantly in lower              can prevent disease. Incubation from
                                         loosely wound, irregular    cause persistent, chronic                                                                                   extremities - 50-60% of untreated             3 to 32 days (<50 of patients recall tick Serological detection of immune
Borr. burgdorferi   Borrelia             coils                       infections.                                                                                                 patients.                                     bite).                                    response
                                         Spirochete - large,         Commensal organisms,
                                         loosely wound, irregular    cause persistent, chronic
Borr. recurrentis   Borrelia             coils                       infections.                                                                                                 Louse borne relapsing fever - serious
                                         Spirochete - large,         Commensal organisms,
                                         loosely wound, irregular    cause persistent, chronic
Borr. hermsii       Borrelia             coils                       infections.                                                                                                 Tick borne relapsing fever - mild
                                         Spirochete - large,         Commensal organisms,
                                         loosely wound, irregular    cause persistent, chronic
Borr. duttonii      Borrelia             coils                       infections.                                                                                                 Tick borne relapsing fever - mild
                                         Spirochete - large,         Commensal organisms,
                                         loosely wound, irregular    cause persistent, chronic
Borr. turicatae     Borrelia             coils                       infections.                                                                                                 Tick borne relapsing fever - mild
                                                                     Commensal organisms,
                                         Spirochete - tight spiral   cause persistent, chronic
Lepto. interrogans Leptospira            with hooked ends            infections.
Lepto.                                                               Commensal organisms,
icterohemorrhagic                        Spirochete - tight spiral   cause persistent, chronic
a                  Leptospira            with hooked ends            infections.
                                                                                                                                                                                                                                                                    (1) Chest X-ray - may show
                                                                                                                                                                                                                                                                    Ghon complexes or Ghon foci.
                                                                                                                                                                                                                                                                    (2) PPD (Purified Protein
                                                                                               Thick, hydrophobic cell wall. Has Mycolic acid                                                                                                                       Derivative) Skin test -
                                                                                               (branched, beta-hydroxy 80-90C chain fatty                                                                                                                           intradermal injection of MTB
                                                                                               acid), Cord factor (mycolic acid linked to                                        (1) Primary infection - asymptomatic,                                              antigenic proteins - positive
                                                                                               disaccharide trehalose - causes granuloma                                         forms granulomas in lungs, contained                                               result indicates exposure
                                                                     Obligate aerobes, Very    formation), Waxes D (mycolic acid,                                                by cell mediated immunity (2)                                                      (primary infection or vaccination)
                                                                     slow growth - 12-18 hours polysaccharides, and peptides - acts as adjuvant                                  Reactivation (Adult) TB - systemic.                                                - positive result is >1cm
                                                                     in vivo. Resistant to     to increase Ab response to antigen), and                                          Occurs in 10% of infected people in                                                induration at 48-72 hours (time
                                                                     drying and disinfectants, Lipoarabinomannan. Virulence is dependent                                         lifetime, and 10% of HIV + people per         Damage and destruction from MTB is for Type 4 DTH reaction to
Mycob.                                                               but sensitive to UV light upon ability to survive and replicate in M0 by                                    year. Called "consumption disease" -          due to DTH (type 4) immune response. occur) (3) Sputum acid-fast
tuberculosis        Mycobacterium        Acid fast, rod              and heat.                 preventing phagosome/lysozome fusion.                                No toxins.   appears like cachexia (wasting).              (M0 activated by TH1 cells)          stain or culture.
                                                                                                                                                                                 Spectrum of disease, depending on
                                                                     Obligate aerobes, Very                                                                                      patient's ability to mount immune
                                                                     slow growth - 12 days in                                                                                    response. Lepromatous leprosy - no
                                                                     vivo. Resistant to drying                                                                                   immune response, very severe disease.         Likes skin, but cooler areas (not
                                                                     and disinfectants, but                                                                                      Tuberculoid Leprosy - cell mediated           armpits, perineum, etc.). Damages
                                                                     sensitive to UV light and                                                                                   defense contains bacteria, milder, self-      skin, superficial nerves, eyes, nose.
Mycob. leprae       Mycobacterium        Acid fast, rod              heat.                                                                                                       limiting disease.                             Also called Hansen's disease.
                                                                     Obligate aerobe, slow
Mycob. bovis        Mycobacterium        Acid fast, rod              growth.
                    Mycobacterium    -
Mycob. avium-       atypical (non-                                                                                                                                               Cavitary pulmonary disease in elderly
intracellulare      tuberculous)         Acid fast, rod              Obligate aerobe                                                                                             males, particularly AIDS patients.
                    Mycobacterium    -                                                                                                                                           photochromogen - a substance which
                    atypical (non-                                                                                                                                               transforms into a pigment with photon
Mycob. kansasii     tuberculous)         Acid fast, rod                                                                                                                          stimulation
                    Mycobacterium    -
                    atypical (non-
Mycob. fortuitum    tuberculous)         Acid fast, rod                                                                                                                          Rapid abscesses at drug injections
                    Mycobacterium    -
                    atypical (non-
Mycob. marinum      tuberculous)         Acid fast, rod                                                                                                                          Swimming pool granuloma, a skin ulcer
                    Mycobacterium    -
                    atypical (non-
Mycob. ulcerans     tuberculous)         Acid fast, rod                                                                                                                          Burundi ulcer
                 Mycobacterium -
Myocb.           atypical (non-
scrofulaceum     tuberculous)      Acid fast, rod                                                                                              Granulomatous cervical lymphadenitis
                                                                                            Noninvasive - adheres to respiratory epithelium.
                                   Very small, No cell wall,                                Antigens on M. pneumo are similar to Ag on
                                   Gram nothing. Obligate                                   RBC, thus can trigger a cross reaction. Causes
Mycop.                             parasite, can invade                                     RBC to clump at cold temperatures - 4C. "Cold      Atypical pneumonia (looks milder, like
pneumonia        Mycoplasma        most any animal.                                         Agglutinin"                                        viral), tracheobronchitis                                                      Cold Agglutinins - IgM

                                   Very small, No cell wall,
                                   Gram nothing. Obligate                                                                                      Non-gonococcal urethritis - causes
Ureaplasma                         parasite, can invade                                                                                        about 50% of non-gonococcal, non-
urealyticum      Mycoplasma        most any animal.                                                                                            chlamydial UTI
                                   No cell wall, Gram
                                   nothing. Obligate
                                   parasite, can invade
Mycop. hominis   Mycoplasma        most any animal.                                                                                            Non-gonococcal urethritis


                                                                                                                                               Treponema, Rickettsia, Mycobacteria,
                                                               Bugs which do not gram                                                          Mycoplasma, Legionella pneumophilia,
TRMMLC                                                         stain.                       These Rascals May Microscopically Lack Color       Chlamydia
                                                               Lactose Fermenting                                                              Klebsiella, Escherichia coli,              Grow pink colonies on MacConkey's
KEE                                                            Enteric Bacteria             Lactose is KEE                                     Enterobacter.                              agar.

Really Cold                                                    Obligate intracellular bugs stay inside when it is Really Cold.                 Rickettsia, Chlamydia.
                                                                                                                                               Borrelia burgdorferi, Brucella,
                                                                                                                                               Francisella tularensis, Yersinia pestis,
BFYP                                                           Zoonotic bacteria            Bugs, Bugs From Your Pet                           Pasteurella multocida

                                                                                                                                               Vibrio parahaemolyticus, Vibrio
                                                                                                                                               vulnificus (seafood), Bacillus cereus
                                                               Gastroenteritis causing                                                         (reheated rice), Staphylococcus aureus
                                                               bacteria - **note, not all                                                      (meats, mayonnaise, custard),
VBSC                                                           cause emesis!                Vomit Big Smelly Chunks                            Clostridium perfringens (reheated meat)
Rx                          Resistance?                Vaccine?              Misc.




Penicillin V.
Macrolides are almost                                                        Extracellular, but can
50% resistant in USA                                                         invade epithelial cells in
[PL, 5/02]                                                                   invasive dx.




(1) Penicillin G (2)
Vancomycin + AG


(1) Penicillin G (2)
Vancomycin + AG


(1) Penicillin G (2)
Vancomycin + AG


(1) Penicillin G (2)
Vancomycin + AG


(1) Penicillin G (2)
Vancomycin + AG

(1) Vancomycin + AG
(2) Ureidopenecillin
(Piperacillin,
Mezlocillin). (3)
Aminopenicillins     VRE - (Vancomycin
(Amoxicillin,        Resistant Enterococcus).
Ampicillin), Zosyn   Highly resistant.

(1) Vancomycin + AG
(2) Ureidopenecillin
(Piperacillin,
Mezlocillin). (3)
Aminopenicillins     VRE - (Vancomycin
(Amoxicillin,        Resistant Enterococcus).
Ampicillin), Zosyn   Highly resistant.




                                                       Pneumovax has 23
                                                       of most common
                                                       capsule serotypes -
                                                       given to elderly,
                                                       immunocompromise
(1) Penicillin G                                       d, asplenic




Drain abscess,
prevent spread of skin
lesions with attentive
hygeine. Drugs: (1)
Beta-lactamase
resistant penicillins -     MRSA - has resistant
nafcillin, dicloxacillin.   PBP2 (Penicillin Binding
(2) Vancomycin +            Protein 2). Use
AG. (3)                     Vancomycin for resistant                         Major defense is PMN
Fluoroquinolones?           strains                                          and C3b opsonization
                           Yes, highly resistant to
                           many antibiotics

Beta-lactamase
resistant penicillins -
Nafcillin, Dicloxacillin




Metronidazole,
Vancomycin




"To Be Healed
Rapidly" - Give
immunoglobulin (Ig)
for Tetanus,
Botulinum, HBV,
Rabies.
"To Be Healed
Rapidly" - Give
immunoglobulin (Ig)
for Tetanus,
Botulinum, HBV,
Rabies.



Penicillin G




(1) Antitoxin (2)
Penicillin or
Erythromycin (3)                                      DPT - Diptheria,
DPT vaccine                                           Pertussis, Tetanus




                     (1) Developing penicillin
                     resistance due to PBP2 -
                     Penicillin Binding Protein
3rd generation       2. (2) Uses phase
cephalosporin        variation (switches certain
(ceftriaxone),       surface protein synthesis
fluoroquinolones,    on/off) and antigenic
possilby             variation (changes its
aminoglycosides with surface proteins to avoid
cephalosporin.       immune system).
Penicillin G or 3rd
gen cephalosporin
(Cephotaxime,                                                               Major defense is PMN
Ceftriaxone).                                      Vaccine w/ capsular      and opsonization.
Rifampin for                                       polysaccharides          Individuals with C5-C9
prophylax of people in                             A,C,X,Y,W135             deficiency are highly
close contact w/                                   available for military   susceptible to Neisseria
infected.                                          personnel, travelers.    infection.




                         Produce beta-lactamase,
                         penicillin resistant

MOC therapy -
Metonidazole,
Omeprazole,
Clariethromycin.
Triple therapy -
Metronidazole,
Bismuth, Tetracycline
(+ omeprazole)




ORT - Oral
Rehydration Therapy.
IV fluid replacement.
Doxycycline will
shorten course.




Fluid and electrolyte
replacement.
Antibiotics may
shorten course.




Fluid and electrolyte
replacement.
Antibiotics may
shorten course.




Fluid and electrolyte
replacement.
Antibiotics may
shorten course.




Fluid and electrolyte
replacement.
Antibiotics may
shorten course.
Resolves in 3-10 days




Quinolones,
ceftriaxone,
amoxicillin, ampicillin
               haEMOPhilus -
               Epiglottitis, Meningitis,
               Otitis Media, Pneumonia




Erythromycin
                  Carried by wood tick.
                  Reservoir is rodents, dogs




                  Carried by mite.
Doxycycline       Reservoir is mouse.




                  Carried by tick. Reservoir
                  is rodents, dogs.




                  Carried by louse.
                  Reservoir is humans.




Doxycycline,      Carried by flea.
chloramphenicol   Reservoir is rodent.




                  Carried by mite.
                  Reservoir is rodents.




                  Sheep, goats, cattle
(1) For new (within 1
year of exposure)
patients - 1 large IM
dose of benzathine-
Penicillin G. If >1 yr
but no neurosyphilis,
1 IM benzathine-
Penicillin G for 3
weeks. (2) For
penicillin allergic
patients - Oral
tetracycline for either
15 or 30 days.                                                                  More common in blacks.




                          Uses phase variation
                          (slippage of coding frame
                          which switches off
                          antigenic surface protein
Doxycycline,              synthesis), and antigenic
erythromycin, beta-       variation (codes different   Uses OspA for
lactams                   surface proteins).           immunization.




                                                       BCG - Bacillus of
                                                       Calmette and Guerin -
Isoniazid,                                             live attenuated strain
Pyrazinamide,                                          of Mycobacterium
rifampin, ethambutol      MDRTB - MDR TB               Bovis.
Erythromycin