Gram Negative

Bacterial Diseases

Proteobacteria Alpha: Parasitic bacteria

Tick borne diseases Flea vector

Beta: GNC Gamma

Largest group Enterics

Delta Sulfur reducing bacteria in

soil/water Predatory (attack other

bacteria) Epsilon : GI

Gram Negative Cell Wall

Neisseria Characteristics

GNC, diplococci Capnophile Nonmotile Oxidase (+)

Pathogenicity Fimbria Capsule Protease (inhibit IgA) LOS (oligosaccharide)

Lipid A endotoxin

Neisseria meningitidis Epidemiology

Normal microbiotica (resp) Pathogenicity

Various strains Capsule LOS: lipid A

Disease meningitis Septicemia/death

Dx: CNS, Ab Tx: AB Prevention

Vaccination Prophylactic AB to exposed

Neisseria gonorrhoeae Gonococci

Eye Pharynx Uritogenital Rectum

Pathogenicity Adhesins

Pili Protein II

Replicate in WBCs Disease

STD “Clap” PID scar tissue Neonatal conjunctivitis Inflammation

Urinary Repro Oral Cavity

Neisseria gonorrhoeae Dx

Culture/Isolation Symptoms

Tx: AB

Cepha- quinolones

Iodine/Silver Nitrate (eye) Prevention:

Screen/Detection Tx infected individuals Condom use Public education

Enterobacteriaceae Characteristics

GNR Motile = flagella Capsule/slime layer Nitrate reduction FA Oxidase (-)

Epidemiology Source

GI Water Soil Decaying vegetation

Gamma Proteobacteria

Enterobacteriaceae Groups

Gammaproteobacteria: Enterics Coliforms Noncoliforms Pathogens

FA Oxidase (-) Reduce nitrate (cocco)bacilli

Enterobacteriaceae Pathogenicity

LPS Core polysaccharide O polysaccharide Lipid A endotoxin

Antigens Capsular (K) Flagellar (H)

Virulence factors Immune evasion

Capsule Fimbriae Type III secretion system

Adhesins Exotoxins Hemolysins Iron-binding compounds

Enterobacteriaceae Dx

Culture/Isolation MAC EMB

Location

Tx Supportive AB

Prevention Hand washing Sewage control

Coliforms Normal GI microbiotica Groups

Escherichia Klebsiella Serratia Enterobacter Hafnia Citrobacter

Biochemical tests Ferment lactose

Enteric Bacteria Pathogenicity

Glycocalyx LPS

Core polysaccharide O antigen Lipid A endotoxin

K (capsular) antigens H (flagellar) antigens Fimbria Adhesins Exotoxins Hemolysins Bacteriocins Iron binding proteins Sex Pili AB resistance

Enteric Bacteria Diagnosis

Culture Biochemical tests

Treatment AB Toxin neutralization

Prevention Hygiene Clean water supply

Esherichia coli Coliform

E. coli O157:H7 Pathogenicity

O, H, K antigens Plasmids for virulence Shiga-like Toxin Type III secretion system

Disrupt PM Receptors for attachment

Diseases Gastroenteritis

Food-fecal contamination UTI

Uremic syndrome Pyelonephritis

Septicemia Neonatal meningitis

Klebsiella Epidemiology

Nosocomial Reservior

Soil, water GI Respiratory tract

Pathogenicity Polysaccharide capsules

Diseases UTI Bacteremia Meningitis Pneumonia

Cherry red sputum Lung abscess Empyema

Dx: Culture Tx: AB

Serratia Characteristics

Red pigment coliform

Agent: S. marcescens Epidemiology

Nosocomial Opportunistic Fomites (catheters, saline solutions)

GI Soil, water

Pathogenicity AB resistance Endotoxin

Diseases UTI URTI

Enterobacter Agents

E. aerogenes E. cloacae

Location Coliform Water, sewage Soil

Epidemiology Opportunistic

Blood Wounds/incisions

Nosocomial Pathogenicity

Endotoxin AB resistance

Disease Dairy contaminant UTI Pneumonia

Hafnia (formerly Enterobacter sp) Characteristics

GNR, FA motile

Agent: H. alvei (2 biogroups) Epidemiology

GI micorbiotica (HARF) Opportunistic, nosocomial

Pathogenesis Attach and efface enterocyte mucosa

(LEE) Disease

Diarrhea Gastroenteritis Peritinitis Septecemia Liver Abscesses UTI Endocarditis Meningitis Pneumonia

Dx: Culture fluids Tx: AB

Citrobacter Characteristics

GNR, FA Ferment lactose

Agent: C. freundii Epidemiology

GI microbiotica (HARF) Soil, water Decaying vegetation

Pathogenesis Opportunistic Lipid A endotoxin

Disease UTI Cholecystitis Meningitis OM

Dx: Culture fluids Tx: AB

Noncoliform Opportunistic Nosocomial Diseases

UTI Kidney stones

Groups Proteus Morganella Providencia Edwardsiella

Biochemical Non lactose fomenters

Proteus Characteristics

GNR, FA Flagella (polar), swarms Urease (+)

Agent P. mirabilis P. vulgaris

Epidemiology Colon, soil & water Opportunistic

Pathogenicity Urease Motility Endotoxin

Disease UTI (catheter) Kidney stones

Dx: Culture Tx: AB, resistance is developing

Morganella (formerly Proteus sp.) Characteristics

GNR, FA, motile Only glucose fermentation

Agents M. morganii

Epidemiology GI microbiotica (HAR) Nosocomial

Pathogenesis: Lipid A endotoxin Disease

UTI GI diarrhea CNS infection Ear and Sinus infections

Dx: Culture Tx: AB

Providencia Characteristics

GNR Motile FA

Agents: P. stuartii P. rettgeri P. alcalifaciens

Epidemiology Normal GI microbiotica

animals humans

Nosocomial Catheter Endotracheal tubes

Pathogenesis: plasmid codes for urease Disease

GU: UTI, prostatitis, kidney stones Pneumonia Bacteremia

Dx: Culture fluids, feces Tx: AB, but developing resistance

Edwardsiella Characteristics

GNR, FA +/- motility

Agents E. hoshinae E. tarda

Epidemiology Opportunistic GI tract (HARF)

Pathogenesis Disease

Gastroenteritis UTI Wound infections

Dx: Culture fluids Tx: AB

Pathogenic Enteric Bacteria Characteristics

NLF Virulence

Type III secretion Toxins

Groups Salmonella Shigella Yersinia

Salmonella Characteristic

GNR Motile (peritrichous) Gas production H2S production Urease (-) Oxidase (-)

Location GI (S. enterica) 2,000 serovars

Examples S. typhi S. paratyphi S. typhimurium

Salmonella pathogenicity Epidemiology

Fecal contamination Poultry products Milk

Pathogenicity Many serotypes Proteins endocytosis Invade intestinal mucosa Toxins

Enterotoxin Cytotoxin

Diseases Salmonellosis

N/V/D Bacteremia

Typhoid fever Gastroenteritis Bacteremia Peritonitis

Salmonella Dx

Culture Isolation Symptoms

Tx Supportive AB Cholecystectomy

Prevention Hygiene Proper food handling

Cooking Refrigeration

Vaccination

Salmonella typhi Epidemiology

Source Carrier’s feces

Transmission Contaminated food/H2O

Pathogenesis Invade GI spread to LN, Liver, GB Shed bacteria in feces: 3mos Abdominal pain, anorexia

Disease Typhoid fever

Dx: Culture blood, feces; Serology Tx: AB Prevention:

Food handling Isolation of infected individuals Vaccine for high risk individuals

Shigella Characteristics

GNR Nonmotile FA (-): urease, oxidase

Examples S. dysenteriae S. flexneri S. boydii S. sonnei

Shigella Location

GI pathogen

Epidemiology Source: food/water

contamination with feces Transmission

Fecal-oral 4 F’s

food fingers feces flies

Shigella Pathogenesis

Multiply in colon mucosa Disrupt phagosome membrane and

invade Toxins

Exotoxin: Shiga Toxin Endotoxin

Disease Diarrhea:

water, blood, mucus Shigellosis dysentery

Ulcerate colon Dx: Isolates, biochemical tests, serology Tx: fluid support, AB Prevention

Hygiene Sewage treatment

Yersinia Characteristics

GNR Location

GI of animals Endemic (in West Texas)

Epidemiology Food/H20 contamination with

feces Direct contact Indirect: inhalation

Vector: flea bite Agents

Y. enterocolitica Y. pseudotuberculosis Y. pestis

Yersinia Pathogenicity

Pathogen YOPS

outer membrane proteins

Prevent phagocytosis Plasmid virulence factors

Adhesins Type III secretion systems

Trigger apoptosis PMN MO

Yersinia Diseases

Gastroenteritis (Y. enterocolitica) SI Mesenteric LN

Plague (Y. pestis) Bubonic (LN) Pneumonic (Lungs)

Dx: Blood ID, culture, PCR Tx: AB Prevention: control

Rodent Flea Vaccination Isolation of infected persons

Plague life cycle Reservoir

Rats Mice Voles

Vector: Flea Hosts

Amplify Prairie dogs Rabbits Deer Dogs/Cats

Cycle Flea bite Exposure to infected animals

Bubonic Plague Lymphadenopathy Bacteremia DIC S.C. Hemorrhage Gangrene “Black” Death

Pneumonic Plague

Lungs Bloody sputum Dyspnea

Respiratory droplet

Alpha, Beta, & other Gamma proteobacteria Aerobic GNR Groups

Alpha Bartonella Brucella

Beta Bordetella Burkholderia

Gamma Pseudomonads

Pseudomonas Moraxella Acinetobacter

Francisella Legionella Coxiella

Alpha Proteobacteria

Bartonella Characteristics

Aerobic

Location: animals Vectors: insects Examples

B. bacilliformis B. quintana B. henselae

Bartonella Diseases Bartonellosis

Sand flies RBCs invaded

Trench fever Lice Bone pain

Bacillary Angiomatosis Peliosis hepatitis

Cat-Scratch fever fleas Cat nails, teeth LN and abscesses

Brucella Characteristics

coccobacillus Location

Intracellular parasite Animal hosts

Pathogenicity Prevent phagolysosome

Examples B. melitensis B. abortus B. suis B. canis

Brucella Epidemiology

Unpasteurized dairy Animal blood / urine Reproductive organs

Disease Undulant fever (Bangs)

Tx: AB Prevention

Animal vaccination

Beta Proteobacteria

Bordetella Characteristics

Aerobic GN coccobacillus

Location Examples

B. pertussis B. parapertussis B. bronchiseptica

Bordetella Epidemiology

Inhaled aerosols Inhibit ciliary action

Pathogenicity Adhesins Toxins

Pertussis Adenylate cyclase Dermonecrotic Tracheal

Disease: whooping cough Prevention

Hygiene Vaccination (DPT)

Burkholderia Characteristics

Aerobic Flagella

Location environmental Opportunistic:

Lungs Joints Skin

Diseases Meliodosis Glanders

Example Burk. cepacia Burk. mallei Burk. pseuodomallei

Gamma Proteobacteria

Pseudomonads Characteristics

GNR aerobic

Location Environment: soil Moist areas opportunistic

Examples Pseudomonas Moraxella Actinobacter

Pseudomonas aeruginosa Pathogenicity

Fimbria= biofilms Adhesins Enzymes

Neuraminidase elastase

Capsule ROS Drug Antiports Toxins

Endotoxin: Lipid A Exotoxin

Exotoxin A Exoenzyme S

Pseudomonas aeruginosa Diseases

Bacteremia Endocarditis UTI CNS GI M/SK Burn Resp

Moraxella catarrhalis (formerly Branhamella sp)

Characteristics Aerobic Short bacilli

Disease Opportunistic URTI Ears Sinusitis

Acinetobacter Characteristics

Aerobic Short bacillus

Location Soil Water Sewage

Diseases Opportunistic URTI UTI CNS Endocarditis

Francisella Characteristics: GNR Agent: F. tularensis Epidemiology

Animal reservoirs (rabbits) Transmission

Vector bite (tick, fly, mosq) Direct contact with infected

tissue Inhalation

Pathogenesis Ulcer Enlarged LN

Disease Tuleremia

Dx: Culture, PCR, FlorescentAb/Agglut Tx: AB Prevention

Vector control Vaccination

Francisella tularensis Characteristics

Aerobic Coccobacillus

Location Water Intracellular parasite

Epidemiology Zoonotic

Bite mosquito, fly Tick feces Infected animal

Rabbit muskrat

Tularemia Pathogenicity

Capsule Beta lactamase

Disease LN buboes Resp: cough, pain Death

Legionella Source: environment

Soil Water (A/C, showers)

Epidemiology Airborne Chronic illness susceptible

Path Cytotoxic protease

Diseases Severe bronchopneumonia Pontiac fever

Dx : Isolation, urine Ag Tx: AB Prevention

clean environment Water chlorination

Legionella pneumophila Characteristic

Aerobic Pleomorphic

Location: water Epidemiology

Intracellular parasite Inhalation of aerosols

Pathogenicity Protozoa carry Exit pores

Disease Pneumonia 2nd: GI, Urinary

Coxiella burnetii Characteristic

aerobe Location

Intracellular parasite phagolysosome

Epidemiology Hosts

Avian Mammals

Vector: Tick Pathogenicity

Spore like infective body Human Disease

Inhale infective body Q fever

Acute Chronic

Pasteurellaceae Gammaproteobacteria

GNR Oxidase (+) FA Nonmotile

Groups Pasteurella Haemophilus

Bovine pneumonia

Pasteurella Characteristics

GNR Agent: P. multocida Location

Normal microbiotica in animals Oral Resp

Exposure Animal bite Aerosol

Pathogenesis Zoonotic

Disease Humans

Abscess Arthritis

Animals Pneumonia Sepsis

Haemophilus Characteristics

GNR Pleomorphic

Location MM parasite

Examples H. influenza H. ducreyi H. aphrophilus H. parainfluenza H. aegyptius

Haemophilus influenzae Pathogenicity

Capsule K antigen Various strains

Disease Meningitis Infantile arthritis Cellulitis Epiglottitis Ocular and Aural (OM) Sinusitis URTI (bronchitis. Pneumonia)

Tx: AB Prevention

vaccination

Haemophilus parainfluenza Characteristics Epidemiology

Component of dental plaque

Pathogenesis Disease

POD Valvular endocarditis

Dx

Haemophilus aegyptius

Purpuric Fever South America Children Disease

Conjunctivitis N/V/D Shock Death

Haemophilus ducreyi

STD Pathogenicity

toxin

Disease Genital ulcer (chancroid)

Vibrios

Vibrio Campylobacter Helicobacter

Vibrio Characteristics

GNR Agent: V. cholera Epidemiology

carriers Fecal contamination

Water Food

Pathogenesis Serotypes: O1 and O139 Adhere to intestinal mucosa Toxin: Choleragen (from bacteriophage)

Subunit A Activates adenylate cyclase Hypersecretion of Cl- and H20

Subunit B Binds to intestinal receptors

Disease Muscle cramps Profuse diarrhea Circulatory shock and collapse

Dx: culture of feces, Agglutination Rxn Tx: supportive; AB Prevention: water sanitation

Proteobacteria

Epsilon Campylobacter Helicobacter

Campylobacter Characteristics

GNR, curved Capnophile

Agent: C. jejuni Epidemiology

Source GI animals

Birds Cattle

Water Transmission

Contaminated water Undercooked food Contact with infected

animals

Campylobacter Pathogenesis

Invades SI Exotoxin (similar to cholera

toxin) Disease

Gastroenteritis and ulceration Bloody watery diarrhea Endocarditis Septic arthritis Meningitis

Dx: Culture and Isolation Tx: Supportive, AB: erythromycin Prevention:

Hygiene Proper food handling

Pasteurization Cooking of meat

Helicobacter (Campylobacter) Characteristics

GNR Agent: H. pylori Epidemiology

Gastric mucosa (mucus) Food-water: person-person

Pathogenesis Adhesins: Fimbria Enzymes

Urease Proteases Phospholipidase Cytokines

Toxins: cytoxins Diseases

Gastritis Peptic ulcers Gastric cancer

Dx: Gastric biopsy culture Tx:

Peptobismol Metronidizole Beta lactam AB Prevacid

Anaerobic GNR Bacteroides Prevotella

Bacteroides fragilis Characteristics

GNR Pleomorphic anaerobic

Location Normal GI microbiotica

Epidemiology 85% of GI disease

Pathogenicity Fimbria Capsule Inhibit lysosomes

Disease Peritonitis (ruptured GI) Pelvic Abscesses Wound necrosis

Provotella Characteristic

GNR anaerobic

Location: normal flora Urogenital Respiratory

Epidemiology: opportunistic Pathogenicity

Adhesins Antiphagocytic capsules Proteases

Disease Sinusitis OM POD PID

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