1. Spirochetes Curved Gram Negative Rods
    Treponema pallidum
    • Yaws(tropical worldwide), Pinta(American), Bejel(Africa, Asia, Australia)
    • RPR aka VDRL in blood
    • Gummas
    • Painless chancre @ initial site of infection
    • MHA-TP dx
    • Secondary stage rash on palms and soles
    • DOC PCN
  2. Spirochetes Curved Gram Negative Rods
    Borrelia burgdorferi
    Lyme Disease most common in US
    • Other species cause Relapsing Fever in U.S. and worldwide
    • Transmitted by louse or tick, deer tick in CT
    • erythema migrans 60 to 80% of patients infected have this mark.
    • Arthritis
    • DOC DOXY
  3. Spirochetes Curved Gram Negative Rods
    Weil's Disease( fatal kidney and liver failure)
    • Broken skin is exposed to animal urine rat urine or contaminated water or soil or by ingestion
    • tightly coiled spirochetes with hooked ends L. interrogans
    • worldwide living in soil and freshwater
    • 30 degrees C liquid media in dark
    • urine looking for leptospires using darkfield scope
  4. Vibrio Curved or S shaped Gram Negative Rod
    Resistant to salt
    Ingestion of contaminated water 
    Shellfish most common in US
    • Vibrio Vulnificus
    • cause most seafood-related death in US
    • death by seafood
    • Vibrio Cholerae
    • rice-water
    • fluid loss by vomiting 
    • NO FEVER
    • TX electrolye replacement therapy
    • Adenylate cyclase toxin
    • Vibrio parahemolyticus
    • most common cause of diarrhea in Japan
  5. Campylobacter Curved or S shaped Gram Negative Rod
    Probably most common cause of bacterial gastroenteritis in US today
    Spread from contact with infected animal or food
    Undercooked poultry
    • Campylobacter Enteritis
    • highest incidence in infants and young children followed by adults 20-40
    • dx: isolate from stool 
    • blood-based campy media 
    • 10% CO2 42 degree C reduced O2
    • Campylobacter jejuni
    • most common cause of diarrhea in the US
    • Guillain-Barre' Syndrome
  6. Helicobacter Curved or S shaped Gram Negative Rod
    Helicobacter pylori
    Cause stomach ulcers
    • Acute gatritis
    • Sx: abdominal pain nausea vomitting
    • becomes chronic 
    • causes 60% of all cases of stomach cancer even if no ulcer present
    • migraines when ulcer is treated migraine go away
    • DX: Gastric biopsy, rapid urease test, urea breath test
    • TX: multi-drug regimen
    • metronidazole or clarithromycin given with anti-acid medications
  7. Mycoplasma
    smallest free-living organisms
    no cell wall 
    no gram stain
    tiny colony looks like fried egg
    • common in most mammals
    • humans associated with mucus membranes
    • cause human disease in URT and urogenital tract
    • DX: antigen detection PCR or DNA probes
    • TX: tetracycline or macrolides erythromycin
  8. Mycoplasma pneumoniae
    Tri-layered cell membrane 
    • Causes 20% of community-acquired pneumonia 
    • walking pneumonia
    • last for wks and can infect entire household
    • usually not cultured out, since it may take 2-6wks
    • infectious even while on antibiotic
  9. Mycoplasma and Ureaplasma
    Cause urogenital infections
    • Nongonococcal urethritis NGU
    • can become PID or kidney infections
    • some species are STDs, although urinary and genital tracts of babies and young girls can also be colonized
  10. Rickettsia Gram Negative small obligately intracellular bacteria
    Transmitted ticks, lice, mites, etc
    Worldwide distribution causes tick-typhus
    • Rocky Mountain spotted fever
    • most common rickettisial disease in US
    • seen in Southeastern US and Appalachia
    • tick bite 
    • rash is very distinctive on palms and soles 
    • petechial in half cases
    • death can result from kidney respiratory or heart failure
  11. Rickettsia Gram Negative
    Epidemic or Louse-Borne Typhus
    Body Louse
    • common in crowded areas
    • infected louse defecates while feeding person scratches bite, rubs feces into the wound
    • more common in colder area reservoir in US
    • SX: fever, headache, malaise rash palms and soles does not extend to face
    • disease can reappear yrs later at Brill-Zinsser
  12. Rickettsia Gram Negative
    Obligate intracellular parasite of WBC leading to leukopenia
    • HGE: Human Granulocytic Ehrlichiosis is found in northern states Dx: nuetrophil is best cell to dxing
    • HME: Human Monocytic Ehrlichiosis found in southern states DX: monocyte cell is best cell to dxing
  13. Chlamydia Nonmotile Gram Negative Obligate Intracellular Bacteria
    Chlamydia trachomatis
    DX: tissue cultures, genital swab or urine culture, sputum, throat swab, conjunctival swab
    • causes trachoma of the eye and genital disease, pneumonia in infants, cervical cancer
    • non-gonococcal urethritis in men
    • most common bacterial STD in US
    • SX: can be mild to none females: can develop PID resulting in sterility or ectopic pregnancy
    • can cause eye infection n babies passing through birth canal of infected mother, or conjunctivitis in adults
    • TX: tetracyclines, macrolides(erythromycin) rifampin
  14. What 3 diseases must you consider after a tick bite in New England area especially in CT
    Lyme disease(Borrelia bergdorferi, a spirochete bacteria)

    Ehrlichiosis or HGE/HME(Ehrlichia, an obligate intracellular bacteria)

    Babesiosis (Babesia microti, a protozoan)
  15. Chlamydia pneumomiae Nonmotile Gram Negative obligate intracellular bacteria
    • can cause pharyngitis, bronchitis, or mild pneumonia from contact with respiratory droplets 
    • may be responsible for 10% of community-acquired pneumonias
    • atherosclerosis
    • arthritis
  16. Chlamydia psittici Nonmotile Gram Negative obligate intracellular bacteria
    • parrot fever or ornithosis
    • causes psittacosis, infected birds and mammals or breathing in aerosolized bird droppings 
    • SX: fever, headache, chills, leading to pneumonia
    • causes abortion in domestic mammals or in pregnant women who are exposed to infected animals
  17. Nesisseria Gram Negative Cocci 
    Only genus that causes disease in humans
    coffee bean-shaped always in pairs
    • dislike cold and temps 
    • needs enhanced CO2 atomosphere
    • fimbria 
    • capsules
    • Lipooligosaccharide (LOS) a combination of Lipid A and sugar
  18. Nesisseria gonorrhoeae Gram Negative Cocci
    coffee bean shaped always in pairs
    • gonorrhea one of the common STDs
    • attaches to mucosal cells using fimbriae
    • can infect mouth, anus, cervix, vagina, urethra, eye
    • SX: Male painful urination, discharge of pus from urethra, gram stain of penile exudate is diagnostic Female:infect cervical cells, mild urethritis or increased vaginal discharge 
    • left untreated can cause PID 
    • opthalmia neonatorum
    • penicillinase not beta-lactamase
    • thayer martin agar or nyc agar
    • DOC ceftriaxone or cefixime given as a single dose
  19. Nesisseria meningitidis Gram Negative Cocci
    coffee bean shaped always in pairs
    • LOS Lipooligosaccharide
    • person to person through direct contact with respiratory secretions
    • outbreaks in high-density areas college dorms, military camps where young ppl are crowded into stressful environment
    • UCONN at Storrs
    • Vaccine available
    • Petechia rash or purpuric skin rash in 75% of cases
    • TX: PCN, chloramphenicol, or broad spectrum cephalosporins
  20. Pasteurella Gram Negative Rod 
    Small nonmotile 
    Fastidious requires heme
    • Pasteurella multocida: seen after cat bite
    • SX: inflammation at site of bite can spread to systemic infection
    • TX: PCN, tetracycline, or cephlasporins
  21. Haemophilus Small Gram Negative Rod Plemorphic
    Requires Heme X(X factor) V(NAD) for growth
    obligate parasites 
    colonize mucous membranes of humans and animals
    • Haemophilus influenzae Pink eye, ear infections,
    • bacterial meningitis and epiglottitis in children under age 5
    • must be grown on chocolate agar under 5% CO2
    • transmitted by exposure to nasal exudate or aerosolized droplets
    • will grow on blood agar if S. aureus is present 
    • TX: rifampin
  22. Haemophilus aegyptius
    Small plemorphic Gram Negative Rods
    Brazilian purpuric fever in children which begins with conjunctivitis which can progress and become fatal rapidly
  23. Haemophilus ducreyi Gram Negative Rods
    Small pleomorphic
    • Chancroid or soft chancre: causes sexually transmitted disease
    • produces ulcer at the site of infection most visible on the penis caused a toxin that kills human epithelial cells 
    • common in tropical areas but rare in US
  24. Bartonella Gram Negative Aerobic Bacilli
    • Bartonellosis: bite of sand fly in South America
    • SX: anemia, headaches, skin infections, 
    • Trench Fever: body lice common in WWWI
    • SX: recurrent fever
    • Cat-Scratch Disease: from cat bite or scratch or cat flea bite
  25. Brucella Gram Negative Aerobic Bacilli
    small aerobic nonmotile coccobacilli
    • can pass thru minute cuts on skin
    • contracted from infected animals or animal products, 
    • Undulant fever: chills, headache, muscle aches, wt loss, 
    • TX: antibiotics for 6wks
    • Biosafety Level III pathogen
  26. Pseudomonas aeruginosa Gram Negative 
    Small coccobacilli not fastidious grows well on MacConkey
    • not normal flora should be treated if on body  Cystic fibrosis: patients that usually get breathing treatments
    • Swimmers ear: eye infections that can quickly result in blindness
    • Pyocyanin: a blue-green pigment, triggers formation of oxygen radicals which can damage tissue
    • Cystic Fibrosis Lung Infection
  27. Bordetella Gram Negative Aerobic Bacilli
    Small aerobic, nonmotile coccobacillus
    • Bordetella pertussis: human pathogen causing Whooping Cough
    • Adenylate cyclase toxin which causes mucous excretion cells to go into overdrive
    • vaccine available
    • DX: cultured on media that's very rich in blood preferably 20% horse blood 
    • Cough plates held under patients mouth o
  28. Francisella tularensis Gram Negative Aerobic coccobacillus
    • Biosafety III
    • Rabbit Fever: causes tularemia usually acquired from exposure to infected animals esp rabbits. 
    • aerosolized and breathed in, can also be swallowed in water or food injected by bite of insect from skin mucous
  29. Leginonella pneumophila Aerobic Gram Negative pleomorphic Rod
    • present in all types of water even chlorinated 
    • must be aerosolized by a fountain or water tower and breathed in to cause infection 
    • SX: flu like, progresses to high fever, respiratory failure and death
    • Pontiac Fever: in younger ppl Pontiac Michigan where an entire health dept was infected
    • DOC is erythromycin rifampin
    • Legionnaires Disease:
    • BCYE: Buffered Charcoal Yeast Extract, since yeast is rich in both of the above factors
  30. Coxiella burnetti Small Aerobic obligate intracellular parasite 
    transmitted by tick bites
    • transmitted to humans by dust or dander from infected animals or ticks
    • Q fever: usually in animals handlers, acute Q fever is like the flu, chronic may take years to cause endocarditis
    • most common cause of endocarditis in Australia
  31. Anaerobic Gram Negative Rods 
    Bacteroides fragilis
    • Bile Resistant
    • accounts for 85% of GI diseases such as peritonitis, genital infections, and wound infections
  32. Anaerobic Gram Negative Rods 
    • Bile Sensitive 
    • is seen in sinus, ear, periodontal infections and in pelvic infections.
  33. Gram Negative nonsporeformers either aerobic or facultative
    Escherichia coli 
    true stool pathogen
    • causes most UTIs than any other organism 
    • accounts for most traveler's diarrhea some strains may have toxins similar to Shigella
  34. E coli O157:H7
    1980's (Sorbitol)
    non-lactose fermenters
    • sorbitol negative
    • hemolytic uremic syndrome in children-elderly leading cause of kidney failure in children in US
    • consumed in contaminated meat with animal feces that is insufficiently cooked increasingly seen in vegetables and fruits grown around animals
  35. Salmonellosis Gram Negative nonsporeformers
    aerobic or facultative
    fermenter of glucose
    • common Isource poultry especially eggs never eat raw eggs Transovarian transmission 
    • chicken transmits bacteria into the eggs before they laid them
    • Invade intestinal mucosa and multiply there
    • SX: fever, cramps, diarrhea, nausea
    • can invade blood stream especially in young and old 
    • TX: self-limiting no antibiotics
  36. Salmonella typhi
    • Typhoid fever: uniquely to humans not seen in animals
    • SX: high fever headache diarrhea in 2nd-3rd week 
    • bacteria multiply in phagocytic cells 
    • rare in US but seen worldwide when sanitation is poor
    • Vaccine for typhoid fever 
    • Typhoid Mary
    • TX: 3rd generation of cephalosporins like ceftriaxone
  37. Shigella
    • 4 species which cause bacillary dysentery aka Shigellosis 
    • severe diarrhea with abdominal cramping and fever
    • produce a toxin shiga toxin which inhibits protein synthesis killing infecting cells
    • TX: fluoroquinolone like ciprofloxacin oral rehydration
  38. Yersinia pestis 
    transmission occurs from fleas
    • Now confined to a few endemic areas Africa America and Asia most common in US in Southwest
    • after bitten by flea organism travels to bloodstream to nearest lymph node 
    • SX: bubo intense inflammatory response causing swelling of lymph node, septicemic followed by meningitis or pneumonia
    • pneumonic plague can then be spread person to person via aerosol
    • Black death due to necrotic lesions in peripheral blood vessels
    • TX: vaccines- neither vaccine is very effective against pneumonic disease streptomycin is DOC but tetracycline gentamycin or chloramphenicol also effective
  39. Yersinia enterocolitica Yersinia pseudotuberculosis
    • Causes gastroenteritis or yersiniosis
    • Bloody diarrhea, fever, headache, and abdominal pain so severe it may be misdiagnosed as appendicitis
    • usually associated with ingesting raw pork or pork products
    • bacteria can multiply at refrigrator temps
    • occasionally transfused blood 
    • causing infection and shock to blood recipient
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