Classification of Bacteria

4 major simple categories of bacteria 1. 2. 3. 4. Gram positive cocci: Staph and strep Gram positive rods: Clostridium and actinoyces Gram negative cocci: Neisseria and moraxella Gram negative rods: E. coli, pseudomonas, salmonella, shigella

Groups that dont fall in the system: 1. Coccobacilli o Gram positive: Listeria o Gram negative: Haemophillus, legionella, bordetella o Gram variable: Acinetobacter 2. Anaerobes o Grow in absence of oxygen o Predominantly found in GI tract o Examples: Clostridium, bacteroides, peptostreptococcus, actinomyces 3. Atypicals o Inexact term applied to bacteria that are unusual in cell structure, morphology, biochemistry or life cycle o Eg. Mycoplasma, Chlamydia, Ricketsia, Legionella Main tests in clinical microbiology: 1. Coagulase test Used to differentiate staph species Coagulase positive staph: Staph aureus Coagulase negative staph: generally not pathologic, are contaminants 2. Hemolysis test Used to differentiate strep series Alpha hemolytic (no Lancefield): Strep pneumonia Beta hemolytic (Lancefield A and B): Strep pyogenes Gamma hemolytic (Lancefield D): Strep bovis 3. Lancefield serotypes 4. Lactose fermentation Major differentiating characteristic of gram negative rods Culturing on MacConkey agar Lactose positive: E. coli, klebsiella, enterobacter Lactose non-fermenters (negative): Pseudomonas, proteus, salmonella, shigella, hemophillus Lactose slow fermenters: Serratia

Practical Classification

Gram positive

o o

Cocci Staphylococci Streptococci Coccobacilli Listeria Cocci Neiserria Moraxella Rods a. Lactose fermenting E. coli Klebsiella Enterobacter b. Lactose non-fermenting Pseudomonas Proteus c. Lactose slow fermenting Serratia Citrobacter Coccobacilli Haemophillus Bordetella Clostridium Bacteroides Peptostreptococcus Actinomyces Mycoplasma Chlamydia Rickettsia Legionella

Gram negative

o o

Anaerobic

Atypical

Bacterial Etiologies of Common Infections

Meningitis o 1 month to 50 years: Strep pneumonia, Neiserria meningitides o >50 years: Strep pneumonia, listeria, GNR Lungs o CAP: Strep pneumonia, Haemophillus influenza, Mycoplasma, Legionella o HCAP: Staph aureus (with underlyinf CAP), Enteric GNR, Pseudomonas o VAP: HCAP + Stenotrophomonas, Acinetobacter o Aspiration pneumonia: Anaerobes, klebsiella, staph aureus, streptococci Diabetic foot o Superficial: Staph aureus o Deep: Everything ENT o Otitis media: Strep pneumonia, haemophillus, Moraxella o Otitis externa: Pseudomonas, staph epidermidis, staph aureus o Sinusitis: Strep pneumonia, haemophillus Cardiovascular o Endocarditis: Viridans strep, Staph aureus, enterococcus, other strep

GI o o o Gastroenteritis: E. coli, shigella, salmonella, campylobacter Various intraabdominal processes: Enteric GNR, pseudomonas, enterococcus, anaerobes Infectious colitis: C. difficile

GU o UTI: E. coli, proteus, klebsiella, enterococcus, staph saprophyticus o PID: N. gonorrhoea, chlamydia, enteric GNR Musculoskeletal o Osteomyelitis: Staph aureus, group A strep o Septic arthritis: Staph aureus, gonorrhoea, strep o Cellulitis: Beta-hemolytic strep, staph aureus