bacteria G shape oxygen spo cap mot oxi cat virulence factors toxins epidemiology transmission incu clinical

epidemiology transmission incu clinical manifestations diagnosis treatment

Staphylococcus + cocci aerobe - + - + teichoic acid, slime hemolysins, Panton- many neonates direct contact - pyogenic skin infections, tracheitis, isolation empiric: vancomycin (life-
aureus layer, coagulase, valentine leukocidin, within 1st week of pneumonia, sepsis, pyomyositis, threatening), nafcilin or oxacillin
clumping factor, exfoliatin, exterotoxin, life osteomyelitis, suppurative arthritis, (non-life threatenign) clindamycin
protein A, catalase, toxic shock syndrome meningitis, acute endocardities, (non-life threatening, MRSA area),
beta-lactamase toxin-1 renal abscess, food poisoning vancomycin + gentamicin (MRSA)
coagulase (-) + cocci aerobe - + - + exopolysaccharide most common cause hospital- - bacteremia, endocarditis, central blood cultures vancomycin
Staphylococcus biofilm of hospital acquired acquired venous catheter infection, CSF
infection shunts, UTI
Streptococcus + diplococci aerobe - + - peptidoglycan, most frequent cause respiratory - pneumococcal pneumonitis, otitis isolation amoxicillin (uncomplicated CAP),
pneumoniae teichoic acid, capsular of bacteremia, droplet media, sinusitis, pneumonia, vancomycin, cefotaxime,
polysaccharide, C- peumonia, otitis sepsis, bacteremia -> meningitis, ceftriaxone (meningitis)
polysaccharide media, meningitis in osteomyelitis, suppurative arthritis,
children endocarditis, brain abscess
Streptococcus + coccoid facultative - + - M protein, T streptokinase highly communicable airborne 2-5 d pharyngitis, pneumonia, scarlet culture penicillin (+ clindamycin for
pyogeens chains anaerobe substance, R protein, (fibrinolysin), salivary fever impetigo, erysipelas, perianal necrotizing fasciitis and TSS)
P substances deoxyribonucleases, droplets, nasal dermatitis, necrotizing fasciitis,
hyaluronidase, discharge bacteremia, streptococcal toxic
pyrogenic exotoxin A, schock syndrome, rheumatic fever
B C, hemolysins
(streptolysin O, S)
Streptococcus + coccoid facultative - + - capsular beta-hemolysin prominent neonatal perinatal - early-onset neonatal GBS disease isolation penicillin
agalactiae chains anaerobe polysaccaharide pathogen (sepsis, pneumonia, meningitis),
late-onset GBS disease
(bacteremia, meningitis, other focal
infections)
non-Group A or + cocci facultative - + - O, M protein, streptococcal - - similar to GAS penicillin
B Streptococci anaerobe hyaluronidase pyrogenic exotoxin B,
Enterococcus + cocci facultative - + - lacks CRISPR normal GI tract flora - - neonatal bacteremia and penicillin or ampicillin/vancomycin +
anaerobe septicemia, necrotizing aminoglycoside (invasive infections,
enterocolitis, meningitis, UTI linezolid, quinupristin/dalfopristin,
daptomycin, tigecycline
(vancomycin-resistant)
Corynebacterium + bacilli aerobe - - - diphteria exotoxin airborne - respiratory tract diphtheria, culture diphtheria antitoxin, erythromycin or
diphtheriae respiratoryd cutaneous diphtheria penicillin
roplets, direct
contact
Listeria + bacilli facultative - tumblin + O, H antigens grows at 4 degrees foodborne, 21-30 maternal: flu-like, bacteremia, culture ampicillin + aminoglycoside
monocytogenes anaerobe g celsius, milk, soft perinatal neonatal: early onset (septicimic),
cheeses, raw meat late-onset (meningitic), post-natal:
meningitis
Actinomyces + bacilli anaerobe - higher incidence in - - cervicofacial (lumpy jaw), microscopic penicillin
males, endogenous pulmonary actinomycosis examination
flroa (endobronchitis, pneumonia, pleural
effusion), laryngeal, oropharyngeal,
periodontitis
Nocardia + filamentous aerobe compromised aerosolized - pulmonary nocardiosis (pneumonia, microscopic trimethoprim-sulfamethoxaole
cellular immunity dust necrotitizing pneumonia), examination
extrapulmonary lesions (brain: brain
abscess, meningitis, skin:
sporotrichoid nocardiosis,
mycetoma)
Clostridium + bacilli, anaerobe + botulinum toxin foodborne, 12-36 hr classic triad (symmetric flaccid demonstration botulism immune globulin
botulinum spindle direct contact, (food), 4- descending paralysis with clear of presence of
aerosolized 14 d sensorium, no fever, no toxin
toxin (wound) paresthesia), infant, foodborne,
wound and inhalational botulism
Clostridium + bacilli, anaerobe + tetanospasmin - 2-14 d generalized tetanus (trismus, risus clinical tetanus immunoglobulin,
tetani spindle sardonicus, opisthotonos), neonatal metronidazole, diazepam
tetanus (poor suck, paralysis,
spasms), localized tetanus,
cephalic tetanus
Clostridium + bacilli anaerobe + toxin A, toxin B, - - pseudomembranous colitis (bloody toxin in stool metronidazole
difficile binary toxin diarrhea with fever, abdominal pain,
nausea, vomiting)
Neisseria - diplococci aerobe + + PorA, PorB, LPS, <1 y.o. aerosol 1-14 d acute meningococcal septicemia isolation penicillin, ampicillin (allergy:
meningitides polysaccharide droplets, close (fulminant: purpura fulminans), chloramphenicol, ciprofloxacin)
capsule, pili contact meningococcal meningitis, occult
menicococcal bacteremia, chornic
meningococcemia (fever, arthralgia,
headache, splenomegaly, petechial
rash)
Neisseria - diplococci aerobe - - PorI, phospholipids, lipooligosaccharides sexual, 2-5 d genital gonorrhea (urethritis, culture ceftriaxone/cefixime +
gonorrhea peptidoglycan perinatal (M), 5-10 vulvovaginitis, cervicitis), azithromycin/doxycycline
d (F) opthalmitis, opthalmia neonatorum)
disseminated gonococcal infection
(tenosynovitis-dermatitis syndrome,
suppurative arthritis syndrome)
Kingella kingae - coccobacilli facultative pili and nonpilus Repeat-in-Toxin one of most common - - septic arthritis, bacteremia, isolation ampicillin or cefotaxime/ceftriaxone
anaerobe factors etiology of joint and osteomyelitis, endocarditis
bone infections
Haemophilus - coccobacilli facultative + capsular lipooligosaccharides <5 y.o. direct contact, meningitis, cellulitis, preseptal culture ceftriaxone/cefotaximem, ampicillin
influenzae anaerobe polysaccaharide, respiratory cellulitis, orbital cellulitis, acute if susceptible, amoxicillin (oral),
pilus, non-pilus droplets epiglottitis, supraglottitis, amoxicillin/clavulanate (oral,
factors pneumonia, suppurative arthritis, resistant)
pericarditis, otitis media,
conjunctivitis, sinusitis
Haemophilus - bacilli facultative sexual 4-7 d chancroid (papule on preputial rule out azithromycin, ceftriaxone
ducreyi anaerobe orifice or frenulum in men on labia, syphilis and
perineal region in woman -> HS
pustular -> ulcerative),
lymphadenopathy -> buboes ->
rupture
Moraxella - diplococci aerobe - + adhesin, biofilm lipooligosaccharides - - otitis media, sinusitis, bacteremia culture amoxicillin/clavulanate,
catarrhalis formation cephalosporins, macrolides, TMP-
SMX, fluroquinollones
Bordatella - coccobacilli aerobe + + filamentous pertussis toxin, attack rates of 100% aerosol 3-12 d whooping cough (catarrhal, culture azithromycin, erythromycin
para/pertussis hemagglutinin, tracheal cytotoxin, in susceptible droplets paroxysmal, convalescence)
agglutinin adenylate cyclase, individuals
dermonecrotic toxin,
hemolysin,
lipopolysaccharide
Salmonella - bacilli aerobe - - + - somatic O antigens, effectors (SopE, foodborne 6-72 hrs acute enteritis (bloody diarrhea), culture third generation cephalosporin,
flagellar H antigens SopE2, SopB, SipB) bacteremia ampicillin, rehydration
Salmonella typhi - bacilli aerobe - - + - somatic O antigens, effectors (Sip A, Sip foodborne 7-14 d typhoid fever (high grade fever, TyphiDot, ciprofloxacin, ceftriaxone
flagellar H antigens C), SifA, PipB2), S. abdominal discomfort, culture
typhi toxin diarrhea/constipation, vomiting)
Shigella - bacilli facultative - somatic O antigen autolytic endotoxin, S. most common in 2-3 foodborne 12 h to bacillary dysentery (bloody Culture ceftriaxone, cefixime, ciprofloxacin
anaerobe dysenteriae exotoxin y.o. days diarrhea)
Escherichia coli - bacilli facultative + - O antigen, K antigen, ETEC (ST, LT), EIEC Culture TMP-SMX, if susceptible, otherwise
anaerobe H antigen, (effectors: IpaB, ciprofloxacin, azithromycin,
aggregative fimbrae IpaC), EPEC ampicillin; not indicated in STEC
(EAEC), surface (effectors EspA, B,
D), STEC (Stx1, 2)
 fimbrae, AIDA-1 EAEC (EAST 1, Pet,
(DAEC) STATE, ShET1),
DAEC (Sat), EAHEC
(Stx2a)
Vibrio cholera - bacilli, facultative + + H antigen, O antigen V. cholera enterotoxin foodborne, 1-3 d cholera (watery diarrhea, rice- culture, stool doxycycline, tetracycline (pedia),
curved anaerobe (choleragen) waterborne watery stool), cholera gravis exam rehydration, zinc
Campylobacter - bacilli, microae- - + + flagellae, surface cholera-like toxin, one of leading cause foodborne, 3d acute gastroenteritis (watery Culture controversial (macrolides,
curved rophilic proteins (PEB1, cytotoxin of acute diarrhea water borne diarrhea, sometimes bloody), fluoroquinolones, aminoglycosides,
CadF), surface bacteremia, perinatal infections chloramphenicol, tetracyclines,
adhesin (SipA) clindamycin), rehydration
Yersinia - coccobacilli facultative - antiphagocytic Enterotoxin more common in foodborne, enterocolitis (diarrhea, fever, Isolation TMP-SMX, third generation
enterocolitica anaerobe proteins northern Europe, <5 waterborne abdominal pain), acute enteritis, cephalosporins
y.o. mesenteric lymphadenitis
Yersinia - coccobacilli aerobe, - + O antigen foodborne, pseudoappendicitis and mesenteric PCR, culture aminoglycoside, ampicillin, TMP-
pseudotubercu- facultative waterborne lymphadenitis (abdominal pain, SMX, cephalosporin,
losis anaerobe RLQ tenderness, fever) fluoroquinolone, chloramphenicol
Yersinia pestis - coccobacilli facultative - - endemic in 24 vectorborne bubonic plague (lymphadenitis, Culture streptomycin, gentamicin
anaerobe countries (flea), direct buboes, fever, headaches,
contact septicemia, purpura from DIC),
septicemic plague (without bubo),
pneumonic plaque (sever
pneumonia)
Aeromonas - bacilli facultative + + flagella, fimbriae, LPS, collagenase, found in fresh and waterborne enteritis (watery diarrhea), skin and Culture third generation cephalosporin, or
anaerobe outer membrane elastase, nuclease, brackish aquatic soft-tissue infections, septicemia aminoglycoside
protein, S-lyer, gelatinase, lipase, sources, 3rd/4th
capsule chitinase, aerolysin, common cause of
hemolysins bacterial diarrhea
Plesiomonas - bacilli facultative - + + + beta-lactamase beta-hemolysin found in warmer and foodborne, 1-2 d enteritis (watery diarrhea, vomiting, Culture TMP-SMX, cephalosporins,
shigelloides anaerobe tropical water waterborne fever, headache, cramps) carbapanems, fluoroquinolones
Pseudomonas - bacilli aerobe + pili proteases, elastases, classic opportunist direct contact, hours to ecthyma gangrenosum, dermatitis, Isolation ceftazidime,
aeruginosa cytotoxins, nosocomial 2d UTI, folliculitis, colonization of piperacillin/tazobactam,
exopolysaccharide, wounds, bacteremia, conjunctivitis ciprofloxacin
exotoxin A
Burkholderia - filamentous lipopolysaccharide airborne, invasive pneumonia, septic shock TMP-SMX, doxycycline (PO),
cepacia direct contact, meropenem + TMP-SMZ/
nosocomial doxycycline (IV)
Strenotropho- - bacilli nosocomial, pneumonia, bacteremia, soft-tissue TMP-SMX
monas airborne infections, endocarditis,
maltophilia osteomyelitis
Francisella - coccobacilli aerobe - - vectorborne, 3d lymphadenopathy, serum gentamicin, streptomycin
tularensis foodborne, hepatosplenomegaly, skin lesions agglutination
airborne ulceroglandular and glandular test
disease, pneumonia, oropharyngeal
tularemia, oculoglandular tularemia,
typhoidal tularemia
Brucella - coccobacilli aerobe - - lipopolysaccharide foodborne 2-4 wks fever, arthralgia/arthritis, isolation doxycycline + aminoglycoside
hepatosplenomegaly
abdominal pain, headache,
diarrhea, rash, night sweats,
pharyngitis
Legionella - bacilli aerobe - - found in freshwater, airborne, Legionnaires disease (fever, cough, culture Azithromycin, clarithromycin and
streams, thermally microaspira- chest pain, alveolar filling ciprofloxacin, levofloxacin
polluted water and tion infiltrates), Pontiac fever (high
potable water, fever, myalgia, headache, extreme
aerosols debilitation)
Bartonella - bacilli aerobe - - most have contact cutaneous 7-12 d Cat scratch disease: red papules at microscopic not always needed, azithromycin,
henselae with cats, esp. inoculation site of cuteanous inoculation, examination of rifampin + TMP-SMZ (children with
kittens lymphadenopathy, chronic regional tissue hepatosplenal CSD)
lymphadenitis, fever, constitutional
symptoms, hepatospenomegaly;
Parinaud oculoglandular syndrome
(unilateral conjunctivitis +
preauricular lymphadenopathy)
Bartonella - bacilli aerobe + - found in South vectorborne 2-14 wk Oroyo fever (fever with rapid blood smear, chloramphenicol, rifampin,
bacilliformis America (sandfly) development of anemia), verruca blood culture tetracycline, fluoroquinolone
peruana (arthralgia, myalgia,
paresthesia, verrucae)
Bartonella - bacilli aerobe - - WW1, WW2 Vectorborne 22 d Periodic febrile illness with 3-8 blood culture, tetracycline, chloramphenicol
quintana (body louse) episodes lasting 4-5 days each, serology
malaise, chills, sweats, anorexia,
erythematous macules/papules on
trunk, splenomegaly, mild
hepatomegaly