Actinomycetes

Actinomycetes
Classification
Order Actinomycetales
Show fungus-like characteristics such as branching in tissues or in
culture (look like mycelia). The filaments frequently segment during
growth to produce pleomorphic, diphtheroidal, or club shaped cells.
The cell wall and the internal structures are typical of bacteria rather
than fungi.
Some are aerobic and others are anaerobic.
All are slow growing
Actinomycetes
The anaerobic genera: Actinomyces, Arachnia, and Bifidobacterium
Morphology and cultural characteristics
G+ branching, or diphtheroid-like bacilli
Anaerobic and require CO
2
for growth
Non-sporing
Will grow on anaerobic BA or PEA. A israelii, the most commonly
isolated species, produces rough, granular colonies that resemble molars.
Biochemistry
ID by gas liquid chromatography (GLC) of metabolic by-products or
fluorescent antibody studies
Actinomycetes
Clinical significance
Are part of the NF found in the cavities of humans and other
animals.
All may cause actinomycosis or lumpy jaw. A cervicofacial
infection that used to occur following tooth extractions or dental
surgery which provided traumatized tissue for growth of the
microorganism which may also invade the bone. This is rare
today because of prophylactic antibiotic therapy.
May cause thoracic or abdominal infections
May cause meningitis, endocarditis, or genital infections
Actinomycetes
Every kind of infection is characterized by draining sinuses,
usually containing characteristic granules which are colonies of
bacteria that look like dense rosettes of club-shaped filaments in
radial arrangement
Treatment
Penicillin

Granules
Actinomycetes
The aerobic genera: Nocardia, Actinomadura, and Streptomyces.
There are three clinically important species of Nocardia N.
asteroides, N. brasilensis, and N. caviae
Morphology and cultural characteristics
G+ branching bacillus that may fragment to bacillary or coccoid forms
Aerobic
Specimens should be inoculated onto 7H10 agar or Lowenstein-Jensen
agar and brain heart infusion agar. Colonies produced are typically
orange, dry, crumbly, and adherent.
The organisms are weakly acid fast or non acid fast
Nocardia acid fast stain
Actinomycetes
Biochemistry
The organisms are identified based on sugar fermentations and
hydrolysis reactions (caseine, tyrosine, etc.)
Clinical significance
Mycetoma organism enters the body through breaks in the skin
and causes a localized infection involving skin, cutaneous, and
subcutaneous tissue. The three most characteristic features seen
are swelling, draining sinuses and granules. This disease can also
be caused by fungi as well as Nocardia, Actinomadura, and
Streptomyces.

Actinomycetes
Nocardiosis is a localized or disseminated disease occurring
after inhalation of organisms. Pulmonary infections resemble
tuberculosis and can remain confined to the lungs or may
disseminate, with a predilection for the brain and meninges. The
disease is characterized by multiple confluent abscesses and
intense suppuration. It is usually a disease of compromised
hosts.
Antimicrobic susceptibility/treatment
Mycetoma aminoglycosides
Nocardiosis sulfonamides or sxt