Name

Struct/Physio
Catalase (+), Coagulase (+) Grape cluster, Facultative anaerobe, Teichoic acid Prot A (evade immune) Fibronectin (adhere) Normal flora: nasopharangeal skin

Toxin/Virulence Factors
Cytosolic exotoxin: Hemolysins Superantigens: Enterotoxin TSS toxin Exfoliatin

Clinical
Skin infections: (Furuncle, carbuncles Impetigo) Osteomyelitis Acute endocarditis Septicemia Necrotizing pneumonia Gastroenteritis Toxic Shock Syndrome Scalded Skin Syndrome MRSA vs CA-MRSA Infection of prosthetic heart valves, catheters Acute pharyngitis Scarlet Fever Impetigo GAS disease Acute Rheumatic Fever Streptococcal toxic shock Acute bacterial pneumonia Otitis media Meningitis (adults common) Diphtheria: Upper resp infect Increase mucus blocks airway Myocarditis, congest heart failure, nerve/muscle paralysis Cutaneous Diphtheria Pulmonary anthrax: hemorrhagic pneumonia, inflamm lymph nodes Cutaneous anthrax Listeriosis: Septicemia, meningitis Skin lesions Fetal abortion Gonorrhea: Male urethritis, pus discharge Female vaginal pus discharge, gonococcal salpingitis, pelvic inflammatory disease Ophthalmia neonatorum Septic arthritis

Treatment
Nafcillin Oxacillin Vancomycin Linezolid Daptomycin

Staphylococcus aureus

Staph. epidermidis

Streptococcus. pyogenes

Strep. pneumoniae Corynebacterium diphtheriae

Catalase (+), Coagulase (-) Normal skin flora, clusters Slime layer (VF) Catalase (-) Non-motile Facultative anerobes Hyaluronic acid capsule Fimbriae (M Prot) Prot F (adhesion) Nasopharngeal/skin carriage Capsule (antiphago) Rod, small, slender Non motile Facultative anaerobes Blunt rods Endospore forming Non motile Aerobic Capsule (antiphagocytic) Catalase (+) Intracelluar pathogen (phagocytes) Slender, short rods Tumbling motility Utilize host actin to move Oxidase (+) Kidney shape diplococci Pilli (most imp VF) Aerobic

Pyrogenic exotoxins Streptolysin O,S Streptokinase C5a peptidase Streptodornase Hyaluronidase Autolysin/Pneumolysin enzymes Diphtheria exotoxin Stops prot synth ADP-ribosylation, EF2 factor Edema factor: up cAMP levels Lethal toxin: necrosis Protective antigen: entry toxins Listeriolysin O: escape phagosome

Nafcillin Oxacillin Vancomycin Penicillin G Clarithromycin Azithromycin

Penicillin G Vancomycin Horse serum antitoxin Erythromycin Penicillin Vaccine (toxoid) Cutaneous: Penicillin (not recommended) Doxycycline, Erthythromycin Pulmonary: Ciprofloxacin + rifampin + vanco Ampicillin TMP/SMZ

Bacillus anthracis

Listeria monocytogenes

Neisseria gonorrheae

LOS: IgM antibodies attack this OMP I +III : porin proteins OMP II: mediate attachment IgA protease (most imp VF)

Gonorrhea: ceftriaxone, doxycycline, spectinomycin Ophthalmia: tetracycline in newborns eyes

Name Neisseria meningitidis

Struct/Physio
Oxidase (+) Kidney shaped diplococci Capsule antiphago (VF) Pilli Catalase (+), Oxidase (-) Short rod Fimbriae/pilli Motile/non Capsule Facultative anaerobe Glu+, Lac+

Toxin/Virulence Factors
LOS endotoxin IgA protease OMPs Antigenic factors: O antigenLPS, H antigen-flagella, K antigen-capsule ETEC: enterotoxins, ST-cGMP, LT-cAMP EHEC: Verotoxin (VT)hemorrhage EPEC: Shiga-like toxin, destroy microvilli

Clinical
Meningitis (most freq cause)

Treatment
Penicillin G Cefotaxime Ceftriaxone Diarrhea: Rehydration/electrolyte replenish Antibio shorten course Meningitis: Cephalosporin + gentamicin UTI: TMP/SMZ, ciprofloxacin

Escherichia coli

Salmonella typhi

Catalase (+), Oxidase (-) Rods, flagella Facultative anaerobe Glu+, LacExclusively human Intracellular pathogen (phagocytes) See S. typhi Curved, spiral, S-shaped rod Single. polar flagellum Darting motion Microaerophilic Does not ferment CHO Capsular/flagellar antigen Catalase (+), Oxidase (-) Rod Non-motile Glu+, LacFacultative anaerobe Intracellular pathogen (large intest mucosa)

LPS Endotoxin

ETEC: enterotoxins increase ion/water loss, watery diarrhea EPEC: destruct microvilli, watery diarrhea (shiga-like) EHEC: hemorrhagic colitis (VT) Hemolytic Uremic Syndromeacute renal failure EIEC: dysentery-like, bloody diarrhea EAEC: watery diarrhea children, HIV patients Extraintestinal: UTI Neonatal meningitis Septicemia, endotoxic shock Typhoid Fever: infect macrophage lymphatic intest tiss Life threatening systemic illness Fever, ab pain, maculopapular rash on trunk Bacteremia: fever, headache, malaise, bloody diarrhea Enterocolitis: nausea, vomiting, ab cramp, diarrhea Food poisoning Systemic: fever, headache, myalgia Intestinal: acute enteritis, pseudoappendicitis, diarrhea, ulceration jejunum, ileum, colon Leading Cause Food-Borne Disease Shigellosis (bacillary dysentery) Bloody diarrhea, mucus, pain ab cramp, severe dehyro

Ceftriaxone Ciprofloxacin Vaccine (attenuated)

Salmonella enteriditis

LPS Endotoxin LPS, enterotoxin, cytotoxin

Fluid/electrolye replenish Antibioitics shorten disease Diarrhea: Fluids/electrolytes Antiobiotics: if severe, ciprofloxacin

Campylobacter jejuni

Shigella

Exotoxin: Shiga toxin, has endo/cytotoxic props, AB Toxin B: attachement, entry A: cleavage 28S rRNA 60S ribosome, inhibit prot synth

Fluid/electrolyte replacement Ciprofloxacin, azithromycin

Name

Struct/Physio
Oxidase (+)Short, curved, rod Single. polar flagellum Rapidly motile Facultative anaerobe Req/stimulated NaCl

Toxin/Virulence Factor
Cholera Toxin (enterotoxin) AB Toxin B: bind GM1 ganglioside receptor intest cell A2: penetrate cell membrane A1: ADP-ribosyl transferase Ribosylate G prot, act adenylate cylcase, increase cAMP, increase ion, water loss to lumen Urease: secrete NH3, lower acidity, damage tissue Cytotoxins HispB (heat shock prot) Adhesins Mucinase Phospholipase Superoxide dismutase Hib capsular antigen (Polyribose Phosphate) IgA protease (colonization)

Clinical
Cholera: Massive fluid/electrolyte loss

Treatment
Fluid/electrolyte replacement Doxycline to shorten duration

Vibrio cholerae

Heliobacter pylori

Urease (+) Curved, spiral rod Multiple. polar flagella Corkscrew motion Microaerophilic Live in mucous layer gastric cell Bacillus, pleopmorphic Capsulated/non Obligate pathogen (req host hemin/NADH+) Norm flora resp tract, conjuct, genital tract Coccobacillus Encapsulated Aerobic Human reservoir (respir droplets)

Haemophilis influenzae

Acute gastritis -> chronic gastritis Activate inflammatory cells Decreased mucous production Correlated to infection: Duodenal/gastric ulcers Risk factor: Gastric carcinoma, gastric B-cell lymphoma Flu Meningitis (common children) Otitis media, sinusitis, bronchopneumoniae Invades bloodstream Pertussis (Whooping cough): common young children Catarrhal phase: rhinorrhea, conjuct infect, malaise, fever Paroxysmal phase: severe cough, copious mucus, cyanosis, vomiting Leukocyte count> 50,000cells/L Localized: Eye: keratitis, endophthalmitis Ear: external otitis Skin: burn/wound sepsis, rashes UTI Resp tract: cystic fibrosis, congest heart failure GI: mild diarrhea to entercolitis CNS: meningitis, brain abcess Systemic: Bacteremia Endocarditis

Antibio and H+ pump inhibit Amoxicillin, clarithromycin, omeprazole

Cephalosporins TMP/SMZ Ampicillin w/ clavulanate Vaccine (conjugated Hib PRP) Erythromycin TMP/SMZ Vaccine: Killed cells Pertussis toxoid

Bordetella pertussis

Oxidase (+) Encapsulated rods Polar flagella, motile Obligate aerobe Opportunistic pathogen

Pseudemonas aeruginosa

Pertussis Toxin: A/B Type, sensitization to histamine, up insulin prod -> hypoglycemia Dermonecrotoxin: ischemic necrosis Tracheal cytotoxin: inhibit cilia Adenylate cyclase toxin: decrease phagocytosis Flimamentous hemagglutin Agglutinogens: atachement Pili Glycocalyx (anti phago) LPS (sepsis syndrome) Exoenzyme S/T, Exotoxin A: ADP-ribosylate EF2 Elastase, alkaline phosphates, Phospholipase C

Combo therapy: Aminoglycoside + fluroquinolone

Name

Struct/Physio

Toxin/Virulence Factor
Exotoxin (12 varieties): Alpha toxin (phospholipase C) Hemolytic, necrotic, cytotoxic Enterotoxins: heat labile, disrupt ions, fluid loss Hydrolytic enzymes: Hyaluronidase, protease, DNase Botulinum toxins A,B,E: neurotoxic, prevent ACh release at NMJ, flaccid paralysis 2 toxic polypeptides: Toxin A-enterotoxin, fluid loss, inflamm, cytopathic Toxin B-cytotoxin, inhibit prot synth Tetanus Toxin (tetanospasmin): plasmid encoded, AB toxin B: bind neuronal cells A: blocks nt release at inhibitory synapse, cleave vesicle prot Intracellular Pathogen Cannot survive outside host OMP promote adherence Hylauronidase

Clinical
Myonecrosis (gas gangrene) Alpha, exotoxins, hydro enzymes Ferment tissue CHO, gas Shock, renal failure, hemolysis Acute food poisoning Enteritis necroticans Clostridial endometritis Botulinum (food poisoning): unfocused vision, trouble swallowing, muscle paralysis, death by asphyxiation Floppy baby syndrome Clostridial anti-biotic associated diarrhea (AAD), colitis

Treatment
O2 exposure, hyperbaric chamber Penicillin, broad spectrum antibiotics

Clostridia perfringens

Horse serum antitoxin

C. botulinum

Blunt ended rods Endospore forming Motile Obligate anaerobe Opportunistic pathogen

C. difficile

Fluid/electrolyte replacement Metronidozole, vancomycin Do Not Use Beta-lactams!!! Vaccine (toxoid) Tetanus immune globulin Penicillin Penicillin Erythromycin, tetracycline

C. tetani

Tetanus: progressive spastic paralysis of muscle Death from paralysis of chest muscles, asphyxiation Syphilis (STD): Stage 1: hard genital chancre sore at site infection, spread through lymph system Asymptomatic Period Stage 2: red body rash, pale, moist papules anogenital, axiallary, oral region, hepatitis, meningitis, nephritis Latent period up to 30-40yrs Stage 3: degen nervous syst, CV lesions, skin gumma Congenital syphilis: thru placenta, death fetus, abormalities Stage 1: red circular lesion, rash, spread via lymph/blood to skin, CNS, musculoskeletal, heart Stage 2: arthritis, arthralgia, cardiac/neurologic complications Stage 3: chronic arthritis, degen CNS

Treponema pallidum
(Spirochetes) Long, slender corkscrew Flexible, highy motile Central protoplasmic cylinder Outer sheath glycosaminoglycans Endoflagella, axially orienteted Zootic disease, spread by tick bite to humans Invasive enzymes

Cephalosporins Amoxicillin Doxycycline

Borrelia burgdorferi
(Spirochetes)

Name Leptospira interrogans

(Spirochetes)

Struct/Physio
See Treponema pallidum

Toxin/Virulence Factor
Invasive enzymes

Clinical
Leptospirosis: Fever, 1-2wks then bacteremia Disappear Reappear, invade liver, kidney, CNS Jaundice, hemorrage, necrosis, aseptic meningitis Nongonoccocal urethritis (NGU) STD, males: urethral infect females: cervicitis, urethritis, mucoid discharge, like gonorrhea Lymphogranuloma venereum (LGV): serotype L1-L3, invasive STD, chronic inflamm genital area Trachoma: chronic keratoconjuctivis, lead to blindness, lesions cloud cornea Primary Tuberculosis: Invade and reproduce in alveolar macrophage, attract T cells wh/ release cytokines, inflam, damage Tubercle forms as mass of cells around bacteria Lesion can arrest, or rupture and spread to other organs

Treatment
Penicillin G Tetracycline

Chlamydia trachomatis

Round to ovid Two layer lipid bilayer envelope No peptidoglycan, muramic acid Resemble Gram (-) envelope Cysteine Rich Proteins Rigid prot layer connected to membranes (shell) Does Not Gram Stain

Obligate intracellular Parasite Depends on host ATP/NADH+ LPS Adhesins on cell envelope Elementary Body; resistant, spore-like, infects epithelial/macrophage, taken in by phagocytosis Reticulate Body: metabolically active, reproduces, reform EB and released from host cell Mycolic acid wall, resists harsh environment, and chem. attack Facultative Intracellular Pathogen Reproduce in alveolar macrophage Phospholipids inhibit fusion w/ lysosome

Tetracyclines, erythromycin, sulfonamides Safe sexual practices

Mycobacterium tuberculosis

Slender, non-motile rods Cell wall 60% lipids, beta-OH fatty acuds, esp mycolic acid, make cell extreme hydrophobic Will Acid Fast Stain

Vaccine, Bacille Calmette-Gurin (BGC), attenuated M. bovis Multidrug therapy: Isonazid, rifampin

Gram (+) Gram (-) Do not traditionally Gram Stain Exotoxins: released by Gram (+/-) AB type toxin: B subunit adheres to cell; A subunit enters and causes damage Endotoxins: only Gram (-) LPS: in all Gram (-), always an endotoxin