Gram Negative Bacterial Diseases

Proteobacteria Alpha: Parasitic bacteria Beta: GNC Gamma Delta Tick borne diseases Flea vector Beta: GNC Gamma Largest group Enterics Delta Sulfur reducing bacteria in soil/water Predatory (attack other bacteria) Epsilon : GI

Gram Negative Cell Wall

Neisseria Characteristics Pathogenicity GNC, diplococci Capnophile Nonmotile Oxidase (+) Pathogenicity Fimbria Capsule Protease (inhibit IgA) LOS (oligosaccharide) Lipid A endotoxin

Neisseria meningitidis Epidemiology Normal microbiotica (resp) Pathogenicity Various strains Capsule LOS: lipid A Disease meningitis Septicemia/death Dx: CNS, Ab Tx: AB Prevention Vaccination Prophylactic AB to exposed

Neisseria gonorrhoeae Gonococci Eye Pharynx Uritogenital Rectum Pathogenicity Adhesins Pili Protein II Replicate in WBCs Disease STD “Clap” PID  scar tissue Neonatal conjunctivitis Inflammation Urinary Repro Oral Cavity

Neisseria gonorrhoeae Dx Culture/Isolation Symptoms Tx: AB Cepha- quinolones Iodine/Silver Nitrate (eye) Prevention: Screen/Detection Tx infected individuals Condom use Public education

Enterobacteriaceae Characteristics GNR Motile = flagella Capsule/slime layer Nitrate reduction FA Oxidase (-) Epidemiology Source GI Water Soil Decaying vegetation Gamma Proteobacteria

Enterobacteriaceae Groups Gammaproteobacteria: Enterics Coliforms Noncoliforms Pathogens FA Oxidase (-) Reduce nitrate (cocco)bacilli

Enterobacteriaceae Pathogenicity LPS Antigens Virulence factors Core polysaccharide O polysaccharide Lipid A endotoxin Antigens Capsular (K) Flagellar (H) Virulence factors Immune evasion Capsule Fimbriae Type III secretion system Adhesins Exotoxins Hemolysins Iron-binding compounds

Enterobacteriaceae Dx Tx Prevention Culture/Isolation Location MAC EMB Location Tx Supportive AB Prevention Hand washing Sewage control

Coliforms Normal GI microbiotica Groups Biochemical tests Escherichia Klebsiella Serratia Enterobacter Hafnia Citrobacter Biochemical tests Ferment lactose

Enteric Bacteria Pathogenicity Glycocalyx LPS K (capsular) antigens Core polysaccharide O antigen Lipid A endotoxin K (capsular) antigens H (flagellar) antigens Fimbria Adhesins Exotoxins Hemolysins Bacteriocins Iron binding proteins Sex Pili  AB resistance

Enteric Bacteria Diagnosis Treatment Prevention Culture Biochemical tests Treatment AB Toxin neutralization Prevention Hygiene Clean water supply

Esherichia coli Coliform E. coli O157:H7 Pathogenicity O, H, K antigens Plasmids for virulence Shiga-like Toxin Type III secretion system Disrupt PM Receptors for attachment Diseases Gastroenteritis Food-fecal contamination UTI Uremic syndrome Pyelonephritis Septicemia Neonatal meningitis

Klebsiella Epidemiology Pathogenicity Diseases Dx: Culture Tx: AB Nosocomial Reservior Soil, water GI Respiratory tract Pathogenicity Polysaccharide capsules Diseases UTI Bacteremia Meningitis Pneumonia Cherry red sputum Lung abscess Empyema Dx: Culture Tx: AB

Serratia Characteristics Agent: S. marcescens Epidemiology Red pigment coliform Agent: S. marcescens Epidemiology Nosocomial Opportunistic Fomites (catheters, saline solutions) GI Soil, water Pathogenicity AB resistance Endotoxin Diseases UTI URTI

Enterobacter Agents E. aerogenes E. cloacae Location Coliform Water, sewage Soil Epidemiology Opportunistic Blood Wounds/incisions Nosocomial Pathogenicity Endotoxin AB resistance Disease Dairy contaminant UTI Pneumonia

Hafnia (formerly Enterobacter sp) Characteristics GNR, FA motile Agent: H. alvei (2 biogroups) Epidemiology GI micorbiotica (HARF) Opportunistic, nosocomial Pathogenesis Attach and efface enterocyte mucosa (LEE) Disease Diarrhea Gastroenteritis Peritinitis Septecemia Liver Abscesses UTI Endocarditis Meningitis Pneumonia Dx: Culture fluids Tx: AB

Citrobacter Characteristics GNR, FA Ferment lactose Agent: C. freundii Epidemiology GI microbiotica (HARF) Soil, water Decaying vegetation Pathogenesis Opportunistic Lipid A endotoxin Disease UTI Cholecystitis Meningitis OM Dx: Culture fluids Tx: AB

Noncoliform Opportunistic Nosocomial Diseases UTI Kidney stones Groups Proteus Morganella Providencia Edwardsiella Biochemical Non lactose fomenters

Proteus Characteristics Agent Epidemiology Pathogenicity Disease GNR, FA Flagella (polar), swarms Urease (+) Agent P. mirabilis P. vulgaris Epidemiology Colon, soil & water Opportunistic Pathogenicity Urease Motility Endotoxin Disease UTI (catheter) Kidney stones Dx: Culture Tx: AB, resistance is developing

Morganella (formerly Proteus sp.) Characteristics GNR, FA, motile Only glucose fermentation Agents M. morganii Epidemiology GI microbiotica (HAR) Nosocomial Pathogenesis: Lipid A endotoxin Disease UTI GI diarrhea CNS infection Ear and Sinus infections Dx: Culture Tx: AB

Providencia Characteristics GNR Motile FA Agents: P. stuartii P. rettgeri P. alcalifaciens Epidemiology Normal GI microbiotica animals humans Nosocomial Catheter Endotracheal tubes Pathogenesis: plasmid codes for urease Disease GU: UTI, prostatitis, kidney stones Pneumonia Bacteremia Dx: Culture fluids, feces Tx: AB, but developing resistance

Edwardsiella Characteristics Agents Epidemiology Pathogenesis Disease GNR, FA +/- motility Agents E. hoshinae E. tarda Epidemiology Opportunistic GI tract (HARF) Pathogenesis Disease Gastroenteritis UTI Wound infections Dx: Culture fluids Tx: AB

Pathogenic Enteric Bacteria Characteristics NLF Virulence Type III secretion Toxins Groups Salmonella Shigella Yersinia

Salmonella Characteristic GNR Motile (peritrichous) Gas production H2S production Urease (-) Oxidase (-) Location GI (S. enterica) 2,000 serovars Examples S. typhi S. paratyphi S. typhimurium

Salmonella pathogenicity Epidemiology Fecal contamination Poultry products Milk Pathogenicity Many serotypes Proteins  endocytosis Invade intestinal mucosa Toxins Enterotoxin Cytotoxin Diseases Salmonellosis N/V/D Bacteremia Typhoid fever Gastroenteritis Peritonitis

Salmonella Dx Culture Isolation Symptoms Tx Supportive AB Cholecystectomy Prevention Hygiene Proper food handling Cooking Refrigeration Vaccination

Salmonella typhi Epidemiology Source Carrier’s feces Transmission Contaminated food/H2O Pathogenesis Invade GI spread to LN, Liver, GB Shed bacteria in feces: 3mos Abdominal pain, anorexia Disease Typhoid fever Dx: Culture blood, feces; Serology Tx: AB Prevention: Food handling Isolation of infected individuals Vaccine for high risk individuals

Shigella Characteristics Examples GNR Nonmotile FA (-): urease, oxidase Examples S. dysenteriae S. flexneri S. boydii S. sonnei

Shigella Location GI pathogen Epidemiology Source: food/water contamination with feces Transmission Fecal-oral 4 F’s food fingers feces flies

Shigella Pathogenesis Multiply in colon mucosa Disrupt phagosome membrane and invade Toxins Exotoxin: Shiga Toxin Endotoxin Disease Diarrhea: water, blood, mucus Shigellosis dysentery Ulcerate colon Dx: Isolates, biochemical tests, serology Tx: fluid support, AB Prevention Hygiene Sewage treatment

Yersinia Characteristics Location Epidemiology Agents GNR GI of animals Endemic (in West Texas) Epidemiology Food/H20 contamination with feces Direct contact Indirect: inhalation Vector: flea bite Agents Y. enterocolitica Y. pseudotuberculosis Y. pestis

Yersinia Pathogenicity Pathogen YOPS outer membrane proteins Prevent phagocytosis Plasmid virulence factors Adhesins Type III secretion systems Trigger apoptosis PMN MO

Yersinia Diseases Gastroenteritis (Y. enterocolitica) SI Mesenteric LN Plague (Y. pestis) Bubonic (LN) Pneumonic (Lungs) Dx: Blood ID, culture, PCR Tx: AB Prevention: control Rodent Flea Vaccination Isolation of infected persons

Plague life cycle Reservoir Vector: Flea Hosts Cycle Rats Mice Voles Amplify Prairie dogs Rabbits Deer Dogs/Cats Cycle Flea bite Exposure to infected animals

Bubonic Plague Lymphadenopathy Bacteremia DIC S.C. Hemorrhage Gangrene “Black” Death

Pneumonic Plague Lungs Bloody sputum Dyspnea Respiratory droplet

Alpha, Beta, & other Gamma proteobacteria Aerobic GNR Groups Alpha Bartonella Brucella Beta Bordetella Burkholderia Gamma Pseudomonads Pseudomonas Moraxella Acinetobacter Francisella Legionella Coxiella

Alpha Proteobacteria

Bartonella Characteristics Location: animals Vectors: insects Examples Aerobic Location: animals Vectors: insects Examples B. bacilliformis B. quintana B. henselae

Bartonella Diseases Bartonellosis Trench fever Bacillary Sand flies RBCs invaded Trench fever Lice Bone pain Bacillary Angiomatosis Peliosis hepatitis Cat-Scratch fever fleas Cat nails, teeth LN and abscesses

Brucella Characteristics Location Pathogenicity Examples coccobacillus Intracellular parasite Animal hosts Pathogenicity Prevent phagolysosome Examples B. melitensis B. abortus B. suis B. canis

Brucella Epidemiology Disease Tx: AB Prevention Unpasteurized dairy Animal blood / urine Reproductive organs Disease Undulant fever (Bangs) Tx: AB Prevention Animal vaccination

Beta Proteobacteria

Bordetella Characteristics Location Examples Aerobic GN coccobacillus B. pertussis B. parapertussis B. bronchiseptica

Bordetella Epidemiology Pathogenicity Disease: whooping cough Inhaled aerosols Inhibit ciliary action Pathogenicity Adhesins Toxins Pertussis Adenylate cyclase Dermonecrotic Tracheal Disease: whooping cough Prevention Hygiene Vaccination (DPT)

Burkholderia Characteristics Aerobic Flagella Location environmental Opportunistic: Lungs Joints Skin Diseases Meliodosis Glanders Example Burk. cepacia Burk. mallei Burk. pseuodomallei

Gamma Proteobacteria

Pseudomonads Characteristics Location Examples GNR aerobic Environment: soil Moist areas opportunistic Examples Pseudomonas Moraxella Actinobacter

Pseudomonas aeruginosa Pathogenicity Fimbria= biofilms Adhesins Enzymes Neuraminidase elastase Capsule ROS Drug Antiports Toxins Endotoxin: Lipid A Exotoxin Exotoxin A Exoenzyme S

Pseudomonas aeruginosa Diseases Bacteremia Endocarditis UTI CNS GI M/SK Burn Resp

Moraxella catarrhalis (formerly Branhamella sp) Characteristics Aerobic Short bacilli Disease Opportunistic URTI Ears Sinusitis

Acinetobacter Characteristics Location Diseases Aerobic Short bacillus Soil Water Sewage Diseases Opportunistic URTI UTI CNS Endocarditis

Francisella Characteristics: GNR Agent: F. tularensis Epidemiology Animal reservoirs (rabbits) Transmission Vector bite (tick, fly, mosq) Direct contact with infected tissue Inhalation Pathogenesis Ulcer Enlarged LN Disease Tuleremia Dx: Culture, PCR, FlorescentAb/Agglut Tx: AB Prevention Vector control Vaccination

Francisella tularensis Characteristics Aerobic Coccobacillus Location Water Intracellular parasite Epidemiology Zoonotic Bite mosquito, fly Tick feces Infected animal Rabbit muskrat Tularemia Pathogenicity Capsule Beta lactamase Disease LN buboes Resp: cough, pain Death

Legionella Source: environment Epidemiology Path Diseases Soil Water (A/C, showers) Epidemiology Airborne Chronic illness susceptible Path Cytotoxic protease Diseases Severe bronchopneumonia Pontiac fever Dx : Isolation, urine Ag Tx: AB Prevention clean environment Water chlorination

Legionella pneumophila Characteristic Aerobic Pleomorphic Location: water Epidemiology Intracellular parasite Inhalation of aerosols Pathogenicity Protozoa carry Exit pores Disease Pneumonia 2nd: GI, Urinary

Coxiella burnetii Characteristic Location Epidemiology Pathogenicity aerobe Location Intracellular parasite phagolysosome Epidemiology Hosts Avian Mammals Vector: Tick Pathogenicity Spore like infective body Human Disease Inhale infective body Q fever Acute Chronic

Pasteurellaceae Gammaproteobacteria Groups GNR Oxidase (+) FA Nonmotile Groups Pasteurella Haemophilus Bovine pneumonia

Pasteurella Characteristics GNR Agent: P. multocida Location Normal microbiotica in animals Oral Resp Exposure Animal bite Aerosol Pathogenesis Zoonotic Disease Humans Abscess Arthritis Animals Pneumonia Sepsis

Haemophilus Characteristics Location Examples GNR Pleomorphic MM parasite Examples H. influenza H. ducreyi H. aphrophilus H. parainfluenza H. aegyptius

Haemophilus influenzae Pathogenicity Capsule K antigen Various strains Disease Meningitis Infantile arthritis Cellulitis Epiglottitis Ocular and Aural (OM) Sinusitis URTI (bronchitis. Pneumonia) Tx: AB Prevention vaccination

Haemophilus parainfluenza Characteristics Epidemiology Component of dental plaque Pathogenesis Disease POD Valvular endocarditis Dx

Haemophilus aegyptius Purpuric Fever South America Children Disease Conjunctivitis  N/V/D  Shock  Death

Haemophilus ducreyi STD Pathogenicity Disease toxin Genital ulcer (chancroid)

Vibrios Vibrio Campylobacter Helicobacter

Vibrio Characteristics GNR Agent: V. cholera Epidemiology carriers Fecal contamination Water Food Pathogenesis Serotypes: O1 and O139 Adhere to intestinal mucosa Toxin: Choleragen (from bacteriophage) Subunit A Activates adenylate cyclase Hypersecretion of Cl- and H20 Subunit B Binds to intestinal receptors Disease Muscle cramps Profuse diarrhea Circulatory shock and collapse Dx: culture of feces, Agglutination Rxn Tx: supportive; AB Prevention: water sanitation

Proteobacteria Epsilon Campylobacter Helicobacter

Campylobacter Characteristics GNR, curved Capnophile Agent: C. jejuni Epidemiology Source GI animals Birds Cattle Water Transmission Contaminated water Undercooked food Contact with infected animals

Campylobacter Pathogenesis Invades SI Exotoxin (similar to cholera toxin) Disease Gastroenteritis and ulceration Bloody watery diarrhea Endocarditis Septic arthritis Meningitis Dx: Culture and Isolation Tx: Supportive, AB: erythromycin Prevention: Hygiene Proper food handling Pasteurization Cooking of meat

Helicobacter (Campylobacter) Characteristics GNR Agent: H. pylori Epidemiology Gastric mucosa (mucus) Food-water: person-person Pathogenesis Adhesins: Fimbria Enzymes Urease Proteases Phospholipidase Cytokines Toxins: cytoxins Diseases Gastritis Peptic ulcers Gastric cancer Dx: Gastric biopsy  culture Tx: Peptobismol Metronidizole Beta lactam AB Prevacid

Anaerobic GNR Bacteroides Prevotella

Bacteroides fragilis Characteristics Location Epidemiology GNR Pleomorphic anaerobic Location Normal GI microbiotica Epidemiology 85% of GI disease Pathogenicity Fimbria Capsule Inhibit lysosomes Disease Peritonitis (ruptured GI) Pelvic Abscesses Wound necrosis

Provotella Characteristic Location: normal flora GNR anaerobic Location: normal flora Urogenital Respiratory Epidemiology: opportunistic Pathogenicity Adhesins Antiphagocytic capsules Proteases Disease Sinusitis OM POD PID

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