Gram Positive Bacillus

Medically Important GPR

Bacillus Clostridium Listeria Erysipelothrix Lactobacillus Actinobacteria

Streptomyces Proprionibacterineae Corynebacterium Nocardia Mycobacterium

Bacillus anthracis Characterisitics

GPR FA Capsule Spore: central endospore Nonmotile

Reservoir, zoonotic Hoof stock (sheep, cattle, goats) Fur, hides (textile workers) Soil contaminated with spores

Virulence Capsule Spore Exotoxin (anthrax toxin)

Necrosis Edema

Protective Ag

Pathogenicity

B. anthracis diseases

Exposure Inhalation Inoculation Ingestion meat

Dz Gastrointestinal

Hemmorhage/death Cutaneous

Eschar/toxemia Inhalation

Toxemia/death

B. anthracis

Cutaneous Anthrax: Eschar

B. anthracis

Dx Culture/Isolation

Tx AB (cipro)

Prevention Vaccination (toxoid) Proper disposal

Chemical disinfection Burn carcasses

B. cereus Characteristics

Aerobic Non-encapsulated Motile spore

Virulence Spores Enterotoxins Hemolysins Lecithinase (pLC)

Dz Food poisoning Catheter sepsis Ocular infections

B. subtilis Location

Soil Decaying organic matter

Nonpathogenic Research organism

Endospores antibiotics

Commercial use Enzyme production Insect toxin

Fungicide Food spoilage

Clostridium

Examples C. tetani C. perfringes C. botulinum

Characteristics GPR Obligate anaerobes Motile Spore former (terminal) Exotoxins

C. perfringens Membrane disrupting toxin

(phospholipids) Alpha toxin (lecithinase)

Rupture RBCs Destroy Tissue

Enzymes Collagenase Hyaluronidase DNase CH2O fermentation Gas

Exposure Puncture wounds, fractures Surgical Contaminated food

Diseases Food poisoning

Improper cooking V/D

Gas gangrene Anaerobic cellulitis myonecrosis

Gas Gangrene

Treatment Debride AB Hyperbaric O2

C. tetani Epidemiology: saphrophyte

Soil Dust GI tract Wounds (deep)

Burns Umbilical stump Animal bites

A-B neurotoxin (exotoxin) Tetanospasm Blocks release of inhibitory NT

Glycine Relaxes opposing muscle Without: both muscle groups

contract Tonic Spasms

Localized (Lockjaw) Cephalic Generalized

Death respiratory failure

C. tetani Dx

Spores in wound Blood toxin levels Toxin neutralization test

Treatment Antitoxin (HTIg) AB Debride Curare poison

paralysis ventilator

Prevention Vaccination

Toxoid (DPT) Antitoxin

Tetanus neonatorum

C. tetani Umbilical cord infected

soil, dirt rubbed on stump Dirty instruments

C. botulinum Location

Soil Water Improper canning GI tracts of animals

Epidemiology Intoxication

Food borne Toxin (canned food)

Infant Ingestion of endospores Source: honey

Wound endospores

C. botulinum

Pathogenicity A-B neurotoxin

botulinum toxin 7 toxins A-G

Type A Proteolytic Heat resistant

Type B: both Type E

Nonproteolytic Heat labile

Bind to neuron prevent ACH from binding at NMJ Flaccid paralysis

Descending Death in 3-7 days

C. botulinum

Dx Culture/Isolation Symptoms

Tx Antitoxin AB: penicillin Ventilator

Prevention Proper food handling Boiling 10 minutes

Botox

Clostridium difficile

GI source Epidemiology

Long term care facilities Chronic AB use Fecal-oral route

Pathogenicity Toxins Spores

Diseases Colitis pseudomembrane Cecal perforation = fatal

Colitis

Actinobacteria

Suborder Actinomycinae Suborder Propionibacterineae Suborder Streptomycineae Suborder Corynebacterineae

Family Corynebacteriaceae Family Mycobacteriaceae Family Norcariaceae

Actinomycosis

Actinomycetes Characteristics

Anaerobic

Diseases Abscesses Sulfur granules Body cavities

Jaw Thoracic Abd/pelvic

Proprionibacterineae GPR Non motile, NSF FA to aerotolerant Catalase (+) Location

Skin GI Dairy (cheese)

Types P. acnes

Body odor Acne

Oil glands Acne vulgaris

Streptomycineae

Streptomyces Aerial hyphae, conidia Obligate aerobes Location:soil Problems

S.C infection Abscess Bone destruction

Use AB synthesis

Mycobacteriaceae

Examples M. tuberculosis M. leprae

Characteristics AF (mycolic acid) Aerobic Nonmotile, NSF

Reservoir = humans Transmission

Respiratory droplets

M. tuberculosis Slow growing TB

Pulmonary Nodular scars

Calcification T cells and macrophages

CT Tubercle

Caseous necrosis Disseminated (consumption)

Brain Bone Kidneys GI LN Skin

Disease stages Primary Latent Recrudescent

M. tuberculosis Virulence factors

Mycolic acid Decrease phagocytosis

Catalase Mycobactin

Chelates iron Dx

Culture/isolation of sputum Radiography of chest TB skin test (PPD)

Tx multi-drug Resistance Research: rDNA vaccine

M. Leprae (Hansen’s bacillus) Slow growing Epidemiology

Tropical environments (TX) Not readily communicated

Types Tuberculoid

Rash with plaques Nerve damage

Lepramatous (Leproid) Erythemia nodosum Neuritis Ulceration/bacteremia Skin appendage loss Treatment: AB

Corynebacterium C. diptheriae Characteristics

Club shaped Weakly AF Metachromic granules

Epidemiology Source: carriers

Cutaneous Fomites

Respiratory infection Aerosol Pharynx, LN, tonsils Pseudomembrane

Pathogenicity Diptheria toxin

A-B exotoxin A: Inactivates proteins B: attacks heart, NS

Neuraminidase Protease (Dipthin)

coryne = club shaped

C. diptheria disease Pseudomembrane

Pharynx and tonsils MM

Nasal Larynx External ear (OM) Conjunctiva Vulvo-vaginal

Complications (toxins) Edema Myocarditis Neuritis Cutaneous rash

C. diphtheria

Dx Pseudomembrane Metachromic granules

Tx Antitoxin AB

Prevention Vaccination (DPT)

Nocardia

N. asteroids Characteristics

Saprophyte (soil) Filamentous, branch Weakly AF

Transmission immunosuppressed

Dz Resp: resemble TB Skin: abscesses

Tx: AB

Lactobacillales (Lactobacillus) Characteristics

Coccobacillus FA – microaerophilic Lactic acid fermentation

Epidemiology Food: meat, dairy, fruit Environment: water

Uses Food production

Fermented vegetables Beverages: beer, wine, juices Milk products: yogurt, cheese

Problems Food spoilage

Listeria L. monocytogenes Characteristics

Soil, mammal gut Non caspule, NSF Motile [petrichous flagella] FA Catalase (+) Resist: Cold, pH, temp, salt, bile

Transmission Direct: neonate, uterus Vertical

Dz Food poisoning (dairy) Skin-> bacteremia-> endocarditis-

>NS Tx: AB Prevention

Cook foods Pasteurize dairy products

Food Safety

Erysipelothrix E. rhusiopathiae Characteristics

Saphrophyte Nonmotile, NSF microaerophilic

Epidemiology Water, sewage Animals

Pathogenicity: capsule Transmission: Fecal Disease

Macropapular rash Endocarditis Septicemia

Tx AB Animal vaccination (pigs)

Mycoplasmas

Characteristics Lack cell walls Pleomorphic (fried egg) NM FA-Obligate anaerobes

Examples M. genitalium M. pneumoniae M. hominis

Diseases Pneumonia Uritogenital infections

Wash your hands!