B03

Microbiology

Form
[Common characteristics of Enterobacteria] 4. aerobes or facultatively anaerobes [Common factors for Enterobacteria] 4. sequestration of growth factors (iron obtaining)
1. mostly Gram negative 5. generally lack cytochrome C oxidase 1. endotoxin (lipid A) 5. resistance to serum killing
2. no endospore, partially flagellate motile 6. fermentation of glucose, forming acid+(gas) 2. capsule (part) 6. antimicrobial resistance
3. simple growth requirement 7. reduction of nitrate 3. antigenic phase variation 7. type 3 secretion system (part): protein host cell
membrane ruffling

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1. Gram 1.Endotoxin: Lipid A (LPS) 1. endogenous exogenous 1.

2. Falculative anaerobic 2.Adhesions: P pili & Type 1 pili 2. bacteremia( ) ascending infection, neonatal genome 2.
3. Oxidase negative 3.ETEC enterotoxin:
a. heat stable (STa, b) meningitis( 3.
4.
5. EPEC, EHEC, EAEC, EIEC, ETEC b. heat labile (LT-I, II) (cholera toxin) 3. 4.
4.EHEC EAEC a. EPEC: pedastalike structure (A/E)
Shiga like toxin
(Stx-1, 2) (HUS)
b. EHEC(O157, H7): hemolytic uremic syndrome(HUS,
5.Drug resistance: MDR, XDR, PDR
Escherichia coli ) 28s rRNA
6.Extended spectrum beta-lactamase
7.Carbapenemase. Ex:NDM-1 c. ETEC: travelers diarrhea; LT(heat labile ) or
ST(heat stable) cAMP
d. EIEC: phagocytosis
e. EAEC:
f. Shiga-toxin-producing E. coli(O104:H4): EAEC Shiga toxin
gene HUS gastroenterist 2011

1. Gram 1. Endotoxin: Lipid A (LPS) 1.S. typhi & S. paratyphi asymptomic colonization [ ] 1.
2. Falculative anaerobic 2. Acid tolerance response gene (ATR gene) (S. typhi) 2.Microfold cell Salmonella (membrane ruffling) macrophage 1. 1 2. (S.typhi & S.
Salmonella 3. Oxidase negative
3. ( S. enterica):prostaglandin, cAMP 2. 3 4 stool paratyphi)
enterica 4. S. typhi S. paratyphi 3. Living in macrophages (S. typhi) 4.Bacteremia( ): culture 3. (S.typhi),
5.Enteric fever (S. typhi): 3. selective medium 4.
5.
Salmonella typhi 6. 5. S. enterica
6. S. typhi

1. Gram 1.Endotoxin: Lipid A (LPS) 1. Self-limited Stool+selective medium 1.

2. Falculative anaerobic 2.Genes for adhesion, invasion & intracellular replication 2. Gastroenteritis( )Shigellosis
3. Oxidase negative 3.Shiga toxin (A-B exotoxin) 3. 1-2 (water diarrhea) (abdominal cramps) 2.
Shigella 4. (tenesmus)
dysenteriae 5. 4. Shigella dysenteriae
6. S. dysenteriae for most severe infection 5. HUS( ) hemolytic colitis( )
7.
6. (asymptomatic carriage)

1. Gram 1.Endotoxin: Lipid A (LPS) 1. Y. pestis: (Bubonic plague) (Pulmonary (4) 1.

2. Falculative anaerobic 2.Capsule(Yersinia pestis): plague) Yersinia enterocolitica Y. pestis :
Yersinia pestis 3. Oxidase negative 3.Genes for adhesion, cytotoxic activity, phagocytosis & 2. Sepsis( ): ;
4. Yersinia enterocolitica engulfment inhibition, platelet aggregation inhibition 3. Yersinia pestis ( !!) Y. enterocolitica :
5. Yersinia pestis protein capsule
4. Y. enterocolitic prostaglandin, cAMP 2.
Yersinia
enterocolitica 3.
6. (zoonotic infection)
4.

1. 1. ESBL (Extended Spectrum -lactamase): only in G (K. [ ] 1. penicillin

2. Endogenous infection( pneumonia, E. coli) 1. Klebsiella pneumoniae
)
2. ( ) 2. 30
Klebsiella
pneumonia 3. (pyogenic liver abscess,PLA)
4. (1%) (5%)
5. Septic shock( )
[Common properties of Mycobacterium ] [Classification]
1. Gram +, acid-fast (mycolic acid: Mycobacterium>Nocardia>Corynobacterium) 1. Tuberculous Mycobacteria (TB) (tuberculosis & bovis (used in BCG))& non-tuberculous Mycobacteria (NTM)
2. non-motile 2. Growth rate:
3. (doubling time: 12~24 hr) a.Slow (over 7 days): TB, Group,, of NTM
4. b.Rapid (under 7 days): Group of NTM
c. Non-cultivable: Mycobacterium leprae
5. High C+G content of DNA (61~71%)
3. Runyon classification (NTM): -photochromogens( ), - scotochromogens( ),- nonchromogens( )

Runyon classification NTM NTM

Group I (photochromogens)
Group II (schotochromogens)
Group III (nonchromogens)
Group IV (rapid growing)
MAC, M. kansasii: Tap water; airborne
M. kansasii( ), M. marinum M. marinum: Salt, fresh water ; swimming pool ( swimming poolgranuloma)
M. xenopi: Hot water; hospital heating tank
M. gordonae, M. scrofulaceum M. simiae: Tap water
M. genavense: Dogs, pet bird (psittacine birds)
M. avium complex (MAC slow grower ), M. haemophilum Rapid growers: Tap or distilled water, dialysate; nosocomial
M. chelonae, M. fortuitum, M. abscessus

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1. Gram ghost 1. 1. 1. Tuberculin Skin Test(TST): (NTM, BCG ) 1.
2. a. 2. IGRA: INF- 2. 10
Mycobacterium 3. b. 3. 3.
tuberculosis 4. 2. 2. CNS isoniazid, rifampicin, ethambutol, pyrazinamide
5. ( !!) 3. (10%) 4. (L-J medium) (3-8 week) 4. MDR-TB INH RMP
6. 3~5% & XDR-TB fluoroquinolone
7. : ( ) ,macrophage , 5% 5. X 0.3%

Mycobacterium 1. [Hansens disease] 1. 1. Rifampicin dapsone

leprae 2. 1. (Tuberculoid Leprosy): delayed hypersensitivity2. Skin testing 2. clofazimine 12
2. (Lepromatous Leprosy): hypergammaglobulinemia 3.

[Common properties of Corynebacterium ] 3. Catalase positive

1.Gram +, non-acid-fast 4. Ferment carbohydrates to lactic acid
2.Aerobic, non-spore-forming, high C+G content, non-motile 5. Meta-chromatic granules
Corynebacterium Mycobacterium Mycobacteriaceae

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1. Gram + bacilli 1. Exotoxin DTxR Tox protein leader sequence 1. 1.Anti-toxin

Corynebacterium 2. a. A: catalytic EF-2 ADP-ribosylation 2.Exotoxin HB-EGF receptor 1.Smear and stain (Gram or acid- 2. (penicillin, tetracycline & erythromycin)
diphtheriae 3. b. B: receptor-binding & translocation fast)
arabinose, galactose, mannose
2. 2. (Loeffler's agar...)
cord factor mycolic acid 3. Pseudomembrane: local 3. Formaldehyde-inactivated
3. 3.Toxigenicity test:
4. tox structural gene phage lesionnecrosisfibrin network + bacteria subunit DPT
4.Schick test: toxin
5. Meta-chromatic granules 4.

Legionella 50

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1. coccobacilli, Gram [ ] [Legionellosis] (legionnaire's desease + pontaic fever) 1. BCYE agar 1.Macrolides
2. 15 serotypes, type 1 ( 50% ) 1. L-cysteine 35~37 3~5%CO2 tRNA
3. 2. 35~37 , 55 ; pH6~8 [ Legionnairesdesease ](<5%) 2. (3~5 Days) 2.Fluoroquinolones
1. ,mortality: 15~20% DNA
4. [ ] 3.
2. 3.
5. 1. [ ]
Legionella 3. 4.
6. 2. 1. Culture assay: 80~90%
pneumophila 4. [ ]
7. 3. 2. DFA:
[Pontiac fever](>90%) 1.Hyperchlorination: 25ppm [Cl2]
[ ] 3. Urinary Antigen tests: serotype 1
1. , fatality: <1% 2.Superheating: 65
LPS 4. IFA: (4 >1:128 3.Copper-silver ionization
2. 3 5

[Common properties of Rickettsiaceae (Rickettsia, Orientia)] 3. DNA, RNA, Kreb's cycle enzymes ribosomes
1. Aerobic, Gram - 4. Energy parasites: ATP glycolysis ATP
2. Small, Gram stain Orientia peptidoglycan, Rickettsia peptidoglycan ,
5. binary fission
[Common properties of Bacillaceae ]
1. Gram positive
2. Endospore-forming
3. Bacillus: aerobic or facultative anaerobic ( )
ium : Strict anaerobic( ), cannot reduce sulphate to sulfite

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1. adherent colony 1. Protective antigen (PA): receptorEF/LF 1. Inoculation , Ingestion & Inhalation 1.
2. Non-hemolytic endocytosis 2.Wool-sorters disease endospore ! 2. ciprofloxacin, doxycycline,
3. pXO1 2. Edema factor (EF): adenylate cyclase 3.Anthrax: erythromycin or chloraphenicol
Bacillus 3. Lethal factor (LF): zinc-dependent protease a. Cutaneous: painless papule, ulcer (leads to eschar), lymphadenopathy, edema
4. AH 3.
anthracis b. Gastrointestinal: same as above plus sepsis
5. MAPK macrophage TNF-, IL-1
4. PA+EF=Edema toxin (EdTx) c. Inhalation: 2 3 spore macrophage mediastinal lymph nodes X
6. capsule, macrophage, 50% meningeal symptom
5. PA+LF=Lethat toxin(LeTx)
7. Wool-sorter's disease 6. Capsule: antiphagocytosis

Enterotoxin: Gastroenteritis 1.
2.
Form: Emetic Diarrheal 3.
4. vancomysin, clindamycin,
Food (starch) ciprofloxacin, gentamicin

Incubation time <6 (2) spore >6 (9)

Bacillus cereus
Symptoms

Duration 8-10 (9) 20-36 (24)

Enterotoxin Heat stable Heat labile (stimulates adenylate cyclase)

Ocular infection:
1. necrotic toxin, cereolysin & phospholipase C
2. Bacillus panophthalmitis 48 hr

1. 12 1. Soft tissue infection: 1.

2. spore 1. toxin phospholipase C a. cellulitis: 2. penicillin
3. blood smear toxin toxin b. suppurative myositis:
Clostridium c. myonecrosis:
perfringens 4. A~E type 2. toxin
2. Gastroenteritis
Type A: toxin
a. food poisoning:(A)
Type C: toxin
b.necrotizing enteritis:(C)

1. (2~18 um) ( ) 1.Tetanospasmin: 1. (spastic paralysis) risus sardonicus, opisthotonos 1. 12 1.

spore a. 2. Tetanus: ( ) 2. Metronidazole
Clostridium 2. b. Heavy chain: motor neuron sialic acid receptor a. Generalized: 2. 3. (tetanus toxoid) 10
tetani c. Light chain: zinc endopeptidase b. Localized:
GABA, glycine c. Cephalic: 70%
2.Tetanolysin: d. Neonatal: spore 90%

1. A~G botulinum toxin A, B, E , Botulinum toxin: 1. (flaccid paralysis) 1. 1. 4

F 1.Heavy chain: receptor 2. Botulism: 2. 60~100
2. spore 2.Light chain: SNARE Ach a. Food borne: 2. , 3.
Clostridium
botulinum 3. Pathogenic strain lipase b. Infant: 4. Trivalent (A, B, E) botulinum
c. Wound: food borne antitoxin
d. Inhalation:

1. 5% 1.Enterotoxin (toxin A): chemotaxis, breaks tight 1. Antibiotic associated diarrhea cytotoxin 1. endogeneous infection:
Clostridium junction, causes hemorrhagic necrosis
2. endogeneous infection 2. Pseudomembranous colitis: diarrhea enterotoxin 2. metronidazole vancomycin
difficile
2.Cytotoxin (toxin B): pseudomembrane
3. spore exogenous infection 3.
[Common properties of Neisseriae] 6. Aerobic ( )
1. Gram negative 7. Non motile
2. Dplococci 8. Fastidious ( )
3. Oxidase positive (TMPD test) Catalase positive 9. Encapsulated (Pathogenic strain)
4. Most produce catalase 10.Produce acid from oxidation of carbohydrates( )
5. Non endospore-forming 11.pili

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1. Gram 1. Pili (adhesion, prevents neutrophil killing) 1. Gram stain of urethral 1.

2.oxidase + (TMPD test) 2. Membarne proteins: [ ]urethritis [ ] specimens 2.
3.catalase + a. porin proteins (Por) 1. suppurative arthritis 2. Culture:
1. 3.penicillin, tetracycline, erythromycin,
4. (anti-phagolysosome) a. pre-warmed to 35~37
b.opacity proteins (Opa) (adhesion, localized 2. 2. aminoglycosides !
5. capsule capsule 3. Fitz-Hugh-Curtis syndrome b. 5 10% CO2
infection) 3. 95% 4. Ceftriaxone
6. (perihepatitis) c. chocolate agar(
c. Rmp proteins ( IgG, IgA1 IgG3) [ ]cervicitis 5. Chlamydia( )
Neisseria 4. )modified Thayer-Martin medium
7. (stratified squamous) ( !!) 3. Lipooligosaccharides (LOS) Azithromycin Doxycycline
gonorrhoeae 1. 3. NAAT (nucleic acid
8. 50% 20% (no O-antigen, lipid A as endotoxin, TNF-
inducing) 2. amplification test)
9. 4.
4. Tbp1, Tbp2 & Lbp, Hbp 3.
10. autolysis: 4
(binds transferrin, lactoferrin, hemoglobin) 4. ( )
11.Pili is highly variable( ) 5. IgA protease
(IgA1 H chain destruction)
6. -lactamase

1. 1. Fimbriae: colonization on nasopharynx 1. Meningitis 1. Gram stain : CSF 1.

2. 2. phagocytic vacuoles 2. Meningococcemia: (skin rash /purpura DIC (CSF: ) 2.
3.13 serogroup A, B, C( 90% ), 3. Capsule (anti-phagocytic, opsonization) ) 2. 3. Penicillin( ), ceftriaxone & cefotaxime
W135, Y(10%) 4. Lipooligosaccharides(LOS):endotoxin a. 5 10% CO2 4.
*Waterhouse-Friderichsen syndrome( )
Neisseria 4.Capsule swiching
meningitidis 3. Pneumonia b. culture pre-warmed to
5. 4. Arthritis 35~37
6. 5. c. chocolate agar ,

7. Meningitis Belt blood agar modified
8. Thayer-Martin medium
3. PCR

[Common properties of Staphylococcus] 3. Catalase positive

(S. aureus( ), S. epidermidis( ), S.saprophyticus) 4. Facultative anaerobe Oxidase-negative
1. Respiratory tracts, open wound, 5. 10% 18~40
2. Gram positive, , Non motile 6. Toxic shock syndrome, , bacteremia,

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1. coagulase positive Structural components : S. aureus: (SSSS) 1. Gram stain 1. Methicillin (Methicillin-resistant S.
2. carotenoid 1. Capsule (adhesion, anti-phagocytic) TSS 2. PCR aureus: MRSA)
3. 2. Peptidoglycan (penicillin-binding, endotoxin-like) 3. Culture 2.
3. Teichoic acid (adhesion to fibronectin, species-specific) S. saprophyticus: 4. Biochemical test: Enzyme test,
4. 3.
4. Protein A (bind Fc of IgG) Mannitol-fermentation test S.
a. S. aureus 5. Clumping factor (Bound coagulase, fibrinogen) 4. Vancomycin
aureus
, ferments Toxin : 5. FISH
mannitol 1. Cytolytic/membrane-damaging: ( ), (phospholipid ), , , 6. Anti-biograms S. aureus
Staphylococcus b.S. epidermidis
leukocidin + penicillinase
aureus , doesn't 2. Exfoliative (serine protease, breaks desmosome): ETA, ETB 7. Chemical profiles
ferment mannitol Superantigens (bind TCR):

1. Enterotoxin (8 ):
a. Food poisoning CNS effect
b. 10030min
2. Toxic shock syndrome toxin 1 (TSST-1): proteolysis
Enzymes: coagulase, catalase, hyaluronidase, fibrinolysin, lipase, nuclease (
), -lactamase
 Vibrio, Campylobacter, Helicobacter

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1. Gram Cholera toxin (A-B) Secretory diarrhea ( osmotic, ) 1. 1.

Vibrio cholerae
ctxBB: cell adhesion
2. (polar flagella) infection dose 2. 2.
ctxAA: toxin subunit, excessive cAMP
3. production (A1 binds NAD) 3.
[ ] 4. Oxidase + [ cholera] [ ]
A:B=1:5 4.
O1, O139 5. 1. cholera stool>
6. Pathogenicity islands(PAIs), 2.

Vibrio 1. Gram Kanagawa hemolysin 1. Gastroenteritis 1. 3.

parahaemolyticus 2. 2. 2.
3. 4.

1. Gram 1. Capsule 1.
Vibrio vulnificus 2. Hydrolytic enzymes
2. 2. sepsis
3. 50%

1. Gram 4. CapsuleGuillain-Barr syndrome 1. 5%O2 10%CO2 1.

Campylobacter jejuni 2. 5. (autoimmune): oligosaccharides 2. 2.
3. 6.infectious dose glycosphingolipids 3. Guillain-Barr syndrome: 3.
(Polyradiculoneuropathy)

1. 4~6 Gram 1. Urease (anti-acid) 1. 1. 1.

2. 2. Flagella (penertration) 2. 2. 2. combined therapy( ):
Helicobacter pylori 3. virulence factor a. Proton-pump inhibitor: omeprazole
3. urease 3. 3.PCR tetracycline, clarithromycin,
b.
4. 4. (antibody) (antigen) amoxicillin, metronidazole)
[2005 Nobel prize] B.J. Marshall & J.R. Warren 5.C-13 urea breath test 3.

[Common properties of Glucose-Nonfermentative Gram-Negative Bacilli (NFGNB)]

1. 2. 3. 1. Saccharolytic: citric acid TCA 2. Nonsaccharolytic:

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1. Gram 1.Capsule (alginate, mucoid appearance) [ ] 1. Cytochrome oxidase +

2. 2.Pili (adhesion) 1. 2. 2-aminoacetophenone: grape-like 1.
3.LPS (endotoxin) smell
3. Polar, monotrichous flagellum a. 2.combined antibiotics (aminoglycoside & -lactam
4.Pyocyanin (blue pigment, produces oxygen 3. Produce pyocyanin (blue) and
4. Cytochrome oxidase + b. cystic fibrosis, neutropenia colonize antibiotics)
Pseudomonas radicals, stimulates IL-8 secretion) pyoverdins (yellow, fluorescent
5. natural antibiotic resisitance
aeruginosa 5.Exotoxin: protein synthesis inhibition, 2. under UV)
immunosuppression 4. Arginine dihydrolase +
3.
6.Enzymes( ): elastase, alkaline protease, 5. Growth at 42
4. (swimmers ear)
hemolysin
7.Biofilms: 5.
6.

1. Gram [ ] 3. 1.combined antibiotics (aminoglycoside & -lactam

Acinetobacter 2. Cytochrome oxidase - 4. CSF antibiotics)
1.
baumannii 3. 2.in vitro susceptibility tests
4. 2. 5.
5.

Stenotrophomonas 1. ( imipenem)
maltophilia 2.

Burkholderia cepacia [ ]
complex (cystic fibrosis )/ aminoglycosides & polymyxins resistance

1. saprophyte [ (melioidosis)] 1. polymyxin B resistance

Burkholderia 2. 1. 2.
/
pseudomallei
3. oxidase + 2. 3. bipolar staining

1. 1. Oxidase +
Moraxella 2. Nonmotile, Gram ( Neisseria spp. )
3. Oxidase + 2.
catarrhalis
4. -lactamase
[Common properties of Rickettsiaceae (Rickettsia, Orientia)] 3. DNA, RNA, Kreb's cycle enzymes ribosomes
1. Aerobic, Gram - 4. Energy parasites: ATP glycolysis ATP
2. Small, Gram stain Orientia peptidoglycan, Rickettsia peptidoglycan ,
5. binary fission

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1. Spotted fever group 1. (hard tick) ( Rocky mountain spotted fever 1. Giemsa or Gimenez stain 1.
2. RH AH reservoir) 1. 90% 4~10 2. 2. Doxycycline, fluoroquinolones
Rickettsia rickettsii
3. Actin-based motility, long cytoplasmic 2. transovarian transmission 2.Centripetal spread rash 3. ( ) PCR 3.
projections 3. endothelial cell 3. 4. MIF test
4. CD8 T cell DEA, MIF, PCR: genus
Western blot: species
1. Typhus group 1. (louse) 1. Epidemic typhus: 1. 1.
Rickettsia prowazekii 2. primary reservoir 2. Body louse centrifugal spread rash 12 2. MIF test 2.
3. 3. transovarian transmission 3.
actin tail 4. endothelial cell 2. Recrudescent disease
3. Sporadic typhus: squirrel fleas

1. Typhus group 1. (reservoir) (flea) Endemic typhus:

2. 2. endothelial cell
Rickettsia typhi
3. 3. [scrub typhus]
actin tail 1. 9 12
2.
3. 4~10 (20~29 )

1. Scrub typhus group 1. (mite) (larval stage) 1.

Orientia tsutsugamushi
2. 2. 2. Rash
3. peptidoglycan LPS
4. long cytoplasmic projections

[Common properties of Streptococcus] [Classification]

1. , Gram positive, Non motile 4. 1. Serological properties: C (group A~H, K~M, O~V)
2. Facultative anaerobe: 5. 2. Hemolytic patterns: ( ), ( ), ( )
3. Catalase negative ( Staphylococcus ) 6. 3. Biochemical, physiological properties:

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1. Group A Capsule (anti-phagocytic) 1. Suppurative diseases: 1.
2. -hemolytic Surface proteins: STSS 2. PCR Penicillin
3. Peptidoglycan cell wall 1. M (I & II): anti-phagocytic ( C3b), adhesion 3. Culture
2. M-like: anti-phagocytic ( ), binds IgM, IgG 2. Nonsuppurative diseases:
Streptococcus 4. Bacitracin test: 99% group A bacitracin
3. T ( trypsin), F ( fibronectin), Lipoteichoic acid (adhesion)
pyogenes Toxin: Streptococcal Pyrogenic Exotoxins ( phage , superantigens) 5. Immunological detections: (ASO)
Enzymes:
1. Leukocidins: ASO test
(a) Streptolysin S: O2 (b) Streptolysin O: O2
2. Streptokinase (A,B): Plasmin fibrin anti-streptokinase test
3. DNase (A,B,C,D,): anti-DNase B test
4. C5a peptidase: degrades C5a
1. Group B 1. 1.
Streptococcus 2. 9 serotypes: Ia, II, III~VIII 2. 2. CAMP test: CAMP factor S. aureaus Penicillin
agalactiae 3. -hemolytic streptococcus
a. early-onset: (60%) sphingomyelinase C -hemolysis
3. Hippurate hydrolysis test
b. late-onset:
4. PCR

1. Viridens group ( S. mutans, ) 1. Hydrogen peroxide: H2O2 1. Penicillin

Streptococcus 2. -hemolytic; Diplococci( ); Capsule 2. Peumolysin: ciliated epi., C5a 2.Optochin-sensitivity test
pneumoniae 3. Bile salt solubility test:
3. Amidase: 3. Teichoic acid, Peptidoglycan fragment: C3a
4. optochin 4. Phosphorycholine: 4. Amidase: colony

5. 5. Capsule, Surface protein adhesins, Secretory IgA protease

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Enterococcus 1. Group D 1.Aggregation substance: Hairlike protein, 1.Optochin-sensitivity test: resistant Resistant to aminoglycoside, -
2. 2.Pheromone: Chemoattractant for neutrophils 2.Bile salt solubility test: lactams(penicillin ), even vancomycin
Small Gram Negative Bacilli

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1. Gram-, ( ), Non-spore-forming, [ Hib] 1. 1. Chocolate agar (heated blood agar; destroys V inhibitor) [ ]
(Satellite phenomenon; S. aureus)
Non motile 1. Adhesins(pili + others) 2. 1. PRP
2. CSF
2. 2. Cell wall respiratory epithelium 3. conjugated vaccine
3. PRP (particle agglutination, only HiB)
3. V & X factor endothelium 4. 2.Rifampin ( )
4. polysaccharide of capsule: 3. polyribitol phosphate (PRP) on the capsule 5. [ ]
Haemophilus a. serotype: a~f, b (1) (2) biofilm 6. 3. ampicillin 35%
influenzae b. ( )biotype: I~VIII 4. ( )LPS (lipid A): meningitis 7. 4. broad-spectrum cephalosporins
c. ( )biogroup: aegyptius 5. ( )Immunoglobulin A1 protease: 8.

[ ] Gram - [ ] 1. Nasopharygeal aspirate 1.

[ adhesin] 1. 7~10 2. 35 Regan-Lowe charcoal 2. 10 15
1. Pertussis toxin S2-S5 2. 1~2 medium 3.2000
2. Filamentous hemagglutinin ciliated cells leukocytes 3. PCR a. (6 )
[ toxin] 3. 2~4 4.
3. Adenylate cyclase 3 5. 4. erythromycin
4. Tracheal cytotoxin 6.
5. Pertussis toxin S1 Adenylate cyclase, cAMP 4. 3~4
Bordetella pertussis 6. ( )Dermonecrotic toxin, LPS [ ]
[ ] A-B toxin, both adhesion & toxin 1.
7. A: S1 unitexcessive cAMP production 2.
8. B: S2~S5 unitadhesion 3.

1. Gram - 1. 1. Cysteine-supplemented media 1.

2. Thin lipid capsule 2. phagosome cytosol 2. Ulceroglandular: tick ulcerate, EX: Chocolate agar
3. apoptosis bacteremia 2. tetracycline, chloramphenicol
[ ] [Infection dose] 3. Oculoglandular: 3.Penicilli cephalosporins
1. Low infection dose25 c.f.u. 1. Arthropod's bite: 10 4. Respiratory tularemia: 4.
30%
2. ( ) tick 2. Inhalation: 50
Francisella tularensis 3. Ingestion: 108
3. host
4. (2nd)
5. (P4 )

1. Gram - 1. 1. Brucellosis 1.Doxycycline, combined with rifampin & gentamicin

2. granuloma 2. erythritol 2. trimethoprim-
sulfamethoxazole
3. 2. reticuloendothelial system(RES)
Brucella abortus( ), 3.
4. Catalase & oxidase +
melitensis( ), 5. Urease + 3.
suis( ), 6. (3rd) ( !!)
canis( )
Spirochaetales [General structure]
1. Family Spirochaetaceae 1. Gram negative
a. Genus Borelia: relapsing fever, lyme borreliosis 2. Small(5~30m X 0.1~0.5m), 0.45m filter
b.Genus Treponema: venereal or non-venereal disease 3. Flagella: periplasmic, between peptidoglycan and outer membrane, high motility
2. Family Leptospiraceae
a. Genus Leptospira: leptospirosis

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1. Gram 1.Hyaluronidase (penetration) [ ] T. pallidum 1. 1.

Treponema spp. 2. 3 2.Fibronectin coated (anti-phagocytosis) 1. 1 (10~90 D 2~6 W) 2. 2. penicillin, tetracycline,
3.
4. 2. 2 (2~24 W ) 3. : reagin VDRL & RPR doxycycline
5. 3. 3 4. TPHA (hemagglutination) 3.
6. 5.FTA-ABS( ) ,RDT(fast)

Borrelia 1. Gram [ ] [ ] amoxicillin, doxycycline,

burgdorferi 2. 7 22 1. 1. IgM & IgG cefuroxime
3. toxin 2. (bull's eyes) 2.
4. 3.

Borrelia [ ] [ ] tetracycline, erythromycin

recurrentis 1. ( ) ( ) 1. blood smear
2. 2.

1. Gram 1. 1. Gram stain, 1. Penicillin

Leptospira spp. 2. Doxycycline
2. 2 2. ( ) Weil syndrome 2.
3. 3. PCR

4.

1. Eaton agent, PPLO 1.P1 adhesin protein: 1. 1. penicillin

Mycoplasma
2. 2. (IgM, IgG): 2. Erythromycin
pneumoniae
3. cholesterol 2. H2O2, O2 a.Complement fixation 3. Doxycycline
4. Strict aerobe b.Cold agglutinin
3. Mycoplasma
5. (24 hr)

Common properties of family Chlamydiaceae: Rickettsiaceae 3. anti-apoptosis pro-apoptosis

[ (2~3 )] 4. persistent stage
1. EB (3~400nm) phagosome RB 5. Inc protein phagosome phagolysosomal fusion ATP MOTC CPAF MHC
2. RB (8~1000nm) (phagosome (inclusion body) binary fission) energy parasites
ATP apoptosis EB

& &

[ ] 1. EB receptor: non-ciliated colum./cub./ 1. Trachoma: 1.

1. Biotype: Trachoma, LGV, mouse pneumonititis tran. Epithelium a. immune cells 1. 2.
2. Serotype (MOMP) 2. LGV b. (IL-11)
2. DFA, ELISA 3.LGV: tetracycline, macrolides,
1. (trachoma) c.
Chlamydia trachomatis 3. eye to eye 3. PCR sulfisozazole
2. 18-30 D~K types
A, B ,Ba, C: 3. D~K types 4.
4. Giemsa stain inclusion body( )
D~K: 4. azithromycin
5. Iodine stain: inclusion bodies
2. (LGV) 5. (STD) 25%, 80% 35~50% 5. erythromycin
6. Reiters syndrome + + cofactor HLA-B27 glycogen
L1, L2, L2a, L3:
7. LGV: macrophage ( 1~4 W)

Chlamydophila pneumonia 1. serotype: TWAR 1. 20~30 50% 1. HEp-2 cell line

2. RH 2. 2. PCR

1. [ ] 1. 45 chlortetracycline
Chlamydophila psittaci 2. HCl
3. reticuloendothelial cell 2. tetracyclines or
macrolides