GRAM STAIN

PleoMorphs/coccobacilli
GRAM-POSITIVE (gram - RODS)
STAIN POORLY
GRAM-NEGATIVE 1. Moraxella
2. Actintobacter
3. Bordatella
4. Francisella
5. Brucella

COCCI
RODS ANAEROBIC TB!!!

COCCI RODS Bacteroides OBLIGATE INTRACELLULAR SPIROCHETES Mycobacteria sp. Mycoplasma sp.
CATALASE •Pleomorphic, Stain poorly, Easy to grow ATYPICAL PNEUMONIA
Breaks down H2O2 •Normal GI, oral flora
● Share an obligatory requirement to ●Helical shaped ● Small rods that Gram ● Lack a cell wall, completely
grow and multiply in eukaryotic cells Endoflagella produces
stain poorly (if at all) resistant to β-lactam antibiotics
to water and oxygen
●

Prevotella ● Stain poorly, but have G- cell wall ●Stain poorly, but have
niacin ● ACID FAST ● Require sterols for growth

●Cannot culture on semi-solid media

• Very small, Slow growing, fastidious, Normal oral flora Orienta- infects vascular Gram-negative cell wall ● Cell wall contains waxy ● Pleomorphic gained from the host

+ - Porphyromonas endothelium
Like Ricksettsia
mycolic acids
● Resistant to drying,
● Sensitive to environmental

conditions
•Very small, Slow growing, Fastidious chemical agents, ● Hard to grow in laboratory

• Normal (?) oral flora NO PG cell wall at ALL germicides ● Extremely fastidious

● Slow growing
Fried egg like colonies
ENTEROBACTERIACEAE
all ferment glucose and oxidase (-)
STREPTOCOCCI/ENTEROCOCCI SPORE-FORMING Neisseria Acinetobacter Moraxella Chlamydia & chlamydiophila sp. Coxiella sp.
STAPHYLOCOCCI Anaerobes that are gram NON SPORE-FORMING DIPLOCOCCI
ciprofloxacin is effective in Atypical Pneumo
positive. Cannot make their own ATP Zoonoses
● Grows best in chocolate ● Classically considered ● Classically considered to be treating UTI and GI infections ● ●

agar of 5% CO2. to be Gram-negative Gram-negative rods, but have have LPS, no PG, NEED ATP FROM HOST ● Extremely infectious
Clostridium ● Chocolate agar or Thayer-
rods, but have coccobacillary appearance NON-ENTEROBACTERIACEAE PREVENT THE FUSION
● Acquired by inhalation

Martin agar (chocolate agar ● Resemble Neisseria

COAGULASE coccobacillary do not ferment glucose
Lactobacilis plus antibiotics often used appearance ● Sinusitis Ox+ and Cat + BUT not a Ehrlichia sp. & Anaplasma sp. Atypical Mycobacterium
PMNs
Binds fibrinogen to form fibrin Actinomyces to inhibit growth of normal ● Resemble Neisseria
fermenter. Strict Aerobe
MacConkey agar Monocytes
Mycobacteria avium
flora and nonpathogenic ● Nosocomial infections STRICT AEROBE, ● Coxiella burnetti
AEROBIC ANAEROBIC Strep Pneumo neisseria key differentiating factor
Lactose is sole carbohydrate. If ferments lactose,
Pink or red colonies. If it does not ferment lactose,
● Arthropod-borne ● Causes Q fever
interstitial pneumonia
Mycobacterium leprae
+intracellulare (MAC)
Grows on blood agar Infect leukocytes
BILE ESCULIN AGAR ● ●

peptostrep ● Oxidase-positive Green or transparent. ● Transmitted via inhalation

Typical Pneumo (3rd)
● Obligate intracellular
Bile salts inhibit growth of G+ ● Ferment glucose Catalase + NO PG/LPS of contaminated particles Mycobacterium kansasii
organisms except Group D Streptococci
and Enterococcus. Esculin is hydrolyzed
OXIDASE - Giemsa Stain Rickettsia sp. ● Phagocytosed by alveolar infections prevelent in
macrophages
to produce a black precipitate. 2 forms, reticulate or Vascular endothelim immunocomprised people
Bacillus sp. Clostridium sp. AEROBIC
● Resides and multiplies
+ -
Arthropod-borne tick
●
elementry
ANAEROBIC ● Rickettsia rickettsii causes
within fused

Found in soil and

Exotoxin N. meningitidis Rockey Mountain Spotted
phagolysosome
Exotoxin ●Found in soil ●
-Lecinthinase/PLC- gas gangrene can now grow on Axenic agar
Anthrax
and water water and in human Fever Leptospira sp. causes flu-like symptoms
GI tract -Botulinum-Neurotoxins A-G G- diplococcus
● CAN REPLICATE within Nucleus do the Weill-Felix (neg=coxiella)
● Clostridium ● Encapsulated N. gonorrhea tightly coiled, have hooks on the end
Causes botulism (inhibits AcH Vaccine- not Thin PG layer
perfringens: normal for B.
● Oxidase +, catalase +, Oxidase +, Catalase + Lactose-fermenting Non-lactose fermenting obligate aerobes
Pink/red colonies Need Giemsa stain
skin flora in about
release utilize glucose and maltose, Ferments Glucose citrobacter-H2S producing Endemic typhi- rodent fleas-typhi
Borrelia sp.
doxycycline and ceftriazone
20% of healthy -Tetani- Tetanospasmin not lactose ● Serratia sp.Citrobacter
● Non-motile
treatment: Ceftriaxone Epidemic typhi- louse-prowzekii
individuals causes tetanus Enterobacter sp.
S. Aureus
Use Nafcillin (second generation penicillin)
Coagulase-negative STREPTOCOCCI ENTEROCOCCI ● Obligate anaerobe ● Causes meningococcal
●

● Eschirichia sp.
Arthropod-borne
●

ixodes tick
Blocks GABA/glycine release Lyme disease
●

Staphylococci meningitis, ● Klebsiella sp.

not motile, (klebsiella) Pathogens of the Zoonoses among others same vector for anaplasma and Babesia (parasite)
for treatment
● Normal flora, β-hemolytic
Lancefield antibodies bacteremia/sepsis Curved and spiral rods A successful opportunist
Lancefield Group D respiratory tract relapsing fever
● ●
●Causes many kinds of infections encapsulated Primary pathogens of animals
Normal flora, rarely cause classify groups antigen positive Treatment: Ceftriaxone or encapusulated
●Salt tolerant: poly-γ-glutamic acid
●
● Pasturella sp.
oxidase +, grow on microaerophiles
disease ● Hemolysis patterns help ● Normal GI flora
Penicillin G RED CURRANT JELLY ● Campylobacter sp. ● Pseudomonas aeruginosa #2Typical Pneumo
● Produces acid from mannitol Novobiocin sensitive ● Haemiophilus sp. coccobaccilus
● Staphylococcus epidermidis with identification ● Nosocomial infections second major cause of meningitis in E. coli common to ● Can have “gull wing” ● Oxidase-positive ● Coccobacillarychocolate/blood agar.
● MANNITOL SALT AGAR ● Normal, pathogenic, both
●
sputum. cause of noso appearance Motile, β-hemolytic
MCC ● Fastidiouslong, filamentous Can have bi-polar staining
● Part of normal skin flora adults ● Encapsulated accend to ● ●
● Normal skin flora and conjunctiva
grow on Bile esculin agar epiglottis Requires factor X
● Opportunist in hospital Use EMB agar comial UTIs Guillain-Barre ● Oxidase-positive ● Important opportunist will cause ● ● Think dog/cat bite
Facultative anaerobe Treponema sp. can cause
● Superantigen: TSS toxin
settings Produces a black precipitate Lactobacillus Actinomyces Eosin methylene Blue
● Microaerophilic ● Nosocomial infectionsapoptosis, cell (heme) and factor V ● Brucella sp. Rx- penicillin
Osteomyelitis in children Incubate at 42°C Exotoxin A- A-B (NAD) growth on choc. agar ● Pleomorphic rods Oxidase +, Cat + "tree bark" aortic aneurysm
● Also part of normal eye flora
Bile resistant ● ●
shrinkage
MCC septic arthritis in Will be a shiny, metallic green color ● Vibrio sp. Encapsulated Fastidious- slow growing grows on blood agar
● Has never been cultured
● Conjunctiva Filamentous,
● Exotoxins S, T, U, Y- Injected ● ●
pertussis toxin. inhibits●
children
●Part of normal flora ● Exotoxin ● Bordetella sp.
Transmission occurs via 3 days incubation
● Syphilis, among others
branching bacteria
● Comma shaped rods ● Phospholipase C- cytolysin
(mouth, vagina, GI Cholera toxin. A:5B Gi (increases cAMP
there is also staph straphotyicus. H₂S-producing ● Oxidase-positive ● Elastases 7-10 incubation● Fastidious contact with animals or their
● Part of normal flora
Forms black precipitate Non-H₂S-producing activates Gs,
● Grows in water grows on Bordet- ● Requires specialized products
This is going to be prevelent in UTIs, Catalase - but can cause increases cAMP produces pyocyanin media to remove ● Francisella sp.
infections On HE agar levels. Watery rice
● High tolerance for salt Gengou agar (potato)
This is a novobiocin resistant strain. Aerotolerant to strict Rx- Ampicillin/ ● Helicobacter sp. Grows on Cetramide agar, Uses NAAT inhibitory substances ● Coccobacilliary Rabbits.
● Facultative or strict ● Shigella sp.
Fastidious- requires cysteine BCYE or
diarrhea ● Legionella sp. Atypical Pneumo
anaerobes-varies Amoxicillin Non-motile ● Urease-positive will see blue green for the
●
anaerobe ●
Fastidious chocolate agar-
●Staphylococcus – grape-like clusters ● Low infectious dose ● Microaerophilic ● ● Very low infectious dose
israellii-sulfur granules present ● Yersinia sp.
pyocyanin and fluorescein ● BCYE agar ● Occupational risk Oxidase - needs cysteine
Staph. ● Bartonella sp.
Can exhibit bi-polar (yellow green) treatment: Erythromycin
TSST-1 they are not really sulfur, just bacteria surrounded by ●

staining (safety pin Treatment: aminoglycoside + ● Pleomorphic rods Bacilli, Aerobe

Infective endocarditis in PMNs
SEA, SEB, SEC, SED, SEE (food broad spec penicillin Slow-growing and difficult to
Corynebacterium Listeria Nocardia
●
appearance) UREASE + remember this with patients that have Cystic
contaminated IV catheters OR ● Legionella pneumophila isolate use nucleic acid tests, 7-10 day incubation
poisoning) Will grow on Tellurite
● Animals and rodents
infected surgical wounds fibrosis, this is an opportunistic infection that ● Transmission via ● Bartonella henselae causes
important reservoirs
a-toxin-poreforming agar (cystein-tellurite ● Part of normal flora ● Will grow at 4°C ● Filamentous, branching UREASE TEST builds. contaminated, cat-scratch disease;
b-toxin-sphingomyelinase agar) (except C. diphtheriae if ● Facultative ● Found in soil and water Rx- penicillin Detects presence of urease, which breaks Ox+, Cat+, non fermentative aerosolized water bacillary hemangiosis
down amides, producing ammonia Invades and survives
gamma-toxin-poreforming PVL α-hemolytic Β-hemolytic non-hemolytic C. diphtheria will grow
person is not vaccinated)
● Can be “club-shaped” or
intracellular organism
●Display tumbling
● Opportunistic infections catalase negative
Legionella
●

within activated alveolar

B.quinine- trench fever
● Partially acid fast
● Mannitol salt agar Exfoliatins (degrade desmosomes
partial lysis of cells complete clearing of RBC's
gray/black ssx- lumpy jaw, gingivitis Needs silver stain, Dieterle
can take appearance of motility in broth macrophage; alters
, epidermal detachment (Scalding Skin) Chinese letters ● β-hemolytic reasons- poor oral hygiene Obligate aerobe maturation of endosomal
● Group D strep C. diptheria- produces ● Partially acid-fast
pts that aspirate like alcoholics and seizure pts vacuole, preventing fusion
Requires cystein/iron
grow on Bile esculin agar exotoxin diphetheria
BETA-HEMOLYTIC can get a pneumonia or an emphyma coiling phagocytosis
STREP BOVIS. patient with Colon toxin. Inhibits Ef2. ● Listeria monocytogenes
cancer can form masses that mimic cancer

-
Causes watery diarrhea ● Contaminated food
has a mucous secreting cancer
will produce an infective
toxin interferes with
●

●
Internalins trigger uptake
Listeriolysin O and shows colonies in 48hours
+ diagnosis is made with
urine serology
endocarditis due to this bacteria! tRNA transfer phospholipases allow
Penicillin rare to see infections, will see
can cause myocarditis escape into cytosol in immunocomprised pts, diabetics
Yersinia
S. pneumoniae Viridans Streptococci and peripheral nerve damage can grow on chromogenic agar and alcoholics
pt will die of asphyxia actin rockets!!! ActA polymerizes actin. Legionella on BCYE agar
● Optochin-sensitive ● Normal flora Optochin will present as an exudative pharyngitis WILL GROW ON BLOOD AGAR
● Bile-soluble ● Bile-resistant resistant
● Diplococci ● Most common cause of Exotoxin- pore forming, causes
● At risk Exotoxin: SIP (Salmonella Invasion Proteins)
subacute endocarditis listeriosis and neonatal meningitis ● Proteus sp. ● Salmonella sp.
Asplenic ● Strep. mutans is normal flora
Actin rearrangement, causes membrane ruffling and bacterial internalization
●
urease + ● Swarming motility ● Cause of
● Smokers of mouth, think dental caries ● Urease-positive gastroenteritis,
● Alcoholics ● Common cause systemic infection,
● Virulence factors
Beta-hemolytic of UTI and enteric fever
● sIgA protease ● Motile
Sigma-toxin-●
Surfactant ●
Capsule Group A strep Group B strep
Pneumolysin
● Can induce
(Streptococcus pyogenes) (Streptococcus agalactiae)
HE agar= Hektoen enteric agar
endocytosis
● Vaccinations ● Bacitracin-susceptible ● Part of normal GI flora, can be present H2S producing= black colonies
● PPSV ● Causes pharyngitis in the upper in vaginal secretions and infect baby Fermenters= yellow-pink
● PCV conjugated respiratory tract during delivery, leading to bacterial
● Encapsulated
non fermenter= green/clear
#1 Typical Pneumo can lead to rheumatic fever septicemia of the newborn.
(adults) Rx- penicillin Bacitracin resistant
Early onset of neonatal pneumo (3days of On HE agar GRAM NEGATIVE
Sinusitis (adults) Strep Pyogenes. SpeA, B, C, F
Otitis Media (children) called erthytogenic toxins. SUPERANTIGEN being delivered) treat the mother with prophylactic
Meningitis in adults causes toxic shock syndrome penicillin
scarlet fever rash
necrotizing fascitis