Grampositiv

e
cocci
+
Staphyloco
cci

CATALASE
H2O2H2O + O2
*found in peroxisomes

COAGULASE
(fribinogenfibrin)
*agglutination: bound
coagualse
*test tube: free coagulase

S. aureus
Normal colonization of
anterior nares
opportunist infection
Salt tolerant haloduric
Facultative anaerobe
-hemolytic
Infects open wounds
Mannitol salt agar (turns
yellow)
Toxins:
Bound
coagulase
Alpha-toxin:
forms pores
SEC B & SEC C
Teichoic acids:
binds to
fibronectin
Protein A :
binds Fc of Ig to
inhibit
phagocytosis
Binds fibrnogen and
fibronectin
endocarditis
Food poisoning (N/V)
Bollous Impetigo (will
bubble with H2O2
addition)
Scalded Skin Syndrome:
exfoliants split epidermis
b/n spinosum and
granulosum layers
TSST1: dec LPS
clearance, pyrogenic,
hypotension
Osteomyelitis in healthy
pts
Soinal epidural abscess
Causes styes
Orbital cellulitis
Sticky eye in neonates

Coagulasenegative
Staphylococci
S. epidermidis
Endocarditis
Non hemolytic
Novobiocin sensitive
Indwelling catheters
and IV drug abusers

S.
saphrophyticus
Novobiocin resistant
Leukocyte Esterase
Test +
Nitrate nitrite test
negative
honeymoon cystitis
Lower UTI
Young,
sexually active
female
Late summer,
early fall

Streptococci/
Enterococci

Streptococci
Naturally competent
(genetic exchange)
Lancefield antibodies
Cause endocarditis
S. pyogenes
Facultative anaerobe
Facultative intracellular
B-hemolytic
Lancefield grp A
Virulence factors
M-protein
Hemolysin:
Streptolysin S &
O
Hyaluronidase
Exotoxin A
Cardiotoxic
Dec LPS
clearance,
capillary
leakage, fever,
shock
Leads to rheumatic heart
dz
Causes scarlet fever
(strawberry tongue)
Strep Throat
Necrotizing fascitis
Mediated by
SPEA (exotoxin
A)
S. pneumoniae
Facultative anaerobe
Extracellular
Capsule
Transient normal flora of
nasopharynx
Alpha hemolytic
Seen via quelling rxns
Optochin + Bile sensitive
Crosses BBB
Causes otitis media
MCC of CA pneumonia
(lobar & typical)
MCC of meningitis in
adults
Viridans Streptococci A
hemolytic
S. mutans
Bacterial biofilms on
teeth polymicrobial
abscess and
osteomyelitis

S. agalactiae
Grp B, Beta-hemolytic

Enterococci
Lancefield
Group D
antigen
positive
Normal GI
flora
Nosocomial
infections
PYR test
positive
Alpha
hemolytic
Bile esculin
agar
Resistant to
bile salts
Spinal epidural
abscess
E. faecalis
Causes UTI
Leukocyte test
positive
Nitrate
nitrite test
negative
Resistant to
vancomycin
(binds to D-ala
D-ala
glycopeptide
and inhibits
transpeptidase
s and
transglycosylas
es

Gram positive
rods
* Spores are
formed when cell
is stressed (decd
alanine conc)

Sporeforming

Aerobi
c
Bacillus
sp.

* Found in soil and

water

B. cereus

Catalase positive
Emetic form
Heat
stabile
Cerulide
toxin
Starchy
food
Diarrheal form
Heat
labile
Toxin inc
cAMP
Food held
warm

Non sporeforming

Anaerobic
Aerobi
c

Clostridium
sp.

Catalase
neg;opportunist

C. difficile

Enterotoxin A:
chemotactic for PMN,
fluid hypersecrtn,
hemorhage, cytokine
release
cytotoxin B:
depolymerize actin
filaments
Pseudomembranous
colitis (post antibiotic
use)
MCC nosocomial
diarrhea
Tx: metrandazole

C. tetani

Spastic paralysis
Blocks Ach degradation
Tetanospasmin
(neurotoxin): Blocks
release of GABA and
glycine and causes
spastic paralysis
Sardonicus, trismus,
opisthotonus
Lock jaw

C. perfringens C. botulinum

Corynebacteriu
mClub shaped
Catalse positive
Telurite agar grey
colonies
Stains partially acidfast

C.
diphtheriae

Causes gray
membranes in mouth
Cystinase activity
turns agar brown

Heat labile toxin

Flaccid paralysis
Alpha toxin:
Canned foods
PLC/lechinaseBlocks Ach release
hemolyzes RBC, WBC,
platelets
Theta toxin: targets
cardiac mm, causes
cell leakage Listeria
Watery diarrhea, no
Grows at low temps (4
N/V
Cellulitis, C)
gas
Facultative intracellular
gangrene (H2S),
supprativeanaerobe
myositis
Tumbling motility
Can withstand pH/salt
extremes

L.
monocytogen
es

Catalse positive;
chromogenic agar
B-hemolytic
Heat resistant
Uses ZIPPER method for
invasion
Unpasturized dairy, soft
cheeses, deli meats
Crosses placenta and
causes abortion,
premature delivery,
stillbirths
Causes meningitis,
meningoencephalitis,
septicemia, pneumonia
in neonates
usually targets

Anaerob
ic
Erysipelothr
ix
rhusropathi
ae
Encapsulate
d
Facultative
Lactobacill
anaerobe
us
Cellulitis
Part of normal
flora (mouth,
vagina, GI)
*maintains
acidic pH of
vaginal lumen

Actinomyces
sp.

Filamentous,
branching
bacteria
Part of normal
flora but can
cause infections
Non acid-fast
Trophemya
whipelli
Causes
Whipples dz:
malabsorptn,
reactive arthirits,
lymphadenopath
y
PAS positive
Tx: Broad
spectrum
antibiotics

Nocardia
Filamentous,
branching bacteria
Found in soil &
water
Opportunistic
infections
Stains partially acidfast

Gramnegative
cocci

Neisseria
Often associated with PMNs in
direct smear
Naturally competent in genetic
exchange
Grows best on chocolate agar in
atmosphere of 5% CO2
Chocolate agar or Thayer-Martin
agar (chocolate agar plus
antibiotics often used to inhibit
growth of normal flora and
nonpathogenic neiserria)
Oxidase-positive
Ferment glucose

Acinetobact
er
Resemble Neisseria
Nosocomial infections
Can colonize skin
Antibiotic resistant
Oxidase negative
Does not ferment glucose
Gingivitis and peridontal dz
(+HIV =trench mouth)

Moraxella

Oxidase positive
Does not ferment
glucose
Normal upper
respiratory flora
Causes otitis media,
bacteremia, meningitis

N. Meningitides

Maltose and glucose fermenting

Non motile
Encapsulated
Seen via quelling rxn
Kidney bean shaped
Transmission: resp droplets
IgA protease: attach and invade mucosa
Endotoxin : fever, septic shock
Pili to colonize nasopharynx
MCC of bacterial meningitis in kids 2-18 y/o
Meningitis
Sxns: fever, headache, stiff neck
Positive Kernigs and Brudzinska signs
Petechiae purpura
Incd ICP
Meningococcemia
Leads to multi organ failure and Waterhouse
Fredchelson syndrome

N. Gonorrhea

Diplococci
Facultattive intracellular
Non-encapsulated
Coffee bean shaped
Asmptomaitc infections or cervicitis,
urethritis, proctitis, PID
Human pathogen
Doesnt survive in cold, dry palces

Gram-negative
rods
ENTEROBACTERIACEAE
Ferment
Ferment glucose
glucose
Oxidase-negative
Oxidase-negative
Normal
Normal habitat
habitat is
is GI
GI tract
tract of
of humans
humans
Endotoxins: O,H,K
Nitrate
Nitrate
nitrite
nitrite test
test positive
positive

NONENTEROBACTERIACEAE

Non-lactose
fermenting

Lactosefermenting

(McConkey agar- pink)

H22S

* EMB agar blue metabolic sheen

-producing
Serratia sp.
Non-H22S
Proteus sp.
Causes UTI
-producing
Swarming motility
DNAse- red pigment
Urease-positive
Shigella sp.
Enterobacter sp.
Common cause of
Non-motile; uses TRIGGER
Motile
UTI
mechanism for invasion
Nosocomial
Kidney stones
Low infectious dose
ESCHERICHIA sp.
HE agar
Motile; opportunist; contaminated food
Facultative anaerobe
Salmonella sp.
Catalse pos
S. Typhi
Bloody diarrhea ; high fever
O157.H7 cannot ferment Sorbitol Motile; TRIGGER
Causes enteric
mech for invasion
S. sonnei, S. flexneri, S.
MCC of community acqd UTI
fever
dysenteriae
EPEC, EAEC, ETEC, EHEC, EIEC Facultatitive
Rose spots
anaerobe
KLEBSIELLA sp
(macular rash)
HE agar black dots
Yersinia sp.
Non motile
Lymphadenopath
Y. Pestis
Polysaccharide capsule (mucoid) Survive acidi env
y, splenomegaly,
Causes osteomyelitis
Bipolar stain
K. granulomatis
reactive arthirits
Uses ZIPPER mechanism for
in sickle cell anemia
Granuloma inguinale
Small infectious
pts
invasion
K. Pnuemoniae
dose
facultative
Bubonic plague (resevoirH2O organism
F/O
intracellular
rodents)
Causes UTI
Capsule,
Facultative intracellular
S. enterica, S.
endotoxin
Bangori
Curved and Spiral
Large infectious dose
Pathogens
Pathogens of
of the
the respiratory
respiratory
A successful
Resevoir:
tract
reptiles,
rods
tract
Zoonses
opportunist
poultry,
dairy
Campylobacter sp.
Haemophilus
sp.
Killed
Gull-wing appearance
Pasturella sp.
Requires factor X (heme) and
Pseudomonas
extraintestinally sp.
Microaerophilic
Bipolar staining
factor V (NAD); naturally
P. Auerginosa
Oxidase positive
P. multicida, canis
competent in GE
Colonizes GIT; grows in
42C; low O2, high CO2
Chocolate agar
Brucella sp.
distilled H2O
C.Jejuni
H. Influenzae
Single polar flagellum at each Nosocomial
Pleomorphic rods
Normal URT flora; 6 serotypes
Cetrimide agar
end
Facultative
(A-F)
Does not ferment glucose
Campy/skirow agar
intracellular
Polyribitol
phosphate
PS
Assoc w/ Guillan barre & reiters Strict Aerobic (oxidase pos)
Fastidious slow growing
capsule
Biofilm, exopolysacharide
syndrome
Inhibit phagolysosome
IgA
protease;
capsule
Fruity
odor
H2O foul diarrhea blood, pus
fusion
LPS
endotoxin
Exotoxin A: stops protein
Most common cause of
B. Abortus (cattle)
Causes
conjuctivitis,
otitis
synthesis
bacterial enterocolitis in U.S.
media, typical pneumonia,
Causes diarrhea
B. Melentis (goat,
(Tx supportive)
epiglottitis, cellulitis
Causes otitis externa in
sheep)
H. ducryei
diabetics
Vibrio sp.
B. Suis (swine)
Osteomyelitis in pts w/
Cause painful genital lesions
Comma shaped, Oxidase
Francisella sp.
traumatic wounds
positive
Inhibits phagolysosome
MCC of keratitis
V. Cholera
Bordetella sp.
fusion
Causes erythema
Single polar flagellum
Fastidious
Highly contagious
gangrenosum
Alkalinophile, halophile
Requires specialized media
Facultative intracellular
O-antigen; cholera, mucinase, Causes psuedomonal folliculitis
to remove inhibitory
Via
F. tularensis
hot
tubs
adhesin
substances
Meningitis, resp infections,
Rabbit fever
TCBS agar
B. Pertussis
Cysteine rich media
Heat-labile enterotoxin (cAMP) sepsis
Causes whooping cough
Cellulitis in burn pts
encapsulated
High infectious dose (>1
Blue/green pus
billion)
Legionella sp.
Bartonella sp.
(pyocyanin)
Mucous flecks, rice water
L. Pneumoniae
B. Hensale
Virulence factors
stools
BCYE agar; fac. intracellular
Cat scratch dz
4
Mm aches, pain
*Urease
Requires L-cysteine for
Bacillary
angiomatis
CagA
growth & Fe
B. quintana
VacA
Helicobacter sp.
Chlorine resistant; lives in

Organisms that stain

poorly with Gram-stain
Obligate
Intracellular

Spirochetes
Helical shaped
Endoflagella
Stain poorly, but
have Gram-negative
cell wall
Dark field
microscopy

Treponema sp.

Has never been cultured

Syphilis

T. pallidum
Obligate pathogen
Assoc with Granulomas
resevoir: genital tract
Crosses placenta
Flexible wall- lipoproteins
Endoflagellum
Dark field (chancre fluid)
or fluorescent ab turns
green
Not cultured in vivo
Gram neg, but poorly
staining
Transmit through sexual
contact
Mucosal chancres
gumma

Borrelia sp.
Ixodes tick
Lyme disease among
others

B. burgdorferi
Erythema migrans (bulls
eye rash) myocarditis
meningitis scleroderma
Neuroborreliosis

Stain poorly, but have

Gram-negative cell
wall
Cannot culture on
semi-solid media

Chlamydia &
Chlamydiophila sp.

Cannot make their own ATP

Sexually transmitted
Sinusitis, atypical pneumonia
Assoc w/ atherosclerosis
Elementary body- contagious
Has PM/OM but no PG layer

C. trachomatis
Obligate intracellular
Cant make ATP
Elementary body- extracellular
infective form
Serotypes A, B, Ba, C :
Trachoma
blindness
Serotypes D K
neonatal
conjunctivitis
pneumonia
Adult trachoma
inclusion
conjunctivitis (TRIC)
Female: cervicitis, urethritis,
PID
Male: proctitis, epidiymitis

Mycobacteri
a sp.
Small rods
poor Gram staining
Cell wall- waxy mycolic
acids
Resistant to drying,
chemical agents,
germicides
Slow growing

M. tuberculosis

Strict aerobe; acid fast

Facultative Intracellular
Lives in macrophages
Causes TB; assoc with
Granulomas
MCC of chronic
meningitis
Stains: Ziehl Neelson,
Kinyoun acid fast
(viable bacteria),
Flourochrome (dead
and viable bacteria)
Dx: culture on
Middlebrook agar or
Lowenstein Jensen Egg
agar (very slowgrowing!)

M. leprae

does not grow in

culture
Obligate intracellular
Rickettsia sp.
Results in leprosy (CMI
Use PLA to cleave endosome
response gives the
Live in cytoplasm
Tuberculoid form [ILR. rickettsiae
Anaplasma
12]; sp.
Ag response gives
Rocky mt spot fever Ixodes tick the Lepromatous form
D. variablis and D. andersoni
Forms morulae
[IL-4])

R. akari
Mites

R. prowazeki
Epidemic
Louse born

R. typhi

Mycoplasma
sp.
Lack a cell wall Mollicute
Membrane contains
sterols
Pleomorophic
Sensitive to
environmental
conditions
Hard to grow in
laboratory requires
cholesterol in media
Normal flora in
mucosa
Atypical pneumonia
GU infections
IgM- diagnostic
Extracellular
pathogen

Mycoplasma
hominis

vaginitis, cervicitis

Ureaplasma
urealythicum
Grows on special
medium with urea
Found in lower
urinary tract
Found in neonates
resp tract
vaginitis, cervicitis,
salpingitis,
chorioamnionitis,
infertility
Sexually transmitted
Self resolving

Infects PMNs preferentially

Prevents phago-lysosome fusion

Ehrlichia sp.

Infects monocytes preferentially

Prevents phago-lysosome fusion

Endemic typhus
rodent flea

Coxiella sp.

Resistant to drying
Highly infectious
Zoonosis
Lives in phagolysosome (req.
low pH)
Targets macrophages
C. burnetti

Viruses

+
ssRNA

- ssRNA

*All are
*NAKED*:
Picornavirdae enveloped*
Naked
Orthomyxovir
Rhinovirus
dae
Enterovirus
Type 70
conjunctivitis
Echovirus
Hep A
Coxsackie
Type A24
conjunctivitis

Calcivirdae
Naked

Norvovirus
Hep E

Astroviridae
Naked

Astrovirus

Influenzae
Segmented

Paramyoxyviri
dae
Parainfluenza
RSV
Metapneumovirus

Filoviridae
Filamentous
Pleomorphic

Bunyviridae
Arbovirus
segmented

*ENVELOPED* Arenaviridae
:
Retrovirdae
Hepatitis D
Capsule

HIV

Flaviviridae
Capsule

Hepatitis C
Arbovirus

Coronavirida
e
Capsule

Coronavirus

Togaviridae
Capsule

Togavirus
Rubella (congenital:
cataracts,
microcephaly)

Defective

Rhabdovirus
Bullet shaped
G-protein spikes

dsRN
A

dsDN
A

Reovirdae

Adenavirida
e

Rotovirus
Segmented
Naked

Naked
spiked
Pink eye
Swimming pool
conjunctivitis
shipyard
keratoconjunctivits

ssDNA
Parvovirda
e
Small
Naked

Parvo B19
Erythrovirus

Herpesvirida
e
HSV
MCC of viral
encephalitis
HSV 1= encephalitis
HSV 2= meningitis

CMV
EBV
VZV
Conjunctivitis
Vesicular lesions
on eyelid

Hepatitis B
Gapped
Enveloped

Polyomaviri
dae
BK/JC virus

Papillomaviri
dae
HPV
Naked

Roseolovirus
(HHV6)
Linear
Enveloped

Poxviridae

Small pox (variola)

Linear
Most complex virus
Replicates in
cytoplasm