Gram Positive Bacilli

A Lecture
By

Dr. Khalid Tawil

 Gram positive Bacilli

Spore forming Non-sporeforming

• Corynebacteria
Anaerobic Aerobic • Listeria
• Actinomyces
• Clostridia • Bacillus
• Nocardia
Spore forming
• Anaerobic
• Clostridia
•G+ve anaerobic - Saprophyte
•Commensals of human and animal gut
1- Clostridium tetani
• drum stick spore appearance
•Motile (peritrichous)
•Neurotoxin “ Tetanospasm”
Transmission
• wound contamination
•Nail punctures
Causes tetanus (Lock jaw)
•Lock jaw
•Opsithotonus
•Septic abortion
•Tetanus neonatoinm
Lab. Diagnosis
serology

Treatment
•HTIG
•Penicillin + Metronidazole
•Resp. support + Muscle relaxants
•Constant nursing

Prevention
•DPT vaccine
2- Cl. boutlinum
• Motile
• Found in soil vegetable, fruits, and leaves
• There are Seven antigenically distinct botulinum toxins (A to G)
• Human disease is associated mainly with types A, B & also
types E, and F.
• Best grow at 350C
 Transmission
• Vegetables, meat
• Canned food
• processed food
Pathogenesis

•Botulism (Food poisoning)

• Intoxication
• Neurotoxin affect cholinergic system and block
the release of Ach. Flaccid paralysis
* Infant botulism (Floppy child syndrome) source Honey
Lab diagnosis
• Toxin detected in suspected food

Treatment
• Gastric lavage
• Antitoxin
• Resp. support

Prevention
• Proper sterilization of canned food
• Swollen cans must be discarded
3- Cl. difficile
• Gr+ve bacilli, oval spore, motile
• NF of GIT 3% adult, 30% of hospitalized patient

Prior history of antibiotics

•Clindamycin & Ampicillin

Suppress NF

Allowing cl. difficile to multiply + produce toxin

Enterotoxin cytotoxin
A B

Diorrhea pseudomembrano us colitis

Antibrotic – associated diarrhea

Lab. Diagnosis
Serology ELISA

Rx.
•Antibiotic replaced by Vancomycin
4- Cl. perferengens “ Welchii”
• Gr+ve, bacilli, rounded end,
capsulated, non-motile
• produce different toxin
•Types: A, B, C, D and E
• Type A: human pathogen
• double hemolitic zone
•Causes: Gas –gangrene,
Food poisoning, primary
septicemia
Gas-gangrene =
myonicrosis
• bacteria produce – gas, a-
Toxin, enzymes

Transmission
• wound contamination
Other bacteria associated with gas gangren
1. Cl. histolyticum
2. Cl. septicum
3. Cl. novyi

Lab. diagnosis
✓ exudate from deep wound
✓ Gram stain
✓ Culture on blood agar \ anaerobically

Treatment
• wound cleaned: oxygen exposure
• penicillin + Metronidazole + Aminoglycosides for Gr-ve bacteria
• Flying maggots “consume only dead flesh
Food poisoning
• Type A: ingestion contaminated food “minced meat”
• Enterotoxin
• Self limited
Spore–Forming Bacilli
 Bacillus species
1- e.g. Bacillus anthracis
 Square ends, single, Pairs or chains
 Polypeptide capsule
 Non – motile
 Wavy margin colonies, sticky
 Medusa head
 Grow at 12 – 45 oC
 Saprophytes

 Germ warfare

(spores up to 60 years)
❑ Cause Anthrax
✓ Primary herbivores disease
✓ Zoonosis (sheep, cattle, horses, …. etc.)
✓ Risk groups: Farmers, Vets, Slaughter house …. etc.
 Virulence factors
➢ Capsule

➢ Anthrax toxins (3 proteins, Plasmid mediated)

✓ Protective antigen (PA)

✓ Edema factor (EF)

✓ Lethal factor (LF)

 Transmission
➢ Inhalation
➢ Cutaneous
➢ GIT
❑ Inhalation: Pulmonary Anthrax 95%
Wool-sorters’ disease
N.B. Most likely route of infection with biological weapons
❑ Cutaneous: Malignant pustules
❑ GIT: Gastrointestinal anthrax (common in herbivores),

Symptoms depend on invasion sites

 Laboratory Diagnosis
➢ Specimen
➢ Culture
➢ Gram stain
➢ Capsule stain
➢ DFA (direct fluorescent Ab test for capsular polypeptide)
➢ PCR
 Treatment & Prevention
Rx: Ciprofloxacin
Prevention:
➢ Sterilizing dead animal + their products
➢ Animal vaccination (effective)
➢ Vaccine for high risk personnel
a. Endemic area
b. Possible deals with contaminated animal products
c. Military personnel
➢ Prophylactic drugs
2. e.g. Bacillus cereus

 Cereus = waxen (wax colonies)

 Motile

 Non – capsulated

 Cause Food Poisoning (rice, meat, vegetables, sauces)

 Intoxication
 Virulence factors
Produce Enterotoxins

➢ Heat-stable (Proteolysis resistant)

causes the emetic form

➢ Heat-labile

causes the diarrheal form

 Clinical diseases
➢ Gastroenteritis
➢ Ocular infection
➢ Intravenous – catheter related species
➢ Sever pulmonary disease (IC patients)
 Treatment & Prevention,
 Self – limited
 Rx: Vancomycin, Ciprofloxacin can be used
 Prevention:
Proper cooling & storage of food