TABLES, DIAGRAMS AND

SUMMARIES
DR. WILSON R. DELOS REYES JR.
C. urealyticum C. C. jeikeium C. ulcerans C. pseudotuberculosis
pseudodiphtheriticum
Most frequently Normal flora of Skin normal flora in Animal contact and Animal pathogens that
isolated and most nasopharynx inguinal, axillary and unpasteurized dairy human can contract
clinically significant. rectal sites. products. thru direct contact with
Respiratory infection, infected animals.
Urinary pathogen, UTI, cutaneous wound Obligate aerobe and Skin ulcers and
strict aerobe and infection in antibiotic resistant exudative pharyngitis Dermonecrotic toxin
lipophilic immunocompromised. causes death of
Immunocompromised, Assoc with diphtheria- various cell types
Do not ferment Microscopy: arranged Common cause of like sore throats.
glucose and maltose in parallel rows or diphtheriod prosthetic Diphtheria toxin
palisades and do not valve endocarditis in Culture: BAP-narrow
Microscopy: V0shaped exhibit any other adults. zone of -hemolysis Culture: CTBA – black
and palisades characteristics CTBA-brown halo color and surrounded
“pleomorphism” that is Microscopy: Loeffler’s serum agar: by brown halo
Culture: BAP – similar to other. Pleomorphic, club- Exhibit growth BAP: small and
pinpoint, white smooth, shaped and arranged yellowish-white
non- haemolytic Urease and nitrate in V-shaped (+): Urease and
positive gelatinase; (-) nitrate (+) urease; (-)
Urease producer Urease and Nitrate reduction. gelatinase
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SUMMARY

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ANAEROBIC
BACTERIA
DR. WILSON R. DELOS REYES JR.
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 DIFFERENTIAL CHARACTERISTICS OF ANAEROBIC NON-SPORE
FORMING BACILLI AND COCCI
Organism Gram Stain Reaction Distinguishing characteristics
Actinomyces Anaerobic, straight or slightly curved, Gram- • Young colonies – spider-like or
positive rods that are banded or beaded wooly appearance
• Old colonies – “molar tooth”
appearance
Bacteroides fragilis Pale-staining, pleomorphic, Gram-negative rods • Grayish-white, circular, smooth,
with a “safety pin” appearance and non-hemolytic
Bacteroides ureolyticus Pale-staining, thin, Gram-negative rods • Colonies corrode (pit) the agar

Bifidobacterium spp. Gram-positive diphtheroids; that are coccoid or • Small, white, shiny and convex
pointed in shape with bifurcated (forked) ends colonies
which resemble a shape of a “dog bone”
Clostridium septicum Gram positive rods in young culture that turn Gram • Formation of Rhizoid margins that
negative with age; resemble “medusa head”
Have subterminal spores 26
 DIFFERENTIAL CHARACTERISTICS OF ANAEROBIC NON-SPORE
FORMING BACILLI AND COCCI
Organism Gram Stain Reaction Distinguishing characteristics
Eubacterium Pleomorphic, Gram-positive rods that are seagull • Fluorescent chartreuse color
wing-shaped
Fusobacterium Spindle-shaped, Gram-negative rods that resemble • The medium exhibits a green color
nucleatum a Capnocytophaga upon air exposure; colonies have
“breadcrumb-like” appearance

Lactobacillus Gram variable rods or short coccobacilli that • Pinpoint colonies

resemble streptococci
Leptotrichia Large-fusiform Gram negative rods • “Raspberry-like” colonies

Peptococcus niger Gram positive cocci that are paired singly, pairs or • Small black and shiny colonies
in tetrads
Peptostreptococcus Large, Gram-positive coccobacilli in chains • Grayish-white colonies that emits
anaerobius foul odor. 27
 DIFFERENTIAL CHARACTERISTICS OF ANAEROBIC NON-SPORE
FORMING BACILLI AND COCCI
Organism Gram Stain Reaction Distinguishing
characteristics
Porphyromonas Gram negative coccobacilli • Brown, mucoid colonies with
brick red fluorescence
Propionibacterium Diphtheroids-like, Gram-positive rods; that • Small, grayish-white colonies
(anaerobic have a palisade arrangement
diphtheroids)
Prevotella Gram negative rods • White, Shiny colonies with a
brick-red fluorescence
Veillonella parvula Tiny Gram-negative diplococci • Red fluorescence

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Lactobacillus acidophilus

▪ Part of indigenous microbiota of the

mouth, GIT and vaginal canal.
▪ Protects female genital tract from
urogenital infections
▪ Related infection: Bacterial vaginosis
▪ Differential medium: Tomato juice agar
(pH 3 to 4)
▪ Biochemical Test: (-) catalase, H2S
and esculin hydrolysis.

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LABORATORY DIAGNOSIS

▪ Gram stain ▪ Specimen: Stool, rectal swab, pus and

▪ Culture Media tissue
▪ String Test ▪ Gram stain: Gram neg
▫ Straight or slightly curved
▪ Vibriostatic Test
▪ String Test: Rgt: 0.5% sodium
▪ Biochemical Test
desoxycholate
▪ Serological Test ▫ (+): lysis of cells releases DNA, which
V. cholerae: (+) citrate &
indole can then be pulled up into a viscous
V. vulnificus: (+) indole & string.
cellobiose 39
V. mimicus: (+) indole ▪ Biochemical Test:
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RICKETSSIACEAE AND
RELATED ORGANISMS
DR. WILSON R. DELOS REYES JR.
ORGANISM INFECTION/DISEASE VECTOR/ MOT

SPOTTED FEVER GROUP

A. Rickettsia conorii Boutonneuse fever or Ticks (Rhipicephalus
Mediterranean spotted fever sanguineus)

B. Rickettsia rickettsii Rocky Mountain Spotted

Fever Wood ticks (Dermacentor
andersoni)
Dog ticks (Dermacentor
variabilis)
Brown Dog ticks (Rhipicephalus
sanguineus and Amblyomma
cajennense
TRANSITIONAL GROUP
A. Rickettsia akari Rickettsial pox Mouse mite (Liponyssoides
sanguineus)

B. Rickettsia felis Flea-borne spotted fever Flea bite or feces

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ORGANISM INFECTION/DISEASE VECTOR/ MOT
TYPHUS GROUP
A. Rickettsia prowazekii Epidemic typhus/Brill-Zinsser Body louse (Pediculus humanus
disease corporis)
Squirrel flea (Orchopeas
howardi)
Squirrel louse (Neohematopinus
sciuriopteri)
B. Rickettsia typhi Endemic murine typhus
Rat flea (Xenopsylla cheopis)
SCRUB TYPHUS GROUP
A. Orientia tsutsugamuchi Scrub typhus Chigger (Leptotrombidium
deliense) bite
ANAPLASMATACEAE
A. Ehrlichia chaffeensis Human Monocytic ehrlichiosis Lone star tick (Amblyomma
americanum)
B. Anaplasma Human granulocytoropic Deer tick (Ixodes scapularis and
phagocytophila anaplasmosis Ixodes pacificus)

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ORGANISM INFECTION/DISEASE VECTOR/ MOT
Coxiella burnetti Q fever Inhalation of aerosol and
infected animals
Bartonella quintana Trench fever Feces of body louse
(Pediculus humanus
corporis)
Bartonella henselae Cat scratch disease Kitten scratch or bite
Bacillary angiomatosis

Bartonella bacilliformis Oroya fever and Sandfly (Lutzomyia) bite

verruga peruana

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Properties C. trachomatis C. psittaci C. pneumoniae
Host range Human Birds Humans
Elementary body Round Round Pear-shaped
Inclusion morphology Round, vacuolar Variable, dense Round, dense
and inclusion body Halberstaeder-Prowazek Levinthal-Cole-Lillie
bodies bodies
Stain used Lugol’s Iodine Macchiavello stain and Giemsa stain
Giemsa stain

Glycogen-containing Present Absent Absent

inclusions

Susceptibility to Susceptible Resistant Resistant

sulfonamides
Disease Trachoma, LGV and Psittacosis Pneumonia, Pharyngitis
inclusion conjunctiva
Number of Serovars 20 10 1
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Specie Distinguishing Growth Factor Associated
characteristics Infection/disease

H. influenzae (Pfeiffer’s Mousy/bleach-like odor; Meningitis, epiglottitis,

bacillus) Non-haemolytic X, V arthritis

H. aegypticus (Koch- Genetically related to H. Pink eye conjunctivitis

weeks bacillus) influenzae X, V

H. influenzae biogroup Non-typable Brazilian purpuric fever

aegypticus X, V
H. haemolyticus Beta-haemolytic X, V --
H. ducreyi School of fish X Chancroid or Soft
chancer
H. parahaemolyticus Tan and dry colonies; Pharyngitis
Beta-haemolytic V
Specimen: CSF, sputum, genital H. ducreyi: Cleansed with sterile gauze
H. parainfluenzae
lesions or ulcer,Fructose and
joint fluid, maltose
vaginal swab, Endocarditis
that is pre-moistened with sterile
fermentation V
abscess drainage, conjunctival swab phosphate-buffer saline
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and bronchial washing and blood. ▪ bedside plating is preferred
Aggregatibacter Aggrigatibacter Cardiobacterium Eikenella corrodens Kingella sp.
aphrophilus actinomycetemcomi hominis “Corroding Bacilli”
tans
-“foam-loving -formerly known as -infects the Aortic -least common -tendency to resist
bacteria” Actinobacillus valve than other isolate decolorization
actinomycetemcomi
-formerly known as tans -”false Gram positive” -assacharolytic like -Microscopy: Plump,
H.aphrophilus in some parts of the the species of genus square-ended,
-common cause of cells Moraxella. arranged in pairs or
-Greek: aphros and periodontitis short chains.
philos, “foam-loving” -the only indole- -Infections from
-only catalase positive HACEK human bites or BAP: exhibit white to
-most common positive in HACEK; member; indole clenched fist injuries. yellowish-brown
species that causes urease negative positive pigmentation.
ENDOCARDITIS BAP: exhibit a yellow TMA: K. denitrificans
-isolated from dental -Virulence factor: BAP: capnophilic and color; pit or corrode
plaques and gingival collagenase and may exhibit “pitting” the agar; and have a K. kingae: isolated
scrapings leukotoxin “sharp bleach” odor. from degenerative
Yeast Extract: joint and bone
-Culture: CAP, -Colonies: “star- “rosette formation LDC: (+) infections
raised, convex, shaped appearance and appear Arginine dihydrolase: (osteoarthritis) in
granular and -Serotypes: A, B, C, filamentous (-) children younger than
yellowish D, E and F 3 year old 54
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Brucella

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BAP

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Stage
Primary Syphilis • Appearance of hunterian or hard chancre,
• Painless, usually seen on the genitalia
• Develops 10 to 90 days after infection
• No systemic signs and symptoms
Secondary Syphilis • Develops 2 to 12 weeks after appearance of chancre
• All lesions that are observed seen in this phase are highly infectious
• Chancre heals but organisms are still disseminated via blood stream
• Symptoms: Fever, Sore throat, headache and rashes (palms and soles)
Latent Stage • Disease becomes subclinical but not necessarily dormant
• Occurs within more than a year of infection
• In this stage, diagnosis can be made only by serological test
Tertiary stage/Late • Tissue-destructive phase
syphilis • Appears 10 to 25 years after initial infection
• In this stage, individuals are not usually infectious
• Complications: Central nervous disease (neurosyphilis), cardiovascular
abnormalities, eye disease and granuloma-like lesions (gummas)
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 Borrelia Related diseases and Laboratory diagnosis
Related diseases
RELAPSING FEVER
▪ It is an acute infectious disease with
recurring febrile episodes (2 to 10
relapses)
▪ Symptoms: Fever, headache, myalgia
(2 to 15 days after infection)
LYME DISEASE
▪ Acute, recurring inflammatory infection
involving the large joints, like kenees.
▪ Hallmark of infection are erythema
migrans (bull’s eye lesion on the skin)
and swelling.
Laboratory Diagnosis
MICROSCOPIC EXAMINATION
▪ Giemsa and Wright stain
▪ Dark field microscopy, Blood culture
after 2 to 3 weeks of incubation at 35C.
▪ Relapsing Fever
▫ Specimen: Peripheral blood
▫ Spirochetes in peripheral blood,
stained as blue colored.
▪ Lyme Disease
▫ Specimen: Blood, CSF, and
Biopsy specimen
▫ Tissue section: Warthin-Starry
stain is used 62
 Leptospira spp.
Leptospirosis or Infectious Jaundice
▪ Zoonotic disease in humans caused by
Leptospira interrogans
▪ Acquired in home and recreational
settings (swimming pools)
▪ Symptoms: Fever, headache, myalgia,
anorexia and vomiting.
▪ MOA:
▫ Entry through breaks in the skin,
mucous membranes or
conjunctiva
▫ Direct contact with the urine of
carriers like rats
▫ Contact with bodies of water that
are contaminated with the urine of
▫ Upon entry, leptospira rapidly
invades the bloodstream and spread
throughout the CNS and Kidneys.
TYPES OF LEPTOSPIROSIS
Icteric leptospirosis or Weil syndrome
▪ Severe form of illness that affects the liver
and kidneys and causes vascular
dysfuction
▪ Death upto 10% of the cases
Anicteric leptospirosis
▪ Symptoms: Septicemic stage of infection,
high fever and severe headache (three to
seven days) followed by the immune
astage
▪ Hallmark of immune stage: Aseptic63
 Laboratory diagnosis
Specimen: Blood, CSF and tissues for the
bacterimic phase (first week); urine for the
immune phase (second week)
MICROSCOPIC EXAMINATION
▪ Dark field microscopy, can be used for
the detection of motile leptospires in
the specimens.
CULTURE
▪ Culture media: Fletcher’s medium,
Ellinghausen-McCullough-Johnson-
Harris (EMJH) medium, Bovine serum
albumin, Stuart’s broth and Noguchi’s
medium
▪ Fletcher’s and EMJH media are semi-
solid media.
SERODIAGNOSIS
▪ Commonly used methods for antigen
detection: ELISA, Radio immunoassay
(RIA) and immunomagnetic capturing
▪ Antigen detection: Immunofluorescence
and immunohistochemistry
▪ Reference method: Microscopic
agglutination (MA) using living cells
MOLECULAR TEST
▪ Detects leptospiral DNA in infected
patients
▪ Methods: Plymerase chain reaction and
hybridization techniques.
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Streptobacillus
moniliformis
-Etiologic agent: Rat-bite
fever and Haverhill fever in
humans
-Gram-negative bacillus
-Normally found in
oropharynx of wild and
laboratory rats
-Facultatively anaerobic
-Non-motile, non
encapsulated and non
haemolytic
-Diene’s stain: required to
demonstrate the L-form
colonies
-Microscopy: Yeast-like
shape, Chains of bacilli
-Broth: fluff or
breadcrumbs appearance
-BAP: Fried-egg
appearance with dark
center
Spirillum minus/minor Klebsiella granulomatis Capnocytophaga
• Rat-bite fever known as -Formerly known as -Indigenous microbiota of
sodoku in humans Calymmatobacterium the oral cavity of humans
• Grown on artificial granulomatis and animals (dog and cats)
culture media -Etiologic agent: -Resembles HACEK group
• Strictly aerobic, closely Granuloma inguinale or in their CO2 requirements
related Neisseria donovanosis: Sexually for enhanced growth
• Direct visualization of transmitted disease nodule -Gliding motility on solid
specimen (blood, enlarge with beefy, surface
exudates or lymph node erythematous, -Facultatively anaerobic
tissue) using Giemsa granulomatous and with a negative reaction to
stain, Wright stain or painless lesion that easily most biochemical tests
dark field microscopy is bleed. -Microscopy: Gram-
recommended. --Culture: Yolk sac or fresh negative rods to
egg yolk medium. filamentous or spindle-
• Microscopy: Thick, -Microscopy: Blue rods with shaped bacteria
helical, gram-negative “safety pin” app and is Culture: BAP or CAP: slight
bacilli with two to three surrounded by a pink yellow or orange
coils and are motile by capsule, presence pigmentation.
polytrichous polar Donovan bodies in
flagella. mononucleated endothelial
cells
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 Enterococcus spp.
▪ Non-haemolytic or may be alpha or beta
Belong to family Streptococcaceae haemolytic
▪ Produce D antigen ▪ Laboratory test: (+) Bile esculin and PYR;
▪ Indigenous microbiota of human and (+) growth in 6.5% Nacl
animals intestinal tracts
▪ Not highly pathogenic but are frequent
causes of nosocomial infections
▪ Resistant to multiple antimicrobial
agents
▪ Most common isolates: E. faecalis
▪ Virulence factor: Extracellular serine
protease, gelatinase and cytolysin
▪ Related infections: UTI, endocarditis,
bacteremia, wound infections
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 WHIFF TEST or KOH Test
-Specimen: Vaginal secretions
-Reagent: 10% KOH
-(+) Result: Exhibits “fishy amine odor”
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THANK YOU!

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