19 BACTERIAL INFECTIONS OF HUMANS St. Scholastica’s College Tacloban Inc.

MICROBIOLOGY & PARASITOLOGY Maharlika Highway, Brgy. Campetic Palo, Leyte

MICROBES CLASSIFICATION GRAM STAINING  Hair follicles are infected (kuliti, bulingit)
3. Furuncle
CLASSIFICATION GRAM STAINING (BASED)  Commonly known as boils; skin abscesses like the hair follicle and
1. Gram positive surrounding tissue.
2. Gram negative 4. Carbuncle (several boils coalescent together)
 Carbonara sauce
GRAM POSITIVE 5. Osteomyelitis
1. GRAM (+) COCCI  Bone infection (bone marrow and surr tissues)
A. Staphylococcus  Infect children
B. Streptococcus (Enterococcus)  Targeted bone: femur and tibia in adults
2. GRAM (+) BACILLI
A. Bacillus TREATMENT FOR STAPHYLOCOCCUS INFECTIONS
B. Clostridium 1. Penicillin (S. Aureus is not penicillinase producing)
C. Listeria 2. Methicillin (Penicillinase producing)
D. Corynebacterium 3. MRSA- Vancomycin
4. VRSA- Linezolid, daptomycin, quinupristin, dalfopristin
STAPHYLOCOCCUS
 Drug of choice: Penicillin (resistant) (Pen G) Nursing intervention: use Standard nursing interventions
 (+) CATALASE TEST- determine if microbes (catalase) (detoxify
peroxidase ion) STREPTOCOCCUS
 Addition (H2O2)  Drug of Choice: Penicillin G
 Two Major Normal Microflora  Appears in chains: Diplo
1. Skin (S. Epidermidis)  Classification:
2. Nose (S. Aureus) (salt tolerant) I. Hemolysis (alpha, beta, gamma)
 Medium (Mannitol salt agar) II. Lancefield (group a and b streptococcus)
A. Lancefield Group A: S. Pyogenes
STAPHYLOCOCCUS EPIDERMIDIS (microflora of the skin) B. Lancefield Group B: S. Agalactae
 Dangerous (heart valves and catheters)
 Endocarditis- contamination (heart valves, artificial heart valves) of the 1. STREPTOCOCCUS AGALACTAE
endocardium (lining of the heart).  Hemolysis: Beta hemolytic
 Affected: Neonates
STAPHYLOCOCCUS AUREUS (microflora of the nose)  Disease: Meningitis in newborn/neonates
 (+) Catalase test  Infantile arthritis
 (-) Coagulase test- test to differentiate (S. Aureus and S. Epidermidis)  Epiglottitis
which produces coagulase (plasma clots).
 Coagulase- causes plasma to clot 2. STREPTOCOCCUS PYOGENES
 It forms golden yellow colonies  Hemolysis: B-hemolytic
 Disease caused:  Sore throat- aka streptococcal sore throat, strep throat, pharyngitis.
A. Skin Boils and Scalded skin syndrome  Rheumatic heart disease
B. Toxic shock syndrome  Acute glomerulonephritis- AG-AB complex goes to the blood. Circulate
C. Acute bacterial endocarditis stays in kidney (cause inflammation) leading to decrease blood flow
D. Food poisoning resulting to kidney failure.
 Scarlet fever- aka Scarlatina; accompanied with sore throat and has a
I. SKIN BOILS AND SCALDED SKIN SYNDROME strawberry red tongue resulting to wide spread rash.
A. Scalded skin syndrome
 Redness of the skin IMMUNE SYSTEM-SENSITIVE/ HYPERSENSITIVE
 Skin starts to peel off  See antigen on heart even with no presence of antigen
 Toxin: Exfoliative toxin  Starts attack the heart and destroy –
 Rheumatic Heart Disease (RHD): caused by immune response that is
B. Skin Boils
hyper-reactive.
 Aka furuncles
 Pigsa (Tagalog) Bursot (waray-waray)
STREPTOCOCCUS GROUP A OTHER INFECTIONS
II. TOXIC SHOCK SYNDROME 1. Necrotizing Faciitis- aka “Flesh eating disease”
 Aka TSS (caused by toxin)  Skin (starts hot and red) painful to touch and starts separating.
 Associated with tampon  Separation- (causes infection)
 8 hours use of tampon (37 degrees, blood, 8 hours)  Blood-deeper infection
 Signs and symptoms:  Start degrading from (1) muscle, (2) skin, (3) cartilage.
A. Fever 2. Erysipelas- an infection of the upper layers of the skin (superficial).
B. Redness of skin (peels off) - hands 3. Cellulitis- infection of cell tissue (non-necrotizing infection)
C. Hypotension
D. Organ damage/ failure 1. VIRIDANS STREPTOCOCCI
 Hemolysis: Alpha hemolytic (incomplete/partial)
III. ACUTE BACTERIAL ENDOCARDITIS  Causes: subacute bacterial endocarditis (SBE) (slower type of
 Heart valves endocarditis)
 Lining of the heart
 Signs and symptoms:
A. Similar to heart failure 2. STREPTOCOCCUS MUTANS
B. Acute-signs and symptoms are severe  Normal flora of the mouth (no toothbrush)
 Has ability to produce large polysaccharide (produce slime layer)
IV. FOOD POISONING (presence of dextran)
 Aka food intoxication or gastroenteritis  Soft dental plaque hard tartar (leads to cavity)
 Mayonnaise is the source of food (S. aureus)
3. STREPTOCOCCUS PNEUMONIAE
 Aka pneumococcus
 Old name: diplococcus pneumoniae (pairs) (shape cocci)
OTHER INFECTIONS CAUSED BY STAPHYLOCOCCUS:
 Lancet shaped bacteria
1. Impetigo (passed kissing)
 Hemolysis: Alpha hemolysis
 Lips-redness, vesicle (pus) eruption and crust in the corners of lips.
 Structure: capsule (+) (Quellangs test)
2. Folliculitis
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 19 BACTERIAL INFECTIONS OF HUMANS St. Scholastica’s College Tacloban Inc.
MICROBIOLOGY & PARASITOLOGY Maharlika Highway, Brgy. Campetic Palo, Leyte

 Disease: Community acquired pneumonia/ adult pneumonia/ pneumonia  Two drugs (pseudomembranous colitis):
lobar.  Metronidazole
 Vancomycin
OTHER STREPTOCOCCUS INFECTION
1. Sinusitis-inflammation of nasal sinuses (fluid) (pain and pressure) 3. C. BOTULINUM
2. Difference between flu and colds- not painful  Disease: botulism
3. Otitis externa "swimmers ear" - infection of the outer earlobes and canal  Toxin: botulinum/botulism toxin
of the ear.  Mode of Action of Toxin: increased release of neurotransmitter
4. Otitis media- inflammation of the middle ear. Prevalent on children acetylcholine.
(eustachian tube a flat horizontal tube which connects ear to respiratory  Ache: binds to receptor muscle contraction
system).
 Botulism- flaccid paralysis (cause)
 4 clinical manifestation
ENTEROCOCCUS
 Two SPP:
1. Food borne botulism (ingestion of botulinum toxin)
A. E. Faecalis
 Source: canned goods not heated 100 degree Celsius for 20 minutes
B. E. Facelum
(enough to destroy toxin).
 Hardy microbes
 Grow well in 6.5% NaCl 2. Infant botulism (baby)
 Grow well in presence of bile  Ingestion: endospore
 Major problem: resistance to antibiotics  Food source: honey
 Infection: UTI  Aka floppy baby syndrome (decreased muscle tone) (hypotonia)
GRAM POSITIVE BACILLI 3. Wound botulism
 Sporulation-process allows a bacterium to survive unfavorable or even  Endospore seen in drug users causes muscle paralysis and relaxation.
potentially lethal environmental conditions.
 Botulism toxin A- used in Botox
 Two types:
A. Endospore producing (bacillus, clostridium) 4. C. TETANI
B. Non-endospore forming (listeria, corynebacterium)
 Toxin: tetanus toxin
 Mode of Action: neurotoxin increase release of inhibitory neurotransmitter
1. BACILLUS ANTHRACIS
(GABA)
 Endospore: centrally
 Neurotransmitter: inhibits relaxation of muscle
 Capsule: glutamic acid
 Tetanus: muscles contracted (severe muscle spasm)
 Toxin: Anthrax toxin (anthrax disease)
 Symptoms of tetanus:
 3 clinical manifestation:
 Risus sardonicus (facial muscle rigid) aka sardonic smile or ficks smile.
A. Inhalational anthrax (inhale)
 Lockjaw
 Source: Tan hides, sheep wool
 Aka woolsorters diseases  Opisthotonus
 TREATMENT:
B. Gastrointestinal  Pen G
 Endospore-ingested (intestinal bleeding→→ death)  Toxoid- stimulates immune system (produce immunoglobulin)
 Immunoglobulins (IgG)
C. Cutaneous anthrax
 Enters the skin via cuts and wounds then undergo germination
(active) NON-ENDOSPORE FORMER LISTERIA MONOCYTOGENES
 Causes eschar (ulcer of the skin) characteristic as swollen black and  Small rod shaped bacteria
crusty ulcer  Exhibit tumbling motility
 The only (gram +) to produce endotoxin (which only gram -)
2. BACILLUS SUBTILLIS  Can cross the placenta (meningitis on infants)
-ENDOSPORE: SUBTERMINAL  Can cause disease to immunocompromised patients
-AKA: HAY BACILLUS AND GRASS BACILLUS
-ISOLATED FROM DEBILITATED WOUND OF MARGARET TRACY
(BACITRACIN)
-A POLYPEPTIDE ANTIBIOTIC NON-ENDOSPORE FORMER CORYNEBACTERIUM DIPHTHERIAE
 Shape: under microscope (club shaped appearance)
 Pleomorphic
3. BACILLUS CEREUS  Chinese letter arrangement- picket fence, v shaped, palliside shaped
 Fried rice  Toxin: diphtheria toxin
 Toxin: enterotoxin  Mode of action toxin: destroys elongation factor on protein synthesis.
 Causes: fried rice poisoning  Disease: diphtheria
 Vaccine used= (DPT) Diphtheria-pertussis-tetanus vaccine
 "Balik bakuna program of DOH" = many believe that vaccines causes
autism and slow learners which if untrue.
CLOSTRIDIUM (ANAEROBE) ENDOSPORE FORMER
GRAM (-) COCCI NEISSERIA
1. C. PERFRINGENS
 Gram (-) produces (+) to oxidase test
 Clostridium perfringens
 Two SPP:
 Toxin produced: Lecithenase
 (1) N. gonorrhea aka gonococcus/gonococci (glucose and maltose) (no
 Causes: gangrene
capsule)
 Infection produces gas that tissues die suddenly
 (2) N. Meningitidis aka meningococcus/ meningococci (glucose) (has
 Tissue black, produces frothy brown liquid
capsule)
 Both are sugar fermenters
2. C. DIFFICILE
 Normal flora of the intestine
GRAM (-) COCCI NEISSERIA GONORRHEA
 Very resistant to drugs
 Aka tulo, drip or clap
 Infection: increased in the number C. Difficile
 Medium used chocolate agar: (blood or RBC)
 Cells (lining of stomach) = diarrhea (pseudomembrane colitis)
 Disease caused: gonorrhea
 Clindamycin- broad spectrum (side effects: diarrhea)
 TREATMENT: GONOCOCCAL INFECTIONS:
1. Discontinue 1. Proctitis- anal
2. 2nd day if not managed
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 19 BACTERIAL INFECTIONS OF HUMANS St. Scholastica’s College Tacloban Inc.
MICROBIOLOGY & PARASITOLOGY Maharlika Highway, Brgy. Campetic Palo, Leyte

2. Pharyngitis  Vector: fleas

3. Gingivitis- gums  3 types of plague:
4. Keratitis-conjunctiva of the eyes  Pneumonic plague
5. Gonococcal infection in children (ophthalmia neonatorum) (erythromycin  Bubonic plague- infection of the lymph nodes, causing it to swell as
drops) big as a tennis ball (buboes means tennis ball); tissue is necrotic (color
black) aka black plague
GRAM (-) COCCI NEISSERIA MENINGITIDIS  Septicemic plague
 Disease: septicemia
 Symptoms: fever, stiff neck and rash  (2) Salmonella Typhi
 Infection: petechiae (small blood hemorrhage on skin)  disease: typhoid fever
 DOC: chloramphenicol
GRAM (-) BACILLI  Mary Malone- asymptomatic carrier (infected 3000)
 Enterobacteriaceae and pasteurellaceae
 Oxygenase test- test to differenciate (uses chromogenic agent) producing  (3) Shigella SPP.
purple/ violet colonies  A.S. Flexneri
 Pasteurellacea (+) to oxidase test  B.S. Boydi
 C.S. Sonne
GRAM (-) BACILLI ENTEROBACTERIACEAE
 D.S. Dysenteriae
-microorganisms in the intestine
 Transmitted: finger, food, flea, feces
1. Escherichia
2. Klebsiella
3. Serratia PASTEURELLACEAE
 (+) Oxidase test, purple in color
GRAM (-) BACILLI ENTEROBACTERIACEAE (ESCHERICHIA)  (1) P.multicoda
I. Escherichia coli  Respiratory disease: difficulty in breathing, shortness of breath
 Disease: UTI and gastroenteritis  Mode of transmission: animal scratches and bites
 Serotypes of E. Coli
 A. Etec (Enterotoxegenic e. Coli) HAEMOPHILUS SPP.
 Travellers’ diarrhea aka montezumas revenge  (1) Haemophilus influenzae
 Toxin: 2 types (heat labile and heat stable) (cholera like toxin)  Causes meningitis in children
 Watery diarrhea  Infantile arthritis
 source water (not potable)  Life threatening epiglottitis

 B. Epec (Enteropathogenic E. Coli)  (2) H. Ducreyi

 poor sanitation  STD aka soft chancre
 diarrhea (infants)  Forms (chancroid)
 sids (sudden infant death syndrome)  Diagnosed in males
 Very painful
 C. Ehec (Enterohemorrhagic)  Difference (syphilis) (hard chancre) (painless)
 hemorrhagic colitis (bloody diar) (left untreated) —hus (hemolytic uremic  Treponema Pallidum
syndrome) overload- kidney failure-caused (e. Coli 0157-H7)
 Toxin: shiga like toxin (verotoxin) OTHER GRAM (-) BACTERIA
I. Bartonella Bacilliformis
 Food source: hamburger (undercooked ground beef)
Vector: blood sucking sand fly (phlebotomus)
 D. Eiec (Enteroinvasive E. Coli)
 Plasmid (main virulence factor) II. Bartonella Quintana
 Epithelial cells (invade)  Trench fever
 Shigella and e coli- both (syndrome sim to shigelosis)
 SX:acute and recurring febrile fever (with rashes)
 aka 5 day fever
 Eaec (Enteroaggregative E. Coli)
 acute and chronic diarrhea III. Bartonella Henselae
 seen countries (poor sanitation)  aka Cat scratch disease
 Obtained from: cat scratches and bites and fleas
GRAM (-) BACILLI KLEBSIELLA
 Klebsiella pneumoniae OTHER GRAM (-) BACTERIA BRUCELLA SPP
 Mucoid colonies (capsules)  Brucella- zoonotic disease comes from animals
 Pneumonia (hospital acquired)  (1) Brucenella melitensis- goats and sheep
 At risk alcoholic and copd  (2) Brucenella abortus- cattle
 (3) Brucenella suis-swine
GRAM (-) BACILLI SERATIA MARSCENCE
 (4) Brucenella canis- dogs, foxes, cayotes
 Produces red colonies (pigments)
 Disease: brucellosis aka: bang fever, udulant fever, Malta fever, rock fever
of Gibraltar, fever of Cretu.
ENTEROBACTERIACEAE NON CHOLIFORM FORMING
OTHER GRAM (-) BACTERIA BORDETELLA
I. Proteus (Peritrichous)
 Bordetella pertussi (aka whooping cough)
 Produces concentric rings aka swarming phenomenon
 Sound: whooping
 Urease (produced enzyme) (urea)
 Damages (cilia) (death of cilia) (lining of the trachea
 Breaking down produces-ammonia and co2 (inch of urine) (urine is basic)
(decrease the solubility of solutes and precipitate) (kidney stones)
OTHER GRAM (-) BACTERIA PSEUDOMONALS
 UTI- kidney stone induced (proteus)
I. Pseudomonas aeruginosa
 Soil and moist (live)
II. Edwardsiella
 Numerous virulence factors- cannot cause disease to healthy individuals
III. Morganella
IV. Providencia  Hospitalized, burns, cystic fibrosis (immunocompromised patients)
 Most common cause of hospital acquired pneumonia
 Difficult to treat
ENTEROBACTERIACEAE TRULY PATHOGENIC
 (1) Yersinia pestis  4 pigment produced
 Causes: plague  I. Pyoverdin-green
 Source: fleas and rats flea  Ii. Pyocyanin-blue
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19 BACTERIAL INFECTIONS OF HUMANS St. Scholastica’s College Tacloban Inc.
MICROBIOLOGY & PARASITOLOGY Maharlika Highway, Brgy. Campetic Palo, Leyte

 Iii. Pyorubin-red
 Iv. Pyomelanin-brown  II. Lepromatous leprosy (progressive form)- spread entire body (weak t
 Grape like odor (sweat) cell response)
 Cold regions of body:
OTHER GRAM (-) BACTERIA FRANCISELLA TULARENSIS  Feet, hands, face
 Tularemia  Dapsone, rifampin, clofazine
 Bipolar
 Mania ACID-FAST BACTERIA AVIUM INTRACELLULAR
 Absence seizure -on AIDS patients
 DOC: ethosuximide
 Source: rabbits OTHER BACTERIAL INFECTIONS
 Aka: rabbit fever  A. Spirochetes
 DOC: streptomycin, doxycycline, ciprofloxacin  flagella- endotrichous-wrapped around the cell
 in a corkscrew movement
OTHER GRAM (-) BACTERIA LEGIONELLA PNEUMOPHILIA  1. Borrelia
 Disease: Legionellosis  2. Leptospira
 Aka legionnaire's disease  3. Treponema
 DOC: erythromycin
OTHER BACTERIAL INFECTIONS TREPONEMA
ACID-FAST BACTERIA  Agent: Treponema pallidum
 Fast-(color fast) it would not fade (presence of acid)  Aka syphilis/ hard chancre (painless lesion)
 Mycolic acid (present in cell wall)  Diagnosis: scrapings of lesion (Darkfield microscopy)

 I. Primary stain- Carbol fuschin  Stages of syphilis

 Stain- (hot method) Ziehl Neelsen method  I. Primary stage
 No stain- (cold method) Kinyoun stain  Red small, painless, lesion (hard)
 Decolorizer- acid alcohol aka (HCl)  Reproductive organ:
 Anus, nipples, lips
 II. 2nd stain counter stain (methylene blue)  Lesions: no scar
 2 genera (bacteria)
 A. Mycobacterium  II. Secondary stage
 B. Nocardia  Rash (back. Palms and soles) filled with T. pallidum
 No scar
ACID-FAST BACTERIA MYCOBACTERIUM
 M. tuberculosis  III. Latent stage
 M. Leprae  No signs and symptoms (10 years)
 Avium intracellular  Immune system (hyperactive) behavioral stage
 Insanity, blindness (soft rubbery and very painful lesions)
 (1) Mycobacterium tuberculosis  DOC: Pen G
 Serpentine arrangement (s-shaped)
 Corded growth OTHER BACTERIAL INFECTIONS BORRELIA
 Cord factor (substance that cause disease) (toxic to mammalian) very  Causes: Lyme disease
virulent  Rash: Bull's eye rash
 Treatment doxycycline
ACID-FAST BACTERIA MYCOBACTERIUM TUBERCULOSIS
 Culture media: Lowenstein Jenseen agar OTHER BACTERIAL INFECTIONS LEPTOSPIRA INTERROGANS
 Disease: TB  Disease: Leptospirosis
 Aka wasting disease, consumption, white plague  Source: flood- renal and kidney failure (waded flood green water)
 Aka Koch's Bacillus or Tubercle bacillus  San Lazaro Hospital (only infectious disease)
 Transmission: airborne
 Diagnosis: Tuberculin test (aka Mantoux test) OTHER BACTERIAL INFECTIONS VIBRIO CHOLERAE
 Site: forearm  Stool: Rice watery diarrhea
 Drug: antigen  Toxin: cholera like toxin
 Route: intradermal  MOA: Increased cyclic amp (leads electrolyte wasting)→→ severe
 Interpretation: dehydration →→electrolyte imbalance (weakness)
 48-72 hours
 (+) result-formation of wheel or hard induration OTHER BACTERIAL INFECTIONS HELICOBACTER PYLORI
 Measure of wheel  Peptic ulcer disease (causes)
 Bacteria (produces urease) breaks down urea (co2 and ammonia)
 I. Less (5 mm) (-)
 Diagnosis:
 II greater (10 mm) (+ Filipino)
 1. Biopsy
 III. Greater (15 mm) (+ no risk factor) (first world country)
 Filipino (false positive result)  2. Urea breath test
 A. Exposed
OTHER BACTERIAL INFECTIONS CHLAMYDIA
 B. Vaccinated of BCG
 1. Chlamydia trachomatis
 Loss of serotypes
 2. Chest x-ray-see infiltration
 Causes chlamydial urethritis, lymphogranuloma (severe form) (targets
 circle shaped (x-ray) (tubercles/ cavities bec of fibrosis)
groin area) swell (tennis ball) till burst (draining)
 Sores
 3.sputum test-acid fast staining (smear)
 Asymptomatic (silent disease)
 TX: rifampicin, ethambutol, streptomycin, pyrazinamide, isoniazid
OTHER BACTERIAL INFECTIONS CHLAMYDIA PSITACCI
ACID-FAST BACTERIA MYCOBACTERIUM LEPRAE
 Aka parrot fever
 Aka Hansen's disease
 Causes: Ornithosis
 Found: cold regions of the body
 2 forms (leprosy)
OTHER BACTERIAL INFECTIONS MYCOPLASMA PNEUMONIAE
 Pleomorphic
 I. Tuberculoid leprosy (non-progressive) (strong T-cell response)
 Aka walking pneumonia
(destruction of nerves) loss of sensation
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19 BACTERIAL INFECTIONS OF HUMANS St. Scholastica’s College Tacloban Inc.
MICROBIOLOGY & PARASITOLOGY Maharlika Highway, Brgy. Campetic Palo, Leyte

 Signs and symptoms are mild staining: Giemsa stain/ Gimenez stain

OTHER BACTERIAL INFECTIONS RICKETTSIA

1. Rickettsia Rickettsii
 Disease rocky mountain spotted fever
 Vector: hard ticks (dermacentor)

2. Rickettsia Prowazeckii
 Disease epidemic typhus
 Vector: Pediculus humanus
 Aka Louse borne typhus
 Other bacterial infections rickettsia

3. Rickettsia typhi
 Epidemic typhus
 Aka murine typhus
 Vector fleas and rat flea

OTHER BACTERIAL INFECTIONS ORRENTIA TSUTSUGAMUSHI

 Causes: Scrub typhus
 Vector: chiggers/ red mites
 Leptotrombidium

BSN 1-A | 5