Summaries of Microbial Pathogens

SUMMARIES OF MICROBIAL PATHOGENS
BACTERIA
Name: Staphylococcus aureus
Natural Reservoir: Ubiquitous in nature. Transient normal flora on skin, vagina

and other mucosal surfaces. Nasopharynx is a common colonization site.
Transmission: by direct contact or respiratory droplets.
Diseases: Skin infections: cellulitis, impetigo, folliculitis, carbuncles, scaled skin

syndrome, osteomyelitis, endocarditis, pneumonia, gastroenteritis, septic
arthritis, toxic shock syndrome, bacteremia, and many nosocomial infections.
Risk factors: Implanted devices, IV drug abuse, intubation, many infections

without risk factors.
Pathogenesis factors: many adhesion proteins,MSCRAMMs, many toxins
Identification: Gram stain and culture. This species is catalase positive,

coagulase-negative, beta-hemolytic with yellow colonies on mannitol-salt agar.
Treatment: Incision and drainage for skin infections. Antibiotic resistance often a
problem. If MRSA, use vancomycin. If MSSA, use nafcillin.
Prevention: Good hygiene

Name: Coagulase-negative staphylococci
Natural Reservoir: Common normal skin flora, mucosal surfaces, conjunctiva,

ears, vagina. It is pretty much everywhere
Transmission: from normal flora by direct contact
Diseases: Infections due to implanted devices
Risk factors: Implanted devices
Pathogenesis factors: ability for form biofilms
Identification: Gram stain and culture.
Treatment: Vancomycin with rifampin or gentamicin
Prevention: Good hygiene

Name: Staphylococcus saprophyticus
Natural Reservoir: Transient normal flora
Transmission: from normal flora
Diseases: Cystitis in women
Risk factors: unclear
Pathogenesis factors: unclear
Identification: Gram stain and culture.
Treatment:Penicillin
Prevention: Unclear
Name: Streptococcus agalactiae or Group B Streptococci
Natural Reservoir: upper respiratory & genitourinary tracts
Transmission: mother to newborn during pregnancy, during delivery, or later
Diseases: meningitis, sepsis in neonates, skin infections, esp. in diabetic foot

ulcers
Risk factors: carriage of bacteria by mother, premature delivery, membrane

rupture, intrapartum fever, diabetes
Identification: gram stain and culture
Treatment: penicillin, ampicillin with gentamycin for severe cases
Prevention: screening of pregnant women

Name: Streptococcus pyogenes or Group A Streptococci
Natural Reservoir: transient flora without symptoms on skin, infected people
Transmission: respiratory droplets or direct contact
Diseases: cellullitis, impetigo, erysipelas, scarlet fever, puerperal sepsis, invasive

disease like bacteremia and pneumonia, necrotizing fasciitis, toxic shock
syndrome, pharyngitis. Rheumatic fever and glomeruloephritis are post-infectious
sequelae.
Risk factors: Invasive diseases—debilitated or immunocompromised, impetigo—

child with poor hygiene. Many infections without risk factors.
Pathogenesis factors: capsule, M protein which interferes with complement,

Streptolysins, pygogenic toxins, sometimes on lysogenic phages(cause scarlet
fever)
Identification: gram stain and culture, these are catalase negative, beta-hemolytic
gram positive cocci that are bacitracin sensitive. Strep test that is an ELISA test
for strep throat. Streptolysin antibodies for rheumatic fever or
glomerulonephritis.
Treatment: penicillin
Name: Viridans streptococci (this is a collection of species)
Natural Reservoir: normal flora of oropharynx
Transmission: from normal flora, transient bacteremia after dental procedures
Diseases: subacute endocarditis, dental caries
Risk factors: invasive dental procedures
Prevention: none
Name: Streptococcus pneumoniae
Natural Reservoir: nasopharynx
Transmission: respiratory droplets or endogenous from nasopharynx or

oropharynx into the lungs, ears, sinuses or meninges
Diseases: pneumonia, otitis media, sepsis, meningitis, sinusitis
Risk factors: age, but many infections without a clear risk factor, asplenics
Pathogenesis factors: capsule with many variants
Treatment: ceftriaxone often with vancomycin. Some like to use penicillin for
pneumoniae. Otitis media and sinusitis treated with amoxicillin-clavulanate
Prevention: Two vaccines: conjugate vaccine with 7 capsule variants for those
under 2. PPV vaccine for those over 2 which has 23 common capsule variants.
Name: Mycoplasma pneumoniae
Natural Reservoir: infected humans
Transmission: respiratory droplets
Diseases: pneumonia, URIs, often followed by lasting cough
Risk factors: many infections without a clear risk factor
Pathogenesis factors: pilus that attachs to base of ciliated cells and kills them.
Identification: unclear, cold aggultinins phased out, PCR rarely used.
Treatment: macrolide like azithromycin or clarithromycin
Prevention: good hygiene

Name: Chlyamdia pneumoniae
Diseases: pneumonia, URIs
Risk factors: many infections without a clear risk factor
Pathogenesis factors: intracellular pathogen
Identification: unclear

Name: Chlyamdia psittaci
Natural Reservoir: infected birds and other animals, esp. pet birds
Diseases: pneumonia, called psittacosis.
Risk factors: handling birds, pet shop employees, animal processors if birds
being processed.
Identification: serology with four fold increase in titers
Treatment: tetracyclines
Prevention: treatment or quarantine for sick birds

Name: Chlyamdia trachomatis(there are many different strains, called serovars)

Transmission: sexual contact for urethritis and lymphogranuloma venereum, from
mother to child during birth for perinatal infections, for trachoma, transmission
by droplets, contaminated hands or clothing or passage through infected birth
canal.
Diseases: non-gonococcal urethritis, PID, trachoma, perinatal infections(involving

conjuntivitis and pneumonia), lymphogranuloma vereneum.
Risk factors: for trachoma, this is mostly unhygienic living conditions in third
world; for urethritis, PID, lymphogranuloma vereneum this is unsafe sex with new
or many partners; for perinatal disease, it is being born with an infected mother.

Identification: molecular probes or PCR; Direct fluoroscent antibody test(DFA)
used for conjunctivitis.
Treatment: tetracyclines or azithromycin
Prevention: trachoma, good hygiene; sexual disease-safe sex; perinatal diseases,

screening and treatment of infected mothers, treatment of the eyes of newborns
with macrolides is controversial but still usually done.
Name: Mycoplasma hominis
Transmission: sexual contact or from mother to child
Diseases: postpartum or postabortal fever, pyelonephritis
Risk factors: sexual experience
Identification: culture, but slow and often unavailable
Treatment: macrolide like azithromycin or clarithromycin or tetracyclines
Prevention: safe sexual practices

Name: Mycoplasma genitalium
Transmission: sexual contact
Diseases: implicated in non-gonococcal urethritis, cervicitis, PID

Name: Ureaplasma urealyticum
Diseases: implicated in non-gonococcal urethritis

Name: Legionella pneumophila
Natural Reservoir: infected water sources where water is vaporized
Transmission: usually inhalation of contaminated aerosols
Diseases: pneumonia, usually with multi-system effects(esp. diarrhea/vomiting);

Pontiac fever(flu like symptoms)
Risk factors: immunocompromised, smoking, underlying lung disease
Pathogenesis factors: intracellular organism that survives inside macrophages by

inhibiting phagolysozyme fusion and oxidative burst
Identification: culture on buffered charcoal yeast extract agar, urine antigen test,
also direct fluorescent antibody test.
Prevention: identification and treatment of contaminated water source

Name: Haemophilus influenza
Natural Reservoir: part of normal flora in humans in upper respiratory tract
Transmission: respiratory droplets, fomites, direct contact from infected humans
Diseases: Type b: meningitis, epiglottitis; non b:sinusitis, otitis media,

conjunctivitis, pneumonia.
Risk factors: no vaccine for type b(this is Hib), child for epiglottitis.
Pathogenesis factors: capsule type b needed for invasive disease.
Identification: gram stain on samples from sterile sites: small pleomorphic gram
negative rods. Culture on chocolate agar with hemin, NAD, and CO2.
Treatment: ceftriaxone for invasive disease, amoxicillin-clavulanate for non-

invasive
Prevention: Hib vaccine against type b capsule, recommended starting at 2

months.
Name: Haemophilus ducreyi
Diseases: genital lesions, often penile ulcers with ragged edges that are painful
Risk factors: sexual contact in Africa or Southeast Asia
Identification: Culture on chocolate agar
Treatment: ceftriaxone or azithromycin
Prevention: Safe sexual practices.S

Name: Haemophilus parainfluenza and aphrophilus
Natural Reservoir: part of normal flora in humans in upper respiratory tract
Transmission: endogenous
Diseases: opportunistic infections, esp. endocarditis
Identification: gram stain on samples from sterile sites: small pleomorphic gram
negative rods. Culture on chocolate agar with hemin, NAD, and CO2.
Treatment: ceftriaxone
Prevention: unclear
Name: Bordetella pertussis
Natural Reservoir: in upper respiratory tract of infected human
Diseases: whopping cough in young children, cold-like symptoms with persistent

cough in adults
Risk factors: not vaccinated
Pathogenesis factors: pertussis toxin and adenylate cyclase/hemolysin toxin
Identification: mostly by clinical signs, hard to culture during paroxysmal phase

of whooping cough
Treatment: macrolide, like azithromycin, but effectiveness unclear
Prevention: vaccine, part of DPT series starting at 2 months. Also, vaccine for
teens and adults as part of Tap vaccine(T part is for tetanus).5
Name: Leptospira interrogans
Natural Reservoir: Many animals, including cattle, dogs, pigs, horses
Transmission: by contact with waters contaminated with urine from infected

animals. Enters through breaks in the skin
Diseases: Leptospirosis—fever, headache, myalgia, conjunctival suffusion,

aseptic meningitis. Patients often have elevated liver enzymes and kidney
problems.
Risk factors: animal handlers, recreactional boaters, canoers, kayakers, etc
Identification: Darkfield microscopy or culture from blood, CSF or urine. Serology

tests positive after a week.
Treatment: Penicillin or doxycycline
Prevention: Avoid exposure, doxycycline for prophylaxis

Name: Borrelia burgdorferi
Natural Reservoir: Ixodes ticks and infected rodents and deer
Transmission: tick bite
Diseases: Lyme disease: first phase is erythema migrans along with fever,
headache, myalgias and arthralgias. Second phase is usually arthritis along with
neurological abnormalities, fatigue, 10% have carditis. Third phase is chronic
arthritis and neurological abnormalities
Risk factors: exposure to ticks, but patients often unaware of bite.
Identification: Serology followed by Western blot
Treatment: Doxycycline or amoxicillin
Prevention: Avoid tick exposure.

Name: Borrelia recurrentis
Natural Reservoir: Humans
Transmission: by contact with infected body lice
Diseases: Epidemic relapsing fever with fever, headache, myalgia, malaise.

Symptoms come and go in cycles due to waves of Borrelia growth.
Risk factors: lice infestation due to lack of hygiene, especially in wartime or

refugee camps.
Identification: Exam of blood smears with Wright or Giemsa stains
Treatment: Doxycycline
Prevention: Good sanitation

Name: Treponema pallidum
Transmission: sexual contact and also mother to newborn during pregnancy
Diseases: Syphilis. First phase is an indurated, painless, smooth-edged genital

lesion. Second phase is a generalized maculopapular rash on trunk, but also on
palms and soles of feet. Can be papules in the genital area(condylmata
acuminata). Can be fever, muscle and joint pains, hair loss, headaches. Third
phase can involve gummas, degeneration of CNS and also many cardiac
problems.
Risk factors: unsafe sex, mother who is infected
Identification: Darkfield microscopy of sample from genital lesion, serology for

other phases. First, non-specific tests like RPR or VDRL, then specific
treponemal tests to confirm.
Prevention: safe sex and screening of pregnant women

Name: Treponema pallidum subspecies endemicum, subspecies pertenue, and
Treponema carateum.
Transmission: by direct contact
Diseases: These are all skin or mucosal disease primarily of children in tropical
regions. Bejel is due to endemicum and has skin and oral lesions and later
gumma. Pinta is due to carateum and has papules that become hypopigmented.
Yaws is due to pertenue and has papules in early stages. Gumma form in late
stages.
Risk factors: poor hygiene in endemic areas.
Identification: Same as for Treponema pallidum. These organisms are all positive
with the syphillis tests.
Prevention: avoid contact with infected lesions

Name: Neisseria gonorrhoeae
Transmission: by sexual contact or from mother to newborn during vaginal

delivery.
Diseases: Urethritis with penile or vaginal discharge, cervicitis, proctitis,

asymptomatic infection in many females. Disseminated infection leads to skin
lesions and septic arthritis. Neonates can get eye infections.
Risk factors: poor hygiene in endemic areas.
Pathogenesis factors: pili and opa proteins involved in attachment. Both of these
vary by having many copies of the genes that recombine.
Identification: Gram-negative diplococci(often intracellular) on stain, molecular

probes or PCR, culture seldom used.
Treatment: ceftriaxone, usually with azithromycin for possible chlamydia co-

infection
Prevention: safe sex

Name: Neisseria meningitidis
Natural Reservoir: infected humans, often asymptomatic carriage in upper

respiratory tract
Transmission: by respiratory droplets, especially in close living situations, like

barracks or dorms
Diseases: bacterial meningitis, sepsis(called meningococcemia) or both together.
Risk factors: close living conditions
Pathogenesis factors: capsule with many variants
Identification: Gram-negative diplococci(often intracellular) on stain of CSF or

blood sample. PCR tests and cultures.
Treatment: ceftriaxone,
Prevention: vaccine to capsule(but serotype B not covered), recommended for all

children age 11-18, Prophylaxis with rifampin for close contacts.
Name: Moraxella catarrhalis
Natural Reservoir: infected humans, often asymptomatic carriage in upper

respiratory tract
Transmission: by respiratory droplets
Diseases: otitis media, sinusitis, pneumonia in COPD patients
Identification: gram negative cocci, usually diplococci (sometimes described as

coccobacilli), not usually recovered in otitis media or sinusitis cases. Culture
also.
Treatment: amoxicllin-clavulanate often used.
Prevention: unclear
Name: Mycobacterium tuberculosis
Transmission: by respiratory droplets
Diseases: tuberculosis, miliary tuberculosis, with infections in bone marrow,

vertebrae, other sites with high oxygen levels. Latent TB is where patient has
been exposed but is without symptoms.
Risk factors: residence in high prevalence area(usually third world), homeless,

prisoners.
Pathogenesis factors: Mycolic acids in extensive cell envelope allow grow inside
unactivated macrophages. Cell envelope resists lysis by immune response.
Identification: acid-fast stain, culture, esp. bactec type media. PPD test or
interferson gamma test measure exposure(or latent TB).
Treatment: ioniazid, rifampin, pyrazinamide, ethambutol for active disease.

Ioniazid to latent TB(if treated)
Prevention: BCG vaccine used in Third world. Modest effect for children. Effect
on adults less clear.
Name: Mycobacterium leprae
Transmission: by respiratory droplets or direct contact(no definitely established)
Diseases: leprosy or Hansen’s Disease. Two forms-tuberculoid form gives mild

disease, with flat skin lesions. Lepromatous form is more severe with disfiguring
skin lesions and loss of sensation in lesions. Fingers, toes, and noses are
common sites with lesions.
Risk factors: contact with infected persons, mostly in Third world
Pathogenesis factors: Mycolic acids in extensive cell envelope allow growth

inside unactivated macrophages. Cell envelope resists lysis by immune
response. Organism prefers cooler temps so that fingers etc most often effected.
Identification: acid-fast stain in biopsy samples.
Treatment: dapsone, rifampin, clofazimine
Prevention: unclear.
Name: Mycobacterium avium complex(MAC)
Transmission: by respiratory droplets or ingestion from the environment
Diseases: sympoms are similar to tuberculosis, including miliary TB and infected

lymph nodes.
Risk factors: immunocompromised status, increasingly normal persons.

response.
Identification: acid-fast stain and culture
Treatment: clarithromycin, rifampin, ethambutol
Name: Mycobacterium marinum
Natural Reservoir: waters, including swimming pools and fish tanks
Transmission: exposure by contact with infected waters
Diseases: skin lesions that start as small violet papules and become shallow,
crusty ulcerations with scar formation. This is a granulomatous response.
Risk factors: exposure to contaminated waters 2-3 weeks previously. Sometimes

called “swimming pool” or “fish tank” granulomas.

response.
Identification: acid-fast staining in biopsy samples or culture
Treatment: definitive treatment unclear. Rifampin plus ethambutol.
Name: Shigella species(including S. sonnei, S. flexneri, S. dysenteria, S. boydii)
Transmission: person to person contact by oral fecal route. Ingestion of

contaminated food or water.
Diseases: inflammatory diarrhea, severe cases have dysentery with blood and pus
in stool. Patients can get HUS(hemolytic uremic syndrome)
Risk factors: In US, day care centers. Children more likely to be infected.
Pathogenesis factors: Organism invades cells in GI tract with Type III secretion
systems and some strains produce a shiga toxin and enterotoxins.
Identification: culture from stool
Treatment: Fluid and salt replacement. Fluoroquinolone for severe cases.

Name: E. coli—Enteroinvasive E. coli--EIEC
Transmission: person to person contact by oral fecal route. Ingestion of

contaminated food or water.
Diseases: inflammatory diarrhea, severe cases have dysentery with blood and pus
in stool. Patients can get HUS(hemolytic uremic syndrome)
Risk factors: mild inflammatory diarrhea, mostly in Third World
Pathogenesis factors: Organism invades cells in GI tract with Type III secretion
systems and some strains produce a shiga toxin and enterotoxins. Similar to
Shigella species
Identification: not clear, PCR for inv genes
Treatment: Fluid and salt replacement. Fluoroquinolone for severe cases.

Name: E. coli regular or K1(not a special pathogenic strain)
Natural Reservoir: normal flora in GI tract of humans
Transmission: endogenous, person to person contact by oral fecal route.

Ingestion of contaminated food or water.
Diseases: cystitis, pyelonephritis, many nosocomial infections or infections in

debilitated patients. K1 capsule type associated with meningitis in neonates.
Risk factors: cystitis, pyelonephritis—elderly women, patients with urinary tract

stones or other abnormalities.
Pathogenesis factors: Many urinary tract strains carry genes for P1 pilus on
pathogenecity island
Identification: culture
Treatment: Fluoroquinolones

Name: E. coli Enterohemmorrhagic EHEC, also called STEC
Natural Reservoir: infected cattle and environment contaminated with cattle feces
Transmission: ingestion of contaminated food, esp. undercooked hamburgers
Diseases: inflammatory diarrhea, can have blood and pus in stool. Patients can
get hemolytic uremic syndrome(HUS).
Risk factors: eating undercooked hamburgers or other beef
Pathogenesis factors: phage mediated shiga toxins
Identification: Elisa for toxins, growth on MacConkey sorbitol
Treatment: fluid and salt replacement. Avoid antibiotics.
Prevention: eating well-done beef, good hygiene.

Name: E. coli Enteropathogenic(EPEC) and Enteroaggregative(EAEC)
Natural Reservoir: infected humans and contamined food and water
Transmission: oral-fecal
Diseases: watery, non-inflammatory diarrhea
Risk factors: child in Third World where sanitation is poor
Pathogenesis factors: various adhesions factors. EAEC proteins stimulate mucus

secretion.
Identification: not usually attempted. PCR for adhesion genes
Treatment: fluid and salt replacement. Severe cases get fluoroquinolone
Prevention: good hygiene.

Name: E. coli Enterotoxigenic(ETEC)
Natural Reservoir: infected humans and contamined food and water
Transmission: oral-fecal
Diseases: watery, non-inflammatory diarrhea
Risk factors: travelers diarrhea, children in Third World where sanitation is poor
Pathogenesis factors: heat labile and heat stable enterotoxins
Identification: not usually attempted.
Treatment: fluid and salt replacement. Severe cases get fluoroquinolone

Name: Yersinia enterocolitica & Yersinia pseudotuberculosis
Natural Reservoir: variety of animals, esp. pigs
Transmission: ingestion of contaminated meats or contact with diseases animals.

Rarely transmission by blood transfusion
Diseases: inflammatory diarrhea, occasionally gets into blood causing sepsis. T
Risk factors: consumption of undercooked pork, colder climates, eating

chitterlings(or undercooked pork intestines)
Pathogenesis factors: These organisms can penetrate the mucosal layer and get
into the blood.
Identification: grows on most enteric media. Either stool or blood samples
Treatment: fluid and salt replacement plus a fluoroquinolone

Name: Normal flora enterics(outside of E. coli): Enterobacter, Serratia, Citrobacter
Natural Reservoir: normal human GI flora
Diseases: UTIs in catherized patients, variety of infections in other organs
Risk factors: debilitated or immunocompromised status. These are opportunistic

pathogens.
Pathogenesis factors: Unclear
Identification: grows on most enteric media.
Treatment: fluoroquinolone
Name: Non-typhoidal Salmonella(species names are controversial but S. enterica
is more common as the species name)
Natural Reservoir: normal bird and reptile GI flora
Transmission: contact with birds or reptiles or eating contaminated food/water,

especially eating poultry, eggs.
Diseases: inflammatory diarrhea, but often just watery diarrhea. Fecal leukocytes
usually present
Risk factors: unclear, many normal healthy people infected by ingestion or

contact with organisms.
Pathogenesis factors: many of these, but nothings really sticks out.
Identification: grows on most enteric media.
Treatment: salt and fluid replacement + fluoroquinolone if patient severely ill.
Prevention: good hygiene and careful food preparation

Name: Campylobacter species(Most C. jejuni and C. coli)
Natural Reservoir: normal bird and GI flora of many animals
Transmission: contact with birds or other animals or eating contaminated

food/water, especially eating poultry.
Diseases: inflammatory diarrhea, but often just watery diarrhea. Fecal leukocytes
usually present. Rarely, bacteremias and systemic infections, usually in
immunocompromised. Rarely, organism penetrated through GI mucosa.
Risk factors: Eating undercooked poultry or contaminated food/water. Many times

this is unclear, many normal healthy people infected by ingestion or contact with
organisms.
Pathogenesis factors: many of these, but nothings really sticks out.
Identification: culture, sometimes curved gram negative bacilli seen in stool
Treatment: salt and fluid replacement + fluoroquinolone if patient severely ill.
Prevention: good hygiene and careful food preparation

Name: Vibrio cholerae and V. parahaemolyticus
Natural Reservoir: infected humans and contaminated waters, esp. salt and
brackish waters in the tropics.
Transmission: oral/fecal, usually be ingestion of contaminated water
Diseases: excessive, watery diarrhea. This is the classic non-inflammatory

diarrhea.
Risk factors: Eating shellfish grown in contaminated waters. Water exposure to

contaminated waters, esp. brackish waters. V. parahaemolyticus common in
Japan.
Pathogenesis factors: many of these, but cholera toxin is A/B toxin where adenyl
cyclase is activated and cAMP goes up with massive outflow of waters and salts.
Identification: culture, sometimes curved gram negative bacilli seen in stool
Treatment: salt and fluid replacement + doxycycline if patient severely ill.
Prevention: good hygiene and careful food preparation. Vaccines exist but their
protection is very poor and seldom used.
Name: Vibrio vulnificus
Natural Reservoir: common. salt and brackish waters in the tropics and
subtropics.
Transmission: ingestion of contaminated water or inoculation via trauma
Diseases: cellulitis, with vesicles and bullae, can be severe esp. if patient has
liver disease. Systemic illness with fever and skin lesions.
Risk factors: Eating shellfish grown in contaminated waters. Water exposure to

contaminated waters, esp. brackish waters.
Pathogenesis factors:capsule
Identification: culture, but be sure to tell the lab what you are looking for.
Treatment: fluoroquinolones maybe with cefotaxime.
Prevention: unclear, avoidance of contaminated waters.

Name: Salmonella typhi or paratyphi(species names are controversial in
Salmonella so Salmonella enterica subspecies typhi or paratyphi would be the
same organisms as S. typhi or paratyphi)
Natural Reservoir: infected humans and water contaminated with human

feces/urine, only common in undeveloped nations with poor water sanitation.
Transmission: ingestion of contaminated food/water or direct contact.
Diseases: Typhoid fever(or the milder paratyphoid fever). This is a systemic
illness, with fever, abdominal pain, rose spots, heptospleenomegaly, maybe
diarrhea. 1-4% may become chronic carriers.
Risk factors: ingestion of unclean water or food in endemic areas
Pathogenesis factors: ability to penetrate the mucosal layer of GI tract and enter
blood, and then go to bone marrow, spleen, liver, and gall bladder.
Identification: grows on most enteric media, usually isolated from blood, stool, or
bone marrow samples.
Treatment: fluoroquinolones
Prevention: good hygiene and careful food preparation. Two vaccines exist. Live,
attenuated vaccine given orally(Ty21a) and this is the best vaccine, except for
pregnant women, those taking antibiotics or immunocompromised. Capsular
vaccine given IM(Vi CPS) also available.
Name: Proteus species(mirabilis and vulgaris most common)
Natural Reservoir: normal human flora
Transmission: endogenous or exogenous
Diseases: UTIs esp. in catheterized patients. Occasionally found in blood if

patients are uroseptic.
Risk factors: debilitated, esp. catheterized
Pathogenesis factors: strains have urease which raises the pH of urine and
sometimes causes stones
Identification: grows on most enteric media, usually isolated from urine or blood,
Treatment: fluoroquinolones
Prevention: good hygiene and careful catheter management

Name: Klebsiella pneumoniae and K. oxytoca
Transmission: inhalation, direct contact or unclear
Diseases: UTIs esp. in catheterized patients. Occasionally found in blood if

patients are uroseptic. Pneumonias in alcoholics or COPDers. This pneumonia is
often severe, with red “currant jelly” sputum,abscesses, and bulging fissures
seen on x-ray due to edematous lobar consolidation. K. oxytoca has been
implicated in antibiotic-associated diarrhea/colitis.
Risk factors: debilitated, esp. catheterized, for UTIs. Acoholics and debilitated
with lung disease for pneumonias.
Pathogenesis factors: capsules and pili
Identification: grows on most enteric media, isolated from sputum, urine or

blood,
Treatment: many resistant strains, maybe a fluoroquinolone
Prevention: good hygiene and careful catheter management

Name: Listeria monocytogenes
Natural Reservoir: normal flora in a variety of animals and infected humans

Transmission: ingestion of contaminated food, esp. unpasteurized milk and
cheeses, but also cold cuts and hot dogs. In utero or at birth transmitted to fetus.
Diseases: Neonates: meningitis/sepsis syndrome, granulomatosis infrantiseptica-

systemic infection with multiple abscesses and granulomas. Pregnant women,
cancer patients and transplant recipients all have higher risk of meninigitis. Other
get mild flu-like illness sometimes with diarrhea.
Risk factors: Neonates: mother with listeria infection(2/3 of infants with mother
with listeria infection get infected themselves); cancer and transplant patients
have higher risk of meningitis. Pregnant women get more meningitis, but also
more severe flu-like illness and diarrhea.
Pathogenesis factors: intracellular pathogen phagocytosed by macrophages or

epithelial cells. Organism produces listerolysin O to get out of phagolysozome.
Identification: culture, gram stain often fails(it is a gram positive coccobacillus)
Treatment: ampillicin maybe with gentamicin
Prevention: avoidance of possible contaminated foods, esp. by pregnant women.

Name: Rickettsia rickettsii
Natural Reservoir: infected ticks(several different species) and wild infected

rodents.
Transmission: by tick bite, usually in the summer
Diseases: Rocky Mountain Spotted Fever(RMSF) which is a systemic illness with

fever, headache, malaise, myalgias along with edema and a maculopapular rash,
esp. at the site of the bite(but also elsewhere). Often, rash starts on ankles and
wrists and spreads to trunk. Rash can be on palms and soles.
Risk factors: Related to tick exposure, such as walking in the woods, camping etc
Pathogenesis factors: organism gets into blood, induce phagocytosis by

enthothelial cells esp. in small blood vessels. Use phospholipases to escape from
phagosome. Vasculitis and inflammation lead to rash.
Identification: Serology
Treatment: doxycycline
Prevention: avoidance of tick bites, esp. by use of protective clothing and insect
repellants.
Name: Rickettsia prowazeckii
Natural Reservoir: infected humans and some animals, e.g. flying squirrels
Transmission: by louse bite or aerosols of dust from clothing contaminated with
lice feces.
Diseases: Epidemic or louse-borne typhus which is a systemic illness with fever,

headache, malaise, myalgias along with edema and a maculopapular rash.
Risk factors: Related to louse exposure, such as large human groups housed
together with very poor sanitation, e.g. refugee camps, military camps in WWI.

Prevention: louse control measures, good sanitation

Name: Rickettsia typhi
Natural Reservoir: rodents and opossums

Transmission: by flea bite during warm weather in crowded conditions.
Diseases: Endemic flea-borne or murine typhus which is a systemic illness with

fever, headache, malaise, myalgias along with edema and a maculopapular rash.
Risk factors: Related to louse exposure, such as large human groups housed
together with very poor sanitation, e.g. refugee camps, military camps in WWI.

Prevention: rodent control measures, good sanitation

Name: Rickettsia tsutsugamushi or Orienta tsutsugamushi(this is the more
common name)
Natural Reservoir: rodents

Transmission: by mite or chigger bite
Diseases: Scrub typhus which is a systemic illness with fever, headache, malaise,
myalgias along with edema and a maculopapular rash.
Risk factors: Not in US, but common on tropical islands in Pacific and Indian
oceans and also in southern Asia.

Prevention: rodent control measures, insect repellants

Name: Yersinia pestis
Natural Reservoir: rodents and other small mammals

Transmission: by flea or by inhalation if infected person has pneumonic plague
Diseases: Plague, bubonic form due to flea bite which gives necrotic lymph node
nearby(bubo) and can spread hematogenously. Pneumonic form is overwhelming
pneumonia. Both forms often followed by sepsis and death.
Risk factors: Southwest US has focus of infection(many other countries also have
foci of infections) and handling or being around small mammals is the biggest
risk. So, park rangers and animal handlers are high risk groups.
Pathogenesis factors: organism carried to lymph node and survives inside APCs
and then grows there and spreads hematogenously.
Identification: culture and staining(gram negative pleomorphic bacillus). There

are serology tests and Elisa antigen tests. PCR tests on the way.
Treatment: streptomycin or gentamicin
Prevention: gentamicin or doxycycline. Older vaccine no longer available.

Name: Bacillus anthracis
Natural Reservoir: herbivores, such as sheep, goats, cattle, horses

Transmission: by contact with spores, usually from contaminated dust. In
bioterror setting, by inhalation of spores spread by terrorists.
Diseases: Three form: cutaneous anthrax-ulcer that becomes necrotic along with
systemic symptoms. Inhalational anthrax-overwhelming pneumonia with lots of
edema. GI anthrax-not in US, ulcers in mouth, esophagus, intestines, etc that can
spread systemically.
Risk factors: Handling herbivores or their hides, esp. handling sheep and goat
hides. This disease is more common outside of US. Bioterrorism.
Pathogenesis factors: plasmids encode three factors: protective antigen, edema

factor, and lethal factors that together made two different toxins that produce the
diseases.
Identification: culture and staining(gram positive bacillus). PCR tests.
Treatment: fluoroquinolones or doxycycline
Prevention: fluoroquinolones or doxycycline. Vaccine available that is safe and

effective, but usually only given to animal or hide handlers at risk and some
members of military and US government . This is recombinant protective factor.
Name: Brucella species(B. abortus, B. melitensis, B.canis, B. suis)
Natural Reservoir: many animals: abortus: cattle, melitensis: goats; canis: dogs;
suis: pigs. In animals, brucellosis is a chronic infection with organisms shed in
milk, urine, and tissues discharged during birth or abortion.
Transmission: by contact with contaminated animal tissues, or ingestion of
contaminated milk products. Ingestion of unpasteurized milk and cheeses is
most common. Animal handlers can get it by contact.
Diseases: brucellosis-general systemic symptoms-fever, myalgias, malaise,

headaches. Fever can be undulating. Sometimes, hepatosplenomegaly. Infections
can spread to joints and vertebrae.
Risk factors: Handling infected animals, esp. goats. Ingestions of unpasteurized
dairy products. B. melitensis seems to cross over most easy to humans. This is
most common in Mediterranean areas and also Mexico. Most US cases acquired
in Mexico.
Pathogenesis factors: intracellular pathogen that can escape from

phagolyzosome and spread to many tissues.
Identification: difficult to do, usually by serology
Treatment: doxycycline with rifampin or gentamicin.
Prevention: avoid unpasteurized dairy products.

Name: Francisella tularensis
Natural Reservoir: many animals, esp. rabbits, muskrats and deer.

Transmission: by contact with infected animal tissues or tick bite. No human to
human transmission
Diseases: tularemia different form:1) ulceroglandular with a skin lesion and

enlarged nearby nodes; 2) pneumonic with a non-specific pneumonia; 3) typhoidal
with general systemic symptoms-fever, myalgias, malaise, headaches, 4)
conjunctivitis with enlarged nearby nodes.
Risk factors: Handling infected animals, esp. skinning or butchery of infected wild
game animals. Bioterror agent.
Pathogenesis factors: intracellular pathogen that can survive inside

phagolyzosome of macrophages and then spread to many tissues.
Identification: difficult to do, usually by serology or PCR
Treatment: streptomycin or gentamicin
Prevention: avoid infected animals, insect repellants for tick bites. Doxycycline for
post-exposure prophylaxis. A live attenuated vaccine is available but seldom
used as it only reduces symptoms.
Name: Coxiella burnetti
Natural Reservoir: many animals, esp. cattle, sheep and goats

Transmission: mostly by inhalation of contaminated dust, also direct contact
Diseases: Q fever. Acute illness usually flu-like illness with fever, chills,
headaches which can develop into an atypical pneumonia. Chronic infections
often involve endocarditis(this is culture-negative endocarditis) and hepatitis.
Usually no rash(this distinguishes it from other Rickettsial infections)
Risk factors: Handling infected animals, esp. sheep, goats and cattle. This is very
unusual US disease, but more common in other countries, esp. Australia.
Pathogenesis factors: intracellular pathogen that can survive inside

phagolyzosome of macrophages and then spread to many tissues.
Identification: serology-Acute has antibodies to phase II; chronic to phase I and II
Treatment: doxycycline with addition of rifampin in chronic cases
Prevention: avoid infected animals and their excreta. There is a safe and effective
vaccine but not used in US. But it is used in Australia.
Name: Ehrlichia chaffeensis, E. ewingii, & Anaplasma phagocytophilum
Natural Reservoir: mostly deer, dogs and humans, some other animals also
Transmission: tick bite
Diseases: Human monocytic ehrichiosis and Human granulocytic ehrichiosis or

anaplasmosis. Typical symptoms are fever, headache, myalgias, and malaise.
Usually patients are leukopenic and thrombocytopenic with slightly elevated liver
enzymes.
Risk factors: Handling infected animals, esp. sheep, goats and cattle. This is very
unusual US disease, but more common in other countries, esp. Australia.
Pathogenesis factors: intracellular pathogen that inhibits phagosome/lysozyme

fusion. Ehrlichia species infect mostly monocytes, Anaplasma mostly neutrophils.
Identification: Usually serology. Sometimes, characteristic morulae can be seen
inside infected monocytes or granulocytes.
Prevention: avoid tick bite with insect repellants.

Name: Erysipelothrix rhusiopathiae
Natural Reservoir: many animals, including swine, turkeys and fish

Transmission: contact with infected animals and their products
Diseases: Erysipeloid—localized skin infection that is violaceous and not pus

forming, usually on fingers or hands. Lesions are pruritic and painful.
Risk factors: Handling and butchering animals or fish.

Identification: Culture
Treatment: Penicillin
Prevention: safe butchering of animals and fish

Name: Burkholderia pseudomallei
Natural Reservoir: common is soils and waters of Southeast Asia and Australia
Transmission: not clearly established, but probably by inhalation or direct contact

of organisms via soil and water exposure.
Diseases: melioidosis: many syndromes, skin ulcers/abscesses, bacteremia with

shock, pneumonia that resembles TB.
Risk factors: residence in high prevalence areas, esp. rural residence
Pathogenesis factors: organism can grow inside WBCs.
Treatment: ceftazidime
Prevention: unclear
Name: Enterococci—E. faecalis and E. faecium
Natural Reservoir: normal human GI flora; also in female genitourinary tract and
also in animals, soils, and waters.
Transmission: mostly endogeneous, but person to person by direct contact,
fomites or contaminated medical equipment.
Diseases: UTIs, esp. in persons with indwelling devices; intra-abdominal

abscesses along with other microbes; endocarditis; skin infections, esp in
decubitus and diabetic ulcers.
Risk factors: nosocomial pathogen for debilitated and immunocompromised
patients. People with indwelling devices, GI tract integrity problems, or chronic
ulcers.
Pathogenesis factors: not well defined

Identification: culture, stains can be helpful—organisms are gram positive
diplococci.
Treatment: often difficult due to antibiotic resistance. VRE strains are resistant to
vancomycin. Linelozid often used. Quinupristin/dalfopristin combo active versus
E. faecium
Prevention: unclear
Name: Pseudomonas aeruginosa
Natural Reservoir: ubiquitous, very common soil and water organisms

Transmission: mostly due to soil and water exposure but organisms is very hardy
and common. Person to person by direct contact.
Diseases: Pneumonias, esp. in intubated patients and those with cystic

fibrosis;UTIs, esp. in persons with indwelling devices; skin infections in burn
patients; hot tub folliculitis, osteomyelitis in foot puncture wounds, otitis
externa(swimmers ear), eye infections in contact lenses wearers.
Risk factors: nosocomial pathogen for debilitated and immunocompromised
patients. People with indwelling devices esp. at risk.
Pathogenesis factors: many, but overall pathogenicity is low.

Identification: culture, stains can sometimes be helpful--organism is a gram-
negative rod.
Treatment: often difficult due to antibiotic resistance. Antibiotic sensitivity testing

a must. Piperacillin/tazobactam for inpatients, ceftazidime with a aminoglycoside
like gentamicin for outpatients.
Prevention: good management of indwelling devices.

Name: Actinomyces israeli
Natural Reservoir: normal oral human flora, organism is an obligate anaerobe.

Diseases: actinomycosis: opportunistic infections which occur when the

organism get into otherwise sterile places. Lumpy jaw after dental problems,
abdominal or thoraic infections after surgery or loss of GI integrity.
Risk factors: people with dental problems, surgery or abdominal infections.
Pathogenesis: unclear
Identification: culture, can detect so-called “sulfur granules” in samples.
Organism is gram positive and forms filamentous tangled masses called mycelia.
Prevention: unclear
Name: Nocardia species, esp. N. asteroides and N. brasiliensis
Natural Reservoir: very common soil and water organisms

Transmission: by contact or inhalation of organisms from soil or water
Diseases: Nocardiosis: chronic pneumonia with abscesses, necrosis, and cavity

formation. Nearby sites can be involved. Cutaneous infections with chronic
ulcers,nodules, abscesses and granulomas(similar lesions can be due to
Streptomyces or Actinocyces species). These skin nodules are called
mycetomas. Systemic infections that can spread to the CNS.
Risk factors: debilitated or immunocompromised
Pathogenesis: unclear, can survive inside macrophages

Identification: culture, can be detected as weakly acid fast organism that gives
branching, filamentous structures. They also stain as gram positive rods
Treatment: Trimethoprim/sulfa
Prevention: unclear
Name: Pasteurella multocida
Natural Reservoir: common in the oral cavity of many animals, esp. cats and dogs
Transmission: by animal bite
Diseases: cellulitis at site of wound that can progress to /be accompanied by

tendon infections, septic arthritis, osteomyelitis, and bacteremia and sepsis.
Risk factors: children get more animal bites, otherwise immuncompromised have
more severe infections.
Pathogenesis: capsule which is anti-phagocytic.

Identification: culture and sometimes stain—its is a gram negative coccobacillus
or rod
Treatment: amoxicillin-clavulanate
Prevention: unclear, reduction in animal bites.
Name: Capnocytophaga canimorsus
Natural Reservoir: common in the oral cavity of many animals, esp. dogs
Transmission: by animal bite

tendon infections, septic arthritis, osteomyelitis, and bacteremia and sepsis.
Risk factors: asplenics and immuncompromised at special risk for bacteremia and
sepsis
Prevention: unclear, reduction in animal bites.
Name: Eikenella corrodens
Natural Reservoir: common in the oral cavity of humans

Transmission: by human to human bite or endogenous from oral flora

tendon infections, septic arthritis, osteomyelitis, and bacteremia and sepsis. Can
be a cause of endocarditis(It is a HACEK organism).
Risk factors: clenched fist injury due to blow to teeth of human opponent
Name: Corynebacterium diphtheriae
Natural Reservoir: humans, many are colonized without symptoms

Transmission: respiratory droplets, direct contact for skin lesions
Diseases: Diphtheria: upper respiratory disease with sore throat, low grade fever,
and an adherent pseudomembrane in the upper respiratory tract. Toxin leads to
systemic symptoms in many organs and death.
Risk factors: usually a disease of childhood, now on in third world
Pathogenesis: Toxin carried on lysogenic phage. Toxin inactivates host protein
synthesis.
Identification: culture and test for toxin by antibody-based test or PCR
Treatment: anti-sera given along with penicillin or erythromycin.

Prevention: safe and effective vaccine which consists of inactivated toxin. Part for
DPT vaccine.
Name: Corynebacterium minutissimum
Transmission: direct contact for skin lesions
Diseases: Erythrasma: probably a polymicrobial infection involving C.

minutissimum along with other bacteria. Chronic superficial infection of the skin,
esp. in most intertriginous areas. Lesions are irregular, reddened , itchy scaly
patches that glow red under wood’s lamp or UV light(Fungal infections glow
yellow/green).
Risk factors: poor hygiene
Identification: exam under Wood’s lamp or UV light.
Treatment: erythromycin and other topical antibiotics.

Name: Bartonella species—B. henselae and B. quintana
Natural Reservoir: B. henselae, common in the oral cavity of cats, occasionally

other animals. For B. quintana, infected humans.
Transmission: by animal bite or scratch or flea bite(B.h.) or louse bite(B.q.)
Diseases: Cat-sratch disease(CSD) due to B henselae involves a scratch or flea

bite that often heals and then papules appear along a lymphatic drainage line
and/or at the bite site and then a nearby swollen lymph node appears. Bacillary
angiomatosis due to B. henselae and B. quintana involves mucocutaneous
nodules due to neovascular profileration that are red and raised and are similar to
the lesions of Kaposi’s sarcoma. This can also involve the liver and cause
hepatis peliosis(mostly due to B. quintana). Hepatis peliosis is the presence of
cavities filled with blood in the liver. Systemic disease and bacteremia(trench
fever) with fever, myalias, headache and bone pain due to louse bite and B.
quintana.
Risk factors: children get more animal bites, otherwise immuncompromised have
bacillary angiomatosis and hepatis peliosis. Poor hygiene for trench fever.
Identification: Serology for CSD and histology for bacillary angiomatosis and
hepatis peliosis.
Treatment: macrolide or tetracyclines
Prevention: unclear, reduction in animal bites for CSD, hygiene for trench fever
Name: Helicobacter pylori

Transmission: unclear, probably oral-fecal.
Diseases: Acute gastritis sometimes with diarrhea. Chronic infections lead to

gastric and duodenal ulcers. Patients are at risk for gastric carcinoma
Pathogenesis: organism produces a urease to counteract stomach acid and a
cytotoxin that kills mucus producing cells, resulting in a lesion.
Identification: several methods. Urease breath test. Elisa test for bacterial
antigens in stool. Serology had to interpret. Can stain samples obtained by upper
endoscopy.
Treatment: controversial—usually amoxicillin, clarithromycin, proton pump

inhibitor and bismuth.
Prevention: unclear
Name: Obligate anaerobes that are normal human flora, including Bacteroides,
Fusobacteria, Prevotella, Peptostreptococcus,Gardenella, Porphyromonas, etc.
Natural Reservoir: human surfaces, including skin, GI tract, genitourinary tract,

oral cavity.
Diseases: due to these organisms getting out of their normal location. Usually
polymicrobial infections with abscesses and necrosis. Peritonitis and abdominal
abscesses. Dental abscesses. Mixed soft tissue infections, diabetics foot ulcers.
Lemierre’s syndrome(Fusobacteria), retropharyngeal infections. Anaerobic
pneumonias. Bacteroides species often most serious pathogens in these mixed
infections.
Risk factors: some event, often trauma, that gets these organisms into a sterile
location. For anaerobic pneumonia, aspiration due to loss of consciousness.
Pathogenesis: some of the organisms in these groups produces toxins that cause
tissue injury and death.
Identification: several methods. Foul odor smell distinctive. Presence of gas in

tissues. Culture slow.
Treatment: often metronidazole or clindamcyin with other agents, like amoxicillin-

clavulanate or fluoroquinolone or piperacillin/tazobactam.
Prevention: unclear
Name: Propionibacterium acnes
Natural Reservoir: human surfaces, esp. skin

Diseases: acne vulgaris, Acne vulgaris is a disease of pilosebaceous follicles and

occurs at mostly in areas where there are many sebaceous glands such as face,
neck, arms, etc.
Risk factors: patients often get this as sebum production increases in teen years
Identification: appear of characteristic lesions.
Treatment: benzoyl peroxides, retinoids, topical antibiotics like erythromycin or

clindamycin.
Prevention: good hygiene helps but cannot eliminate problem
Name: Clostridium perfringens group: C. perfringens, C. novyi, C. septicum
Natural Reservoir: common in soil and water and transient flora in human skin
and GI tract.
Transmission: endogenous, contact with soil, ingestion of contaminated meat.
Diseases: cellulitis, gas gangrene, gastroenteritis due to food poisoning

Risk factors: trauma for cellulitis and/or gas gangrene, ingestion of contaminated
foods for gastroenteritis.
Pathogenesis: obligate anaerobes that form spores and thrive in tissues with poor
blood supply due to trauma. Produces many toxins, including phospholipases,
that destroy tissue, enterotoxins, degradative enzymes.
Identification: skin and soft tissue infections: appear of characteristic lesions with
gas and necrosis(often black or purple patches), culture, gram staining often
shows gram positive rods with few WBCs. Rarely spores can be seen inside
bacterial cells. For gastroenteritis, not usually identified. Watery diarrhea
resolves quickly.
Treatment: skin and soft tissue, penicillin and surgical debridement.

Prevention: good hygiene for gastroenteritis. Good trauma management for skin
and soft tissue infections.
Name: Clostridium botulinum
Natural Reservoir: common in soil and water and GI tract of animals. Often
contaminates vegetables, fruits and meats.
Transmission: spores get into preserved foods and obligate anaerobe grows up in
improperly preserved food and produces the toxin which is ingested. Direct
contact for wounds.
Diseases: Foodborne botulism: patients become dizzy and weak. Develop bilateral
descending weakness of peripheal muscles and progressive flaccid paralysis.
Infant botulism where organism grows in GI tract giving flaccid paralysis. Wound
botulism where spores enter a wound to grow there and produce the toxins.
Risk factors: Foodborne: eating improperly preserved food, esp. due to home
canning. Infant: eating contaminated honey. Wound: contaminated wounds.
Pathogenesis: Botulinum toxins, a group of proteins with similar modes of action.
These toxins pass through the gut into the blood, where they block the release of
acetylcholine from chlorinergic nerves.
Identification: by clinical symptoms, culture usually unsuccessful. There is test

for the toxin, available in reference labs.
Treatment: antisera is available. Antibiotic use not clear of benefit but usually
penicillin is given.
Prevention: good food prep., no honey for infants.
Name: Clostridium tetani
Natural Reservoir: common in soil and water where spores survive for many
years.
Transmission: inoculation via trauma with contaminated soils.
Diseases: rigid paralysis, often including the jaw(lockjaw). Starts often with
cramping and twitching at wound site. Then spreads. Death can occur from
respiratory paralysis.
Risk factors: trauma with wound contaminated with soil
Pathogenesis: toxin called tetanospasmin which blocks the release of inhibitory
neurotransmitters such as gaba and glycine, which results in unrestrained of the
motor neurons.
Identification: by clinical symptoms, culture usually unsuccessful.
Treatment: antitoxin sera along with penicillin or metronidazole.

Prevention: Safe and effective vaccine, which is inactivated toxin. Part of DPT
series. Needs booster every 10 years.
Name: Clostridium difficle
Natural Reservoir: often in human GI tract, but minor part of normal GI flora
Diseases: antibiotic associated diarrhea/colitis. Symptoms usually begin about a

week after antibiotic use. Varies from mild diarrhea to pseudomembraneous
colitis, sometimes with perforation
Risk factors: frequent antibiotic use
Pathogenesis: two cytotoxins called A and B. Antibiotics are thought to kill off
competing normal flora allowing this organism to grow up. Ability to form spores
means disease can often reappear.
Identification: Elisa tests for toxins in stools.
Treatment: metronidazole or vancomycin.

Prevention: Appropriate antibiotic use.
Name: Klebsiella granulomatis(formerly Calymmatobacterium granulomatis)

Diseases: Donovanosis or Granuloma inguinale: starts as small painless papule

which soon ulcerates to beefy red ulcer with rolled edges and velvet-like surface
that bleeds easily. Ulcers can be multiple and spread. Spontaneous healing can
give scar formation and often nearby nodes are swollen and lymphedema can
occur.
Risk factors: unsafe sex with multiple partners in high risk areas, such as India,
Brazil, some Carribean spots, Africa.
Identification: Histological examination of biopsy sample with demonstration of

typical intracellular Donovan bodies.
Treatment: azithromycin, but not very clear cut.

Prevention: Less unsafe sex.
THE END

Summaries of Microbial Pathogens

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SUMMARIES OF MICROBIAL PATHOGENS

Natural Reservoir: Ubiquitous in nature. Transient normal flora on skin, vagina

Transmission: by direct contact or respiratory droplets.

Diseases: Skin infections: cellulitis, impetigo, folliculitis, carbuncles, scaled skin

Risk factors: Implanted devices, IV drug abuse, intubation, many infections

Pathogenesis factors: many adhesion proteins,MSCRAMMs, many toxins

Identification: Gram stain and culture. This species is catalase positive,

Prevention: Good hygiene

Natural Reservoir: Common normal skin flora, mucosal surfaces, conjunctiva,

Transmission: from normal flora by direct contact

Diseases: Infections due to implanted devices

Risk factors: Implanted devices

Pathogenesis factors: ability for form biofilms

Identification: Gram stain and culture.

Treatment: Vancomycin with rifampin or gentamicin

Prevention: Good hygiene

Natural Reservoir: Transient normal flora

Transmission: from normal flora

Diseases: Cystitis in women

Risk factors: unclear

Pathogenesis factors: unclear

Identification: Gram stain and culture.

Natural Reservoir: upper respiratory & genitourinary tracts

Transmission: mother to newborn during pregnancy, during delivery, or later

Diseases: meningitis, sepsis in neonates, skin infections, esp. in diabetic foot

Risk factors: carriage of bacteria by mother, premature delivery, membrane

Pathogenesis factors: unclear

Identification: gram stain and culture

Treatment: penicillin, ampicillin with gentamycin for severe cases

Prevention: screening of pregnant women

Natural Reservoir: transient flora without symptoms on skin, infected people

Transmission: respiratory droplets or direct contact

Diseases: cellullitis, impetigo, erysipelas, scarlet fever, puerperal sepsis, invasive

Risk factors: Invasive diseases—debilitated or immunocompromised, impetigo—

Pathogenesis factors: capsule, M protein which interferes with complement,

Natural Reservoir: normal flora of oropharynx

Transmission: from normal flora, transient bacteremia after dental procedures

Diseases: subacute endocarditis, dental caries

Risk factors: invasive dental procedures

Pathogenesis factors: unclear

Identification: gram stain and culture

Natural Reservoir: nasopharynx

Transmission: respiratory droplets or endogenous from nasopharynx or

Diseases: pneumonia, otitis media, sepsis, meningitis, sinusitis

Pathogenesis factors: capsule with many variants

Identification: gram stain and culture

Natural Reservoir: infected humans

Transmission: respiratory droplets

Diseases: pneumonia, URIs, often followed by lasting cough

Risk factors: many infections without a clear risk factor

Identification: unclear, cold aggultinins phased out, PCR rarely used.

Treatment: macrolide like azithromycin or clarithromycin

Prevention: good hygiene

Natural Reservoir: infected humans

Transmission: respiratory droplets

Diseases: pneumonia, URIs

Risk factors: many infections without a clear risk factor

Pathogenesis factors: intracellular pathogen

Treatment: macrolide like azithromycin or clarithromycin

Prevention: good hygiene

Transmission: respiratory droplets

Diseases: pneumonia, called psittacosis.