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116 Cards in this Set
- Front
- Back
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Bugs that don't Gram stain well
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Treponema- too thin, use darkfield microscopy and fluorescent ab; Rickettsia- intracellular; Mycobacteria- high lipid content of cell wall use acid fast instead; Mycoplasma- no cell wall; Legionella pneumophila- primarily intracellular; Chlamydia- intracellular and lacks muramic acid in cell wall
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Giemsa stain
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Borrelia, Plasmodium, trypanosome, Chlamydia
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Periodic acid Schiff
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Stains glycogen, mucopolysaccharides, use to diagnose Whipple's dz (Tropheryma whippelii)
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Ziehl-Neelsen stain
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Acid fast organisms like mycobacteria
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India ink or Mucicarmine
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cryptococcus neoformans
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Silver stain
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Fungi like Pneumocystis, Legionella
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Culture on chocolat agar with factor V (NAD+) and X (hematin)
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H. influenzae
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Thayer-Martin (or VPN) media (V=vancomycin against GP orgs, P=Polymixin against GN orgs, N=nystatin against fungi)
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N. gonnorrhoeae
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Tellurite plate, Loffler's media
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C. diphtheriae
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Lowenstein-Jensen's agar
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M. tuberculosis
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MacConkey's agar- Think MacConKEE'S agar
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Lactose fermenting enterics- make pink colonies. Citrobacter, Klebsiella, E. coli, Enterobacter, Serratia
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Eosin-methylene blue
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E.coli- colonies will be blue-black with metallic sheen
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Charcoal yeast extract buffered w/ cysteine
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Legionella
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6.5% NaCl
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Enterococci are hardier and can grow in 6.5% NaCl better than nonenterococcal group D
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Sabouraud's agar
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Fungi
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Obigate aerobes
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Nagging Pests Must Breathe= Nocardia, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Bacillus
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Obligate anaerobes
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anaerobes Can't Breathe Air- Clostridium, Bacteroides, Actinomyces
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Obligate Intracellular bugs
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Rickettisia and Chlamydia- they can't make their own ATP
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Facultative Intracellular bugs
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Some Nasty Bugs May Live FacultativeLy- Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella
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Encapsulated bacteria
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Kapsules Shield SHiN- Klebsiella pneumoniae, Salmonella, Streptococcus pneumoniae, Haemophilus influenzae type B, Neisseria meningitidis. Have a positive Quellung reaction when anticapsular antisera are added
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Urease positive bugs
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Particular Kinds Have Urease- Proteus, Klebsiella, H. pylori, Ureaplasma
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Protein A
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S. aureus virulence factor, Binds Fc portion of Ig. Prevents opsonization and phagocytosis
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IgA protease
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SHiN virulence factor. Secreted enzyme that cleaves IgA. Secreted by S. pneumoniae, H. influenzae B, and Neisseria to colonize respiratory mucosa.
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M protein
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Group A strep virulence factor. Helps prevent phagocytosis.
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Exotoxin
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secreted by certain GP and GN orgs, usually a polypeptide w/ gene on plasmid or bacteriophage, high toxicity, induces high-titer abs called antitoxins, destroyed at 60ÁC except staph enterotoxin, Typical dz- Tetanus, Botulism, Diptheria
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Endotoxin
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outer cell membrane of most GN bacteria and Listeria, aka LPS, encoded on bacterial chromosome, low toxicity, induces fever and shock, induces TNF and IL-1, poorly antigenic, stable at 100ÁC, Typical dz- meningococcemia, sepsis by GNR
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S. aureus exotoxins
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Superantigen- TSST-1 superantigen, Causes Toxic Shock Syndrome (Fever, rash, shock). Enterotoxin-causes food poisoning, preformed toxin. Exfloliatin- staphylococcal scalded skin syndrome
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Superantigen
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binds directly to MHC II and TCR simultaneously, activates large number of T cells to stimulate release of IFN-gamma and IL-2
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S. pyogenes exotoxins
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Scarlet fever- superantigen, erythrogenic toxin, causes toxic shock-like syndrome. Streptolysin O- hemolysin, antigen for ASO ab used in diagnosis of rheumatic fever.
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ADP ribosylating A-B toxins
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Interfere w/ host cell fxn. B-binding component binds to receptor on host cell surface enabling endocytosis. A-active component attaches an ADP-ribosyl to host cell protein and altering protein fxn
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C. diptheriae exotoxin
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ADP ribosylating A-B toxin- Inactivates Elongation Factor (EF-2) inhibits protein synthesis, causes pharyngitis and pseudomembranes. Similar to pseudomonas exotoxin A
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Vibrio cholerae exotoxin
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ADP ribosylation of G protein stimulate adenylate cyclase, increases pumping of Cl- into gut and decreased Na+ absorption. Water moves into gut lumen, causes voluminous rice-water diarrhea
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E. coli exotoxin
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ADP ribosylating A-B toxin. Heat-labile toxin stimulate Adenylate cyclase. Heat-stabile toxin stimulates Guanylate cyclase. Both cause watery diarrhea. "Labile like the Air, stable like the Ground."
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Bordetella pertussis exotoxin
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ADP ribosylating A-B toxin. Increases cAMP by inhibiting Galpha1. Causes "whooping cough", inhibits chemokine receptor causing lymphocytosis
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Clostridium perfringens toxin
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alpha toxin causes gas gangrene, gets double zone of hemolysis on blood agar
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Clostridium tetanus toxin
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Blocks release of inhibitory neurotransmitters GABA and glycine. Causes lockjaw.
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Clostridium botulinum toxin
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Blocks release of Ach. Causes anticholinergic symptoms, CNS paralysis especially CNs. Causes floppy baby. Spores found in canned food and honey.
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Bacillus anthracis toxin
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Exotoxin-Edema factor, part of the toxin complex, is an adenylate cyclase. Cell capsule has D-glutamate instead of polysaccharide
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Shigella toxin
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Shiga toxin (also produced by E. coli O157:H7) cleaves host cell rRNA (inactivates 60s ribosome), enhances cytokine release causing HUS
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cAMP inducing bacterial toxins
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1. V. cholerae permanently activates Gs- rice water diarrhea. 2. Pertussis toxin permanently disables Gi- whopping cough. 3. E.coli- heat labile toxin- watery diarrhea. 4. B. anthracis- edema factor is an adenylate cyclase that can increase cAMP
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Bacterial Transformation
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ability to take up DNA from the environment. Feature of SHiN. Any DNA can be used.
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Bacterial Conjugation F+ x F-
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F+ plasmid contains genes for conjugation. Plasmid is replicated and transferred thru pilus to F- from F+
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Bacterial Conjugation Hfr x F-
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F+ plasmid can be incorporated into bacterial chromosomal DNA. Replication of incorportated plasmid DNA may include some flanking chromosomal DNA. Transfer of plasmid + chromosomal genes.
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Generalized bacterial transduction
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"packaging" event. Lytic phage infects bacterium leading to cleavage of bacterial DNA and synthesis of viral proteins. Parts of chromosomal DNA may be packaged in viral capsid. Phage infects another bacterium and transfer packaged DNA.
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Specialized bacterial transduction
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"Excision" event. Lysogenic phage infects bacterium. Viral DNA incorporated into chromosome. When phage is excised, flanking DNA go too. When phage infects other cells, transfers bacterial genes.
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Bacterial transposition
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Segment of DNA that can "jump" from one location to another, can transfer genes between plasmids and chromosomes. May include some flanking DNA.
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Lysogeny
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Genes for bacterial toxins encoded in a lysogenic phage- ABCDE- ShigA-like toxin, Botulinum toxin, Cholera toxin, Diptheriae toxin, Erythrogenic toxin of S. pyogenes.
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Staphylococcus aureus
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GPC, clusters, Catalase +, Coagulase +. Virulence factors- Protein A, TSST, Enteroxin, Exfoliatin. Causes: 1. Inflammatory- skin infections, organ abscesses, pneumonia. 2. Toxin-mediated dz- Toxic shock syndrome, scalded skin syndrome, rapid onset food poisoning. 3. MRSA- cause of nosocomial and increasingly community acquired infections, resistant due to altered penicillin binding protein
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Staphylococcus epidermidis
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GPC, clusters, Catalase +, Coagulase -, Novobiocin sens. Compenent of normal skin flora, common contaminate of blood cultures. Infects prosthetic devices and IV catheters by producing adherent biofilms. Righ sided Bacterial endocarditis in IVDU.
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Streptococcus pneumoniae
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GPC, chains, catalase -, alpha hemolytic, positive quellung, optochin sens, bile soluble. Virulence factor- IgA protease. Most common cause of Meningitis, Otitis media, Pneumonia, Sepsis =MOPS. Associated with rusty sputum, sepsis in sickle cell anemia, and splenectomy. One of the SHiN bacteria.
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Viridans group
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GPC, chains, catalase -, alpha hemolytic, negative quellung, optochin resist, not bile soluble. Normal flora of oropharynx. S. mutans causes caries. S. sanguis causes bacterial endocarditis.
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Stretococcus pyogenes/Group A Strep
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GPC, chains, catalase -, beta-hemolytic, bacitracin sensitive. Virulence factor- M protein prevents phagocytosis, superantigen, Streptolysin O. Causes- 1. pyogenis- pharyngitis, cellulitis, impetigo. 2. Toxigenic- scarlet fever, toxic shock syndrome. 3. rheumatic fever, acute glomerulonephritis. Ab to M protein enhance host defense but can lead to rheumatic fever. ASO titer to Streptolysin O detects recent infection.
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Rheumatic fever
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"No rheum for SPECCulation" Subcutaneous plaques, Polyarthritis, Erythema marginatum, Chorea, Carditis.
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Streptococcus agalactiae/Group B strep
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GPC, chains, catalase -, beta-hemolytic, bacitracin resistant. Causes pneumonia, meningitis, and sepsis, mainly in babies. Pregnant women are screened and treated to prevent vertical transmission.
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Enterococci/Group D strep (E. faecalis, E. faecium)
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GPC, chain, catalase -, gamma-hemolytic. Normal colonic flora. Penicillin G resistant. Cause UTI and subacute endocarditis. VRE important cause of VRE.
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Streptococcus bovis/Group D strep
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GPC, chain, catalase -, gamma-hemolytic. Colonizes the gut. Can cause bacteremia and subacute endocarditis in colon cancer patients.
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Corynebacterum diphtheria
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club shaped GPR. Grows on tellurite agar. Exotoxin encoded by beta-prophage. ADP ribosylating exotoxin ribosylates Elongation Factor (EF-2) and inhibits protein synthesis. Causes pseudomembranous pharyngitis with lymphadenopathy. Lab diagnosis- GPR w. metachromatic (red and blue) granules. Toxoid vaccine prevents diphtheria.
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Spore forming bacteria
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Certain gram positive rods. Spores are highly resistant to destruction by heat and chemicals. Have dipicolinic acid in core. No metabolic activity. Must autoclave to kill. Soil- Bacillus anthracis, Clostridium perfringens, Clostridium tetani. Other- Bacillus cereus, Clostridium botulinum.
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Clostridium tetani
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GPR, spore forming, obligate anaerobic. Produces tetanospasm-spastic paralysis, trismus/lockjaw, risus sardonicus. Exotoxin blocks release of inhibitory GABA and glycine from Renshaw cells in spinal cord.
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Clostridium botulinum
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GPR, spore forming, obligate anaerobic. Produces a preformed, heat-labile toxin that inhibits Ach release at neuromuscular junction. Adults- ingestion of preformed toxin. Babies- floppy baby, ingestion of spores in honey
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Clostridium perfringens
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GPR, spore forming, obligate anaerobic. Produces alpha toxin ("lecithinase" a phospholipase) that can cause gas gangrene (myonecrosis) and hemolysis
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Clostridium dificile
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GPR, spore forming, obligate anaerobic. Produces cytotoxin- kills enterocytes leading to pseudomembranous colitis. Often secondary to use of clindamycin or ampicillin. Treat with metronidazole.
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Bacillus anthracis
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GPR, spore forming. Produces anthrax toxin. Only bacterium with a polypeptide capsule made of D-glutamate. Cutaneous anthrax- contact leads to black eschar, a painless necrotic ulcer surrounded by edematous ring caused by lethal factor and edema factor (an adenylate cyclase) that can lead to bacteremia and death. Pulmonary anthrax- inhalation of spores leads to flulike symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis (hemorrhagic), and shock. Woolsorters' dz- inhalation of spores from contaminated wool'
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Listeria monocytogenes
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GPR, facultative intracellular microbe. Only GP with endotoxin. Acquired by ingestion of unpasteurized milk/cheese, deli meats, vaginal transmission at birth. Form "actin rockets" to move from cell to cell. Tumbling motility. Pregnant women- amnionitis, septicemia, and spontaneous abortion. Immunocompromised pts including neonates- granulomatosis infantiseptica, neonatal meningitis, meningitis. Healthy individuals- mild gastroenteritis.
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Actinomyces israelii
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GPR anaerobe forming long branching filaments resembling fungi. Normal oral flora. Causes oral/facial abcesses. May drain through sinus tract in skin. Forms yellow "sulfur granules" in sinus tracts. Treat with penicillin.
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Nocardia asteroides
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GPR, weakly acid-fast, from soil, forming long branching filaments resembling fungi. Causes pulmonary infection in immunocompromised pts. Treat with sulfa drugs.
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Ghon complex
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TB granulomas (Ghon focus) with lobar and perihilar lymph node involvement. Reflects primary infection or exposure.
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Mycobacteria kansasii
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GP, acid fast rods. Pulmonary TB-like symptoms.
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Mycobacterium avium-intracellulare
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GP, acid fast rods. Often resistant to many drugs. Causes disseminated dz in AIDS
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Mycobacterium leprae
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GP, acid-fast rods. Likes cool temperatures so infects skin and superficial nerves. Cannot be grown in vitro. US reservoir- armadillos. Causes Hansen's dz- lepromatous- presents diffusely over skin and is communicable and lethal. Tuberculoid- limited to a few hypoesthetic nodules. Treat- long term dapsone but tox=hemolysis and methemoglobinemia. Alt treat- rifampin, combination clofazimine and dapsone.
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Penicillin and Gram negatives
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resistant to benzylpenicillin but may be susceptible to penicillin derivatives like ampicillin. The outer membrane layer inhibits entry of penicillin and vancomycin.
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Neisseria meningitidis
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GNC, glucose fermenter, maltose fermenter. Virulence factor-Produce IgA protease. Polysaccharide capsule, vaccine, transmitted in respiratory and oral secretion, Causes meningococcemia, meningitis, Waterhouse-Friderichsen syndrome
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Neisseria gonorrhea
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GNC, glucose fermenter only. No polysaccharide capsule, no vaccine due to rapid antigenic variation, sexually transmitted. Causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID, Fitz-Hugh-Curtis syndrome (scarring of liver capsule secondary to PID)
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Haemophilus influenza
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GN coccobacillary.Virulence factor- IgA protease. Aerosol transmission. Special growth requirements on chocolate agar w/ factors V/NAD+ and X/hematin. Causes epiglottitis, Meningitis, Otitis media, Pneumonia. Most invasive dz caused by capsular Type B. Vaccine contains type capsular polysaccharide conjugated to diphtheria toxoid, given between 2-18 mos of age. Treat- meningitis- ceftriaxone, Rifampin for close contacts.
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Legionella pneumophila
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GNR, poor gram stain- use silver stain. Grow on charcoal yeast extract w/ Fe and cysteine. Detect clinically for Ag in urine. Aerosol transmission from environmental water source habitat. Causes Legionnaire's dz-severe pneumonia and fever, Pontiac fever- mild flulike syndrome. Tx- erythromycin
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Pseudomonas aeruginosa
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GNR, aerobic, non-lactose fermenter, oxidase -. Blue green pigment (pyocyanin) w/ grape or corn tortilla odor. Water source. Virulence factor- exotoxin A inactivate EF-2 and causes pseudomembranes, endotoxin causes fever and shock. PSEUDOmonas causes Pneumonia, Sepsis (black lesions on skin), External otitis, UTI, Drug use and Diabetic osteomyelitis, hot tub folliculitis. Malignant otitis extern in diabetics. Tx- aminoglycoside plus extended spectrum penicillin like piperacillin, ticarcillin
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Enterobacteriaceae- "Pro Salmon Enter, Swim, Spawn, End Killed."
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Familiy where all species have COFFee: Capsular (K) ag that is related to virulence, O ag=polysaccharide endotoxin, Flagellar ag (H), Ferment glucose. Oxidase negative. Family includes- E.coli, Salmonella, Shigella, Klebsiella, Enterbacter, Serratia, Proteus
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E. coli
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GNR, lactose fast fermenter, oxidase negative. One of the enterbactericeae. Different kinds. Causes cystisi, pyelonephritis, pneumonia, neonatal meningitis, septic shock, dysentery, traveler's diarrhea, diarrhea
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EIEC= enteroinvasive E. coli
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Causes dysentery. Produces Shiga-like toxin. Microbe invades and toxin causes necrosis and inflammation.
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EHEC=enterohemorrhagic E. coli
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Causes dysentery. Produces Shiga-like toxin. Toxin alone causes necrosis and inflammation. Some strains also cause HUS.
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HUS
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triad of anemia, thrombocytopenia, acute renal failure. Can be caused by EHEC. Endothelium swells (maybe bc of toxins), lumen narrows, mecahnical hemolysis, reduced renal blood flow. Damaged endothelium consumes plts.
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ETEC=entertoxigenic E. coli
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Causes traveler's diarrhea. Produces Labile toxin and Stable toxin.
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EPEC=enterpathogenic E. coli
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Causes diarrhea usually in children. No toxin produced. Adheres to apical surface, flattens villi, prevents absorption.
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Klebsiella pneumoniae
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GNR, Lactose fast fermenter. Intestinal flora. Causes pneumonia in alcoholics and diabetics when aspirated. Red current jelly sputum. Causes nosocomial UTIs. 4A's= Aspiration pneumonia, Abscess in lungs, Alcoholics, diAbetics
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Salmonella
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GNR, non-lactose fermenter, oxidase -. Invades intestinal mucosa and can cause bloody diarrhea. Have flagella and can disseminate hemotogenously. Have an animal reservoir. Produce H2S. Abx can prolong symptoms. Monocytic response. Transmission via Food, Fingers, Feces, and Flies.
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Shigella
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GNR, non-lactose fermenter, oxidase -. Invades intestinal mucosa and can cause bloody diarrhea. More virulent than Salmonella (10 v 100000 orgs). No flagella but can propel themselves w/in cel by actin polymerization. Transmission via Food, Fingers, Feces, and Flies.
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Salmonella typhi
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GNR, non-lactose fermenter, oxidase -. Causes typhoid fever- fever, diarrhea, headache, rose spots on abdomen. Can remain in gallbladder chronically. No animal reservoir- only found in humans. Think Typhoid Mary.
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Yersinia enterocolitica
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Transmitted from pet feces, contaminated milk, or pork. Outbreaks common in day-care centers. Can mimic Crohn's or appendicitis esp in adolescents.
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Helicobacter pylori
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GNR. Urease + (use urease breath test to diagnose). Creates alkaline environment. Causes gastritis and 90% of duodenal ulcers. Risk factor for peptic ulcer, gastric adenomacarcinoma, and lymphoma. Tx w/ triple therapy: 1. metronidazole, bismuth, tetracycline/amoxicillin. 2. ($$$) metronidazole, omeprazole, clarithromycin
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Spirochetes
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spiral shaped bacteria w/ axial filaments. Borrelia, Leptospira, Treponema. Only Borrelia can be visualized w/ LM. Others use darkfield and fluorescent labels.
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Leptospira interrogans
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Question mark shaped bacteria. Found in water contaminated w/ animal urine. Causes- flulike symptoms, fever, headache, abdominal pain, jaundice, photophobia w/ conjunctivitis. Prevalent in tropics. Weil's Dz (icterhemorrhagic leptospirosis)- severe dz, jaundice and azotemia from liver and kidney dysfxn, fever, hemorrhage, anemia
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Borrelia burgdorferi
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Big spirochete. Transmitted by tick Ixodes. Presents w/ erythema chronicum migrans, expanding bull's eye rash. Affects joints, CNS, heart. Mice are reservoir. Deer required for tick life cycle. 3 stages- 1. erythema chronicum migrans, flulike symptoms, 2. neuro (Bells palsy) and cardiac (AV nodal block manifestations, 3. Chronic monoarthritis, migratory polyarthritis. Tx- doxycycline, ceftriaxone
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Treponema pertenue
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Spirochete. Causes yaws- infection of bone, skin and joints. Heals w/ keloids that lead to severe limb deformaties. Dz of tropics. Not an STD but VDRL positive.
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Treponema pallidum
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Spirochete. Causes syphilis. 1Á- painless chancre, 2Á disseminated dz w/ constitutional symptoms, maculopapular rash on palms and soles, condyloma lata. Many treponemes present in chancre and condyloma late. 3Á Gummas (chronic granulomas), aortitis due to destruction of the vasa vasorum, Argyll Robertson pupil, neurosyphilis=tabes dorsalis. Signs- broad based ataxia, Romberg +, Charcot joints, stroke w/out HTN. Congenital syphilis- often results in stillbirth, hydrops fetalis, saber shins, saddle nose, CN VIII deafness, Hutchinson's teeth, mulberry molars.
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VDRL vs. FTA-ABS
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FTA-ABS is specific for treponemes. Turns + earliest and stays + longest.
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Causes of VDRL false positives
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VDRL= Viruses (mono, hepatitis), Drugs, Rheumatic fever, Lupus and leprosy
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Bartonella
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zoonosis, Causes cat scratch fever. Transmitted by cat scratch. Causes bacillary angiomatosis in immunocompromised pts. Confused w/ Kaposi's sarcoma
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Brucells
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zoonosis, Causes brucellosis, undulant fever. Transmitted by dairy products, contact w/ animals
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Francisella
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zoonosis, causes tularemia. Transmitted by tick bite; life cycle- rabbits, deer
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Yersinia pestis
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zoonosis, causes plague. Transmitted by fleas; life cycle rodents, esp prairie dogs
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Pasturella multicoda
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zoonosis, causes Cellulitis, transmitted by animal bite. Oral flora of cats and dogs.
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Gardeneralla vaginalis
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Pleomorphic, gram-variable rod that causes vaginosis. Presents as gray discharge w/ fishy small, nonpainful. Anaerobe Mobiluncus is also involved. Associated w/ sexual activity but not STD. Characterized by Clue Cells- vaginal epithelial cells covered w/ bacteria, visible on LM. Tx- metronidazole.
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Rickettsiae
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Obligate intracellular organisms. Need CoA and NAD+. All except Coxiella transmitted by arthropod vector. Coxiella transmitted by aerosol and causes pneumoina. Cause headache, fever, rash (vasculitis). Tx- tetracycline
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Ricketssial v. typhus rash
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Starts on hands and feet, typhus rash starts centrally and spreads out w/ out involving palms or soles
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Coxiella burnetti
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causes Q fever, different from other rickettsiae bc transmitted by aerosol not arthropod
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Rickettsia rickettsiae
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causes Rocky Mountain spotted fever. Rash on hands and feet migrating to wrists and ankles then trunk, headache, fever. Transmitted by tick. Endemic to East coast. Tx- tetracycline
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Rickettsia typhi
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causes endemic typhus, transmitted by fleas. Tx- tetracyline
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Rickettsia prowazekii
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causes epidemic typhus, transmitted by human body louse. Tx- tetracyline
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Ehrlichia
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causes Ehrlichosis, transmitted by tick. Tx- tetracyline
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Palm and sole rashes
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Secondary syphilis, Coxsackievirus A, Rocky Mountain Spotted fever
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Weil-Felix reaction
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Diagnostic test. Pts w/ rickettsial infxn have ab. Pt serum is mixed w/ Proteus ag, cross rxn leads to agglutination. Negative w/ Coxiella infxn.
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Chlamydiae
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Obligate intracellular organisms. Can't make own ATP. Cause mucosal infections. Life cycle has 2 forms: 1. Elementary body- small, dense, infectious, enters cell via endocytosis, 2. Reticulate body- replicates in cell. Cell wall lacks muramic acid. Dx by observing cytoplasmic inclusions on Giemsa or fluorescent ab-stained smear.
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Chlamydia trachomatis
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Different serotypes: 1. Types A, B, C- chronic infxn, blindness in africa. 2. D-K- urethritis/PID, ectopic pregnancy, neonatal pneumonia, neonatal conjunctivitis. 3. Type L1, L2, L3- lymphogranuloma venereum (acute lymphadenitis w/ positive Frei test). Tx- oral erythromycin
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Chlamydia pneumoniae
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atypical pneumonia. Tx- erythromycin or tetracycline
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Chlamydia psittaci
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atypical pneumonia. Tx- erythromycin or tetracycline. Bird resrvoir
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Mycoplasma pneumoniae
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No cell wall, only bacterial membrane containing cholesterol. Grow on Eaton's agar. Classic cause of atypical "walking" pneumonia, insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate. More common in pts<30 years. CXR looks worse than pt. High titer of cold agglutinins (IgM)- can agglutinate or lyse RBCs. Tx- erythromycin or tetracycline. Resistant to penicillin bc no cell wall.
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