Gram Positive Bacilli

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Listeria monocytogenes

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Found in environment

Nonsporeforming

disease affects:

newborns (meningitis, exposed by transvaginal delivery)

pregnant women (more susceptible to disease)

adults with compromised immune systems

Listeriosis (infection caused by ingestion of contaminated food. GI symptoms - diarrhea, nausea, fever, headache)

Infection normally spreads beyond Gastrointestinal tract

Meningitis (GI Infection can spread to CNS causing Meningitis)

Stillbirths/Miscarriage (occur when infection during pregnancy)

Has a 20-30% mortality rate, highest of most food borne illnesses

Bacteria survives and can grow in cold temperatures.

GI illness: not usually tested

Meningitis: isolate bacteria from cerebral spinal fluid in baby

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Corynebacterium species

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Found in environment and normal flora

- NF of skin, oral cavity and genitourinary tract

Opportunistic organism - invades when immune compromised system

Pleomorphic rods (changes shape)

Palisade (in line grouped next to each other)

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Corynebacterium diphtheriae

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Nonsporeforming

Spread by direct contact or breathing the aerosolized secretions of infected people

Diptheria - upper respiratory infection

(bacteria release exotoxins, these spread through blood stream)

- pharyngitis, develop thick gray coating on nasal cavity, throat and airway

Cutaneous Diphtheria - Non healing ulcer covered with gray membrane.

Exotoxin has an affinity for heart and nerve cells, can cause myocarditis, paralysis (infect peripheral nervous system) and death from asphyxiation (blocked airway) or myocarditis

Specimen:

dipheria - exudate from nasopharynx or throat

cutaneous dipheria - material collected from wound

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Corynebacterium jeikeium

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Normal Flora of skin

Opportunist - infect immunocompromised

Causes infection in patients with indwelling medical devices.

Endocarditis (affect prosthetic valves in heart)

Septicemia (life-threatening blood stream infection)

Skin infections (lesions)

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Nocardia species

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Found in environment

Nonsporeforming

Aerobic

Opportunistic - infect immunocompormised

Long, slender gram positive rods that show branching and beading

Partially acid fast (waxy wall, doesn't stain well)

Bronchopulmonary (Infection starts in the lung)
Spread to cutaneous (skin) infection
May disseminate to central nervous system (brain)

Specimen:

respiratory illness - sputum, BAL

wound infection - specimen from wound

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Gardnerella vaginalis

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1 species only

Facultative anaerobe

Gram variable pleomorphic rods (may appear gram + or gram - according to conditions)

Bacterial vaginosis - grayish discharge and fishy odor

(Not a STD but occurs when upset in vaginal microbiome from sexual activity or antibiotics)

Specimen:

Vaginal swab - Look for clue cells (epithelial cells covered in bacteria), if present positive diagnosis

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Bacillus species

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Found in the environment

Spore forming

Obligate aerobe or facultative anaerobe

Large, box shaped robes that my stain gram variable (may appear gram + or gram - according to conditions)

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Bacillus anthracis

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Not part of normal flora, major pathogen for bacillus genus.

ANTHRAX - spores found in soil, active anthrax in animals.

three types:

Pulmonary (inhalation of spores) often fatal, flu-like symptoms, fatal hemorrhagic meningitis)

Cutaneous (skin) through cut or sore, most common and less severe

Gastrointestinal (ingestion) eat infected animal meat, more serious 25-40% die, nausea, vomiting, fever, diarrhea

Agent used for biological warfare.

Specimen depends on site of infection

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Bacillus cereus

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Opportunistic - infect immunocompromised

Food poisoning associated with rice dishes (enterotoxin - exotoxin that acts on GI tract)

Eye and wound infections (not as common, usually result from injury)

Specimen depends on site of infection

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Clostridium species

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Found in environment

Normal flora of large intestines in humans and animals

Sporeforming

Anaerobes - do not survive in oxygen

Large gram + rods

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Clostridium perfringens

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produce many exotoxins (7 types A-G) Alpha toxin produces phospholipase which destroys RBCs, WBS and muscle cells

rapid growth, quick onset of disease

large "box-car" shaped gram + bacilli

Disease:

Gas gangrene - invasion of muscle by wound site, spores germinate and multiply. Alpha toxin kills cells, causing area of necrosis. Bacteria produce Hydrogen and CO2 as byproduct of replication, causing characteristic gas formation in tissues. (lethal unless treated)

Food poisoning (spores survives cooking)

Specimen:

GI illness - not usually tested

Wound infection - material collected from wound

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Clostridium Difficile

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Normal flora of the bowel

Can be acquired from exogenous source

Affects people in hospitals or in long term care facilities after taking antibiotics which alters the normal flora of the bowel and allows C.difficile to overgrow. Spores can spread through diarrhea, infected people can contaminate surfaces and food if not wash hands.

Disease:

Bloody Diarrhea

Pseudomembranous colitis - inflammation of the colon, bacteria produce toxins which damage cells, cause inflamed cells to burst and C. difficile spores leave colon via diarrhea.

Identification: colony smells like horse manure and have "ground glass" appearance.

Specimen: Stool

Treatment:

Fecal transplantation - fixes balance of microorganisms in the gut by introducing bacteria from a non-infected persons gut

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Clostridium tetani

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Found in enviornment (soil, dust)

Human and animal excreta

Sporeforming

spores enter through wounds, then germinate to vegetative cells. Produce toxins which enter the blood stream and travel to the CNS and neurally through the tissues.

Tetanus - painful muscle spasms, rigidity, lock jaw

Normally a nerve impulse initiates contraction of a muscle. At the same time, an opposing muscle receives the signal to relax so as not to oppose the contraction. Tetanus toxin (neurotoxin produced) blocks the relaxation so both sets of muscles contract.

Death can result from paralysis of throat and respiratory muscles.

Diagnosis is clinical (symptoms and medical history)

Tetanus can be prevented by tetanus vaccine

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Clostridium botulinum

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Found in environment (spores in soil, water and on surface of vegetables)

Food Botulism - associated with inadequate processing of canned vegetables. Organism multiplies in storage and releases toxin. If not properly cooked, ingestion of toxin is absorbed in intestine. Enters the blood stream and travels to the nervous system. Blocks the impulses that allows the muscle contraction to release. Trouble seeing and speaking, drooping face, weakness occurs in muscles and paralysis occurs.

Wound botulism - infection of wound by bacteria

Infants - 3wk to 8 mo. organism introduced into baby system with spores in honey. Constipation, generalized weakness, poor feeding and loss of head control.

Relaxes muscles, doesn't contract like tetanus.