Gram Positive Bacillus (Rods) Spore Forming

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Two types of bacillus

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Anthracis and Cereus

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Properties of bacillus Anthracis

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gram positive rod with anti phagocytic capsule made up of D Glutamate (NOT Polysaccharide) that forms endospores.

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How does bacillus anthracis enter the body?

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Systemic (through inhalation of endospores)
Gastrointestinal (rare--through undercooked meat)
Cutaneous (spores enter through cut) (most common)

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Pathogensis of bacillus anthracis

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Anthrax Toxin (A B toxin): 3 factors--protective antigen (B-unit), edema factor(A unit), and lethal factor (A unit).
Edema factor: exotoxin that is a calmodulin dependenant adenylate cyclase that increases cAMP and then leads to fluid loss form cell.
Lethal Factor is a zinc metalloproteinase that leaves MAPK kinases leading to cell death.
YOU NEED THE PROTECTIVE ANTIGEN in order for either exotoxin to work..its the B subunit that lets the other two into the cell.

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Clinical findings of bacillus anthracis

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painluess ulcer with black necrotic eschar lesion secondary lesion that is deep and indicative of necrosis (for common cutaneous entry)
Woolsorter's disease: life threatening pneumonia caused by inhalation of spores

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Lab determination of bacillus anthracis?

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Gram positive rods that are AEROBIC! (catalase positive aka capable of breaking down H2O2)

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Properties of Bacillus Cereus

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Food Poisoning most common.
Produces 2 enterotoxins

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Where is bacillus cereus most commonly found

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spores on grains surviving steaming and rapid frying. (reheated fried rice)

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Pathogenesis:

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Eneterotoxins that are not widely understood. Their mode of entry is the gastrointestinal tract

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Clostridium types

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C tetani
C Botulinum
C Difficile
C perfringens

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Clostridium Tetani pathogenesis:

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Tetanus toxin: blocks relase of inhibitory mediators (resulting in leaving acetylcholine in the synaptic cleft--muscles are permanantly "active")

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Clinical Findings of clostridium tetani

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Lockjaw due to rigid contraction and characteristic grimace "risus sardonicus"

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Properties of Clostridium Botulinum

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Causes botulism

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Clostridium properties

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Endospores that can resist a variety of environmental stresses.
Multiple exotoxins
Collagenase
Protease
hyaluronidase

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Clostridium Botulinum pathogenesis

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Botulinum toxin that prevents fusion of acetylcholin vesicles with neruonal membrane preventing its release. Remember this is an AB Toxin! 8 immunological types of the toxin with A B and E being the most common.

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Clostridium perfringens properties

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Can cause 2 types of pathogenesis: gas gangrene and food poisoning (can also be caused bacillus cereus)

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Clostridium Perfringens pathogenesis

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Can produce alpha toxin lecithinase which damages cell membranes (including RBC resulting in hemolysis) Degradtive enzymes produce gas in tissues

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Describe how alpha toxin works?

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Typically disrupts the cell membrane. In clostridium perfringens it disrupts the cell membrane with phospholipase C activity that results in gas gangrene
In S. Aureus it creates pores in the membranes causing hemolysis.

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What are clinical findings of C. Perfringens?

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Pain and edema in wounded area.

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Where can you find C. Perfringens spores?

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Soil.
Vegetative cells are members of the normal flora of the colon and vagina.

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Properiteis of C. difficile

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C. Diff is most commonly associated with excessive diarrhea and pseudomembranous colitis (due to long term antibiotic treatment--clears out the competing normal flora). Antibiotics allow C. Diff to multiply and produce toxin.

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which antibodies are typically over used resulting in C. Diff?

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Clindamycin and ampicillin

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Describe pseudomembranous colitis

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inflammation of colon characterized by diarrhea and yellow pseudomembranes that appear in a sigmoidoscopy.

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Which are the spore forming gram positive rods?

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Bacillus Anthracis and Cereus and Clostridium Difficile, tetani, perfringens, and botulinum.