Transcript Classification, nomenclature, taxonomy,identification

Practical taxonomy
Bacteria
Gram positive
lGram negative
G+cocci
Gram+rods
G-cocci
G-rods
anaerobic
aerobic
anaerobic
aerobic
anaerobic
aerobic
aerobic
anaerobic
Peptostreptococcus
Peptococcus
Sarcina
Ruminococcus
Staphylococcus
Micrococcus
Streptococcus
Enterococcus
Clostridium -spore
Bacillus
Corynebacterium
Arcanobacterium
Rhodococcus
Veillonella
Megasphoera
Neisseria
Moraxella
Branhamella
Vibrionaceae
Campylobacter
Helicobacter
Bacteroides
Porphyromonas
Prevotella
Fusobacterium
Gemella
Pediococcus
Leuconostoc
Lacotococcus
Non-spore
Propionibacterium
Mobiluncus
Bifidobacterium
Listeria
Erysipelotrix
Gardnerella
NONFERMENTERS
Pseudomonas
Acinetobacter
Stenotrofomonas......
Leptotricha
Wolinella
Miscellanous bacteria
Mycoplasma, Ureaplasma, Chlamydia
Ricketsiaceae
Spirochetales - Spirochetes, Leptospira, Borrelia
Mycobacterium
Nocardia , Actinomycetes,
ENTEROBACTERIACEA
Bordetella
Pasteurella
Franciscella
Brucella
Haemophilus
Legionella
Bartonella
Eikenella...
Anaerobic bacteriae
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G+cocci
G-cocci
G-rod
G+rod – nonspores forming
polymicrobial
endogenouse
mixture
fac.patogenic
– sporeforming– patogens,
clinical units
G+cocci anaerobic
• Peptostreptococcus, -Peptococcus,- Sarcina (fac. anaerobic)
- Coprococcus, - Ruminococcus
- colonisation of the skin and mucouse membrane GIT, UGT,
- oportunistic patogens in connection with foreign bodies – cultivation
– require special grow conditions, slowly growing
Clinical symptoms - pleuropneumonia following aspiration, sinusitis,
brain absces – spreading from oropharynx or lung,
- intraabdominal infection and sepsis – spreading from colon,
- pelvic infections (endometritis, absces, puerperal sepsis, bacterial
vaginosis)
- infection of soft tissue (celulitis), endocarditis, osteomyelitis
• Laboratory diagnosis – colonising bacteria or ethiological agent,
sampling and transport under anaerobic conditions, prolonged
cultivation on enriched media
• Th - PNC, cefalosporins, imipenem, CMP - polymicrobial ethiology.
G-cocci
• anaerobic
• Veillonella, Megasphera – present in oropharynx,
low virulence, in cultivation usually part of
polymicrobial mixture
G-rod anaerobic
• Bacteroides fragilis
obligatory anaerobic rod, not sporeforming,
- most important part of fysiological flora in oropharynx, UGT, GIT.
Clinical symptomes - pleuropneumonia, intraabdominal abscess, genital infections.
Endogenous and polymicrobial infections, absceses after break down of
physiological barieres.
Lab.dg. strictly anaerobic sampling, transport and cultivation
stimulation of the growth by 20% cholic acid.
Th surgery intervention + ATB, - B.producesa betalactamase, Metronidasol
• B(G). stearothermophilus- spores used for testing efficiency of sterilisation
devices
• Prevotella, Porphyromonas, Fusobacterium, Leptotricha,
Wolinella – colonisation of orofarynx, GIT, UGT, part of physiological flora,
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pathogenic after the breakdown of natural barieresr – e.g.. Surgical intervention
They produce histolytical enzymes,
absceses and polymicrobial infection (CNS, UGT,intraabdominal)
Production of betalaktamase – resistente to PNC.
Lab. dg. Anaerobic sampling and transport, prolonged cultivation
G+rods aerobic
• Spores forming
- Bacillaceae - Bacillus cereus, B. antracis - flagella,
facultative anaerobes or strict aerobes. Production of toxins.
• Nonsporesforming
- Listeria monocytogenes - motile, aerobic, surviving 22*C and broad
interval of pH, infecting annimals
- Corynebacteriaceae -aerobic nonmotile slightly curved, forming
picture of alphabet letters, irregularly stainable – Containing metachromatic
granules, production of toxin - lysogenic conversion - toxigenicita of strains
- Elek´s test.
Corynebacterium diphtheriae, C. pseudodiphtericum,
Erysipelotrix rusiopathiae - facult. anaerobic, transmission from
annimals, grey colonies, alfa hemolysis,
Nocardiaceae Nocardia asteroides – contain lipid in the cell wall
– modified Ziehl Neelsen staining, nonmotil, filamentous form in microscopy,
prolonged cultivation
G+rods anaerobic nonsporesforming
• - Actinomycetaceae Actionomyces israeli, A.naeslundii
Clinical signs: cerebral, cerevicofacial, abdominal, thoracal actinomycosis,
chronical pyogenic infection with absceses.
Lab.dg. Sampling from the depth of sinus or abscess containing sulphur granules,
typical colonies looking like tooth molar, requiring, long cultivation.
Th: surgery +ATB prolonged PNC
-Propionibacteriaceae Propionibacterium acnes
colonisation of skin, external ear, conjunctiva, orofarynx, female external genital
tract.
Clinical symptomes: Acne and opportunistic infections in patients with foreign
bodies.
Lab. dg. On common media, prolonged cultivation
- Mobiluncus ---gram variable, structue of G+, curved, growth
reqirements, colonisation of fem.external genital – in case of dysmicrobia vaginosis
-Bifidobacteriaceae, Eubacteriaceae,- Lactobacillaceae . –part of
physiological flora
Anaerobic Gram + sporesforming rods
Clostridium sp.
• strictly anaerobic, spores typically localised in the cell enlarging the body,
proteolytical ensymes, production of toxins,
C. tetaní – tetanus – traumatic
- newborne
C. botulinum - botulizmus – newborne
- wound
- food borne
C. septicum - nontraumatic myonecrosis, patients
immunocompromised - Ca of colon
- breakdown of the integrity of colon, spread of clostridia in tissues,
hyperacute course
C. difficile - pseudomembranouse colitis connected with broad
spectrum ATB therapy,
produces 2 toxins, part of FF, exposition to ATB taht eliminate colon
bacterial flora – overgrowth of C. difficile and its spores
Anaerobic gram + spores forming rods
Clostridia of anaerobic traumatoses
• Clostridia - 100 species, some of them can be
aerotolerantné
- C. histolyticum – can looks like gram negatívne, spores
not constantly detectable. Commonly present in soil,
water, GIT of annimal and human.
• C. perfringens - Bacteraemia, myonecrosis – gas
gangrene, infection of soft tissue, necrotising enteritis
Clostridium tetani
• Motile rod, spores forming, spores enlarging cell,squash rocket,
transiently gram negative. Very sensitive to oxygen, metabolically
very active.
• Produces 2 toxins - Termolabil neurotoxin- tetanospasmin – released
from lysing cells. AB toxin - blocking neurotransmitters in CNS on
na inhibation synapsesh – nonregulation of excitation synaptic
activity - spastic paraysis, convulsions.
- tetanolysin
• Present in soil and GIT of annimal. Vegetative formes are very
sensitive on oxygen. Spores are surviving years
Generalised tetanus, - localised tetanus, - nexborne tetanus, - tetanus
of drug abusers
Therapy - PNC, antitoxin, - toxin bound on synapses is not
neutralisable and ATB are active agains viable cells (not toxin)
Symptomatic
• Vaccination
Clostridium botulinum
• Heterogennous group, nutritionnaly requiring spores forming rods.
4 groups I - IV based on proteolytical aktivity a type of toxin.
Producing 7 antigenically different botulotoxines A,B,C alfa, D, E, F, G
- A,B,E most frequent. AB toxin , termolabil toxin - 20minutes/80*C
• Blocking transmission on nervemuscular platelet on synapses of
periferic nerves.
Food borne, wound botulisme, infant botulisme
Blurred vision, dilatation of pupils, dry tongue, constipation, bilateral
muscular weakness – complete restoration after months or years
Wound botulisme – very rare
Infant botulisme - 1976 - in vivo production of neurotoxin in colon
colonising clostridia (age of 6mnth - 1 y) – progresive paralysis,
respiration failure - mortality 1% - frequently cause of SIDS
Dg. - clinical, detection of clostridium or toxin
Th. – lavage of stomach + antitoxin,
PNC, destruction of spores and prevention of spores germination
Clostridium botulinum
Clostridium perfringens
• Colonisation or sever disease, spores are seen scarecely, hemolysis,
metabolic aktivity.
• Production of letal toxins (alfa, beta, epsilon, iota, termolabil
enterotoxin) with sever life threating biological activity, + ensymes.
Types A-E: A in environment, B-E in colon,
A gas gangrene and intoxication, C necrotizing enteritis
• Microscopy - G+rods without leu in clinical samples
Th – surgery in traumatoses, high doses of PNC, antitoxin, hyperbaric
room for oxygen therapy
Clostridium perfringens
• Bacteraemia – usually not significant, transient from skin
contaminant.
• Gas gangrene – life threating, histotoxic clostridia, after
injury, devitalised tissue – gas production. (C. septicum,
histolyticum, novyi)
• Celulitis, fasciitis – after colonisation of the wound,
oftently not important or rapidly progressing destruction of
tissue (C. septicum)
• Necrotizing enteritis –small intestine, typ C, 50% letality
Food borne intoxication – short incubation time, spasmes,
watery diarrhoe – ingestion of contaminated food, toxin termolabil protein
Genus:Bacillus - G+sporeforming bacilli, aerobic
and facultatively anaerobic
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Bacillus anthracis,Bacillus cereus,Other Bacillus sp.
• Bacillus cereus - 2 enterotoxins
- heat stable - emetic form - contaminated rice - heat resistant spores
survive initial cooking that kills vegetative cells, germinate, multiply
and toxin is not destroyed by reheting
- heat labile - diarrheal form - adenylcyclase-cAMP system
stimulation in intestinal cells - fluid accumulation -contaminated meat
and vegetable - toxin is produced in situ, longer incubaion
• Panophthalmitis - traumatic eye infection (soil, penetrating object),
complete loss, massive destruction
- toxins - necrotic - heat labile enterotoxin
- cereolysin - hemolysin
- phospholipase C - lecithinase
• Ubiquitous, isolation witout symptoms = contamination
• Other Bacillus - immunosupressed patients - shunt and catheter inf.
Bacillus antracis
Bacillus anthracis
• Spore and capsule (protein) not seen in clinical specimens
• Antrax toxin - 3 antigenically distinct components: protective Ag, lethal factor, edema factor - not active
separately,
• Pathogenesis: capsule - antiphagocytic, Ab are not
protective, toxins are active in cooperation of: protective +
lethal or edema f.
• Cultivation - on nonselective media, rapidly growing
adherent colonies, no hemolysis, Non motility,liquifaction
of agar
Microscopy: caput medusae – serpentine like chains,
Bacillus anthracis
• Human diseases - cutaneous - inoculation - painless papule,
ulcer, necrosis
- respiratory - inhalation - rapid progresive diffuse
pulmonary involvement - respiratory failure - 95% mortality
- gastrointestinal - ingestion - rare - mesenteric adenopathy,
hemorrhage, ascites, 90% mortality
• Therapy - PNC (TTC, CMP)., control of animal antrax,
vaccination.
Bacillus antracis
Non sporeforming G+ bacilli heterogenous group
• Corynebacterium - coryneforms, diphtheroids- C. diphteriae
(diphtheria), C. jeikeium (oportunistic). C.
urealyticum(urinary tranct inf.), C. pseudodiphthericum
(endocarditis), C. ulcerans (pharyngitis)
• Arcanobacterium haemolyticum - pharyngitis
• Actinomyces - granulomatous ulcerative inf.
• Rhodococcus - suppurative pneumonia, opportunistic
• Listeria - meningitis, septicemia, granulomatosis
infantiseptica
• Erysipelothrix - erysipeloid, septicemia, endocarditis
• Gardnerella - bacterial vaginosis
Corynebacterium
• Pleoimorphia, G+rods, forming short chains, china letters,
or letter Y,V - forms
• Metachromatic granuls – resulting colour differs from the
colour of the used one
• Special cell wall structure – mesodiaminopimelic acid,
arabinogalactan, mycolic acid with short chains – taxonomic
neighbour to mycobacteria
• C. diphtheriae – preventabil disease diphthteria
• asymptomatic carriage in pharynx droplet transmission
• C. jeikeium - JK - oportunistic patogen in
immunocompromised - hematological disorders
• Others - transmitted from annimals
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Corynebacterium- patogenesis and
immunity
Diphtheric exotoxin - tox gen can be transmitted to bacteria
(C. diftérie, C. ulcerans, C.pseudotuberculosis
via bacteriophage –
lysogenic conversion
• A-B protein: B phragment – binding on the cell surface
enable enter of A phragment to the cell. A phragment is
enzymatically active - blocking synthesis of proteins –
prolngation of peptid chain on ribosomes
• Skin test – detection of neutralising antibodies in vivo - i.d.
application of diphtheric toxin
• Phospholipase D - dermonecrotic toxin – enable
spread by increasing vascular permeability . ulcerans,
C. pseudodiphthericum
• Urease - C. urealyticum – alkalinisation of urine and
urine calculi forming
• ATB resistence –selection of resistent strains - C.
urealyticum, C. jeikeium – resistent to commonly
used ATB in UT infection
Diphtheria
• Clinical presentation depends on state of immunity and
place of infection: - asymptomatic colonisation, mild
respiratory infection, fulminant diphtheria
• Difphtheria – URT infectionwith low grade fever, toxin
induce local damage adherent pseudomembrane on tonsils,
pharynx, nose and general symptoms of intoxication.
Myocarditis.
• Skin diphtheria – transmission via skin contact from
infected persons, colonisation and enter via small injurie papules and chronic ulcers with membrane and general
signs of intoxication, less sever,
Diphtheria
Laboratory diagnosis
• Microscopy – detection of metachromatic granules –
methylen blue staining – not important
• Cultivation – on common media (blood agar),
special media – Loffler medium,
- tellurit agar – gray brown colonies
• 3 types of colonies - gravis (big, irregular, gray), mitis
(small, convex,round, black), intermedius (small, plate,
gray) – connected with importance and virulence – not
considered more
• Biochemical identification
• Detection of toxigenicity - Elek´s test - immunodiffusion,
- antitoxic test on annimal model.,
Arcanobacterium
• A.haemolyticum - colonise human, responsible for
pharyngitis (+/- scarlet fever-like rash), cutaneusinf.,
endocarditis, meningitis - in older patients
• Missdiagnosed as Str. pyogenens, grows slowly,
weak hemolysis
• 2 toxins - hemolysin and phospholipase D
• enzymes neuraminidase
Erysipelotrix
• E. rusiopathiae: G+ non spore forming facultative anaerobic
bacillus, worldwide distribution in animals
• Cultivation in reduced oxygen athmosphere, small grayish,
alfa hemolytic colonies, 2-3 days, sample from deep tissue
or deep aspirates.
• Erysipeloid - occupational disease (butchers, meat
processors) after subcutaneous innoculatio -localised skin
infection
-generalised cutaneous forme
-septicaemia - associated with endocarditis (undamaged
heart valve - aortic)
• Therapy PNC, ERY,CLI (sulfonamids, vancomycin, aminoglycosides resistent)
Listeria
• 7 species, most important L. monocytogenes – facultatively
anaerobe neonporeforming G+ rod
• meningoencephalitis, bacteraemia, endocarditis
• New borne, older gravid women, immunocompromised
patients (after transplantation
• Frequently transfer via milk and row milk products, row
vegetable
• Able to grow in wide range of pH a and low temperature
22*C , faible beta hemolysis, motile in liquid media
Clinical syndroms
• Newborne listeriosis - infection in utero - granulomatosis
infantiseptica, devasting disease, diseminated abscesses and
granulomes multiorgan involvement
- late listeriosis - 2-3 weaks after delivery - meningitis,
septicaemia
• Meningitis of adults – in immunocompromised,after
transplantation
• Bacteraemia, Endocarditis
• Dg. Microckopy of CSF usually negat.- few bacteria,
Cultivation and indentification
• Therapy - penicillin +/- combination with aminoglycosids
Rhodococcus
• G+, obligate aerobic, red-pigmented, acid fast,
mycolic acid. Veterinary pathogen. Present in soil
• Intracellular - surviving in macrophages
• Granulomatous inflammation with abscess
formation (lung,lymph nodes, menings, pericardium,
skin) - immnosupressed
• Cultivation - nonselected media, aerobically,
pigmented colonies after 4 and more days
• Therapy : prolonged - multiple ATB able to
penetrate into macrophages
Gardnerella
• Morphologically resembles gram negative bacilli, has cell
wall structure of gram +, nonmotile, not capsule
• part of normal vaginal flora
• present in bacterial vaginosis together with obligate
anaerobes - Mobiluncus, Peptostreptococcus,absence of
Lactobacillus. Present in postpartum bacteremia,
endometritis, vaginal abscesses
• Lab. dg. - simple isolation is not prooving, importance of
microscopic examination - clue cells - epitelial cells covered
with G variable bacilli (Gardnerella) and G- small curved
bacilli (Mobiluncus), absence of G+ bacilli (Lactobacilli)
• Therapy: ampicilin, metronidasol
Actinomyces
• G+ filamentous rods, 5-10%CO2,
• Actinomyces israeli, A. meyeri, A. naeslundii,
A.odontolyticus
• chronical disease with abscess, tissue destruction and
sulphur granules in tissue (mass of mycelia surrounded by
protein, polysaccharide and bacteria)
• cervicofacial forme(endogenous, after tooth extraction) abdominal,( starting in appendix and diverticules) -pelvic
forme (from IntraUterinDevices)
• hematogenous disemination
• Lab. Dg. - pus with sulphur granuls - Ziehl Neelsen microscopy, cultivation - agar with heart brain infusion - 10
days, colony shape - mollar tooth
Nocardia
• G+strictly aerobe rods. Similar to quickly growing mycobacteria,
saprophytes in environment. Acid fast., Mycolic acid
• Nocardia asteroides, N. brasiliensis, N. madurae
• pneumonia - with confluent abscess formation, exogenous
inhalation
• skin infection - Actinomyces brasilinensis - localised celulitis,
purulent sinuses with chronical granulomatous inflamation mycetoms
• Madurmycosis - chronical granulomatous infection of bone and soft
tissue, deformations, (Sudam, Northern Africa, East India)
• diseminated - CNS - brain abscesses, in immunocompromised
• Lab. Dg. - microscopy - modified Ziehl Neelsen, Gram +,
cultivation - standard media -2-30 days, colonies adherent to agar,
cream, orange rose color, chalky consistence
• Therapy: surgery+ATB 3 months sulphonamids, amikacin,
imipenem, broad spectrum to be effective if fungal ethiology