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Clinically Encountered Bacteria

Clinically Encountered Bacteria. Suthan Srisangkaew, MD. Review: Classification. Gram-positive Gram-negative Cocci Chain Cluster Bacilli Spore forming Non-spore forming Branching Non-branching. Aerobic Anaerobic Bacilli predominate. Aerobic Gram-positive Cocci. In chain

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Clinically Encountered Bacteria

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  1. Clinically Encountered Bacteria Suthan Srisangkaew, MD.

  2. Review: Classification • Gram-positive • Gram-negative • Cocci • Chain • Cluster • Bacilli • Spore forming • Non-spore forming • Branching • Non-branching • Aerobic • Anaerobic • Bacilli predominate

  3. Aerobic Gram-positive Cocci • In chain Streptococcus (Lancefield group) Enterococcus • In cluster Staphylococcus (Coagulase) (Micrococcus, Leuconostoc)

  4. Aerobic Gram-positive Bacilli • Spore forming Bacillus • Non-spore forming - Non-branching Corynebacterium Listeria Lactobacillus - Branching Nocardia

  5. Aerobic Gram-negative Cocci Always in pair! Coffee bean shape Neisseria Moraxella

  6. Aerobic Gram-negative bacilli LARGE GROUP…. • Enterobacteriaceae • E. coli, Klebsiella, Enterobacter • Salmonella, Shigella • Yersinia • Proteus, Providencia, Serratia, Morganella • Vibrionaceae • Vibrio, Aeromonas, Plesiomonas

  7. Non-fermentative Pseudomonas Acinetobacter Burkholdderia • Curve, Microaerophilic Campylobacter jejuni Helicobacter pyroli

  8. Fastidious, Coccobacilli Haemophilus Bordetella • Fastidious, Zoonosis Brucella Pasteurella

  9. Anaerobic Gram-positive Bacilli Spore forming • Clostridium Non-spore forming Branching • Actinomyces Non-branching • Proprionibacterium • Bifidobacterium

  10. Anaerobic Gram-negative bacilli • Bacteroides • Fusobacterium • Prevotella

  11. Special groups • Mycobacterium • Rickettsia • Chlamydia • Mycoplasma • Spirochetes Treponema Leptospira

  12. Systemic Orientation • Skin, Wound, Soft tissue • Bone, Joint • Eye, Ear, Sinus • Respiratory tract • Gastrointestinal tract • Urinary tract, Sexual transmitted infection • Central nervous system • Blood stream, Endocarditis

  13. Skin infection • Primary infection • S. aureus, group A strep., P. acne • Blood-borne • Syphilis, rickettsia, virus • Bacterial toxin: gr. A strep,S. aureus • Scarlet fever: gr. A strep • Staphylococcal scalded skin syndrome: S. aureus

  14. Scarlet fever

  15. Staphylococcal scalded skin syndrome

  16. Skin infection • Folliculitis: S. aureus • Hair follicle • Acne: P. acne • Sebaceous gland • Impetigo: gr. A strep. • Superficial dermis • Erysipelas: gr. A strep. • Deep dermis • Cellulitis: S. aureus, gr. A strep., GNB, Clostridium • Subcutaneous connective tissue

  17. Folliculitis

  18. Impetigo

  19. Erysipelas

  20. Cellulitis

  21. Wound Infection • S. aureus: most common • GNB: immunocompromized host • Human bites: anaerobic bacteria : Bacteroides • Dog, cat bites: Pasteurella multocida • Burn wound, necrosis: P. aeruginosa • Tetanus: Clostridium tetani • Gas gangrene: Clostridium pefringen

  22. Gas Gangrene

  23. Bone & Joint Infection • Osteomyelitis: S. aureus • Both blood-borne and direct trauma Gr. A strep, GNB, anaerobes • Septic arthritis: • S. aureus • Neisseria gonorrhea (young adult)

  24. Eye, Ear, Sinus Infection • Conjuctivitis: S. aureus, Chlamydia trachomatis, N. gonorrhea • Ear Otitis externa: P. aeruginosa Otitis media: S. pneumoniae, H. influenzae • Sinus Acute sinusitis: S. pneumoniae, H. influenzae, Moraxella catarrhalis Chronic sinusitis: + anaerobes

  25. Upper Respiratory Tract Infection • Rhinitis: mostly virus • Pharyngitis & Tonsillitis: • Exudate & hemorrhage: Bacteria • Gr. A strep. (S. pyogenes) • Vesicle & ulcerative lesion: Virus • Psuedomembranous pharyngitis (Diphtheria) • Corynebacterium diphtheria

  26. Middle Respiratory Tract Infection • Epiglottitis • 90% bacteria: H. influenzae, S. pneumoniae • Laryngitis (Croup) • 90% virus • Bronchitis • 80% virus • 20% bacteria: H. influenzae, M. pneumoniae, C. pneumoniae, Bordetella pertussis

  27. Lower Respiratory Tract Infection • Acute pneumonia: days to hours • Children: 80% Virus • Adults: 80% Bacteria • S. pneumoniae, S. aureus, H. influenzae M. pneumoniae, C. pneumoniae • Enterobacteriaceae, P. aeruginosa • Chronic pneumonia: weeks to months • M. tuberculosis, Nocardia • Fungus • Lung abscess & Empyema • S. aureus • Anaerobes

  28. Enteric Infection • Watery diarrhea: proximal small intestine • Vibrio cholerae • Vibrio parahaemolyticus • Enterotoxigenic E. coli (ETEC) • Food poisoning • S. aureus, B. cereus • Many viruses • Dysentery: colon • Salmonella, Shigella • Campylobacter jejuni • Enteroinvasive E. coli (EIEC) • Plesiomonas spp. • Yersinia enterocolitica • C. difficile (ATB associated) • Entamoeba histolytica

  29. Food Poisoning No infection, Vomiting prodominate • S. aureus 5-25% • Bacillus cereus 1-2% (Fried rice) • Clostridium botulinum • Neuromuscular paralysis • Chemical 20-25% Recurrent Peptic Ulcer: Helicobacter pyroli

  30. Dairy Campylobacter, Salmonella, Listeria,andStaphylococcusspecies Eggs Salmonellaspecies Meats C perfringensandSalmonella, Aeromonas, Campylobacter,andStaphylococcusspecies Ground beef EnterohemorrhagicE coli Poultry Campylobacterspecies Pork C perfringensandY enterocolitica Seafood Aeromonas, Plesiomonas,andVibriospecies and astrovirus Oysters PlesiomonasandVibriospecies and calicivirus Vegetables Aeromonasspecies andC perfringens Alfalfa sprouts EnterohemorrhagicE coliandSalmonellaspecies Fried rice Bacillusspecies Custards, mayonnaise Staphylococcusspecies Foods and Germs

  31. Urinary Tract Infection • Cystitis: lower UTI • Pyelonephritis: upper UTI, systemic symptoms • 90-95% E. coli • Other enterobacteriaceae K. pneumoniae, Enterobacter • Staphylococcus saprophyticus (coag. Neg.) • Candida

  32. Sexual Transmitted Infection • Neisseria gonorrhea • Urethritis, Cervicitis(phyryngitis, conjunctivitis) • Chlamydia trachomatis • Non-gonococcal urethritis • Lymphogranuloma venerum • Treponema pallidum • Syphilis (Chancre) • Haemophilus ducreyi • Chancroid

  33. Infection of fetus and newborn • Transplacental: • Listeria monocytogenes • Treponema pallidum • Perinatal: • Gr. B streptococci • E. coli • C. trachomatis • N. gonorrhea

  34. Central Nervous System Infection • Acute Meningitis • Newborn: Gr. B Strep., E. coli, Listeria monocytogenes, • Children: S. pneumo., H. influenzae, N. meningitidis, Salmonella • Adults: N. meningitidis, S. suis,S. pneumo., S. agalactiae • Chronic Meningitis • Mycobacteria • Fungi

  35. Bacteremia & Septicemia • Bacteremia: occur normally • Septicemia: bacteremia + clinical symptoms • Most common from: • Urinary tract infection • Respiratory tract infection • Infection of skin and soft tissue

  36. Endocarditis • Native valve • Viridans streptococci 30-50% • S. aureus 15-40% • Other strep 15-25% • Enterococci 5-18% • Coag. Neg. Staph. 4-30% • Gram-negative bacilli 2-13% • Intravenous drug abuse • S. aureus • Prosthetic valve • Coag. Neg. Staph.

  37. Systemic Zoonosis • Leptospirosis: Leptospira interrogans • Rats, Rodents • Brucellosis: Brucella abortus • Goats, Sheeps • Plaque: Yersinia pestis • Rats > Flea • Anthrax: Bacillus antrasis • Cow, Horse > Spore

  38. Thailand Endemic • Leptospirosis • Dirty water contact • Mellioidosis: Burkholderia pseudomallei • NE Thailand, soil contact • Scrub typhus: Orientia tsutsugamushi • Chigger > bush contact, “Eschar” • Murine typhus: Rickettsia typhi • Mouse > flea bites

  39. Hospital Acquired Infection • Pseudomonas aeruginosa • Acinetobacter baumanii, A. lwoffii • Sternotrophomonas maltophilia

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