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Gram Positive (purple/blue)

Gram Positive (purple/blue). Cocci. Rods (bacilli) CLOSTRIDIUM (anaerobe) LISTERIA BACILLUS CORYNEBACTERIUM. Capsule S. PNEUMONIA. Catalse (+) STAPH. Catalse (-) STREP. α. No Capsule VIRIDANS STREP. Coagulase (+) S. AUREUS. Coagulase (-). Group A S. PYOGENES. Hemolysis. β.

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Gram Positive (purple/blue)

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  1. Gram Positive (purple/blue) Cocci Rods (bacilli) CLOSTRIDIUM (anaerobe) LISTERIA BACILLUS CORYNEBACTERIUM Capsule S. PNEUMONIA Catalse (+) STAPH Catalse (-) STREP α No Capsule VIRIDANS STREP Coagulase (+) S. AUREUS Coagulase (-) Group A S. PYOGENES Hemolysis β Group B S. AGALACTAIE Novobiocin (+) S. EPIDERMIDIS Novobiocin (-) S. PNEUMONIAE ENTEROCOCCUS PEPTOSTREPTOCOCCUS γ

  2. Gram Negative (pink) Cocci Rods “Coccoid” Rods H. FLU PASTURELLA BRUCELLA BORDETELLA PERTUSSIS Maltose Fermenter NEISSERIA MENINGITIDIS Non Fermenter NEISSERIA GONORRHOEAE Fast lactose Fermenter KLEBSIELLA E. COLI ENTEROBACTER Slow Fermenter CITROBACTER SERRATIA Lactose Nonfermenter Oxidase Negative SHIGELLA SALMONELLA PROTEUS Oxidase Positive PSEUDOMONAS

  3. Viva the Difference

  4. Metabolic Characteristics • Love oxygen • Need it to grow • Have all 3 enzymes • Obligate aerobes • Facultative anaerobes • Microaerophilic bacteria • Obligate Anaerobes • Like oxygen /doesn’t require it • Can use anaerobic fermentation • Catalase and Superoxide Dismutase • Like small amounts of oxygen • Aerotolerent anaerobes • Superoxide Dismutase • Don’t like oxygen • No enzymes to counter act

  5. Gram Positive Pathogens • Cocci • Staphylococci • Streptococci • Rods (bacilli) • Spore formers • Bacillus • Clostridium • Nonspore formers • Nonfilamentous • Corynebacterium • Listeria • [Mycobacterium-kind of] • Filamentous • Actinomyces • Nocardia

  6. Gram Positive Pathogens Streptococcus • Cocci-catalase test • Streptococci-negative • Staphylococci-positive Staphylococcus

  7. Genus: Staphylococci • Gram Positive Cocci in groups and clusters • Catalase positive • Coagulase Test for differentiation • S. Aureus-positive • S. Epidermidis-negative • S. Saprophyticus-negative • Virulence factors • Surface protein A binds to Fc portion of IgG (prevents opsonization) • Enterotoxin and TSST-1 toxins

  8. Staphylococcus AureusDirect infection Impetigo MRSA

  9. Staphylococcus Aureus diseases due to toxins TSST-1 Enterotoxin Very stable Scalded Skin Syndrome

  10. Genus: Staphylococcus Staph Epidermidis

  11. Genus: Streptococcus Catalase Negative Gram Positive Cocci in pairs and chains

  12. Genus: Streptococcus • S. pyogenes • S. agalactiae • S. pneumoniae • Enterococcus

  13. Genus: Streptococcus • Lancefield Antigens • Lancefield antigens denote cell wall carbohydrates • The presence of Lancefield antigens defines the pyogenic streptococci • Groups A through T • A,B, C and D are most important • Some Streptococcus are not assigned (they do not possess) Lancefield antigens

  14. Genus: Streptococcus • Hemolysis on BAP • The hemolysis is defined as alpha, beta and gamma No Complete Partial

  15. Genus: Streptococcus • Strep Pyogenes • Group A Beta Strep • Strep throat, scarlet fever, rheumatic fever, acute glomerulonephritis, impetigo • Strep Agalactactiae • Group B Beta Strep • Perinatal sepsis, meningitis and/or pneumonia • Strep Pneumoniae • Pneumococcus • Optichin Sensitive • Otitis media, pneumonia, meningitis • Enterococcus • Group D • UTI

  16. Genus: Streptococcus Strawberry tongue Lancefield Antigen Hemolysis on BAP • Group A Beta Strep • S. pyogenes • Strep Throat • Scarlet Fever • Rheumatic Fever • Post Streptococcal Glomerulonephritis • Impetigo Chromatographic Immunoassay Pharyngitis

  17. Genus: Streptococcus • Strep Agalactactiae • Group B Beta Strep • Perinatal sepsis, meningitis and/or pneumonia • Early Sepsis within one week of birth • Late Sepsis from 7days to 3 months of birth

  18. Genus: Streptococcus • Alpha hemolysis • Optichin Sensitive • Gram positive Lancet Shaped Diplococci • Strep Pneumoniae • Pneumococcus (nickname) • Otitis media, pneumonia, meningitis Significant sequalae Right lower lobe pneumonia encapsulated

  19. Genus: Streptococcus • Enterococcus • Group D • Virulence Factors • Abx resistant due to PBP • Acquired Resistance • Enzymes • Adherence factors • Biofilm formation • UTI, catheter related infections

  20. Gram Positive Spore Forming Rods • Bacillus (Fac. Anaerobe) • Clostridium (Strict Anaerobe)

  21. Genus: Bacillus • Fac. Anaerobe • G + Spore Forming Rod • Bacillus • B. Anthracis • Cutaneous • Respiratory • Intestinal BAP Respiratory B. Anthracis

  22. Genus: Clostridium • Anaerobic G + Rod • Spore formers • Clostridium • C. Perfringens • C Tetni • C. Botulinum • C. Difficile Target hemolysis on BAP ~ two zones due to production of 2 toxins Myonecrosis/ gas gangrene

  23. Genus: Clostridium Neurotoxin binds to presynaptic terminals in prevents transmission of inhibitory neurotransmitters • Anaerobic G + Rod • Spore formers • Clostridium • C. Perfringens • C Tetni • C. Botulinum • C. Difficile Terminal Spore Tennis Racket DTP and DTaP

  24. Genus: Clostridium • Anaerobic G + Rod • Spore formers • Clostridium • C. Perfringens • C Tetni • C. Botulinum • C. Difficile Toxin ingestion (usual) Infantile Botulism caused by spore ingestion with endogenous toxin production Spores

  25. Genus: Clostridium Endoscopic view of Psuedomembranous colitis • Anaerobic G + Rod • Spore formers • Clostridium • C. Perfringens • C Tetni • C. Botulinum • C. Difficile Plain film of abdomen showing bowel wall thickening, loss of haustral markings (thin arrow) and dilation of the ascending and transverse colon (thick arrow)

  26. Gram Positive Nonspore Forming Rods • Nonfilamentous • Corynebacterium • Listeria • [Mycobacterium-kind of]

  27. Genus: Corynebacterium • Gram Positive Nonspore Forming Rods • Immobile • Nonencapsulated • Nonfilamentous • Corynebacterium • C. Diphtheriae Pseudomembrane of throat and/or nasal cavity DTP and DTaP Pallisades/ Chinese Letter Arrangements Barred appearance (metachromatic granules)

  28. Genus: Listeria • Gram Positive Nonspore Forming Coccobacilus • Tumbling motility at 25 degrees Celsius • Nonfilamentous • Listeria • L. Monocytogenes Transplacental and birth canal transmission Raw milk, soft cheeses, ice cream, raw vegetables, raw or cooked poultry, raw meat, raw or smoked fish Beta hemolysis

  29. Genus: Mycobacterium • Gram Positive Nonfilamentous Nonspore Forming Rods • Strict aerobe • Very slow growing • Weakly gram positive • Acid Fast-waxy cell wall-mycolic acid • [Mycobacterium -kind of] • M. Tuberculosis • M.Leprae Divides every 15 to 20 hours Acid fast gram positive bacteria PPD

  30. Genus: Mycobacterium • Gram Positive Nonfilamentous Nonspore Forming Rods • Waxy coating->acid fast • Aerobic/ nonmotile • Can not grow in artificial culture • [Mycobacterium -kind of] • M. Tuberculosis • M.Leprae • Leprosy • Hanson’s Disease Nine banded Armadillo Incubation is 2-20 years

  31. Gram Positive Filamentous Nonspore Forming Rods • Aerobic to Fac. Anaerobe • Opportunistic • Actinomyces • A. Israelii • Nocardia

  32. Genus: Actinomyces • Gram Positive Filamentous Nonspore Forming Rods • Aerobic to Fac. Anaerobe • Non acid fast • Opportunisitic • Actinomyces • A. Israelii Actinomycoses infections are polymicrobial Lumpy Jaw

  33. Primary source is soil Colonies smell like wet dirt Genus: Nocardia • Gram Positive Filamentous • Branching • Weakly acid fast • Strict aerobe • Catalase positive • Nonspore Forming Rods • Nocardia Low virulence opportunistic infection

  34. Now on to Gram Negatives

  35. Gram Negative Cocci • Neisseria • N. Meningitidis • N. Gonnorhea • Moraxella • Branhemella Cattorhalis

  36. Gram Negative Cocci • Kidney bean shape • Ferments maltose and glucose like meningitis • Oxidase and catalase positive • Endotoxin production • Neisseria • N. Meningitidis • Meningiococcus (nickname) • Meningitis, septic shock • N. Gonnorhea Kidney bean shape Not B Nonblanching petechial rash Direct or from cultured specimen

  37. Gram Negative Cocci • Kidney bean shaped • Neisseria • N. Gonorrhea • Gonorrhea • Ophthalmia Neonatorum Culture is the gold standard $$$ Nucleic Acid Amplification Tests Ophthalmia Neonatorum

  38. Otitis media • Gram Negative Cocci • Aerobic • Moraxella • Branhemella Catorrhalis • Otitis media, sinusitis sinusitis

  39. Gram Negative Spirochetes • Treponema • T. Pallidum • Borrelia • B. Burgdorfi • B. Recurrentis • Leptospira

  40. Gram Negative Spirochetes • Too small for gram stain • Can not be cultured from clinical specimen • Dark field microscopy of clinical sample • Treponema • T. Pallidum • Syphillus-acquired and congenital • Nontreponemal tests • Treponemal tests Electron Micrograph Secondary stage

  41. Gram Negative Spirochetes • Microaerophilic • Geimsa or Wright stain • Borrelia • B. Burgdorfi western black-legged tick (Ixodes) Erythema migrans

  42. Gram Negative Spirochete • Aerobic • Motile • G –cell envelope • Animal reservoirs • Flexible spirochete • Not seen on gram stain • Dark field microscopy • Leptospira • L. Interrigans Fine spirals with hooked ends Water transmission Petichial rash

  43. Many Many Gram Negative Bacilli • Respiratory • Heamophilus • Bordetella • Legionella • Gardnerella • Zoonotics • Yersinia • Franicisella • Brucella • Pasteurella • Bartonella • Enterics • Many many

  44. Respiratory Gram Negative Bacilli • small pleomorphic, gram-negative coccobacillus. • Nonmotile • non–spore-forming • fastidious • facultative anaerobe • Heamophilus • H. Influenzae • H. Ducryi

  45. Respiratory Gram Negative Bacilli • Small pleomorphic, gram-negative coccobacillus. • Nonmotile • non–spore-forming • Fastidious-X &V factor • facultative anaerobe • Heamophilus • H. Influenzae • HIb • Epiglottitis, otitis media, meningitis, pneumonia • H. Ducryi Otitis media Epiglottitis Insp. Stridor Satelliting around Staph. conjugated

  46. Respiratory Gram Negative Bacilli • small pleomorphic, gram-negative coccobacillus. • Nonmotile • non–spore-forming • Fastidious-X &V factor • Dies quickly outside of body • facultative anaerobe Heamophilus • H. Ducryi • “soft chancre” • Culture is difficult • chancroid Painful genital ulcer

  47. Respiratory Gram Negative Bacilli • Small aerobic G- Coccobacilllus • Singly and in pairs • Nicotinamide required for (slow) growth • Bordetella • B. Pertussis • Whooping cough ELISA or PCR assays Bordet-Gengou medium DTP & DTaP Paroxysmal cough with an inspiratory whoop

  48. Respiratory Gram Negative Bacilli • Nicotinamide required for (slow) growth • Bordetella • B. Pertussis • Whooping cough ELISA or PCR assays • Virulence factors • Pili and surface protein for adhesion • Pertussis toxin • Enzyme that disrupts immune response • Peptidoglycan injury to ciliated trachea cells DTP & DTaP Bordet-Gengou medium

  49. Respiratory Gram Negative Bacilli • Poorly staining • Facultative Intracellular parasite • Compromised host • Aerobic • Legionella • L. Pneumophila • Legionnaires' disease • Pneumonia Paired serum sample Urinary antigen Sputum culture

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