Gram Positive Bacillus Medically Important GPR l l

Gram Positive Bacillus

Medically Important GPR l l l Bacillus Clostridium Listeria Erysipelothrix Lactobacillus Actinobacteria l l l Streptomyces Proprionibacterineae Corynebacterium Nocardia Mycobacterium

Bacillus anthracis l Characterisitics l l l Reservoir, zoonotic l l GPR FA Capsule Spore: central endospore Nonmotile Hoof stock (sheep, cattle, goats) Fur, hides (textile workers) Soil contaminated with spores Virulence l l l Capsule Spore Exotoxin (anthrax toxin) l l l Necrosis Edema Protective Ag

Pathogenicity

B. anthracis diseases l Exposure l l Inhalation Inoculation Ingestion meat Dz l l l Gastrointestinal l Hemmorhage/death Cutaneous l Eschar/toxemia Inhalation l Toxemia/death

B. anthracis Cutaneous Anthrax: Eschar

B. anthracis l Dx l l Tx l l Culture/Isolation AB (cipro) Prevention l l Vaccination (toxoid) Proper disposal l Chemical disinfection l Burn carcasses

B. cereus l Characteristics l l l Virulence l l l Aerobic Non-encapsulated Motile spore Spores Enterotoxins Hemolysins Lecithinase (p. LC) Dz l l l Food poisoning Catheter sepsis Ocular infections

B. subtilis l Location l l l Soil Decaying organic matter Nonpathogenic l Research organism l l l Commercial use l l Endospores antibiotics Enzyme production Insect toxin Fungicide Food spoilage

Clostridium l Examples l l C. tetani C. perfringes C. botulinum Characteristics l l l GPR Obligate anaerobes Motile Spore former (terminal) Exotoxins

C. perfringens l l Membrane disrupting toxin (phospholipids) l Alpha toxin (lecithinase) l Rupture RBCs l Destroy Tissue Enzymes l Collagenase l Hyaluronidase l DNase l CH 2 O fermentation Gas Exposure l Puncture wounds, fractures l Surgical l Contaminated food Diseases l Food poisoning l Improper cooking l V/D l Gas gangrene l Anaerobic cellulitis l myonecrosis

Gas Gangrene Treatment Debride AB Hyperbaric O 2

C. tetani l l l Epidemiology: saphrophyte l Soil l Dust l GI tract l Wounds (deep) l Burns l Umbilical stump l Animal bites A-B neurotoxin (exotoxin) l Tetanospasm l Blocks release of inhibitory NT l Glycine § Relaxes opposing muscle § Without: both muscle groups contract Tonic Spasms l Localized (Lockjaw) l Cephalic l Generalized l Death respiratory failure

C. tetani l Dx l l Spores in wound Blood toxin levels Toxin neutralization test Treatment l l Antitoxin (HTIg) AB Debride Curare poison l l l paralysis ventilator Prevention l Vaccination l l Toxoid (DPT) Antitoxin

Tetanus neonatorum l l C. tetani Umbilical cord infected l l soil, dirt rubbed on stump Dirty instruments

C. botulinum l l Location l Soil l Water l Improper canning l GI tracts of animals Epidemiology l Intoxication l Food borne § Toxin (canned food) l Infant § Ingestion of endospores § Source: honey l Wound § endospores

C. botulinum l Pathogenicity l A-B neurotoxin l l botulinum toxin 7 toxins A-G § § § l Type A § Proteolytic § Heat resistant Type B: both Type E § Nonproteolytic § Heat labile Bind to neuron § § prevent ACH from binding at NMJ Flaccid paralysis § Descending § Death in 3 -7 days

C. botulinum l Dx l l l Tx l l Culture/Isolation Symptoms Antitoxin AB: penicillin Ventilator Prevention l l Proper food handling Boiling 10 minutes

Botox

Clostridium difficile l l GI source Epidemiology l l Pathogenicity l l l Long term care facilities Chronic AB use Fecal-oral route Toxins Spores Diseases l l Colitis pseudomembrane Cecal perforation = fatal

Colitis

Actinobacteria l l Suborder Actinomycinae Suborder Propionibacterineae Suborder Streptomycineae Suborder Corynebacterineae l l l Family Corynebacteriaceae Family Mycobacteriaceae Family Norcariaceae

Actinomycosis l l Actinomycetes Characteristics l l Anaerobic Diseases l l l Abscesses Sulfur granules Body cavities l Jaw l Thoracic l Abd/pelvic

Proprionibacterineae l l l GPR Non motile, NSF FA to aerotolerant Catalase (+) Location l Skin l GI l Dairy (cheese) Types l P. acnes l l Body odor Acne § § Oil glands Acne vulgaris

Streptomycineae l l l Streptomyces Aerial hyphae, conidia Obligate aerobes Location: soil Problems l l S. C infection Abscess Bone destruction Use l AB synthesis

Mycobacteriaceae l Examples l l l Characteristics l l l M. tuberculosis M. leprae AF (mycolic acid) Aerobic Nonmotile, NSF Reservoir = humans Transmission l Respiratory droplets

M. tuberculosis l l Slow growing TB l l l Pulmonary l Nodular scars § Calcification § T cells and macrophages CT § Tubercle l Caseous necrosis Disseminated (consumption) l Brain l Bone l Kidneys l GI l LN l Skin Disease stages l l l Primary Latent Recrudescent

M. tuberculosis l Virulence factors l Mycolic acid l l l Catalase Mycobactin l l Chelates iron Dx l l Decrease phagocytosis Culture/isolation of sputum Radiography of chest TB skin test (PPD) Tx l l l multi-drug Resistance Research: r. DNA vaccine

M. Leprae (Hansen’s bacillus) l l Slow growing Epidemiology l l l Tropical environments (TX) Not readily communicated Types l Tuberculoid l l l Rash with plaques Nerve damage Lepramatous (Leproid) l l Erythemia nodosum Neuritis Ulceration/bacteremia Skin appendage loss Treatment: AB

Corynebacterium l l C. diptheriae Characteristics l Club shaped l Weakly AF l Metachromic granules Epidemiology l Source: carriers l Cutaneous l Fomites l Respiratory infection l Aerosol l Pharynx, LN, tonsils l Pseudomembrane Pathogenicity l Diptheria toxin l A-B exotoxin § A: Inactivates proteins § B: attacks heart, NS l Neuraminidase l Protease (Dipthin) coryne = club shaped

C. diptheria disease l Pseudomembrane l l Pharynx and tonsils MM l l l Nasal Larynx External ear (OM) Conjunctiva Vulvo-vaginal Complications (toxins) l l Edema Myocarditis Neuritis Cutaneous rash

C. diphtheria l Dx l l Pseudomembrane Metachromic granules Tx l Antitoxin l AB Prevention l Vaccination (DPT)

Nocardia l l N. asteroids Characteristics l l Transmission l l immunosuppressed Dz l l l Saprophyte (soil) Filamentous, branch Weakly AF Resp: resemble TB Skin: abscesses Tx: AB

Lactobacillales (Lactobacillus) l Characteristics l l Epidemiology l l l Coccobacillus FA – microaerophilic Lactic acid fermentation Food: meat, dairy, fruit Environment: water Uses l Food production l l Fermented vegetables Beverages: beer, wine, juices Milk products: yogurt, cheese Problems l Food spoilage

Listeria l l l L. monocytogenes Characteristics l Soil, mammal gut l Non caspule, NSF l Motile [petrichous flagella] l FA l Catalase (+) l Resist: Cold, p. H, temp, salt, bile Transmission l Direct: neonate, uterus l Vertical Dz l Food poisoning (dairy) l Skin-> bacteremia-> endocarditis>NS Tx: AB Prevention l Cook foods l Pasteurize dairy products

Food Safety

Erysipelothrix l l l l E. rhusiopathiae Characteristics l Saphrophyte l Nonmotile, NSF l microaerophilic Epidemiology l Water, sewage l Animals Pathogenicity: capsule Transmission: Fecal Disease l Macropapular rash l Endocarditis l Septicemia Tx l AB l Animal vaccination (pigs)

Mycoplasmas l Characteristics l l l Examples l l Lack cell walls Pleomorphic (fried egg) NM FA-Obligate anaerobes M. genitalium M. pneumoniae M. hominis Diseases l l Pneumonia Uritogenital infections

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