V' A'Bacterial Diseases

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V. A. Bacterial Diseases

• A. Airborne Bacterial Diseases
• B. Foodborne Waterborne Bacterial Diseases
• C. Soilborne Bacterial Diseases
• D. Arthropodborne Bacterial Diseases
• E. Sexually Transmitted Bacterial Diseases
• F. Miscellaneous Bacterial Diseases

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V. A. Airborne Bacterial Diseases

• 1. Streptococcal Diseases
• 2. Diphtheria
• 3. Pertussis
• 4. Meningococcal Infections
• 5. Haemophilus influenzae Infections
• 6. Tuberculosis
• 7. Pneumococcal Pneumonia
• 8. Primary Atypical Pneumonia
• 9. Legionellosis

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V. A. 1. Streptococcal Diseases

• Properties of the Genus Streptococcus
• General Properties
• Gram-positive Cocci in Chains or Pairs
• Catalase Negative

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V. A. 1. Streptococcal Diseases

• Properties of the Genus Streptococcus (cont.)
• Hemolytic Reactions
• Detected by Blood Agar Cultures
• Beta Hemolysis
• Complete Hemolysis
• Clear Zone Around Colonies on Blood Agar
• Alpha Hemolysis
• Incomplete Hemolysis
• Greenish Zone Around Colonies on Blood Agar
• Gamma Reaction
• Absence of a Hemolytic Reaction
• No Change Around Colonies on Blood Agar

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V. A. 1. Streptococcal Diseases

• Properties of the Genus Streptococcus (cont.)
• Lancefield Groups
• Based on Serological Groupings Also may be
  distinguished by Biochemical Testing or
  Antibiotic Sensitivity
• Group A
• Streptococcus pyogenes
• The most virulent human pathogen of the genus
• Beta hemolytic
• Often identified by rapid serological tests or by
  antibiotic resistance

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V. A. 1. Streptococcal Diseases

• Properties of the Genus Streptococcus (cont.)
• Lancefield Groups (cont.)
• Group B
• Streptococcus agalactiae
• Mildly to moderately virulent esp. in children
  elderly
• Usually beta or alpha hemolytic some strains
  are gamma
• Detected biochemically

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V. A. 1. Streptococcal Diseases

• Properties of the Genus Streptococcus (cont.)
• Lancefield Groups (cont.)
• Group D
• Includes the fecal streptococci (enterococci)
• Normal colon flora in humans other animals
• Genus Enterococcus
• Several species eg. Enterococcus faecalis
• Occasionally pathogenic often in urinary tract
  infections
• Usually gamma reactive
• Detected biochemically

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V. A. 1. Streptococcal Diseases

• Diseases Associated with Streptococcus pyogenes
• Respiratory Symptoms
• Upper Respiratory Tract
• Pharyngitis
• Systemic Symptoms
• Septicemia
• Internal infections
• Scarlet feverDue to strains that produce an
  erythrogenic toxin

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V. A. 1. Streptococcal Diseases

• Diseases Associated with Streptococcus
  pyogenes(cont.)
• Immune-Related Complications
• Rheumatic fever
• Glomerulonephritis
• Other Conditions/Portals of Entry
• Erysipelas
• Necrotizing fasciitis
• Puerperal sepsis

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V. A. 2. Diphtheria

• Cause Corynebacterium diphtheriae
• Properties of the Genus Corynebacterium
• Gram-positive rods non-sporeforming
• Coryneform (diphtheroid) arrangement
• Snapping division
• Metachromatic Granules
• Several different species
• Frequently found in soil in the skin flora
• Only virulent strains of Corynebacterium
  diphtheriae are considered pathogenic

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V. A. 2. Diphtheria

• Cause Corynebacterium diphtheriae
• Properties of Corynebacterium diphtheriae
• Virulent strains contain a extra gene that
  encodes for the diphtheria exotoxin
• The exotoxin is a cytotoxin that inhibits
  protein synthesis -- kills host cells

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V. A. 2. Diphtheria

• Transmission Symptoms
• Airborne contact with infected persons
• Upper Respiratory Infection
• Pseudomembrane Formation
• May Spread into Bloodstream
• Cardiovascular damage
• Vaccination with diphtheria toxoid vaccine

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V. A. 3. Pertussis

• Cause Bordetella pertussis
• Gram-negative aerobic rod
• Found among the respiratory flora of humans
  other animals
• Transmission and Symptoms
• Airborne contact with infected persons
• Upper respiratory tract infection may be severe
  in children  elderly
• Difficulty breathing staccato cough (whooping
  cough)
• Usually does not spread into bloodstream

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V. A. 4. Meningococcal Infections

• Cause Neiserria meningitidis
• Properties of the Genus Neiserria
• Gram-negative cocci in pairs
• Several speciessome of which are normal colon
  flora
• Fastidious nutritional requirementsGrow best on
  chocolate agar
• Notable pathogenic species
• Neiserria meningitidis
• Neiserria gonorrhoeae

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V. A. 4. Meningococcal Infections

• Transmission Symptoms
• Airborne contact with infected persons
• Often associated with children with persons in
  close or crowded quarterseg. schools, daycare,
  etc.
• Upper respiratory tract symptoms
• Septicemia
• Meningitis
• Headache and stiff neck
• Listlessness dizziness disorientation
• Seizures coma death

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V. A. 5. Haemophilus influenzae Infections

• Cause Haemophilus influenzae
• Properties of the genus Haemophilus
• Gram-negative rod
• Facultatively anaerobic
• Fastidious -- requires chocolate agarfor growth
• Several species common among the respiratory
  flora

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V. A. 5. Haemophilus influenzae Infections

• Cause Haemophilus influenzae (cont.)
• Notable species
• Haemophilus influenzae Several strains common
  in the upper respiratory tract. Type b is
  associated with some cases of bacterial
  meningitis type III is sometimes the cause of
  certain eye infections
• Haemophilus ducreyii Causative agent of
  chanchroid

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V. A. 5. Haemophilus influenzae Infections

• Transmission Symptoms
• Infections most frequently associated with the
  virulent strain, type b
• Upper respiratory tract symptoms
• Rhinitis and Sinusitis
• Otitis media
• Epiglottitis
• Septicemia and Meningitis
• Prevented by HIB vaccine

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V. A. 6. Tuberculosis

• Cause Mycobacterium tuberculosis
• Properties of the genus Mycobacterium
• Acid-fast rods
• Grow slowly some species are difficult to
  culture
• Several speciessome found in soil and among
  skin flora
• Major pathogenic species
• Mycobacterium tuberculosis
• Mycobacterium avium-intracellulare
• Mycobacterium cheloni
• Mycobacterium scrofulaceum
• Mycobacterium leprae

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V. A. 6. Tuberculosis

• Transmission Symptoms
• Transmission
• Airborne Contact
• Prolonged Exposure
• Occasionally via skin contactor wounds

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V. A. 6. Tuberculosis

• Transmission Symptoms (cont.)
• Symptoms
• Lung Infection
• Destruction of alveoli
• Cough sputum
• Tubercle Formation
• May remain dormant for yearsand then become
  active again
• May spread to other areas of the bodyMiliary TB

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V. A. 6. Tuberculosis

• Transmission Symptoms (cont.)
• Detection
• Microscopic examination
• Chest X-Ray
• Culture
• Tuberculin Skin Test
• TB Vaccination

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V. A. 7. Pneumococcal Pneumonia

• Cause Streptococcus pneumoniae
• Properties of the Genus -- See Earlier Notes
• Formerly Known as Diplococcus pneumoniae
• No Lancefield classification
• Gram-positive diplococcivirulent strains are
  encapsulated
• Alpha Hemolytic
• A common cause of secondary bacterial pneumonia

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V. A. 7. Pneumococcal Pneumonia

• Transmission Symptoms
• A frequent cause of secondary bacterial pneumonia
  
• Airborne transmission
• Lower Respiratory Tract Infection
• Pneumonia
• Fluid Buildup in Lung

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V. A. 8. Primary Atypical Pneumonia

• Cause Mycoplasma pneumoniae
• Properties of the Genus Mycoplasma
• Small, irregular cells
• Naturally cell wall deficient
• Several species
• Common among respiratory flora in humans other
  animals

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V. A. 8. Primary Atypical Pneumonia

• Transmission Symptoms
• Airborne Transmission
• May be opportunistic
• Frequently causes mild cases of primary pneumonia
  
• Mycoplasma pneumoniae may also cause severe
  secondary pneumonia in immunocompromised patients

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V. A. 9. Legionellosis

• Cause Legionella pneumophila
• Properties of the genus Legionella
• Gram-negative rods
• Strictly aerobic
• Found in highly aerated, moist environmentseg.
  streams
• May parasitize certain aquatic protozoa
• Can contaminate building ventilation systems, air
  filters, etc.

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V. A. 9. Legionellosis

• Transmission Symptoms
• Airborne
• Contact with infected persons or environments
• Mild to Moderate Pneumonia

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V. B. Foodborne Waterborne Bacterial Diseases

• 1. Foodborne Intoxications vs Infections
• 2. Botulism
• 3. Staphylococcal Food Poisoning
• 4. Clostridial Food Poisoning
• 5. Typhoid Fever
• 6. Salmonellosis
• 7. Shigellosis
• 8. Cholera
• 9. Diseases associated with Escherichia coli
• 10. Camphylobacteriosis and Helicobacteriosis

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V. B. 1. Foodborne Intoxications vs Infections

• Foodborne intoxications Caused by the exotoxin
  secreted by bacteria in contaminated food
• Foodborne infections Caused by the ingestion of
  live bacteria that colonize the digestive tract

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V. B. 2. Botulism

• Cause Clostridium botulinum
• Properties of the genus Clostridium
• Gram-positive rod
• Strictly anaerobic
• Spore-former
• Widely distributed, especially in soil
• Important species
• Clostridium botulinum
• Clostridium perfringins
• Clostridium tetani

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V. B. 2. Botulism

• Transmission Symptoms
• Transmitted via contaminated food
• Botulinum toxin
• A neurotoxic exotoxin
• Heat sensitive
• Inhibits synaptic transmission at motor neuron
  end plates
• Causes flaccid paralysis
• Very deadly Death due to respiratory cardiac
  failure
• Treatment Administration of antitoxin

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V. B. 2. Botulism

• Transmission Symptoms (cont.)
• Other mechanisms of transmission
• Wound botulism
• Animal botulism
• Infant botulism

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V. B. 3. Staphylococcal Food Poisoning

• Cause Staphylococcus aureus
• Properties of the genus Staphylococcus
• Gram positive coccus in clusters
• Catalase positive
• Two major species
• Staph. aureus is more virulent is coagulase
  positive
• Staph epidermidis is more common is coagulase
  negative
• Both are common skin upper RT flora

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V. B. 3. Staphylococcal Food Poisoning

• Transmission  Symptoms
• Certain strains of Staph. aureus Produce
  staphylococcal enterotoxin
• Toxin is secreted in contaminated food
• Causes abdominal pain, nausea, diarrhea, for a
  few hours
• Staph. aureus enterotoxin is unusually
  heat-resistant

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V. B. 4. Clostridial Food Poisoning

• Cause Clostridium perfringins
• Certain strains secrete an enterotoxic exotoxin
• Transmission Symptoms
• Similar to staphylococcal food poisoning, except
  that the clostridial enterotoxin is not as
  heat-stable

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V. B. 5. Typhoid Fever

• Cause Salmonella typhi
• Properties of the genus Salmonella
• A member of the family Enterobacteriaceae
• Colon flora sometimes carried asymptomatically
• Gram negative rods
• Facultatively anaerobic
• Salmonella typhi
• Most virulent member of the genus

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V. B. 5. Typhoid Fever

• Transmission Symptoms
• Transmission via oral route
• often associated with contact with infected
  persons, either symptomatic or carriers
• sewage
• flies

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V. B. 5. Typhoid Fever

• Transmission Symptoms
• Invades intestinal epithelium tissue
• ulceration
• bloody stools but little diarrhea
• Blood invasion
• fever delirium
• blood vessel hemorrhaging
• rose-colored spots on the abdomen
• bowel perforation
• gall-bladder infection

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V. B. 6. Salmonellosis

• Cause Salmonella serotypes
• Serotypes of the genus Salmonella other than S.
  typhi
• Hundreds of serotypes species names exist but
  are often not reported
• Examples
• Salmonella enteriditis
• Salmonella gallinarum
• Salmonella typhimurum

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V. B. 6. Salmonellosis

• Transmission Symptoms
• Contaminated food
• Meat
• Poultry products
• Dairy products
• Gastroenteritis
• Cramps
• Nausea
• Vomiting
• Diarrhea

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V. B. 7. Shigellosis

• Cause Shigella species
• Genus Shigella
• A member of the family Enterobacteriaceae
• Colon flora sometimes carried asymptomatically
• Gram negative rods
• Facultatively anaerobic
• Species
• Shigella sonnei
• Shigella dysenteriae
• Shigella flexneri
• Shigella boydii

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V. B. 7. Shigellosis

• Transmission Symptoms
• Transmission
• Similar to salmonellosis
• Gastroenteritis
• Often with watery diarrhea
• Sometimes with bloody stools Dysentery

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V. B. 8. Cholera

• Cause Vibrio cholerae
• Genus Vibrio
• Gram-negative curved bacteria
• comma-shaped
• facultatively anaerobic
• Normal flora in many animals
• Notable Pathogenic Species
• Vibrio cholerae
• Vibrio parahaemolyticus

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V. B. 8. Cholera

• Transmission Symptoms
• Transmission
• Contaminated food
• shellfish
• vermin
• livestock

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V. B. 8. Cholera

• Transmission Symptoms (cont.)
• Gastroenteritis with extensive severe diarrhea
• Cholera enterotoxin
• Toxin blocks water reabsorption by inhibiting the
  anion active transport mechanism in large
  intestinal epithelium
• Rice water stools
• Dehydration death
• Recent epidemic due to spread of new
  drug-resistant strain

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V. B. 9. Diseases associated with Escherichia coli

• Cause Escherichia coli
• Family Enterobacteriaceae
• Gram-negative rods
• Facultatively anaerobic
• Widely distributed among humans animals
• Normal colon flora
• Used as indicator of water food contamination

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V. B. 9. Diseases associated with Escherichia coli

• Transmission Symptoms
• Oral route
• Extremely common normal flora
• Different strains in different geographical
  regions
• Colonize gut in infancy
• Infantile diarrhea
• Traveler's diarrhea

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V. B. 9. Diseases associated with Escherichia coli

• Transmission Symptoms (cont.)
• E. coli strain O157H7
• A rare, particular virulent deadly strain
• Hemorrhagic E. coli disease
• Kidney damage in children

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V. B. 10. Camphylobacteriosis and
Helicobacteriosis

• Camphylobacter jejuni
• Gram-negative spirillum
• Microaerophilic
• Normal flora of colon
• Common cause of mild to moderate gastroenteritis

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V. B. 10. Camphylobacteriosis and
Helicobacteriosis

• Helicobacter pylori
• Gram-negative spirillum
• Microaerophilic
• Can colonize the stomach lining underneath the
  protective mucous layer
• Stomach irritation and ulcers

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V. C. Soilborne Bacterial Diseases

• 1. Anthrax
• 2. Tetanus
• 3. Gas Gangrene
• 4. Leptospirosis
• 5. Listeriosis

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V. C. 1. Anthrax

• Cause Bacillus anthracis
• Genus Bacillus
• Gram-positive rods
• Facultatively anaerobic
• Spore-forming
• Widely distributed in soil
• Many species Bacillus anthracis is the most
  important human pathogen of the group

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V. C. 1. Anthrax

• Transmission Symptoms
• Transmission
• Contact with contaminated soil
• Livestock
• Through skin wounds abrasions
• Also through oral route or airborne
• Skin anthrax
• Intestinal anthrax
• Pulmonary anthrax Woolsorters disease

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V. C. 2. Tetanus

• Cause Clostridium tetani
• Genus properties See Botulism
• Transmission Symptoms
• Wounds esp. deep or puncture wounds
• Tetanospasmin A neurotoxic exotoxin
• Acts as a cholinesterase inhibitor
• Short-circuits nerve synapses esp. in the
  central nervous system
• Causes rigid paralysis
• Treatment Antitoxins plus muscle relaxants
• Prevention Vaccination with tetanus toxoid

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V. C. 3. Gas Gangrene

• Often caused by Clostridium perfringins
• Genus properties See Botulism
• Transmission Symptoms
• Wounds esp. deep wounds
• Gangrene
• Tissue death due to reduced oxygen to tissue
• Gas or moist gangrene Gangrene accompanied by
  bacterial infection
• Swelling tissue death blackish discoloration

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V. C. 4. Leptospirosis

• Cause Leptospira interrogans
• A spirochete
• Found in soil contaminated with animal waste
• Transmission Symptoms
• Contact with contaminated soil or animals
• Often enters through the feet
• Spreads to several organs, including liver,
  kidney, meninges
• Jaundice may be present
• May have bloody vomit

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V. C. 5. Listeriosis

• Cause Listeria monocytogenes
• Genus Listeria
• Small Gram-positive rods
• Non-sporeforming
• Found in soil esp in soil contaminated with
  animal waste

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V. C. 5. Listeriosis

• Transmission  Symptoms
• Contact with contaminated soil
• Also possibly transmitted via contaminated food
• Listeric meningitis
• Blood infection with high white count
• Uterine infections miscarriage or congenital
  damage

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V. D. Arthropodborne Bacterial Diseases

• 1. Plague
• 2. Lyme Disease
• 3. Rocky Mt. Spotted Fever
• 4. Epidemic Typhus
• 5. Endemic Typhus

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V. D. 1. Plague

• Cause Yersinia pestis
• Gram-negative, facultatively anaerobic rods
• in Family Enterobactereaceae however, not
  normally found in colon
• Characterized by bipolar staining

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V. D. 1. Plague

• Transmission Symptoms
• Vector Fleas, esp. rodent fleas
• Bubonic plague Infection of lymph node tissue
  swelling hemorrhaging buboes
• Septicemic plague
• Pneumonic plague
• Cases of airborne transmission among humans have
  been noted

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V. D. 2. Lyme Disease

• Cause Borrelia burgdorferi
• A spirochete
• Transmitted by deer ticks
• First noted in Northeastern US

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V. D. 2. Lyme Disease

• Transmission Symptoms
• Vector Ticks of the genus Ixodes (deer ticks)
  may be transmitted by both immature mature
  ticks
• Incubation period of several weeks
• Initial symptoms
• Flu-like symptoms
• Rash Erythema chronicum migrans (ECM)
• Several weeks/months later
• Joint pain/swelling
• Arthritis-like symptoms
• Cardiovascular nervous system damage

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V. D. 3. Rocky Mt. Spotted Fever

• Cause Rickettsia rickettsii
• A rickettsia Small, gram-negative bacterium
  Obligately intracellular parasite
• Detected by serological testing, eg. the
  Weil-Felix test (Reaction of serum to Proteus
  OX19)
• Transmission Symptoms
• Vector Ticks
• Macropapipular rash begins on palms soles then
  spreads to other parts of the body
• High fever other flu-like symptoms

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V. D. 4. Epidemic Typhus

• Cause Rickettsia prowasekii
• Genus properties See Rocky Mt. Spotted Fever
• Transmission Symptoms
• Vector Human Louse
• Epidemics often in areas with reduced sanitation
  
• High fever high fatality rate
• Rash begins on trunk of body spreads to
  extremities

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V. D. 5. Endemic Typhus

• Cause Rickettsia typhi
• Genus properties See Rocky Mt. Spotted Fever
• Transmission Symptoms
• Vector Fleas esp. rodent fleas
• Endemic in many areas
• Often with mild or no symptoms

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V. E. Sexually Transmitted Bacterial Diseases

• 1. Syphilis
• 2. Gonorrhea
• 3. Chlamydia
• 4. Chanchroid

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V. E. 1. Syphilis

• Cause Treponema pallidum
• A spirochete
• Cannot be cultured on lab medium
• Detected microscopically or serologically

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V. E. 1. Syphilis

• Transmission Symptoms
• Transmission Sexual contact or congenitally
• Primary Syphilis
• Few days after contact
• Hard Chancre
• Secondary Syphilis
• Several weeks after chancre disappears
• Fever flu-like symptoms
• Rash

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V. E. 1. Syphilis

• Transmission Symptoms (cont.)
• Tertiary Syphilis
• Months or years later
• Gummae Lesions on skin  mucous membranes
• Damage to internal organs
• Cardiovascular central nervous system damage

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V. E. 2. Gonorrhea

• Cause Neiserria gonorrhoeae
• Genus Properties See Neiserria meningitidis
• Transmission Symptoms
• Transmission Sexual contact or congenital
• Urinary Tract Symptoms
• Urethritis Burning sensation discharge
• Cystitis kidney infection
• Male Reproductive Tract Symptoms
• Prostatitis
• Inflammation of epididymis  testes sometimes
  sterility

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V. E. 2. Gonorrhea

• Transmission Symptoms (cont.)
• Female Reproductive Tract Symptoms
• Uterine Infections
• Fallopian Tube inflammation blockage occasional
  sterility
• Pelvic Inflammatory Disease
• Other Infections
• Gonococcal Eye Infections
• Respiratory Tract Infections

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V. E. 3. Chlamydia

• Cause Chlamydia trachomatis
• Genus Properties
• A small, Gram-negative bacterium
• Obligately intracellular parasite similar to
  Rickettsia
• Occasionally carried subclinically as part of the
  normal vaginal flora

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V. E. 3. Chlamydia

• Transmission Symptoms
• Very similar to gonorrhea Often mistaken for
  gonorrhea
• Important to distinguish because the treatment is
  different from gonorrhea
• Identified by serological testing
• Transmission Sexual contact or congenital
• Urinary and Reproductive Tract Symptoms
• Respiratory Tract and Eye Infections

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V. E. 4. Chanchroid

• Cause Haemophilus ducreyii
• Genus Properties See Haemophilus influenzae
• Haemophilus ducreyii is occasionally found among
  the vaginal flora or under the prepuce in males
• Transmission Symptoms
• Transmission Sexual contact
• Symptoms
• Painful soft chancre sometimes mistaken for
  syphilis
• Urethritis occasional pelvic inflammation

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V. F. Miscellaneous Bacterial Diseases

• 1. Leprosy
• 2. Staphylococcal Infections
• 3. Pseudomonas aeruginosa Infections

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V. F. 1. Leprosy

• Cause Mycobacterium leprae
• Genus Properties See Tuberculosis
• Cannot be cultured detected by skin biopsy
• Transmission Symptoms
• Skin contact not particularly contagious
• Whitish skin lesions
• Loss of sensation due to nerve damage
• Disfiguration

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V. F. 2. Staphylococcal Infections

• Cause Staphylococcus aureus
• Genus Properties See Staph. Food Poisoning
• Transmission Symptoms
• Skin contact opportunistic
• Skin Infections
• Acne boils pimples
• Abscesses carbuncles
• Impetigo
• Scalded Skin Syndrome
• Toxic Shock Syndrome
• Septicemia High fever

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V. F. 3. Pseudomonas aeruginosa Infections

• Cause Pseudomonas aeruginosa
• Genus Pseudomonas
• Gram-negative rods
• Nonfermentative metabolism
• Most species are strictly aerobic
• Widely distributed in aquatic moist soil
  environments
• Can contaminate moist aerated surfaces water
  faucets respiration equipment

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V. F. 3. Pseudomonas aeruginosa Infections

• Transmission Symptoms
• Frequently an opportunistic or a nosocomial
  infection
• Respiratory tract infections
• Urinary tract infections
• Infections in burn patients

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