1. 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

2. 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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3. 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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4. 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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5. 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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6. 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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7. 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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8. V. A. 1. Streptococcal Diseases
Diseases Associated with Streptococcus pyogenes
Respiratory Symptoms
Upper Respiratory Tract
Pharyngitis
Systemic Symptoms
Septicemia
Internal infections
Scarlet fever Due to strains that produce an erythrogenic toxin
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9. 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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10. 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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11. 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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12. 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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13. 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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14. V. A. 4. Meningococcal Infections
Cause: Neiserria meningitidis
Properties of the Genus Neiserria
Gram-negative cocci in pairs
Several species; some of which are normal colon flora
Fastidious nutritional requirements Grow best on chocolate agar
Notable pathogenic species
Neiserria meningitidis
Neiserria gonorrhoeae
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15. V. A. 4. Meningococcal Infections
Transmission & Symptoms
Airborne contact with infected persons
Often associated with children & with persons in close or crowded quarters eg. schools, daycare, etc.
Upper respiratory tract symptoms
Septicemia
Meningitis
Headache and stiff neck
Listlessness; dizziness; disorientation
Seizures; coma; death
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16. V. A. 5. Haemophilus influenzae Infections
Cause: Haemophilus influenzae
Properties of the genus Haemophilus
Gram-negative rod
Facultatively anaerobic
Fastidious -- requires chocolate agar for growth
Several species; common among the respiratory flora
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17. 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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18. 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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19. V. A. 6. Tuberculosis Cause: Mycobacterium tuberculosis
Properties of the genus Mycobacterium
Acid-fast rods
Grow slowly; some species are difficult to culture
Several species; some 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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20. V. A. 6. Tuberculosis Transmission & Symptoms Transmission
Airborne Contact
Prolonged Exposure
Occasionally via skin contact or wounds
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21. V. A. 6. Tuberculosis Transmission & Symptoms (cont.) Symptoms
Lung Infection
Destruction of alveoli
Cough; sputum
Tubercle Formation
May remain dormant for years and then become active again
May spread to other areas of the body: Miliary TB
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22. V. A. 6. Tuberculosis Transmission & Symptoms (cont.) Detection:
Microscopic examination
Chest X-Ray
Culture
Tuberculin Skin Test
TB Vaccination
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23. 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 diplococci; virulent strains are encapsulated
Alpha Hemolytic
A common cause of secondary bacterial pneumonia
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24. 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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25. 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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26. 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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27. V. A. 9. Legionellosis Cause: Legionella pneumophila
Properties of the genus Legionella
Gram-negative rods
Strictly aerobic
Found in highly aerated, moist environments eg. streams
May parasitize certain aquatic protozoa
Can contaminate building ventilation systems, air filters, etc.
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28. V. A. 9. Legionellosis Transmission & Symptoms Airborne
Contact with infected persons or environments
Mild to Moderate Pneumonia
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29. 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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30. 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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31. 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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32. 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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33. V. B. 2. Botulism Transmission & Symptoms (cont.)
Other mechanisms of transmission:
Wound botulism
Animal botulism
Infant botulism
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34. 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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35. 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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36. 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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37. 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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38. 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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39. 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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40. 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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41. V. B. 6. Salmonellosis Transmission & Symptoms Contaminated food
Meat
Poultry products
Dairy products
Gastroenteritis
Cramps
Nausea
Vomiting
Diarrhea
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42. V. B. 7. Shigellosis Cause: Shigella species Genus Shigella Species
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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43. V. B. 7. Shigellosis Transmission & Symptoms Transmission:
Similar to salmonellosis
Gastroenteritis
Often with watery diarrhea
Sometimes with bloody stools: Dysentery
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44. 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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45. V. B. 8. Cholera Transmission & Symptoms Transmission:
Contaminated food
shellfish
vermin
livestock
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46. 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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47. 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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48. 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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49. V. B. 9. Diseases associated with Escherichia coli
Transmission & Symptoms (cont.)
E. coli strain O157:H7
A rare, particular virulent & deadly strain
Hemorrhagic E. coli disease
Kidney damage in children
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50. 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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51. 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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52. V. C. Soilborne Bacterial Diseases
1. Anthrax
2. Tetanus
3. Gas Gangrene
4. Leptospirosis
5. Listeriosis
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53. 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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54. V. C. 1. Anthrax Transmission & Symptoms Transmission Skin anthrax
Contact with contaminated soil
Livestock
Through skin; wounds; abrasions
Also through oral route or airborne
Skin anthrax
Intestinal anthrax
Pulmonary anthrax; “Woolsorter’s disease”
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55. V. C. 2. Tetanus Cause: Clostridium tetani Transmission & Symptoms
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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56. 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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57. 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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58. 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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59. 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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60. 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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61. 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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62. 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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63. V. D. 2. Lyme Disease Cause: Borrelia burgdorferi A spirochete
Transmitted by deer ticks
First noted in Northeastern US
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64. 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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65. 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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66. 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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67. 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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68. V. E. Sexually Transmitted Bacterial Diseases
1. Syphilis
2. Gonorrhea
3. Chlamydia
4. Chanchroid
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69. V. E. 1. Syphilis Cause: Treponema pallidum A spirochete
Cannot be cultured on lab medium
Detected microscopically or serologically
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70. 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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71. 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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72. 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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73. 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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74. 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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75. 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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76. 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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77. V. F. Miscellaneous Bacterial Diseases
1. Leprosy
2. Staphylococcal Infections
3. Pseudomonas aeruginosa Infections
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78. V. F. 1. Leprosy Cause: Mycobacterium leprae Transmission & Symptoms
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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79. 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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80. 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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81. 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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