Nocardia and Related Bacteria [Gram + Rods]

Physiology & Virulence Factors Epidemiology Diseases Laboratory

Structure Diagnosis

Nocardia (Gram + strict aerobic, opportunistic disease most bronchopulmonary, BCYE agar (orange
Rod) branched hyphae, pathogen, cord factor common in cutaneous, and pigment)
shorter chain mycolic (prevents intracellular immunocompetent nervous system dry, wrinkled, chalk-
acids, weakly acid killing by interfering pts. with chronic infections like appearance
fast, related to with fusion of pulmonary disease gram + rods with
mycobacteria phagosome with and subcutaneous branching
human pathogen = lysosome), catalase tissues
N.asteroids and superoxide
dismutase, toxins,
hemolysins

Actinomyces (Gram Anaerobic, some

+ Rod) branching, non-motile,
not acid fast

Rhodococcus (Gram weakly acid fast opportunistic, abscess formation pink pigmented
+ Rod that can revert branching, R. equi facultative intracellular colonies, mucoid
to coccoid forms) (human pathogen) colonies, weakly acid
fast

Streptomyces (Gram member of bacterial form spores, found worldwide in culture on SDA
+ Rod) order synthesize antibiotics soil
Actinomycetales, (streptomycin)
branching filamentous
structure, non-motile,
FORM SPORES,
earthy smell of soils
(rain smell)
 Gram + Cocci (Staphylococcus and Streptococcus)

General Characteristics of Staphylococcus:

- indigenous microbial flora
- spherical form (bunches of grapes)
- endospore absence
- catalase activity
- non-motile
- facultative anaerobe
- halotolerant (Mannitol Agar) - this will differentiate between the 3 species of Staphylococcus
- Novobiocin Susceptility - will differentiate between the coagulase negative Staphylococus

Physiology & Virulence Enzymes Toxins Epidemiology Diseases Laboratory

Structure Factors Diagnosis

S. aureus gram + cocci, capsule (evade Catalase, hemolysin colonize Mannitol salt
(coagulase +) capsule, slime pathogenesis), Coagulase cytotoxin (pore- anterior agar, hemolytic
layer, slime layer (conversion of forming toxins) zones may
peptidoglycan (protection from fibrinogen to gamma - lyse
nares in 30- produce yellow
(stimulates neutrophiles), fibrin, neutrophils and 40% of pigment on
production of protein A (binds prevention of macrophages people, skin sheep blood
endogenous to Fc portion of phagocytosis), Superantigens: agar
pyrogens), IgG to prevent hyaluronidase, exfoliative toxin spreads by
teichoic acids antibody beta-lactamase A, TSST-1,
(complement mediated (hydrolyzes heat-stable
direct contact
activation and immunity), penicillin), enterotoxin or aerosols
adherence), coagulase Penicillin-
protein A, binding protein entry by skin or
coagulase, 2a (PBP2a - mucous
cytoplasmic resistance to membrane
membrane penicillin), damage
fibrinolysin,
lipases,
nucleases
 Physiology & Virulence Enzymes Toxins Epidemiology Diseases Laboratory
Structure Factors Diagnosis

S. epidermidis produce slime opportunistic catalase + skin susceptible to

(coagulase -) layer that allows coagulase - novobiocin
them to adhere
to medical
prostheses

S. catalase + urinary tract resistant to

saprophyticus coagulase - infection novobiocin
(coagulase -)
General Characteristics of Streptococcus:
- facultative anaerobes, capnophilic (little CO2 needed) growth
- Lancefield groups (A to W)
- alpha, beta, and gamma hemolytic patterns
- vancomycin susceptible
- pin-point colonies
- Bacitracin Susceptivity - used to distinguish between S. pyogenes and S. agalactiae

Hemolytic Physiology & Enzymes Virulence Toxins Epidemiology Laboratory Random Notes
Reaction Structure Factors Diagnosis

S. pyogenes beta catalase - capsule, Streptococcal colonizes the susceptible to M proteins are
(Group A) hemolysis PYR positive protein F Pyrogenic oropharynx bacitracin similar to
[GAS] streptolysin O (fibronectin Exotoxin proteins in the
and S for binding), (SPEs) spread catalase heart so
hemolysin Lancefield (Erithrogenic through secondary
Dnase B group specific Toxin) respiratory PYR reaction infections may
C5a cell-wall C- droplets or (blackish cause cross
peptidase carbohydrate May act as through color) reactions and
(inactivates antigen, super antigen: breaks in skin attack
C5a) fimbria Scarlet fever after direct ASO test antigens of
(contains M or contact with the heart
protein and streptococcal infected Dnase B test
lipoteichoic toxic shock person,
acid) syndrome fomite, or
M protein - arthropod
GAS without vector
this are
avirulent;
adhesion,
degrades
component
C3b
 Hemolytic Physiology & Enzymes Virulence Toxins Epidemiology Laboratory Random Notes
Reaction Structure Factors Diagnosis

S. agalactiae beta capsule capsule resistant to

(Group B) hemolysis with sialic bacitracin
acid
colonies
C5a buttery with
peptidase narrow
zone of
beta
hemolysis

CAMP +
(synergistic
hemolysis
between
group B
streptococc
us and beta
hemolytic
S. aureus)
(having
camp
factor)

PYR -
Group C, F, G beta S. bovis has
hemolysis associated wit
S. anginosus occult
S.dysgalctiae malignancy of
S. bovis (D) colon
 Hemolytic Physiology & Enzymes Virulence Toxins Epidemiology Laboratory Random Notes
Reaction Structure Factors Diagnosis

Viridans alpha colonize the dental

Streptococci hemolysis and oropharynx, caries,
non-hemolytic GI tract, subacute
genitourinary endocarditis,
tract, skin supperative
intra-
abdominal
infections
S. pneumonia alpha capsular IgA endogenou optochin
hemolysis polysaccharid protease - s diseases sensitive
e, small,
round, mucoid
prevent IgA Quellung test
colonies, mediated nasopharyn (capsules)
lancet-shaped immune x
diplococci clearance microscopy
occurs most
pneumococca frequently in antigen
cal C antigen
autolysin- detection of
very young,
pneumolysi elderly, pneumococca
s forms debilitated, or lC
pores into immunosupre
eukaryotic ssed sensitivity to
individuals bile solubility
membranes

neuraminidas
e (unmask
cell-surface
binding
receptors)

General Characteristics of Enterococcus:

 - facultative anaerobe
- grow on blood agar with large white colonies
- non hemolytic but can algo be alpha or beta hemolytic (these are hardest to I.D.)
- halotolerant and can hydrolyze esculin
- laboratory diagnosis: blood agar, resistant to optochin, resistant to bile, hydrolyze PYR (black pigment)
- examples: E. faecalis and E. faecium which are both opportunistic infections
- normal flora in the GI tract, oral cavity, urethra, and vagina
- E. faecalis is one of the most important due to nosocomial disease

Non-enterococci (Group D):

- S. bovis and S. equinus
- part of normal fecal flora

Gram Negative Cocci

General Characteristics of pathogenic Neisseria: (non-pathogenic are Eikenella and Kingella which colonize human oropharynx)
- aerobic
- arranged in pairs (diplococci)
- not motile and do not form endospores
- oxidase positive
- produce catalase properties
- require cystine for growth
- Pili (adhesion), PorB (invasion), and Opa (adhesion) mediate attachment and penetration into host cells
- LOS (LPS) stimulates inflammatory response (antigen A)
- release of TNF-alpha
- chocolate agar for gram - cocci but Thayer-Martin specifically for Neisseria

Physiology & Virulence Factors Virulence Factors Epidemiology Lab. Diagnosis

Structure cont.

N. gonorrhoeae gram - diplococci Pilin - initial tranferrin binding humans only natural gram stain of
(fastidious) attachment protein - for iron host; transmission by urethral
lactoferrin sexual contact;
oxidase and Por protein hemoglobin binding disease most
specimens is
catalase + (protein 1) - protein common in blacks accurate for
ferments glucose intracellular LPS symptomatic
only survival by IgA1 protease males
outer surface with pili preventing beta-lactamase
protein, Por proteins, phagolysosome culture is sensitive
Opa, Rmp protein,
protein receptors for
Opa (protein 2)- and specific
transferrin, lactoferrin, firm attachment
and hemoglobin; LPS; Rmp (protein 3)- pattern of oxidation of
immunoglobulin protects other surface carbohydrates
protease; beta- antigens such as LPS (glucose only)
lactamase and por protein from
bacterial antibodies
 Physiology & Virulence Factors Virulence Factors Epidemiology Lab. Diagnosis
Structure cont.

N. meningitidis gram - diplococci capsule, pili allows humans only natural gram stain of CSF is
(fastidious) colonization of host; spread by sensitive and specific
nasopharynx, bacteria aerosolization; highest but of limited value for
oxidase and can survive incidence of disease blood specimens;
catalase + intracellular killing in under 5 y/o; culture is definitive but
ferments glucose absence of humoral meningitis and organism is fastidious;
and maltose immunity, endotoxin meningococcemia by chocolate blood agar
outer surface proteins: mediates most clinical serogroups B and C; and Thayer-Martin
capsule, pili, and LPS manifestations disease occurs medium; pattern of
worldwide most oxidation of
commonly in dry cold carbohydrates
months (glucose and maltose)

N. sicca & N. (other notes) - commensal

mucosa isolated cases of organisms in the
meningitis, oropharynx
osteomyelitis,
endocarditis,
bronchopulmonary
infections, acute otitis
media and sinusitis

Eikenella Corrodens non-motile; non-spore opportunistic

(gram - rod) forming; facultative pathogen
anaerobic

Kingella kingae small, facultatively reside in human

(gram - coccobacilli) anaerobic, ferment oropharynx;
carbs, fastidious responsible for septic
growth requirements arthritis in children
and endocarditis of all
ages