Bacteria

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Listeria  Monocytogenes   Neonatal  Dz:  Early   Facultative  Intracellular  pathogen.   Hard  to  find  on  CSF   Gentamicin  plus   Capable  of  growth  at  wide  
  onset-­‐acquired   Can  be  ingested  and  survive   gram  stain.  Cold   penicillin  or  ampicillin   temperature  range  and  in  
Morphology:  Aerobic,  Non-­‐spore   transplacentally,  can   stomach  conditions  by  activation  of   enrichment  on     high  concentration  of  salt.  
forming,  gram  -­‐  positive  rods,   lead  to  abortion,   stress  response  genes.  Adhere  to   selective  media.   Avoid  eating  raw  or   Motile  @  room  temperature.  
uniform  in  shape.  Catalase  -­‐ stillbirth,  or  premature   host  cells  through  Internalin  A  (cell   Beta-­‐hemolysis,   undercooked  meat,   Macrophages  engulf  the  
Positive   birth.  Granulomatosis   wall  surface  protein)  –  E  cadherin   with  positive  CAMP   unwashed  vegetables,   bacteria  and  transport  them  
  infantiseptica.  Late   interaction.  After  entering  cells,  the   test.     or  soft  cheese.     to  the  spleen  and  liver.  
Epidemiology:  Isolated  from   onset-­‐acquired  at   acid  pH  activates  Listeriolysin  O,     Virulence  genes  are  
animal  feces,  soil,  and  decaying   birth,  presents  as   and  two  different  phospholipase  C   No  Vaccine   clustered  on  the  positive  
organic  matter.  Outbreaks   meningitis  or   enzymes.  This  allows  the  bacteria   regulatory  factor  (prfA)  
associated  with  contaminated   meningioencephalitis   to  escape  from  Phagolysosome.   gene.  Patients  with  a  
food.  Peaks  in  warmer  months.   with  septicemia.   ActA  move  the  bacteria  to  the  host   defective  cellular  immune  
Refrigerated  food  can  become   Healthy  adult  Dz  is   cell  membrane  through  assembly  of   response  are  at  increased  
grossly  contaminated.     usually  mild  influenza   actin.  This  leads  to  directional   risk.  Serotype  4b  causes  
like,  or  asymptomatic.   movement.  Can  move  from  cell  to   most  food-­‐borne  outbreaks.  
May  cause  meningitis   cell,  which  avoids  antibodies  and   Iron  is  important  and  Listeria  
in  adults.   complement.     produce  siderophores,  which  
obtain  it  from  transferrin.  

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Neisseria  Meningitidis   Acute  Meningitis:   Major  Virulence  factor  is  the   Meningitis:  CSF   Penicillin  G,  or  3   Strictly  human  pathogen.  
  Abrupt,  HA,  meningeal   polysaccharide  capsule,  which  is   stain  unless  prior   generation   Have  special  receptors  that  
Morphology:  Aerobic,  gram-­‐ signs,  fever,  and   the  basis  for  antigenic  variations.   antibiotic  therapy.   cephalosporin  for   bind  to  host  cell  transferrin  
negative,  coccoid  (usually   vomiting.     Pili  expression  is  controlled  by  the     those  who  are  allergic   (Not  siderophores).  Produce  
diplococci)  shaped.  Adjacent  sides     Pil  gene  and  allows  the  bacteria  to   ID:  oxidase  positive,   to  penicillin.  Penicillin   Immunoglobulin  A1  
of  cocci  are  flattened.  Oxidase   Meningococcemia:   adhere  to  nonciliated  epithelial   gram-­‐negative,   does  not  eradicate  the   protease,  which  cleaves  the  
and  Catalase  positive.  Oxidize   with  or  without   cells  and  resist  killing  by   diplococci,  that   carrier  state   hinge  region  of  IgA1.  
both  Glucose  and  Maltose.  Pili,   meningitis,  thrombosis   neutrophils.  Attach  to  mucosal   grows  well  on     Spontaneously  release  LOS,  
which  are  important  for   and  multiorgan   cells,  penetrate,  multiply,  and  then   chocolate  blood   Rifampin  is  used  for   which  has  endotoxin  activity.  
pathogenesis.  PorA  and  PorB   involvement,   pass  into  the  sub  epithelial  space  to   agar  or  on  Neisseria   prophylaxis  and   Rmp  proteins  stimulate  
genes.     petechiae,  DIC,  and   establish  infection.  LOS  stimulates   selective  media.   elimination  of  the   antibody  production  the  
  possible  Waterhouse-­‐ release  of  TNF-­‐alpha,  which  leads   carrier  state.   block  serum  bactericidal  
Epidemiology:    Worldwide,  but   Friderichsen   to  diffuse  vascular  damage.     activity.  Disease  occurs  more  
outbreaks  are  common  in   syndrome.  Antibiotic   Complement  is  also  important  for   Polyvalent   frequently  in  cold  dry  
developing  countries.   response  is  excellent.   the  clearance  of  infection.     Polysaccharide-­‐protein   months.  Most  prevalent  in  
Transmitted  by  respiratory     conjugate  vaccine  is   children,  infants,  teenagers,  
droplets  of  people  in  close   **Note:  Those  with  Asplenia  or   recommended  for   and  young  adults.    
contact.  Asymptomatic  carriage   complement  deficiencies  are  at   people  aged  11-­‐18  and  
occurs  in  the  nasopharynx.   increased  risk  for  severe  disease.   others  at  risk.  Group  B  
Humans  are  the  only  known   does  not  illicit  
reservoir.     protective  immunity.  
Mycobacterium  Leprae   Leprosy  (Hansen   Intracellular  pathogen.  Spread  by   Fastidious,  Slow   Sulfones  (Dapsone)   Leprosy  mainly  occurs  in  
  Disease):  Long   person  to  person  by  contact,   growers,  DOES  NOT   are  first  line  of   Asia.  NEVER  been  cultured  
Morphology:  Non-­‐spore  forming,   incubation  period,   through  aerosols  or  skin  contact   GROW  in  CELL  FREE   treatment.  Rifampin   on  nonliving  media.  Lesions  
non-­‐motile,  aerobic,  acid  fast,   symptoms  20  years   with  secretions  or  exudates.     CULTURES.   and  Clofazimine  are   typically  involve  cooler  
rods.  Cell  wall  is  enriched  in   after  infection.       Diagnosed  by  skin   also  used  in  combo   regions  of  body.  
lipids,  which  makes  the  bacteria     Clinical  manifestations  depend  on   test  to  lepromin  or   with  Dapsone.     Disfigurement  is  caused  by  
resistant  to  many  disinfectants   1.  Tuberculoid   patient’s  immune  system.     observation  of  acid-­‐   skin  infiltration  and  nerve  
and  stains.  Presence  of  mycolic   leprosy:  Patient  has     fast  bacilli  in  the   Requires  several  years   involvement.  Lepromatous  
acids  and  high  C+G  content  in   strong  cellular   Bacteria  induce  cytokine   lesion.   of  therapy.     leprosy  follows  a  progressive  
their  DNA.  Typical  gram-­‐positive   reaction  to  the   production  (INF-­‐gamma),  which     and  malignant  course,  which  
cell  wall.  Lipoarabinomannan   bacteria,  which  large   mediate  macrophage  activation  and   Bacteria  are  often   leads  to  the  development  of  
(LAM)  in  cell  wall  (related  to  LPS).   number  of   granuloma  formation.   seen  within   skin  nodules,  symmetric  
Nonpigmented  or  tan  colonies.   lymphocytes  and   endothelial  cells  or   nerve  involvement,  
  granulomas  in  tissue   mononuclear  cells.     continuous  bacteremia,  and  
Epidemiology:  Prevalence  has   and  few  bacteria.     a  negative  lepromin  test  
fallen  with  effective  treatment  of   2.  Lepromatous   (Skin  is  infiltrated  by  
modern  times.  Uncommon  in  US.   Leprosy:  Strong   suppressor  T  cells).    
Endemic  in  Armadillos  of  Texas   humoral  response  to  
and  Louisiana.     bacteria  leads  to  
abundance  of  bacteria  
in  dermal  
macrophages  and  
Schwann  cells.  MOST  
INFECTIOUS  FORM.  
 
In  general,  two  species  of  bacteria  are  isolated  from  a  brain  abscess.  Brooks  pg.  737-­‐738  
Hematogenous  spread  is  the  most  common  entry  mechanism  for  bacteria  into  the  CNS.    
Meningitis:  
1. Acute  (Pyogenic)  =  Neonates  –  Group  B  Strep  and  E.  coli;  Older  patients  –  S.  pneumoniae  and  L.  monocytogenes;  Adolescents  
and  young  adults  –  N.  meningitidis;  Infants  –  S.  pneumoniae  and  H.  influenzae.  CSF  (cloudy)  shows  increased  neutrophils  and  
proteins,  with  decreased  glucose.  Klebsiella  may  cause  meningitis  in  immunocompromised  patients.      
2. Aseptic  (Viral)  =  CSF  shows  no  organisms,  increased  lymphocytes  and  proteins,  and  normal  glucose.