Gram Negative Cocci and Coccobacilli (Lecture Notes) PDF

SAINT LOUIS UNIVERSITY DEPARTMENT OF PHARMACY Pharm 214: Pharmaceutical Microbiology and Parasitology (Lecture) Unit 3: CLINICALLY SIGNIFICANT BACTERIA GRAM NEGATIVE COCCI Prepared by: CRISTOPHERSON P....

SAINT LOUIS UNIVERSITY DEPARTMENT OF PHARMACY Pharm 214: Pharmaceutical Microbiology and Parasitology (Lecture) Unit 3: CLINICALLY SIGNIFICANT BACTERIA GRAM NEGATIVE COCCI Prepared by: CRISTOPHERSON P. MATA, RPh, MS Pharm Neisseria Characteristics: Differentiation: Only pathogenic gram-positive cocci Carbohydrate Utilization Test/ Fermentation Test Kidney-shaped diplococci ▪ Neisseria gonorrheae: Glucose Catalase and oxidase positive ▪ Neisseria meningitidis: Glucose and Maltose NEISSERIA Isolation: Chocolate Agar Plate → black colonies Thayer-Martin CAP + VCN ▪ Vancomycin – gram-positive ▪ Colistin – gram-negative ▪ Nystatin – fungi * + Trimethoprim – Proteus sp. Neisseria gonorrheae Gonococcus Second most common cause of STI Virulence Factors: ▪ Pili ▪ Beta-lactamase: PPNG ▪ Endotoxins (lipooligosaccharides) PENILE DISCHARGE PRESENTATIONS: 1. GENITAL GONORRHEA o MALES: Penile discharge, dysuria, urethritis Complications: Epididymitis, Prostatitis o FEMALES: Asymptomatic → ascending infection ; detected with complications Complication: PID (salpingitis, endometritis, oophoritis) → scarring → infertility Neisseria gonorrheae TREATMENT: PRESENTATIONS: o CEFTRIAXONE (IM) single dose + Doxycycline BID for 7 days 2. OPHTHALMIA NEONATORUM o Passage of the newborn through infected vaginal canal. o Prophylaxis: ________________________________ o Treat sexual partners 3. DISSEMINATED GONOCOCCAL INFECTION o Gonococcal bacteremia o Septic arthritis Neisseria miningitidis Meningococcus Lipooligosaccharides – very potent PRESENTATIONS: 1. MENINGITIS → Most common in young adults → Prevention: Meningococcal Vaccine 2. MENINGOCOCCEMIA o Flu-like symptoms o Widespread thrombosis → DIC o Waterhouse-Friderichsen Syndrome (Fulminant) → hemorrhage of the adrenal glands o Septic shock PROPHYLAXIS: Rifampicin, Ciprofloxacin TREATMENT: PCN, 3rd Gen. CPN, Chloramphenicol  SAINT LOUIS UNIVERSITY DEPARTMENT OF PHARMACY Pharm 214: Pharmaceutical Microbiology and Parasitology (Lecture) Unit 3: CLINICALLY SIGNIFICANT BACTERIA GRAM NEGATIVE COCCOBACILLI Complied by: CRISTOPHERSON P. MATA, RPh, MS Pharm Haemophilus Blood-loving Isolation: Chocolate Agar Plate 1. Haemophilus influenzae 2. Haemophilus ducreyi 3. Haemophilus aegypticus 4. Haemophilus vaginalis Haemophilus influenzae Pfeiffer’s bacillus MOT: Respiratory droplets Virulence factor: Capsule (Type B) → most virulent PRESENTATIONS: 1. MENINGITIS 2. COMMUNITY-ACQUIRED PNEUMONIA → Most common infection caused by HIB 3. URTI Most common cause of bacterial meningitis by Acute bacterial epiglottitis AGE GROUP GBS 4. SEPTIC ARTHRITIS Neonates Escherichia coli 5. SEPSIS 6. OTITIS MEDIA Listeria monocytogenes Infants and Haemophilus influenzae Toddlers PROPHYLAXIS: HiB Vaccine Teenagers and TREATMENT: 3rd Gen. CPN Neisseria meningitidis Young Adults Elderly Streptococcus pneumoniae Haemophilus ducreyi PRESENTATION: 1. CHANCROID o Chancroid → soft, painful genital ulcer (VS Chancre) o Lesion is accompanied with painful and swollen inguinal lymph nodes (when ruptures, releases pus) PROPHYLAXIS: TREATMENT: Ceftriaxone IM single dose Haemophilus aegypticus Gardnerella vaginalis PRESENTATION: Formerly Haemophilus vaginalis 1. PURULENT CONJUNCTIVITIS PRESENTATION: TREATMENT: Topical Sulfonamides 1. VAGINITIS o Burning sensation and pruritus of the vagina o Dysuria o Copious, foul-smelling vaginal discharge (fishy odor) Bordetella pertussis MOT: Respiratory droplets Virulence factor: Pertussis toxin → lymphocytosis PROPHYLAXIS: Vaccines Isolation: Bordet-Gengou Media → Pearl-like colonies TREATMENT: Macrolides PRESENTATION: 1. WHOOPING COUGH o Aka: Pertussis Legionella pneumophila MOT: aerosolized contaminated water → contaminant in air-conditioning systems PRESENTATION: 1. PONTIAC FEVER → Acute flu-like symptoms → Self-limiting 2. LEGIONNAIRE’S DISEASE o Aka: Legionellosis → Atypical pneumonia TREATMENT: Macrolides Zoonotic Infections Brucella sp. B. Abortus B. melitensis Francisella tularensis Pasteurella multocida B. suis B. canis Ingestion of unpasteurized dairy products/ Rabbit contact, bite of ticks Infected cat bites or scratches Direct contact with infected animals PRESENTATION: PRESENTATION: PRESENTATION: 1. BRUCELLOSIS 1. RABBIT FEVER 1. PASTEURELLOSIS o Aka: Bang’s Disease; Malta o Aka: Tularemia o Cellulitis at the site of wound/ Fever, Undulant Fever o Fever, chills, HA, muscle aches, injury o Intermittent Fever (rising dry cough and falling fever) o Pneumonic tularemia Tetracycline + Gentamicin Streptomycin Penicillin