Microbial Diversity: Prokaryotes PDF

PHA 046 – SAS 2 MICROBIAL DIVERSITY: PROKARYOTES Prepared by: Hanilyn C. Panimdim, RPh TOPIC OUTLINE: I. Basics II. Gram (+) cocci III. Gram (+) bacilli IV. Gram (-) cocci V. Gram (+) bacilli LESSON PREVIEW: GRAM STAINING PROCEDURES GRAM (+)...

PHA 046 – SAS 2 MICROBIAL DIVERSITY: PROKARYOTES Prepared by: Hanilyn C. Panimdim, RPh TOPIC OUTLINE: I. Basics II. Gram (+) cocci III. Gram (+) bacilli IV. Gram (-) cocci V. Gram (+) bacilli LESSON PREVIEW: GRAM STAINING PROCEDURES GRAM (+) GRAM (-) Crystal Violet Violet Violet Iodine Violet Violet Alcohol Violet Colorless Safranin Violet Red or Pink  CELL WALL FEATURE GRAM (+) GRAM (-) PEPTIDOGLYCAN LAYER Thick (multilayered) Thin (single-layered) TEICHOIC ACID (provides rigidity) - OUTER MEMBRANE - LIPOPOLYSACCHARIDES - (LPS) PORINS *passageway - (outer membrane) RESISTANCE TO Higher resistance Lower resistance PHYSICAL DISRUPTION SENSITIVITY TO More sensitive Less sensitive PENICILLIN AND LYSOZYME GRAM STAINING Purple Red / Pink MORPHOLOGY Cocci MORPHOLOGY Bacilli  MORPHOLOGY Spirilla Pleomorphic MORPHOLOGY  VIRULENCE FACTOR: MOTILITY Flagella Shigella spp. Vibrio cholerae Campylobacter jejuni. Pseudomonas fluorescens Helicobacter pylori Escherichia coli  VIRULENCE FACTOR: TOXIN FEATURE ENDOTOXIN EXOTOXIN Part of the outer membrane of Secreted by both Gram (+) and SOURCE Gram (-) bacteria Gram (-) Stable at high temperatures (up to Usually unstable; inactivated at HEAT STABILITY 250°C) high temperatures (60-80°C) Generally less potent Highly potent, even in small TOXICITY quantities General, can cause fever, Specific; targets specific cells or MOA inflammation, septic shock functions (e.g., neurotoxins, enterotoxins) Pyrogenic (induces fever) Non-pyrogenic (generally does FEVER INDUCTION not induce fever) Encoded by chromosomal genes Encoded by plasmids or GENETIC ORIGIN bacteriophages Lipid A component of LPS in E. Botulinum toxin from EXAMPLE coli Clostridium botulinum VIRULENCE FACTOR: SPORES Spores: Dormant, tough, and non-reproductive structures produced by some bacteria. Purpose: Spores allow bacteria to survive extreme conditions such as heat, desiccation, chemicals, and radiation. Resistance: Spores are highly resistant to environmental stressors. Germination: Spores can germinate into vegetative cells when conditions become favorable. Germination SPORES VEGETATIVE FORM Sporulation  GRAM (+) COCCI - Catalase test + (bubbles) STREPTOCOCCUS Spp. STAPHYLOCOCCUS Spp. Blood agar plate Alpha hemolytic Beta hemolytic - Coagulase test + (clumps) Gamma hemolytic Novobiocin S. aureus Resistant Susceptible S. saphrophyticus S. epidermidis STAPHYLOCOCCUS Spp: S. aureus ○ Characteristics ▪ Morphology: ✓ Grape-like clusters ✓ Smooth, round, yellow colonies ▪ Growth Conditions: ✓ Temperature range: 15-45°C ✓ NaCl tolerance: Can grow at concentrations as high as 15% ▪ Biochemical Tests: ✓ Coagulase-positive ✓ Catalase-positive ✓ Beta-hemolytic ▪ Infection Context: ✓ Primary cause of nosocomial (hospital-acquired) infections ✓ Associated with tampon use (notably in Toxic Shock Syndrome) Diseases and Associated Toxins: 1. Scalded Skin Syndrome (Ritter Disease): Bacterial skin infection that causes the skin to peel. ○ Toxin: Exfoliative toxin 2. Toxic Shock Syndrome: A rare but life-threatening condition caused by bacteria getting into the body and releasing harmful toxins. 3. Acute Gastroenteritis: Inflammation of the gastrointestinal tract, including the stomach and small intestine. ○ Manifestation: Diarrhea ○ Toxin: Enterotoxin Diseases and Associated Toxins: 4. Food Poisoning: ○ Treatment: Anti-staphylococcal penicillins (Methicillin, Oxacillin, Dicloxacillin, Cloxacillin) 5. Diseases by Direct Organ Invasion: ○ Conditions: Pneumonia, Meningitis, Cerebritis, Brain abscess, Osteomyelitis ○ Acute Endocarditis: Infection caused by bacteria entering the bloodstream and settling in the heart lining, a heart valve, or a blood vessel. ○ Septic Arthritis: Infection in the joints STAPHYLOCOCCUS Spp: S. epidermidis ○ Characteristics ▪ Morphology: ✓ Forms clusters, similar to Staphylococcus aureus ✓ Colonies are usually white or pale ▪ Growth Conditions: ✓ Can grow at a range of temperatures, typically similar to other staphylococci ✓ Less tolerant to high NaCl concentrations compared to S. aureus ▪ Biochemical Tests: ✓ Catalase-positive ✓ Coagulase-negative ✓ Gamma-hemolytic (non-hemolytic) ▪ Infection Context: ✓ Part of normal skin flora but can be opportunistic ✓ Common cause of nosocomial infections, especially in patients with indwelling devices (e.g., catheters, prosthetic joints, heart valves). Diseases and Clinical Relevance: 1. Prosthetic Valve Endocarditis: Infection of heart valves, particularly prosthetic valves. ○ Manifestation: Fever, Heart murmur, Heart failure 2. Urinary Tract Infections (UTIs): Infection of the urinary tract, often in patients with catheters. 3. Surgical Site Infections: Infections occurring at the site of surgical incisions. ○ Redness, swelling, pain, discharge from the wound STAPHYLOCOCCUS Spp: S. saprophyticus ○ Characteristics ▪ Morphology: ✓ Forms clusters, typical of Staphylococcus species ✓ Colonies are usually white to yellowish ▪ Growth Conditions: ✓ Optimal growth at 37°C ✓ Can grow in the presence of high salt concentrations (similar to S. aureus) ▪ Biochemical Tests: ✓ Catalase-positive ✓ Coagulase-negative ✓ Novobiocin-resistant (a key distinguishing feature from S. epidermidis) ▪ Reservoir: ✓ Commonly found in the genitourinary tract, perineum, and gastrointestinal tract. Diseases and Clinical Relevance: 1. Urinary Tract Infections (UTIs): Second (2nd) cause of community acquired UTIs, especially common in young, sexually active women. o Manifestation: Symptoms include dysuria (painful urination), frequency, urgency, and lower abdominal pain. o Diagnosis: Often identified through urine culture; resistance to novobiocin can help distinguish it from other coagulase-negative staphylococci. 2. Other Potential Infections (though less common): ○ Inflammation of prostate gland and urethra STREPTOCOCCUS Spp: General Characteristics: ▪ Morphology: ✓ Spherical, gram positive bacteria ✓ Appear in chains and often encapsulated ▪ Hemolysis types: ✓ Alpha hemolysis: Partial hemolysis, reduces hemoglobin to methemoglobin, causing a greenish zone around the colony. ✓ Beta hemolysis: Complete hemolysis, creatin a clear zone around the colony. ✓ Gamma hemolysis: No hemolysis, no change in the red blood cells around the colony (non-hemolytic). ▪ Biochemical Tests: ✓ Catalase-negative ✓ Coagulase-negative STREPTOCOCCUS Spp: Alpha-Hemolytic Streptococci ○ Produces alpha-hemolysis, reducing hemoglobin to methemoglobin, which causes a greenish zone around the colony. ○ Examples: 1. Streptococcus pneumoniae: Causes pneumonia, otitis media, and meningitis. 2. Streptococcus viridans: Part of the normal oral flora, can cause endocarditis. 3. Streptococcus mutans: Associated with dental caries. STREPTOCOCCUS Spp: Beta-Hemolytic Streptococci ○ Produces clear zone hemolysis on blood agar. ○ Examples: 1. Streptococcus pyogenes: Causes pharyngitis, scarlet fever, rheumatic fever, and necrotizing fasciitis. 2. Streptococcus agalactiae: Causes neonatal infections, such as sepsis and meningitis, and infections in pregnant women. STREPTOCOCCUS Spp: Gamma-Hemolytic Streptococci ○ No effect on red blood cells, hence no hemolysis. ○ Examples: 1. Streptococcus bovis: Associated with gastrointestinal diseases, including colorectal cancer. 2. Enterococci: Includes species like Enterococcus faecalis and Enterococcus faecium, which can cause urinary tract infections, endocarditis, and are known for antibiotic resistance, particularly vancomycin-resistant enterococci (VRE). Lancefield Grouping A serological method for classifying streptococci based on the presence of polysaccharide and teichoic acid antigens in the bacterial cell wall. Group A (β-hemolytic) Group B (β-hemolytic) Group C (β-hemolytic) Group D (𝛼 -hemolytic) Unclassifed streptococcus (𝛼 -hemolytic) Group A (β-hemolytic) Characteristics: ○ Species: Streptococcus pyogenes ○ Hemolysis: Beta-hemolytic, producing a clear zone of hemolysis on blood agar. ○ Sensitivity: Sensitive to bacitracin (inhibited by antibiotic reaction). ○ Motility: Non-motile. ○ Virulence: Highly virulent. Group A (β-hemolytic) Diseases and Associated Manifestations: 1. Streptococcal Pharyngitis (Strep Throat): Inflammation of the throat caused by S. pyogenes. Symptoms: Sore throat, fever, swollen lymph nodes, and white patches on the tonsils. 2. Recurrent tonsilitis: Repeated episodes of tonsil inflammation and infection. Symptoms: Sore throat, difficulty swallowing, and fever. 3. Streptococcal Skin Infections: Infections of the skin and soft tissues. Examples: Impetigo, erysipelas, and cellulitis. 4. Scarlet Fever (Erysipelas/Scarlatina): Toxin-related illness resulting in a distinctive rash. Symptoms: Strawberry red tongue, sand-paper like rash, sunburn-like rash. Diagnostic test: Dick test, used to determine immunity to scarlet fever. Group A (β-hemolytic) Diseases and Associated Manifestations: 5. Toxic Shock Syndrome: A severe, toxin-mediated illness. Fever, rash, shock, and multi-organ failure. 6. Pyoderma: A skin infection characterized by pus-filled lesions. Impetigo and ecthyma 7. Necrotizing Fasciitis: A rapidly progressing infection of the fascia (connective tissue) and surrounding tissues. Severe pain, swelling, and tissue death. Group A (β-hemolytic) Diseases and Associated Manifestations: 8. Rheumatic fever: An inflammatory disease that can develop after a streptococcal infection. Symptoms: Fever, joint pain, carditis, and chorea. 9. Acute Glomerulonephritis: Inflammation of the glomeruli in the kidneys following a streptococcal infection. Symptoms: Hematuria (blood in urine), proteinuria (protein in urine), and hypertension. Common Serotype: Serotype 12 is often associated with post- streptococcal glomerulonephritis. Group B (β-hemolytic) Characteristics: ○ Species: Streptococcus agalactiae ○ Hemolysis: Beta-hemolytic, producing a clear zone of hemolysis on blood agar. ○ Sensitivity: Resistant to Bacitracin ○ Natural Habitat: Found on the vaginocervical tract, urethral mucous membranes, and gastrointestinal tract. Group B (β-hemolytic) Diseases and Clinical Relevance: 1. Neonatal Infections: Streptococcus agalactiae is a major cause of infections in pregnant women and newborns. Neonatal meningitis: Inflammation of the membranes surrounding the brain and spinal cord in newborns. Symptoms: Fever, irritability, poor feeding, and lethargy. Pneumonia: Lung infection that can occur in newborns, leading to respiratory distress. Symptoms: Rapid breathing, grunting, flaring of nostrils, and cyanosis. Neonatal sepsis: A severe infection that spreads throughout the body in newborns. Symptoms: Fever, difficulty breathing, lethargy, and poor feeding. Group C (β-hemolytic) Characteristics: ○ Hemolysis: Beta-hemolytic, producing a clear zone of hemolysis on blood agar. ○ Sensitivity: Group C streptococci have varying antibiotic sensitivities and are not specifically noted for bacitracin sensitivity like Group A or B. Group C (β-hemolytic) Notable species and relevance: 1. Streptococcus dysgalactiae: "Dysgalactiae" refers to difficulty producing milk. ○ Primarily associated with mastitis in cows but can occasionally cause infections in humans, such as pharyngitis and skin infections. 2. Streptococcus equi: "Equi" refers to horses. ○ Mainly causes strangles, a contagious upper respiratory tract infection in horses. It is rarely associated with human infections. Group C (β-hemolytic) Notable species and relevance: 3. Streptococcus equisimilis: "Equisimilis" means horse-like. ○ Has been recovered from pharyngitis and tonsillitis in patients with underlying conditions such as cardiopulmonary disease, diabetes, immunosuppression, and HIV. It can cause invasive infections, including bacteremia and endocarditis. 4. Streptococcus zooepidemicus: "Zooepidemicus" refers to outbreaks in zoos. ○ An opportunistic pathogen in animals and humans, often associated with zoonotic infections. It can cause severe infections such as septicemia, pneumonia, and meningitis in humans, particularly in individuals with close contact with animals. Group D (α-hemolytic) Characteristics: ○ Hemolysis: Generally alpha-hemolytic, but some strains can be gamma-hemolytic (non-hemolytic). ○ Biochemical Tests: Bile-esculin positive (ability to grow in the presence of bile and hydrolyze esculin). Group D (α-hemolytic) Notable species and relevance: 1. Enterococci: Highly resistant organisms, part of the normal flora of the intestines. 2. Enterococcus faecalis: Responsible for many infections of surgical wounds and the urinary tract. In medical settings, they frequently enter the bloodstream through invasive procedures, such as indwelling catheters. 3. Enterococcus faecium: Similar to E. faecalis, it causes infections of surgical wounds and the urinary tract and can enter the bloodstream through invasive procedures. E. faecium is also known for its high level of antibiotic resistance. Group D (α-hemolytic) Notable species and relevance: 4. Enterococcus durans: A facultative anaerobic organism. Causes enteritis in piglets, foals, and calves. 5. Streptococcus bovis: Can be either alpha or gamma (non- hemolytic), can be found in the colon. Associated with bacteremia and endocarditis, and there is a notable association with colorectal cancer. It can cause serious infections, particularly in immunocompromised individuals. Unclassified Streptococcus (𝛼 -hemolytic) Characteristics Hemolysis: Alpha-hemolytic, producing a greenish zone around colonies due to the partial reduction of hemoglobin. Notable species and relevance: 1. Streptococcus viridans: A group of alpha-hemolytic streptococci that are part of the normal flora of the oral cavity and gastrointestinal tract. 2. Streptococcus pneumoniae (Pneumococcus): Encapsulated diplococci, non-motile, and lancelet-shaped.  GRAM (+) BACILLI SPORE FORMING NON-SPORE FORMING Bacillus spp. Corynebacterium Clostridium spp. Listeria Lactobacillus Erysipelothrix Actinomyces Nocardia Propionibacteria  SPORE FORMING BACILLUS SPP. CLOSTRIDIUM SPP. B. anthracis C. botulinum B. cereus C. tetani B. subtilis C. perfringens C. difficile BACILLUS SPP. BACTERIA DISEASE DESCRIPTION B. anthracis Only bacteria with amino acid capsule (poly-D- Anthrax / glutamate) Woolsorter’s Largest microscopic bacterium (Medusa head-like disease colony) Used as biological warfare agent Respiratory – most deadly form of infection in humans DOC: Pen G, Ciprofloxacin B. cereus Non-encapsulated, motile Produces Exotoxin Fried rice Heat stable toxin: vomitus form poisoning Heat labile toxin: diarrheal form DOC: Pen G B. subtilis UTI, wound Isolated from debrided tissue of a compound fracture in infection 7-year old, Margaret Tracy Produced Bacitracin CLOSTRIDIUM SPP. BACTERIA DISEASE DESCRIPTION C. Botulinum Flaccid paralysis Lethal Botulinum toxin, a NEUROTOXIN (inhibits the NT / Floppy baby Ach) syndrome DOC: Metronidazole C. Tetani Tennis rackets or drumsticks, non-motile Manifestations: Lock jaw, Sardonic smile Spastic paralysis DOC: Metronidazole Prophylaxis: Active – tetanus toxoid; Passive – tetanus immunoglobulin C. Perfringens Pleomorphic, capsulated, non-motile, strictly anaerobes Gas gangrene DOC: Metronidazole, Clindamycin, Pen G Non-pharmacologic tx: amputation, hyperbaric oxygen chamber, maggot/larval therapy C. Difficile Associated with clindamycin use, affecting the Pseudomembranous pseudomembranous intestinal lining colitis Sx: Sever diarrhea, abdominal cramping, fever DOC: Metronidazole, Vancomycin NON-SPORE FORMING: Corynebacterium diphtheriae Listeria monocytogenes Lactobacillus Erysipelothrix rhusiopathiae Actinomyces israelii Nocardia asteroids Propionibacterium acne NON-SPORE FORMING: BACTERIA DESCRIPTION Corynebacterium Aerobic, non-motile, actinobacteria, pleomorphic, palisade arrangement of diphtheriae cells. Produces Diphtheria toxin Common site of infection: Upper respiratory tract Symptom: Sore throat SCHICK test (screening) – determine susceptibility LOEFFLER’s slant (lab diagnosis) Prophylaxis: DTP Vaccine Tx: Erythromycin, Pen G Listeria Motility: tumbling monocytogenes Facultative anaerobe and produces hemolysin Produces acid in various sugar fermentation test (not gas) Causes Listeriosis and neonatal meningitis Tx: Cotrimoxazole, Ampicillin Lactobacillus Location: Vagina, Intestinal tract and oral cavity Used commercially in production of sauerkraut, pickles, buttermilk, and yogurt NON-SPORE FORMING: BACTERIA DESCRIPTION Erysipelothrix Occupational pathogen – fish handlers rhusiopathiae Causes seal finger disease Tx: Penicillin Actinomyces israelii Causes actinomycosis - a tissue destroying disease usually affecting the head, neck, or lungs Skin lesions – pus forming Sulfur granule – containing pus Tx: surgical removal of lesion Nocardia asteroides Occasionally cause a chronic, difficult-to-treat pulmonary infection. Also one of the causative agents of mycetoma, a localized destructive infection of the feet or hands. Tx: Co-trimoxazole Propionibacterium Primary bacterial cause of acne acne Derived from the organism’s ability to form propionic acid; some species are important in the fermentation of Swiss cheese GRAM (-) COCCI NEISSERIA SPP. N. meningitidis N. gonorrhea Moraxella catarrhalis NEISERRIA SPP. BACTERIA DISEASE DESCRIPTION N. meningitidis Meningitis and Prophylaxis: Rifampicin, Ciprofloxacin meningococcemia Tx: Ciprofloxacxin N. gonorrhea Gonorrhea Can grow in enriched media such as chocolate agar PID (Pelvic Oval shaped, diplococci and occurs in pair and non-motile, it Inflammatory is capsulated and have pilli and are glucose fermenter Disease) ROT: sexual, passage in vaginal canal Ophthalmia Tx: Ceftriaxone + Doxycycline neonatorum Moraxella Ear (otitis media) Gram-negative diplococcus catarrhalis and upper and lower respiratory infections.  GRAM (-) BACILLI ENTERIC RESPIRATORY ZOONOTIC OTHERS Enterobacteriaceae Haemophilus Brucella Klebsiella Vibrioceae Bordotella Francisella granulomatis Pseudomonas Legionella Bartonella Gardnerella vaginalis Bacteroides fragilis Pasteurella Yersinia GRAM (-) BACILLI: ENTERIC ENTEROBACTERIACEAE Escherichia coli Klebsiella pneumoniae Salmonella typhi Salmonella choleraesius Salmonella enteritidis Shigella dysenteriae Proteus mirabilis Serratia marcescens ESCHERICHIA COLI Gram negative bacilli and motile by peritrichous flagella Non-spore forming, non-acid fast, aerobe and facultative anaerobe and capsulated. Normally found in GI tract Toxins: ENTEROTOXIN and ENDOTOXIN Diseases: UTI, Neonatal meningitis, Sepsis, Gastroenteritis, Common cause of Hospital-acquired pneumonia (HAP) Treatment: Cotrimoxazole, Quinolones  E. Coli Classifications EPEC ETEC EIEC EHEC Enteropathogenic E. Enterotoxigenic E. coli Enterotoxigenic E. coli Enterohemorrhagic E. coli Endemic in Similar to shigellosis coli Associated w/ developing countries Characterized by Bloody diarrhea with diarrhea in infants in tropics, all age bloody diarrhea with no pus and fever and children groups pus and fever Most common MOA: Attach to the Causes Traveller’s serotype: O157:H7 mucosa of upper diarrhea (VEROTOXIN) small intestine, cause (Montezuma’s Can cause Hemolytic disruption of brush revenge) Uremic syndrome border microvilli (HUS) – can be prevented by cooking. KLEBSIELLA PNEUMONIAE Aka FRIED LANDER’s bacillus mucous capsulatus. Capsulated, non-motile, non-spore former, lactose fermenting bacteria and facultative anaerobe. Present in respiratory tract and feces about 5% of normal individuals. 2nd most common cause Gram negative sepsis, Pneumonia (HAP) KLEBSIELLA PNEUMONIAE Belongs to ESKAPE: Hospital acquired infections that are resistant to antibiotics: Enterococcus faecium Staphylococcus aureus Klebsiella pneumoniae Acinetobacter baumanii Psedomonas aeruginosa Enterobacter spp. SALMONELLA TYPHI Gram negative rods, motile, non-sporing, non-capsulated. Forms acid in glucose and mannose Non-lactose fermenter that produces H2S Lives in GI of humans and many animals (turtle and snake eggs) Diseases: Typhoid fever, Rotten egg diarrhea, Rose spots on belly Diagnostic test for Salmonella: Widal test DOC for typhoid fever: Chloramphenicol (old), Ciprofloxacin, Ceftriaxone (new) SALMONELLA CHOLERAESIUS Causes sepsis or septicemia SALMONELLA ENTERITIDIS Causes diarrhea or gastroentiritis SHIGELLA DYSENTERIAE Short rod, non-encapsulated, non-motile Non-spore former, non-lactose fermenter Highly adapted to humans Acid resistant EXOTOXIN: neurotoxic, cytotoxic and enterotoxic Treatment: Cotrimoxazole and Quinolones PROTEUS MIRABILIS SWARMING motility Very motile, non-capsulated Possessing peritrichous flagella Non-lactose fermenting Urease positive Common cause of UTI SERRATIA MARCESCENS Produces blood red pigment (red colonies) Endocarditis VIBRIOCEAE Vibrio cholerae Vibrio parahemolyticus Helicobacter pylori Campylobacter jejuni VIBRIO CHOLERAE Causes Cholera Virulence: EXOTOXIN *Cholera toxin Non-invasive infection Treatment: Tetracycline and Oral Rehydration Salt (ORS) Cholera toxin: Activates the enzyme adenylate cyclase, increased cAMP levels and stimulates the secretion of chloride ions and water from enterocytes into the small intestines, and causing watery diarrhea. VIBRIO PARAHEMOLYTICUS Halophilic Found in contaminated raw fish (SUSHI) HELICOBACTER PYLORI Spiral shaped and highly motile (4-6 flagella) Microaerophilic Catalase + Oxidase + Strong producer of UREASE Diagnostic test: Urea Breath Test Diseases: Gastritis, gastric ulcer, stomach cancer, duodenal ulcer Treatment: Multidrug therapy, Bismuth compounds, Metronidazole, Tetracycline, Amoxicillin ○ Prevpac®: Lansprazole + Clarithromycin + Amoxicillin ○ Helidac®: Bismuth subsalicylate + Tetracycline + Metronidazole HELICOBACTER PYLORI Virulence factors: 1. Flagella for bacterial motility to colonize under mucosa; allows penetration of H. pylori into gastric mucous layer. 2. Urease: neutralize gastric acid 3. Mucinase and Phospholipase: disrupt gastric mucosa which will cause localized tissue damage. 4. Adhesin/ adherence factors: mediate biding to the host cells. CAMPYLOBACTER JEJUNI Rapid DARTING motility Microaerophilic, Capnophilic, Thermophilic From uncooked poultry and unpasteurized milk Enterocolitis; 3rd leading cause of diarrhea in the world Diseases: Bloody diarrhea Treatment: Quinolones PSEUDOMONAS They are widely distributed in soil and water. Gram negative rods and are aerobic and motile and are opportunistic bacteria. Characteristics of the pigments of Pseudomonas: ○ Pyocyanin: blue green ○ Pyoverdin: green ○ Pyorubin: red ○ Pyomelanin: black/brown PSEUDOMONAS AERUGINOSA Facultative aerobe Fluorescent blue –green on culture media when exposed to UV light Sweet grape like odor Motile and occurs as single bacterium, in pairs or in short chains Oxidase + and (-) ferment CHO Exotoxin A (diphtheria like toxin) Treatment: Anti-pseudomonal Penicillins and Aminoglycosides ○ Carbenicillin ○ Ticarcillin ○ Mezlocillin ○ Azlocillin ○ Piperacillin (most effective) BACTEROIDES FRAGILIS Gram negative bacilli Anaerobe Diseases: Brain abscess, GIT abscess and UTI DOC: Metronidazole, Clindamycin, Chloramphenicol GRAM (-) BACILLI: RESPIRATORY HAEMOPHILUS SPP. BACTERIA DESCRIPTION Haemophilus influenza Small uniform coccobacilli, non motile and pleomorphic, non-sporing, aerobic or facultative anaerobic Encapsulated and fastidious Diseases: Meningitis in children, Epiglottis, Septic arthritis and Sepsis Treatment: Second and Third generation Cephalosporins DOC: Cefotaxime Haemophilus ducreyi Chancroid ulcers / Soft chancres Haemophilus vaginalis Causes bacterial vaginosis and causing fishy vaginal discharge DOC: Metronidazole BORDETELLA PERTUSSIS Fastidious coccobacilli, non-motile and non-sporing Capsulated in virulent strains Oxidase + Urease + Diseases: Whooping cough Prevention: DPT vaccine (live attenuated) Treatment: Macrolide LEGIONELLA PNEUMOPHILA Thin, Gram-negative, Aerobic, Pleomorphic, Flagellated Non-spore forming, unencapsulated, catalase + Poorly stained by Gram stain Natural habitat is water Diseases: Legionellosis or Legionnaires disease and Pontiac fever Treatment: Macrolides (DOC: Erythromycin), Ciprofloxacin, TCN and rifampicin. GRAM (-) BACILLI: ZOONOTIC BRUCELLA SPP. Causes Brucellosis Aka Fever of Crete, Rock fever of Gibraltar, Bang’s Fever, Undulant Fever, Malta fever MOT: Open skin, Ingestion, Inhalation of infectious aerosols Treatment: Doxycyline, Streptomycin, Rifampicin Types: ○ B. melitensis: goats/ sheeps: most common ○ B. abortus: cattle ○ B. suis: pig ○ B. canis: dog FRANCISELLA TULARENSIS Non motile and capsulated Reservoir: rodents and squirrels MOT: Vector - Tick or deerfly Causes Tularemia / Rabbit fever / Deer fly fever It can occur in ulderoglandular, oculoglandular, and pulmonary form. DOC: Streptomycin and Doxycycline BARTONELLA SPP. BACTERIA DESCRIPTION Bartonella henselae Causes cat-scratch disease DOC: Azithromycin Bartonella bacilliformis Disease: Carrion’s Disease Vector: Sandflies (spp: Lutzomyia) Bartonella quintana Causes Trench fever Aka 5 day fever Vector: human Body Louse PASTEURELLA MULTOCIDA Gram-negative, nonmotile, penicillin-sensitive coccobacillus of the family Pasteurellaceae Most common cause of infection following a bite or scratch from domestic pets. Treatment: Penicillin, Cephalosphorin, Clindamycin YERSINIA PESTIS Causes Bubonic and pneumonic plague Reservoir: Rodents and Squirrels MOT: Flea bite or animal contact DOC: Streptomycin YERSINIA ENTEROLITICA From unpasteurized milk Causes Enterocolitis, Arthritis, Rash, Diarrhea Treatment: ORS, Fluoroquinolones and Cotrimoxazole GRAM (-) BACILLI: OTHERS KLEBSIELLA GRANULOMATIS formerly known as Calymmatobacterium granulomatis Causes Granuloma inguinale (donovanosis) - a genital ulcerative disease Treatment: Multiple antimicrobial regimens have been effective Recommended regimen: Azithromycin 1 gm orally once weekly or 500 mg daily for > 3 weeks and until all lesions have completely healed Granuloma Inguinale (Donovanosis) - STI Treatment Guidelines (cdc.gov) GARDNERELLA VAGINALIS Causes bacterial vaginosis (BV) BV is a condition that causes abnormal vaginal discharge and involves a polymicrobial overgrowth of anaerobic bacteria within the vaginal environment. It is associated with infertility, preterm birth, postpartum endometritis, pelvic inflammatory disease, and an increased risk of acquiring human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Treatment: Metronidazole PHA 046 – SAS 2 MICROBIAL DIVERSITY: EUKARYOTES Prepared by: Hanilyn C. Panimdim, RPh TOPIC OUTLINE: I. Fungi II. Algae III. Protozoa IV. Helminths I. FUNGI “MYCOLOGY” They are chemoheterotrophs and acquire food by absorption. Are multicellular except yeasts Reproduce through sexual and asexual spores Molds and Yeasts Reproduction: Budding and Fission Spore formation: Asexual and Sexual FUNGI vs. BACTERIA FEATURE FUNGI BACTERIA CELL TYPE Eukaryotic Prokaryotic CELL Sterols present Sterols absent except MEMBRANE mycoplasma CELL WALL Glucans; Manna; Chitin (no Peptidoglycan peptidoglycan) SPORES Sexual and asexual spores Endospores (not for reproduction); some asexual reproductive spores METABOLISM Limited to heterotrophic; Heterotrophic, Autotrophic; Aerobic; Facultatively Aerobic; Facultatively anaerobic anaerobic; Anaerobic CLASSIFICATIONS: 1. Zygomycota ○ Saprophytic (feed on dead organic material) ○ Have coenocytic hyphae (lack septum) and Sporangiospores (asexual spores) ○ Zygospores (sexual spores morphologically similar) eg. Black bread mold Rhizopus stolonifera 2. Microsporidia ○ Lack mitochondria and microtubules ○ Are obligate intracellular parasites ○ Can cause chronic diarrhea, and keratoconjunctivitis ( inflammation of the conjunctiva near the cornea),in AIDS patients. CLASSIFICATIONS: 3. Ascomycota ○ Includes molds with septate hyphae and some yeasts ○ Conidiophores (asexual) ○ Ascospore (sexual spores can be morphologically similar or dissimilar) ○ Produced in ascus (saclike structure) 4. Basidiomycota ○ Septate hyphae and produce mushrooms ○ Basidiospores formed on base pedestal (basidium) ○ 4 basidiospores per basidium ○ Some basidiospores produce Conidiospores (asexual)  FUNGAL DISEASES SUPERFICIAL CUTANEOUS SUBCUTANEOUS SYSTEMIC Dermatophytes are aerobic fungi that can invade and infect the keratinized layers of skin, hair, and nails. SUPERFICIAL MYCOSES DISEASES CAUSATIVE AGENT Black Piedra Piedra hortai White Piedra Trichosporon beigelli Pityriasis versicolor Malasseiza furfur Tinea nigra/ superficial Hortaea werneckii phaeophypomycosis  CUTANEOUS MYCOSES DERMATOPHYTOSIS CANDIDIASIS T. pedis T. unguium AKA Moniliasis T. corporis Candida albicans - T. cruris pathogen T. manuum T. capitis Treatment: Griseofulvin T. faciei MOA of Griseofulvin: Interact with fungal T. barbae microtubules and thus inhibits mitosis T. axillaries SUBCUTANEOUS MYCOSES DISEASES ORGANISM TREATMENT Mycetoma Eumycotic mycetoma Oral KI Sporotrichosis Sporothrix schenkii Systemic triazoles Chromoblastomycosis Phialophora verrucosa Terbinafine SYSTEMIC MYCOSES DISEASE ORGANISM DESCRIPTION TREATMENT Blastomycosis Blastomyces North American Amphotericin B dermatitidis Blastomycosis Paracoccidomycosis Paracoccidioides South American Amphotericin B brasiliensis Blastomycosis/ Brazilina/ Blastomycosis Histoplasmosis Histoplasma Spelunker’s Disease / Amphotericin B capsulatum Darling’s Disease Itraconazole “great mimic” Affects macrophages in lungs (resembling TB) Has operculated eggs  SYSTEMIC MYCOSES DISEASE ORGANISM DESCRIPTION TREATMENT Coccidioidomycosis Coccidioides San Joaquin Valley Fever Amphotericin B immitis Dark skinned type B males Influenza-like symptoms Immunocompromised Chronic pulmonary infection/ widespread infection Cryptococcosis Cryptococcus Inhalation of particles from Fluconazole neoformans Pigeon Droppings / Soil Marker disease of AIDS Identification: India Ink staining capsule Systemic candidiasis Candida albicans Visceral organs affected: Brain, Amphotericin B heart, kidney, liver, spleen Ketoconazole Aspergillosis flavus , A. Causes allergy (asthma, farmer’s Amphotericin B fumigatus lung) Asthma-like symptoms II. ALGAE Algae belong to several super clades and exhibit a wide variety of forms and reproductive strategies. It can be unicellular or multicellular, forming colonies, filaments, or even simple tissues. Some algae produce toxins. They produce their own food through photosynthesis using various photosynthetic pigments. They can reproduce both sexually (through gamete fusion) and asexually (via mitosis). They lack the true tissues such as roots, stems, and leaves that are found in higher plants. II. ALGAE: Vegetative structure Thallus: The body of a multicellular alga is called a thallus. Seaweeds: Larger multicellular algae, commonly referred to as seaweeds, have specific structures: ○ Holdfasts: Branched structures that anchor the alga to a substrate, like a rock. ○ Stipes: Stem-like, often hollow structures that provide support. ○ Blades: Leaf-like structures that extend from the stipe. Support: Unlike plant stems, the stipes are not lignified or woody. Instead, the surrounding water provides support. Some algae have gas-filled bladders called pneumatocysts that help them float. II. ALGAE: Life Cycle Asexual Reproduction: Algae can reproduce asexually through mitosis, producing identical offspring. Sexual Reproduction: They can also reproduce sexually through the fusion of gametes, leading to genetic diversity. III. PROTOZOA Protozoa are part of the kingdom Protista, along with algae. Most protozoa are unicellular, but some can be multicellular, forming colonies. Classification by Locomotion: ○ Amebas (Amoebae): Move using pseudopodia ("false feet"). ○ Flagellates: Move using whiplike flagella. ○ Ciliates: Move using hairlike cilia. ○ Sporozoa (Sporozoans): Exhibit no motility as they lack pseudopodia, flagella, or cilia. III. PROTOZOA Protozoa are part of the kingdom Protista, along with algae. Most protozoa are unicellular, but some can be multicellular, forming colonies. Classification by Locomotion: ○ Amebas (Amoebae): Move using pseudopodia ("false feet"). ○ Flagellates: Move using whiplike flagella. ○ Ciliates: Move using hairlike cilia. ○ Sporozoa (Sporozoans): Exhibit no motility as they lack pseudopodia, flagella, or cilia. III. PROTOZOA Parasitic protozoal infections are diagnosed by observing different stages in a specimen: ○ Trophozoites: The motile, feeding, and dividing stage. ○ Cysts, Oocysts, Spores: Dormant stages, similar to bacterial spores. Infection Transmission: Acquisition: Protozoal infections are typically acquired by ingestion or inhalation of cysts, oocysts, or spores, or via the bite of an infected arthropod. Trophozoites: Due to their fragile nature, trophozoites rarely serve as the infective stage. III. PROTOZOA: Life Cycle Asexual Reproduction: Protozoa reproduce asexually through: ○ Fission: Simple division. ○ Budding: Formation of a new organism by the outgrowth of a part of a cell. ○ Schizogony (Multiple Fission): The nucleus undergoes multiple divisions before the cell divides. After many nuclei are formed, a small portion of cytoplasm concentrates around each nucleus, leading to the formation of daughter cells. Sexual Reproduction: ○ Gametocytes: Some protozoa produce gametes (haploid sex cells). ○ Zygote Formation: Two gametes fuse during reproduction to form a diploid zygote. III. PROTOZOA: Type of Hosts Definitive host: Harbor the adult, sexually mature form of a parasite / harbors the sexually reproducing stage of the parasite Parantenic host: The parasite does not develop further to later stages, but the parasite remains alive & is able to infect another susceptible host. Intermediate host: Harbors the Asexual or Larval Stage of the parasite/ where the asexual reproduction occurs.  GROUPS OF PROTOZOA AMOEBAS FLAGELLATES CILLIATES SPOROZOANS Entamoeba histolytica Giardia lamblia Balantidium coli Plasmodium falciparum Trichomonas vaginilis Plasmodium vivax Leishmania tropica Plasmodium ovale Leishmania Plasmodium malariae braziliensis Taxoplasma gondii Leishmania donovani Isospora belli Trypanosoma cruzi Blastocystis hominis Trypanosoma brucei AMOEBA It moves by pseudopods (non-flagellated) and are free-living growing in water, including tap-water ENTAMOEBA HISTOLYTICA Most common parasite in human colon Transmission: FECAL-ORAL Causes Amebiasis, Amoebic colitis Diagnosis: Fecalysis Mature cyst nuclei: 4 nuclei Immature cysts: 1 to 3 nuclei They ingest RBC Chromatid body of Entamoeba histolytica is Cigar or sausage shaped with rounded ends. Treatment: ○ Symptomatic: : Metronidazole for 10 days (DOC) ○ Asymptomatic: Doloxanide, Iodoquinol, Paromomycin FLAGELLATES Has no mitochondria and have multiple flagellates PROTOZOA DESCRIPTION Giardia The first intestinal microorganism to be observed lamblia under a microscope. Causes Giardiasis (Beaver fever, Leningrad’s curse) Transmission: Fecal-Oral Trophozoite: ―old man’s eyeglass like Common among male homosexuals A protozoan which has high incidence of infection among campers and backpackers after drinking from ―clear mountain streams DOC: Metronidazole FLAGELLATES PROTOZOA DESCRIPTION Trichomonas vaginalis Causes trichomoniasis Transmission: Sexual Manifestations: burning urination and clear, white, yellowish green frothy vaginal discharge DOC: Metronidazole FLAGELLATES PROTOZOA DESCRIPTION Leishmania spp. Zoonotic disease Vector: Sandfly Old world cutaneous leishmaniasis L. tropica (oriental sore) Symptom: ulcerating skin sore New world cutaneous leishmaniasis L. braziliensis (espundia) Affects mucous membranes Severe form of leishmaniasis Affects visceral organs such as spleen and L. donovani (kala-azar) liver DOC: Sodium Stibogluconate FLAGELLATES PROTOZOA DESCRIPTION Trypanasoma cruzi Causes American Sleeping Sickness and Chagas’ disease Vector: Triatomine/ kissing bug (reduvid) Signs/symptoms: unilateral conjunctivitis, with facial edema, chills, fever Treatment: Nifurtimox and Benznidazole FLAGELLATES PROTOZOA DESCRIPTION Trypanosoma brucei T. Brucei gambiense Disease known as West African sleeping sickness Treatment: Suramin Pentamidine T. brucei rhodiense Disease known as East African sleeping sickness Vector: Tsetse fly DOC: Melarsoprol; Eflornithine CILLIATES BALANTIDIUM COLI Largest protozoan parasite to affect man Causes Balantidiasis Reservoir: pig (feces) Treatment: Metronidazole and Tetracycline SPOROZOANS Life cycle characterized by 1 sexual + 1 asexual cycle Sexual cycle/ Sporogeny - produces sporozoites (infective stage) Asexual cycle/ Schizogeny - produces merozoites Mosquito: definitive host Humans: intermediate host PLASMODIUM SPP. PROTOZOA DESCRIPTION P. falciparum Deadliest and most common A malarial organism producing ringlike and crescent-like forms within red blood cells Lancet shaped Clinical manifestation: Malignant tertian malaria P. vivax Clinical Manifestation: Benign tertian malaria Schuffner’s dots (red dots on RBC), enlarged RBC Intermediate Host: Human Definitive Host: Anopheles mosquito P. ovale Clinical manifestation: Tertian malaria P. Malariae This is the malarial species that causes the called quartan malaria. PLASMODIUM SPP. Prophylaxis: Chloroquine Drug-resistant malaria: Quinine + Fansidar (Sulfadoxime + Pyrimethamine) Radical cure: Primaquine - also indicated as terminal prophylaxis for travelers who just came from areas where P. vivax & P. ovale are endemic. Mefloquine & Atovaquone-Proguanil (Malarone) are the recommended prophylaxis for travelers in malaria-endemic areas with known chloroquine-resistant strains of Plasmodium Falciparum DOC against P.vivax & P.ovale: Chloroquine DOC against severe Falciparum malaria: Quinidine Gluconate (IV) and Quinidine Sulfate (oral) TOXOPLASMA GONDII Causes toxoplasmosis Reservoir: cat feces (oocysts) Diagnosis: serology, radiology, retina exam Treatment: Fansidar ISOSPORA BELLI Causes Isosporiasis Transmission: fecal-oral DOC: Cotrimoxazole This organism is one of the important cause of severe diarrhea in immunocompromised individuals such as patients with AIDS BLASTOCYSTIS HOMINIS Causes blastocytosis A yeast resembling a protozoan cyst Transmission: Fecal-oral Treatment: Metronidazole To be continued…