Normal Microbiota vs “Usual Suspects” 5.0

Skin - normal microbiota

• Staphylococcus epidermidis

• Propionibacterium acnes

Skin - usual suspects

• Staphylococcus aureus

• Streptococcus pyogenes

Upper respiratory - Normal microbiota

Nose

• Staph. sp

• Corynebacterium sp

Oral Cavity-10^10

• Strep. sp

• Actinomyces sp

• Fusobacterium sp

Throat

• Strep. sp

• Hemophilus sp

• Neisseria sp

Upper respiratory - usual suspects

Sinusitis & Otitis

• Mostly viral

• Streptococcus pneumoniae

• Staphylococcus aureus

• Haemophilus influenzae

Pharyngitis

• mostly viral

• lots of normal microbiota

• Streptococcus pyogenes

• Other causes:

  • EBV-Mononucleosis

  • Neisseria sp.

  • Diphtheria (not likely)

Sterile parts of body - no normal microbiota

• lower respiratory

• meninges

• endocardium

• abdominal cavity

• urinary tract

Lower respiratory - usual suspects

Community Acquired

• Streptococcus pneumoniae

• Staphylococcus aureus

• Haemophilus influenzae

Atypical

• Mycoplasma pneumoniae

Viral

• Respiratory syncytial virus (RSV)

• Influenza Type A or B

Meninges - meningitis - usual suspects

Neonate

• E. Coli

• Group B streptococcus (S. agalactiae)

Children and adults

• Streptococcus pneumoniae

• Neisseria meninigitidis

Endocardium - endocarditis - usual suspects

• Oral streptococci

• Enterococcus sp

• Staphylococcus sp

GI - normal microbiota

• stomach

• small bowel

• large bowel

GI - normal microbiota - stomach

10^2 -10^4

• Lactobacillus sp

GI - normal microbiota - small bowel

10^5 - primarily aerobes

• Lactobacillus sp

• Enterococcus sp

GI - normal microbiota - large bowel

10^14 - 1000x more anerobes than aerobes

• E. Coli

• Pseudomonas sp

• Proteus sp

• Klebsiella sp

• Bifidobacterium sp***

• Lactobacillus sp

• Streptococcus sp

• Clostridium sp

• Enterococcus sp

• Candida albicans

GI - enteritis - usual suspects

Many Viruses

•Bacterial causes are usually secondary to “food poisoning”:

• Salmonella sp

• Escherichia coli

• Campylobacter jejuni

• Shigella sp

• Staphylococcus aureus

• Clostridium sp

•Standout for Peptic Ulcer:

• Helicobacter pylori

Abdominal cavity - peritonitis - usual suspects

•Usually polymicrobial

• Gram-negative rods

  • Facultative anaerobes

    • Enterobacteriaceae

  • Obligate anaerobes

    • Bacteroides sp

    • Fusobacterium sp

• Sometimes gram positive cocci

• Aerobic

  • Enterococcus sp

  • Streptococcus sp

• Anaerobic

  • Peptostreptococcus sp

•Obligate anaerobic gram positive rods

• Clostridium sp

Abdominal cavity - peritonitis - usual suspects - Gram-negative rods

• facultative anaerobes

• obligate anaerobes

Abdominal cavity - peritonitis - usual suspects - gram (-) - facultative anaerobes

• enterobacteriaceae

Abdominal cavity - peritonitis - usual suspects - gram (-) - obligate anaerobes

• Bacteroides sp

• Fusobacterium sp

Abdominal cavity - peritonitis - usual suspects - Sometimes gram positive cocci

• aerobic

• anaerobic

Abdominal cavity - peritonitis - usual suspects - gram (+) - aerobic

• Enterococcus sp

• Streptococcus sp

Abdominal cavity - peritonitis - usual suspects - gram (+) - anaerobic

• Peptostreptococcus sp

Abdominal cavity - peritonitis - usual suspects - gram (+) - Obligate anaerobic

• Clostridium sp

Urinary tract - UTI - usual suspects

• Escherichia coli (~80%)

• Proteus mirabilis

• Klebsiella pneumonia

• Staphylococcus sp

Vagina - genital tract - normal microbiota

• Lactobacillus sp

• Streptococcus sp

• Candida albicans

Vagina - genital tract - STI

Some Protists

• Trichomonas vaginalis

Most are viral

• HPV

• HHV

• HIV

Typical bacteria include…

• Neisseria gonorrhoeae

• Treponema pallidum

• Chlamydia trachomatis