BACTE 4

EMB

(Enteric Media)

Inhibitory: **Eosin Y, Methylene Blue**

CHO: **Lactose**

Indicator: **Eosin Y, Methylene Blue**

LF: **Red purple (E. coli: GMS)**

NLF: **Colorless**

MAC

(Enteric Media)

Inhibitory: **Bile salts, Crystal violet**

CHO: **Lactose**

Indicator: **Neutral red**

LF: **Red/Pink**

NLF: **Colorless**

SSA & DCA

(Enteric Media)

Inhibitory: **Bile salts**

CHO: **Lactose**

Indicator: **Neutral red**

LF: **Red/Pink**

NLF: **Colorless**

TCBS

(Enteric Media)

Inhibitory: **Bile salts**

CHO: **Sucrose**

Indicator: **Bromthymol blue**

LF: **Yellow**

NLF: **Green**

HEA

(Enteric Media)

Inhibitory: **Bile salts**

CHO: **Salicin, Lactose, Sucrose**

Indicator: **Bromthymol blue** 

LF: **Yellow**

NLF: **Green**

XLD

(Enteric Media)

Inhibitory: **Bile salts**

CHO: **Xylose, Lactose, Sucrose**

Indicator: **Phenol red**

LF: **Yellow**

NLF: **Red**

BSA

(Enteric Media)

Inhibitory: **Brilliant salts (Old: Wilson-Blair)**

CHO: **Glucose**

Indicator: **Bismuth sulfite**

LF/NLF: *S. typhi* = black colonies

*Escherichia coli, Enterobacter aerogenes, Enterobacter gergoviae, Edwardsiella tarda, Arizona, Serratia, Hafnia, Salmonella enteritidis, Salmonella choleraesuis, Vibrio*

(Lysine-Ornithine-Arginine Reactions)

L: +

O: +

A: -

*Enterobacter cloacae, Enterobacter sakazakii, Enterobacter taylorae*

(Lysine-Ornithine-Arginine Reactions)

L: -

O: +

A: +

*Salmonella typhi, Klebsiellapneumoniae, Klebsiella oxytoca, Klebsiella ozaenae*

(Lysine-Ornithine-Arginine Reactions)

L: +

O: -

A: -

*Shigella sonnei, Proteus mirabilis, Morganella morganii, Citrobacter, Yersinia enterocolitica, Salmonella paratyphi*

(Lysine-Ornithine-Arginine Reactions)

L: -

O: +

A: -

*Providencia, Proteus vulgaris, Klebsiella rhinoscleromatis, Pantoea agglomerans, Yersinia pseudotuberculosis, Yersinia pestis*

(Lysine-Ornithine-Arginine Reactions)

L: -

O: -

A: -

*Plesiomonas shigelloides*

(Lysine-Ornithine-Arginine Reactions)

L: +

O: +

A: +

*Aeromonas hydrophila*

(Lysine-Ornithine-Arginine Reactions)

L: +

O: -

A: +

*Pseudomonas aeruginosa*

(Lysine-Ornithine-Arginine Reactions)

L: -

O: -

A: +

*E. coli*

“Colon Bacillus”

* #1 UTI
* #2 Neonatal meningitis (K1 Ag)
* MUG (+) except E. coli O157:H7
* MUG (+): Electric blue fluorescence

ETEC

* Traveler’s diarrhea 
* Montezuma revenge
* Turista
* Belly Delhi
* Cholera like, watery diarrhea (SL, LT)

EPEC

* Infantile diarrhea
* Pili: pathogenicity island

EIEC

* Dysentery (Shigella)-like diarrhea
* Invasin: Pathogenicity
* Stool: bloody w/ mucus
* Sereny test

EHEC/VTEC

* HUS
* Hemorrhagic colitis
* Verotoxin: Shigella-like toxin

*E. coli* O157:H7

* EHEC/VTEC
* Sorbitol MAC (-)

EAEC

* Acute and chronic diarrhea
* Aggregative adhesion fimbriae

Other Escherichia spp

* *E. hermanni* = yellow colonies
* *E. vulneris* = yellow colonies
* Alkalescens dispar (Anaerogenic *E. coli/E. coli* inactive)
* Nonmotile, (-) H2S, NLF, PG (-), Vi (-)

*Enterobacter*

* UTI, wound, septicemia
* *E. sakazakii* = yellow pigment
* *E. (Pantoea) agglomerans* = yellow pigment

*K. pneumoniae*

“Friedlander’s bacillus”

* (+)Capsule, ESBL
* __Diseases:__
* Pneumonia: “Currant jelly-like sputum” 
* Wound infections
* Meningitis
* UTI

*K. rhinoscleromatis*

Biochemically inert

PMP Group (Proteeae)

All are indole (+) except *P. mirabilis* (-)

*Proteus*

* Swarm on BAP but not on MAC
* #2 UTI
* Renal stone association
* Odor: Burnt gun powder/Burnt chocolate 
* *P. mirabilis:* Rapid urease producer

*Salmonella*

* Indole (-)
* BSA & SSA: Black colonies
* Gold standard: Culture
* Kaufmann White schema
* Vi Ag = heat-labile, masks the O Ag
* O Ag
* H ag
* Tx: Chloramphenicol

*S. typhi*

* Typhoid fever
* Meningitis
* Osteomyelitis
* Complication: Psychosis

__Lab Diagnosis:__

* 1st week: Blood
* 2nd week: Urine and stool (carrier)

*S. paratyphi C (S. choleraesuis)*

Septicemia

*S. enteritidis*

“Gardner’s Bacillus”

*Shigella*

* Biochemically inert
* SSA: colorless
* Related to E. coli:
* E. coli: Acetate (+)
* Shigella: Acetate (-)
* Intestinal pathogen: Dysentery
* __Lab. Diagnosis:__
* BEST: Culture of fresh stool w/ mucous flecks
* Rectal swab of ulcer

*Shigella* Subgroups (O Ag)

* A = *S. dysenteriae* (“Shiga Bacillus”)
* B = *S. flexneri* (“Strong Bacillus”)
* C = *S. boydii*
* D = *S. sonnei* (Cross reacts w Plesiomonas)

*Serratia marcescens*

* Red pigment (Prodigiosin)
* (+) DNase, Gelatinase, LPS
* Red milk
* Resistant to many antibiotics

*Serratia odorifera*

Rancid, potato-like odor

*Y. pestis*

“Plague Bacillus”

* (+) Stalactite on broth medium
* V and W antigens
* MOT: Rat flea bite
* __Infections:__
* Bubonic plague: buboes, lymphadenopathy
* Pneumonic plague
* Septicemic plague
* Black death

*Y. enterocolitica*

* Motile at RT’ 
* Appendicitis-like infection
* (+) ONPG

*Y. pseudotuberculosis*

* Motile at RT’
* Mesenteric lymphadenitis, septicemia

*Vibrio*

“Comma Bacillus”

* Comma-shaped
* Darting motility
* Oxidase (+) except *V. mitschnikovii* (-)
* Halophilic except:
* *V. cholerae*
* *V. mimicus*

*V. cholerae*

* (+) Indole
* (+) String test (0.5% Na desoxycholate)
* Cholera: Ricewater stool
* “Fish in the stream” appearance

Polymyxin Susceptibility

Classical Biotype: S

El Tore Biotype: R

Lysis by bacteriophage

Classical Biotype: +

El Tor Biotype: -

Chicken RBC agglutination, Hemolysis of sRBC, VP test

Classical Biotype: -

El Tor Biotype: +

Anti-Ogawa

Ogawa Serotype: +

Inaba Serotype: -

Hikojima Serotype: +

Anti-Inaba

Ogawa Serotype: -

Inaba Serotype: +

Hikojima Serotype: + 

Lab. Diagnosis (*V. cholerae*)

Culture:

* TCBS: Sucrose fermenter
* TTGA: Tellurite Taurocholate Gelatin Agar
* APW: 6-8 hrsSubculture (TCBS)
* Cary Blair: Transport medium (stool)
* Rectal swab: Carrier

O129 Susceptibility test = (S)

*V. parahaemolyticus*

* Halophilic (8% NaCl)
* (+) Indole
* #1 Gastroenteritis in Japan (seafood)
* Nonsucrose fermenter (TCBS)
* Kanagawa (+) = Beta hemolysis on Wagatsuma agar

*V. vulnificus*

* Stool pathogen
* (+) Blood culture
* (+) Lactose fermentation, ONPG Nonsucrose fermenter (TCBS)

*V. alginolyticus*

Sucrose fermenter (TCBS)

*Aeromonas*

* Motile (monotrichous)
* (+) Oxidase
* Beta-hemolytic
* (R) O129
* (+) DNase
* (+) Bile esculin hydrolysis

*Plesiomonas*

* (+) Oxidase
* Non-hemolytic
* (V) O129
* (-) DNase
* (-) Bile esculin hydrolysis

*Campylobacter*

* (G) 42’C
* Curved, S-shaped (Wings of Seagull)
* (+) Catalase
* (+) Oxidase
* Darting motility
* C. jejuni: (+) Hippurate

*H. pylori*

* (+) Catalase
* (+) Oxidase
* (+) Urease
* Test: Urease breath test

OF test

* Fermentative (close) = O/F = +/+ = Y/Y
* Oxidative (open) = O/F = +/- = Y/G
* Nonutilizer = O/F = -/- = G/G
* Medium: Hugh and Leifson (1% glucose, 1% agar)
* Indicator: Bromthymol blue

*P. aeruginosa*

* Old: P. pyocyanea
* Pyocyanus: Blue pus agent
* (+) Oxidase
* Motile (monotrichous)
* Capsule: Slimy layer
* Grapelike odor (aminoacetaphenone)
* (G) 42’C
* Cetrimide medium: selective
* __Pigments:__
* Pyocyanin: Best
* Pyoverdin/Fluorescein: (+) P. putida/P. fluorescens 
* __Infections:__
* #2 Burns (#1: S. aureus)
* Wound: Ecthyma gangrenosum
* Swimmer’s ear (Otitis externa) 
* Dermatitis: whirlpool baths
* Contact lens infection
* #1 Cystic fibrosis

*B. cepacia*

* (+) Oxidase
* Motile (lophotrichous)
* #2 Cystic fibrosis
* (+) Lactose, ONPG

*B. pseudomallei*

“Whitmore’s Bacillus”

* Vietnamese timebomb
* Melioidosis/Glanders-like disease
* Ashdown medium: Wrinkled colony 
* (G) 42’CMotile (lophotrichous)
* (+) Lactose
* Long incubation period: 10-20 years

*B. mallei*

* Nonmotile
* Glander’s disease (Horses)

*P. stutzeri*

* Brown (buff colored) wrinkled colony
* (+) 6.5% NaCl
* (+) NO2 → N2
* (-) Lactose
* Found in stagnant water

*S. maltophilia*

* (-) Oxidase
* (+) DNase
* (+) Maltose and Glucose
* Motile (lophotrichous)
* Colony: Lavender green
* Common w/ the use of catheter

*P. syncyanea*

Blue milk

*Shewanella putrefaciens*

* TSI: K/K + H2S
* (+) Oxidase

*Acinetobacter*

* (-) Oxidase
* (+) Catalase
* Nonmotile
* MAC: purple colonies
* Mistaken as Neisseria – (+) oxidase
* Causes UTI

*A. anitratus (A. baumanii)*

* Oxidizer
* Herella vaginocola

A. lwoffi

* Nonoxidizer
* Mima polymorpha

*Alcaligenes faecalis*

* (+) Oxidase
* (+) Catalase
* Motile (peritrichous)
* Asaccharolytic 
* “Fruity” odor

*M. lacunata*

* (+) Pitting of agar
* (+) Oxidase
* (+) Catalase
* Assacharolytic
* (NG) MAC
* Infection: Blepharoconjunctivitis
* Mistaken as Neisseria

*Flavobacterium (Chryseobacterium) meningosepticum*

* Flavin = Yellow pigment
* (+) Oxidase
* (+) DNase
* (+) Indole
* (+) Gelatin hydrolysis
* Nonmotile
* Causes neonatal meningitis

*E. corrodens*

* Twitching motility
* MOT: Human bite 
* “Clenched fist” 
* Corrodes agar
* Odor: Bleach-like
* (-) Catalase
* (+) Oxidase

*Kingella spp*

* Cause SBE (HACEK)
* Pits agar

*Haemophilus*

* Require X factor (hemin) and V factor (NAD)
* (+) Satellitism
* (+) Oxidase
* HCAP: medium of choice (5% CO2)

*H. influenzae,* H. aegyptius, H. haemolyticus

X factor: +

V factor: +

Porphyrin: -

*H. parainfluenzae, H. parahaemolyticus, H. paraphrophilus*

X factor: -

V factor: +

Porphyrin: +

*H. ducreyi*

X factor: +

V factor: -

Porphyrin: -

*H. aphrophilus*

X factor: -

V factor: -

Porphyrin: +

Porphyrin test

* X factor
* D-ALA → (+) Protoporphyrin (Red)

*H. influenzae*

“Pfeiffer’s Bacillus”

* Serotype polysaccharide:
* Hib = *Haemophilus* type B: capsular antigen type B (polyribose ribitol PO4)
* __Infections:__
* Epiglotitis (Major)
* #3 Meningitis (#1: S. pneumoniae/#2: N. meningitidis)
* Otitis media, CF, conjunctivitis, pneumonia, URTI, sepsis
* __Lab. Diagnosis:__
* Culture: Grayish, dew drop colony w/ Mousy odor

a. CAP \n b. Levintha

c. Fildesl

*H. ducreyi*

“Chancroid Bacillus”

* (G) CAP + Vancomycin (33’C) 
* Soft chancre (painful)
* School of red fish

*H. aegyptius*

“Koch Week’s Bacillus” 

* Pink eye conjunctivitis
* Brazilian purpuric fever

*B. pertussis*

“Whooping cough Bacillus”

* Strictly aerobic
* Encapsulated, nonmotile
* Require cysteine and methionine for growth
* Toluidine blue: Bipolar granules

__Stages: Whooping cough__


1. Catarrhal: mild
2. Paroxysmal: successive cough
3. Convalescence: recovery

__Lab. Diagnosis:__

* NPS: Carrier
* Culture media:
* BG (PBGA) = mercury droplet colonies (pearl-like)
* RL (Charcoal horse blood)
* Jones Kendrich (Charcoal, yeast extract)
* CCBA
* Stainer and Scholte
* Casamino broth

*B. pertussis*

Motility: -

Urease: -

Oxidase: +

MAC/BAP: -

*B. parapertussis*

Motility: -

Urease: +

Oxidase: -

MAC/BAP: -

*B. bronchiseptica*

Motility: +

Urease: +

Oxidase: +

MAC/BAP: +

*B. bronchiseptica*

“Kennel cough Bacillus”

*Brucella*

* (-) Capsule
* Obligate aerobe
* Nonmotile
* Facultatively intracellular (phagocytes)
* Erythritol: enhances growth
* Zoonotic: found in animal placenta
* __Infections:__
* Undulant fever
* Malta fever
* Aboriton in cattle
* Endocarditis
* __Lab. Diagnosis:__
* Castañeda broth: Best medium
* SB: Best medium
* W (Wisconsin) medium: Selective

*Brucella*

* (-) Capsule
* Obligate aerobe
* Nonmotile
* Facultatively intracellular (phagocytes)
* Erythritol: enhances growth
* Zoonotic: found in animal placenta
* __Infections:__
* Undulant fever
* Malta fever
* Aboriton in cattle
* Endocarditis
* __Lab. Diagnosis:__
* Castañeda broth: Best medium
* TSB: Best medium
* W (Wisconsin) medium: selective
* (+) Rose Bengal & 2-ME agglutination

*B. abortus* 

 “Bang’s Bacillus”

*B. abortus* 

Urease: +

CO2: +

Thionine (Dye Inhibition): - (NG)

Fuchsin (Dye Inhibition): + (G)

*B. melitensis* 

Urease: +

CO2: -

Thionine (Dye Inhibition): + (G)

Fuchsin (Dye Inhibition): + (G)

*B. suis & B. canis* 

Urease: +

CO2: -

Thionine (Dye Inhibition): + (G)

Fuchsin (Dye Inhibition): - (NG)

*F. tularensis*

* (+) Capsule
* Nonmotile
* Facultatively intracellular
* Obligate aerobe
* Lab. acquired infection (BSL II)
* __Tularemia:__
* Lymphadenopathy
* Deerfly, lemming, rabbit, water rat trapper’s disease 
* __Lab. Diagnosis:__


1. GCBA: Glucose cysteine blood agar
2. PCA: Peptone cysteine agar
3. CHA: Cysteine heart agar
4. Biochem:


1. (+) Catalase
2. (-) Oxidase
3. (-) Urease
4. (-) MAC

*P. multocida*

* Multocida: Multiple killing
* (+) Capsule
* Nonmotile
* (+) Oxidase
* (+) Catalase
* (+) Glucose
* (+) Ornithine
* (+) Indole
* (+) Urease
* (G) BAP
* (NG) MAC
* __Infections:__
* Animal (cat) bite wound infection
* Shipping fever

*Treponema*

* (-) Catalase
* Dx: Serology

*Leptospira*

* (+) Catalase
* Dx: Culture

*Borrelia*

* (-) Catalase
* Dx: Giemsa (blood smear), Serology

*T. pallidum*

* Noncultivable on agar
* Obligate intracellular (Rabbit’s testicle)

Syphilis

1’ = Hard chancre (Painless)

2’ = Condylomata lata (HPV: Condylomata acuminata) 

Latent: Asymptomatic, Dx: Serology

3’: Gummas, neurosyphilis

Congenital syphilis: Hutchinsonian triad, abortion, still birth

Neurosyphilis

Tabes dorsalis

Penicillin

* Treatment for syphilis
* (Jarisch-Herxheimer reaction)