Gamma Proteobacteria:

          ENTERICS

                    Gram negative rods

                    Facultative anaerobes

                    Oxidase (-)

                    Catalase positive

                    Ferment glucose

                    Reduce nitrates to nitrites

                    Virulence: Fimbria for attachment

                         Sex Pili for tranmsision of resistance (AB)

                         Bacteriocins ā proteins that cause the lysis of related species


Enterobacter

     E. aerogenes

     E. cloacae

          Nosocomial infection

          Reservoir: colon, soil, water, sewage

          Diseases: UTI, pneumonia

          Virulence factor: AB resistance

                                 Endotoxin

          TX: AB [broad spectrum penicillin]

Klebsiella

          Klebsiella  pneumonia

                   Nonmotile

                   Nosocomial infections

                   Rare, but severe pulmonary infection

                   Reservoir: Human URT, soil, water

                   Clinical signs: dark brown to cherry red jelly like sputum

                                      Lung abscesses

                                      Empyema

                   Most common in diabetics, alcoholics, chronic respiratory

                   Virulence factor: polysaccharide capsule

                   DX: culture organism

                   TX: AB [cephalosporins and aminoglycocides]

Serratia

     Serratia marcescens

          Nosocomial : catheters, Saline irrigation solutions   

          Reservoir: colon, soil, water

          Diseases: UTI, pneumonia

          Virulence factor: AB resistance

                                 Endotoxin

          TX: AB [broad spectrum penicillin]

     Proteus

          P. mirabilis

          P. vulgaris

                   Highly motile. Peritrichous flagella

                   Habitat: colon, soil, water

                   Disease: UTI, wound sepsis (catheter infections)

                   Virulence: Endotoxin

                                   Urease +

     Morganella

          M. morganii

                   Habitat: feces, soil, water

          Clinical disease: found in superficial wounds where normal flora is absent and cause Infections of ear, sinuses, urinary tract

     Providencia

          P. rettgeri

          P. alcalifaciens

          P. stuartii

                   Same as above regarding habitat and clinical disease


Pasteurellales

          Nonmotile, gram neg rods

                   Haemophilus [see other notes]

                   Pasteurella

                             Pasteurella multocida

                                      Pneumonia and sepsis in animals

                                      Zoonotic Dz: transmitted by animal bite [dog, cat]

                                                Humans: abscess ā arthritis


Epsilon proteobacteria

          Slender gram neg rods

          Helical or vibroid

          Motile

          Microaerophilic

      Campylobacter

          Transmission: Indirectā contaminated or undercooked food; contaminated water

          C. jejuni

          Clinical signs: Enteritis, ulcerative colitisāwatery, bloody diarrhea

          Can progress to endocarditis ā septic arthritisā meningitis

                   DX: growth on selective media

                   TX: AB [erythromycin, ciprofloxacin]

          C. fetus

                   Diseases: bacteremia in susceptible patients [DM, cirrhosis]

                                  Diarrhea

          C. coli

                   Diseases: diarrhea

     Helicobacter pylori

          Diseases: peptic ulcers

                      Gastric carcinoma

          Virulence factor: Urease +

          TX: AB [metronidizole]


OTHER ORGANISMS

Bacteroidetes

     Bacteroides fragilis

          Gram neg rod

          Anaerobic

          nonmotile

          Reservoir: Human intestine

          Diseases: PID, Peritonitis, Abscesses

          TX: Metronidizole


Francisella tularensis

          Gram negative pleomorphic coccobacillus

          Non motile

          Non sporeformer

          Reservoir: Rabbits and Rodents that carry Type A

                         Water and aquatic mammals that carry Type B

          Transmission: Ingestion, inoculation, inhalation, contamination, biting vector such as a tick or biting horse fly

          Incubation: 5-8 days

          Clinical sign: Headache/chills/ fever ā N/Vāpustular papule that ulcerates to cause focal necrosis of infected organs -->Finger, eye, Lymphatic system, liver, kidney, lung

          Virulence factors: capsule

                                  Endotoxin (LPS)

          TX: AB [streptomycin]


Streptobacillus

          S. moniliformis

                   Causative agent of Streptobacillary rat bite fever

                   Reservoir: oropharynx of rats

                   Transmission: Direct (bite), Indirect (contamination of milk)

                   Clinical Signs: Flu like signsā rashā polyarthralgiaā                                                               endocarditis

                   DX: Id organism on culture of blood or joint fluid

                   TX: AB [penicillin or erythromycin]


Plesiomonas shigelloides

          Gram neg rod

          Facultative anaerobe

          Reservoir: Gut of fish

          Transmission: Eating raw fish, contaminated food or water

          Clinical Disease: Diarrhea

          TX: AB


Aeromonas hydrophilia

          Gram neg rod

          Reservoir: soil and water

          Transmission: contaminated food

          Clinical Disease: diarrhea

          Virulence factor: enterotoxin

          TX: AB


Alcaligenaceae

          Alcaligenes denitrificans

          Alcaligenes faecalis

          Bordetella pertusis

                   Gram neg bacillus

                   Aerobic

                   Nonmotile

                   Transmission: Respiratory droplet

                   Clinical Disease: Pertussis [Whooping cough]

                             Malaise/ fever ā mucus accumulatesā paroxysmal                                                coughing for weeks to months

                   Virulence factor: Pili/Fimbria that attach to cili of URT cells

                   DX: organism on culture sample

                   TX: AB [penicillin, erythromycin]

                   Prevention: Vaccination [DTaP]  p = pertussis