MICROBIOLOGY NOTES

(Derived from “Review Handbook in Diagnostic Microbiology” by Maria Teresa Rodriguez and Ma’am Aldave’s notes)

COMMON NAMES OF BACTERIA (RODRIGUEZ)

COMMON NAME ORGANISM

Anthrax Bacillus Bacillus anthracis
Bang’s Bacillus Brucella spp.
Battey Bacillus Mycobacterium intracellulare
Bordet-Gengou Bacillus Bordetella pertussis
Canned food Bacillus Clostridium botulinum
Colon Bacillus Escherichia coli
Comma-shaped / Curved Bacillus Vibrio spp.
Corroding Bacillus Eikenella corrodens
Foam-loving Bacterium Aggregibacter aphrophilus
Friedlander’s Bacillus Klebsiella pneumonia
Fried rice Bacillus Bacillus cereus
Gas gangrene Bacillus Clostridium perfringes
Hansen’s Bacillus Mycobacterium leprae
Hay Bacillus Bacilllus subtilis
Hoffman Bacillus Corynebacterium pseudodiptheriticum
Kleb-Loeffler Bacillus Corynebacterium diptheriae
Koch’s Bacillus Mycobacterium tuberculosis
Koch-Weeks Bacillus Haemophilus aegypticus
Morax-Axenfeld Bacillus Moraxella lacunata
Pfeiffer’s Bacillus Haemophilus influenza
Plague Bacillus Yersina pestis
Tackhead Bacillus Clostridium tetani
Tap Water Bacillus Mycobacterium gordonae
Whitmore Bacillus / Vietnamese Time Bomb Burkholderia pseudomallei
Wood pigeon Bacillus Mycobacterium avium subsp. Silvaticum
Yellow Bacillus Mycobacterium kansasii

VIRULENCE FACTORS (RODRIGUEZ)

ORGANISM VIRULENCE FACTOR(S)

GRAM POSITIVE COCCI
Staphylococcus aureus Coagulase
Streptococcus pyogenes M protein
Streptococcus agalactiae Capsule with sialic acid
Viridans Streptococci Capsule
Streptococcus pneumoniae Polysaccharide capsule
Enterococci Extracellular serine protease, gelatinase, cytolysin
GRAM NEGATIVE COCCI
Neisseria gonorrhoeae Common pili
Neisseria meningitides IgA1, Por A, Por B, LOS endotoxin
ENTEROBACTERIACEAE
Escherichia coli Endotoxin
Klebsiella pneuomoniae Polysaccharide capsule
Salmonella spp. Fimbriae & enterotoxin (S. enterica)
Yersinia pestis Endotoxin, coagulase, fibrinolysin
Shigella dysenteriae Shiga toxin
NON-ENTERIC GASTROINTESTINAL PATHOGENS
Vibrio cholera Choleragen
Vibrio parahaemolyticus Heat-stable hemolysin
NON-FERMENTATIVE GRAM NEGATIVE BACILLI
Endotoxin, pili, alginate
SMALL, PLEOMORPHIC, GRAM NEGATIVE BACILLI
Haemophilus influenzae Polysaccharide capsule (ser. A – F)
Aggregibacter actinomycetemcomitans Collagenase & leukotoxin
Bordetella pertussis Pertussis toxin
Francisella tularensis Capsule
Pasteurella spp. Endotoxin & capsule
AEROBIC, GRAM POSITIVE BACILLI
Bacillus anthracis D-glutamic acid capsule & exotoxins
Bacillus cereus Enterotoxins (heat-stable & heat-labile), cerelysin,
phospholipase C, pyogenic toxin
Corynebacterium diptheriae Diptheria toxin
Listeria monocytogenes Listeriolysion O (hemolytic, cytotoxic), superoxide dismutase, p60
MYCOBACTERIA (ACID FAST BACILLI)
Mycobacterium tuberculosis Cord factor
ANAEROBIC BACTERIA
Clostridium perfringes Alpha toxin & enterotoxin
Clostridium tetani Tetanospasmin (neurotoxin)
Clostridium difficile Toxin A (enterotoxin) & Toxin B (cytotoxin
Clostridium botulinum Botulism toxin – MOST POTENT TOXIN
SPIROCHETES AND MISC. BACTERIA
Leptospira Hemolysin interrogans
 CHARACTERISTICS OF MOTILE BACTERIA (RODRIGUEZ)

ORGANISM FLAGELLA MOTILITY PATTERN

Bartonella spp. Atrichous Twitching in wet mounts
Capnocytophaga Atrichous Gliding motility
Chromobacterium violaceum Polar flagella -
Pseudomonas spp. Polar flagella -
Burkholderia spp.
Polar flagella -
(except B. mallei = non-motile)
Burkholderia pseudomallei Polar tuft of flagella -
Aeromonas (Mesophilic grp.):
Single polar flagellum -
A. hydrophila, A. veronii, A. caviae
Campylobacter spp. Single polar flagellum Darting motility
Helicobacter spp. Monopolar or multi-polar flagella -
Vibrio spp. Monotrichous
 Broth = polar, sheathed Shooting star motility
 Solid media = unsheathed
Acaligenes faecalis Peritrichous flagella -
Bacillus spp.
Peritrichous flagella -
(except B. anthracis & B. mycoides)
Clostridium spp.
(except C. perfringes, C. ramosum, C. Peritrichous flagella -
innocuum)
Enterobacteriaciae
Peritrichous flagella -
(except Klebsiella, Yersinia, Shigella)
Kurthia spp. Peritrichous flagella -
Listeria monocytogenes Tumbling (Hanging drop @ RT)
Peritrichous flagella Umbrella/inverted Christmas
tree (SIM @ RT)

NON-MOTILE AT 35C: Shigella, Klebsiella, Yersinia, Listeria

APPEARANCE OF SOME BACTERIA IN MICROSCOPY / CULTURE

ORGANISM CHARACTERISTICS (SHAPE/ODOR/COLOR)

GRAM POSITIVE COCCI
Staphylococcus aureus Culture: “Buttery looking,” golden yellow, pinhead colonies
Staphylococcus epidermidis Culture: Gray, pinpoint colonies
Streptococcus pneumoniae GS: Oval / lancet-shaped in gram stain
Culture:
 Young colonies: “dome-shaped”
 Old colonies: “Coin with raised rim / dimple-shaped”
Abitrophia, Granulicatella GS: Gram-variable, pleomorphic
 Culture: “Satellites” around organism with pyridoxal
GRAM NEGATIVE COCCI
Neisseria gonorrhoeae GS: Coffee / kidney-bean shaped
Neisseria elongata GS: Rod-shaped
Neisseria bacilliformis
Neisseria weaver
Neisseria meningitides Culture: Bluish gray colonies on BAP
Neisseria sicca Culture: “Bread-crumbs”
Moraxella catarrhalis GS: Resemble Neisseria; grow from end to end with adjacent sides flattened
(Branhamella catarrhalis) Culture: “Hockey-puck” appearance
ENTEROBACTERIACEAE
Enteroadherent E. coli (EAEC) “Stacked brick” appearance
Serratia odorifera Culture: Musty, pungent, “rotten potato-like” odor
Proteus Culture: “Burnt chocolate or gunpowder” odor
Yersinia pestis GS: Closed safety pin, with bipolar bodies
Broth: Stalactite-shaped pattern
Yersinia enterocolitica GS: With bipolar bodies
Culture: “Bull’s eye” appearance in CIN
NON-ENTERIC GASTROINTESTINAL PATHOGENS
Vibrio GS: Comma, curved bacilli
Aeromonas Culture: “Bull’s eye” appearance in CIN
Campylobacter GS: S-shaped rods, seagull wing-shaped
Culture: Tailing effect, spreading
Helicobacter GS: S-shaped rods, similar to Campylobacter
NON-FERMENTATIVE GRAM NEGATIVE BACILLI
Pseudomonas aeruginosa Culture: Metallic sheen in BAP, “grape-like” or “corn tortilla” odor
Acinetobacter GS: Mistaken as Neisseria
Stenotrophomonas maltophilia Culture: “ammonia” odor
 BAP: Lavender-green colonies
 MAC: blue colonies
Buckholderia cepacia Culture: Non-wrinkled yellow colonies in BAP
Buckholderia pseudomallei GS: With bipolar bodies
Chromobacterium violaceum GS: Comma, curved bacilli
Culture: Violet (violacein pigment)
Alcaligenes faecalis Culture: Fruity odor (“apples or strawberries”)
Shewanella putrefaciens Culture: Mucoid and greenish (including media)
SMALL, PLEOMORPHIC, GRAM NEGATIVE BACILLI
Haemophilus spp. GS: “Amorphous serous material”
Haemophilus influenzae Culture: “Mousy” or “bleach-like” odor
Haemophilus ducreyi GS: “School of fish”
Aggregibacter actinomycetemcomitans Culture: “Star-shaped” appearance
Cardiobacterium hominis GS: “False Gram positive” reactions in some parts of cells
Culture: Exhibit “rosette” formation; pits agar
Eikenella corrodens Culture: “Sharp bleach odor”; pits agar
Brucella GS: “Sandy appearance”
Bordetella pertussis Culture: “Mercury drops” in Berdet-Gengou agar
Francisella tularensis GS: Faint bipolar staining
Pasteurella multocida Culture: “Mushroom smell”
Legionella Culture: “Rainbow color” colonies in buffered charcoal
yeast extract (BCYE) agar
AEROBIC, GRAM POSITIVE BACILLI
Bacillus spp. GS: Box-car shaped with “empty spaces” (central spores)
Bacillus anthracis GS: “Bamboo fishing rod” appearance
Culture:
 BAP: “Medusa head” colonies with swirling projections
 INOCULATING LOOP IS USED: “Beaten egg white” appearance
 PENICILLIN IS USED: “String of pearls”
 GELATIN MEDIUM: “Inverted pine tree”
Bacillus cereus Culture: “Frosted glass” appearance; spreading growth
Bacillus subtilis Culture: “Ground-glass” appearance; exhibit pigment atoms in BAP
Bacillus pumilus Culture: “Blister-like” appearance in BAP
Corynebacterium diptheriae GS:
 “Club-shaped” swellings
 Highly pleomorphic, resemble Chinese letters
Culture:
 “Poached egg” in Pai’s slant or Loeffler’s serum agar
 Biotype mitis: “Fried egg” colonies
 Biotype gravis: “Daisy head” colonies
Corynebacterium urealyticum GS: V-shaped forms and palisades
Culture: Pinpoint colonies
Corynebacterium pseudodiptheriticum GS: Parallel rows or palisades; does not exhibit any other characteristic
“pleomorphism” from other spp.
Corynebacterium jeikeium GS: Club-shaped, V forms
Listeria monocytogenes GS: Resemble Streptococci spp.
Erysipelothrix rhusiopathiae Culture: “Pipe cleaner” or “test tube brush” appearance in gelatin stab culture
Kurthia Culture:
 BAP: “Medusa head”
 NA: Rhizoid growth
Aerobic Actinomycetes GS: Beaded appearance
Nocardia Culture: Wrinkled, chalk-like, orange-tan pigmentation
Rhodococcus equi GS: “Zigzag pattern”
Streptomyces Culture: “Musty basement” odor
Actinomadura GS: Very similar to Nocardia spp.
Culture: “Molar tooth” appearance
MYCOBACTERIA (ACID FAST BACILLI)
Mycobacterium tuberculosis Culture: “Cauliflower-like” with cording
Mycobacterium kansasii GS: Distinct crossbanding
Culture: Exhibit dark red crystals of 10-b-carotene
Mycobacterium marinum GS: With cross-barring
Mycobacterium ulcerans GS: No crossbanding
Mycobacterium terrae complex Culture:
 M. triviale: Rough/dry colonies
 M. terrae: Smooth colonies
 M. nonchromogenicum: Smooth to rough colonies; white to buff
Mycobacterium leprae GS: “Cigar-shaped” or “pocket-fence” arrangement
ANAEROBIC BACTERIA
Clostridium perfringes GS: Subterminal spores, “boxcar-shaped”
Culture:
 BAP: Double zone of hemolysis
 Litmus milk: Stormy fermentation
Clostridium tetani GS: Terminal spores, “drumstick” or “tennis racket” appearance
Clostridium botulinum GS: Subterminal spores
Clostridium difficile GS: Subterminal spores
Culture:
 “Ground-glass” appearance in cycloserine-cefoxitin-fructose agar
(CFFA)
 BAP: “Horse stable” odor
Anaerobic Actinomycetes Culture:
 Young colonies: “Spider-like” or “wooly” appearance
 Old colonies: “Molar tooth” appearance
Bacteroides fragilis GS: Safety pin appearance
Bacteroides ureolyticus GS: “Dog bone” shape
Culture: Pits agar
Clostridium septicum Culture: “Medusa’s head” appearance
Eubacterium Culture: “Seagull wing” shaped; fluorescent chartreuse color

Fusobacterium Culture: Medium turns green upon air exposure; “breadcrumb-like” colonies
Lactobacillus Culture: Pinpoint colonies
Porphyromonas Culture: Brick red fluorescence
Prevotella Culture: Brick red fluorescence
Veilonella parvula Culture: Red fluorescence
RICKETTSIACEAE AND RELATED ORGANISMS
Ehrlichia GS: “Mulberries” or morula (Wright-Giemsa stain)
CELL WALL-DEFICIENT BACTERIA
Mycoplasma hominis Culture: “Fried egg” appearance
Ureaplasma urealyticum Culture: Dark brownish lumps on A7 or A8 agar
SPIROCHETES AND MISC. BACTERIA
Treponema pallidum subsp. pallidum 3 axial filaments; 1 insertion disk
Borrelia spp. 15-20 axial filaments; 2 insertion disks
Leptospira Tightly coiled, 2 long axial filaments
Streptobacillus moniliformis GS: “L forms” or “Yeast-like” shape
Culture:
  BAP: “Fried egg” appearance
 Broth: “Fluff balls/bread crumbs”
Klebsiella (Calymmatobacterium) GS: Safety pin appearance; presence of Donovan bodies in mononucleated
granulomatis endothelial cells
Capnocytophaga GS: Spindle-shaped
Culture: Slight yellow or orange pigmentation

 PINPOINT COLONIES:  C. ulcerans – pathogenic

 Streptococcus epidermidis  C. pseudotuberculosis – pathogenic
 Corynebacterium urealyticum
 Lactobacillus  WITH BIPOLAR BODIES
 Yersinia pestis
 SAFETY PIN APPEARANCE:  Yersinia enterocolitica
 Yersinia pestis  Buckholderia pseudomallei
 Bacteroides fragilis  Francisella tularensis
 Klebsiella granulomatis  Pasteurella multicoda

 FRIED EGG APPEARANCE:  SPREADING COLONIES

 Corynebacterium diphtheria biotype mitis  Proteus
 Mycoplasma hominis  Bacillus cereus
 Streptobacillus moniliformis  Campylobacter
 Clostridium tetani
 MEDUSA HEAD  Clostridium septicum
 Bacillus anthracis
 Clostridium septicum  PITS AGAR
 Kurthia  Chromobacterium violaceum
 Cadiobacterium hominis
 CHINESE LETTERS (ALDAVE)  Eikenella corrodens
 C. amylocatum – normal  Arcanobacterium
 C. minutissimum – normal  Bacteriodes ureolyticus
 C. diptheriae – pathogenic  Moraxella lacunata

CULTURE MEDIA FOR SOME BACTERIA (RODRIGUEZ)

ORGANISM DESIGNATED MEDIA (SELECTIVE, ENRICHMENT, ETC.)

GRAM POSITIVE COCCI
Staphylococcus aureus Mannitol Salt Agar (MSA) – yellow halo
Colistin-nalidixic-agar (CNA) – for purulent exudates
Phenyl ethyl alcohol (PEA) – selective for Gram (+) bacteria
CHROM – for MRSA
Streptococcus agalactiae Carrot broth – medium turns yellow or orange
Granada agar – yellow to orange colonies
Lim broth – improves recovery
 Todd-Hewitt broth – for transport; during pregnancy for ID of S. agalactiae;
inhibits vaginal flora
Streptococcus pyogenes BAP with SXT
GRAM NEGATIVE COCCI
Neisseria spp. Thayer-Martin Agar – Vancomycin + Colistin + Niacin
Modified Thayer-Martin Agar – VCN + Trimethoprim lactate
Martin-Lewis medium – VCT + anisomycin
New York City medium – VCT + amphotericin B
GC-Lect medium – same as NYC + lincomycin
NA @ 25C – Neisseria mucosa & Neisseria sicca
ENTEROBACTERIACEAE
Escherichia coli Eosin methylene blue (EMB) agar – green metallic sheen
Yersinia enterocolitica Cefusulodin-irgasan-novobiocin (CIN) – selective medium (bull’s eye
appearance)
Plesiomonas shigelloides Inositol-brilliant green-bile salt agar – enhances recovery; white or green to
pink colonies for other enterics
NON-ENTERIC GASTROINTESTINAL PATHOGENS
Vibrio spp. Alkaline peptone water – enrichment medium
*10% NaCl – for V. alginolyticus
Aeromonas CIN – bull’s eye appearance
(Grows at 42C)
Campylobacter Butzler agar – enrichment
(Grows at 42C) Skirrow’s media – enrichment
Charcoal cefoperazone desoxycholate agar (CCDA) – selective
Helicobacter Skirrow’s media
Brucella agar with 5% sheep’s blood
NON-FERMENTATIVE GRAM NEGATIVE BACILLI
Pseudomonas aeruginosa Seller’s medium – promotes pigment production
(Grows at 42C) Cetrimide agar – enhances pyoverdin and pyocyanin production
Buckholderia pseudomallei Ashdow medium with colistin – dry, wrinkled, deep pink colonies
SMALL, PLEOMORPHIC, GRAM NEGATIVE BACILLI
Haemophilus spp. CAP with X and V factor
Haemophilus influenza Horse’s blood bacitracin agar – selective; for resp. secretions of px
with cystic fibrosis
Haemophilus ducreyi Nairobi biplate medium – selective; gonococcal agar & MHA + horse’s blood &
vancomycin
Haemophilus aegypticus CAP with 1% IsoVitaleX or Vitox – selective
Bordetella pertussis Regan-Lowe agar – selective; charcoal + horse’s blood + yeast extract
Modified Jones-Kendrick charcoal agar – yeast extract + cephalexin
Legionella BCYE with L-cysteine, ferric salt, a-ketoglutarate – preferred
AEROBIC, GRAM POSITIVE BACILLI
Bacillus anthracis Heat or alcohol shock – enrichment and selective technique
Corynebacterium spp. Cystine tellurite blood agar (CTBA) – preferred; black color surrounded by halo
Tinsdale agar – black color surround by brown halo
 Pai’s slant or Loeffler’s serum agar – metachromatic granules of C. diptheriae
Christensen urea slant – for C. urealyticum
Listeria monocytogenes Cold enrichment (4C) – enrichment technique
Nocardia Fungal media [Sabouraud dextrose agar (SDA) w/o chloramphenicol, Potato
dextrose agar (PDA), tap water agar]
MYCOBACTERIA (ACID FAST BACILLI)
Mycobacterium Egg-based media:
 Lowenstein-Jensen (LJ) medium
 American Thoracic Society (ATS) – sterile spx (CSF, BM)
 Petragnani – isolation of Mycobacterium from heavily contam. Spx
 Wallenstein – for M. avium complex
Serum-agar-based (transparent media)
 Middlebrook 7H10/7H11 – positive culture in 3-4 weeks
 Mitchison 7H11
Liquid/Broth media
 BACTEC 12B (MB 7H12) and BACTEC 13A (MB 7H13)
 Middlebrook 7H9 and Dubos Tween albumin broth – subculturing
stock strains
 Septi-Chek AFB – biphasic medium; rapid ID of mycobacteria
Mycobacterium leprae Footpads of mice
ANAEROBIC BACTERIA
Clostridium difficile Cycloserine-cefoxitin-fructose agar (CCFA) – ground glass appearance
Bacteroides fragilis Bacteroides bile esculin (BBE) agar
Lactobacillus Tomato juice agar – differential
Anaerobes (in general) Laked kanamycin-vancomycin agar – selective for anaerobes
 Kanamycin – inhibits Gram (-) bacilli
 Laked blood – aids in ID of pigmented Prevotella spp.
RICKETTSIACEAE AND RELATED ORGANISMS
Rickettsia Yolk sacs of embryonated eggs and tissue cultures
Coxiella burnetti Lung tissue cells – preferred
CHLAMYDIACEAE
Chlamydia trachomatis Buffalo green monkey kidney cells
HeLa 229 cells
McCoy cells (cycloheximide-treated McCoy cells)
CELL WALL-DEFICIENT BACTERIA
Mycoplasma pneumonia SP4 broth – yellow color growth
Mycoplasma hominis Only Mycoplasma spp. that grows in BAP and CAP
SPIROCHETES AND MISC. BACTERIA
Borrelia spp. Barbour-Stoenner-Kelly medium or chick embryo
Leptospira Ellinghausen-McCullough-Johnson-Harris medium
Fletcher’s medium
Gardnerella vaginalis Human blood Tween (HBT) bilayer agar – for isolation of G. vaginalis from
female genital tract
  GROWTH AT 42C:  GROWTH IN KCN MEDIUM:
 Campylobacter  Klebsiella pneumonia
 Pseudomonas aeruginosa  Enterobacter
 Acinetobacter  Serratia liquefaciens
 Streptophomonas maltophilus  Morganella morganii
 Chromobacterium  Proteus
 Providencia
 Citrobacter freundii

 NO GROWTH IN MAC (ALDAVE):

 Haemophilus (HACEK)
 Pasteurella
 Moraxella
 Legionella
 Brucella
 Francisella
 Bartonella
 Bordetella pertussis

CLINICAL SIGNIFICANCE (RODRIGUEZ)

ORGANISM DISEASE / CLINICAL SIGNIFICANCE

GRAM POSITIVE COCCI
Staphylococcus aureus Toxic shock syndrome, Scalded skin syndrome, food poisoning
Staphylococcus epidermidis Infection from catheter, prosthetic heart valve implant contaminations
Staphylococcus lugdunensis Antibiotic resistance (mecA gene)
Streptococcus pyogenes Strep throat, Scarlet fever, Rheumatic fever, Acute
glomerulonephritis/Bright’s disease, Strep toxic shock syndrome
Streptococcus mitis MOST COMMON CAUSE OF SUBACUTE BACTERIAL
ENDOCARDITIS (SBE)
Streptococcus mutans Isolated from dental carries
Streptoccus gallolyticus GIT carcinoma
Streptococcus pneumonia Lobar pneumonia; community-acquired pneumonia
MOST COMMON IN ADULTS: bacterial meningitis
MOST COMMON IN CHILDREN: otitis media
GRAM NEGATIVE COCCI
Neisseria gonorrhoeae Leading cause of STDs (gonorrhea)
Neisseria meningitides Waterhouse-Friederichsen Syndrome (from LOS endotoxin)
ENTEROBACTERIACEAE
Escherichia coli (UPEC) Leading cause of nosocomial UTI
EPEC Infantile diarrhea
ETEC Traveller’s diarrhea
EIEC Dysentery-like
EHEC Hemolytic uremic syndrome (HUS), hemorrhagic diarrhea
Klebsiella ozaenae Chronic atropic rhinitis
Klebsiella rhinoscleromatis Granuloma of nose and oropharynx
Proteus spp. Acute glomerulonephritis, kidney stones (Struvite)
Providencia stuartii Nosocomial infection in burn units
Providencia rettgeri Diarrhea among travelers
Citrobacter koseri (diversus) Outbreaks of neonatal meningitis, brain abscesses in nursery units
Salmonella Gastroenteritis, enteric/typhoid fever (“rose spots”)
Shigella flexneri Gay bowel syndrome
Shigella dysenteriae Acute inflammatory colitis, dysentery, rectal prolapse in children
Yersinia pestis Bubonic plague (“buboes”), pulmonary plague
Yersinia enterocolitica Waterborne gastroenteritis, blood transfusion hazard,
appendicitis-like infection
Plesiomonas shigelloides In HIV(+) individuals with inflammatory bowel syndrome
NON-ENTERIC GASTROINTESTINAL PATHOGENS
Vibrio cholera Cholera (rice-watery stool)
Vibrio parahaemolyticus Summer diarrhea
Aeromonas Traveler’s diarrhea, “red leg disease” in amphibians
Aeromonas hydrophila Gastroenteritis, cellulitis
Aeromonas hydrophila & veronii HUS
Campylobacter Guillain-Barre syndrome
Campylobacter jejuni MOST COMMON CAUSE OF BACTERIAL GASTROENTERITIS,
septic arthritis in AIDS patients
Helicobacter pylori MAJOR CAUSE OF TYPE B GASTRITIS, PEPTIC ULCER,
GASTRIC CARCINOMA
NON-FERMENTATIVE GRAM NEGATIVE BACILLI
Pseudomonas aeruginosa Agent of Blue Pus, ecthyma gangrenosum, swimmer’s ear, Jacuzzi
syndrome (necrotizing skin rash), lung infection in cystic fibrosis px
Pseudomonas fluorescens & putida Transfusion-associated septicemia (active at 4C)
Stenotrophomonas maltophilia Endocarditis (isolated in blood drawing equipment)
Buckholderia cepacia Pneumonia in px with cystic fibrosis
Buckholderia mallei Agent of glanders or farcy disease in horses or donkeys
Buckholderia pseudomallei Melioidosis or glanders-like disease
Oligella Distal urethra infection
Moraxella lacunata Agent of blepharoconjunctivitis or angular conjunctivitis
Chromobacterium Neutrophil deficiency of immunocompromised patients
SMALL, PLEOMORPHIC, GRAM NEGATIVE BACILLI
Haemophilus influenza MAIN CAUSE OF MENINGITIS IN CHILDREN
SECOND ETIOLOGIC AGENT OF OTITIS MEDIA
Haemophilus parahaemolyticus Pharyngitis
Haemophilus parainfluenzae Endocarditis
Haemophilus aegypticus Pink eye conjunctivitis
Aggregatibacter aphrophilus MOST COMMON HACEK THAT CAUSES ENDOCARDITIS
Aggregatibacter actinomycetacomitans Periodontitis
Kingella kingae Endocarditis, Osteoarthtritis < 3 years old
Brucella Spontaneous abortion, Malta/Crimean/Mediterrean/Undulent fever
(brucellosis)
Bordetella pertussis Whooping cough
Francisella tularensis Tularemia (deer fly / rabbit fever)
Pasteurella multocida Dog and cat bite infections
Legionella micdadae Pittsburg pneumonia agent
Legionella bozemanii WIGA agent
Legionella pneumophila Legionnaire’s disease or Pontiac fever
AEROBIC, GRAM POSITIVE BACILLI
Bacillus anthracis Anthrax
 Cutaneous anthrax
 Pulmonary (Woolsorter’s) anthrax
 GIT anthrax
Bacillus cereus Food poisoning (Diarrheal – from meat; Emetic – from improperly cooked rice)
Bacillus subtilis Eye infection among prohibited drug users
Corynebacterium diptheriae Respiratory diphtheria (pseudomembranous lining), cutaneous/skin
diphtheria (Veldt sore or Barcoo rot)
Corynebacterium jeikeium Diptheroid prosthetic valve endocarditis
Corynebacterium ulcerans Diptheria-like sore throat
Listeria monocytogenes Stillbirth or miscarriage
Erysipelothrix rhusiopathiae Endocarditis, erysipeloid (red-skin infection); predisposed individuals:
veterinarians & fish handlers
Nocardia brasilienses Actinomycetoma (Actinomycotic mycetoma) – sulfur granules present
Nocardia cyriacigeorgica & farcinica Pulmonary disease – no sulfur granules
Rhodococcus equi Slowly progressive, granulomatous pneumonia
Streptomyces somalinensis Agent of actinomycotic mycetoma
Actinomadura Eumycetoma (mycetoma pedis or Madura foot)
Tropheryma whipplei Whipple’s disease
MYCOBACTERIA (ACID FAST BACILLI)
Mycobacterium tuberculosis Pulmonary tuberculosis, Pott’s disease (skeletal TB), military tuberculosis
(extrapulmonary TB)
Mycobacterium avium MOST COMMON CAUSE OF PULMONARY INFECTION SIMILAR TO TB
Mycobacterium marinum Swimming pool granuloma
Mycobacterium ulcerans Buruli ulcer
Mycobacterium fortuitum Localized cutaneous or soft tissue infections
Mycobacterium leprae Leprosy (Hansen’s disease) – tuberculoid or lepromatous
ANAEROBIC BACTERIA
Clostridium perfringes Gas gangrene (myonecrosis), clostridia/necrotizing enteritis/enteritis
necroticans
Clostridium tetani Tetanus – trismus/lockjaw & risus sardonicus/distorted grin
Clostridium botulinum Botulism (Foodborne – toxin A; infant – honey/breastfeeding)
Clostridium difficile Pseudomembranous colitis
Bacteroides fragilis Intra-abdominal abscess
Actinomyces israelii MOST COMMON CAUSE OF ACTINOMYCOSIS
RICKETTSIACEAE AND RELATED ORGANISMS
SPOTTED FEVER GROUP
 Rickettsia conorii Bountonneuse fever or Mediterranean spotted fever
 Rickettsia rickettsi Rocky mountain spotted fever (RMSF)
TRANSITIONAL GROUP
 Rickettsia akari Rickettsialpox
 Rickettsia felis Flea-borne spotted fever
TYPHUS GROUP
 Rickettsia prowazekii Epidemic typhus / Brill-Zinsser disease
 Rickettsia typhi Endemic murine typhus
SCRUB TYPHUS GROUP
 Orientia tsutsugamushi Scrub typhus
ANAPLASMATACEAE
 Ehrlichia chaffeensis Human monocytic anaplasmosis
 Anaplasma phagocytophila Human granulocytic anaplasmosis
Coxiella burnetti Q fever
Bartonella quintana Trench fever
Bartonella henselae Cat scratch disease, Bacilliary angiomatosis
Bartonella bacilliformis Oroya fever and verruga peruana
CHLAMYDIACEAE
Chlamydia trachomatis Trachoma, Lymphogranuloma venerum (LGV), inclusion conjunctivitis
CELL WALL-DEFICIENT BACTERIA
Mycoplasma pneumonia Walking pneumonia / primary atypical pneumonia
SPIROCHETES AND MISC. BACTERIA
Treponema pallidum subsp. pallidum Syphilis
Treponema pallidum subsp. pertenue Yaws or frambesia tropica
Treponema pallidum subsp. Endemic non-venereal syphilis or bejel
endemicum
Treponema carateum Pinta or carate
Treponema denticola and Treponema Ulcerative gingivitis and chronic periodontitis
socranski
Borrelia recurrentis Agent of European/epidemic/louse-borne relapsing fever
Borrelia hermsii, turicatae, dutoni, Agent of American/endemic/tick-borne relapsing fever
parkeri
Borrelia burgdorferi, garinii, afzelii Lyme disease
Leptospira interrogans Leptospirosis or infectious jaundice (Icteric – Weil syndrome; Anicteric)
Streptobacillus moniliformis Rat bite fever / Haverhill fever
Spirillum minus Sodoku
Gardnerella vaginalis Vaginosis
 MISCELLANEOUS (ALDAVE)

 BACTERIAL MENINGITIS:  RAPID UREASE

 Newborn – S. agalactiae  Proteus
 1 month to 5 years old – H. influenza  Providencia
 5 to 29 years old – N. meningitides  Morganella
 > 29 years old – S. pneumoniae  Corynebacterium urealyticum
 All ages – L. monocytogenes
 LATE UREASE
 OTITIS MEDIA (ALDAVE)  Citrobacter freundii
 S. pneumonia  Klebsiella pneumoniae
 H. influenzae  Yersinia enterocolitica
 M. catarrhalis
 PYR(+)
 FOOD POISONING (ALDAVE)  S. pyogenes
 S. aureus – MOST COMMON  Grp D. Streptococci
 B.cereus  S. lugdunensis
 C. botulinum – MOST SEVERE  S. intermedius
 C. perfringes  S. urinalis
 L. monocytogenes - coleslaw
 DNAse(+)
 ESBL(+) ORGANISMS:  S. aureus
 Escherichia coli  S. marcescens
 Klebsiella pneumoniae  M. catarrhalis
 Klebsiella oxytoca  C. diptheriae
 S. maltophilia
 ANTIBIOTIC RESISTANT:  Aeromonas
 Citrobacter
 Enterobacter  LIPASE (+)
 Serratia  C. botulinum
 C. novyii
 CITRATE (+)  C. sporogenes
 Proteus-Providencia
 Enterobacter  LECINITHINASE (+)
 Citrobacter  B. cereus – aerobic
 Klebsiella  C. perfringes – anaerobic
 Arizona
 Salmonella enteritidis  H2S (+)
 Proteus
 PAD, Urease, LD+  Edwardsiella
 Proteus  Citrobacter
 Morganella  Salmonella
 Providencia  E. rhusiopathiae
 Shewanella putrefaciens
 CAMP (+)  INDOLE (+)
 S. agalactiae  Proteus-Providencia-Morganella
 L. monocytogenes  E.coli
 Rhodococcus  Edwardsiella
 Arcanobacterium  Citrobacter diversus
 C. perfringes w/ S. agalactiae  Shigella flexneri/boydii
 Serratia
 LDC (+)
 Klebsiella  ASSACHORYLTIC NEISSERIA:
 E. coli  N. elongata
 Enterobacter  N. flavescens
 Edwardsiella  N. weaver
 Serratia  N. cinerea
 Salmonella
 Arizona