Gram Positive Bacilli Flashcards by Richhpal Singh

All bacilli are gram Negative except

MAC DONALD
M - Mycobacterium
A - Anthracis Bacillus
C- Clostridium species
D - Corynebacterium diphtheria
N - Nocardia
A - Actinomyces
L - Listeria
D - Diphtheroids

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Corynebacterium is also known as

Kleb Loeffler’s Bacillus

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Features of Corynebacterium

Gram Positive
Non motile
Non sporing
Non capsulated

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Types of Corynebacterium

C. Diphtheria
Others - C. Ulcerans, C. Pseudotuberculosis, C. Minitissimum

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Corynebacterium Pseudotuberculosis is also known as

Preisz Nocard Bacillus

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Characteristic clinical features of Corynebacterium Minitissimum

Erythrasma - Red Rash around axilla, groins

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Erythrasma caused by C. Minitissimum finding under woodlamp examination

Coral red Fluorescence due to Coproporphyrin iii

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Liphophilic Corynebacterium can be divided into

C. Jeikeium
C. Urealyticum

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C. Jeikeium can cause

Prosthetic valve endocarditis
Immunocompromised pt

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C. Urealyticum is associated with which stone

Struvite stone

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Diphtheria toxin is produced by

DUP
Diphtheria
Ulcerans
Pseudotuberculosis

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Diphtheria toxin is associated with which gene

TOX gene

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Examples of Phage mediated Toxins

ABCDE
A and C - Strep Pyogenes
Botulinum toxin
Cholera toxin
Diphtheria toxin
EHEColi

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Virulent factors of Diphtheria toxin

Fragment A - ADP phosphorylation of EF2 - Decrease protein synthesis
Fragment B - bind to cells

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Strain of Diphtheria toxin used for vaccine

Park William 8 Strain

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Examples of Toxin decreasing Protein Synthesis

Decreasing Protein Synthesis
DT
Exotoxin A of Pseudomonas
Shiga toxin
Verocytotoxin (Shiga like toxin)

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Diphtheria toxin And Exotoxin A decreases protein synthesis by

Inhibiting ADP phosphorylation of EF2

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Shiga toxin and Shiga like toxin Decreases protein synthesis by

Cleaving 60S ribosomes

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Incubation period of C. Diphtheria infection

3-4 days

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Forms of Diphtheria infection

Respiratory/Faucial diphtheria
Cutaneous diphtheria
Systemic diphtheria

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Respiratory/Faucial form of Diphtheria is associated with

Pseudomembrane
Bull’s neck

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Complications of Diphtheria infection

Myocarditis (7-10th day ) - MC cause of death
Neurological - Oculomotor paralysis
Hemorrhagic - Thrombocytopenia

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Sample for C. Diphtheria infection is taken from

2 swabs under the membrane

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Microscopic Finding of C. Diphtheria

Chinese letter/Cuneiform appearance
Snapping division

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Volutin Granules can be seen in

Corynebacterium diphtheria Yersinia pestis M Tb Gardenella Spirillum

Volutin Granules are also termed as

Bipolar granules or Metachromatic granules or Babes ernst granules

Stains used for Volutin Granules

PLAN Ponders stain Loeffler Methylene Blue Albert stain Neissers Stain

Enriched media used for C. Diphtheria

Loeffler serum slope - 6-8 hrs

Selective media used for diagnosis of C. Diphtheria

Macleod/Hoyes/Tinsdale Medium PTA (Potassium tellurite Agar) - Best media for Growth

Potassium tellurite Agar takes how much time to grow and shows which color colonies

Takes 48 hours Black colonies

Test done to know toxigenicity diphtheria toxin

Eleks Gel precipitation test

Schick test is done to know

Susceptibility of person SPIN Positive Shick test -; Susceptible Negative Shick test - immune

Dosage of Diphtheria antitoxin in case of Nasopharyngeal disease

40,000 to 80,000 Im/ov

Diphtheria antitoxin dose for extensive disease

80,000 to 1,20,000 im/iv

Antibiotics used for Diphtheria infection

Penicillin or Azithromycin

Difference between DTaP and TdaP vaccine

DTaP - Higher dose of Diphtheria toxin Given to children less than 7 years TdaP - Lower dose of DT Given to >7 years of age

Biotyping of Corynebacterium is done on basis of

Potassium tellurite agar

Biotyping of Corynebacterium based on PTA includes

C. Gravis C. Intermedius C. mitis GIM - Head Egg Egg

C. Gravis shows

Daisy head colonies Starch fermentation

C. Intermedius shows

Frog egg appearance Non Hemolytic

C. Mitis shows

Poached egg appearance Least virulent

Gram Positive Filamentous Bacteria includes

Nocardia Actinomyces

Characteristic features of Nocardia

Nocardia = Nature Strict aerobe(O2) Soil (exogenous) 1% acid fast (acid rain)

Characteristic features of Actinomyces

Strict Anaerobes Found in mouth (Endogenous flora) Non acid fast

Culture method of Nocardia

Paraffin Bait Technique

Clinical features caused by Nocardia

In immunocompetent - Cutaneous Immunocompromised - Pulmonary manifestation (MC) M/C extrapulmonary - Brain

Treatment of Nocardia infection

Sulphonamides

Colonies shown by Actinomyces on Solid media

Spider/molar tooth colonies

Colonies shown by Actinomyces on Liquid media

Fluffy ball

Clinical features of Actinomyces infection

Orocervical (M/C) - Lumpy jaw, Swelling of jaw, Multiple sinus discharges Thoracic Abdominal - following surgery Pelvic - IUCD use

Treatment of Actinomyces Infection

Penicillin

Nocardia and Actinomyces known to cause which phenomenon

Spleudore Hoepplei phenomenon

Combination of Nocardia and Actinomyces causes

Actinomycetoma

Which Actinomyces species can be acid fast sometimes

Actinomyces Israelli

Actinomyces shows which granules on Israel yellow sand

Yellow sulphur granules

Virulence factor of Listeria monocytogenes

Listeriolysin O

Motility shown by Listeria monocytogenes

Tumbling motility - motile @22°C, non motile at 37°C

Mnemonic for Listeria monocytogenes

ABCDEFG A- Anton test B - Beta hemolysis (Listeriolysin O) C - contact, Contaminated food, cheese (Dairy), Cold enrichment, CAMP +ve, Catalase +ve D - Diarrhea E - Flagella (Peritrichous) , Females, pregnancy, neonates (sepsis) G - Granulomatous Infanti septicum

Clinical features of Listeria monocytogenes

Gasteroenteritis Pregnant females - Abortion/still birth Early neonatal period - Sepsis Late neonatal period - Meningitis Granulomatous Infanti septicum

Specimen taken for Listeria monocytogenes diagnosis

Cervical/vaginal Meconium/cord blood CSF

Anton test is positive in

Listeria monocytogenes Animal (Rabbit eye) - On injecting listeria - cause Keratoconjunctivitis

CAMP test and Catalase in Listeria monocytogenes

Positive

Examples of Spore forming Bacteria

Bacillus Clostridium

All bacillus are motile, unencapsulated and Hemolytic except

Bacillus anthracis

Bacillus family includes

B. Stearothermophilus - Autoclave, Plasma sterilization B. Subtilis - Hot air oven B. Pumilus - Radiation B. Globigri - Gas sterilization

First pathogenic bacteria seen under Microscope

B. Anthracis

First pathogenic bacteria having live attenuated vaccine

B. Anthracis

First pathogenic bacteria isolated in pure culture

B. Anthracis

Virulence factors of B. Anthracis

Capsule - Polypeptide made of Polyglutamate - PxO2 plasmid Anthrax toxin - PxO2 plasmid

Why anthrax toxin is called Tripartite

EPL 3 Factors E - Edema factor - increases cAMP P - Protective Factor - attachment L - Lethal factor - Death

Ways to spread Bacillus anthracis

Cutaneous (M/C) Inhalational Ingestion

Clinical features of Cutaneous anthrax

Hide Porter's disease - Malignant Eschar (Black)

Clinical features of Pulmonary anthrax

Wool sorter's disease Results in hemorrhagic mediastinitis Pericarditis Septicemia Associated with Bioterrorism

Clinical features of Intestinal anthrax

Undercooked meat Hemorrhagic enteritis

Complications of Anthrax

CSF/Meningitis/Meningoencephalitis Hemorrhagic CSF

Microscopic Finding of Bacillus anthracis

Bamboo stick appearance or Box car appearance

Demonstration of Capsule is done in case Bacillus anthrax infection

Mc Fadyeans Reaction - Smear+ Polychrome Methylene blue - Purple color around capsule

Culture findings in Bacillus anthracis infection

Forsted glass @edge of colony - Medussa head appearance Comet tail Beaten egg

B. anthracis is susceptible to penicillin and incubation on medium containing low levels of penicillin causes the bacterium to

swell and form a chain of cells that resemble a String of pearls

Bacillus Anthrax on Gelatin liquifaction

Shows Inverted Fir tree appearance

Selective media used for diagnosis of Bacillus anthrax

PLED (Polymxin lysosome EDTA thallous acetate)

Serology exams for Bacillus anthrax infection

Ascoli's ring therompercipitin ELISA

Duckering means

Disinfection of wool by 2% Formaldehyde at 30-40°C for 20 min

According to CDC, when to give presumptive diagnosis of Anthrax

Any gram +ve bacillus, non motile, non Hemolytic, Catalse +ve

Which vaccine is given to vets/occupational exposure against Bacillus anthrax

AVA biothrax

Vaccines given to animals against Bacillus anthrax

PSM Pasteurs anthrax vaccine Sterne vaccine Mazzucchi vaccine

Treatment of Uncomplicated Cutaneous anthrax

Ciprofloxacin or Doxycycline (7 to 10day)

Treatment of Sytemic anthrax

Ciprofloxacin or Doxycycline Add Antoxin (Raxibacumab) In case of Anthrax meningitis - 60 Days antibiotics (Ciprofloxacin+ Meropenem + Clindamycin)

Post exposure prophylaxis for System anthrax

AVA Biothrax+ 60 days antibiotics

Bacillus cereus habitat

Soil

Bacillus cereus causes

Food poisioning

Types of Food poisoning caused by Bacillus cereus

Emetic type Diarrheal type

Incubation period of Emetic type and Diarrheal type

Emetic - 1 to 5 hours Diarrheal - 8 to 16 hrs

Food responsible for Emetic type and Diarrheal type of Bacillus cereus infection

Emetic - Chinese fried rice Diarrheal - Meat and milk

Which one is heat stable - Emetic type or diarrheal type

Emetic type

Mechanism of action of Emetic type Bacillus cereus

Increases cGMP - Vagomimetic action

Mechanism of action of diarrheal type of Bacillus cereus infection

Increases cAMP Nhe toxin - Secretory diarrhea

Features of Bacillus cereus

Motile Hemolytic Non encapsulated

Selective media used for bacillus cereus

MYPA (Mannitol, Yolky, Polymyxin Agar) PEMBA ( Polymyxin, Mannitol, Bromothymol blue Agar)

Gram Positive Bacilli Flashcards

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