BACTERIOLOGY

STAPHYLOCOCCUS AUREUS DISEASE ASSOCIATIONS

MNEMONIC:

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"SOF2T PAINS"
Staphylococcus aureus, a gram positive, coagulase positive
organism is known to be associated with the following
diseases:
✅ Skin infections
-scalded skin syndrome
-ritter's disease
-carbuncles
✅ Osteomyelitis ALL COCCI ARE GRAM POSITIVE; EXCEPT
-#1 causative agent esp in young adults
✅ Food poisoning "NEver MEind Bad VEibs MA"
✅ Folliculitis - NEisseria
✅ Toxic Shock Syndrome
-associated with tampon use, tampon photo below - MEgasphera
✅ Pneumonia
- Branhamella
✅ Acute endocarditis
✅ Infective arthritis - VEIlonella
✅ Necrotizing fasciitis
- Moraxella
✅ Sepsis
Staphylococcal enzymes such as hyaluronidase (aka Duran- - Acidaaminococcus
Reynal factor), protease and lipase facilitate the spread of
These are the GRAM NEGATIVE COCCI.
infection.
 BACTERIOLOGY

ENCAPSULATED ORGANISMS ❌Yersinia

"SPaNKS BaSH" ❌ SOME E.coli

- Salmonella typhi TRUE PATHOGENS in ENTEROBACTERIACEAE are "YeSS!"
- Pseudomonas aeruginosa ✅ Yersinia
- Neisseria meningitidis
✅ Shigella
- Klebsiella pneumoniae
✅ Salmonella
- Strep pneumoniae
; others are considered as commensal flora.
- Bacillus anthracis (D-glutamate)

- Strep agalactiae
HAEMOPHILUS DUCREYI QUICK NOTES
- Haemophilus influenzae
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✅ ADDITIONAL NOTES ABOUT BACTERIA WITH CAPSULE:

❌ mostly have slimy/mucoid looking colonies "school of red fish" appearance seen in direct exam of Haemophilus
❌ can resist phagocytosis ducreyi

H. ducreyi is also the causative agent of chancroid or painful soft

❌ may cause meningitis
chancre. This is a venereal infection or infection transmitted by
❌ immunoinvasion sexual intercourse.

Do not be confused about chancroid and chancre. Chancre or

painless hard chancre is caused by Treponema pallidum and is the
ALL from ENTEROBACTERIACEAE are MOTILITY (+), EXCEPT causative agent of the sexually transmitted disease syphilis (brought
"SKYE" by Christopher Columbus' crew from New world to Old World)
❌Shigella ORGANISMS THAT SHOW GREEN METALLIC SHEEN

❌Klebsiella E. coli. on EMB ; P. aeruginosa on BAP

 BACTERIOLOGY

SPIRAL ORGANISMS are GRAM (-)

YEAST are GRAM (+) Associated with ECTHYMA GANGRENOSUM: Pseudomonas
aeruginosa
SD, DS:
Brucella (undulant fever),
Scarlet fever= DICK'S Borrelia recurrentis (relapsing fever)
Diptheria = SCHICK

ZONE OF INHIBITION is INVERSELY PROPORTIONAL to the MIC

Leishmania tropiCa
METHYLENE BLUE, MALACHITE GREEN:
(CUTANEOUS leishmaniasis/Jericho boil);
Leishmania donoVani counterstains for ACID FAST STAINING
(VISCERAL leishmaniasis/kala-azar)
Streptococcus pneumoniae "lancet-shaped" cocci, aka Diplococcus
pneumoniae, causative of lobar pneumonia with RUST-BROWN
Group A STREP (S. pyogenes) is the agent of NECROTIZING sputum.
FASCIITIS TYPE 2;

Clostridium perfringens is the agent of NECROTIZING FASCIITIS

Streptococcus pneumoniae tests:
TYPE 3.
FRANCIS test & NEUFELD-QUELLUNG test

Corynebacterium diptheriae:
ERYTHEMA DISEASES
BABES-ERNST GRANULES,
✅ 1ST DISEASE: Measles (Rubeola)
Mycobacterium tuberculosis: ✅ 2ND DISEASE: Scarlet Fever (Streptococcus pyogenes)
✅ 3RD DISEASE: German Measles (Rubella)
MUCH'S GRANULES,
✅ 4TH DISEASE: Staphylococcus aureus (Filato-Duke's Disease)
Actinomyces: ✅ 5TH DISEASE: Parvovirus B19, Erythema Infectiosum (slapped
cheek)
SULFURE GRANULES
✅ 6TH DISEASE: Roseola Infantum (HSV 6)
 BACTERIOLOGY

CATALASE TEST BACILLUS

✅ General information:
- aerobic and facultative anaerobic
Principle: When exposed to catalase enzyme from microorganisms,
- gram positive BACILLI
hydrogen peroxide (3%) will breakdown and become oxygen and
- catalase POSITIVE
water. The positive result is rapid, bubbling
- SPORE FORMING
formation/effervescence/gas bubbles.
This test is useful in differentiating Staphylococcus spp./Microroccus Bacillus anthracis
spp. (CATALASE POSITIVE) and Streptococcus spp. (CATALASE - produces ENDOSPORES
NEGATIVE) - MEDUSA HEAD in 5% SBA (also ground-glass colonies/beaten egg
The photo below shows the test being done in two ways: 1. slide whites)
and 2. tube. - STRING OF PEARLS in MHA
In the slide method, a small amount of bacterial colony (<24 hours - described as looking like "BAMBOO RODS"
old) is placed on a clean, glass slide. 1-2 drops of 3% hydrogen - capsule is made of D-GLUTAMIC ACID
peroxide is added and a bubbling formation is observed. ✅ Disease associations:
In the tube method, 2-3 drops of 3% hydrogen peroxide is placed in - cutaneous anthrax causing BLACK ESCHAR
a clean tube where a small amount of bacterial colony is dipped and - gastrointestinal anthrax the MOST SEVERE
mixed. Formation of bubbles is also observed. - pulmonary anthrax also known as WOOLSORTER'S/RAGPICKER'S
REMEMBER: To avoid false (+) results, be careful not to SCRAPE disease
BLOOD AGAR while you collect colonies. Blood also reacts with - injectional anthrax among drug addicts because of re-using
hydrogen peroxide and will cause bubble formation even if the needles, associated with SKIN POPPING
bacteria is catalase negative. ✅ Laboratory:
Moreover, use PLASTIC inoculating needles/loops in collecting and SUSCEPTIBLE for PENICILLIN
mixing. Metal can also react with hydrogen peroxide and not only (+) STRING OF PEARLS TEST
cause a false positive reading but can also damage your metal (-) MOTILITY
instruments. (-) hemolysis
Bacillus cereus
- aka FRIED RICE BACILLUS
- colonies appear like FROSTED GLASS
- colonies are also described as FEATHERY/SPREADING BETA-
HEMOLYTIC COLONIES
✅ Disease associations:
- opportunistic food-borne infections especially from eating
contaminated MEAT, POULTRY, FRIED RICE/PASTA.
- causative agent of PROGRESSIVE ENDOPHTHALMITIS
 BACTERIOLOGY

✅ Laboratory: STAGE 1: PRIMARY SYPHILIS

RESISTANT TO PENICILLIN ✅ Characterized by the presence of a HARD, PAINLESS
(-) STRING OF PEARLS TEST CHANCRE that is full of live treponemes and is HIGHLY
(+) MOTILITY CONTAGIOUS.
(+) BETA-HEMOLYSIS ✅ Infection is LOCALIZED.
Bacillus subtilis ✅ Infection is more obvious in the male genitalia than
- known as HAY'S BACILLUS females.
- rods in chain with CENTRAL SPORE Other areas aside from the primary sexual organs include the
- MOST COMMON LABORATORY CONTAMINANT and BIOLOGIC tongue, throat, mouth and anal area.
INDICATOR Lab Dx:
- INDICATOR FOR ETHYLENE OXIDE STERILIZATION Dark field microscopy: spirochetes with characteristic
Geobacillus stearothermophilus "cork-screw" motility.
- AUTOCLAVE INDICATOR STAGE 2: SECONDARY SYPHILIS
-aka Clostridium PA3679 ✅ Occurs 2 to 8 weeks after the development of the hard
Bacillus pumilus chancre.
- BIOLOGIC INDICATOR FOR IONIZING RADIATION ✅ Characterized by general body rash and lesions.
/end.
✅ Lesions are called condylomata lata and are flat, moist, and
wart-like. Such lesions may be present within the perianal area,
mouth and buccal cavity and skin.
ALL ABOUT SYPHILIS These lesions are also potentially infectious.
Syphilis is a sexually transmitted disease caused by the ✅ Infection is SYSTEMIC.
spirochete Treponema pallidum. Lab Dx:
The disease is also known as the new world disease brought to Dark field microscopy: spirochetes with characteristic
the old world by Christopher Columbus. "cork-screw" motility.
Other names of the disease include: SEROLOGY (testing for ANTIBODIES)
"The Great Pox" LATENT SYPHILIS/LATENCY STAGE/HIDDEN STAGE.
"Evil Pox" ✅ May be experienced after a year or beyond the 2nd year of
"Spanish Disease untreated syphilis infection.
"Great Imitator" ✅ Rashes, lesions may heal and disappear and patients
"French Disease" undergo the hidden/latent period for 1 to 20 years.
"Lues Venerea"
Syphilis infection has 3 stages:
 BACTERIOLOGY

✅ Patient is asymptomatic but still a carrier of the disease and Uses heated/inactivated patient serum (heated at 56 degrees
may unknowingly transmit the disease to other people Celcius for 30 minutes).
through unsafe sexual intercourse, oral and anal sex. Antigen:
Lab Dx: - CARDIOLIPIN (for reactivity)
SEROLOGY (testing for ANTIBODIES) - CHOLESTEROL (to increase antigen size)
STAGE 3: TERTIARY SYPHILIS -LECITHIN (for standard reactivity)
✅ Very serious stage that occurs 10-30 years after the initial Antigen suspension (HAMILTON SYRINGE):
infection. 100 drops, using 23 gauge syringe (quantitative)
✅ Lesions called gummas are present. These are 60 drops, using 18 gauge syringe. (qualitative)
granulomatous lesions with central necrosis and are filled eith Mixture of patient serum and antigen is centrifuged at 180 rpm
dead treponemes. for 4 minutes and checked for flocculation MICROSCOPICALLY.
Gummas are typically painless and may spread around the ✅ 2.) RPR (Rapid Plasma Reagin) TEST
patient's body and may also penetrate the long bones. Uses antigen similar to VDRL but with the addition of:
Gummas present in the bones are highly painful. - CHARCOAL (for visibility)
✅ Cardiovascular defects may be a complication of tertiary - EDTA
syphilis. - THIMEROSAL (preservative)
✅ Neurosyphilis is also characteristic of tertiary syphilis - CHOLINE CHLORIDE (to stabilize antigen and inactivate it)
infection. Antigen amount: 60 drops
✅ Patient is not contagious but infection is serious and may Mixture is centrifuged at 100 rpm for 8 minutes and read
affect other organs. This stage is FATAL. MACROSCOPICALLY.
Lab Dx: TREPONEMAL TESTS (confirmatory tests)
CSF specimen may be used and may be the specimen of These are specific confirmatory tests that checks for
choice. TREPONEMAL ANTIBODIES against TREPONEMAL ANTIGENS.
SEROLOGIC TESTS (testing for ANTIBODIES) ✅ 1.) TREPONEMA IMMOBILIZATION TEST
-- Reference confirmatory test and uses live rabbit testicles.
SEROLOGIC TESTING FOR SYPHILIS (+): MORE THAN 50% treponemes are IMMOBILIZED.
NON-TREPONEMAL TESTS (screening tests) (-): LESS THAN 20% treponemes are IMMOBILIZED.
These are non-specific screening tests that determine the Doubtful: 20-50% immobilized.
presence of REAGIN antibodies against CARDIOLIPIN antigen. ✅ 2.) FLUORESCENT TREPONEMAL ANTIBODY ABSORPTION
✅ 1.) VDRL (Venereal Disease Research Laboratory) TEST (FTA-ABS) TEST
 BACTERIOLOGY

Uses the non-pathogenic Reiter treponeme strain as absorbent BACTERIOLOGY QUICK NOTES: follow me for more
to remove cross-reactive antibodies other than T. pallidum and #MedTechQuickNotes
the pathogenic Nichol's strain to bind to T. pallidum COLONY/GROWTH APPEARANCE/UNIQUE CHARACTERISTICS
antibodies. OF DIFFERENT BACTERIA
✅ 3.) OTHER INDIRECT HEMAGGLUTINATION TESTS:
- Treponema pallidum hemagglutination (TPHA)
- Microhemagluttination T. pallidum (MHA-TP) ✅Klebsiella spp. (large, pink, mucoid colonies on MAC)
- Hemagglutination treponemal test for syphilis (HATTS) ✅Actinomyces israelii (molar tooth colonies)
- Treponema pallidum particle agglutination (TPPA) ✅Yersinia enterocolitica & Aeromonas (bull's eye colonies on
/end. CIN)
✅Staphylococcus aureus (white, pin head colonies)
✅Streptococci (white, pin point colonies)
✅Bacillus anthracis (medusa head, ground glass appearance,
beaten egg whites on 5% SBA)
✅Erysipelothrix rhusiopathiae (brush-like appearance in
gelatin stab culture)
✅Rhodococcus equi (salmon pink pigment, CAMP +)
✅Cronobacter sakazakii (yellow pigment enhanced by 25
degrees C incubation)
✅Proteus spp. (swarming colonies on BAP, burnt
chocolate/chocolate cake smell)
✅Serratia spp. (red pigmentation due to prodigiosin)
✅Mycoplasma pneumoniae (fried egg colonies)
✅Yersinia pestis (cauliflower appearance at 48hours in SBA,
stalactite pattern in broth culture)
✅Pseudomonas aeruginosa (grape, rubber, corn-tortilla, taco
odor with spreading, serrated edges and bluish green metallic
sheen on BAP)
✅Burkholderia pseudomallei and cepacia (dirt, earth-like
"Ben 10" odor)
Hepatitis B is killed within 10 minutes using 10% bleach. ✅Eikenella corrodens (pits and corrodes the agar)
HIV is killed within 2 minutes.
 BACTERIOLOGY

✅Chromobacterium violaceum (almond/ammonium cyanide - Acute Post-streptococcal Glomerulonephritis in children

smell) - Scarlet fever (strawberry tongue)
✅Staphylococcus aureus (old socks/stockings smell) ⭕ Streptococcus agalactiae
✅Bordetella pertussis (small, shiny, mercury droplets-like - #1 cause of NEONATAL meningitis
colonies) ⭕ Streptococcus pneumoniae
✅Streptobacillus moniliformis (fluff balls or bread crumbs - lobar pneumonia with rusty, brown sputum
appearance in broth cultures) - #1 CAUSE of COMMUNITY-ACQUIRED PNEUMONIA in the
✅Clostridium difficile (horse stable, barn yard odor and Philippines
yellow, ground glass colonies in CCFA) - #1 cause of meningitis in ADULTS
** check my profile for more #medtechnotes - #1 MOST COMMON CAUSE of OTITIS MEDIA
⭕ Viridans streptococci
- MOST COMMON CAUSE of SUBACUTE BACTERIAL
SPECIFIC DISEASE ASSOCIATIONS OF DIFFERENT ENDOCARDITIS (SBE)
MICROORGANISMS ⭕ Neisseria gonorrhoeae
Try your best to memorize these, popular ang mga gantong - gonorrhea aka "the clap"
tanong sa exams - opthalmia neonatorum
⭕ Staphylococcus aureus - Fitz-Hugh Curtis syndrom
- Toxic Shock Syndrome (TSS) ⭕ Neisseria meningitidis
- Scalded Skin Syndrome (SSS)/Ritter disease - meninggococcemia
- Osteomyelitis/septic arthritis in children and young adults - Waterhouse-Friedrichsen Syndrome
- #1 cause of FOOD POISONING in the Philippines ⭕ Escherichia coli (5 serotypes)
- impetigo ✅ Enteropathogenic E. coli (EPEC) - infantile diarrhea
⭕ Staphylococcus epidermidis ✅ Enterotoxigenic E. coli (ETEC) - "traveler's diarrhea",
- MOST COMMON CAUSE of HOSPITAL-ACQUIRED urinary "montezuma revenge"
tract infection (UTI) ✅ Enteroinvasive E. coli (EIEC) - dysentery like Shigella
- prosthetic heart valve endocarditis infection
⭕ Staphylococcus saprophyticus ✅ Enterohemorrhagic E. coli (EHEC) - hemolytic uremic
- associated with urinary tract infection (UTI) among sexually syndrome (HUS)
active women ✅ Uropathogenic E. coli (UPEC) - MOST COMMON CAUSE of
- always significant UTI
⭕ Streptococcus pyogenes ⭕ Proteus spp.
 BACTERIOLOGY

- UTI with kidney stones/struvite - meningitis in children <5 years old

⭕ Salmonella typhi ⭕ Haemophilus biogroup aegyptus
- typhoid fever - pink eye conjunctivitis
⭕ Shigella spp. - Brazilian Purpuric Fever
- dysentery ⭕ Haemophilus ducreyi
⭕ Shigella flexneri - painful, soft chancre
- "gay bowel syndrome" ⭕ Pasteurella multocida
⭕ Klebsiella granulomatis/Calymmatobacterium granulomatis - animal "shipping fever"
- donovanosis - cat scratch abrasions
⭕ Yersinia pestis ⭕ Brucella melitensis
- the plague, bubonic, glandular and pneumonic plague - brucellosis aka "Mediterranean fever", "Malta", "Gibraltar"
⭕ Yersinia entercolitica fever, Bang's disease, undulant fever
- mesenteric lymphadenitis aka "pseudoappendicitis" ⭕ Francisella tularensis
- erythema nedosum - tularemia
⭕ Vibrio cholerae O1 - "Deerfly fever"
- cholera, "rice water" stool diarrhea ⭕ Legionella spp.
⭕ Vibrio parahaemolyticus - Legionnaire's disease
- "summer diarrhea" - Pontiac fever
⭕ Campylobacter jejuni ⭕ Bordetella pertussis
- MOST COMMON CAUSE of BACTERIAL GASTROENTERITIS - whooping cough/pertussis
WORLDWIDE These are IMPORTANT, try your best to MEMORIZE by
⭕ Helicobacter pylori HEART
- MAJOR CAUSE of TYPE B GASTRITIS /end.
⭕ Pseudomonas aeruginosa
- bacteremia with echthyma gangrenosum
- "Jacuzzi tub", "hot tub", "businessman" syndrome DIPHTHERIA
- causative agent of blue puss
⭕ Burkholderia pseudomallei (follow me for more#MedTechQuickNotes)
- meliodosis aka Vietnamese Time Bomb Corynebacterium diphtheriae is the causative agent of
⭕ Haemophilus influenzae diphtheria. This is a gram positive bacilli.
- epiglotittis in children Thanks to science and vaccines, this disease is not as common
anymore!
 BACTERIOLOGY

NOTES ABOUT C. DIPHTHERIAE: b.) Elek's Plate Test (in-vitro, DEFINITIVE TEST, (+) is
- aka Kleb-Löffler's Bacillus/Bull's Neck Bacillus precipitation)
- most common site of infection is the TONSIL/PHARYNX, - vaccine is DPT (diphtheria, pertussis & tetanus) vaccine
pseudomembrane formation may cause suffocation, choking injected at the gluteus area
and death (see photo below) - treatment is DIPHTHERIA ANTITOXIN produced in horses
2 forms of DIPHTHERIA: ** check my profile for more #medtechnotes
a.) Respiratory: pseudomembrane
b.) Cutaneous: non-healing ulcers
- often CAUSE OF DEATH by diphtheria is CARDIAC FAILURE BACTERIAL MENINGITIS CAUSATIVE AGENTS ACCORDING TO
(toxin is absorbed and produces systemic effects involving DIFFERENT AGE GROUPS
multiple organs causing organ failure)
Neonates: S. AGAlactiae = "masyadong ma-AGA, baby pa sya"
- appearance in gram stain described as "chinese characters",
"palisade", "L and V forms" (see photo below) Children <5y/o: H.influenzae = madaling ma-INFLUENZ ang mga
- shows pleomorphism: irregular staining with beaded "club- bata
shaped" appearance (see photo below)
- Babe's Ernst Granules/Volutin Granules: metachromatic Adolescent: N.MENingitis = nagiging MEN & woMEN
granules that are accumulated nutrient reserves
- other laboratory tests for C. diphtheriae:
CATALASE (+) Geriatrics: S.PNEUmoniae = matandan'y madaling maPNEUMONIA
GRAM (+) BACILLI Immuno compromised px: L.MONOcytogenes =
NON-MOTILE imMONOcompromised
DNAse (+)
- culture media:
Loeffler's serum slant 1st S.agalactiae
Tinsdale agar (black colonies with brown halo)
Potassium tellurite (gray-back colonies) 2nd E.coli
CT-BAP (gun metal gray colonies)
3rd H. influenzae
- Virulence tests (confirmatory tests for the toxin and final dx
of Diphtheria):
a.) Guinea Pig Lethality Test (in-vivo)