Clinically most important human pathogenic bacteria genuses and species
| Genus | Important species | Gram staining | Shape | Capsulation | Bonding tendency | Motility | Respiration | Growth medium | Intra/Extracellular |
|---|
| Bordetella |
| Gram-negative | Small coccobacilli | Encapsulated | singly or in pairs | | aerobic | Regan-Lowe agar | extracellular |
| Borrelia | Borrelia burgdorferi | Gram-negative, but stains poorly | | | Long, slender, flexible, spiral- or corkscrew-shaped rods | highly motile | (difficult to culture) | extracellular |
| Brucella | Brucella abortus Brucella canis Brucella melitensis Brucella suis | Gram-negative | Small coccobacilli | Unencapsulated | singly or in pairs | | aerobic | Blood agar | intracellular |
| Campylobacter | Campylobacter jejuni | Gram-negative | Curved, spiral, or S-shaped with single, polar flagellum | | | characteristic darting motion | microaerophilic | Blood agar inhibiting other fecal flora | extracellular |
| Chlamydia | Chlamydia pneumoniae Chlamydia psittaci Chlamydia trachomatis | (not Gram-stained) | Small, round, ovoid | | | | motile | Facultative or strictly aerobic | Obligate intracellular |
| Clostridium | Clostridium botulinumClostridium difficile Clostridium perfringensClostridium tetani | Gram-positive | Large, blunt-ended rods | | mostly motile | Obligate aerobic | Anaerobic blood agar | extracellular |
| Corynebacterium | Corynebacterium diphtheriae | Gram-positive (unevenly) | Small, slender, pleomorphic rods | unencapsulated | clumps looking lika Chinese characters or a picket fence | nonmotile | Mostly facultative anaerobic | Aerobically on Tinsdale agar | extracellular |
| Enterococcus | Enterococcus faecalis Enterococcus faecum | Gram-positive | Round to ovoid | | pairs or chains | | 6.5% NaCl, bile-esculin agar | extracellular |
| Escherichia | Escherichia coli | Gram-negative | Short rods | | | | Facultative anaerobic | MacConkey agar | extracellular |
| Francisella | Francisella tularensis | Gram-negative | Small, pleomorphic coccobacillus | | | | strictly aerobic | (rarely cultured) | Facultative intracellular |
| Haemophilus | Haemophilus influenzae | Gram-negative | Ranging from small coccobacillus to long, slender filaments | | | | | Chocolate agar with hemin and NAD+ | extracellular |
| Helicobacter | Helicobacter pylori | Gram-negative | Curved or spiral rods pultiple polar flagella | | | rapid, corkscrew motility | | Medium containing antibiotics against other fecal flora | extracellular |
| Legionella | Legionella pneumophila | Gram-negative, but stains poorly | Slender rod in nature, cocobacillary in laboratory. monotrichious flagella | unencapsulated | | motile | | Specialized medium | facultative intracellular |
| Leptospira | Leptospira interrogans | Gram-negative, but stains poorly | Long, very slender, flexible, spiral- or corkscrew-shaped rods | | | highly motile | | Specialized medium | extracellular |
| Listeria | Listeria monocytogenes | Gram-positive, darkly | Slender, short rods | | diplobacilli or short chains | Distinct tumbling motility in liquid medium | | enriched medium | intracellular |
| Mycobacterium | Mycobacterium leprae Mycobacterium tuberculosis | (none) | Long, slender rods | | | nonmotile | aerobic | M. tuberculosis: Lowenstein-Jensen agar M. leprae: (none) | extracellular |
| Mycoplasma | Mycoplasma pneumoniae | (none) | Plastic, pleomorphic | | singly or in pairs | | | (rarely cultured) | extracellular |
| Neisseria | Neisseria gonorrhoeae Neisseria meningitidis | Gram-negative | Kidney bean-shaped | | diplococci | | aerobic | Thayer-Martin agar | Gonococcus: facultative intracellular N. meningitidis: extracellular |
| Pseudomonas | Pseudomonas aeruginosa | Gram-negative | rods | encapsulated | | motile | Obligate aerobic | MacConkey agar | extracellular |
| Rickettsia | Rickettsia rickettsii | Gram-negative, but stains poorly | Small, rod-like coccobacillary | | | | | (rarely cultured) | Obligate intracellular |
| Salmonella | Salmonella typhi Salmonella typhimurium | Gram-negative | | | | | Facultative anaerobic | MacConkey agar | acellular |
| Shigella | Shigella sonnei | Gram-negative | rods | | | | Facultative anaerobic | Hektoen agar | extracellular |
| Staphylococcus | Staphylococcus aureusStaphylococcus epidermidisStaphylococcus saprophyticus | Gram-positive, darkly | Round cocci | | in bunches like grapes | | Facultative anaerobic | enriched medium (broth and/or blood) | extracellular |
| Streptococcus | Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes | Gram-positive | ovoid to spherical | | pairs or chains | nonmotile | Facultative anaerobic | blood agar | extracellular |
| Treponema | Treponema pallidum | Gram-negative, but stains poorly | Long, slender, flexible, spiral- or corkscrew-shaped rods | | | highly motile | | none | extracellular |
| Vibrio | Vibrio cholerae | Gram-negative | Short, curved, rod-shaped with single polar flagellum | | | rapidly motile | Facultative anaerobic | blood- or MacConkey agar. Stimulated by NaCl | extracellular |
| Yersinia | Yersinia pestis | Gram-negative, stains bipolarly | Small rods | encapsulated | | nonmotile | | MacConkey or CIN agar | extracellular |
|
Species of human pathogenic bacteria
| Species | Transmission | Diseases | Treatment | Prevention | laboratory diagnosis |
|---|
| Bacillus anthracis |
- Contact with sheep, goats and horses
- Inhalation or skin penetration through abrasions of spor-contaminated dust
| Cutaneous anthraxPulmonary anthraxGastrointestinal anthrax | In early infection:PenicillinDoxycyclineCiprofloxacin | Anthrax vaccineautoclaving of instruments | Large, grayish, nonhemolytic colonies with irregular borders on blood agar Direct immunofluorescence |
| Bordetella pertussis | Contact with respiratory droplets expelled by infected human hosts. | Whooping cough
Complications:
| Macrolide antibioticsAzithromycinErythromycinClarithromycin | Pertussis vaccine, DTP | Direct immunofluorescencePCR amplification |
| Borrelia burgdorferi | Ixodes ticks reservoir in deer, mice and other rodents | Lyme disease | Early stages:If arthritic symptoms have appeared:- Longer courses of antibiotics
| Lyme vaccinewearing clothing that limits skin exposure to ticksinsect repellent | Microscopy using Giemsa or Wright stainPCRserology (low precision rate) |
| Brucella abortus Brucella canis Brucella melitensis Brucella suis | Direct contact with infected animal Oral, by ingestion of unpasteurized milk or milk products | Brucellosis | Combination therapy of: doxycycline streptomycin or gentamicin | - | Culture (difficult and time consuming) Agglutination serology |
| Campylobacter jejuni | Fecal/oral from animals (mammals and fowl) Contaminated meat (especially poultry) Contaminated water | Acute enteritis | Symptomatically by fluid and electrolyte replacement Ciprofloxacin in severe cases | No available vaccine Good hygiene Avoiding contaminated water Pasteurizing milk and milk products Cooking meat (especially poultry) | Finding campylobacter in feces |
| Chlamydia pneumoniae | Respiratory droplets | Community-acquired respiratory infection | DoxycyclineErythromycin | None | None for routine use |
| Chlamydia psittaci | Inhalation of dust with secretions or feces from birds (e.g. parrots) | Psittacosis | Tetracycline Doxycycline Erythromycin (less efficient) | - | Rise in antibody titer- Complement fixation
- indirect immunofluorescence
|
| Chlamydia trachomatis | Sexual (NGU, LGV)Direct or contaminated surfaces and flies (trachoma)Passage through birth canal (ICN) | Nongonococcal urethritis (NGU)TrachomaInclusion conjunctivitis of the newborn (ICN)Lymphogranuloma venereum (LGV) | AzithromycinErythromycinTetracyclines | No vaccineErythromycin or silver nitrate in newborn's eyesSafe sex | Cellular cytoplasmic inclusions by immunofluorescenceDNA hybridizationELISA for lipopolysaccharides |
| Clostridium botulinum | Spores from soil and aquatic sediments contaminating vegetables, meat and fish | Botulism | Antitoxin (horse antiserum) | Proper food preservation techniques | Mouse inoculation detects toxin from food, intestinal contents or serum Culture in standard aerobic culture |
| Clostridium difficile | Spores both indoors and outdoorsHuman flora, overgrowing when other flora is depleted | Pseudomembranous colitis | Discontinuing predisposing antibioticFluid and electrolyte replacementVancomycin or metronidazole if severe | None | ELISA for Toxin ELISA for toxin A or BEndoscopy for pseudomembrane |
| Clostridium perfringens | Spores in soilHuman flora in vagina and GI tract | Gas gangreneAcute food poisoningAnaerobic cellulitis | Gas gangrene:Debridement or amputationHyperbaric medicineHigh doses of penicillin G or doxycycline
Food poisoning:
- Self-limiting; Supportive care is sufficient
| Appropriate food handling | MicroscopicallyBlood agar culture, forming double-zone ß-hemolysisSugar fermentationOrganic acid production |
| Clostridium tetani | Spores in soil infecting puncture wounds, severe burns or surgery | Tetanus | Tetanus immune globulinHorse antitoxin, alternativelySedativesMuscle relaxantsMechanical ventilation | DPT vaccine | (difficult) |
| Corynebacterium diphtheriae | Respiratory dropletsPart of human flora | Diphtheria | Horse serum antitoxinErythromycinPenicillin | DPT vaccine | (no rapid)Culture on Tinsdale agar, followed by immunologic precipitin reaction |
| Enterococcus faecalis and Enterococcus faecum | Part of human flora, opportunistic or entering through GI tract or urinary system wounds | Nosocomial infections | Penicillin and an aminoglycosideVancomycinQuinupristin and dalfopristin | No vaccine Hand washing and other nosocomial prevention | Culture in 6.5% NaClCan hydrolyze esculin in presence of bile |
| Escherichia coli (generally) | Part of gut flora, spreading extraintestinally or proliferating in the GI tract | Urinary tract infections (UTI)DiarrheaMeningitis in infants | UTI:
(resistance-tests are required first)
Meningitis:
Diarrhea:
- Antibiotics above shorten duration
- Electrolyte and fluid replacement
| (no vaccine or preventive drug)Food and water preparation- Cooking ground beef and pasteurizing milk against O157:H7
Hand washing and disinfection | Culture on MacConkey agar and study carbohydrate fermentation patterns:- Lactose fermentation (most E. coli strains)
- Gas production in glucose fermentation
- Mannitol fermentation
|
| Enterotoxigenic Escherichia coli (ETEC) | Fecal-oral through food and waterDirect physical contact | Traveller's diarrhea |
| Enteropathogenic E. coli | Vertical, in utero or at birth | Diarrhea in infants |
| E. coli O157:H7 | Reservoir in cattle | Hemorrhagic colitis Hemolytic-uremic syndrome |
| Francisella tularensis | vector-borne by anthropodsInfected wild or domestic animals, birds or house pets | Tularemia | StreptomycinGentamicin | Avoiding insect vectorsPrecautions when handling wild animals or animal products | (rarely cultured)Serology |
| Haemophilus influenzae | Droplet contactHuman flora of e.g. upper respiratory tract | Bacterial meningitisUpper respiratory tract infectionsPneumonia, bronchitis | Meningitis:
(resistance-tests are required first)
| Hib vaccine to infantsRifampin prophylactically | Culture on chocolate agar with hemin (factor X) and NAD+ (factor V)Quellung reactionImmunofluorescence staining of capsuleDetection of capsular antigen in CSF or other body fluids |
| Helicobacter pylori | Colonizing stomachUnclear person-to-person transmission | Peptic ulcerRisk factor for gastric carcinoma and gastric B-cell lymphoma | Tetracycline, metronidazole and bismuth salt combination | (No vaccine or preventive drug) | MicroscopicallyUrease-positivity by radioactively labeled ureaSerology by ELISA |
| Legionella pneumophila | Droplet contact, from e.g. cooling towers, humidifiers, air conditioners and water distribution systems | Legionnaire's DiseasePontiac fever | Macrolides, e.g. erythromycin or azithromycinFluoroquinolones | (no vaccine or preventive drug)
Heating water |
- Culture from respiratory secretions on buffered charcoal yeast extract enriched with L-cysteine, iron and a-ketoglutarate
- Serology, including direct immunofluorescence and radioimmunoassay for antigen in urine
- Hybridization to ribosomal RNA using DNA probe
|
| Leptospira interrogans | Food and water contaminated by e.g. urine from wild or domestic animals. Leptospira survives for weeks in stagnant water. | Leptospirosis | Penicillin GTetracycline, e.g. doxyxycline | (no vaccine)Doxycycline
Prevention of exposure
| Dark-field microscopy on fresh blood smear (but doesn't stain well)Serologic agglutionation tests |
| Listeria monocytogenes | Dairy products, ground meats, poultryVertical to newborn or fetus | Listeriosis | AmpicillinCo-trimoxazole | (no vaccine)Proper food preparation and handling | Isolation from e.g. blood and CSFBeta-hemolysis and catalase production on blood agarMicroschopy for morphology and motility |
| Mycobacterium leprae | Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person | Leprosy (Hansen's disease) | Tuberculoid form:Dapsone and rifampin
Lepromatous form:
| BCG vaccine shows some effects | Tuberculoid form:
- Hard to isolate (diagnosis on clinical findings and histology of biopsies)
Lepromatous form:
|
| Mycobacterium tuberculosis | Droplet contact | Tuberculosis | Isoniazid, ethambutol, streptomycin, and/or pyrazinamide combination | BCG vaccineIsoniazid | Ziehl-Neelsen stain showing acid-fast bacteriaHybridization probes for DNA, succeeded by PCRCulture on Lowenstein-Jensen agar |
| Mycoplasma pneumoniae | Human floraDroplet contact | Mycoplasma pneumonia | Doxycycline and erythromycin | | (difficult to culture)Serologic tests, e.g. complement fixation testDNA probes on sputum specimens |
| Neisseria gonorrhoeae | Sexually transmittedvertical in birth | GonorrheaOphthalmia neonatorumSeptic arthritis | Uncomplicated gonorrhea:CeftriaxoneTetracycline, e.g. doxycycline if also chlamydia is suspectedSpectinomycin for resistance or patient allergy to cephalosporin
Ophthalmia neonatorum:
| (No vaccine)Safe sexTetracycline or erythromycin into eyes of newborn at risk | Gram-negative diplococci in neutrophils from urethral exudatesOxidase test on culture on Thayer-Martin agar under increased oxygen tensionFermentation of glucose but not maltose |
| Neisseria meningitidis | Respiratory droplets | Meningococcal disease including meningitisWaterhouse-Friderichsen syndrome | Penicillin GCefotaximeCeftriaxone | NmVac4-A/C/Y/W-135 vaccineRifampin | Microscopy showing gram-negative diplococci, often with PMNsCulture on chocolate agar, giving positive oxidase test and fermentation of glucose and maltose in 5% CO2 in air |
| Pseudomonas aeruginosa | Infects damaged tissues or people with reduced immunity. | Pseudomonas infection
Localized to eye, ear, skin, urinary, respiratory or gastrointestinal tract or CNS, or systemic with bacteremia, secondary pneumonia bone and joint infections, endocarditis, skin, soft tissue or CNS infections. |
| (no vaccine)Topical silver sulfadiazine for burn wounds | Colourless colonies on MacConkey agar.Production of pyocyanine and fluoresceinPositive oxidase test. No lactose fermentation. |
| Rickettsia rickettsii | Bite of infected wood or dog tick | Rocky mountain spotted fever | DoxycyclineChloramphenicol | (no preventive drug or approved vaccine)Vector control, such as clothingPrompt removal of attached ticks | SerologyImmunofluorescence against Rickettsia antigens |
| Salmonella typhi | Human-humanFecal-oral through food or water | Typhoid fever type salmonellosis (dysentery, colitis) | CeftriaxoneFluoroquinolones, e.g. ciprofloxacin | Ty21a and ViCPS vaccinesHygiene and food preparation | Isolation from blood, feces, bone marrow, urine or rose spots on skinColorless, non-lactose fermenting colonies on MacConkey agarSerology for antibodies against O antigen |
| Salmonella typhimurium | Fecal-oralFood contaminated by fowl (e.g. eggs), pets and other animals | Salmonellosis with gastroenteritis and enterocolitis | Fluid and electrolyte replacement for severe diarrheaAntibiotics (in immunocompromised to prevent systemic spread) | (No vaccine or preventive drug)Proper sewage disposalFood preparationGood personal hygiene | Colourless colonies on MacConkey agar |
| Shigella sonnei | Fecal-oralFliesContaminated food or water | Bacillary dysentery/Shigellosis | Ciprofloxacin or azithromycin | Protection of water and food suppliesVaccines are in trial stage | Culture on Hektoen agar or other media for intestinal pathogens |
| Staphylococcus aureus | Human flora on mucosae in e.g. anterior nares and vagina, entering through wound | Coagulase-positive staphylococcal infections:Localized skin infectionsDiffuse skin infection (Impetigo)Deep, localized infectionsAcute infective endocarditisSepticemiaNecrotizing pneumoniaToxinoses | Incision and drainage of localized lesionsNafcillin and oxacillinVancomycin for Methicillin-resistant (MRSA) | (no vaccine or preventive drug)Barrier precautions, washing hands and fomite disinfection in hospitals | Microscopy showing strongly positive Gram stained cells in grape-like clustersPositive Catalase test and coagulase testCulture on enriched media producing deep yellow, hemolytic colonies |
| Staphylococcus epidermidis | Human flora in skin and anterior nares | Infections of implanted prostheses, e.g. heart valves and catheters | Vancomycin | None | Microscopy showing strongly positive Gram stained cells in grape-like clustersPositive Catalase test but negative coagulase testNovobiocin-sensitivity (S. epidermidis)Novobiocin-resistance (S. saprophyticus)Culture on enriched media producing white, nonhemolytic colonies |
| Staphylococcus saprophyticus | Part of normal vaginal flora | Cystitis in women | Penicillin G | None |
| Streptococcus agalactiae | Human flora in vagina or urethral mucous membranes, rectumVertical transmission by birthSexual | Meningitis and septicemia in neonatesEndometritis in postpartum womenOpportunistic infections with septicemia and pneumonia | Penicillin GAmpicillinAminoglycoside in case of lethal infection | None | Culture showing large colonies with ß-hemolysisNegative catalase testHydrolyzes sodium hippurate |
| Streptococcus pneumoniae | Respiratory dropletsOften human flora in nasopharynx (spreading in immunocompromised) | Acute bacterial pneumonia & meningitis in adultsOtitis media and sinusitis in children | Penicillin GVancomycin for resistant strains | 23-serotype vaccine for adults (PPV)Heptavalent conjugated vaccine for children (PCV) | Microscopy showing gram-positive, encapsulated lancet-shaped diplococcia-hemolysis on blood agar, bile-soluble, optochin-sensitivePositive Quellung reaction |
| Streptococcus pyogenes | Respiratory dropletsDirect physical contact with impetigo lesions | Streptococcal pharyngitisScarlet feverRheumatic feverImpetigo and erysipelasPuerperal feverNecrotizing fasciitis | Penicillin GMacrolide, e.g. clarithromycin or azithromycin in penicillin allergyDrainage and debridement for Necrotizing fasciitis | No vaccineRapid antibiotic treatment helps prevent rheumatic fever | Culture on sheep agar forming small, opalescent surrounded by large zone of ß-hemolysisSerology for ASOVery bacitracin-sensitive |
| Treponema pallidum | | Syphillis | | |
| Vibrio cholerae | | | | | |
| Yersinia pestis | | Plague | | |
|