Taxonomy of bacteria

Taxonomic classification based on:
gram staining
gram positive
gram negative

mode of respiration

cell wall shape

Gram Positive Bacilli
Gram Positive Cocci
Gram Negative Bacteria

Clinically important genus


genus of Gram-positive bacteria
ubiquitous in nature (soil, water, and airborne dust)
Some species are natural flora in the human intestines
most species are harmless saprophytes
two species are considered medically significant

B. anthracis
B. cereus

B. anthracis
causes anthrax in cows, sheep, and sometimes humans
Anthrax is transmitted to humans via direct contact with animal
products or inhalation of endospores
Anthrax can be treated with penicillin or tetracycline
The anthrax bacteria can live in the soil for many years
Man may become infected with anthrax by inhaling contaminated soil
particles or by handling wool or hair from diseased animals
Infection of the intestinal tract can occur by eating undercooked
meat from diseased animals

B. cereus
can cause toxin-mediated food poisoning
It is known to inhabit many kinds of food including stew, cereal, and
The toxins released lead to vomiting and diarrhea
toxin production usually takes place after the infected foods are cooked
proper cold storage of food is recommended immediately after

ferment glucose into lactose
hence the name Lactobacillus
most common application of Lactobacillus is industrial
specifically for dairy production
yogurt, sauerkraut, pickles, buttermilk

L. acidophilus
make up part of the natural flora of the human vagina
create an acidic environment which inhibits growth of many
bacterial species
leads to urogenital infections

Lactobacillus is generally harmless to humans
Species of human pathogenic significance
L. monocytogenes
found in soil and water
Vegetables can become contaminated from the soil or from
manure used as fertilizer
Animals can carry the bacterium without appearing ill and can
contaminate foods of animal origin such as meats and dairy
has been implicated in several food poisoning epidemics
normal inhabitant of the gastrointestinal tract and of animal feces
infected suffer from vomiting, nausea, and diarrhea
those at high risk include newborns, pregnant women and their
fetuses, the elderly, and persons lacking a healthy immune

better known as a veterinary pathogen than as a human pathogen
This ubiquitous microbe has been found in many farm animals such as pigs,
horses, and turkeys
can infect a human host and cause Erysipeloid, an inflammatory skin disease

ubiquitous in nature
normally saprophytic and harmless to humans
exception is the bacterium C. diphtheriae

produces the toxin that causes diphtheria
a disease of the upper respiratory system in humans
unique in its exotoxin formation

M. tuberculosis
causative agent of tuberculosis
M. leprae
causative agent of leprosy
anaerobic, ubiquitous in nature, especially fond of soil
secrete powerful exotoxins that are responsible for

gas gangrene

clinically important species
C. tetani
C. perfringens
C. botulinum

C. tetani
causes tetanus (lockjaw) in humans
spores can be acquired from any type of skin trauma involving an
infected device
If an anaerobic environment is present, the spores will germinate and
eventually form active C. tetani
At the tissue level, the bacterium releases an exotoxin that causes
nervous system irregularities
toxin's effect includes constant skeletal muscle contraction
due to a blockage of inhibitory interneurons that regulate muscle
Immunization prevents C. tetani
infections in children and adults
the first four shots are administered within two years of birth
followed up with periodic booster shots given every ten years

C. perfringens
can be contracted from dirt via large cuts or wounds
release of their exotoxin causes necrosis of the surrounding tissue
also produce gas which leads to a bubbly deformation of the infected
tissues (gas gangrene)
can release an enterotoxin that may lead to severe diarrhea

C. botulinum
produces one of the most potent toxins in existence
cause of the deadly botulism food poisoning
may find their way into foods that will be placed in anaerobic storage
such as cans or jars
once the jars are sealed, the spores germinate and the bacteria release
their potent toxin
patients experience muscular paralysis and blurred vision
immediate treatment with anti-toxin is required for the patient to survive
infantile botulism is much milder than the adult version
honey is the most common source of the spores which germinate in the
child's intestinal tract
symptoms last a few days and then subside without the use of an

P. acnes
usually harmless microbe that has pathogenic potential
has been linked to certain cases of endocarditis, wound
infections, and abscesses
Ironically, it can infect acne sites on the skin but it does not cause


clinically relevant gram-positive cocci bacteria

observed as spherical cells forming pairs or clusters
a common human skin contaminant
relatively harmless to humans because they maintain a saprophytic lifestyle
also found in freshwater environments or in soil
two common species are

M. luteus
M. varians

Clinically significant species are
S. aureus
S. epidermis

S. aureus
can cause
soft tissue infections
toxic shock syndrome (TSS)
osteomyelitis (bone infection)

enterotoxins causes cramps and severe vomiting
also secretes leukocidin
toxin which destroys WBC and leads to the formation of puss and acne

S. epidermidis
an opportunistic pathogen which is a normal resident of human skin
individuals susceptible to infection

IV drug users
those using catheters or other artificial appliances

appear as chains
produce exotoxins which destroy

phagocytic cells
host connective tissue
fibrin (blood clots)

clinically significant genus
S. pyogenes
S. pneumoniae
S. agalactiae

S. mutans
S. pyogenes
an opportunistic pathogen is responsible for about 90% of all cases of
"Strep throat"
characterized by inflammation and swelling of the throat, as well as
development of pus-filled regions on the tonsils
if the infection reaches the lungs it could lead to pneumonia or
rheumatic fever

S. pyogenes
also causes impetigo, cellulitis, scarlet fever and erysipelas
S. pneumoniae
causes pneumonia, meningitis, and otitis media
S. agalactiae
the causative agent in mastitis in cows
has also been found to be a cause of sexually transmitted urogenital
infections in females

S. mutans
inhabit the mouth
most tooth decay can be attributed to S. mutans

Clinically significant genus

diplococci which inhabit the mucous membranes
clinically significant

N. gonorrhoeae
N. meningitidis

N. gonorrhoeae
Gonorrhea is transmitted between humans through intimate contact of
the mucous membrane
can be carried by men and women for many years without any sign or
Females infected with gonorrhea exhibit vaginal discharges, abdominal
pain, and abnormal non-menstrual bleeding
In infected males, the disease is characterized by a urethral discharge of
this disease is treatable
sensitive to ultraviolet radiation, drying, and antibiotics
Use of the birth control pill can lower the glycogen concentration of the
vaginal membrane

This environmental change inhibits the growth of acid-producing
such as Lactobacillus, which are the natural flora of the vagina
The vaginal pH soon becomes less acidic and a variety of organisms are
able to grow there

N. meningitidis
the second leading cause of meningitis
inflammation of the membranes covering the central nervous system
Early symptoms may include headache, fever, and vomiting
Death can quickly follow due to endotoxin shock
Infection doesn't always lead to death
can often assume a carrier status with carriers not actually developing
the disease


common in children can cause a secondary respiratory infection that usually
inflicts those who already have the flu

H. influenzae
occur as natural flora of the nose and pharynx
can confer severe illness in patients that are immunosuppressed
or that have pre-existing respiratory ailments
most common cause of bacterial meningitis in children between
the ages of five months and five years
The initial respiratory infection can spread to the blood stream
and eventually the central nervous system
A stiff neck, lethargy, and the absence of the sucking reflex are
common symptoms in infected babies
H. influenzae
is the number one cause of Epiglottitis
potentially fatal disease may cause airway obstruction in children
between the ages of 2 and 4
Haemophilus infection has also been associated with chronic
bronchitis, pneumonia, earaches, conjunctivitis and chancaroid
(sexually transmitted)

most important species in this genus is
B. pertussis
causes whooping cough
highly contagious bacterium makes its way into the
respiratory tract via inhalation
subsequently binds to and destroys the ciliated epithelial cells of
the trachea and bronchi
whooping cough usually afflicts children less than a year old
A vaccine has reduced the incidence of this disease one hundred
fold since its introduction

causes Brucellosis
This organism is sometimes carried by animals and only causes incidental
infections in humans
cattle, swine, goats, dogs

Brucella can enter the body via the skin,
respiratory tract, or digestive tract
Symptoms can include high fever, chills, and sweating

causes tularemia
disease that humans can catch from tick bites
This highly infectious disease is carried by rodents, deer, pets, and many
other animals
Humans can acquire the organism in several different ways through lesions in
A sudden onset of flu like symptoms (headache, fever, chills) is observed in
infected individuals

P. multocida is the species which most commonly infects humans
humans can acquire the organism from dog or cat bites
Patients tend to exhibit swelling, cellulitis, and some bloody drainage at the
wound site
Infection may also move to nearby joints where it can cause swelling and

first discovery of Legionella came in 1976
outbreak of pneumonia at an American Legion convention led to 29 deaths
(Legionnaires' disease)
Respiratory transmission of this organism can lead to infection, which is
usually characterized by a gradual onset of flu-like symptoms
Patients may experience fever, chills, and a dry cough as part of the early
Patients can develop severe pneumonia which is not responsive to penicillins

Vibrio species are non-invasive pathogens
can cause some of the most serious cases of diarrhea and thousands of
people die from infection annually
waterborne organisms are transmitted to humans via infected water or
through fecal transmission
Most clinically important is V. cholerae

in countries with poor sewage or water treatment cholera is sometimes seen
in epidemic proportions
characterized by severe diarrhea which has a rice-water color and consistency
The diarrhea is so severe that about 60% percent of cholera deaths are due to
After cholera organisms are ingested, they descend to the intestinal tract
where they release their exotoxin
induces the epithelial cells to excrete salt
The cells then lose water which passively flows out of the cells
Fluid and electrolyte replacement is the key to treating cholera patients
Another strain which causes diarrhea can be found in raw seafood such as
sushi and oysters

leading cause of peptic ulcers and chronic gastritis
Infected patients can be treated with an antacid as well as tetracycline to treat
the ulcers and inhibit the growth of the organism

Most interesting is a bacterial predator
slips in between the cell wall and cell membrane of a host bacterium and
parasitizes the organism

among the most pathogenic and most often encountered organisms in clinical
large rods are usually associated with intestinal infections
can cause meningitis, dysentery, typhoid, and food poisoning
Clinically important

Escherichia coli

can cause urinary tract infections, pneumonia, meningitis, and traveler's
part of the normal flora of the human intestinal tract
plays a crucial role in food digestion by producing vitamin K from
undigested material in the large intestine
Pathogenic strains can cause severe cases of diarrhea in all age groups
by producing a powerful endotoxin
Treating E. coli
infections with antibiotics may actually place the patient
in severe shock which could possibly lead to death
because more of the bacterium's toxin is released when the cell dies

In many cases Shigella infection will lead to diarrhea accompanied by
an invasive pathogen which can be recovered from the bloody stool of
an infected host
Invasive pathogens colonize the host's tissues as opposed to growing
on tissue surfaces
is easily spread from host to host
the primary suspect in outbreaks of diarrhea

Can cause bacterial food poisoning
Transmission is usually through uncooked meats and eggs
Chickens are a major reservoir of Salmonella
explains its ubiquitous presence in poultry products
Ingesting contaminated foods can cause intestinal infection leading to
diarrhea, vomiting, chills, and headache
capsular properties can cause serious complications in
immunosuppressed individuals such as HIV / AIDS patients
S. typhosa
causes typhoid fever (enteric fever)
characterized by fever, diarrhea, and inflammation of the infected

produces large sticky colonies
K. pneumoniae infections are common in hospitals where they cause
pneumonia and urinary tract infections in catheterized patients
cause of septicemia

can cause urinary tract infections and hospital-acquired infections
usually only targets immunosuppressed individuals

an invasive pathogen which can penetrate the gut lining and enter the
lymphatic system and the blood
ingestion of contaminated foods, can cause a severe intestinal
inflammation called yersiniosis
Release of its enterotoxin can cause severe pain similar to that found in
patients with appendicitis
Y. pestis
causes the bubonic, pneumonic, and septicemic plagues
Human contraction of bubonic plague is usually through flea bites
Once inside the body, Y. pestis
releases a toxin which inhibits the
Kreb’s cycle in host cells
Swelling of the lymph nodes, skin blotches, and delirium are sometimes
observed within a few days of infection
Untreated infections usually result in death within a week of initial
the plague has historically been a deadly pathogen
inflicting Europeans in epidemic proportions during the fourteenth,
fifteenth, and sixteenth centuries
lack of sanitation allowed the plague to go unchecked killing tens of

Typically have a helical or spiral structure
clinically significant genus


T. pallidum is the causative agent of syphilis
B.burgdorferi is the agent which causes Lyme Disease
typically spread by bites of small ticks

members of this genus can cause leptospirosis
spread by contaminated urine from pets
pets are commonly immunized

can reproduce only within a host cell
R. ricketsii
is cause of Rocky Mountain Spotted Fever which is carried in the
digestive tract of some species of ticks

do not require insects or ticks for transmission
C. trachomais
is a sexually transmitted urethritis


Curriculum professionale

nno Scolastico 1982 / 83 : maturità scientifica presso il Liceo Scientifico A. Tassoni di Modena con punti 39/60 3 Ottobre 1989 : laurea in Medicina e Chirurgia presso l'Università Degli Studi di Modena con punti 110 su 110 (tesi di laurea: Perimetria automatica computerizzata e manuale: raffronto dei deficits del campo visivo nel glaucoma ad angolo aperto - relatore: Prof. E

1_hope march

Long Term Care and the 2008 General Assembly eral Assembly this year on SB 315; view of Medicaid home and communi-however, the House voted to adopt the SB 42 continues the Select Joint Com- this session. Although many issues adds additional responsibilities for structuring, other important issues The Commission has been very in-of the bills impacting long term care caid issues such as nur

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