Gram +Ve Bacilli

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* There are 2 important clinically species :

1- Bacillus (( aerobic and faculitative anaerobic , spore forming ))
2- Clostridium (( obligate anaerobic , spore forming ))

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Bacillus anthracis

*larg Gr+Ve bacilli. usually arranged in chain

*spore forming ,non motile bacilli.

Characteristics

*spores are oval , central& non-projecting

*capsule consists of polypeptide glutamic acid.
* polysaccharide cell wall .
*faculitative anaerobic .
* nonfastidious growth (( not need complex media ))
*highly infection organism
*infected animals, human are accidental host .

Habitat

*spores remain viable for years in contaminated soil &

resistant heat up to 150 C for hour .

Transmission

*direct contact
*airborne route
*capsule =antiphagocytosis
* There are 3 extotoxin :- Edma toxin . lethal toxin .
*antrax exotoxin = CNS distress , respiratory failure &

Pathogenesis

anoxia
* Spore can survive in soil for years .
*cutaneous anthrax ( malignant pustule ) . fatal rate 10%
* gastrointestinal anthrax .

Diseases

* inhalation anthrax .
*enteric anthrax (fatal rate 50%)
*pulmonary anthrax (woolsorters disease ) (fatal rate
50%)
*meningitis following anthrax bacteremia .
(medusa head ) colonies on blood agar .

Laboratory
Identification

*McFadyean reaction (capsule stains red mauve with

loeffler polychrome methylene blue .
*catalase
* DFA Test : Positive . (( Direct Fluorescent AntiBody ))
*non hemolytic colonies .
* capsule not observed in culture . but observed with
Indian ink stain

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Bacillus anthracis

Characteristics

larg Gr+ Ve bacilli , usually arranged in chain

Spore forming & motile bacilli

Spores are oval , central & non projecting .

Non capsulated bacilli

faculitative anaerobes

nonfastidious growth(( not need complex media ))

Opprtunistic infection .

* soil ,vegetation , water , food includes cerals meat &

Habitat
Transmission

spices
Foodborne route

heat stable enterotoxin = causes emetic

gastroenteritis .

heat- labile enteroxin = causes diarrheal

gastroenteritis .

Pathogenesis

spore can survive in soil .

cytotoxic enzyme : Destruction Tissues .

* toxic food poisoning includes 2 types of infections :

1-emetic gastroenteritis ( severe nausea & vomiting )

Diseases

2- diarrheal gastroenteritis ( abdominal pain & profuse

watery stool )
* ocular infection
* intravenous catheter .

Laboratory
Identification

( medusa head ) colonies .

complete hemolysis on blood agar .(( Beta

Hemolytic ))

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Corynebacterium

gram +Ve bacilli (( club shaped )) .

aerobic and faculitative anaerobic .

non spore forming .

non Acid fast .

non motile .

catalase +Ve .

most (( but not all )) Ferment carbohydrate .

high guanine and cytocine content .

meta chromatic granulces .

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Corynebacterium diphtheriae

*Gr+ Ve Polymorphic bacilli (club-shaped) .

*cells appear in chineses-letter arrangement .
* non capsulate , non sporing , non motile .

Characteristics

*Facultative anaerobes .
*Ferment carbohydrate .
* Most grow well in lipid free media .
Nasopharynx & occasionally skin of human

Habitat
Transmission

droplets spread

direct contact

Pathogenesis

Diphtheria exotoxin = block protein synthesis

Unknown Virulance Factors.

diphtheria :

1- localized inflammation of the throat

Diseases

2- infecting organisms do not invade but rather

elaborate an exotoxin that spreads through blood
3- pharynx , larynx , & nose are main sites
4- pseudo membrane is formed & may lead to
respiratory obstruction
5-mainly affecting infants over 1 year old children &
young adults
6- Endocarditis

Laboratory
Identification

Specific media for C.diphtheria :-

1- cysteine tellurite agar

2- serum tellurite agar .

back colonies on blood tellurito agar

Use loeffler medium to recover C.diphtheria .

detection toxin by Elek test .

teelurite inhibit growth of most upper respiratory

bacteria and gram negative rods .

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Mycobacterium

gram +Ve bacilli .

non motile .

fastidious growth (( Need Complex media )) .

acid fast .

non spore forming .

aerobic .

Cell Wall Rich With Lipid (( making the organism resistant to most
disinfects , detergents , common antibacterial )) .

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Mycobacterium tuberculosis

acid fast bacilli , slightly curved (ziehl neelsen

stain : red cooler )
cell wall rich with lipid (( making the organism
resistant to most disinfects , detergents , common
antibacterial )) .
non-capsulate , non sporing , non motile
obligate aerobes
highly infection organism

Strict human pathogen

droplets spread
direct contact
foodborn route (rarely)

capsule = Antiphagocytois .
Ability to multiply inside macrophages .

Characteristics

Habitat
Transmission

Pathogenesis

Diseases

Laboratory
Identification

tuberculosis :
1- primary tuberculosis in lungs & lymph nodes
2- progressive primary tuberculosis
-tuberculous bronchopneumonia
- military tuberculosis
-tuberculosis meningitis
- bone & joint tuberculosis
- genito- urinary tuberculosis
3- post primary tuberculosis :
-T.B.remains dormant for years after primary
tuberculosis
-it reactivates due to delayed hypersenseitivity
- it may involve all manifestation in progressive
Primary tuberculosis
rough , dry & yellow colonis on Lowenstein
Jensen medium after 2-3 weeks at 37 C
detection of acid fast bacilli under light
microscope .
tuberculin skin test + kuantiferon-TB test =
sensitive marker

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Mycobacterium leprae

acid fast bacilli , slightly curved (ziehl neelsen

stain : red cooler )

Characteristics

cell wall rich with lipid (( making the organism

resistant to most disinfects , detergents , common
antibacterial )) .
non-capsulate , non sporing , non motile

obligate aerobes

Strict human pathogen

Habitat
Transmission

direct contact

airborne spread

incidence of disease in contact is low

spread in the community is slow

principal target cell for this bacterium is schwann

cell

Pathogenesis

this bacteria causes anaesthesia & miscle

paralysis

leprosy :

1- slow , chronic &progressive infection

Diseases

2- minaly affects the skin & peripheral nerves

3- long incubation period , usually form 3- 5 years
4- tow forms of leprosy :
-lepromatous (lesions spread & involve mucous
membrane . this form is progressive & severe , large
number of bacteria are found in the body which acts
as kind of unlimited culture medium )
- tuberculoid (lesions are localized & tend to be
bening , this form is self healing )

Laboratory
Identification

no growth on Lowenstein Jensen medium

detection of acid fast bacilli in smears or secretion

from lesions

diagnosis with specific skin test .

Microscope sensitive to : lepromatous .

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Clostridium SPP
(Anaerobic, spore-forming,Gram-positive Rods)
-All anaerobic, gram-positive rods capable of forming endospores was placed in the
genus (Clostridium).
-Clostridium spp was defined by four properties
1)presence of endospores.
2)strict(obligate) anaerobic.
3)inability to reduce sulfate to sulfite.
4)gram-positive cell wall structure.
-the Clostridium are ubiquitous in soil, water, and sewage and part of the normal flora
in gastrointestinal tract of animal and human.

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Clostridium tetani

Characteristics

larg Gr+ Ve bacilli

sporing , motile bacilli

spores are spherical , terminal ( drumstick )

non capsulate bacilli

obligate anaerobes

difficult to grow.because the organism is

extremely sensitive to oxygen toxicity.

Habitat

Not ferment carbohydrates.

soil & commensal in intestinal tract of animal .

spore remain viable after dry heat up to 160 C for

1 hour .

Transmission

Via major or minor wounds .

tetanolysin ( exotoxin) = lyses erythrocytes .

tetanospasmin ( exotoxin ) = neurotoxin that

affects CNS causing muscular rigidty and spasns .

spore formation.

Pathogenesis

*tetanus ( human & animals)

1- generalized tetanus

Diseases

2-localized tetanus
3-neonatal tetanus

Laboratory
Identification

swarming colonies on blood agar

detection of neurotoxin by serological method .

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Clostridium perfringens

relatively larg Gr + Ve bacilli , usually arranged

in chain

Characteristics

non motile bacilli & capsulate bacilli

spores are oval , subterminal & non projecting

spores rarely seen in infected materials

anaerobes , but it can tolerate exposure to air for

short time

hemolytic in culture.

Replicate rapidly

Type A is responsible for most human disease.

soil & water & intestinal tract of human and

Habitat

animals

bacteria & spores common contaminants of raw

meats

spores remain viable after heat up to 100 C for up

to 3 hours

Transmission

Pathogenesis

Diseases

direct contact

endogenous spread

foodborne route

alpha toxin = destroys cell membranes

enterotoxin = associated with food poisoning

DNAse = hydrolyses DNA

gas gangrene

food poisoning

septicemia.

Soft- tissue infections.

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Laboratory
Identification

beta hemolytic colonies on blood agar

entire edge for colonies on blood agar

detection of alpha toxin via the nagler reaction

Clostridium difficile

Characteristics

larg Gr+ Ve bacilli usually arranged in chain

sporing , motile bacilli

spores are oval

obligate anaerobes

part of the normal intestinal flora

Soil & water & intestinal contents of various animals .

Habitat

Faeces of 3-5 % of healthy adults.

Regularly , present in faeces of healthy adult infant .

Transmission

Endogenous spread .
Faecal oval route

toxin A ( enterotoxin) = antiphagocytosis

toxin B ( cytotoxin )

pseudo membranous colitis

antibiotic- associated diarrhoea

Pathogenesis

Diseases

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Laboratory
Identification

difficult to isolate in ordinary media

detection toxins in faeces

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Clostridium botulinum

Characteristics

larg Gr +Ve bacilli

sporng , motile bacilli

sporing are oval , terminal or subterminal &

projecting

Habitat

non capsulate bacilli

obligate anaerobes

fastidious growth.

soil , vegetable & fruits are the normal habitat

canned products

spores remain viable after heat up to 100 C for up

to 3 hours

Transmission

Foodborne route

Pathogenesis

spore formation

Botulinum toxin

Binary toxin.

botulism

1- this food poisoning is intoxication rather than an

Diseases

infection .
*Food borne botulism
*infant botulism
*inhalation botulism
*irregulary round colonies on blood agar

Laboratory
Identification

* detection of toxin in the food or serum from the patient

is the way of confirming the diagnosis

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GRAM +VE Bacilli

Medical Microbiology
Patrick Murray

..

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