GENERAL CHARACTERISTICS

Staphylococcus
Micrococcus
Gram
(+)
Gram
Spherical

Spherical
Cluster

Cluster
Motile
X
Motile
Spore-forming
X
Spore-forming
Aerobes

Aerobes
Faculatative Anaerobes

Faculatative Anaerobes
Catalase
(+)
Catalase
Oxidase
(-)
Oxidase
Bacitracin
R
Bacitracin
Carbohydrate utilization
Ferment. Carbohydrate utilization
10% Nacl

10% Nacl
Clostridium

(+)
(+)
S
Oxidat.
-

C. tetani

Gram
Rod
Anaerobe
Spore-forming

(+)

B. anthracis
Gram
Rod
Spore-forming
Capsule
Medusa head

(+)

Gram
Rod
Strict anaerobe
Spore-forming
Motile
Cooked meat broth
Blood agar

B. cereus
Gram
Rod
Spore-forming
Capsule
Motile
Short-lived
Self-limiting
(antibiotic treatment X)

Streptococcus
Gram
Spherical
Chains
Catalase
Facultative Anaerobes
Require CO2

S. pyogenes
(+)

(-)

Some

C. perfringens
(+)

(+)

Gram
Rod
Strict anaerobe
Spore-forming
Capsule
Motile
"Double zone" of
hemolysis
Corynebacterium
Gram
Club-shaped rod
Aerobe
Facultative anaerobe
Metachromatic granules

Enterococcus

-hemolysis

-hemolysis
Gram
Catalase
Pairs
Short chains

S. pneumoniae
Viridans streptococcus
-hemolysis

C. botulinum
(+)

(+)

Gram
Rod
Strict anaerobe
Spore-forming
Fastidious
Motile

Listeria
Gram
Rod
Spore-forming
Aerobe
Facultative anaerobe
Narrow zone of
-hemolysis on blood
agar

(+)
(-)

C. difficile
(+)

(+)

Gram
Rod
Anaerobe
Spore-forming
Nosocomial
Most commonly used
antibiotics

Mycobacteria
Gram
Rod
Spore-forming
Motile
Capsule
Obligate aerobe
Acid fast

(+)

(+)

X
X
X

M. leprae
Gram
Microaerophilic
Culture on artificial
media
Obligate intracellular
pathogen

(+)

Klebsiella
Gram
Rod
Capsule
Motile
Facultative anaerobe

(-)

Haemophilus
Gram
Bacilli
Obligate parasites

(-)

Pasteurella
Gram
Coccobacilli
Motile
Facultative anaerobes

(-)

N. gonorrhoea
Gram
Diplococci
Aerobes
Motile
Oxidase
Fastidious
(enriched medium + CO2)

Proteus
Gram
Rod
Motile
Facultative anaerobe

N. meningitidis
(-)

X
(+)

Gram
Diplococi
Capsule
Small

(-)

Gram
Rod
Motile
Infective dose

Enterobacteriaceae
(-)

Salmonella

H. influenza
Gram
Small
Coccobacilli
Spore-forming
Motile
Capsule
Hib - most virulent

(-)

X
X
Some

Francisella
Gram
Small
Coccus
Pleomorphic rod-shaped
Strict aerobe

(-)

(-)

High

H. ducreyi
Gram
Small
Coccobacilli
Extracellular
Motile
Fastidious

(-)

Brucella
Gram
Small
Coccobacilli
Motile
Stric aerobe
Obligate parasites
Catalase
Oxidase

(-)

(+)
(+)

Gram
Rod
Bile salt
Aerobe
Anaerobe
Glucose
Catalase
Oxidase

(-)

(+)

Ferment.
(+)
(-)

Shigella
Gram
Rod
Motile
Facultative anaerobe
Spore-forming
Infective dose

(-)

X
Low

Bordetella
Gram
Extremely small
Coccobacilli
Aerobic
Fermenters
True pathogens

(-)

Actinobacillus
Gram
Small
Slow-growing
Facultative anaerobe

(-)

E. coli
Gram
Motile
Aerobe
Facultative anaerobe
Glucose

(-)

Ferment.

Yersinia
Gram
Coccobacilli
Motile
Catalase
Oxidase

(-)

X
(+)
(-)

B. pertussis
Obligate parasites

Vibrio
Gram
Oxidase
Curved rod
Aerobe
L-Arabinose
Motile
Spore-forming
Halophilic

(-)
(+)

(+)

V. cholerae O1 Classical
Polymyxin B sensitivity
S
Chicken RBC agglutination
(-)
V-P reaction
(-)
Haemolysin production
(-)
Group IV phage sensitivity
S
Cause mild to asymptomatic
No
disease
Faecal carriage
Days
Survival in water
Days
Transmission
Food
Case-to-case spread

No

V. cholerae O1 El Tor
Polymyxin B sensitivity
R
Chicken RBC agglutination
(+)
V-P reaction
(+)
Haemolysin production
(+)
Group IV phage sensitivity
R
Cause mild to asymptomatic
Yes
disease
Faecal carriage
Weeks
Survival in water
Weeks
Transmission
Food
Water
Case-to-case spread
Yes

Campylobacter
Gram
Oxidase
Motile
Microaerophilic

(-)
(+)

Gram
Oxidase
Aerobe
Motile

Aeromonas
Gram
Oxidase
Motile

Burkholderia

(-)
(+)

Acinetobacter
(-)
(+)

Gram
Oxidase
Motile
Coccobacilli

(-)
(-)
X

Helicobacter
Gram
Oxidase
Microaerophilic

(-)
(+)

Pseudomonas
Gram
Oxidase
Motile
Aerobe
Water-soluble pigment
Glucose

(-)
(+)

Oxidise

Plesiomonas
Gram
Oxidase
Facultative anaerobe
Motile

(-)
(+)

MEDICALLY IMPORTANT SPECIES

Coagulase
S. aureus

Clostridium
C. tetani
C. perfringens
C. botulinum
C. difficile

Staphylococcus
(+)
Coagulase
S. epidermidis
S. saprophyticus
S. haemolyticus
S. lugdumensis
Bacillus
B. anthracis
B. cereus

Neisseria
N. gonorrhoea
N. meningitidis
N. lactamica
N. sicca
N. mucosa
N. flavescens

Enterobacteriaceae
Escherichia
Klebsiella
Proteus
Salmonella
Shigella
Yersinia

Shigella
S. dysenteriae
S. flexneri
S. boydii
S. sonnei

Yersinia
Y. pestis
Y. enterocolotica
Y. pseudotuberculosis

(-)

Streptococcus
S. pyogenes (Group A)
S. agalactiae (Group B)
S. pneumoniae

Viridans Streptococcus
S. intermedius
S. bovis (Group D)
S. mutans
S. salivarus

Corynebacterium
C. diphtheriae
C. ulcerans
C. pseudotuberculosis

Listeria
L. monocytogenes

Mycobacteria
M. tuberculosis
M. bovis
M. microti
M. africanum
M. leprae
Atypical mycobacteria

E. coli

Klebsiella
K. pneumonia

Salmonella
S. typhi
S. paratyphi A
S. paratyphi B
S. enterica

Haemophilus
H. influenzae
H. parainfluenzae
H. ducreyi

Bordetella
B. pertussis
B. parapertussis
B. bronchiseptica

Pasteurella
P. multocida
P. canis
P. bettyae
P. dagmatis
P. stomatis

Escherichia

Enterococcus
E. faecalis
E. faecium

Brucella
B. melitnesis
B. abortus
B. suis
B. canis

Actinobacillus
A. acitnomycetemcomitans
A. equuli
A. bominis
A. lignieresii
A. ureae

Campylobacter
C. jejuni
C. coli
C. fetus

Helicobacter
H. pylori

Vibrio
V. cholerae
V. parahaemolyticus

Aeromonas
A. hydrophila
A. sobria

Pleisomonas
P. shigelloides

Pseudomonas
P. aeruginosa

Burkholderia
B. pseudomallei
B. cepacia
B. mallei

Acinetobacter
A. baumannii

EPIDEMIOLOGY
Staphylococcus
Skin
Mucous membranes

Clostridium

S. aureus
Skin
Mucosal surfaces
Direct contact
Contaminated fomites
Foreign body
Antibiotics

S. saprophyticus
Skin
Mucosal membranes of
genitourinary tract

C. tetani

C. perfringens

Streptococcus
Indigenous respiratory
tract microflora
(animals and human)
Gastrointestinal tract
Urogenital tract

C. botulinum

Soil
Water
Sewage
Normal flora

Soil
Feces of animals

Soil
Water
Dust

Soil
Water
Preserved canned food

Corynebacterium
Skin
Mucous membrane
Soil
Water
Plants
Food products

L. monocytogenes
Soil
Dust
Water
Sewage
Raw unpastuerised milk
Food

Atypical mycobacteria
Saprophytes
NO man to man
transmission
Water
Soil

M. leprae
Human
Armadillos
(spread via droplet/
direct contact)

S. pneumoniae
Nasopharyngeal
Oropharynx

C. difficile
Normal flora
Ampicillin, clindamycin,
cephalosporin
(Antimicrobial agents
associated with
pseudomembranous
colitis)
N. gonorrhoea
Urogenital tract
Oral
Nasopharyngeal
Rectal
(homosexual and
heterosexual contact)

Enterococcus
Gastrointestinal tract
(humans & animals)

Bacillus
Soil
Contact with infected
animal or animal
products (B. anthracis)
Reheated cooked rice
(B. cereus)

N. meningitidis
Human ONLY
Nasopharynx
(Person-to-person
transmission)

Enterobacteriaceae
Free living
Norma indigenous flora
(human & animal)

E. coli
Normal intestinal flora
(man & animal)

Klebsiella
Commensal
enterobacteria

Y. pestis
Wild rodent
(spread via respiratory
droplets)

Y. pseudotuberculosis
Contaminated food

Y. enterocolitica
Transmitted via faecal
oral route

P. multocida
Commensals in upper
repiratory tract
Animal bite

Francisella
Cotton tail rabbit
Bird
Water
Mud
Faeces
Direct cutaneous
innoculation
Conjunctival innoculation
Inhalation
Under-cooked meat
Contaminated water

Brucella
Unpastuerized milk
Direct contact with
infected animals
Insects
Ticks

Plesiomonas
Tropical & subtropical
areas
Fresh fish
Stools of patients with
diarrhoea

Campylobacter
Food and drink
Infected animals

H. pylori
Gastric pathogen

Proteus
Commensals in intestine
(man & animal)
Saprophytes

Haemophilus
Man
Animals

Actinobacillus
Mucous membrane of
respiratory &
genitourinary tract

Pseudomonas
Soil
Water
Plants
Animals

Salmonella
Commensal of animal
Raw meats
Poultry
Eggs
Milk
Dairy products

Shigella
Human ONLY
Intestinal tract
(faecal oral
contamination)

H. ducreyi
Human ONLY

B. pertussis
Human ONLY
Inhalation of infectious
aerosols

V. cholerae
Contaminated food &
water

B. pseudomallei
Soil
Inhalation
Contamination of wound
Abrasions with soil

Aeromonas
Water

VIRULENCE FACTORS

Toxins

Enzymes

Strucutre

Toxin

Staphylococcus
Enterotoxins
Exfoliative toxins
TSST-1
Cytotoxins (,,,)
Panton-Valentine Leukocidin
Hyluronidase
Staphylokinase
Coagulase
Lipase
Penicillinase
Nucleases
Capsule
Peptidoglycan
Teichoic acid
Protein A
C. tetani
Tetanospasmin (heat-labile
neurotoxin)
Tetanolysin (oxygen-labile
hemolysin)

S. pyogenes
Somatic
Capsule
constituents Lipoteichoic acid
M protein
M-like protein
F protein
Extracellular Pyrogenic exotoxins
products
Streptolysin S
Streptolysin O - immunogenic
Streptokinase
DNase
C5a peptidase

Toxin

Enzymes

C. perfringens
Alpha toxin - lecithinase
Kappa toxin - collagenase
Theta toxin - direct vascular
injury, cytolysis, hemolysis
Beta toxin - necrotizing
enteritis
Enterotoxin
DNase
Hyaluronidase
Collagenase

Serological
markers

Toxin

S. agalactiae
B antigen - group specifc cell
wall polysaccharide
Type specific cell wal
polysaccharide
C -protein

C. botulinum
Botulinum toxin
Heat-labile neurotoxin

S. pneumoniae
Surface adhesion protein
Secretory IgA protease
Teichoic acid & peptidoglycan
Capsule
H2O2
Phosphorylcholine
Pneumolysin
(cytotoxic, activates classical
pathway, suppress phagocytic
oxidative burst)

Toxin

C. difficile
Toxin A - slight cytotoxic
Toxin B - decrease cellular
protein synthesis

Structure
Exotoxin

Strucutre
Others

Structure

Toxin

Toxin

Bacillus
Polyglutamic acid capsule
Edema factor
Lethal factor
Protective antigen
M. tuberculosis
High lipid concentration in cell
wall
Intracellular growth
Cord factor
Detoxification of oxygen
radicals

E. coli
Somatic antigen
Flagellar antigen
Capsular antigen
(resistant to heat and alcohol)
Pili
-hemolysin
Shiga toxin
Labile toxin
Stable toxin
Shigella
Endotoxin (LPS)
Exotoxin (Cytotoxin,
enterotoxin, shiga toxin)
inhibit sugar and amino acid
absorption

Toxin

B. cereus
Heat-stable enterotoxin
(vomit)
Heat-labile enterotoxin
(diarrhea)

Enzymes

N. gonorrhoea
Pilus
Lipooligosaccharide
Capsule
Por proteins
Opa proteins
Rmp proteins
IgA protease

Strucutre

K. pneumonia
80 capsular antigens

Strucutre

Protein

Toxin

Structure

Toxin

Strucutre
Enzyme

Strucutre

Y. pestis
LPS (endotoxin)

Strucutre

C. diphtheriae
Diphtheria toxin

N. meningitidis
Specific receptors
(G1 ganglioside)
Pilus
Opa protein
Capsule
Porin
Endotoxin
(Lipid A of LOS)
Proteus
O antigen
H antigen
Urease
(hydrolysis of urea, liberation
of NH3, urine become alkaline,
stone formation)

H. influenzae
Polyribitol phosphate - capsule

Toxin
Structure

Strucutre

Strucutre

Toxin

L. monocytogenes
Listeriolysin O
Surface protein (internalin)

Enterobacteriaceae
LPS (O antigen)
Capsule (K antigen)
Flagella (H antigen)
Pili (fimbriae)

Salmonella
O antigen
H antigen

H. ducreyi
Cyto-lethal toxin

Adhesins

Toxins

Toxin
Enzymes

B. pertussis
Filamentous hemagglutinin
Pertussis toxin
Pili
Pertactin
Pertussis toxin
Hemolysis toxin
Dermonecrotic toxin
Tracheal cytotoxin
LPS
V. cholerae
Cholera toxin
Mucinases
Proteases

Structure

F. tularensis
Antiphagocytic capsule

Brucella
Intracellar pathogen - resistant to serum
& phagocytes

Structure
Toxin

C. jejuni
LPS
Cytopathic extracellular toxins

H. pylori
Adhesins
Motility
Acid neutralisation
Siderophores for iron uptake
PI encoded genes

Toxin
Enzyme

Structure

Enzyme
Toxin

Structure
Enzyme

Toxin

B. pseudomallei
Capsule
Protease
Peroxidase
Lecithinase
Haemolysins
Siderophores

Actinobacillus
Leukotoxin
Collagenase

P. aeruginosa
Pili
Capsule
LPS
Elastases
Proteases
Haemolysins
Exotoxin A

CLINICAL INFECTIONS
Staphylococcus
Wound infections
Urinary tract infections
Catheter and shunt infections
Prosthetic device infections

Toxin-mediated disease :
Scalded-skin syndrome
Food poisoning
Toxic shock

Streptococcus
Upper & lower respiratory tract
infections
Urinary tract infections
Wound infections
Endocarditis

S. pyogenes
Pharyngitis
Scarlet fever
Necrotising fasciitis
Streptococcal toxic shock
syndrome
Bacteraemia
Rheumatic fever
Acute glomerulonephritis

Clostridium
Tetanus
Botulism
Myonecrosis or gas gangrene
Antibiotic associated diarrhea &
colitis

C. tetani
Tetanus - spastic paralysis
Opisthotonos
Risus Sardonicus

S. aureus
Suppurative infections :
Impetigo
Folliculitis
Furuncles/boils
Carbuncles
Bacteremia
Endocarditis
S. agalactiae
Septicaemia
Meningitis
Pneumonia
Mastitis

C. perfringens
Food poisoning
Myonecrosis or gas gangrene
(muscle swelling, pain)

S. saprophyticus
Urinary tract infections

S. haemolyticus
Wound infections
Bacteremia
Endocarditis

S. pneumoniae
Pneumonia
Meningitis
Bacteremia
Sinusistis
Otitis media

Enterococcus
Bacteremia
Urinary tract infections
Wound infections
Endocarditis

C. botulinum
Flaccid paralysis
Respiratory/cardiac failure
Food botulism
Wound botulism
Infant botulism
(sudden infant death syndrome)
Inhalation botulism

C. difficile
Psuedomembranous colitis
Diarrhea
Necrosis mucosa accumulate with
inflammatory cells & fibrins

B. anthracis
Cutaneous anthrax
Intestinal anthrax
Pulmonary anthrax

B. cereus
Food poisoning

M. tuberculosis
Pulmonary TB
Miliary TB
Intestinal TB
Cutaneous TB
Genitourinary TB
Disseminated TB
(immunosuppressed)

Atypical mycobacteria
Pulmonary
Lymph adenitis
Cutaneous
Disseminated
Catheter related infection
Post surgical infection

Enterobacteriaceae
Urinary tract infection
Diarrhea
Endotoxin shock

Shigella
Shigellosis
Microangiopathy
Thrombocytopenic purpura
Haemolytic uraemic syndrome
Dysentery with blood and pus
Inflammatory colitis

C. diphtheriae
Diphtheria
Local effects :
Systemic effects :
Pharyngitis (pseudomembrane in
Degenerative changes in heart,
the throat and trachea)
nervous system, kidneys
Myocarditis
Nerve weakness

M. leprae

N. gonorrhoea

L. monocytogenes
Listeriosis
Abortion (pregnant women)
Bacteremia
Encephalitis
Meningitis (old age & children)
Endocarditis
Gastroenteritis
N. meningitidis

Leprosy
(infection of skin, peripheral
nerve, mucous membranes)
Hypopigmentation

Urethritis
Cervicitis
Salpingitis
Pelvic inflammatory disease
Bacteremia
Arthritis
Pharyngitis
Ophthalmia neonatorum

Meningitis
Fluminant meningoccemia
Thrombosis
Meningoencephalitis
Bacteremia
Pneumonia
Arthritis
Urethritis

E. coli
Urinary tract infection
Meningitis
Gastroenteritis
Haemorrhagic colitis
Haemolytic uraemic syndrome
Bacteremia
Septicemia

K. pneumonia
Urinary tract infection
Hospital acquired infection
Bronchopneumonia
Meningitis
Bacteremia
Septicemia

Proteus
Urinary tract infection
Wound infection
Chronic otitis media
Septicemia
Bacteremia
Pneumonia
Food poisoning

Salmonella
Enteric fever (S. typhi)
Gastroenteritis (S. enterica)

Yersinia
Plague (Y. pestis)
Bubonic plague
Septicemic plague
Pneumonic plague
Gastrointestinal disease
(Y. enterocolotica & Y.
pseudotuberculosis)

Y. pseudotuberculosis
Mesenteric adenitis
Septicemia

Y. enterocolotica
Mesenteric adenitis
Diarrheal disease
Terminal ileitis

Enterobacter
Hospital acquired infection
Urinary tract infection
Lower respiratory tract infection

Invasive disease
Meningitis
Laryngoepiglottitis (Croup)
Pneumonia
Endocarditis
(Children)

H. influenzae
Non-invasive disease
Acute exacerbation of chronic
bronchitis
Otitis media
Sinusitis
(Adult)

Francisella
Ulcero-glandular
Glandular
Typhoidal
Oculoglandular
Oropharyngeal
Headache
Fever
Chills
Vomiting
Myalgias
Lymphadenitis
Lymphadenopathy
Tularaemia

Brucella
Malaise
Fever
Weakness
Sweats
Myalgia
Athralgia
Weight loss
Non-productive cough

Campylobacter
Severe diarrhoea
Stool with blood
Fever
Nausea
Abdominal pain

H. pylori
Chronic gastritis
Gastric ulcers
Gastric carcinomas

H. ducreyi
Chancroid (STD)
Co-infections : Herpes simplex,
Treponema pallidum (Syphillis)

B. pertussis
Pertussis
Cough
Bronchopneumonia
Hypoxic episodes
Ecephalopathy

Pasteurella
Local infections
Systemic speticemia
Osteomyelitis
Meningitis
Respiratory tract infections
Sinusitis
Peritonsillar abscess
Pneumonia

Actinobacillus
Subacute endocarditis
Periodontitis
Brain abscess

Vibrio
Epidemic & pandemic cholera
Cholera-like diarrhea
Gastroenteritis

Aeromonas
Diarrhoea
Primary infections
Nosocomial infections

B. pseudomallei
Melioidosis
Acute pulmonary illness
Bacteremia
Pulmonary infection
Suppuratvie lesions
Septicaemic infection

A. baumannii
Skin & wound infections
Pneumonia
Meningitis

LABORATORY DIAGNOSIS
Staphylococcus
Gram
Clusters
PMNs
Culture
Smooth
Low convex
Glistening
Densely opaque
Creamy to yellow
Identification test Catalase
Bacitracin
Direct smear

Group A Streptococcus
Throat swab
Gram
Cocci
Identification test Trimethoprimsulfamethoxazole
Bacitracin
Catalase
PYR
Bile-esculin
6.5% NaCl
Direct antigen
test
PCR
ASO test
Culture
Golden standard
Specimen
Microscopy

(+)

Direct smear

Culture

(+)
R

(+)

R
S
(-)
(+)
(-)
(-)

Identification test

S. aureus
Gram
Clusters
PMNs
Hemolysis on blood
agar

Coagulase
Bacitracin

(+)

(+)
R

Group B Streptococcus
Gram
(+)
Cocci

Identification test TrimethoprimR

sulfamethoxazole
Bacitracin
R
CAMP
(+)
Hydrolyses sodium
hippurate
Antigen test
Nucleic acid-based test
Culture
LIM broth with colistin &
nalidixic acid
Specimen
Microscopy

Coagulase (-) Staphylococcus

Direct smear
Gram
Clusters
PMNs
Culture
Non-hemolytic
Smooth
Grey to white

Identification test

Coagulase
Bacitracin

S. pneumoniae
Sputum
(pneumonia)
Aspirate from sinus or
middle ear
(ottitis media)
Microscopy
Gram
Encapsulated
Culture
Blood agar
Optochin disk
Identification test Catalase
Bile solubility
Quellung

(+)

S. saprophyticus
Gram
Clusters
PMNs
Non-hemolytic
Smooth
Creamy or yellow

Direct smear

Culture

(-)
R

Specimen

Identification test

Culture

(+)

S
(-)
(+)
(+)

Coagulase
Novobiocin
Furazolidone
Bacitracin

Viridans streptococcus
Blood agar
Optochin disk
Bile esculin
Carbohydrate

(+)

(-)
R
S
R

R
(-)
Ferment.

Identification test

Enterococcus
Catalase
Bile esculin
6.5% Nacl
PYR

Weak
(+)
(+)
(+)

Group D Streptococcus
Identification test Bile esculin
6.5% Nacl

(+)
(-)

Specimen
Microscopy
Culture

Identification test

C. botulinum
Feces
Food
Vomit
Gastric fluid
Wound exudates
Tissue
Culture
Pre-reduced CMB
Egg yolk agar
Identification test Lipase activity
Digest milk protein
Hydrolyse gelatin
Glusoe
Specimen

Specimen
Culture
Identification test

C. difficile
Stool

Cytopathic effect

Enterotoxin by immunoassay
Endoscopic observation

Specimen

Direct smear

Ferment.

C. tetani
Wound exudates
Specimen
Gram
(+)
Cooked meat broth
Smear
Blood agar
BA containing Polymyxin B
Culture
or Neomycin
Swarming growth

Toxigenicity test
Neurotox.

B. anthracis
Blood
Exudate
Lymph
CSF
Polychrome
methylene blue
stain

Culture

Capsule

C. perfringens
Exudate from the deeper
areas of wound, pus, tissue
Gram
(+)
Rod

Glucose blood agar

Meat-glucose medium
Thioglycollate medium
Pre-reduced cooked meat
medium
Litmus milk
Stormy
medium
clot
Nagler's reaction
Alpha.
"Double zone" of hemolysis
B. cereus
Horse and blood
sheep agar

Hemolysis

Corynebacterium
Throat swab
Gram
(+)
Highly pleomorphic
Metachomatic granules
(Neisser's methylene blue)
Culture
Blood tellurite
Greyish
agar
black
colony
Loffler's serum
Yellowish
white
Identification test Elek immunodiffusion test
PCR
ELISA
Antibiotic sensitivity test
Specimen
Direct smear

Specimen
Direct smear
Culture
Identification test

M. leprae
Skin biopsy
Ziehl-Neelsen
NONE
Lepromin test
(tuberculoid stage)
PCR

Specimen

Direct smear
Culture

L. monocytogenes
Aminiotic fluid
Child's blood
CSF
Gram
Blood agar

Identification test

M. tuberculosis
Atypical mycobacteria
Sputum
Identification test Niacin test
CSF
Neutral red test
Pleural effusion
Aryl SO4 test
(+)
Bronchoalveolar lavage
Peroxidase test
Small
Gastric aspirate
Catalase
Grayish Direct smear
Ziehl-Neelsen
Acid fast
blue
Auramine rhodamine
Narrow
fluorescence stains
zone
Culture
LowensteinRaised
of (extremely
Jensen medium
Dry
hemolysis sensitive)
Wrinkled
Catalase
(+)
Creamy
Antimicrobial susceptibility
white/buff
test
Identification test Antibiotic susceptibility
Mantoux test
NAAT/PCR
Mass spectrometry
Niacin test
(+)
Neutral red test
(+)
Aryl SO4 test
(-)
Peroxidase test
(+)
Catalase
Weakly (+)

N. gonorrhoea
Urethral discharge
Acid fast
Vaginal discharge
Direct smear
Gram
(-)
(+)
Diplococci

Culture
Modified Thayer
(+)
Martin
Chocolate agar
(+)
(22C)
Identification test Oxidase
(+)
Glucose
Ferment.
Antibiotic sensitivity test
NAAT
Specimen

Specimen

N. meningitidis
Blood - culture
CSF - smear, culture, test
Nasopharyngeal swab
Direct smear
Gram
(-)
Diplococci

Culture
Chocolate agar
(+)
with 5% CO2
Modified Thayer
(+)
Martin
Identification test Oxidase
(+)
Glucose
(+)
Latex agglutination test
Specimen

Direct smear
Culture
Identification test

E. coli
Gram
Bacilli
Blood agar
MacConkey agar
IMViC
Indole test
Methyl red test
VP test
Citrate test
TSI
Gluc
Lac/Suc
H2S
Urease test
API test

(-)
(-)
(+)
(-)
Strongly (+)

(-)

Hemolysis
Ferment.
(+)
(+)
(-)
(-)
(+)
(+)
(-)
(-)

Specimen
Macroscopic exam

Direct smear
Culture
Identification test

Specimen

Direct smear
Culture

E.coli (UTI)
Urine
Color
Transparency
Odour
pH
Albumin
Sugar
Gram
Pus cells
Blood agar
MacConkey agar
IMViC
TSI
API
Urease test
K. pneumonia
Urine
Wound swab
Blood
CSF
Throat swab
Gram
Blood agar
Nutrient agar
MacConkey agar
Biochemical test
Molecular test

E. coli (Meningitis)
Specimen
CSF
Macroscopic exam Colour
Transparency
Protein
Sugar
Direct Smear
Gram
Culture
Blood agar
(-)
MacConkey agar

Identification test IMViC

Hemolysis
TSI
Ferment.
API
Urease test

Specimen

Direct smear
Culture
(-)
Mucoid
Mucoid
Ferment

Proteus
Urine
Wound swab
Blood
Gram
Blood agar
Nutrient agar
Fishy odour
Biochemical test
Molecular test

E. coli (Diarrhoea)
E. coli (Septic infection)
Faecus
Specimen
Blood
Rectal swab
Wound swab
Culture
Blood agar
Hemolysis Direct smear
Gram
(-)
MacConkey agar
Ferment. Identification test IMViC
Identification test IMViC
TSI
(-)
TSI
API
Hemolysis
API
Urease test
Ferment.
Urease test
Antibiotic sensitivity test
Antibiotic sensitivity test
Serotyping
Serotyping
Specimen

Direct smear

(-)
Swarm
Swarm

Culture

Identification test

S. typhi
Gram
Flagellar stain
Motility test
MacConkey agar
XLD agar
SS agar

IMViC
Indole test
Methyl red test
VP test
Citrate test
TSI
Gluc
Lac/Suc
H2S
Urease test
Catalase
Oxidase
API

(-)

Specimen

NLF
Culture
Pale
with black
center Identification test
(H2S)
(-)
(+)
(-)
(-)
(+)
(-)
(+)
(+)
(+)
(-)

Shigella
Fresh stool
Rectal swab

Feacal
leucocyte
RBC
NLF
Colourless

MacConkey
SS agar
DCA agar
TSI
Gluc
(+)
Lac/Suc
(-)
H2S
(-)
API
Serological identification
Antibiotic sensitivity test

Specimen

Direct smear

Culture

Y. pestis
Blood
Sputum
Lymph node aspirate
Gram
(-)
Giemsa stain
Immunofluorescent stain
Blood agar
MacConkey agar
Serology test

H. parainfluenzae
Nasopharyngeal swab
Pus
Blood
Spinal fluid
Direct smear
Gram
Culture
Chocolate agar
Identification test X dependent
V denpendent
Porphyrin
Specimen

Y. enterocolitica & Y. pseudotuberculosis

Specimen
Faeces
Culture
Selective media

Specimen

Direct smear
(-)
Culture
(-)
(+)
(+)

Identification test

B. pertussis
Saline nasal wash
Nasopharyngeal swab
Cough droplets
Gram
Motile
Fastidious
Slow-growing
Bordet-Gengou medium
Small
Smooth
Round
Shiny
Blood agar
MacConkey agar
PCR
Catalase
Oxidase

Haemophilus influenzae
Nasopharyngeal swab
Pus
Blood
Spinal fluid
Direct smear
Gram
(-)
Culture
Chocolate agar
Identification test Antigen detection in CSF
Test for X and V factor
Satellitism
CO2 enhancement
(+)
X dependent
(+)
V dependent
(+)
Catalase
(+)
Hemolysis
(-)
Porphyrin
(-)
Susceptibility test

(HTM)
Specimen

Culture
Identification test
(-)
X

Pasteurella
Blood agar
Oxidase test
Indole test
ONPG
Penicillin

Specimen

Direct smear
Culture
Identification test

Specimen
(+)
(+)
(-)
S

Culture

X
X
(+)
(+)

Serology

H. ducreyi
Nasopharyngeal swab
Pus
Blood
Spinal fluid
Gram
Chocolate agar
X dependent
V denpendent
Porphyrin

(-)
(+)
(-)
(-)

Francisella
Fluid form primary lesion
Aspirate of enlarged
regional lymph nodes
Sputum
Pharyngeal washes
Gastric aspirates
Blood
Fastidious
Slow-growing
Strict aerobe
Chocolate agar
Thayer-Martin agar
BCYE
Glucose-cysteine agar
Trypticase soy agar
Antibody response
Agglutination test

Specimen
Direct smear
Culture

Identification test
Serology

Culture

Brucella
Blood
Biopsy (lymph node, bone)
Gram
(-)
Coccobacilli
Complex media
5-10% CO2
Non-hemolytic
Small
Convex
Tryptic-soy agar
Catalase
(+)
Oxidase
(+)
ELISA for IgM & IgG
Agglutination test
Aeromonas
TCBS

Green

Actinobacillus
Blood agar
Chocolate agar
Colony with central wrinking
Identification test Catalase
(+)
Oxidase
(-)
Culture

Culture
Identification test

Culture

Serology

B. pseudomallei
Metallic sheen becomes
Wrinkled or
Honeycombed
Antibodies detection

Culture

Campylobacter
Skirrow's medium
Oxidase
Catalase
Carbohydrate
Nitrate reduction
Hydrogen sulfide
Hippurate test
Acinetobacter
FLN medium
MacConkey agar

Culture

Identification test

Colourless Culture
or grey
(+)
(+)
X

V. cholerae
Enrichment in alkaline
Culture
peptone water
TCBS agar
Yellow
"rice water" stool

Oxidase
(+)
Glucose
Ferment.
Indole
(+)
Nitrate reduction
(+)
Methyl red
(-)
Urease test
(-)
String test
(+)

H. pylori
Skirrow's medium
Chocolate agar

Transluc. Culture

V. parahaemolyticus
TCBS agar

P. aeruginosa
Cetrimide agar
grapelike odour
Smooth round
colonies
Fluorescent green
Bluish pigment
Red pigment
Black pigment

Green

Pyoverdin
Pyocyanin
Pyorubin
Pyomelanin

TREATMENTS
Staphylococcus
S. aureus
Penicillin
X
Cloxacillin

MRSA
Vancomycin

(+Rifampicin & Gentamicin)

VRSA/VISA
Linezolid

Quinupristin
Dalfopristin
Daptomycin

Macrolide resistant
Clindamycin

S. pyogenes
Penicillin
Macrolides
Clindamycin
(necrotising fasciitis)

C. tetani
Local debridement
Benzodiazepines
(control spasm)
Penicillins
Metronidazole

C. prefringens
Penicillin
Surgical
debridement

C. diphtheriae
Horse or human
antitoxin sera
Penicillin
Erythromycin
Cephalosporin
Quinolones
Chloramphenicol
Tetracyclines
Trimethoprim

S. agalactiae

L. monocytogenes
Penicillin
Ampicillin
Erythromycin
Chloramphenicol
Tetracycline
Gentamycin

Penicillin

C. botulinum
Penicillin
Metronidazole
Trivalent botulism
antitoxin

M. tuberculosis
Rifampicin
Isoniazid
Ethambutol
Pyrazinamide
Streptomycin

S. pnuemoniae
Penicillin
Cephalosporin
Erythromycin
Chloramphenicol
Vancomycin

C. difficile
Metronidazole

Vancomycin

Discontinuation of offending
antibiotics

M. leprae

Dapsone
Ethionamide
Rifampicin
Clofazimine
(multi drug trt)
Antiinflammatory
drugs
Wound care
Rehablitation

Enterococcus
Combination aminoglycoside
Ampicillin

Penicillin

Vancomycin

(cell wall active agent)

Linezolid

Quinupristi
Dalfopristin
Fluoroquinolones

B. anthracis
Ciprofloxacin
Penicillin
Doxycycline
Erythromycin
Chloramphenicol

N. gonorrhoea

Penicillin
Ceftriaxone
Cefixime
Ciprofloxacin
Oroflaxacin
C.trachomatis infec.
Doxycycline
Erythromycin
Pregnant
Erythromycin
Amoxicillin

N. meningitidis
Penicillin
Chloramphenicol
Cephalosporin

Shigella
Ciprofloxacin
Ampicillin
Tetracycline
Trimethoprimsulfamethoxazole
Chloramphenicol

F. tularensis
Beta-lactam
antibiotics
Streptomycin
Gentamicin

H. pylori
Omeprazole
Lansoprazole
Clarithromycin
Amoxicillin
Metronidazole
Ranitidine
Bismuth
Tetracycline

E. coli
Cephalosporin
Gentamicin
Ciprofloxacin
Correction of fluid and
electrolyte imbalance

Y. pestis
Streptomycin
Tetracycline
Chloramphenicol

Brucella
Tetracycline
(+doxcycline)
Streptomycin
Rifampicin
Trimethoprimsulfamethoxazole
(Children)
P. aeruginosa
Penicillins
Ticarcillin
Piperacillin
(+Gentamicin, amikacin,
tobramycin)
Ciprofloxacin
Cephalosporin
Quinolones

K. pneumonia
Cephalosporin
Gentamicin
Ciprofloxacin

H. influenzae
Ampicillin
Cephalosporin
Chloramphenicol
Meropenem

Actinobacillus
Penicillin
Cephalosporin
-lactam--lactamase
inhibitor
Fluoroquinolones
Tetracycline

B. pseudomallei
Cetazidime
Carbepenems
Amoxycillinclavulanic acid
Quinolones

Proteus
Aminoglycosides
Cephalosporin
Amipicillin
Chloramphenicol
Tetracycline
Benzyl penicillin
(moderate sensitive)
H. ducreyi
Erythromycin
Azithromycin
Ciprofloxacin
Ceftriaxone
Amoxicillinclavulanate
Trimethoprimsulfamethoxazole

Salmonella

V. cholerae
Tetracycline

Doxycycline

Replace water & electrolyte

loss

A. baumannii
Penicillin (most)
Chloramphenicol
(+aminoglycoside &
ticarcillin)

B. pertussis
Erythromycin
(Catarrhal stage)
Oxygen inhalation
& sedation
Prophylaxis erythromycin

Amipicillin

Trimethoprim
sulfamethoxazole
Cephalosporin

Replace fluid and electrolyte

Aeromonas
Tetracycline
Aminoglycoside
Cephalosporine

PREVENTIONS

Prophylaxis

S. pyogenes
Penicillin
(Glomerulonephritis)

C. botulinum
Maintain food in acid pH
Heating of food
Infant younger than 1 year not
given honey
Boil canned food

Prophylaxis
Vaccine

N. meningitidis
Rifampicin
Polysaccharide
tetravalent
vaccine

Y. pestis
Vaccine
Controlling rats and rat fleas

Chong Yiing Yee 19/4/14

S. agalactiae
Conjugated
polyvalent
vaccine
Prophylaxis
Penicillin
Ampicillin
Vaccine

B. anthracis
Control in animals
Vaccinated livestock
Human vaccine
Formalin disinfection

E. coli
Proper food and water hygiene
Pasteurization of milk

Vaccine
Prophylaxis

H. influenzae
Hib conjugate
Rifampicin

Vaccine

Vaccine

S. pneumoniae
7-valent
conjugated
vaccine
23-valent
polysaccharide
vaccine
C. diphtheriae
DPT

K. pneumonia
Good hospital hygiene
Patient with multi resistant
bacteria must be separated

Vaccine

B. pertussis
DPT

Prophylaxis

Enterococcus
Rational use of
antibiotics and
preventions of
nosocomial
infections

L. monocytogenes
Vaccine
NONE
Avoidance of unpasteurized dairy
products
Thorough cooking
Good kitchen practices

C. tetani
Vaccine
Tetanus toxoid
Proper care of soil contaminated
wound
Antitoxin prophylaxis

Vaccine

M. tuberculosis
BCG

Proteus
Good hospital hygiene
Patient with multi resistant
bacteria must be separated

Salmonella
Sanitary measure
Chlorinated water supply
Thoroughly cooked food
Typhoid vaccination

F. tularensis
Vaccine
Live-attenuated
Avoid reservoirs
Protective clothing & gloves
Laboratory personnel made
aware

Brucella
Eradication of animal reservoir
Vaccine
Pastuerization of milk
Protective clothing

C. perfringens
Cleaning of contaminated wounds

N. gonorrhoea
Practise safe sex
Contact tracing
Avoid multiple sexual partners

Shigella
Sanitary control of water, food,
sewage
Isolation of patients
Disinfection
V. cholerae
Phenol killed
vaccine
B subunit +
killed organisms
Safe water and waste disposal
Good personal hygiene
Health education
Vaccine