PSEUDOMONADS, ACINETOBACTERS AND OTHER UNCOMMON GRAM NEGATIVE BACTERIA

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

The Pseudomonad Group

Morphology

Oxygen Requirement
Sugar fermentation Important members:
Pseudomonas spp.
Burkholderia spp.

Stenotrophomonas spp.

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Classification of Some of the Medically Important Pseudomonads

rRNA Homology Group and Subgroup I Fluorescent Group Nonfluorescent Grp. II

Genus & Species P. aeruginosa, P. fluorescens, P. putida P. stutzeri, P. mendocina B. pseudomallei, B. mallei, B. cepacia, R. pickettii Comamonas species, Acidovorax species Brevundimonas species Stenotrophomonas maltophilia
ALLAN JAY C. ESPIRITU, RMT, M.Sc.

III IV V

Pseudomonas aeruginosa

Morphology Flagellation Strict aerobes Oxidase Good growth on MAC

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Gram stain of P. aeruginosa

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

P. aeruginosa
Habitat
Environmental water sources (e.g. hospital

respirators & humidifiers) May inhabit skin, URT and colon

Transmission
Water aerosols, aspiration and fecal

contamination

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

P. aeruginosa
Pathogenicity/Virulence
Pili Exotoxin A diphtheria-like toxin

Endotoxin

Diseases
Wound infections
Ecthyma gangrenosum

UTI
Pneumonia in cystic fibrosis

Nosocomial infections in burn patients

Bacteremia and sepsis
ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Ecthyma gangrenosum

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Lab. Diagnosis of P. aeruginosa

Microscopic Cultural: grape or tortilla corn Biochemical

Oxidase Growth at 42oC Hydrolysis of acetamide Growth on cetrimide agar Nitrate reduction
ALLAN JAY C. ESPIRITU, RMT, M.Sc.

P. aeruginosa

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Pigments Produced by P. aeruginosa Pyocyanin Pyoverdin Pyorubrin Pyomelanin

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Epidemiology of P. aeruginosa
Treatment
Ticarcillin/Piperacillin with tobramycin

Aztreonam, imipinem, ciprofloxacin

Ceftazidime and cefoperazone

Prevention
Moist environments: sinks, showers, tubs,

etc.

Control
Vaccine from appropriate types
ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Other Pseudomonas species

P. fluorescens and P. putida
Pyocyanin production Hydrolysis of acetamide Nitrate reduction Growth at 42oC

P. fluorescens is positive for gelatinase and

lecithinase, P. putida is negative to both. Diseases

Respiratory infection, wound infection and UTI

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Burkholderia species
Burkholderia pseudomallei
Morphology
Oxidase test

Disease: MELIOIDOSIS A.k.a. _____________________________ Commonly a pulmonary infection, primarily a pneumonitis

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Burkholderia species
Burkholderia mallei
Morphology Oxidase test Causes GLANDERS in horses
May be transmitted to man Cutaneous involvement with thickening of the superficial lymphatics

Burkholderia cepacia
May cause pneumonia, UTI and other

infections Oxidase test Potent nosocomial infection in cystic fibrosis patients

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Other Pseudomonads
Stenotrophomonas maltophilia
Nosocomial LRTI

Oxidase negative, motile, LDC (+), DNAse

(+), oxidizes OF maltose (maltophilia)

Shewanella putrifaciens
Only nonfermentor that produces H2S in TSI

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

The Acinetobacter
Important members
A. baumannii, A. lwoffi, A. johnsonii, A.

haemolyticus

Habitat
Skin, oropharynx, vagina

Diseases
UTI, LRTI

Lab. Diagnosis
G(-) coccobacilli to diplococci, Oxidase (-), non-

motile A. baumannii produces acid from 10% lactose A. lwoffi is asaccharolytic ESPIRITU, RMT, M.Sc. ALLAN JAY C.

Uncommon G(-) Bacteria

Moraxella
M. lacunata M. nonliquifaciens M. osloensis M. phenylpyruvica

Chryseobacterium (Flavobacterium)
C. indologenes wound infection

C. meningosepticum neonatal meningitis

Produces yellow-pigmented colonies on BAM

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Uncommon G(-) Bacteria

Alcaligenes
A. faecalis A. xylosoxidans spp. xylosoxidans A. xylosoxidans spp. denitrificans

Eikenella
E. corrodens Normal inhabitant of oral cavity and URT of humans Causes gingivitis, tooth infection, neck & facial abscess, pneumonia, clinched fist injury, bacteremia BAP: bleach-like odor
ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Uncommon G(-) Bacteria

Streptobacillus moniliformis
GNR in chains with irregular bulbous swelling Grown on HI agar or broth Causes Rat bite fever (Haverhill disease)

Spirillum minor
Small G(-) spiral shaped rods Darkfield microscopy Causes Rat bite fever (Soduku)

Calymmatobacterium granulomatis
Causes granuloma inguinale Diagnosis: Donovan bodies in Wrights stain

ALLAN JAY C. ESPIRITU, RMT, M.Sc.

Uncommon G(-) Bacteria

Bartonella bacilliformis
Transmission: Phlebotomus sandfly (vector)

Causes Carrions disease Oroya fever: severe febrile anemia Verruga peruana: nodular disease of cutaneous tissues

Cardiobacterium hominis
Dumb-bell shaped GNR

Causes endocarditis
ALLAN JAY C. ESPIRITU, RMT, M.Sc.