Essential concepts in medical Bacteriology - Mathilde Lescat

Mathilde Lescat Assistant Professor, Université Paris Sorbonne Nord, France

The essential concepts to know in MEDICAL BACTERIOLOGY

Diagnosis by serology, specific culture or molecular biology

Diagnosis by standard culture

Treponema pallidum Borrelia burgdorferi Leptospira sp

Spirochetes

Chlamydiae sp, Mycoplasma sp Legionella pneumophila Ricketsiae, Coxiella sp

Intracellular bacteria

Enterobacteriaceae Parvobacteria (Haemophilus sp, HACCEK, Pasteurella sp, Brucellla melitensis, Bartonella sp) Strict aerobic (Pseudomonas aeruginosa) Anaérobies (Bacteroides sp, Prevotella sp...)

Corynebacteria Listeria monocytogenes Anaerobies (Clostridium sp)

Neisseria meningitidis Neisseria gonnorhoeae Anaerobes (Veillonella sp)

Mycobacteria

Intra cellulaires

Gram + bacillus

Gram - cocci

Gram - bacillus

Gram + cocci

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Staphylococci Streptococci Enterococci Anaerobes (Peptostreptococcus sp)

Major families of bacteria

Digestive microbiota: Anaerobes ++++ (Bacteroides sp, Clostridium sp ...) Enterobacteriaceae (E. coli), enterococci (Enterococcus faecalis)

Vaginal microbiota: Lactobacilli +++, Mycoplasmas, Enterobacteriaceae and Enterococci transiently

Oropharyngeal / nose microbiota: Streptococci, Neisseria sp, Hemophilia, Staphylococcus aureus, Chlamydiae, Mycoplamses, Anaerobes (Veillonella sp ...)

Skin microbiota: Staphylococci, corynebacteria

The great commensal sites

Chhlamydiae psitacci

Leptospires,

Coxiella burnetti Brucella melitensis Escherichia coli O157:H7

Pasteurella multocida, Bartonella henselae

Rickettsia sp, Borrelia sp

Rickettsia sp Yersinia pestis

Main commensal sites in animals and vectors associated with anthropozoonoses

Vibrio cholerae, Aeromonas hydrophila

Legionnella pneumophila

Listeria monocytogenes

Strict aérobic Gram negative bacteria (Pseudomonas aeruginosa)

Saprophytic bacteria from the environment

Urinary tract infections Enterobacteriaceae (E. coli), enterococci (E. faecalis), Streptococcus agalactiae, Staphylococus saprophyticus

Endocarditis: Streptococci, Staphylococci

Meningitis (adult, child) Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes

Digestive infections Ulcers: Helicobacter pylori Extraintestinal: Anaerobes, Enterobacteriaceae, Enterococci Diarrhea: Salmonella, Shigella, Yersina enterocolytica, Campylobacter sp

Genital infections low: Gonococci, Chlamydiae, Syphilis, High: Enterobacteriaceae, Anaerobes Maternal-fetal infections: E. coli, Streptococcus agalactiae, Listeria

Lung infections: Community: Streptococcus pneumoniae, Haemophilus influenzae, atypical (Chlamydiae, Mycoplasmas, Legionella) Nosocomial: Enterobacteriaceae Staphylococcus aureus, Pseudomonas aeruginosa

Skin infections: Staphylococcus aureus, Streptococcus pyogenes Material associated: Pseudomonas aeruginosa, Staphylococci, Enterobacteriaceae

The main infections

Efflux, Impermeability

Enzymes

Target Modification

Decreased ATB concentration

ATB destruction

New targets, or modification of existing targets

Main resistances to antibiotics

*emerging highly resistant bacteria

Vancomycin resistant enterococci*

Carbapenem Enterobacteriaceae producers*

ESBL Gram negative producers

Multiresistant Pseudomonas aeruginosa and Acinetobacter baumanii

MRSA

MDRO and (multi drug resistant organisms)

Urinary tract infections Cystitis: Fosfomycin, sulfamethoxazole, Fluoroquinolone High: 3rd generation cephalosporin, fluoroquinolone

Endocarditis 3rd generation cephalosporin , Amoxicillin + aminoglycoside

Meningeal infections (adult, child) 3rd generation cephalosporin vancomycin, amoxicillin

Digestive infection Ulcers: Chlarythromycin Extra intestinal: Amoxicillin-clavulanate, 3rd generation cephalosporin + metronidazolel, tazocillin Diarrhea: Doxycycline, Fluoroquinolone

Genital infections Low: tetracycline, macrolide, Fluoroquinolone (CT) 3rd generation cephalosporin (NG) High: 3rd generation cephalosporin+ metronidazole + tetracycline Maternal fetal infections: 3rd generation cephalosporin, amoxicillin

Lung infections: Communautary: Amoxicillin-clavulanate, Amoxicillin, C3G, Macrolide Nosocomial: Tazocillin

Skin infections Amoxiciilin, Amoxicillin-clavulanate

The main first-line treatments