GENERAL KNOWLEDGE

BACTERIAL INFECTIONS OF MEDICAL IMPORTANCE

July 16, 2023

Nationally notifiable bacterial diseases

For the most up-to-date information, I recommend referring to the Centers for Disease Control and Prevention (CDC) website or other official health agencies.

  1. Anthrax
  2. Botulism (foodborne, wound, and infant)
  3. Brucellosis
  4. Chancroid
  5. Chlamydia trachomatis infection
  6. Cholera
  7. Diphtheria
  8. Ehrlichiosis and anaplasmosis (Ehrlichia chaffeensis, Ehrlichia ewingii, Anaplasma phagocytophilum)
  9. Gonorrhea
  10. Haemophilus influenzae, invasive disease
  11. Hantavirus pulmonary syndrome
  12. Hemolytic uremic syndrome, post-diarrheal
  13. Hepatitis A
  14. Hepatitis B, acute and chronic infection
  15. Hepatitis C, acute and chronic infection
  16. Human immunodeficiency virus (HIV) infection, laboratory-identified
  17. Influenza-associated pediatric mortality
  18. Legionellosis
  19. Leprosy (Hansen’s disease)
  20. Listeriosis
  21. Lyme disease
  22. Malaria
  23. Measles
  24. Meningococcal disease
  25. Mumps
  26. Novel influenza A virus infections
  27. Pertussis (whooping cough)
  28. Plague
  29. Poliomyelitis, paralytic and non-paralytic
  30. Q fever
  31. Rabies, animal and human
  32. Rubella
  33. Salmonellosis
  34. Severe acute respiratory syndrome-associated coronavirus (SARS-CoV) disease
  35. Shiga toxin-producing Escherichia coli (STEC) infections
  36. Shigellosis
  37. Smallpox (variola) infection
  38. Spotted fever rickettsiosis, including Rocky Mountain spotted fever
  39. Streptococcal toxic shock syndrome
  40. Streptococcus pneumoniae, invasive disease
  41. Syphilis
  42. Tetanus
  43. Toxic shock syndrome (other than streptococcal)
  44. Trichinellosis
  45. Tuberculosis
  46. Tularemia
  47. Typhoid fever
  48. Vancomycin-intermediate Staphylococcus aureus (VISA) infection
  49. Vancomycin-resistant Staphylococcus aureus (VRSA) infection
  50. Vibrio infection, including V. cholerae and non-cholera Vibrio species
  51. Viral hemorrhagic fevers (e.g., Ebola virus, Lassa fever)
  52. Yellow fever
  53. Yersiniosis

Please note that this list may not be exhaustive, and there may be additional diseases that are nationally notifiable based on specific circumstances or regional requirements.

 

Bacterial Disease Overview

Here is a correlation of bacterial diseases with their major signs and symptoms, etiologic agent, reservoir(s), mode(s) of transmission, and diagnostic laboratory procedures:

  1. Tuberculosis (TB):
    • Signs and Symptoms: Chronic cough, fever, night sweats, weight loss, fatigue, chest pain.
    • Etiologic Agent: Mycobacterium tuberculosis.
    • Reservoir: Humans are the primary reservoir, but the bacteria can also survive in animals.
    • Mode of Transmission: Airborne transmission through inhalation of respiratory droplets from an infected person.
    • Diagnostic Laboratory Procedures: Tuberculin skin test (TST), interferon-gamma release assays (IGRAs), sputum culture, chest X-ray, molecular tests like PCR.
  2. Salmonellosis:
    • Signs and Symptoms: Diarrhea, abdominal cramps, fever, vomiting, nausea.
    • Etiologic Agent: Salmonella bacteria (e.g., Salmonella enterica).
    • Reservoir: Various animals, including poultry, livestock, reptiles, and pets.
    • Mode of Transmission: Ingestion of contaminated food (especially raw or undercooked eggs, poultry, meat, and dairy products) or water, contact with infected animals or their feces.
    • Diagnostic Laboratory Procedures: Stool culture, polymerase chain reaction (PCR), serological tests.
  3. Cholera:
    • Signs and Symptoms: Profuse watery diarrhea, vomiting, dehydration, muscle cramps.
    • Etiologic Agent: Vibrio cholerae (usually serotypes O1 and O139).
    • Reservoir: Contaminated water and seafood.
    • Mode of Transmission: Ingestion of contaminated food or water.
    • Diagnostic Laboratory Procedures: Stool culture, rapid diagnostic tests (RDTs), PCR.
  4. Pertussis (Whooping cough):
    • Signs and Symptoms: Severe coughing fits, “whooping” sound during inhalation, post-cough vomiting, fatigue.
    • Etiologic Agent: Bordetella pertussis.
    • Reservoir: Humans are the primary reservoir.
    • Mode of Transmission: Respiratory droplets from infected individuals through coughing or sneezing.
    • Diagnostic Laboratory Procedures: Nasopharyngeal swab or aspirate culture, PCR, serological tests.
  5. Gonorrhea:
    • Signs and Symptoms: Painful urination, abnormal genital discharge, pelvic pain (in women), testicular pain (in men).
    • Etiologic Agent: Neisseria gonorrhoeae.
    • Reservoir: Humans are the only known reservoir.
    • Mode of Transmission: Sexual contact (vaginal, anal, or oral) with an infected person.
    • Diagnostic Laboratory Procedures: Urine or swab culture, nucleic acid amplification tests (NAATs), PCR.

It’s important to note that the diagnostic laboratory procedures mentioned above are commonly used but may vary based on the availability of resources and advancements in testing methods. Additionally, it’s recommended to consult healthcare professionals and official health agencies for the most up-to-date and accurate information on specific diseases.

 

Bacterial Diseases by Body Site

Here are examples of bacterial diseases associated with different body sites:

  1. Urinary Tract:
    • Urinary Tract Infection (UTI): Caused by bacteria such as Escherichia coli (E. coli), Klebsiella pneumoniae, or Proteus mirabilis.
  2. Respiratory Tract:
    • Pneumonia: Caused by bacteria like Streptococcus pneumoniae, Haemophilus influenzae, or Legionella pneumophila.
    • Tuberculosis (TB): Caused by Mycobacterium tuberculosis.
  3. Gastrointestinal Tract:
    • Salmonellosis: Caused by Salmonella enterica.
    • Campylobacteriosis: Caused by Campylobacter jejuni.
    • Shigellosis: Caused by Shigella species.
  4. Skin and Soft Tissues:
    • Cellulitis: Often caused by Streptococcus pyogenes or Staphylococcus aureus.
    • Impetigo: Caused by Staphylococcus aureus or Streptococcus pyogenes.
  5. Central Nervous System:
    • Meningitis: Caused by bacteria like Neisseria meningitidis, Streptococcus pneumoniae, or Haemophilus influenzae.
  6. Bloodstream:
    • Bacteremia: Bacteria can enter the bloodstream and cause bloodstream infections, often originating from other sites in the body. Examples include Staphylococcus aureus or Escherichia coli.
  7. Genital Tract:
    • Gonorrhea: Caused by Neisseria gonorrhoeae.
    • Chlamydia: Caused by Chlamydia trachomatis.

Please note that these examples are not exhaustive, and there may be other bacteria associated with diseases in each body site. Additionally, some diseases can be caused by both bacteria and other types of pathogens, such as viruses or fungi.

 

Gangrene & Gas Gangrene

Gangrene and gas gangrene are both types of tissue death caused by a lack of blood supply, but they differ in certain key aspects:

Gangrene: Gangrene is a term used to describe the death and decay of body tissue, typically due to a severe interruption in the blood supply to that area. It can occur in any part of the body but commonly affects the extremities, such as the fingers, toes, hands, or feet. Gangrene usually develops when the blood flow is obstructed due to conditions like atherosclerosis (narrowing of blood vessels), trauma, or severe infection.

There are different types of gangrene, including dry gangrene, wet gangrene, and gas gangrene. In this response, we will focus on the distinction between gangrene and gas gangrene.

Gas Gangrene: Gas gangrene, also known as clostridial myonecrosis, is a specific type of gangrene caused by certain bacteria of the Clostridium genus, primarily Clostridium perfringens. These bacteria are anaerobic, meaning they can thrive in environments without oxygen. Gas gangrene typically occurs when the bacteria enter deep wounds, such as those caused by traumatic injuries, surgical incisions, or compound fractures.

The key characteristic of gas gangrene is the production of gas within the affected tissue, which gives it its name. The gas is produced by the bacteria as they metabolize tissue components, releasing toxins and causing further damage. As a result, the infected area becomes swollen, discolored, and extremely painful.

Distinguishing Features:

  1. Bacterial Infection: While both gangrene and gas gangrene involve tissue death, gas gangrene is specifically caused by infection with Clostridium perfringens or other gas-producing bacteria.
  2. Gas Formation: Gas gangrene is characterized by the production of gas within the affected tissues, leading to a distinctive swollen appearance. This gas is not present in other forms of gangrene.
  3. Symptoms: Common symptoms of gangrene include discoloration of the skin, severe pain, foul odor, and tissue decay. Gas gangrene shares these symptoms but is often associated with a more rapid progression of tissue destruction and severe pain.
  4. Treatment: The treatment approaches for both conditions differ. While surgical removal of dead tissue (debridement) is necessary for both, gas gangrene often requires additional measures, such as intravenous antibiotics and hyperbaric oxygen therapy, due to the bacterial infection involved.

It is important to note that gas gangrene is a medical emergency requiring immediate attention, as it can progress rapidly and lead to life-threatening complications. If you suspect gas gangrene or any form of gangrene, it is essential to seek prompt medical care.

 

Bacterial STDs and Agents

Here are some common bacterial sexually transmitted diseases (STDs) and their respective etiologic agents:

  1. Gonorrhea:
    • Etiologic agent: Neisseria gonorrhoeae, a gram-negative bacterium.
  2. Syphilis:
    • Etiologic agent: Treponema pallidum, a spirochete bacterium.
  3. Chlamydia:
    • Etiologic agent: Chlamydia trachomatis, an obligate intracellular bacterium.
  4. Chancroid:
    • Etiologic agent: Haemophilus ducreyi, a gram-negative bacterium.
  5. Granuloma inguinale (Donovanosis):
    • Etiologic agent: Klebsiella granulomatis (formerly known as Calymmatobacterium granulomatis), a gram-negative bacterium.
  6. Lymphogranuloma venereum (LGV):
    • Etiologic agent: Chlamydia trachomatis serovars L1, L2, and L3.

It’s important to note that these are just a few examples of bacterial STDs and their etiologic agents. There are other less common bacterial infections that can be transmitted sexually as well. If you have any concerns or suspect you may have an STD, it’s important to consult a healthcare professional for accurate diagnosis and appropriate treatment.

 

Rickettsial & Ehrlichial Infections

Rickettsial and ehrlichial infections are caused by bacteria that belong to the Rickettsiaceae family and Ehrlichia genus, respectively. While these infections primarily affect the endothelial cells lining blood vessels, they can also impact the cardiovascular system. Here are some examples of rickettsial and ehrlichial infections that can involve the cardiovascular system:

  1. Rocky Mountain spotted fever (RMSF): RMSF is caused by the bacterium Rickettsia rickettsii. It is transmitted through the bite of infected ticks. The bacteria infect endothelial cells, leading to inflammation and damage to blood vessels throughout the body, including those in the cardiovascular system. This can result in symptoms such as rash, fever, headache, and in severe cases, organ dysfunction, including heart-related complications.
  2. Epidemic typhus: Epidemic typhus is caused by Rickettsia prowazekii, and it is typically transmitted through lice. This infection can affect the cardiovascular system by causing inflammation of blood vessels. It may lead to symptoms such as high fever, headache, rash, and in severe cases, cardiovascular complications like myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the sac surrounding the heart).
  3. Scrub typhus: Scrub typhus is caused by Orientia tsutsugamushi and transmitted by chiggers. While it primarily affects the endothelial cells of small blood vessels, severe cases can involve cardiovascular complications. These can include inflammation of the heart muscle (myocarditis) or inflammation of the lining around the heart (pericarditis). Symptoms of scrub typhus include fever, headache, rash, and muscle pain.
  4. Ehrlichiosis: Ehrlichiosis refers to several diseases caused by different species of Ehrlichia bacteria. Ehrlichia chaffeensis and Ehrlichia ewingii are two common species associated with human infections. These bacteria infect white blood cells, leading to inflammation and damage to blood vessels. In severe cases, ehrlichiosis can cause cardiovascular complications, such as myocarditis or vasculitis (inflammation of blood vessels). Symptoms include fever, fatigue, headache, muscle aches, and sometimes a rash.

Infections involving the cardiovascular system can vary in severity, and complications may occur in severe or untreated cases. Early diagnosis and appropriate treatment are crucial to manage these infections and minimize their impact on the cardiovascular system. If you suspect you have any of these infections, it is essential to consult a healthcare professional for proper evaluation and treatment.

 

Anaerobic Bacterial Diseases

Anaerobic bacteria are microorganisms that thrive in environments with little to no oxygen. They can cause various diseases in humans, often in areas of the body that have limited oxygen supply. Here are some examples of diseases caused by anaerobic bacteria:

  1. Clostridium difficile infection: Clostridium difficile, commonly known as C. difficile, is a bacterium responsible for causing severe diarrhea and colitis. It typically occurs after antibiotic treatment disrupts the normal gut flora, allowing C. difficile to overgrow and produce toxins. The infection can range from mild diarrhea to life-threatening pseudomembranous colitis.
  2. Gas gangrene: Gas gangrene is a serious and potentially life-threatening condition caused by Clostridium perfringens. This bacterium releases toxins that destroy tissue and produce gas within muscles. Gas gangrene is characterized by severe pain, swelling, and a foul-smelling discharge from the infected wound.
  3. Tetanus: Tetanus is caused by the bacterium Clostridium tetani, which releases a neurotoxin called tetanospasmin. The toxin affects the nervous system, leading to muscle stiffness and spasms. Tetanus is commonly associated with contaminated wounds, and without prompt treatment, it can be fatal.
  4. Bacterial vaginosis: Bacterial vaginosis (BV) is a common vaginal infection primarily caused by an imbalance in the vaginal microbiota. While several bacteria can contribute to BV, anaerobic bacteria like Gardnerella vaginalis and Prevotella species are often involved. BV is characterized by a fishy odor, vaginal discharge, and itching or irritation.
  5. Actinomycosis: Actinomycosis is a chronic bacterial infection caused by Actinomyces species, which are normal inhabitants of the oral cavity, gastrointestinal tract, and female genital tract. It typically affects the face, neck, or abdomen. Actinomycosis can form abscesses and produce draining sinuses, leading to the formation of hard, lumpy masses known as “sulfur granules.”
  6. Dental abscesses: Dental abscesses are localized collections of pus caused by infection in the tooth or surrounding tissues. Anaerobic bacteria, such as Fusobacterium, Prevotella, and Peptostreptococcus species, are commonly involved. Dental abscesses can cause severe pain, swelling, and inflammation.
  7. Anaerobic pneumonia: Anaerobic bacteria can also cause lung infections, particularly in individuals with underlying lung disease or compromised immune systems. Aspiration of oral or gastrointestinal contents containing anaerobic bacteria can lead to the development of anaerobic pneumonia. The bacteria involved can vary but often include species like Prevotella, Fusobacterium, and Bacteroides.

These are just a few examples of diseases caused by anaerobic bacteria. It’s important to note that anaerobic infections often require specific treatment approaches, such as antibiotics that target anaerobic bacteria, surgical intervention, or both. If you suspect you have any of these conditions, it’s essential to seek medical attention for proper diagnosis and treatment.

 

Biofilms & Human Diseases

A biofilm is a complex and structured community of microorganisms that adhere to surfaces and are surrounded by a self-produced extracellular matrix. It consists of bacteria, fungi, algae, or other microorganisms embedded within a matrix of proteins, polysaccharides, and DNA. This matrix helps the microorganisms adhere to surfaces and protects them from environmental stresses, including antibiotics and immune responses.

Biofilms are commonly found in nature and can form on a wide range of surfaces, such as medical devices, pipes, rocks, and teeth. They play both beneficial and harmful roles. In natural ecosystems, biofilms contribute to nutrient cycling, wastewater treatment, and coral reef formation. However, in the context of human health, biofilms are often associated with the development of persistent infections and chronic diseases.

Several human diseases have been linked to biofilms. These diseases include:

  1. Dental plaque and periodontal disease: The biofilm formed on teeth, commonly known as dental plaque, can lead to tooth decay and gum disease if not properly removed.
  2. Chronic wounds: Biofilms can develop in chronic wounds, such as diabetic foot ulcers and pressure ulcers, hindering the healing process and increasing the risk of infections.
  3. Catheter-associated urinary tract infections (CAUTIs): Biofilms can form on indwelling urinary catheters, leading to recurrent and difficult-to-treat urinary tract infections.
  4. Prosthetic joint infections: Biofilms can colonize prosthetic joints, causing chronic infections and implant failure.
  5. Cystic fibrosis lung infections: In individuals with cystic fibrosis, biofilms can develop in the airways, leading to recurrent and severe lung infections.
  6. Endocarditis: Biofilms can form on heart valves, causing inflammation and infection of the inner lining of the heart.
  7. Ventilator-associated pneumonia (VAP): Biofilms can develop in the respiratory tract of patients on mechanical ventilation, increasing the risk of pneumonia.
  8. Chronic otitis media: Biofilms have been implicated in chronic ear infections, particularly in cases of recurrent or treatment-resistant otitis media.

It’s important to note that research is ongoing in understanding the role of biofilms in various diseases, and the list above represents some well-known associations.

 

Bacteria & Disease Mechanisms

Bacteria can cause disease through various mechanisms. Here are some ways in which bacteria can lead to the development of diseases:

  1. Invasion: Bacteria can invade and colonize various tissues and organs in the body. They can enter the body through different routes, such as the respiratory tract, digestive system, or through breaks in the skin. Once inside, bacteria can multiply and disrupt normal cellular function, leading to tissue damage and disease.
  2. Toxins: Many bacteria produce toxins that are harmful to the body. These toxins can be released by bacteria locally at the site of infection or can be carried through the bloodstream to distant sites. Bacterial toxins can damage cells and tissues directly or interfere with essential cellular processes, leading to a wide range of symptoms and diseases.
  3. Inflammation: Bacterial infections often trigger an immune response in the body, resulting in inflammation. The immune system recognizes the presence of bacteria and releases various immune cells and chemicals to fight the infection. However, excessive or prolonged inflammation can lead to tissue damage and contribute to the development of diseases.
  4. Competition for resources: Bacteria can compete with the body’s cells for essential nutrients and resources. They can consume nutrients needed by host cells, depriving them of the resources necessary for proper functioning. This competition can lead to tissue damage and compromise the overall health of the affected individual.
  5. Biofilm formation: Some bacteria have the ability to form biofilms, which are complex communities of bacteria embedded in a protective matrix. Biofilms provide bacteria with increased resistance to antibiotics and the immune system. They can form on various surfaces within the body, such as medical implants or damaged tissues, and contribute to chronic infections that are difficult to treat.

It’s important to note that not all bacteria cause disease. Many bacteria are part of the normal microbial flora in our bodies and perform beneficial functions. However, certain bacterial strains or an imbalance in the microbial community can lead to infections and diseases. The specific mechanisms of bacterial pathogenesis can vary depending on the bacterium involved, the site of infection, and the host’s immune response.

 

Bacterial Infections Treatment

Bacterial infections are generally treated using antibiotics, which are medications specifically designed to kill or inhibit the growth of bacteria. The specific antibiotic prescribed depends on the type of bacteria causing the infection and its susceptibility to different drugs.

The treatment approach may vary based on the severity and location of the infection. In general, the following steps are commonly taken in the treatment of bacterial infections:

  1. Diagnosis: The first step is to diagnose the infection accurately. This typically involves a physical examination, medical history assessment, and often laboratory tests such as blood cultures, urine cultures, or swabs from the affected area to identify the bacteria causing the infection.
  2. Antibiotic prescription: Once the bacteria causing the infection is identified, the healthcare provider will prescribe an appropriate antibiotic. Different antibiotics work against different types of bacteria. The choice of antibiotic takes into account factors such as the bacteria’s susceptibility to the drug, the site of infection, the patient’s age, medical history, and any allergies.
  3. Antibiotic course: Patients are usually prescribed a specific duration of antibiotic treatment. It’s important to complete the full course, even if the symptoms improve, to ensure complete eradication of the bacteria and prevent antibiotic resistance.
  4. Follow-up: In some cases, follow-up visits or tests may be necessary to monitor the progress of the treatment. This helps to ensure that the infection is resolving and that the chosen antibiotic is effective.

In addition to antibiotics, supportive measures may be employed to alleviate symptoms and aid the healing process. These can include pain relievers, fever reducers, adequate hydration, rest, and other measures tailored to the specific infection and patient needs.

It’s worth noting that antibiotic resistance is a growing concern worldwide. Overuse or misuse of antibiotics can contribute to the development of resistant bacteria. Therefore, it is crucial to follow healthcare providers’ instructions, take antibiotics as prescribed, and avoid using them for viral infections, where they are ineffective.

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