Bacillus anthracis (causative organism)

Normally found in soil

Endospore former; inhale, ingest, inoculate endospores

2001 terrorist attacks on U.S. 17 people sickened 5 dead (inhalation anthrax)

Glycocalyx (capsule)

Exotoxin (cytotoxin)

Incubation period about 7 days; inhalation 7-42 days

Inhalation anthrax = Disease

People who work with sheep or sheep products (inhale endospore)

Signs and symptoms fatigue, sore throat, malaise, fever, aches, chest pain, cough (exotoxin via vegetative cell). Later high fever, labored breathing, shock, death.

No treatment 10-15% survive, with aggressive treatment 55% survive

Intestinal anthrax = Disease

Consume contaminated/under cooked meat (ingest endospore)

Signs and symptoms nausea, decrease appetite, fever, bloody diarrhea

No treatment more than 50% die, with treatment 40% die

Cutaneous anthrax = Disease

Skin contact with endospore

Wool or hide worker, veterinarian, livestock handler

Signs and symptoms painless swollen black crusty ulcers (eschar), breathing issues, cough

95% of anthrax cases

Less than 1% die if treated

clostridium

Obligate anaerobes

Endospore former

Found in soil, water, sewage, GI tracts animals and humans

Produces exotoxins (neurotoxin and enterotoxin)

Clostridium perfringens (causative organism)

Bacteria need anaerobic environment, produces enterotoxin

Food poisoning = Disease

Raw meat/poultry; 1 million cases per yr. in U.S. Intense abdominal cramps and watery diarrhea. 8-12 incubation period. Usually resolves in 24 hours.

Gangrene= Disease

Endospore can enter anaerobic wound.  Bacteria produce cytotoxin and may ferment and produce gas (gaseous gangrene).  Toxin causes decrease blood flow; leads to tissue death.

Clostridium difficile (causative organism)

Pseudomembrane colitis = Disease

Large sections of the colon wall slough off

500,000 cases per year in the U.S.

Anaerobic intestinal bacteria (opportunist)

Antibiotic associated diarrhea which can lead to severe infection of the colon. Antibiotic killed normal flora; C. difficile over grows.

Endospores on surfaces or hands of healthcare worker

Motile

Produces an exotoxin (cytotoxin causes necrosis of colon wall) and hyaluronidase

Watery diarrhea, fever, decreased appetite, nausea, abdominal pain/tenderness

29,000 die within 30 days of initial diagnosis

Decrease antibiotic use, hand washing, aseptic technique

Clostridium botulinum (causative organism)

Intoxication, produces an exotoxin (neurotoxin)

Endospore former, manure, organic fertilizer, sewage (soil and water)

Endospores enter anaerobic environment and germinate to bacteria

18-36-hour incubation period (as little as 6 hours as late as 10 days)

145 cases of botulism per year in the U.S

Botulism general signs and symptoms = double/blurred vision, slurred speech, drooping eyelids, difficulty swallowing and chewing, labored breathing, muscle weakness, flaccid paralysis (no acetylcholine released)

Antitoxins to neutralize toxin

1 ounce aerosolized botulism neurotoxin would kill all people in U.S.

Food-borne botulism= Disease

15% of botulism cases

Severe type of food poisoning

Home canned foods, ingest food containing neurotoxin

Destroy neurotoxin if heat to 80^◦C for 10 minutes

Infant botulism = Disease

65% of botulism cases

Ingestion of endospore by infant (honey); germinate in intestine

3-24 months of age; not enough normal flora to compete it out

Lethargy, poor muscle tone = floppy baby syndrome; failure to thrive

Wound botulism= Disease

20% of botulism cases

Deep wound contaminated with endospore; will germinate to bacteria

Clostridium tetani (causative organism)

Endospore former, obligate anaerobe

Ubiquitous in soil, dust, gastrointestinal tract of animals and humans

Vegetative needs anaerobic environment; enters via wound

Produces exotoxin (neurotoxin); intoxication

Tetanus= Disease

Early signs and symptoms = tight jaw/neck/abdomen, difficulty swallowing

Late signs and symptoms = severe muscle spasms, affects breathing (can’t exhale)

10-20% mortality rate

Vaccine available (toxoid vaccine)

Listeria monocytogenes (causative organism)

Motile, small

Intracellular pathogen (goes inside human cells once inside the body)

Facultative anaerobe

1-10% of humans, 37 mammalian species, 17 species of birds, some fish and shellfish carry in intestine so found in soil and human and animal feces

Grows in refrigerator

Listeriosis = Disease

1600 cases per year in the U.S.

Unpasteurized milk and cheese

Third leading cause of death from food poisoning

Incubation period 3-70 days but usually about 30 days

Signs and symptoms fever, muscle aches, stiff neck, headache, confusion, loss of balance, convulsions

Newborns, pregnant women, elderly, immunocompromised (healthy no signs and symptoms)

Pregnant woman (miscarry, still birth, premature delivery

Corynebacterium diphtheriae (causative organism)

Aerobe

Non-motile

Produces an exotoxin (cytotoxin)

Diphtheria = Disease

Transmitted by respiratory droplet

Sore throat, fever, pseudomembrane in throat

Demyelination decreases motor control and causes loss of sensation

1 in 10 infected die, under 5 years of age 1 in 5 infected die

Vaccine (diphtheria, pertussis, tetanus); toxoid vaccine