ow CSF white cell count and elevated CSF opening pressure are also associated with a poor outcome. Mortality in non-HIV-associated cryptococcal meningitis is associated with chronic renal failure, liver failure, or hematologic malignancy, as well as absence of headache and altered mental status. [51]

including hearing loss, developmental disorders, and neuropsychological impairment are reported to occur in up to half of survivors of bacterial meningitis.

case-fatality rates of 30% and 7% in higher-income countries

On average, bacterial meningitis caused about 4,100 cases and 500 deaths in the United States each year between 2003 and 2007.

Symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3 to 7 days after exposure

How people spread the germs often depends on the type of bacteria. It is also important to know that people can carry these bacteria in or on their bodies without being sick. These people are “carriers.” Most carriers never become sick, but can still spread the bacteria to others.

Neisseria meningitidis, Streptococcus pneumoniae

Mechanisms of Pathogenicity

Gram-negative bacteria include opportunistic enterobac­teria (such as Serratia spp. and Klebsiella spp.) that can survive in contact lens fluid and on plastic surfaces, which explains their increased numbers in contact-lens-induced corneal infections.6

β-lactam antibiotics are bacteriocidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms, being the outermost and primary component of the wall.

Beta-lactams: Carbapenems are the most reliable beta-lactam drugs for the treatment of severe Enterobacter infections; fourth-generation cephalosporins are a distant second choice Aminoglycosides: Aminoglycoside resistance is relatively common and varies widely among centers Fluoroquinolones: Resistance to fluoroquinolones is relatively rare but may be high in some parts of the world Trimethoprim-sulfamethoxazole (TMP-SMZ): Resistance to TMP-SMZ is more common

With few exceptions, the major classes of antibiotics used to manage infections with these bacteria include the beta-lactams, carbapenems, the fluoroquinolones, the aminoglycosides, and TMP-SMZ.

DRUG RESISTANCE: Enterobacter spp. are resistant to ampicillin; first- and second- generation cephalosporins(7); and cephalothin(6).

Plants(6), humans, and animals(1). Enterobacteriaceae are primarily colonizers of the lower gastrointestinal tract of humans and animals(10).

From 1970 to 1971, there was an epidemic of septicemia caused by contaminated IV products that affected 378 patients across the United States(9).

They produce acid upon glucose fermentation, are methyl red negative, and Voges-Proskauer positive, with an optimal growth temperature of 30 °C(1). 80 % are encapsulated(1).

Investigation of the Outbreak

Always wash hands thoroughly with soap and water right after touching livestock, equipment for animals, or anything in the area where animals live and roam. This is especially important to do before preparing or consuming food or drink for yourself or others. Adults should supervise hand washing for young children. Use hand sanitizer if soap and water are not available right away. Use dedicated shoes, work gloves, and clothing that you only use when working with livestock. Keep these items outside of your home. Do not eat or drink in the areas where livestock live and roam. Do not allow toys, pacifiers, spill-proof cups, baby bottles, strollers, or similar items in livestock areas. Wash hands after removing any clothes and shoes you wore while working with livestock. Work with your veterinarian to keep your livestock healthy.

Nalidixic acid resistance was observed in 13.3%

Since 1996, an increasing number of S. Enteritidis isolates submitted to NARMS have been resistant to nalidixic acid

ampicillin, amoxicillin, ciprofloxacin, or trimethoprim/sulfamethozazole

It accomplishes this by inhibiting protein synthesis and causes calcium ions to rush in [13]. After the virulence factors have done their duty, the bacteria can move to the liver or spleen, where they are able to replicate. After replication, they can migrate back to the intestines where they can be expelled and transmitted to new hosts.

Here, it binds to the wall of the intestine, and through some special proteins that it makes in response to the particular conditions in the intestine it actually penetrates the barrier between us and the outside. Once it has gained access to our insides, it is taken to the liver or spleen. For most other bacteria, this journey would kill them, however Salmonella has evolved mechanisms to prevent our immune system from doing its job efficiently. In the liver, the Salmonella can grow again, and be released back into the intestine. Of course, not all of the Salmonella pass through the intestinal wall, and many of them are expelled from the intestine in the diarrhea. In regions with poor sanitation, these bacteria can than survive in the soil or in rivers and infect the next person, cow, chicken or mouse that comes along.

Salmonella are traced back to dairy, poultry and meat products, but Salmonella can grow on just about any food. Chickens and eggs are particular high risk foods.

Key biochemical tests are fermentation of glucose, negative urease reaction, lysine decarboxylase, negative indole test, H2S production, and fermentation of dulcitol. Serological confirmation tests typically use polyvalent antisera for flagellar (H) and somatic (O) antigens

a pre-enrichment culture in a non-selective liquid medium such as buffered peptone water, incubated at 37oC for 18 hours. Modified pre-enrichment methods may be necessary for samples containing inhibitory compounds. The pre-enrichment culture is then typically subcultured into two different selective enrichment media, such as Rappaport Vasiliadis Soy broth (RVS) and Muller-Kauffmann Tetrathionate-Novobiocin (MKTTn) broth, and incubated for a further 24 hours at 41.5oC (RVS) or 37oC (MKTTn). The selective enrichment culture is usually inoculated on to at least two selective agar media and incubated at 37oC for 24 hours. The ISO method specifies the XLD agar and one optional selective medium. A variety of alternatives are available, including Bismuth Sulphite agar, Brilliant Green agar and Hektoen Enteric agar. A number of selective chromogenic agar media specifically designed for the differentiation of Salmonella colonies are commercially available. Typical Salmonella colonies on selective agar are subcultured onto non-selective media prior to confirmatory testing.

non-spore forming, usually motile rods

blood, urine, feces, food and feed and environmental materials

by coiling phagocytosis, once phagocytized, the Legionella bacteria reside within a unique phagosome and do not fuse with lysosomes or become highly acidic

Legionella pneumophila antigen—this is the preferred initial test for Legionnaires disease. It detects one of the bacterium's proteins. It is performed on urine and occasionally on another body fluid. It is a rapid way to detect an infection, but it will only detect Legionella pneumophila serogroup 1. Since this is the most common cause of Legionnaires disease in the U.S., it will detect most infections in adults. Legionella culture—this type of culture may be performed along with a routine sputum culture because special nutrient media is required to encourage the growth of Legionella and discourage the growth of other bacteria. This test is considered the "gold standard" for diagnosing an infection caused by Legionella bacteria. A positive culture may be determined in about 48 to 72 hours. Negative cultures are held for at least 7 days before a final result is reported. A culture will identify multiple Legionella species and is used both to confirm that a person has a legionella infection and to help identify the source of an outbreak. Direct fluorescent antibody (DFA) staining for Legionella species—this is a rapid test that can be performed on respiratory samples and tissue and requires only 2 to 4 hours for results. Legionella species by polymerase chain reaction (PCR)—this test detects bacterial genetic material, primarily in respiratory secretions but sometimes in other body fluids. It can detect several species of Legionella but is not widely used.

• Temperature above 68° F • Iron • L-Cysteine • Biofilm (particularly protozoans)

found naturally in freshwater environments, like lakes and streams

Large plumbing systems

In general, people do not spread Legionnaires’ disease and Pontiac fever to other people.

People at Increased Risk Most healthy people exposed to Legionella do not get sick. People at increased risk of getting sick are: People 50 years or older Current or former smokers

Legionella bacilli reside in surface and drinking water and are usually transmitted to humans in aerosols

Symptoms usually begin 2 to 10 days after being exposed to the bacteria, but it can take longer so people should watch for symptoms for about 2 weeks after exposure.

nucleic acid synthesis by disrupting the DNA of microbial cells.

vocal cord palsy, splenic/hepatic abscesses, soft tissue infection, vesiculopustular rash, meningitis, disseminated intravascular coagulation, acute renal failure, and acute respiratory distress syndrome

its ability to produce significant amounts of butyric acid from glucose, giving cultured colonies a characteristic odor.

Though part of the normal flora of human tissues, Fusobacterium can invade tissues after surgical or accidental trauma, edema, anoxia, and/or tissue destruction

Fusobacterium species are normal inhabitants of all mucosal surfaces, including the mouth, upper respiratory tract, gastrointestinal tract, and urogenital tract

Catalase  Negative

Fusobacterium organisms are anaerobic, non-motile, gram-negative bacilli and include

The level of 15% resistance to erythromycinmay be significant as this drug

Penicillin kills susceptible bacteria by specifically inhibiting the transpeptidase that catalyzes the final step in cell wall biosynthesis, the cross-linking of peptidoglycan.

have been known to persist in soil for up to 18 weeks

In the absence of a viable test for the presence of F. necrophorum, Centor suggests that treating with antibiotics empirically may be the best course of action.

The Lemierre syndrome occurs in around one in 70,000 adolescents/young adults each year.

Vancomycin is effective against most Gram-positive cocci and bacilli

Lassa fever is most often diagnosed by using enzyme-linked immunosorbent serologic assays (ELISA), which detect IgM and IgG antibodies as well as Lassa antigen. Reverse transcription-polymerase chain reaction (RT-PCR) can be used in the early stage of disease. The virus itself may be cultured in 7 to 10 days, but this procedure should only be done in a high containment laboratory with good laboratory practices. Immunohistochemistry, performed on formalin-fixed tissue specimens, can be used to make a post-mortem diagnosis.

Lassa fever is an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two missionary nurses died in Nigeria. The virus is named after the town in Nigeria where the first cases occurred. The virus, a member of the virus family Arenaviridae, is a single-stranded RNA virus and is zoonotic, or animal-borne.

Virology

Lassa fever virus is an Arenavirus that is mainly a zoonosis (a disease spread to humans from animals). It is spread to people through contact with household items or food contaminated with the rodent droppings or urine of infected multimammate rats (Mastomys natalensis

To study the effect of the environmental pH on GBS binding to ECM, we evaluated the adherence of strain 2603 to ECM proteins at acidic and neutral pHs. GBS binding to immobilized fibrinogen and fibronectin was greater at a neutral pH than at an acidic pH (Fig. 3B). In contrast, binding to laminin was similar at pH 7.4 and pH 5.0

Asymptomatic carriage in gastrointestinal and genital tracts is common. Intrapartum transmission via ascending spread from the vagina occurs. Mode of transmission of disease in non-pregnant adults is unknown.

Algorithm for recommended laboratory testing for prenatal screening for group B streptococcal (GBS) colonization[1 page](https://www.cdc.gov/groupbstrep/guidelines/downloads/recommended-prenatal.pdf).

Procedures for collecting clinical specimens for culture of group B Streptococcus (GBS) at 35–37 weeks’ gestation[1 page](https://www.cdc.gov/groupbstrep/guidelines/downloads/procedure-collecting.pdf). Procedures for processing clinical specimens for culture of group B Streptococcus (GBS)[1 page](https://www.cdc.gov/groupbstrep/guidelines/downloads/procedure-specimen.pdf).

GBS grows readily on blood agar plates as microbial colonies surrounded by a narrow zone of β-haemolysis. GBS is characterized by the presence in the cell wall of the group B antigen of the Lancefield classification (Lancefield grouping) that can be detected directly in intact bacteria using latex agglutination tests. [9] The CAMP test is also another important test for the identification of GBS. The CAMP factor acts synergistically with the staphylococcal β-haemolysin inducing enhanced haemolysis of sheep or bovine erythrocytes. [9]

As mentioned, S. agalactiae is a Gram-positive coccus with a tendency to form chains, beta-haemolytic, catalase-negative, and facultative anaerobe.

ocially acceptable way. Food insecurity exists whenever food security is limited or uncertain. The measurement of food insecurity at the household or individual level involves the measurement of those quantitative, qualitative, psychological and social or normative constructs that are central to the experience of food in

The genus Pasteurella is a member of the Pasteurellaceae family, which includes a large and diverse group of Gram-negative Gammaproteobacteria, whose members are not only human or animal commensals and/or opportunistic pathogens but also outright pathogens

Most likely due to routine prompt prophylactic treatment of animal bite wounds with antibiotics, pasteurellosis is still a relatively uncommon cause of mortality in humans (37, 38), even though deaths due to pasteurellosis have increased in recent years in the United States (Fig. 1). Nevertheless, pasteurellosis is often associated with significant morbidity due to complications resulting from animal bite or scratch wounds or from respiratory exposure

conventional methods for detection and diagnosis of infection with Pasteurella (pasteurellosis) relied on observation of the bacterium by microscopy using staining and/or isolation by in vitro culturing on selective media, followed by phenotypic and/or serological characterization