Organism Clinical Features Treatment Aerobic and Facultatively

Organism
Clinical Features
Treatment
Enterococcus
faecalis and faecium
Bacteremia, intraabdominal abscess, urinary tract
infection, endocarditis
Staphylococcus
aureus
Cutaneous infections: impetigo, folliculitis,
furuncles, carbuncles, wound; disseminated
infections: pneumonia, empyema, osteomyelitis,
septic arthritis; toxin-mediated infections: toxic
shock syndrome, scalded skin syndrome, food
poisoning
Opportunistic pathogen causing infections on
foreign bodies (e.g., catheters, shunts, prosthetic
joints and heart valves); urinary tract infections
(e.g., S. saprophyticus)
Suppurative infections: pharyngitis, scarlet fever,
sinusitis, skin and soft-tissue infection (impetigo,
erysipelas, cellulitis, necrotizing fasciitis), toxic
shock-like syndrome; nonsuppurative infections:
rheumatic fever; glomerulonephritis
Neonatal disease (early onset, late onset;
bacteremia, pneumonia, meningitis); urinary tract
infections, bacteremia, pneumonia
Aerobic and Facultatively Anaerobic Gram-Positive Cocci
Staphylococcus,
coagulase negative
Streptococcus
pyogenes (group A)
Streptococcus
agalactiae (group B)
Other β-hemolytic
streptococci
Pharyngitis, otitis, sinusitis, skin and soft-tissue
infection, impetigo, erysipelas, cellulitis,
necrotizing fasciitis
Streptococcus bovis Bacteremia, endocarditis
Viridans streptococci Abscess formation; septicemia in neutropenic
Streptococcus
pneumoniae
patients; subacute endocarditis; odontogenic
infections; dental caries
Pneumonia and other respiratory tract infections;
meningitis; spontaneous bacterial peritonitis,
endocarditis, septic arthritis; bacteremia
Penicillin/ampicillin/piperacillin or vancomycin;
combined with gentamicin for endocarditis or severe
infection
Nafcillin; vancomycin (for methicillin-resistant
strains)
Nafcillin; vancomycin (for methicillin-resistant
strains)
Penicillin, macrolides, cephalosporins, clindamycin,
vancomycin; surgical débridement for necrotizing
fasciitis
Penicillin, macrolides, cephalosporins, clindamycin,
vancomycin; penicillin and aminoglycoside for
serious infections
Penicillin (drug of choice), macrolides,
cephalosporins, clindamycin, vancomycin; surgical
débridement for necrotizing fasciitis
Penicillin
Penicillin; penicillin combined with aminoglycoside
Penicillin; levofloxacin, cephalosporins, clindamycin
Aerobic or Facultatively Anaerobic Gram-Positive Rods
Bacillus anthracis
Bacillus cereus
Corynebacterium
diphtheriae
Corynebacterium
jeikeium
Corynebacterium
urealyticum
Erysipelothrix
rhusiopathiae
Listeria
monocytogenes
Cutaneous anthrax, inhalation anthrax,
gastrointestinal anthrax
Fluoroquinolones (ciprofloxacin); penicillin,
doxycycline, erythromycin, or chloramphenicol as
alternative therapy
Gastroenteritis, ocular infections, bacteremia
Fluoroquinolones, vancomycin
Diphtheria: respiratory, cutaneous
Neutralizing exotoxin; penicillin or erythromycin to
eliminate organism and terminate toxin production;
immunization with diphtheria toxoid
Septicemia, endocarditis; wound infections; foreign Vancomycin
body infections
Urinary tract infections, including pyelonephritis
with calculi; septicemia; endocarditis; wound
infections
Erysipeloid (painful, pruritic inflammatory skin
lesion)
Early onset neonatal disease (granulomatosis
infantiseptica); late-onset neonatal disease
(meningitis with septicemia); flulike illness in
adults; bacteremia or disseminated disease in
pregnant women or patients with cell-mediated
immune defects
Vancomycin
Penicillin; cephalosporins, fluoroquinolones,
erythromycin, or clindamycin as alternative therapy
Ampicillin (alone or in combination with gentamicin)
Mycobacteria
Mycobacterium
avium complex
Mycobacterium
leprae
Localize pulmonary disease; disseminated disease
with multiorgan involvement
Leprosy: range from tuberculoid form to
lepromatous form
Clarithromycin or azithromycin combined with
rifabutin or ethambutol
Dapson
and rifampicin for tuberculoid form; add clofazimine
for lepromatous form
Mycobacterium
tuberculosis
Nocardia species
Tuberculosis: pulmonary, extrapulmonary
Rhodococcus equi
Bronchopulmonary disease (lung abscesses);
opportunistic infections in immunocompetent
patients
Neisseria
gonorrhoeae
Neisseria
meningitidis
Acinetobacter
Gonorrhoea, pelvic inflammatory disease, arthritis
Ceftriaxone, ciprofloxacin; cefoxitin plus doxycycline
Meningitis, bacteremia (meningococcemia)
Ceftriaxone, penicillin, chloramphenicol
Bronchopulmonary disease; primary or secondary
cutaneous infections; brain abscesses
Multidrug therapy with isoniazid, rifampin,
ethambutol, and pyrazinamide
Sulfonamides; amikacin, carbapenems, or broadspectrum cephalosporins as alternative therapy if
active
Combination therapy with vancomycin,
carbapenems, aminoglycosides, ciprofloxacin,
rifampin, and/or erythromycin
Aerobic Gram-Negative Cocci
Aeromonas
Bartonella henselae
Bartonella quintana
Bordetella pertussis,
Bordetella
parapertussis
Brucella
Burkholderia cepacia
complex
Pneumonia, septicemia, opportunistic infections
Imipenem or ceftazidime combined with
aminoglycoside for serious infections
Wound infections; gastroenteritis
Ciprofloxacin; trimethoprim-sulfamethoxazole,
gentamicin, or amikacin as alternative therapy
Bacillary angiomatosis; subacute endocarditis; cat Gentamicin alone or with erythromycin; broadscratch disease (CSD)
spectrum cephalosporins used as alternative therapy;
CSD does not response to antibiotic therapy
Trench fever (TF); bacillary angiomatosis (BA)
As with B. henselae
Pertussis (whooping cough)
Supportive therapy, erythromycin (or other
macrolides) to decrease infectivity and prophylaxis
for contacts
Brucellosis
Doxycycline plus rifampin or gentamicin;
trimethoprim-sulfamethoxazole
Pulmonary infections; opportunistic infections
Trimethoprim-sulfamethoxazole; piperacillin,
ceftazidime, or ciprofloxacin as alternative therapy
if trimethoprim-sulfamethoxazole resistant
Meliodosis (asymptomatic to severe pulmonary
Trimethoprim-sulfamethoxazole combined with
disease)
ceftazidime
Gastroenteritis
Self-limited; severe infections treated with
erythromycin; tetracycline or fluoroquinolones used
as alterative therapy
Burkholderia
pseudomallei
Campylobacter
jejuni,
Campylobacter coli,
Campylobacter
upsaliensis
Camplyobacter fetus Septicemia; meningitis; gastroenteritis;
Cardiobacterium
hominis
Eikenella corrodens
Escherichia colienteropathogenic
(EPEC)
E. colienterohemorrhagic
(EHEC)
E. colienterotoxigenic
(ETEC)
E. colienteroaggregative
(EAEC)
E. colienteroinvasive (EIEC)
E. coliuropathogenic
spontaneous abortion
Subacute endocarditis
Subacute endocarditis; wound infections
Watery diarrhea and vomiting
Aminoglycosides, carbapenems, chloramphenicol
Penicillin or ampicillin
Penicillin, cephalosporins, tetracycline, or
fluoroquinolones
Unknown
Watery diarrhea, hemorrhagic colitis, hemolytic
uremic syndrome
Antibiotics contraindicated
Watery diarrhea
Ciprofloxacin shortens course (high level of
resistance)
Diarrhea with mucus
Fluoroquinolones in AIDS patients
Watery diarrhea, hemorrhagic colitis
Antibiotics reduce duration of disease and infectivity
Cystitis, pyelonephritis
Trimethoprim-sulfamethoxazole, fluoroquinolones
Acute meningitis
E. coli-meningitis
associated
Francisella tularensis Tularemia: ulceroglandular, oculoglandular,
Extended-spectrum cephalosporins
Haemophilus
influenzae
Broad-spectrum cephalosporin, azithromycin, or
fluoroquinolone; many strains resistant to ampicillin
Helicobacter pylori
pneumonic
Encapsulated type b strains: meningitis,
septicemia, cellulitis, epiglottitis; unencapsulated
strains: otitis media, sinusitis, bronchitis,
pneumonia
Gastritis, peptic, and duodenal ulcers; gastric
adenocarcinoma
Kingella kingae
Subacute endocarditis
Klebsiella
pneumoniae
Legionella
pneumophila
Pneumonia, urinary tract infections
Legionnaires' disease (pneumonia), Pontiac fever
(flulike illness)
Moraxella catarrhalis Ear, eye, and respiratory infections
Urinary tract infections, wound infections
Proteus
Pseudomonas
aeruginosa
Pulmonary; primary skin infection; urinary tract
infection; ear or eye infections; bacteremia
Salmonella enterica Diarrhea, enteric fever (serovar Typhi)
Streptomycin, gentamicin; fluoroquinolones
Multidrug therapy: tetracycline, metronidazole,
bismuth, and omeprazole
β-Lactam with β-lactamase inhibitor, cephalosporins,
macrolides, tetracycline, fluoroquinolones
Cephalosporins, fluoroquinolones
Macrolides (erythromycin, azithromycin,
clarithromycin); fluoroquinolones (ciprofloxacin,
levofloxacin) used as alternative therapy
Cephalosporins; amoxicillin/clavulanic acid
Amoxicillin, trimethoprim-sulfamethoxazole,
cephalosporins, fluoroquinolones
Combination therapy generally required (e.g.,
aminoglycoside with extended-spectrum
cephalosporins, piperacillin-tazobactam, or
carbapenem)
May prolong carrier state in simple diarrhea
treatment; fluoroquinolones for enteric fever
Carbapenems; piperacillin-tazobactam
Serratia,
Enterobacter
Shigella
Pneumonia, urinary tract infections, wound
infections
Stenotrophomonas
maltophilia
Streptobacillus
moniliformis
Vibrio cholerae
Wide variety of local and systemic infections
Ampicillin; trimethoprim-sulfamethoxazole;
fluoroquinolones
Trimethoprim-sulfamethoxazole
Rat-bite fever; Haverhill fever
Penicillin, doxycycline
Severe watery diarrhea
Vibrio
parahaemolyticus
Vibrio vulnificus
Watery diarrhea
Rehydration; doxycycline, trimethoprimsulfamethoxazole, or furazolidone shortens course
Rehydration
Actinomyces
Actinomycosis: cervicofacial, thoracic, abdominal,
pelvic, central nervous system
Bacteroides fragilis
Polymicrobial infections of abdomen, female
genital tract, cutaneous and soft tissues
Botulism: foodborne, infant, wound
Bacillary dysentery
Wound infections; primary septicemia
Minocycline combined with a fluoroquinolone or
cefotaxime; débridement
Anaerobes
Penicillin; alternative drugs include erythromycin,
clindamycin
Metronidazole
Clostridium
botulinum
Clostridium difficile Antibiotic-associated diarrhea;
Ventilatory support; use of trivalent botulinum
antitoxin
Discontinue implicated antibiotic; metronidazole
Clostridium
perfringens
Clostridium tetani
Surgical intervention and penicillin
Propionibacterium
acne
pseudomembraneous colitis
Soft-tissue infections: cellulitis, fasciitis,
myonecrosis; food poisoning; septicemia
Tetanus: generalized, localized, neonatal
Acne; opportunistic infections (e.g., of prosthetic
devices)
Clean wound; passive immunization; vaccination
with tetanus toxoid
Acne treated with benzoyl peroxide plus clindamycin
or erythromycin
Anaplasma, Ehrlichia, Rickettsia, Coxiella, Mycoplasma, Chlamydia, and Chlamydophila
Anaplasma
Anaplasmosis (granulocytic ehrlichiosis)
Doxycycline; rifampin used as alternative therapy
phagocytophilum
Chlamydophila
pneumoniae
Chlamydophila
psittaci
Chlamydia
trachomatis
Coxiella burnetii
Pneumonia; cardiovascular disease (?)
Macrolides; fluoroquinolones; tetracyclines
Pneumonia
Macrolides; tetracyclines
Trachoma; neonatal conjunctivitis and pneumonia;
urethritis; cervicitis; salpingitis; lymphogranuloma
venereum
Q fever: acute (fever, headache, chills, myalgias,
granulomatous hepatitis) and chronic (endocarditis,
hepatic dysfunction)
Monocytic ehrlichiosis
Tetracyclines; macrolides; fluoroquinolones
Ehrlichia chaffeensis
Atypical pneumonia
Mycoplasma
pneumoniae
Rickettsia rickettsii Rocky Mountain spotted fever
Doxycycline; rifampin with trimethoprimsulfamethoxazole
Doxycycline; rifampin used as alternative therapy
Macrolides; tetracycline; fluoroquinolones
Doxycycline; fluoroquinolones used as alternative
therapy
Spirochetes
Borrelia recurrentis
Lyme disease: erythema migrans; cardiac,
neurologic, or rheumatologic abnormalities
Epidemic relapsing fever
Borrelia species
Endemic relapsing fever
Borrelia burgdorferi
Leptospirosis: mild, viral-like illness to severe
Leptospira
multiorgan illness (Weil's disease)
interrogans
Treponema pallidum Syphilis: primary, secondary, tertiary, congenital
Oral penicillin; tetracyclines; ceftriaxone
Tetracyclines; erythromycin; chloramphenicol;
penicillin
Tetracyclines; erythromycin; chloramphenicol;
penicillin
Penicillin; doxycycline; vaccination of pets and herds
Penicillin; tetracyclines; erythromycin
Murray, Medical Microbiology. 5th Edition
Table 48-1. Overview of Selected Bacterial Pathogens
adaptado