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 -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 dbridement for necrotizing
fasciitis
Penicillin, macrolides, cephalosporins, clindamycin,
vancomycin; penicillin and aminoglycoside for
serious infections
Penicillin (drug of choice), macrolides,
cephalosporins, clindamycin, vancomycin; surgical
dbridement 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
-Lactam with -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; dbridement

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