# Pathogenic bacteria

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**Pathogenic bacteria** are [bacteria](/source/Bacteria) that can cause [disease](/source/Disease).[1] This article focuses on the bacteria that are [pathogenic](/source/Pathogenic) to humans. Most [species](/source/Species) of bacteria are harmless and many are [beneficial](/source/Probiotic) but others can cause [infectious diseases](/source/Infectious_diseases). The number of these pathogenic species in humans is estimated to be fewer than a hundred.[2] By contrast, several thousand species are considered part of the [gut flora](/source/Gut_flora), with a few hundred species present in each individual human's [digestive tract](/source/Digestive_tract).[3]

The body is continually exposed to many species of bacteria, including beneficial [commensals](/source/Commensal), which grow on the skin and [mucous membranes](/source/Mucous_membrane), and [saprophytes](/source/Saprophyte), which grow mainly in the soil and in [decaying](/source/Decomposition) matter. The blood and tissue fluids contain nutrients sufficient to sustain the growth of many bacteria. The body has defence mechanisms that enable it to resist microbial invasion of its tissues and give it a natural [immunity](/source/Immune_system) or [innate resistance](/source/Innate_immunity) against many [microorganisms](/source/Microorganisms).

Pathogenic bacteria are specially adapted and endowed with mechanisms for overcoming the normal body defences, and can invade parts of the body, such as the blood, where bacteria are not normally found. Some pathogens invade only the surface [epithelium](/source/Epithelium), skin or mucous membrane, but many travel more deeply, spreading through the tissues and disseminating by the [lymphatic](/source/Lymphatic_system) and [blood streams](/source/Blood_circulation). In some rare cases a pathogenic microbe can infect an entirely healthy person, but infection usually occurs only if the body's defence mechanisms are damaged by some local trauma or an underlying debilitating disease, such as wounding, [intoxication](/source/Substance_intoxication), [chilling](/source/Chills), fatigue, and [malnutrition](/source/Malnutrition). In many cases, it is important to differentiate [infection](/source/Infection) and [colonization](/source/Colonisation_(biology)), which is when the bacteria are causing little or no harm.

Caused by *[Mycobacterium tuberculosis](/source/Mycobacterium_tuberculosis)* bacteria, one of the [diseases](/source/Disease) with the highest [disease burden](/source/Disease_burden) is [tuberculosis](/source/Tuberculosis), which killed 1.4 million people in 2019, mostly in [sub-Saharan Africa](/source/Sub-Saharan_Africa).[4] Pathogenic bacteria contribute to other globally important diseases, such as [pneumonia](/source/Pneumonia), which can be caused by bacteria such as *[Staphylococcus](/source/Staphylococcus)*, *[Streptococcus](/source/Streptococcus)* and *[Pseudomonas](/source/Pseudomonas)*, and [foodborne illnesses](/source/Foodborne_illness), which can be caused by bacteria such as *[Shigella](/source/Shigella)*, *[Campylobacter](/source/Campylobacter)*, and *[Salmonella](/source/Salmonella)*. Pathogenic bacteria also cause infections such as [tetanus](/source/Tetanus), [typhoid fever](/source/Typhoid_fever), [diphtheria](/source/Diphtheria), [syphilis](/source/Syphilis), and [leprosy](/source/Leprosy).

Pathogenic bacteria are also the cause of high [infant mortality](/source/Infant_mortality) rates in [developing countries](/source/Developing_countries).[5] A [GBD study](/source/Global_Burden_of_Disease_Study) estimated the [global](/source/Global_health) death rates from (33) bacterial pathogens, finding such infections contributed to one in 8 deaths (or ~7.7 million deaths), which could make it the [second largest cause of death globally](/source/List_of_causes_of_death_by_rate) in 2019.[6][7]

Most pathogenic bacteria can be grown in [cultures](/source/Microbiological_culture) and identified by [Gram stain](/source/Gram_stain) and other methods. Bacteria grown in this way are often [tested](/source/Antibiotic_sensitivity_testing) to find which [antibiotics](/source/Antibiotic) will be an effective treatment for the infection. For hitherto unknown pathogens, [Koch's postulates](/source/Koch's_postulates) are the standard to establish a [causative relationship](/source/Causality) between a microbe and a disease.

## Diseases

Each species has specific effect and causes symptoms in people who are infected. Some people who are infected with a pathogenic bacteria do not have symptoms. Immunocompromised individuals are more susceptible to pathogenic bacteria.[8]

### Pathogenic susceptibility

Some pathogenic bacteria cause disease under certain conditions, such as entry through the skin via a cut, through sexual activity or through compromised immune function.[citation needed]

Some species of *[Streptococcus](/source/Streptococcus)* and *[Staphylococcus](/source/Staphylococcus)* are part of the normal [skin microbiota](/source/Human_flora) and typically reside on healthy skin or in the nasopharyngeal region. Yet these species can potentially initiate skin infections. [Streptococcal infections](/source/Streptococcus) include [sepsis](/source/Sepsis), [pneumonia](/source/Pneumonia), and [meningitis](/source/Meningitis).[9] These infections can become serious creating a systemic inflammatory response resulting in massive vasodilation, shock, and death.[10]

Other bacteria are [opportunistic pathogens](/source/Opportunistic_infection) and cause disease mainly in people with [immunosuppression](/source/Immunosuppression) or [cystic fibrosis](/source/Cystic_fibrosis). Examples of these opportunistic pathogens include *[Pseudomonas aeruginosa](/source/Pseudomonas_aeruginosa)*, *[Burkholderia cenocepacia](/source/Burkholderia_cenocepacia)*, and *[Mycobacterium avium](/source/Mycobacterium_avium_complex)*.[11][12]

### Intracellular

[Obligate intracellular parasites](/source/Obligate_intracellular_parasite) (e.g. [Chlamydophila](/source/Chlamydophila), [Ehrlichia](/source/Ehrlichia), [Rickettsia](/source/Rickettsia)) are only able to grow and replicate inside other cells. Infections due to obligate intracellular bacteria may be [asymptomatic](/source/Asymptomatic), requiring an [incubation period](/source/Incubation_period). Examples of obligate intracellular bacteria include *[Rickettsia prowazekii](/source/Rickettsia_prowazekii)* ([typhus](/source/Typhus)) and [Rickettsia rickettsii](/source/Rickettsia_rickettsii), ([Rocky Mountain spotted fever](/source/Rocky_Mountain_spotted_fever)).[citation needed]

[Chlamydia](/source/Chlamydia_(bacterium)) are intracellular parasites. These pathogens can cause [pneumonia](/source/Pneumonia) or [urinary tract infection](/source/Urinary_tract_infection) and may be involved in [coronary heart disease](/source/Coronary_heart_disease).[13]

Other groups of intracellular bacterial pathogens include *[Salmonella](/source/Salmonella)*, *[Neisseria](/source/Neisseria)*, *[Brucella](/source/Brucella)*, *[Mycobacterium](/source/Mycobacterium)*, *[Nocardia](/source/Nocardia),* *[Listeria](/source/Listeria)*, *[Francisella](/source/Francisella)*, *[Legionella](/source/Legionella)*, and *[Yersinia pestis](/source/Yersinia_pestis)*. These can exist intracellularly, but can exist outside host cells.[citation needed]

### Infections in specific tissue

Bacterial pathogens often cause infection in specific areas of the body. Others are generalists.

- [Bacterial vaginosis](/source/Bacterial_vaginosis) is a condition of the [vaginal microbiota](/source/List_of_microbiota_species_of_the_lower_reproductive_tract_of_women) in which an excessive growth of *[Gardnerella vaginalis](/source/Gardnerella_vaginalis)* and other mostly [anaerobic bacteria](/source/Anaerobic_bacteria) displace the beneficial *[Lactobacilli](/source/Lactobacilli)* species that maintain healthy vaginal microbial populations.[14]
- [Bacterial meningitis](/source/Bacterial_meningitis) is a bacterial [inflammation](/source/Inflammation) of the [meninges](/source/Meninges), which are the protective membranes covering the [brain](/source/Brain) and [spinal cord](/source/Spinal_cord).
- [Bacterial pneumonia](/source/Bacterial_pneumonia) is a bacterial infection of the [lungs](/source/Lung).
- [Urinary tract infection](/source/Urinary_tract_infection) is predominantly caused by bacteria. Symptoms include the strong and frequent sensation or urge to urinate, pain during [urination](/source/Urination), and urine that is cloudy.[15] The most frequent cause is *[Escherichia coli](/source/Escherichia_coli)*. [Urine](/source/Urine) is typically sterile but contains a variety of salts and waste products. Bacteria can ascend into the [bladder](/source/Urinary_bladder) or [kidney](/source/Kidney) and causing [cystitis](/source/Cystitis) and [nephritis](/source/Nephritis).[16][17]
- [Bacterial gastroenteritis](/source/Bacterial_gastroenteritis) is caused by enteric, pathogenic bacteria. These pathogenic species are usually distinct from the usually harmless bacteria of the normal [gut flora](/source/Gut_flora). But a different strain of the same species may be pathogenic. The distinction is sometimes difficult as in the case of *[Escherichia](/source/Escherichia)*.
- Bacterial [skin infections](/source/Skin_infection) include: - [Impetigo](/source/Impetigo) is a highly contagious [bacterial](/source/Bacteria) [skin](/source/Human_skin) [infection](/source/Infection) commonly seen in children.[18] It is caused by *[Staphylococcus aureus](/source/Staphylococcus_aureus)*, and *[Streptococcus pyogenes](/source/Streptococcus_pyogenes)*.[19] - [Erysipelas](/source/Erysipelas) is an acute [streptococcus](/source/Streptococcus) [bacterial](/source/Bacteria) infection[20] of the deeper skin layers that spreads via with lymphatic system. - [Cellulitis](/source/Cellulitis) is a diffuse [inflammation](/source/Inflammation)[21] of [connective tissue](/source/Connective_tissue) with severe inflammation of dermal and subcutaneous layers of the [skin](/source/Skin). Cellulitis can be caused by normal [skin flora](/source/Skin_flora) or by [contagious contact](/source/Exogenous_bacteria), and usually occurs through open skin, cuts, [blisters](/source/Blister), cracks in the skin, [insect bites](/source/Insect_bite), [animal bites](/source/Animal_attacks), [burns](/source/Burn_(injury)), [surgical wounds](/source/Surgical_wound), intravenous [drug injection](/source/Drug_injection), or sites of [intravenous](/source/Intravenous) [catheter](/source/Catheter) insertion. In most cases it is the skin on the face or lower legs that is affected, though cellulitis can occur in other tissues.

## Mechanisms of damage

The symptoms of disease appear as pathogenic bacteria damage host tissues or interfere with their function. The bacteria can damage host cells directly or indirectly by provoking an immune response that inadvertently damages host cells,[22] or by releasing [toxins](/source/Microbial_toxin).[23]

### Direct

Once pathogens attach to host cells, they can cause direct damage as the pathogens use the host cell for nutrients and produce waste products.[24] For example, *[Streptococcus mutans](/source/Streptococcus_mutans)*, a component of [dental plaque](/source/Dental_plaque), metabolizes dietary sugar and produces acid as a waste product. The acid decalcifies the tooth surface to cause [dental caries](/source/Dental_caries).[25]

#### Toxin production

[Endotoxins](/source/Endotoxins) are the lipid portions of lipopolysaccharides that are part of the outer membrane of the cell wall of [gram-negative bacteria](/source/Gram-negative_bacteria). Endotoxins are released when the bacteria [lyses](/source/Lysis), which is why after antibiotic treatment, symptoms can worsen at first as the bacteria are killed and they release their endotoxins. [Exotoxins](/source/Exotoxins) are secreted into the surrounding medium or released when the bacteria die and the cell wall breaks apart.[26]

### Indirect

An excessive or inappropriate immune response triggered by an infection may damage host cells.[1]

## Survival in host

### Nutrients

Iron is required for humans, as well as the growth of most bacteria. To obtain free iron, some pathogens secrete proteins called [siderophores](/source/Siderophores), which take the iron away from iron-transport proteins by binding to the iron even more tightly. Once the iron-siderophore complex is formed, it is taken up by siderophore receptors on the bacterial surface and then that iron is brought into the bacterium.[26]

Bacterial pathogens also require access to carbon and energy sources for growth. To avoid competition with host cells for glucose which is the main energy source used by human cells, many pathogens including the [respiratory](/source/Respiratory_disease) pathogen *[Haemophilus influenzae](/source/Haemophilus_influenzae)* specialise in using other carbon sources such as [lactate](/source/Lactic_acid) that are abundant in the human body [27]

## Identification

Typically identification is done by growing the organism in a wide range of cultures which can take up to 48 hours. The growth is then visually or genomically identified. The cultured organism is then subjected to various assays to observe reactions to help further identify species and strain.[28]

## Treatment

Main article: [Antibiotics](/source/Antibiotics)

See also: [List of species and clinical characteristics](/source/Pathogenic_bacteria#List_of_species_and_clinical_characteristics)

Bacterial infections may be treated with [antibiotics](/source/Antibiotic), which are classified as [bacteriocidal](/source/Bacteriocide) if they kill bacteria or [bacteriostatic](/source/Bacteriostatic) if they just prevent bacterial growth. There are many types of antibiotics and each class [inhibits](/source/Enzyme_inhibitor) a process that is different in the pathogen from that found in the host. For example, the antibiotics [chloramphenicol](/source/Chloramphenicol) and [tetracyclin](/source/Tetracyclin) inhibit the bacterial [ribosome](/source/Ribosome) but not the structurally different eukaryotic ribosome, so they exhibit selective toxicity.[29] Antibiotics are used both in treating human disease and in [intensive farming](/source/Intensive_farming) to promote animal growth. Both uses may be contributing to the rapid development of [antibiotic resistance](/source/Antibiotic_resistance) in bacterial populations.[30] [Phage therapy](/source/Phage_therapy), using [bacteriophages](/source/Bacteriophage) can also be used to treat certain bacterial infections.[31]

## Prevention

Infections can be prevented by [antiseptic](/source/Antiseptic) measures such as sterilizing the skin prior to piercing it with the needle of a syringe and by proper care of indwelling catheters. Surgical and dental instruments are also [sterilized](/source/Sterilization_(microbiology)) to prevent infection by bacteria. [Disinfectants](/source/Disinfectants) such as [bleach](/source/Bleach) are used to kill bacteria or other pathogens on surfaces to prevent contamination and further reduce the risk of infection. Bacteria in food are killed by cooking to temperatures above 73 °C (163 °F).[citation needed]

## List of genera and microscopy features

Many [genera](/source/Genera) contain pathogenic bacterial [species](/source/Species). They often possess characteristics that help to classify and organize them into groups. The following is a partial listing.

Genus Species Gram staining Shape Oxygen requirement Intra/Extracellular Bacillus[32] Bacillus anthracis Bacillus cereus Positive Rods Facultative anaerobic Extracellular Bartonella[32] Bartonella henselae Bartonella quintana Negative Rods Aerobic Facultative intracellular Bordetella[32] Bordetella pertussis[33][34] Negative Small coccobacilli Aerobic Extracellular Borrelia[32] Borrelia burgdorferi Borrelia garinii Borrelia afzelii Borrelia recurrentis Negative, stains poorly Spirochete Anaerobic Extracellular Brucella[32] Brucella abortus Brucella canis Brucella melitensis Brucella suis Negative Coccobacilli Aerobic Intracellular Campylobacter[32] Campylobacter jejuni Negative Spiral rods[35] coccoid in older cultures[35] Microaerophilic[35] Extracellular Chlamydia and Chlamydophila[32] Chlamydia pneumoniae Chlamydia trachomatis Chlamydophila psittaci (not Gram-stained) Small, round, ovoid Facultative or strictly aerobic Obligate intracellular Clostridium[32] Clostridium botulinum Clostridioides difficile Clostridium perfringens Clostridium tetani Positive Large, blunt-ended rods Obligate anaerobic Extracellular Corynebacterium[32] Corynebacterium diphtheriae[34][36][37] Positive (unevenly) Rods Mostly facultative anaerobic Extracellular Enterococcus[34][38] Enterococcus faecalis Enterococcus faecium Positive Cocci Facultative Anaerobic Extracellular Escherichia[5][34][39] Escherichia coli Negative Rods Facultative anaerobic Extracellular or Intracellular Francisella[32] Francisella tularensis Negative Coccobacillus Strictly aerobic Facultative intracellular Haemophilus Haemophilus influenzae[34][40] Negative Coccobacilli to long and slender filaments Facultative anaerobic 5 – 10% CO2 Extracellular Helicobacter Helicobacter pylori[41] Negative Spiral rod Microaerophile Extracellular Legionella[32] Legionella pneumophila Negative, stains poorly Cocobacilli Aerobic Facultative intracellular Leptospira[34][42] Leptospira interrogans Leptospira santarosai Leptospira weilii Leptospira noguchii Negative, stains poorly Spirochete Strictly aerobic Extracellular Listeria[32] Listeria monocytogenes Positive, darkly Slender, short rods Facultative Anaerobic Facultative intracellular Mycobacterium[32] Mycobacterium leprae Mycobacterium tuberculosis Mycobacterium ulcerans (none) Long, slender rods Aerobic Intracellular Mycoplasma[32] Mycoplasma pneumoniae (none) Indistinct 'fried egg' appearance, no cell wall Mostly facultative anaerobic; M. pneumoniae strictly aerobic Extracellular Neisseria[34][43] Neisseria gonorrhoeae Neisseria meningitidis Negative Kidney bean-shaped Aerobic Gonococcus: facultative intracellular N. meningitidis: extracellular Pseudomonas[34][44] Pseudomonas aeruginosa Negative Rods Obligate aerobic Extracellular Rickettsia[32] Rickettsia rickettsii Negative, stains poorly Small, rod-like coccobacillary Aerobic Obligate intracellular Salmonella[32] Salmonella typhi Salmonella typhimurium Negative Rods Facultative anaerobic Facultative intracellular Shigella[34][45] Shigella sonnei Negative Rods Facultative anaerobic Extracellular Staphylococcus[5] Staphylococcus aureus Staphylococcus epidermidis Staphylococcus saprophyticus Positive, darkly Round cocci Facultative anaerobic Extracellular, facultative intracellular Streptococcus[32] Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes Positive Ovoid to spherical Facultative anaerobic Extracellular Treponema[32] Treponema pallidum Negative, stains poorly Spirochete Aerobic Extracellular Ureaplasma[5] Ureaplasma urealyticum Stains poorly[46] Indistinct, 'fried egg' appearance, no cell wall Anaerobic Extracellular Vibrio[34][47] Vibrio cholerae Negative Spiral with single polar flagellum Facultative anaerobic Extracellular Yersinia[34][48] Yersinia pestis Yersinia enterocolitica Yersinia pseudotuberculosis Negative, bipolarly Small rods Facultative anaerobe Intracellular

## List of species and clinical characteristics

This is description of the more common genera and species presented with their clinical characteristics and treatments.

Species of human pathogenic bacteria Species Transmission Diseases Treatment Prevention Actinomyces israelii Oral flora[49] Actinomycosis:[49] painful abscesses and cysts MRSA in the mouth, lungs,[50][51] or gastrointestinal tract.[36] Prolonged penicillin G and drainage[49] Bacillus anthracis Contact with cattle, sheep, goats and horses[52] Spores enter through inhalation or through abrasions[34] Anthrax: pulmonary, gastrointestinal and/or cutaneous symptoms.[49] In early infection:[53] Penicillin Doxycycline Ciprofloxacin Raxibacumab[54] Anthrax vaccine[34] Autoclaving of equipment[34] Bacteroides fragilis Gut flora[49] Abscesses in gastrointestinal tract, pelvic cavity and lungs[49] Metronidazole[49] Wound care[55] Aspiration prevention[55] Bordetella pertussis Contact with respiratory droplets expelled by infected human hosts.[34] Whooping cough[34][49] Secondary bacterial pneumonia[34] Macrolides[34] such as erythromycin,[34][49] before paroxysmal stage[49] Pertussis vaccine,[34][49] such as in DPT vaccine[34][49] Borrelia B. burgdorferi[34][49] B. garinii[34] B. afzelii[34] Ixodes hard ticks Reservoir in mice, other small mammals, and birds[56] Lyme disease[57][58] Early localized: erythema migrans Early disseminated: neuroborreliosis, Lyme carditis Late: Lyme arthritis, Achrodermatitis chronica (B. afzelii only) Doxycycline for adults, amoxicillin for children, ceftriaxone for neurological involvement[57] Wearing clothing that limits skin exposure to ticks.[34] Insect repellent.[34] Avoid areas where ticks are found.[34] B. recurrentis[59] and others[note 1] Pediculus humanus corporis body louse (B. recurrentis only) and Ornithodoros soft ticks[59] Relapsing fever Penicillin, tetracycline, doxycycline[60] Avoid areas where ticks are found[59] Better access to washing facilities[59] Reduce crowding[59] Pesticides[59] Brucella B. abortus B. canis B. melitensis B. suis Direct contact with infected animal[34] Oral, by ingestion of unpasteurized milk or milk products[34] Brucellosis: mainly fever, muscular pain and night sweats Doxycycline[34] streptomycin or gentamicin[34] Campylobacter jejuni Fecal–oral from animals (mammals and fowl)[34][49] Uncooked meat (especially poultry)[34][49] Contaminated water[34] Enteritis,[34] bloody diarrhea[49] Guillain–Barré syndrome[49] (muscle weakness) Treat symptoms[34] Fluoroquinolone[49] such as ciprofloxacin[34] in severe cases[34] Good hygiene[34] Avoiding contaminated water[34] Pasteurizing milk and milk products[34] Cooking meat (especially poultry)[34] Chlamydia C. pneumoniae Respiratory droplets[34][49] Atypical pneumonia[49] Doxycycline[34][49] Erythromycin[34][49] None[34] C. trachomatis vaginal sex[34] oral sex[34] anal sex[34] Vertical from mother to newborn(ICN)[34] Direct or contaminated surfaces and flies (trachoma)[34] Trachoma[34][49] Neonatal conjunctivitis[34][49] Neonatal pneumonia[34][49] Nongonococcal urethritis (NGU)[34][49] Urethritis[34][49] Pelvic inflammatory disease[34][49] Epididymitis[34][49] Prostatitis[34][49] Lymphogranuloma venereum (LGV)[34][49] Erythromycin[34][49] (adults)[49] Doxycycline[34][49] (infants and pregnant women)[49] Erythromycin or silver nitrate in newborn's eyes[34] Safe sex[34] Abstinence[34] Chlamydophila psittaci Inhalation of dust with secretions or feces from birds (e.g. parrots) Psittacosis, mainly atypical pneumonia Tetracycline[34] Doxycycline[34] Erythromycin[34] - Clostridium C. botulinum Spores from soil,[34][49] persevere in canned food, smoked fish and honey[49] Botulism: Mainly muscle weakness and paralysis[49] Antitoxin[34][49] Penicillin[49] Hyperbaric oxygen[49] Mechanical ventilation[49] Proper food preservation techniques C. difficile Gut flora,[34][49] overgrowing when other flora is depleted[34] Pseudomembranous colitis[34][49] Discontinuing responsible antibiotic[34][49] Vancomycin or metronidazole if severe[34][49] Fecal bacteriotherapy C. perfringens Spores in soil[34][49] Vaginal flora and gut flora[34] Anaerobic cellulitis[34][49] Gas gangrene[34][49] Acute food poisoning[34][49] Gas gangrene: Debridement or amputation[34][49] Hyperbaric medicine[34][49] High doses of doxycycline[34] or penicillin G[34][49] and clindamycin[49] Food poisoning: Supportive care is sufficient[34] Appropriate food handling[34] C. tetani Spores in soil, skin penetration through wounds[34][49] Tetanus: muscle spasms[61] Tetanus immune globulin[34][49] Sedatives[34] Muscle relaxants[34] Mechanical ventilation[34][49] Penicillin or metronidazole[49] Tetanus vaccine (such as in the DPT vaccine)[34] Corynebacterium diphtheriae respiratory droplets part of human flora Diphtheria: Fever, sore throat and neck swelling, potentially narrowing airways.[62] Horse serum antitoxin Erythromycin Penicillin DPT vaccine Ehrlichia E. canis[49] E. chaffeensis[49] Dog tick[49] Ehrlichiosis:[49] headache, muscle aches, and fatigue Doxycycline[49] Rifampin[49] Enterococcus E. faecalis E. faecium Part of gut flora,[49] opportunistic or entering through GI tract or urinary system wounds[34] Bacterial endocarditis,[49] biliary tract infections,[49] urinary tract infections[49] Ampicillin (combined with aminoglycoside in endocarditis)[49] Vancomycin[34] No vaccine Hand washing and other nosocomial prevention Escherichia E. coli (generally) Gut flora,[34][49] and in urinary tract[49] Spreading extraintestinally or proliferating in the GI tract[34] Diarrhea[34][49] Urinary tract infections (UTI)[34][49] Meningitis in infants[34][49] Hospital-acquired pneumonia[49] Hospital-acquired sepsis[49] UTI:[34] (resistance-tests are required first) Co-trimoxazole Fluoroquinolone, e.g. ciprofloxacin Meningitis:[34] Cephalosporin (e.g. cefotaxime) and gentamicin combination Diarrhea:[34] Antibiotics above shorten duration Electrolyte and fluid replacement (no vaccine or preventive drug)[34] Cooking ground beef and pasteurizing milk against O157:H7[34] Hand washing and disinfection[34] Enterotoxigenic E. coli (ETEC) Fecal–oral[49] through food and water[34] Direct physical contact[34] Traveller's diarrhea[34][49] Enteropathogenic E. coli Vertical, in utero or at birth[34] Diarrhea in infants[34] Enteroinvasive E.coli (EIEC) Fecal–oral[63] bloody diarrhea and fever[49] Enterohemorrhagic (EHEC), including E. coli O157:H7 Reservoir in cattle[34] bloody diarrhea[34][49] Hemolytic-uremic syndrome[34][49] Francisella tularensis vector-borne by arthropods[34] Infected wild or domestic animals, birds or house pets[34] Tularemia: Fever, ulceration at entry site and/or lymphadenopathy.[64] Can cause severe pneumonia.[64] Streptomycin[34] Gentamicin[34] Avoiding insect vectors[34] Precautions when handling wild animals or animal products[34] Haemophilus influenzae Droplet contact[34] Human flora of e.g. upper respiratory tract[34] Bacterial meningitis[34][49] Upper respiratory tract infections[34][49] Pneumonia,[34][49] bronchitis[34] Septic arthritis in infants[49] Meningitis:[34] (resistance-tests are required first) Third generation cephalosporin, e.g. cefotaxime or ceftriaxone[34] Ampicillin and sulbactam combination[34] Hib vaccine to infants[34][49] Rifampin prophylactically[34] Helicobacter pylori Colonizing stomach[34] Unclear person-to-person transmission[34] Peptic ulcer[34][49] Chronic gastritis[49] Risk factor for gastric carcinoma and gastric B-cell lymphoma[34] Tetracycline, metronidazole and bismuth salt combination[34] (No vaccine or preventive drug)[34] Klebsiella pneumoniae Mouth, skin, and gut flora.[65] Pneumonia upon aspiration Klebsiella pneumonia, with significant lung necrosis and hemoptysis[49] Hospital-acquired urinary tract infection and sepsis[49] 3rd generation cephalosporin[49] Ciprofloxacin[49] hand hygiene.[66] Legionella pneumophila Droplet contact, from e.g. cooling towers,[34][49] humidifiers,[34] air conditioners[34][49] and water distribution systems[34] Legionnaires' disease[34][49] Pontiac fever[34][49] Macrolides, such as erythromycin[34][49] Fluoroquinolones[34] Rifampin[49] (no vaccine or preventive drug)[34] Heating water[34] Leptospira species Food and water contaminated by urine from infected wild or domestic animals. Leptospira survives for weeks in fresh water and moist soil.[34] Leptospirosis: Headaches, muscle pains, and fevers; possible jaundice, kidney failure, pulmonary hemorrhage, and meningitis.[67][68] Doxycycline for mild cases[69] Intravenous penicillin for severe cases[69] Vaccine not widely used[34] Doxycycline[34] Prevention of exposure[34] Rodent control[34] Listeria monocytogenes Raw milk or cheese,[34][49] ground meats,[34] poultry[34] Vertically to newborn or fetus[34][49] Listeriosis:[34] Meningitis[49] Sepsis[49] Ampicillin[34][49] Co-trimoxazole[34][49] (no vaccine)[34] Proper food preparation and handling[34] Mycobacterium M. leprae Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person[34] Leprosy (Hansen's disease):[34] granulomas of the nerves, respiratory tract, skin, and eyes.[70] Tuberculoid form: Dapsone and rifampin[34] Lepromatous form: Clofazimine[34] BCG vaccine shows some effects[34] M. tuberculosis Droplet contact[34] Tuberculosis: chronic cough with blood-containing sputum, fever, night sweats, and weight loss[71] (Difficult, see Tuberculosis treatment for more details)[34] Standard "short" course:[34] First 2 months, combination: Isoniazid Rifampicin Pyrazinamide Ethambutol Further 4 months, combination: Isoniazid Rifampicin BCG vaccine Isoniazid Mycoplasma pneumoniae Human flora[34][49] Respiratory droplets[34][49] Mycoplasma pneumonia[34] Doxycycline and erythromycin[34][49] Neisseria N. gonorrhoeae Sexually transmitted[34][49] vertical in birth[34] Gonorrhea[34][49] Urethritis (men)[49] Pelvic inflammatory disease (women)[49] Ophthalmia neonatorum[34][49] Septic arthritis[34][49] Uncomplicated gonorrhea:[34] Ceftriaxone[49] Tetracycline, e.g. doxycycline if also chlamydia is suspected[49] Spectinomycin for resistance[34][49] or patient allergy to cephalosporin[34] Ophthalmia neonatorum: Erythromycin[34][49] + ceftriaxone[49] (No vaccine)[34] Safe sex[34] Erythromycin into eyes of newborn at risk[34][49] N. meningitidis Droplet transmission[34] Meningococcal disease including meningitis[34][49] Sepsis, including Waterhouse-Friderichsen syndrome[34][49] Penicillin G[34][49] Ceftriaxone[34][49] NmVac4-A/C/Y/W-135 vaccine[34][49] Rifampin[34][49] Pseudomonas aeruginosa Opportunistic;[49] Infects damaged tissues or people with immunodeficiency.[34] Pseudomonas infection:[34] Pneumonia[34][49] Urinary tract infection[34][49] Corneal infection[34][49] Endocarditis[34][49] Osteomyelitis[34][49] Burn wound infection[49] Sepsis[34][49] Malignant external otitis[49] Anti-pseudomonal penicillins[34] such as ticarcillin[49] Aminoglycoside[34] (no vaccine)[34] Topical silver sulfadiazine for burn wounds[34] Nocardia asteroides In soil[49] Nocardiosis:[49] Pneumonia, endocarditis, keratitis, neurological or lymphocutaneous infection TMP/SMX[49] Rickettsia rickettsii Wood or dog tick[34][49] Rocky mountain spotted fever[34][49] Doxycycline[34][49] Chloramphenicol[34][49] (no preventive drug or approved vaccine)[34] Vector control, such as clothing[34] Prompt removal of attached ticks[34] Salmonella S typhi Fecal–oral route, through food or water[34][49] Typhoid fever type salmonellosis[34] (fever, abdominal pain, hepatosplenomegaly, rose spots)[49] Chronic carrier state[49] Ceftriaxone[34][49] Fluoroquinolones, e.g. ciprofloxacin[34][49] Ty21a and ViCPS vaccines[34] Hygiene and food preparation[34] Other Salmonella species e.g. S. typhimurium[34] Fecal–oral[34] Food contaminated by fowl[34] (e.g. uncooked eggs)[49] or turtles[49] Salmonellosis[34] with gastroenteritis[34][49] Paratyphoid fever[49] Osteomyelitis in people with sickle cells[49] Sepsis[49] Fluid and electrolyte replacement for diarrhea[34][49] Antibiotics (in neonates[49] and immuno-compromised[34][49]): Ciprofloxacin[49] Ceftriaxone[49] TMP/SMX[49] Azithromycin[49] (No vaccine or preventive drug)[34] Proper sewage disposal[34] Food preparation[34] Good personal hygiene[34] Shigella S. sonnei[34] S. dysenteriae[49] Fecal–oral[34][49] Shigellosis (bacillary dysentery) Fluid and electrolyte replacement[49] Fluoroquinolone[49] such as ciprofloxacin[34] if severe[49] Protection of water and food supplies[34] Vaccines are in trial stage[72] Staphylococcus aureus Human flora on mucosae in e.g. anterior nares, skin and vagina,[34][49] entering through wound Coagulase-positive staphylococcal infections: Skin infections, including impetigo[34][49] Acute infective endocarditis[34][49] Septis[34] Necrotizing pneumonia[34] Meningitis[49] Osteomyelitis[49] Toxinoses Scalded skin syndrome[34][49] Toxic shock syndrome[34][49] Staphylococcal food poisoning[34][49] Incision and drainage of localized lesions[34] Nafcillin,[34][49] oxacillin,[34] methicillin[49] Vancomycin for Methicillin-resistant (MRSA)[34] (no vaccine or preventive drug) Barrier precautions, washing hands and fomite disinfection in hospitals epidermidis Human flora in skin,[34][49] anterior nares[34] and mucous membranes[49] Infections of implanted prostheses (e.g. heart valves[34] and joints[49]) and catheters[34][49] Vancomycin[34][49] None[34] saprophyticus Part of normal vaginal flora[34] Cystitis in women[34][49] TMP/SMX or norfloxacin[73] None[34] Streptococcus agalactiae Human flora in vagina,[34][49] urethral mucous membranes,[34] rectum[34] Vertically during childbirth[34] Sexually[34] Neonatal meningitis[34][49] Neonatal sepsis[34][49] Neonatal pneumonia[49] Endometritis in postpartum women[34] Opportunistic infections with sepsis and pneumonia[34] Penicillin G[34][49] Aminoglycoside in case of lethal infection[34] None[34] pneumoniae Respiratory droplets Human flora in nasopharynx[49] (spreading in immunocompromised)[34] Acute bacterial pneumonia & meningitis in adults[34][49] Otitis media and sinusitis in children[34][49] Sepsis[49] Penicillin G[34][49] 23-serotype vaccine for adults (PPV)[34][49] Heptavalent conjugated vaccine for children (PCV)[34] pyogenes Respiratory droplets[34] Direct physical contact with impetigo lesions[34] Streptococcal pharyngitis[34][49] Sepsis[49] Scarlet fever[34][49] Rheumatic fever[34][49] Impetigo and erysipelas[34][49] Puerperal fever[34] Necrotizing fasciitis[34] Poststreptococcal glomerulonephritis[49] Penicillin G[34][49] or V[49] Macrolide, e.g. clarithromycin[34] or erythromycin[49] in penicillin allergy Drainage and debridement for necrotizing fasciitis[34] No vaccine[34] Rapid antibiotic treatment helps prevent rheumatic fever[34] viridans Oral flora,[49] penetration through abrasions Subacute bacterial endocarditis[49] Dental cavities[49] Abscesses of brain and liver[49] Penicillin G[49] Treponema pallidum subspecies pallidum Sexual[34][49] Vertical (from mother to fetus)[34] Syphilis:[34][49] First a chancre, (a painless skin ulceration), then diffuse rash.[74] Later: gummas (soft growths), neurological, or heart symptoms.[75] Congenital syphilis[34][49] Penicillin G[34][49] Doxycycline if penicillin allergy[34][49] Penicillin offered to recent sexual partners[76] Antibiotics to pregnant women if risk of transmitting to child[34] No vaccine available[34] Safe sex[34] Vibrio cholerae Fecal–oral route[49] Contaminated water and raw seafood[34] Cholera: Severe "rice water" diarrhea[49] Fluid[49] and electrolyte replacement[34] Doxycycline[34][49] Proper sanitation[34] Adequate food preparation[34] Yersinia pestis Fleas from animals[34][77] Ingestion of animal tissues[34] Respiratory droplets[34] Plague: Bubonic plague Pneumonic plague Streptomycin primarily[34][78][79] Tetracyclin[34][80] Supportive therapy for shock[34] Plague vaccine[81] Minimize exposure to rodents and fleas[34]

## Genetic transformation

Of the 59 species listed in the table with their clinical characteristics, 11 species (or 19%) are known to be capable of natural [genetic transformation](/source/Transformation_(genetics)).[82] Natural transformation is a bacterial adaptation for transferring [DNA](/source/DNA) from one cell to another. This process includes the uptake of exogenous DNA from a donor cell by a recipient cell and its incorporation into the recipient cell's [genome](/source/Genome) by [recombination](/source/Genetic_recombination). Transformation appears to be an adaptation for repairing [damage](/source/DNA_damage_(naturally_occurring)) in the recipient cell's DNA. Among pathogenic bacteria, transformation capability likely serves as an adaptation that facilitates survival and infectivity.[82] The pathogenic bacteria able to carry out natural genetic transformation (of those listed in the table) are *[Campylobacter jejuni](/source/Campylobacter_jejuni)*, *[Enterococcus faecalis](/source/Enterococcus_faecalis)*, *[Haemophilus influenzae](/source/Haemophilus_influenzae)*, *[Helicobacter pylori](/source/Helicobacter_pylori)*, *[Klebsiella pneumoniae](/source/Klebsiella_pneumoniae)*, *[Legionella pneumophila](/source/Legionella_pneumophila)*, *[Neisseria gonorrhoeae](/source/Neisseria_gonorrhoeae)*, *[Neisseria meningitidis](/source/Neisseria_meningitidis)*, *[Staphylococcus aureus](/source/Staphylococcus_aureus)*, *[Streptococcus pneumoniae](/source/Streptococcus_pneumoniae)* and *[Vibrio cholerae](/source/Vibrio_cholerae)*.[citation needed]

## See also

- [Human microbiome project](/source/Human_microbiome_project)
- [List of antibiotics](/source/List_of_antibiotics)
- [Pathogenic viruses](/source/Pathogenic_viruses)

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## External links

- [Bacterial Pathogen Pronunciation](http://www.atsu.edu/faculty/chamberlain/Website/studio.htm) by Neal R. Chamberlain, Ph.D. at A.T. Still University
- [Pathogenic bacteria](http://patricbrc.org) genomes and related information at [PATRIC](https://patricbrc.org/), a Bioinformatics Resource Center funded by [NIAID](https://www.niaid.nih.gov/)

1. Relapsing fever can also be caused by the following [Borrelia](/source/Borrelia) species: *[B. crocidurae](/source/Borrelia_crocidurae)*, *[B. duttonii](/source/Borrelia_duttonii)*, *[B. hermsii](/source/Borrelia_hermsii)*, *[B. hispanica](/source/Borrelia_hispanica)*, *[B. miyamotoi](/source/Borrelia_miyamotoi)*, *[B. persica](/source/Borrelia_persica)*, *[B. turicatae](/source/Borrelia_turicatae)* and *[B. venezuelensis](/source/Borrelia_venezuelensis)*. - Barbour, Alan G. (2017). "Relapsing Fever". *Harrison's Infectious Diseases*. 3rd ed. New York: McGraw Hill Education. pp. 678–687. ISBN 978-1-259-83597-1.

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Adapted from the Wikipedia article [Pathogenic bacteria](https://en.wikipedia.org/wiki/Pathogenic_bacteria) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Pathogenic_bacteria?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.