ASSOCIATED WITH:
Humans, animals and the environment.
SPREAD THROUGH:
Patients whose care requires ventilators, urinary catheters, or intravenous catheters.

• Meningitis
• Pneumonia
• Urinary tract infections

The frequency of CRE strains among clinical isolates has increased. Numbers are typically higher in India.

ASSOCIATED WITH:
Humans, animals and the environment.

• Diarrhoea
• Urinary tract infections (UTI)
• Respiratory illness
• Pneumonia

The number of ESBL cases is steadily increasing. Whilst the numbers vary according to region, they are typically high in the Middle East.

ASSOCIATED WITH:
The skin, nose and throat of colonised individuals.
SPREAD THROUGH:
Skin-to-skin contact and contaminated objects e.g. towels, sheets, clothes,  dressings, surfaces, door handles and floors.

• Wound infection
• Skin infection
• Septicaemia
• Endocarditis

The frequency of MRSA strains has shown an increase and decrease in clinical settings and increases in the community.

ASSOCIATED WITH:
Human intestines, female genital tract and is also often found in the environment.
SPREAD THROUGH:
Large amounts of use of antibiotics selects for the bacteria and allows it to multiply and cause infection.

IN A WOUND:
• Red, inflammed and tender skin

IN THE URINARY TRACT:
• Back pain urning sensation and increaed urination

Others symptoms include diarrhoea, weakness, chills, and fever.

There has been a dramatic increase of VRE in the United States possibly due to more use of the antibiotic Vancomycin.

ASSOCIATED WITH:
Soil and water.
SPREAD THROUGH:
Person to person contact or contaminated surfaces,such as bedside tables, hand rails, floors.

• Pneumonia
• Blood infections
• Wound infections

Acinetobacter baumannii is responsible for 80% of all Acinetobacter infections.

ASSOCIATED WITH:
Ccontaminated soil and surface waters
SPREAD THROUGH:
Inhalation of contaminated dust or water droplets, ingestion of contaminated water and contact with contaminated soil, especially through skin abrasions.

• Melioidosis (Burkholderia pseudomallei)
• Not known to cause disease in humans (Burkholderia tropica)

The only place Burkholderia pseudomallei occur naturally in the United States is Puerto Rico.

ASSOCIATED WITH:
Raw meat (usually poultry), raw milk.
SPREAD THROUGH:
Consumption of undercooked meat or contaminated surfaces, such as cooking utensils, chopping board, work surfaces.

• Diarrhoea (often with blood)
• Abdominal pain and cramping
• Fever
• Headache
• Nausea and/or vomiting

Symptoms take 3-6 days to develop.

Campylobacter is the most common food poisioning bacterium in Britain with around 280,000 cases a year.

ASSOCIATED WITH:
Waste water.
SPREAD THROUGH:
Environmental contamination, contact with surfaces such as hand rails, tables, chairs, door handles.

Non-infectious, Involved in biodegradation of compounds.

Numbers increase with both temperature and richness of nutrients.

ASSOCIATED WITH:
The human intestines.
SPREAD THROUGH:
Person to person contact or contaminated surfaces, such as sheets, beds, handrails, wall cladding.

• Watery diarrhoea
• Fever
• Loss of appetite
• Nausea and abdominal pain

May also show signs of dehydration.

C. difficile bacteria are found in the digestive system of about 1 in every 30 healthy adults and around 2/3 of babies.

ASSOCIATED WITH:
Intestines of animals, environments infected with E. coli containing faeces.
SPREAD THROUGH:
Consumption of contaminated food and drink, and contaminated surfaces, such as chopping boards, equipment, kitchen/bathroom sinks.

• Diarrhoea
• Vomiting
• Stomach cramps
• High temperature and aching muscles

O157 causes more severe infections. For example, kidney complications.

E. coli 0157 causes approximately 100,000 illnesses, 3,000 hospitalisations, and 90 deaths each year in the United States.

ASSOCIATED WITH:
Soil, water, dairy products and intestines of animals (including humans).
SPREAD THROUGH:
Hospital settings – equipment, skin to skin contact, beds, table surfaces.

• Skin and eye conditions
• Meningitis
• Bacteremia (bacterial blood infection)
• Pneumonia
• Urinary tract infections

Enterobacter spp. are commonly found in intensive care units and are responsible for 8.6% of nosocomial infections.

ASSOCIATED WITH:
Human intestines, female genital tract and is also often in the environment.
SPREAD THROUGH:
Intravascular or urinary catheters.

In a wound:
• Red, inflammed and tender skin
In the urinary tract:
• Back pain, burning sensation and increased urination

Enterococci faecalis is isolated from 80-90% of human intestine samples.

ASSOCIATED WITH:
Water and potting mixes
SPREAD THROUGH:
Inhalation of contaminated aerosols e.g. Water sprays, jets and mist from backsplash from a sink or shower.

• Respiratory failure
• Multi-organ failure/ dysfunction (MOD)
• Eventually death
• Legionnaires’ disease, ranging from mild cough to fatal pneumonia (duration 2-10 days)

The name “Legionnaires’ disease” came from the outbreak that occurred in 1976 in an American Legion convention in Philadelphia.

ASSOCIATED WITH:
Chilled ready-made food – such as deli soil, animals, refrigerated foods, raw
milk and soft cheeses.
SPREAD THROUGH:
Ingestion of contaminated foods.

• Fever
• Stiff neck
• Confusion
• Vomiting and diarrhoea

Listeria caused the largest foodbourne illness outbreak in the USA, resulting in 30 deaths and 147 reported illnesses.

ASSOCIATED WITH:
Soils, on leaves and other parts of plants, tap water in hospitals and sewage.
SPREAD THROUGH:
Environmental contamination, such as touch surfaces like bedside tables, door handles and hand rails. Also by exposure – skin to skin contact, hospital equipment, such as beds, bed rails, temperature probes.

• Bacteraemia – bacteria in the blood stream
• Central catheter infections
• Peritonitis in patients on chronic ambulatory peritoneal dialysis

Ability to form biofilms and develop a tolerance to disinfecting agents, high temperatures and drying make this microbe highly relevant.

ASSOCIATED WITH:
faeces, soil, sewage and hospital equipment.
SPREAD THROUGH:
Use of contaminated equipment, including catheters.

• Serious infection (usually occurs if there is already an underlying disease)
• External otitis – infection of the ear canal
• Endopthalmitis – inflammation of interior of the eye.
• Meningitis
• Pneumonia
• Diarrhoea
• Fever
• Nausea

Pseudomonas aeruginosa accounts for about 10% of hospital acquired infections.

ASSOCIATED WITH:
moist environments such as soil, rivers and lakes.
SPREAD THROUGH:
contaminated fluids used for patient care.

• Respiratory tract infections
• Sepsis
• Wound infections
• Infections of the ear and nose

In healthy individuals, infections with Ralstonia spp. are extremely rare – they are more commonly found in individuals with compromised immune systems, such as those with cystic fibrosis.

ASSOCIATED WITH:
Poultry, pigs and cattle. Reptitles also carry the bacteria.
SPREAD THROUGH:
Consumption of contaminated food or drink, person to person or animal to person.

• Diarrhoea
• Fever
• Nausea
• Abdominal cramps

Symptoms usually last around 4-7 days.

The CDC estimates 1.2 million illnesses and 450 deaths each year in the United States.

ASSOCIATED WITH:
Human faeces, water from ponds, lakes and untreated pools.
SPREAD THROUGH:
A faecal-oral route, e.g. eating food washed in contaminated water,contaminated surfaces e.g. table tops, kitchen equipment.

• Diarrhoea
• Fever
• Abdominal pain
• Tenesmus

Symptoms take 1-2 days to develop.

Shigella causes about 500,000 cases of diarrhoea each year in the United States.

ASSOCIATED WITH:
both wet and dry environments.
SPREAD THROUGH:
hospital equipment, humidifiers, water, air, bedside water bottles, sinks and temperature probes.

• Leg ulcers
• Peritonitis
• Respiratory infection
• Urinary infection
• Meningitis

An unidentified strain of Sphingomonas is held responsible for coral plague – first discovered in 1995, and a study in 2004 found it present in shower curtain biofilms.

ASSOCIATED WITH:
The skin, nose and throat of colonised individuals.
SPREAD THROUGH:
Skin-to-skin contact and contaminated surfaces, such as hospital beds, hand rails, floors wall cladding, bathroom fittings.

• Wound infection
• Skin infection
• Septicaemia
• Endocarditis

Found on the skin of 80-100% of patients with skin conditions such as atopic dermatitis, yet the reason is unclear.

ASSOCIATED WITH:
The skin, nose and throat of colonised individuals.
SPREAD THROUGH:
Biofilms growing on catheters and intravenous lines.

• Wound infection
• Skin infection
• Septicaemia
• Endocarditis

Part of the normal skin flora, but infections are usually hospital-acquired.

ASSOCIATED WITH:
Human intestines, female genital tract and is also the environment.
SPREAD THROUGH:
Intravascular or urinary catheters devices.

In a wound:
• Red, inflammed and tender skin
In the urinary tract:
• Back pain, burning sensation and increased urination

It is the most frequent species isolated from human intestine samples (80-90%).