HAS EPA CREATED A COLIFORM PANDEMIC?
     3 to 6 million children die each year from infectious gastroenteritis.
by Jim Bynum                                
2/24/2007
   

Today, EPA  uses the term fecal coliform and claims their presence in water or sludge is an indicator of pollution and
possible contamination by pathogens. Since sewage effluent - reclaimed water and sludge - biosolids is composed of
fecal material that went down the toilet from hospitals and homes, and the coliform group are disease causing
pathogens, it would appear EPA is trying to focus attention on other bacteria outside the group as well as viruses,
Helmeiths, protozoa and
fungus which do not show up during a test for coliform. Yet, EPA still promotes coliform
contaminated sludge - biosolids as a soil amendment and sewage effluent - reclaimed water on food crops as the
perfect disposal method and claims its going to do the science one day to see if its safe. EPA's (
Alan Rubin, retired)
documented
position is that there are only a few of the laboratory biosafety level 2 practice coliform group of
bacteria that cause gasteroenteritis.However, the list of bacteria at the end of this article shows that is not true and in
fact, bacterial gastroenteritis is less common than viral.

Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. Most cases are infectious,
although gastroenteritis may follow ingestion of drugs and chemical toxins (eg, metals, plant substances). Symptoms
include anorexia, nausea, vomiting, diarrhea, and abdominal discomfort. an estimated 3 to 6 million children die each
year from infectious gastroenteritis. Infectious gastroenteritis may be caused by viruses, bacteria, or parasites, Four
categories of viruses cause most gastroenteritis: rotavirus, calicivirus (which includes norovirus [formerly Norwalk virus]),
astrovirus, and enteric adenovirus.  
www.deadlydeceit.com/gastroenteritis.html

The coliform group of 12 infectious Enteric bacteria (fecal coliform)  which can invade the body through food (includes
E. coli, Salmonella, Shigella), was adopted in 1914 by the U.S. Public Health Service as the indicator for fecal
contamination in food or water. The simple test in the laboratory indicates at least one is present as they all have the
same signature, they ferment lactose.  It was proposed that this group of pathogenic bacteria would indicate the
presence of  infectious VIbrio cholerae, Campylobacter,  Streptococcus, Staphylococcus, Clostridium as well as  viruses,
the parasites helminths and protozoa, and fungus in food or water that infect the general public as well as those
individuals with poor immune systems. This is especially important because there is no treatment for virus infection.

Around 1970, a  toxin gene was transferred from the Shigella bacteria to E. coli, transforming it into the deadly E. coli
0157:H7. Since E. coli is one of the primary bacteria used in genetic engineering it is difficult to establish whether there
was
acelerated mutation during the sewage treatment process or was a sucessful genetic transfer of toxin genes in
the laboratory. E. coli 0157:H7 is also unique in that any attempt to kill the bacteria with antibiotics will release a load of
toxins into the body, which may send the patient into shock and cause  death shortly thereafter.

Since the coliform test was designed to detect fecal contamination of food and water, and reclaimed water, and biosolids
are the two separated fecal waste streams left after sewage treatment, it appears to be oxymoronic to claim any type of
safe exposure after the test shows deadly bacteria are still viable. What is even more moronic is to recombine  the two
fecal waste streams back into sewage on public parks and school grounds.
True. Biosolids with up to 1,000 most
probable number of coliform is promoted as a safe unlabeled soil amendment for parks, school grounds and lawn.
Reclaimed water which still contain the bacteria indicated by the coliform test is promoted as a safe source of irrigation
water for the same purpose. Just the 12 bacteria that make up a coliform are some of the most dangerous infectious
disease causing organisms to humans.


The
Introduction To Clinical Microbiology, University of Texas - Houston Medical School, describes coliform as the
    "Enterobacteriaceae family have earned a reputation placing them among the most pathogenic and most
    often encountered organisms in clinical microbiology. They are the causative agents of such diseases as
    meningitis, bacillary dysentery, typhoid, and food poisoning."

Furthermore, according to  Kenneth Todar, University of Wisconsin-Madison Department of Bacteriology,
    "The enterobacteriaceae include agents of food poisoning and gastroenteritis, hospital-acquired infections,
    enteric fevers (e.g. typhoid fever) and plague. They also cause infections in domestic, farm and zoo
    animals and include an important group of plant pathogens. Their host range includes animals ranging
    from insects to humans, as well as fruits, vegetables, grains, flowering plants, and trees."

The Federal Food and Drug Administration (FDA) explains the background behind the coliform test.

In 1892, Shardinger proposed the use of E. coli as an indicator of fecal contamination. This was based on the premise
that E. coli is abundant in human and animal feces and not usually found in other niches. Furthermore, since E. coli
could be easily detected by its ability to ferment glucose (later changed to lactose), it was easier to isolate than known
gastrointestinal pathogens. Hence, the presence of E. coli in food or water became accepted as indicative of recent
fecal contamination and the possible presence of frank pathogens [infect normal as well as people with poor immune
systems] . Although the concept of using E. coli as an indirect indicator of health risk was sound, it was complicated in
practice, due to the presence of other enteric bacteria like Citrobacter, Klebsiella and Enterobacter that can also
ferment lactose and are similar to E. coli in phenotypic characteristics, so that they are not easily distinguished. As a
result, the term "coliform" was coined to describe this group of
enteric bacteria. Coliform is not a taxonomic classification
but rather a working definition used to describe a group of Gram-negative, facultative anaerobic rod-shaped bacteria
that ferments lactose to produce acid and gas within 48 h at 35°C. In 1914, the U.S. Public Health Service adopted the
enumeration of coliforms as a more convenient standard of sanitary significance.
http://www.cfsan.fda.gov/~ebam/bam-4.html

EPA documents are misleading in that they imply there is a difference between microorganisms, enteric
bacteria, coliform, fecal coliform and their pathogenic nature to humans.

EPA Definitions:  
Coliform Organisms: Microorganisms found in the intestinal tract of humans and animals. Their presence in
water indicates fecal pollution and potentially adverse contamination by pathogens.
Organism: Any form of animal or plant life.

Fecal Coliform Bacteria: Bacteria found in the intestinal tracts of mammals [include humans]. Their
presence in water or sludge is an indicator of pollution and possible contamination by
pathogens.

Contamination: Introduction into water, air, and soil of microorganisms, chemicals, toxic substances,
wastes, or wastewater in a concentration that makes the medium unfit for its next
intended use. Also applies to surfaces of objects, buildings, and various household and
agricultural use products.

Pathogens: Microorganisms (e.g., bacteria, viruses, or parasites) that can cause disease in humans,
animals and plants.

Bacteria: (Singular: bacterium) Microscopic living organisms. Bacteria in soil, water or
air can also cause human, animal and plant health problems.

Fungus (Fungi): Molds, mildews, yeasts, Some are pathogens, others stabilize sewage and digest
composted waste.

Pollutant: Generally, any substance [biological pollution] introduced into the environment that adversely
affects the usefulness of a resource or the health of humans, animals, or ecosystems..
401.16   Conventional pollutants -- Fecal coliform  (CWA)  

503.9(t) Pollutant is ------ or a pathogenic organism that, after discharge and upon exposure, ingestion, inhalation,
or assimilation into an organism either directly from the environment or indirectly by ingestion through the
food chain, could, on the basis of information available to the Administrator of EPA, cause
death, disease,
behavioral abnormalities, cancer, genetic mutations, physiological malfunctions (including malfunction in
reproduction), or physical deformations in either organisms or offspring of the organisms.
 

EPA and its partner. Water Environmental Federation (WEF), the "water quality professionals" in the sludge industry
have a long running
public relations campagin to fool the public and politicians into believing that all disease causing
organisms in sludge - biosolids are destroyed during the treatment processess. As proof, EPA and its partners hold up
a sludge policy with the claim that sludge (biosolids) with only 1,000 culturable colony forming units (CFU) of fecal
coliform per gram (most probable Number) is safe for direct unlabeled human contact on lawns, gardens, parks and
school grounds.

Is the EPA and WEF misleading us again? You bet. Generally,  the term colony-forming unit (CFU) is used to describe
the cell division of a single bacteria into a colony as it divides every 20 - 30 minutes during the 48 hour test. However, a
coliform (FDA) is composed of 12 human disease causing pathogenic enteric bacteria that pasts through the gut:
ESCHERICHIA COLI, SHIGELLA, EDWARDSIELLA, SALMONELLA, CITROBACTER, KLEBSIELLA, ENTEROBACTER,
SERRATIA, PROTEUS, MORGANELLA, PROVIDENCIA and YERSINIA. When one or  more members of  coliform pass
through the gut, they becomes fecal coliform, indicating sewage contamination. Yet, EPA and its partner, WEF, wave a
sludge policy in our face to prove biosolids is safe and then claim sludge - biosolids with  approximately 1000 CFU of
fecal coliform per gram (1000/1 ml most probable number) (exceptional quality Class A) is perfectly safe for direct
human contact on your lawn, garden, park and school yard. If the safe  human contact level for fecal coliform in water is
6 cfu per gram, why would coliform at1,000 cfu per gram be safe for your child to contact  playing in a park or on a
school yard or your lawn?
.
If each coliform of 12 is a CFU  and there are 1,000 grams in a kilogram, then
1,000 fecal coliform x  1,000 grams
potentially = 12,000,000 (million) CFU of pathogenic bacteria per kilogram of sludge - biosolids soil amendment or
compost?  In the best case, if we were talking about 1,000 bacteria per gram of sludge  x 1,000 grams we would still
have 1,000,000 pathogenic bacteria per kilogram.

EPA even funded a misleading "scientific" study by National Academy of Science's (NAS) 1996 literary review report by
its National Research Council (NRC) Committee :
"Use of Reclaimed Water and Sludge in Food Crop Production",
in which it stated,  "There are instances in sludge processing, such as composting, in which the coliform levels cannot
be satisfactorily reduced even though there is reason to believe that the sanitary quality of the material is otherwise
acceptable (EPA, 1992b; Skanavis and Yanko, 1994)....

This has turned into a very big problem with a new direction. In 2006, a
WEF- WERF study indicated that the coliform
doubled every 20 - 30 minutes after it leaves the treatment process, which means that within 24 hours there are multi-
billions of pathogenic bacteria in sludge - biosolids. Not only that, but the coliform (12 bacteria) were not culturable by
standard laboratory methods after going through the treatment process. They found have the sludge had been through
a centrafuge that the bacteria had been underestimated by several magnitudes. The "regrowth" phenomenon they
found indicated that many coliform were viable, but nonculturable.

The makes the situtation much worse for Class B sludge - biosolids. EPA claims sludge with
two million (most probable
number (MPN))  or 2,000,000 Colony Forming Units (CFU) per gram fecal coliform per gram, (execptional quality Class
B), is safe for use on grazing land, forest and food crops  30 days after disposal. If we give EPA and WEF the benefit of
accepting that 1 coliform is one bacteria, the number is staggering, 2,000,000 (million) bacteria per gram x 1,000 grams
= 2,000,000,000 (billion) bacteria per kilogram and as the WEF study showed, the number doubles every 20 - 30
minutes after it leaves the treatment process.

But it is a guess anyway and a game. EPA went to a lot of trouble in figuring out how to confuse the issue.  Especially in
Class B, first you have to decide if you want to take 7 samples or 30 samples and use the best 7, then you have to
guess how much solids 1/2 % to 4% that might be in a day run of liquid sludge, then how many of the 12 pathogenic
bacteria that make up a coliform  that might be culturally viable by standard methods. At that point you can either guess
what the most probable number of bacteria there are in a single bacteria colony,  or you can use standard laboratory
methods to count the culturable viable 2 million bacterial colony forming units in a gram, in that little petri dish.

But it gets worse, in May 2006,
University of Minnesota researchers published data showing that extremely high
numbers of multi-drug resistant bacteria  (173) in effluent (treated water) at high levels are being released into the
environment from highly efficent, award winning, sewage wastewater treatment plants. Researchers were
very concerned when they found extremely fast transfer of the drug resistant gene between bacteria in
the treatment plant, which simply
confirmed EPA studies from the 80s on drug resistant transfer by Meckes and others.

Yet, it appears EPA and its partner, WEF, succeeded in their long running  public relations campaign to misinform the
public and the politicians about the safety of sludge - biosolids. The states and universities are now giving false
information to the public in claiming pathogenic bacteria that make up a colifom are simply harmless organisms. As
examples:

The State of Kentucky:

    Total coliform bacteria are a collection of relatively harmless microorganisms that live in large numbers in
    the intestines of man and warm- and cold-blooded animals. They aid in the digestion of food. A specific
    subgroup of this collection is the fecal coliform bacteria, the most common member being Escherichia coli.
    These organisms may be separated from the total coliform group by their ability to grow at elevated
    temperatures and are associated only with the fecal material of warm-blooded animals
    http://www.state.ky.us/nrepc/water/wcpfcol.htm


According to Washington State Department of Health:

    Coliform bacteria are organisms that are present in the environment and in the feces of all warm-blooded
    animals and humans.  Coliform bacteria will not likely cause illness.  However, the presence of coliform
    bacteria in drinking water indicates that disease-causing organisms (pathogens) may be present in the
    water system.  Most pathogens that can contaminate water supplies come from the feces of humans or
    animals.  Testing drinking water for all possible pathogens is complex, time-consuming, and expensive.  It is
    relatively easy and inexpensive to test for coliform bacteria.  If coliform bacteria are found in a water
    sample, steps are taken to find the source of contamination and restore safe drinking water
    http://www.doh.wa.gov/ehp/dw/Programs/coliform.htm

COOPERATIVE EXTENSION UNIVERSITY OF CALIFORNIA  ENVIRONMENTAL TOXICOLOGY NEWSLETTER
    Coliforms are bacteria that live and replicate in the intestinal tract of humans and other warm-blooded
    animals, and thus they are a normal constituent of fecal material. In general, coliform bacteria do not cause
    disease in humans. Coliforms are inactivated, or destroyed, to varying degrees by water and wastewater
    treatment processes. It was believed for many years that the processes that inactivate coliforms also
    inactivate any pathogenic (disease-causing) microorganisms that were present in the water or wastewater.
    Thus, coliforms have been used as indicators for the presence of pathogenic microorganisms. In other
    words, if coliforms are detected in water, it is assumed that pathogenic microorganisms may also be
    present, and steps must be taken to protect the public health.
http://extoxnet.orst.edu/newsletters/n111_91.htm

The EPA and WEF public relations campaign to spread misleading and false information culminated in the false and
misleading information being incorporated into state laws and used by the courts to overturn and prohibit sludge bans in
Virginia Counties. Then we have the example In Keggi v. Northbrook Property & Casualty Ins. Co., 199 Ariz. 43, 13 P.3d
785 (App. 2000); recon. den. (Apr 10, 2001), rev. den. (Oct 03, 2001), the Arizona Court of Appeals interpreted the
pollution exclusion in light of “non-traditional” polluters and pollutants. At issue in Keggi, was a golfer’s claim that she
became seriously ill after consuming tap water contaminated with total and fecal coliform. The water in question came
from a distribution system owned, operated and maintained by a mixed-use development including homes, golf courses
and clubhouses. The source of the contamination was never determined.

  • "The Court then held, in no uncertain terms, that living organisms such as fecal coliform bacteria do not fall
    within the definition of pollutant"
http://www.jsslaw.com/publication.aspx?id=2340c772-0447-4469-b8dd-2abc804b86da

But EPA does list fecal coliform as a conventional pollutant in 40 CFR 401.16. As it happens Arizona is one of the few
state with the EPA authority to issue sludge permits for beneficial use and it does reclaimed water for irrigation and
drinking water aquifer recharge. However, its not the first state to dismiss a victims complaint. In Washinton, Ray and
Linda Zander's dairy farm was destroyed by  a county permited sludge dumping operation on a neighor's farm. "Their
suit against Whatcom County and the municipalities were dismissed under the Public Duty Doctrine by summary
judgment. The Whatcom County Superior Court on October 8, 1993, held that the county had no duty to protect the
Zanders, only a duty to the general public and they were individuals
http://deadlydeceit.com/DD5.html

The misleading and false information has even made it into laws which offer no protection to the public. California's
water reclaimation law claims coliform is a generic organism and the wastewater treatment plant coliform reports must
maintain consistency with the montoring data on EPA's existing data sets. Under California's Title 22, Total coliform
should average 2.2 MPN/100ml (most probable number)/mililiter (gram)) over a 7 day period. However, for one day the
coliform could be 240 MPN/100 ml. Translated, that means the most probable number would be 2,400 pathogenic
bacteria per liter of reclaimed water for a full day that is used in Salinas County to irrigated spinach and lettuce,  that
you eat raw. There have been nine contaminated food outbreaks traced back to Salinas valley since 1995. Only bagged
and tagged processed lettuce and spinach could be traced. The last two outbreaks have been a 100 million dollar
disaster for California farmers using reclaimed water and it will probably get much worse as bacterial biofilms build up in
the irrigation pipes and break loose.

CALIFORNIA  TITLE 22  Section 64655(b)

    Total coliforms serve as a generic indicator organism that captures a broad range of potential
    bacteriological contamination.  Fecal coliform and E. coli are indicators of specific fecal or human waste
    contamination.  Coliform monitoring has been used by the industry for many years and the Information
    Collection Rule (61 Fed. Reg. 24354 (May 14, 1996)) database is populated with coliform monitoring data.  
    This regulation specifies coliform monitoring to maintain consistency with existing data sets.
http://www.applications.dhs.ca.gov/regulations/store/regulations/R-20-01%20ISOR.doc

CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD SAN FRANCISCO BAY REGION
  • 6.        Tertiary Recycled Water  Tertiary recycled water shall be coagulated (except as identified in Part C below),
    and filtered, and meet the following total coliform, disinfection process and turbidity limits prior to delivery for
    reuse purposes: .
  • a.        Total coliform          After adequate contact with disinfectant the number of total coliform organisms shall
    not exceed: (1) a median value of 2.2 MPN/100ml as determined from the bacteriological results of the last seven
    days for which  sample analyses have been completed, and (2) a maximum value of 23MPN/100ml in more than
    one sample in any 30 day period. No sample shall exceed a total colform value of 240 MPN/100 ml.
www.swrcb.ca.gov/rwqcb2/download/orderno96-011.doc

But then California is not alone. According to documents,Virginia plans on allowing even higher levels of coliform in its
reclaimed water. Virginia has incorporated the promotion of reclaimed water and biosolids into law as a method of
permitted disposal to the extent that counties are prevented from questioning the safety of sludge use or taking in legal
steps to protect their citizens from exposure. And remember, we are not looking at the full range of disease causing
pathogens as they double every 20 - 30 minutes.

Virginia -- Minutes of the TAC Meeting for the Reclamation and Reuse Regulations
February 27, 2006

  • Virginia is moving away from use of fecal coliform as a surrogate organism for determining adequate disinfection.
    Therefore, reclamation and reuse standards should consider other surrogate organisms to replace or use as
    alternates to fecal coliform.

  • According to State Water Quality Standards for surface waters (except shellfish waters) and for primary contact
    recreation uses, the standards for E. coli are a geometric mean of 126/100 ml and a single sample maximum of
    235/100 ml; for enterococci, a geometric mean of 35/100 ml and single sample maximum of 104/100 ml, and for
    fecal coliform, a geometric mean of 200/100 ml and a single sample maximum of 400/ml. Consequently, why would
    reclaimed water treated to meet at least level 2, not have a fecal coliform standard of 400/100 ml instantaneous
    maximum rather than 1000/100 ml, contained in the previously proposed regulation?
http://www.deq.virginia.gov/water/documents/final.tac.minutes.02.27.06.pdf

Fecal Coliform is just 12 bacterial pathogens out of over 1,400 pathogenic disease causing organisms documented to
cause infectious health effects in humans. Based on the research, Viruses appear to cause more infectious health
effect than bacteria. The dramatic increase of foodborne illnesses, from 2 million in 1986 to 76 million in 1999, and
antibiotic resistant pathogens gives us a hint that spreading these infectious diseases organisms haphazardly around
our environment and on our food crops is not the best idea the government every had. Based on the fact that these
infectious pathogens, and the chemicals that accompany them, cause  every thing from a mild case of diarrhea to
respiratory damage, to organ failure, to nerve damage, to heart attacks, to brain damage and death, should be a bigger
hint that our government agencies are not doing something right. According to recent research, the situation is not as
bad in other countries yet, but then we have had a 20 year head start on destroying our environment, our health and its
showing up in the cost to the gross domestic product figures.

In Jamuary, 2007, the McKinsey Global Institute, released a study on health care with the aim of determining why the
United States spends almost double the average of 13 other industrialized countries on health care and in many cases
the medical outcome is not as good.. The study found that we spend $477 billion more annually on health care than
expected, when compared to the care provided by those 13 countries The study concluded this was a staggering waste
of money and works out to 3.6 percent of the nation's entire economic output, and it works out to an additional $1,645
per person, every year.  While that is serious money to poor people who get hit the hardest by health care, that is only
part of the $6,280 per person in 2004, $5,449.00 per capital spending on health care in 2002.  That is also a dramatic
increase from the $1,313.00 (2002 dollars) spent on health care per capita in 1970. That health cost is also reflect in
the increased percentage of gross domestic product from 7.0 percent in 1970,  14.9 in 2002. and 16 percent in 2004.
The number is expected to be 20 percent of GDP in 2015.

The following list of coliform and other bacteria associated with sludge is limited in scope, but gives some general health
effects caused by coliforms. In reviewing this information, we need to keep in mind that some bacteria are very hard to
detect and in the case of some toxin producing bacteria, the toxin produces food poisoning, or health damage, and
there may be no evidence of bacteria in the food . A second point is that the doctor generally has no idea the coliform is
being spread on lawns, gardens, parks and school yards in an unlabeled soil amendment. Of course, you may not have
that information either. It is little wonder the public health system in the United States is a disaster. No one in authority
wants to admit a few
good old boys who may, or may not, have had good intentions could create a government policy
promoting cheap coliform contaminated sludge disposal as a soil amendment and using sewage effluent for irrigation,
and the rest of the government went along with it.  This is the same stuff that was banned from ocean dumping because
it was infecting/killing the fish and now it  may be causing the 76 + million case of foodborne illnesses each year and an
unknown number of deaths. That's up from 2 million in 1986.  These  figures do not include infectious disease  and
deaths contacted through air or water exposure. An example is the Milwaukee waterborne fecal crytosporidium parasite
outbreak in 1993. 403,000 residents of the five-county area experienced illness, 44,000 persons (11%) were seen as
outpatients; and 4,400 persons (1%) were hospitalized, and approximately 400 died. It was 4 years later before CDC
released the data showing that the infectious crytosporidium parasite originated from human fecal matter.

The coliform test completely missed the crytosporidium parasite. No one will general tell you about the other health
problems that may also be associated with exposure to these coliforms or the other pathogens they are suppose to
indicate.

This general information is adapted from:

          Introduction To Clinical Microbiology
       University of Texas - Houston Medical School,

Coliforms -- Gram- negative rods are usually associated with intestinal infections which may spread to other
parts of the body. The term EPA uses for these infections is gasteroenteritis.

Citrobacter: C. freundii
is suspected to cause diarrhea and possibly extraintestinal infections. C. diversus has been
linked to a few cases of meningitis in newborns.

Edwardsiella tarda:  E. tarda produces hydrogen sulfide. This bacterium is usually found in aquatic animals and
reptiles. However, it has been known to cause gastroenteritis and wound infections in humans.

Enterobacter: several species cause opportunistic infections of the urinary tract as well as other parts of the body.
E. aerogenes and E. cloacae are two such pathogens that do not cause diarrhea, but that are sometimes associated
with urinary tract and respiratory tract infections.

ESCHERICHIA COLI: Besides being the number one cause of human urinary tract infections, E. coli has been linked to
diseases in just about every other part of the body. Pneumonia, meningitis, and traveler's diarrhea are among the many
illnesses that pathogenic strains of
E. coli can cause. Pathogenic strains of E. coli can cause severe cases of diarrhea
in all age groups by producing a powerful endotoxin. [Central America
Shigella strain Toxin] Treating E. coli
infections with antibiotics may actually place the patient in severe shock which could possibly lead to
death. This is due to the fact that more of the bacterium's toxin is released when the cell dies.

Klebsiella:
 Klebsiella's pathogenicity can be attributed to its production of a heat-stable enterotoxin.  K.
pneumoniae
is second only to E. coli as a urinary tract pathogen. Klebsiella infections are encountered far more often
now than in the past. This is probably due to the bacterium's antibiotic resistance properties. Klebsiella species may
contain resistance plasmids (R-plasmids) which confer resistance to such antibiotics as ampicillin and carbenicillin. To
make matters worse, the R-plasmids can be transferred to other enteric bacteria not necessarily of the same species.

Morganella morganii  can cause urinary tract and wound infections, as well as diarrhea.

Providencia species have been associated with nosocomial (hospital acquired) urinary tract infections.
P. alcalifaciens, has been associated with some cases of diarrhea in children.

Proteus,  can cause urinary tract infections and hospital-acquired infections.   P.mirabilis, a cause of wound and
urinary tract infections. most strains of
P. mirabilis are sensitive to ampicillin and cephalosporins.  P. vulgaris is not
sensitive to these antibiotics.

Salmonella: S. typhimurium and S. enteritidis are the two leading causes of salmonellosis (inflammation of the
intestine caused by Salmonella).  
S. typhi is unique because it is only carried by humans. This intracellular parasite can
cause typhoid fever (enteric fever) which is characterized by fever, diarrhea, and inflammation of the infected organs.

Serratia genus were once known as harmless organisms that produced a characteristic red pigment. Today, Serratia
marcescens
is considered a harmful human pathogen which has been known to cause urinary tract infections, wound
infections, and pneumonia.
Serratia bacteria also have many antibiotic resistance properties which may become
important if the incidence of Serratia infections dramatically increases

Shigella is also an invasive pathogen which can be recovered from the bloody stool of an infected host. Invasive
pathogens colonize the host's tissues as opposed to growing on tissue surfaces.

Yersinia genus: Y. enterocolitica and Y. pestis. Y. enterocolitica is the most often encountered species of
Yersinia in the lab. This bacterium is an invasive pathogen which can penetrate the gut lining and enter the lymphatic
system and the blood. Infection, which is usually through ingestion of contaminated foods, can cause a severe intestinal
inflammation called yersiniosis. Release of its enterotoxin can cause severe pain similar to that found in patients with
appendicitis.

Y. pestis is included here because it causes the bubonic, pneumonic, and septicemic plagues. Human contraction of
bubonic plague is usually through flea bites. Once inside the body,
Y. pestis releases a toxin which inhibits electron
transport chain function. Swelling of the lymph nodes, skin blotches, and dilerium are sometimes observed within a few
days of infection. Untreated infections usually result in death within a week of initial infection.

PLEOMORPHIC GRAM-NEGATIVE RODS

Bordetella organisms:
The most important species in this genus is B. pertussis, the organism which causes
whooping cough. This highly contagious bacterium makes its way into the respiratory tract via inhalation and
subsequently binds to and destroys the ciliated epithelial cells of the trachea and bronchi. It does this through the use of
several toxins:
B. parapertussis is a respiratory pathogen that can cause mild pharyngitis. This bacterium is similar to
B. pertussis but lacks some of the toxins which make its sibling so nasty.
 Bordetella bronchiseptica is usually a
cause of pneumonia, otitis media, and other respiratory infections in animals.

BRUCELLA:  The four species of this genus that can infect humans are named for the animal which they are most
commonly found:
B. abortus (cattle), B. suis (swine), B. melitensis (goats), B. canis (dogs).  Brucella can enter the
body via the skin, respiratory tract, or digestive tract. Once there, this intracellular organism can enter the blood and the
lymphatics where it multiplies inside phagocytes and eventually cause bacteremia (bacterial blood infiltration).

Haemophilus genus:  H. influenzae is the most common cause of bacterial meningitis in children between the ages of
five months and five years. The initial respiratory infection can spread to the blood stream and eventually the central
nervous system. A stiff neck, lethargy, and the absence of the sucking reflex are common symptoms in infected babies.
A vaccine is available, but is not always effective in very young children. Adult meningitis is much less common and
usually only occurs in those predisposed to illness.
H. influenzae is the number one cause of Epiglottitisthis, [a] potentially fatal disease, which may cause airway
obstruction in children between the ages of 2 and 4.
Haemophilus infection has also been associated with chronic
bronchitis, pneumonia, bacteremia, conjuctivitis, and a host of other illnesses

Legionella:  L. pneumophila is the bacterium associated with Legionnaires' disease and Pontiac fever. Patients can
develop severe pneumonia which is not responsive to penicillins or aminoglycosides. Legionnaires' disease also has the
potential to spread into other organ-systems of the body such as the gastrointestinal tract and the central nervous
system.
L. micdadei is the second most commonly isolated member of Legionella. This bacterium can cause the same
flu-like symptoms and pneomonia which characterize an
L. pneumophila infection

PASTEURELLA:  P. multocida is the species which most commonly infects humans. Although most members infect
animals, humans can acquire the organism from dog or cat bites. Patients tend to exhibit swelling, cellulitis, and some
bloody drainage at the wound site. Infection may also move to nearby joints where it can cause swelling and arthritis
(not to mention a lot of pain).

.
MISCELLANEOUS GRAM-NEGATIVE RODS

Campylobacter: C. jejuni
, an organism that causes gastrointestinitis.  bloody diarrhea indicates that Campylobacter
is an invasive pathogen that infiltrates the lining of the small intestine. Along the way, the organism excretes toxins that
destroy the gut mucosa.

Helicobacter genus : Helicobacter pylori is the leading cause of peptic ulcers and chronic gastritis in America.

VIBRIO:  Several species of Vibrio are known to be human pathogens,  V. cholerae ([is] the causative agent of
cholera). Another species of
Vibrio that causes diarrhea is V. parahaemolyticus. V. vulnificus is also obtained from
eating contaminated seafood. Unlike other
Vibrio species, this one is invasive and is able to enter the blood stream
through the epithelium of the gut.  Additionally, wound infection may also occur from contaminated sea water. Cellulitis
or ulcer formations may result.

NONFERMENTERS

Acinetobacter species:
A. baumannii can be linked to many hospital acquired infections including skin and wound
infections, pneumonia, and meningitis.
A. lwoffi, in particular, is responsible for most cases of meningitis caused by
Acinetobacter.  

Flavobacterium: cause infection in premature infants and immunocompromised individuals. The species most often
recovered from humans is
F. meningosepticum, a penicillin resistant bacterium that can cause neonatal meningitis

PSEUDOMONAS:  These bacteria are resistant to most antibiotics and they are capable of surviving in conditions that
few other organisms can tolerate. These pathogens colonize the lungs of cystic fibrosis patients, increasing the mortality
rate of individuals with the disease. Infection can occur at many sites and can lead to urinary tract infections, sepsis,
pneumonia, pharyngitis, and a lot of other problems.
Pseudomonas aeruginosa;  pathogenicity involves several
toxins and chemicals which the bacterium secretes upon infection. The lipopolysaccharide layer helps the cell adhere to
host tissues and prevents leukocytes from ingesting and lysing the organism. Lipases and exotoxins then procede to
destroy host cell tissue which then leads to the complications associated with infection. Burkholderia (Pseudomonas)
cepacia is an opportunistic pathogen of cystic fibrosis patients.
Stenotrophomonas maltophila (formerly known as
Xanthomonas maltophila) is very similar to the Pseudomonads. S. maltophila also harbors significant resistance to
many antibiotics considered effective for treating
Pseudomonas infections
.
GRAM POSITIVE ANAEROBES

Actinomycetes:
fungus-like bacteria; A. israelii  most commonly associated with actinomycosis

Bacteroides genus: Their pathogenicity is limited, Infection only occurs after severe trauma to the abdominal region.
Infection could lead to abscess formation and possibly fever.

Clostridium:  When the environment becomes stressed,  the bacteria produce spores that tolerate the extreme
conditions that the active bacteria cannot. In their active form, these bacteria secrete powerful exotoxins that are
responsible for such diseases as tetanus, botulism, and gas gangrene.  This non-motile bacterium is an invasive
pathogen that can be contracted from dirt via large cuts are wounds.
C. perfringens cells proliferate after spore
germination occurs and they release their exotoxin. The toxin causes necrosis [death] of the surrounding tissue
(Clostridial myonecrosis destroys muscular tissus). The bacteria themselves produce gas which leads to a bubbly
deformation of the infected tissues.
C. perfringens is capable of necrotizing intestinal tissues and can release an
enterotoxin that may lead to severe diarrhea.  
Clostridium difficile is a motile bacterium that can be part of the natural
intestinal flora. Infection can occur through the use of broad-spectrum antibiotics which lower the relative amount of
other normal gut flora. When this situation occurs,
C. difficile proliferates and infects the large intestine. The bacterium
then releases two enterotoxins that destroy the intestinal lining and cause diarrhea.

EUBACTERIUM: E. lentum, the most often isolated species, has been linked to endocarditis and some wound infections

Fusobacterium species, the most common of which is F. nucleatum, are associated with pleuropulminary infections
and disease. They are also capable of causing infection in the oral cavity (the mouth).
F. nucleatum has been cited as
one of the causes of gingivitis.

Neisseria genus: N. meningitidis causes meningitis, inflammation of the membranes covering the central nervous
system. The different strains of N. meningitidis are classified by their capsular polysaccharides. This bacterium is the
second leading cause of meningitis in the United States. Early symptoms may include headache, fever, and vomiting.
Death can quickly follow due to endotoxin shock or focal cerebral involvement
.

PEPTOSTREPTOCOCCUS: P. magnus
is  the species that is most often isolated from infected sites.  they can cause
infections of bones, joints and soft tissue. Their increasing resistance to such antibiotics as penicillin G and clindamycin
makes them especially important to clinical work.

Propionibacterium species:  P. acnes, is a usually harmless microbe that has pathogenic potential. It has been
linked to certain cases of endocarditis, wound infections, and abscesses. it can infect acne sites on the skin but it does
not cause them.

GRAM-POSITIVE Bacteria

Bacillus
represents a genus of Gram-positive bacteria with the ability to produce endospores when environmental
conditions are stressful. The only other known spore-producing bacterium is Clostridium.
B. anthracis causes anthrax.
B.cereus cause toxin-mediated food poisoning.  two toxins released by the bacterium lead to vomiting and diarrhea,
symptoms similar to those of Staphylococcus food poisoning. Because toxin production usually takes place after the
infected foods are cooked,

Corynebacterium: C. diphtheriae produces the toxin that causes diphtheria, a disease of the upper respiratory system
in humans.
C.diphtheria is unique in its exotoxin formation.

Listeria:  L. monocytogenes has been implicated in several food poisoning epidemics. The bacterium usually causes
septicema and meningitis in patients with supressed immune function. It also causes listeriosis which is an inflammation
of the brain.  Those at high risk include newborns, pregnant women and their fetuses, the elderly, and persons lacking a
healthy immune system.

Gram-positive cocci --- have taken on the invasive traits in the past 15 years

Staphylococcus genus: S. aureus
is a leading cause of soft tissue infections, as well as toxic shock syndrome (TSS)
and scalded skin syndrome. pathogenic effects of Staph are mainly asssociated with the toxins it produces. it is not
uncommon for an infected site to contain no viable Staph cells. The
S. aureus enterotoxin causes quick onset food
poisoning which can lead to cramps and severe vomiting. microbes also secrete leukocidin, a toxin which destroys white
blood cells and leads to the formation of pus and acne.  
S. aureus has been found to be the causative agent in such
ailments as pneumonia, meningitis, boils, arthritis, and osteomyelitis (chronic bone infection).
S. epidermis is an opportunistic pathogen which is a normal resident of human skin. Those susceptible to infection by
the bacterium are IV drug users, newborns, elderly, and those using catheters or other artificial appliances

Streptococcus genus:  S. pyogenes is responsable for about 90% of all cases of pharyngitis. "Strep throat" which is
characterized by inflamation and swelling of the throat, as well as development of pus-filled regions on the tonsils.
infection spreading from the upper respiratory system into the lungs. Once in the lungs, the infection could give rise to
pneumonia. Some cases also develop into rheumatic fever if left untreated. Other diseases linked to S. pyogenes are
skin infections such as impetigo, cellulitis, and erysipelas.
S. agalactiae. For years this bacterium has been the causative agent in mastitis in cows. Currently, it has been found
to be a cause of sexually transmitted urogenital infections in females. Although infection is easily treated with penicillin,
proper diagnosis is necessary for women nearing labor because the infection can easily spread to the child via the birth
canal.
Type D Streptococcus The Enterococci include E. faecalis, a cause of urinary tract infections, and E. faecium, a
bacterium resistant to many common antibiotics. Diseases such as septicemia, endocarrditis, and appendicitis have also
been attributed to group D Strep.
Streptococcus pneumoniae causes pneumonia, meningitis, and otitis media.
S. mutans and S. mitis, are alpha-hemolytic bacteria. These bacteria inhabit the mouth. In fact, a large percentage of
tooth decay can be attributed to S. mutans.
http://medic.med.uth.tmc.edu/path/00001458.htm This link discontinued by UT. See Kenneth Todar's textbook
http://www.textbookofbacteriology.net/pathogenesis.html

I leave you with a statement by the WHO’s chief of Communicable Disease, David Heymann, before the US Senate
hearing on The Spread of Communicable Disease, in 2001, which has now become a  fact.  
    Some microbes have accumulated resistant genes to virtually all currently available drugs.
    Thus, these have the potential to cause untreatable infections. Accordingly, such diseases may
    have no effective cures over the next 10 years unless there is some uncharacteristic
    breakthrough in drug therapy. Therefore, if current trends continue, many important medical
    and surgical procedures, including cancer therapy, bone marrow and organ transplant, hip and
    knee replacement, and coronary bypass surgery could no longer be undertaken without undue
    risk of unstoppable infection