Bacteria are traditionally classified based on their
Gram-staining response into the
Gram-positive and Gram-negative bacteria. Having just one membrane, the Gram-positive bacteria are also known as
monoderm bacteria, while Gram-negative bacteria, having two membranes, are also known as
diderm bacteria. It was traditionally thought that the groups represent lineages, i.e., the extra membrane only evolved once, such that Gram-negative bacteria are more closely related to one another than to any Gram-positive bacteria. While this is often true, the classification system breaks down in some cases, with lineage groupings not matching the staining result. Thus, Gram staining cannot be reliably used to assess familial relationships of bacteria. Nevertheless, staining often gives reliable information about the composition of the cell membrane, distinguishing between the presence or absence of an
outer lipid membrane. Of these two structurally distinct groups of
prokaryotic organisms, monoderm prokaryotes are thought to be ancestral. Based upon a number of different observations, including that the Gram-positive bacteria are the most sensitive to
antibiotics and that the Gram-negative bacteria are, in general,
resistant to antibiotics, it has been proposed that the outer cell membrane in Gram-negative bacteria (diderms) evolved as a protective mechanism against antibiotic
selection pressure. Some bacteria such as
Deinococcus, which stain Gram-positive due to the presence of a thick
peptidoglycan layer, but also possess an outer cell membrane are suggested as intermediates in the transition between monoderm (Gram-positive) and diderm (Gram-negative) bacteria. • The second group are the clinically relevant
Mycobacterium, expanding to most of its encompassing order of
Mycobacteriales. They do not have the CSI, and their cell wall is made of a different substance:
mycolic acid. Medically relevant Gram-negative
diplococci include the four types that cause a
sexually transmitted disease (
Neisseria gonorrhoeae), a
meningitis (
Neisseria meningitidis), and respiratory symptoms (
Moraxella catarrhalis, A
coccobacillus Haemophilus influenzae is another medically relevant coccal type. Medically relevant Gram-negative
bacilli include a multitude of species. Some of them cause primarily respiratory problems (
Klebsiella pneumoniae,
Legionella pneumophila,
Pseudomonas aeruginosa), primarily urinary problems (
Escherichia coli,
Proteus mirabilis,
Enterobacter cloacae,
Serratia marcescens), and primarily gastrointestinal problems (
Helicobacter pylori,
Salmonella enteritidis,
Salmonella typhi). Gram-negative bacteria associated with
hospital-acquired infections include
Acinetobacter baumannii, which cause
bacteremia, secondary
meningitis, and
ventilator-associated pneumonia in hospital
intensive-care units. ==Bacterial transformation==