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Enterobacteriaceae
MedMicro 2006 UTHSCmed
| Question | Answer |
|---|---|
| Enterobacteriacaea (ALL) | Gram (-) Catalase (+) Oxidase (-) Ferment Glucose MacConkey Agar bacillus(rods) non-spore forming facultative anaerobe nitrate reducers |
| opppurtunistic pothogens (E. coli, Klebsiella) | normal flora but wrong location (or overabundance) |
| frank pathogens (Salmonella, Shigella) | presence in any amount is considered indicative of disease |
| not good in lower respiratory tract | klebsiella, Enterobacter, E. coli |
| not good in blood stream | ANYTHING |
| not good in GI Tract | Salmonella, Shigella, Yersinia |
| not good in Urinary Tract | Escherichia, Klebsiella |
| Escherichia | UTI, gastroenteritis, meningitis, septicemia, hemorrhagic colitis (EHEC) |
| Shigella | Bacillary dysentery |
| Salmonella | Gastroenteritis, septicemia, enteric fevers(typhoid) |
| Klebsiella | Pneumonia, UTI |
| Yersinia | Gastroenteritis, plague, zoonotic infections |
| Serotyping | identification of surface antigens of isolates |
| 3 types of antigens most commonly encountered when serotyping | O=somatic cell wall antigens, H = flagellar antigens, K = capsular antigens |
| MacConkey Agar (Isolation Media) | divides into coliform(lactore fermentors) and non-coliform(noo-lactose fermeters), inhibits gram (+) |
| coliform | E. coli, Klebsiella |
| non-coliform | Salmonella and Shigella |
| coliform bacteria | indictor of water contamination |
| Virulaence factors | Lipip A portion of O antigen (endotoxin), Many have capsule, Phase variation, Exotoxins, Adhesion Factors, Growth Factors, Resistance to Serum, Ab resistance plasmids |
| Exotoxins | Enterotoxins and Cytotoxins |
| Enterotoxin | Heat labile(increases cAMP) and Heat Stable (increases cGMP) |
| Cytotoxins | Shiga toxin(neurotoxic inhibits 60s) and Hemolysins (lysis RBCs free iron) |
| Adhesion Factors | P finbriae = uropathogenesis, s = neonatal Sepsis and meningitis |
| Escherichia coli (E. coli) | most predominate facultative anaerobe normal flora member of Intestinal tract |
| E. coli extra-intestinal infections | UTI, septicemia, neonatal menigitis |
| Intestinal infections(E. coli) | Enteroinvasive(EIEC), Enterotoxigenic (ETEC), Enterohemmorrhagic (EHEC), Enteropathogenic (EPEC), Enteroaggregative (EAECor EaggEC) |
| enteroinvasive(EIEC) | destroys colonic epithelim, becomsed intracellular parasite, Shigellla-like (clinically indistinquishable) |
| enterotoxigenic(ETEC) | makes heat stable and heat labile, major cause of traveller's diarrhea |
| enterohemorrhagic(EHEC) | verotoxin(shiga-like), bloody diarrhea, hemolytic uremic syndrome(HUS)=acute renal failure, serotyping necessary |
| enteropathogenic(EPEC) | nursery outbreaks, secreted factors enhance colonization |
| enteroaggregative (EAEC) | prolonged watery diarrhea, adherence is main virulence factor, common in developing countries |
| invasive organisms | EIEC and shigella |
| adherent organisms | ETEC, EPEC, EAEC |
| penetrent | Salmonella |
| SI infection | ETEC, EPEC, Salmonella |
| LI infection | EIEC, EHEC, Shigella |
| Shigella (dysenteriae, flexneri, boydii, sonnei) | NON-motile, and DO NOT produce gas |
| Mucosal ulcerations, Humans and primates only hosts, Fecal-Oral transmission | Shigella |
| Shigella Diagnosis | Dysentery in 1-4 days, sudden onset of Ab cramps, Diarrhea, fever, blood and mucus in stool, Isolation in SELECTIVE media to confirm |
| Salmonella (typhi, choleraisius, enteritidis) | non fermeter of lactose or sucrose, does produce gas (H2S), not a coliform |
| S. typhi (typhoid fever) | 7-14 day incubation, malaise, anorexia, headache, fever |
| Salmonella (gastroenteritis) | 8-48 hours afrter eating infected food, meats and poultry, initially headache, chills, ab pain, followed by nausea diarhea, vomiting and fever |
| Diagnosis for salmonella | from stool/blood, Widal test for specific aglutinins |
| salmonella treatments | typhoid and septicemia (chloramphenicol w/amp or trimethoprim-sulfomethoxazole) |
| Salmonella Tx duration | at least 2 weeks to avoid relapse due to ability ot survive inside phogocytes |
| gastroenteritis Tx | no antibiotics (will prolong carrier state), Self-limiting |
| Klebsiella | non-motile, encapsulated, lactose fermenter |
| Main virulence factor (Klebsiella) | capsule which inhibits phagocytosis |
| Yersinia (pestis, enterocolitica, pseudotuberculosis) | mainly animal pathogens, but can cause severe disease |
| Y. pestis | Black Plague |
| Y. pseudotuberculosis | pseudo appendicitis, lesions...self-limiting |
| Y. enterocolitica | enterocolitis(primarily), fever, diarrhea, ab pain ...self-limiting |
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