16 – Other Enterobacterales Flashcards

1
Q

Natural host or habitat (Salmonella)

A
  • Found in gut of a variety of animals
  • Canada: Salmonella ID from agricultural animals varies across country
    o Most common in humans: S. Enteritidis and Heidelberg
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2
Q

Taxonomy (Salmonella)

A
  • 3 species
  • *grouped into serovars/serotypes
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3
Q

Serovars

A
  • Defined by presence of surface antigens
    o O-antigens
    o H-antigens
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4
Q

O-antigens

A
  • Based on oligosaccharides associated with LPS
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5
Q

H-antigens

A
  • Based on flagellar proteins
  • Can have 2 phases (express multiple flagellar proteins)
  • Strains may be micro- or di-phasic
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6
Q

Virulence factors

A
  • Salmonella pathogenicity islands (SPI)
  • Type 3 secretion systems
  • Fimbriae: adherence and colonization
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7
Q

Salmonella pathogenicity islands

A
  • Gene clusters containing virulence genes
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8
Q

Type 3 secretion systems

A
  • Detects host cells
  • Act as a needle/syringe to inject effector molecular
  • Involved with INVASION
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9
Q

Salmonella Dublin (cattle)

A
  • Cause of severe disease in endemic herds
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10
Q

S. Dublin (cattle): severe disease in endemic herds

A
  • septicemia in calves <1 week old
  • acute enteritis in older calves and adults
  • abortion in pregnant cows
  • chronic enteritis in older cows (inappetence, decreased weight gain)
  • terminal dry gangrene: necrosis of feet
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11
Q

S. Dublin (cattle): management

A
  • cleaning calving areas
  • rodent control
  • vaccination possible
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12
Q

Salmonella Cholersuis (pig)

A
  • maintained by carriers
  • during acute disease large numbers shed in feces
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13
Q

Salmonella Cholersuis (pig) cause of

A
  • *sepsis
  • Enterocolitis
  • Secondary infections following bacteremia (pneumonia, hepatitis)
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14
Q

Salmonella Cholersuis (pig): management

A
  • Reducing stress=reduce shedding by carriers
    o Housing density, nutrition, concurrent infectious diseases
  • Autogenous bacterins (get bacteria from farm and make a vaccine with the exact strain) may be helpful
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15
Q

Salmonella Pullorum (poultry/birds)

A
  • Canada has been free since 1982
  • Infects ova and chicks infected prior to hatching
    o Environment gets contaminated=facilitate transmission
  • *young chicks and poults
  • Survivors=reservoir for flock
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16
Q

Salmonella Pullorum (poultry): in young chicks and poults

A
  • Inappetence
  • Depression
  • Diarrhea
  • Death
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17
Q

Salmonella Pullorum (poultry): in older birds

A
  • Inappetence
  • Arthritis
  • Decreased production
  • Diarrhea
  • Pyrexia (abnormal elevation in body T (fever)
  • Increased mortality
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18
Q

Salmonella (poultry): other serotypes found in Canada

A
  • Fecal-oral transmission: direct fecal contact or through litter fluff or water
  • Often see highest losses in young <2 weeks old: septicemia
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19
Q

Salmonella Typhi (people)

A
  • Spread by contaminated food and water
  • High fever, weakness, stomach pains, death
  • Uncommon in western countries (usually travel associated, S. Asia=highest risk region)
    o Eat food served hot, and pasteurized, no veggies unless cleaned with clean water
  • Vaccination possible and important
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20
Q

Yersinia microbiological characteristics

A
  • Most biocontainment level 2 (Yersinia pestis=3)
  • Selective media helpful for ID
  • Lactose NON-fermenting
  • Motile (except Y. pestis)
  • Facultative intracellular parasites: survive within macrophages
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21
Q

Y. pestis (humans)

A
  • Black death killed ~60% of Europeans in middle ages
  • Spread through Neolithic decline (population decline)
  • *outbreaks likely started in larger communities and spread along with trade
22
Q

Y. pestis: Sylvatic (disease of wild animals) plague (rodents)

A
  • SW US (ex. New Mexico, Arizona, California)
  • Cycle between rodents and fleas (prairie dogs=highly susceptible)
    o Source for other animals (cat and dogs can get sick if eat rodent or bitten by a flea)
23
Q

Y. pestis in cats: 3 forms

A
  1. Bubonic
  2. Septicemic
  3. Pneumonic
24
Q

Y. pestis in cats: Bubonic

A
  • Lymphadenomegaly, most often submandibular LN following eating infected rodents
  • May look like abscess
  • High fever
25
Q

Y. pestis in cats: Septicemic

A
  • May or may not follow bubonic form
  • Haematogenous dissemination
  • Death 1-2 days
26
Q

Y. pestis in cats: Pneumonic

A
  • may follow haematogenous dissemination
  • may be due to inhaling infectious droplets
  • SERIOUS zoonotic risk
  • Another reason to beware the hissing cat
27
Q

Y. pestis in dogs

A
  • Not as common
  • Treat with Streptomycin
  • Generally start with parenteral antibiotics and switch to oral with improvement
28
Q

Y. pseudotuberculosis

A
  • Most commonly sporadic disease: abscessation of internal organs
  • Found in intestine and can cause enteric infections
  • Cause enteric disease in ruminants under stressful conditions (cold, wet weather, poor diet)
  • Can see cattle and sheep abortions (1-9% of affected animals)
29
Q

Y. pseudotuberculosis: cause of ‘pseudotuberculosis’ in guinea=pigs, 2 forms

A
  1. Septicemic form
  2. Nodules in internal organs
    *reported to cause septicemia in wide variety of species
30
Q

Y. enterocolitica (humans)

A
  • enteric pathogen
  • associated with eating undercooked pork
  • symptoms vary with age
  • septicemia can occur
  • rarely associated with enteric disease in ruminants
31
Q

Y. enterocolitica (humans) septicemia can occur and is associated with

A
  • iron overload
  • treatment with iron-chelating agents
32
Q

Y. enterocolitica (human): young children symptoms

A
  • fever
  • abdominal pain
  • diarrhea which may be bloody
33
Q

Y. enterocolitica (human): older children/adults symptoms

A
  • fever
  • abdominal pain which can mimic appendicitis
34
Q

Y. ruckeri (fish)

A
  • rainbow trout (widely farmed)=very susceptible
  • most often affects fry and fingerling fish
  • outbreaks have low, sustained mortality leads to large losses
  • behavioural changes (swimming near surface, loss of appetite)
  • subcutaneous hemorrhages: post-mortem reveals septicemia
35
Q

Fry

A
  • juvenile fish which can feed themselves
  • no longer dependent on yolk sac
36
Q

Fingerling

A
  • stage past fry
  • juvenile fish which have developed scales and working fins
37
Q

Sample collection for Salmonella sp.

A
  • Feces
  • Blood for serology
  • Other affected tissues (abortuses, viscera/bone if septicemic)
38
Q

Sample collection for Y. pestis

A
  • EXTREME CAUTION (do NOT re-cap needles)
  • Lymph nodes, aspirates
  • Edematous tissue
  • Blood
39
Q

Sample collection for other Yersinia sp.

A
  • Affected tissues (lymph nodes, blood, feces)
40
Q

Sample collection for other Enterobacterales

A
  • Affected tissues depending on site of infection
41
Q

Sample handling

A
  • Do NOT freeze
42
Q

Salmonella spp. : lab ID

A
  • Culture: selective media
  • Serological
43
Q

Yersinia spp. Lab ID

A
  • Selective media helpful
  • Incubation temperature can be helpful
    o Y. ruckeri motile at 22 degree C
44
Q

Lab ID in general

A
  • Colony morphology
  • Biochemical tests
  • Serology MALDI-TOF
  • DNA fingerprinting for strain typing (outbreak ID!)
45
Q

Zoonotic/interspecies transmission

A
  • Probably under-recognized
  • Know what is common in the area you practice
46
Q

Salmonella zoonotic/interspecies transmission

A
  • Consider all zoonotic
  • Foodborne + contact with infected/colonized animals
    o Poultry, pigs, horses, owl pellets (petting zoos)
    o Feeder mice and reptiles that eat them
47
Q

Yersinia pestis zoonotic/interspecies transmission

A
  • Exudates
  • Respiratory droplets (hissing cat!)
  • Fleas
48
Q

Treatment

A
  • Based on SUSCEPTIBILITY TESTING
  • *intrinsic resistance is common and varies WIDELY by genus and species
49
Q

Resistance is emerging

A
  • Broad spectrum beta-lactamases (ESBLs and carbapenemases)
  • Fluroquinolone resistance
  • Mobile genetic elements with multiple resistance genes
50
Q

What drugs are all Enterobacterales intrinsically resistant to?

A
  • Benzylpenicillin
  • Glycopeptides
  • Lipoglycopeptides
  • Fusidic acid
  • Macrolides
  • Lincosaminds
  • Streptogramins
  • Rifampicini
  • oxazolidinones