[3S] Enterobacterales Flashcards
1
Q
How many families are in Order Enterobacterales?
A
9
2
Q
GENERALITIES
Morphology of order enterobacterales
A
Gram neg enteric coccobacilli / short plump bacilli
3
Q
GENERALITIES
Heterogenous group inhabiting the GI tract of humans & animals as well as found in the environment
A
Family Enterobacterales
4
Q
GENERALITIES
3 true pathogens
A
SYS
Shigella
Yersinia
Salmonella
5
Q
GENERALITIES
- Not normal flora
- Associated with a disease
A
True Pathogens
6
Q
Odd Man Out: GENERALITIES
Facultative Anaerobes
Family Enterobacterales
Sporeformers
Mostly gamma hemolytic
A
Sporeformers (non-spore dpt)
7
Q
GENERALITIES
On _____: large moist, circular convex gray colonies
A
BAP/CAP
8
Q
GENERALITIES
Bacteria that has subsurface greening (H2S +) on BAP/CAP
A
Proteus
Edwardsiella
Citrobacter
9
Q
GENERALITIES
Most gamma hemolytic except
A
E. coli
10
Q
T/F: Enterics are able to grow on MAC
A
T
11
Q
GENERALITIES
Most are non-capsulated except
A
Klebsiella & Enterobacter
12
Q
GENERALITIES
T/F: Growth of enteric pathogens can be enhanced using enrichment broth
A
T
13
Q
- GN broth
- Selenite F
- Tetrathionate
A
Enrichment Broths
14
Q
GENERALITIES
Basis of serologic typing
A
Antigenic Structure
15
Q
Odd Man Out: Antigenic Structure - Heat labile
O
H
K
A
O (heat stable sya)
16
Q
Antigen of S. typhi
A
Vi Ag
17
Q
GENERALITIES
All are motile at 37 C except
A
Kleb
Shige
Y. pestis
18
Q
BC TESTS
All are Catalase (+) except
A
S. dysenteriae
19
Q
BC TESTS
All are Oxidase (-) except
A
Plesiomonas
20
Q
BC TESTS
T/F: All are Nitrate oxidizers except Photorhabdus and Xenorhabdus, some biotypes of Pantoea agglomerans, some species of Serratia and Yersinia
A
F; reducers
21
Q
BC TESTS
Vector Borne
A
Y. pestis
22
Q
GENERALITIES
T/F: All are Glucose Fermenters
A
T
23
Q
GENERALITIES
Most are Xylose Fermenters except
A
Shigella
24
Q
GENERALITIES
Sucrose Fermenter
A
Yersinia enterocolitica
25
RAPID Lactose Fermenters (18-24 hrs)
EKE
● Escherichia
● Klebsiella
● Enterobacter
26
LATE Lactose Fermenters (48 hrs or more)
CHSSS
● Citrobacter
● Hafnia — may be NLF
● Salmonella enterica subsp. arizonae (Salmonella arizonae)
● Serratia
● Shigella sonnei
27
T/F: Salmonella except S. enterica subsp. arizonae (Salmonella arizonae) is a NLF
F; lactose fermenter
28
T/F: Shigella is a NLF except S. sonnei
T
29
GENERALITIES
Deaminase (+)
PPM
Proteus, Providencia, Morganella
30
GENERALITIES
Salmonella, Proteus, Citrobacter and Edwardsiella
H2S (+)
31
GENERALITIES
Voges Proskauer (+)
PSHEK group
● Proteus
● Serratia
● Hafnia
● Enterobacter
● Klebsiella
32
GENERALITIES
RAPID Urease Producers
● Proteus
● Providencia rettgeri
● Morganella morganii
33
GENERALITIES
LATE Urease Producers
CKEYS
● Citrobacter
● Klebsiella
● Enterobacter
● Yersinia
● Serratia
34
ODD MAN OUT: VIRULENCE AND ANTIGENIC FACTORS
● Plasmids
● Antigens — O, H, K
● Pili
● Flagella
● Enterotoxins
● Enzymes
● Fraction 1
● Endotoxin
● Antibiotic Resistance
● Chromosomally determined inducible AmpC Beta-lactamases
Fraction 1 - Yersinia
35
ODD MAN OUT: ANTIBIO RESISTANCE
Morganella
Y. enterolitica
S. marcesens
Providencia
Proteus
Aeromonas
Citrobacter
Enterobacter
Proteus (tandaan m MYSPACE organisms)
36
● Normal flora of colon
● Common Name: “Colon Bacillus”
ESCHERICHIA COLI
37
● Associated with UTIs, CNS infections, sepsis, endotoxin induced shock, and diarrheal diseases
● Distant relative of Shigella (cross reactions)
ESCHERICHIA COLI
38
IMViC: ++--
ESCHERICHIA COLI
39
TESTS
LDC +
ODC +
ADH -
4-Methylumbelliferyl-β-D Glucuronide Test (MUG) +
ESCHERICHIA COLI
40
On EMB: purple colonies w/ green metallic sheen
ESCHERICHIA COLI
41
ODD MAN OUT: E. coli Virulence Factors
● Pili
● Cytolysins
● Aerobactins
● W Lipoprotein
● O, H, K Antigens
W Lipoprotein - Yersinia
42
E. COLI
Most common cause of Urinary Tract Infections
UROPATHOGENIC E. COLI
43
E. COLI
Primary Virulence Factor of UROPATHOGENIC E. COLI
Pili
44
E. COLI
OMO: Uropathogenic E. coli Virulence Factors
● Pili
● Hemolysins
● Cytolysins
● Aerobactins
● Flagella
Flagella
45
E. COLI
● A common cause of watery diarrhea among adults and children
● “Traveler’s Diarrhea”/ Turista/ Montezuma’s
Revenge
● Weanling Diarrhea
ENTEROTOXIGENIC E. COLI (ETEC)
46
E. COLI
● Self-limiting
● S/S Profuse Watery diarrhea, cramps, no fever,
vomiting not common;
● High Infective Dose for disease to occur (106 to 1010
organisms)
ENTEROTOXIGENIC E. COLI (ETEC)
47
E. COLI
OMO: ENTEROTOXIGENIC E. COLI (ETEC)
○ Fimbriae
○ Heat Labile Toxin — (cyclic adenosine monophosphate)
○ Heat Stable Toxin — (guanyl cyclase)
○ Presence of Colonization Factor Antigen
○ Cytolysins
Cytolysins
48
E. COLI
● *Infantile Diarrhea*
● S/S Low grade fever, malaise, vomiting, Diarrhea,
mucoid stools but no blood; occasional presence of
*fecal leukocytes*
ENTEROPATHOGENIC E. COLI (EPEC)
49
ENTEROPATHOGENIC E. COLI (EPEC)
Capable of Adhering to intestinal cells capable of
producing lesions called?
“attaching and effacing lesions”
50
ENTEROPATHOGENIC E. COLI (EPEC)
Adhesion on HEp-2 cell cultures
“attaching and effacing lesions”
51
E. COLI
● Shiga-like
● S/S differ greatly from EPEC and ETEC
ENTEROINVASIVE E. COLI (EIEC)
52
E. COLI
Targets: Colonic epithelial cells
ENTEROINVASIVE E. COLI (EIEC)
53
E. COLI
● *Dysentery*, invasion and destruction of intestinal wall
● Fever, severe abdominal cramps, malaise and watery
diarrhea; *abundant fecal leukocytes*
ENTEROINVASIVE E. COLI (EIEC)
54
E. COLI
● May be mis-ID as Shigella
● MOT: Fecal Oral Route
ENTEROINVASIVE E. COLI (EIEC)
55
E. COLI
● Most Important Strain: 0157:H7
○ Implicated in an outbreak of hemorrhagic diarrhea, colitis and hemolytic uremic
syndrome (HUS)
56
E. COLI
S/S: watery to bloody diarrhea and colitis with no
WBCs in stools
57
E. COLI
Processed meats, undercooked ground meat, unpasteurized dairy products and apple cider, bean sprouts, and spinach
58
E. COLI
OMO: Enterohemorrhagic E. coli VF
Cytotoxins
Verotoxin I (Stxl)
Verotoxin II (Stx2)
wla
59
E. COLI
OMO: Enterohemorrhagic E. coli Culture
○ SMAC (sorbitol negative colonies)
○ CT-SMAC
○ CHROMagar 015
wla tinatamad nk magicp
60
E. COLI
Hamburger Syndrome
ENTEROHEMORRHAGIC/ SHIGA-TOXIN/ VEROCYTOTOXIC E. COLI
61
E.COLI
non motile strain; also associated with HUS
Escherichia coli 0157: NM
62
E.COLI
T/F: All are MUG test (-) except EHEC
F; MUG test (+)
63
E.COLI
○ Diffusely Adherent E. coli
○ Enteroaggregative E. coli
ENTEROADHERENT E. COLI
64
E.COLI
Uropathogenic DAEC Strains:
cystitis, acute pyelonephritis
ENTEROADHERENT E. COLI: Diffusely Adherent E. coli
65
E.COLI
■ Watery Diarrhea, vomiting,
dehydration, occasional abdominal pain
■ “Stacked Brick Pattern”
ENTEROADHERENT E. COLI: Enteroaggregative E. coli
66
E.COLI
Gene: aggR
○ Responsible for cellular adherence
ENTEROADHERENT E. COLI
67
E.COLI
VF of Enteroadherent E. coli
Fimbriae
68
● Extraintestinal Infections
○ MNEC
■ Meningitis/Sepsis Associated E.coli
● Neonatal Meningitis
● Capsular K1 antigen
E. coli
69
Other Escherichia species
yellow pigmented organism
Escherichia hermanii, E. vulneris
70
Other Escherichia species
diarrhea among children
E. albertii
71
● Normal Habitat: GI Tract of humans and animals
● Found in environment
● Causes Opportunistic and Nosocomial infections
○ UTI, pneumonia, septicemia, liver abscess, and wound infections
● Capsulated
● Most are Non-Motile
KLEBSIELLEAE
72
BC TESTS
Indole -
VP +
Gas Prod +
Citrate +
KCN +
Late Urease
KLEBSIELLEAE
73
Raoutella that is indole & ODC +
R. ornithinolytica
74
KLEBSIELLA
● Most commonly isolated
● Common Name: Friedlander’s Bacillus/Bacillus
capsulatus
K. PNEUMONIAE
75
KLEBSIELLA
● Lower respiratory tract infections
■ Lobar pneumonia
■ Currant jelly like sputum
■ Lung Abscess; hemoptysis; hemorrhage
■ UTIs and wound infections, liver abscess, bacteremia
● High case of antimicrobial resistance
K. PNEUMONIAE
76
KLEBSIELLA
○ Able to cause infection among healthy ambulatory patients
○ Unusual sites of infection (liver, eyes, CSF)
○ Metastatic spread
○ Production of hypermucoviscous colonies
K. pneumoniae (hvKp)
77
KLEBSIELLA
Resistant to all B-lactam antibiotics
ST258
78
KLEBSIELLA
● Produces infections similar to K. pneumoniae
● Also causes antibiotic associated hemorrhagic colitis
● Characteristic Biochemical Test: Indole (+)
KLEBSIELLA OXYTOCA
79
KLEBSIELLA
IMVIC: +-++
KLEBSIELLA OXYTOCA
80
KLEBSIELLA
● Recovered from nasal secretions and cerebral abscess
● Causes atrophic rhinitis (ozena) - FETID ATROPHY
● Presence of plasmid mediated ESBLs
KLEBSIELLA OZAENAE
81
KLEBSIELLA
Isolated from patients with rhinoscleroma
KLEBSIELLA RHINOSCLEROMATIS
82
KLEBSIELLA
● Formerly Calymmatobacterium granulomatis
● STD
● Fastidious encapsulated bacillus
● Intracellular
KLEBSIELLA GRANULOMATIS
83
KLEBSIELLA
● Associated with Granuloma Inguinale/Donovanosis
● Diagnostic Feature: Donovan Bodies in tissue or
biopsy specimens
KLEBSIELLA GRANULOMATIS
84
KLEBSIELLA
● Formerly Enterobacter aerogenes
● Healthcare associated infections (UTIs, sepsis,
post-neurological meningitis)
● MDR – carbapenem resistant strains report
KLEBSIELLA AEROGENES
85
KLEBSIELLA
Found in contaminated medical devices (IV Fluids)
KLEBSIELLA AEROGENES
86
● Habitat: Intestinal Tract of Humans and animals; found in the environment
● Cause nosocomial and opportunistic infections
● Capsulated
● Significant members are Motile
ENTEROBACTER
87
BC TESTS
VP, Citrate, KCN broth, ODC +
mostly LDC +
some Urease +
ENTEROBACTER
88
Enterobacter that is LDC -
E. asburiae, E. cloacae (E. cancerogenous, E. horma)
88
ENTEROBACTER
recovered from respiratory samples
E. gergoviae
89
ENTEROBACTER
○ Causes osteomyelitis after traumatic wounds
○ On MacConkey: colonies with purple centers
after extended incubation
○ Not susceptible to penicillin and cephalosporins (Resistant)
E. cancerogenus (E. taylorae)
90
Cronobacter sakazakii (formerly: Enterobacter sakazakii)
CRONOBACTER
91
● ’’Yellow Pigmented Enterobacter cloacae”
● Causes meningitis and bacteremia among neonates
CRONOBACTER
92
● Distinct Feature: Yellow colonies; mucoid in BHI
● Yellow pigment further subjected to the biochemical
tests: Indole, Catalase, Oxidase, VP
CRONOBACTER
93
● Contams infant milk formulas
● fusA & rpoB gene
CRONOBACTER
94
Formerly Enterobacter agglomerans
○ Gr (-) aerobic bacillus; appear in rods
PANTOEA AGGLOMERANS
95
● Septicemia (healthcare settings) IV fluids, parenteral nutrition
● Traumatic injury from contaminated soil
○ Wound infections, septic arthritis,
osteomyelitis
PANTOEA AGGLOMERANS
96
Opportunistic pathogens associated with outbreaks in health care settings (bacteremia, urinary, respiratory tract infections)
SERRATIA
96
Triple Decarboxylase Negative
PANTOEA AGGLOMERANS
97
Production of Red Prodigiosin pigment (2-methyl-3-amyl-6-methoxyprodigiosene)
○ Bioactive secondary metabolite produced by
the organism
○ Biosurfactant; incubated at 30 C and stop
producing pigment at 37 C
SERRATIA
97
BC TESTS
ONPG, DNAse + except fonticola
Lipase +
Gelatinase, LDC +
ADH -
SERRATIA
98
SERRATIA
most significant; healthcare associated infections (RT and Urinary Tract infections, bacteremia)
Serratia marcescens
99
SERRATIA
“rotten potato odor”
Serratia odorifera
99
● Linked to an emerging cause of gastroenteritis; isolated in stool cultures
● Also linked to hemolytic uremic syndrome, graft versus host disease, sepsis
HAFNIA ALVEI
100
Cause spoilage due to the action of the enzymes they produce in food (minced meat / dairy products)
HAFNIA ALVEI
100
BC TESTS
Citrate + (delayed)
ONPG +
Lactose, Sucrose, Lipase, Gelatinase, DNAse -
HAFNIA ALVEI
100
UTIs, wound, ear, infections, nosocomial infections, *kidney stone formation*
PROTEUS
101
● Normal flora of the GI Tract; found in the environment
● Opportunistic Pathogens; Nosocomial Infections
● Distinct Biochemical Test:
○ Non-lactose Fermenters
○ Deaminase (+)
○ Motile
PROTEUS, PROVIDENCIA, MORGANELLA
101
● Gr (-) rod shaped and facultative anaerobic
● Majority are lactose (-) with swarming motility
PROTEUS
102
Proteus that is H2S -
Proteus penneri
103
Odor: Burnt Chocolate
PROTEUS
104
BC TESTS
MR, KCN +
Rapid Urease
PROTEUS
105
PROTEUS, PROVIDENCIA, MORGANELLA
Differentiated by Indole Test and ODC Test
Proteus
106
● Gr (-) bacilli, Motile, not lactose fermenters
○ distinguished by their ability to deaminate
phenylalanine and lysine
● Causes UTIs, diarrhea among travelers and children
● nosocomial infections
PROVIDENCIA
107
PROVIDENCIA
burn units
P. stuartii
108
PROVIDENCIA
UTI, diarrhea
P. rettgeri
109
● Only recognized human pathogen
● Opportunistic Pathogen (humans)
● Causes bacteremia, wound infections *(aquatic incidents)*
EDWARDSIELLA TARDA
109
BC TESTS
IMViC: ++-+
Rapid Urease for rettgeri
PROVIDENCIA
110
● Non lactose fermenting G(-) bacteria
● Has the capacity to produce urease and presence of phenylalanine deaminase
● Gelatin liquefaction and hydrogen sulfide production
MORGANELLA MORGANII
111
BC TESTS
LDC, Citrate, Lactose -
MORGANELLA MORGANII
112
● Implicated in UTIs, neonatal sepsis
● Motile but does not swarm
MORGANELLA MORGANII
113
BC TESTS
LDC, ODC, H2S, Indole +
Urease, Citrate -
EDWARDSIELLA TARDA
114
● IMViC: ++--
● Produce large amt of H2S
EDWARDSIELLA TARDA
115
● Straight, facultative anaerobic, Gr (-) bacilli
● Motile (peritrichous flagella)
● Formerly under Salmonellae
● Normal Flora of GI Tract
● Causes nosocomial infections, UTIs, pneumonia, meningitis
● Maybe mistaken for Salmonella
CITROBACTER
116
BC TESTS
Citrate, ONPG, MR +
CITROBACTER
117
CITROBACTER
UTIs, pneumonia, diarrhea, intraabdominal abscess, endocarditis among drug users, hospital acquired infections
C. FREUNDII
118
CITROBACTER
Neonatal meningitis; brain abscess
C. KOSERI
118
OTHER ENTERICS
● Recovered in respiratory, urine, CSF and blood cultures
● Some may produce reddish blue/violet pigment
● May look like E. coli on Mac
KLUYVERA
119
OTHER ENTERICS
● Oxidase (+)
● Gr (-) straight bacilli in singles or in pairs
● Motile (polar flagellum; monotrichous or lophotrichous) Not a normal flora of GI
PLESIOMONAS SHIGELLOIDES
119
OTHER ENTERICS
● Habitat: Freshwater and estuarine waters
● Causes: Gastroenteritis (cholera like illness)
● Ingestion of uncooked shellfish
● Share some biochemical features with Shigella
PLESIOMONAS SHIGELLOIDES
120
OTHER ENTERICS
Growth in 6% NaCl -
Oxidase, Glucose Fermentation +
Susceptible to O/129 strains
PLESIOMONAS SHIGELLOIDES
121
OTHER ENTERICS
Triple Decarboxylase +
PLESIOMONAS SHIGELLOIDES
122
● Primary Intestinal Pathogens
● Not a part of the normal flora of humans
● Salmonella: GI illnesses
● Shigella: GI Illnesses
● Yersinia: zoonotic; transmitted by wild animals and ticks; variety of disease
TRUE PATHOGENS
123
TRUE PATHOGENS
T/F: Salmonella has 2 biochemically discrete species previously. Currently, only 3 are recognized
F; 3 bc discrete & 2 recognized
124
TRUE PATHOGENS
Citrate +
H2S + exc. arizonae
Motility + exc. pullorum & gallinarum
Lactose Fermentation - exc. arizonae
Indole, VP, Deaminase, Urease, KCN -
SALMONELLA
125
TRUE PATHOGENS: VIRULENCE FACTORS
● Fimbriae and most especially enterotoxins are implicated as significant virulence factors
○ Allows them to colonize the upper ileum region of the Gastrointestinal tract
● Ability to traverse intestinal mucosa
SALMONELLA
126
TRUE PATHOGENS: MOT
Ingestion of contaminated water or food (poultry, dairy products), containing animal feces; transmitted human to human (carrier state)
SALMONELLA
127
TRUE PATHOGENS: ANTIGENIC STRUCTURES
Classification based on __________
○ O, H, and K (Vi Ag) Ag serotyping
Kaufmann-White
128
TRUE PATHOGENS
● Gastroenteritis
● Bacteremia or Septicemia without GI symptoms
● Enteric Fever
● Carrier State
● Focal Infections (osteomyelitis; meningitis; brain abscess; endocarditis)
SALMONELLA
129
SALMONELLA
non typhoidal fever w/ or w/o gastroenteritis
S. serotype Cholerasuis
129
SALMONELLA
paratyphoid fever w/ or w/o gastroenteritis
S. serotype Paratyphi
129
SALMONELLA
typhoid fever (humans are the only reservoir)
S. serotype Typhi
130
SALMONELLA
food poisoning (dairy products)
S. serotype Typhimurium
131
SALMONELLA
dairy products; ice cream
S. Enteritidis
132
SALMONELLA DISEASE STATES: GASTROENTERITIS
● Food poisoning (poultry and dairy products)
● Ingestion of poultry, dairy products, peanut butter
other foodstuffs
● Invasion of epithelial cells of intestinal tract
S. Typhimurium
133
SALMONELLA DISEASE STATES: GASTROENTERITIS
● *Cholera-Like Toxin*; main Virulence Factor
● S/S Watery Diarrhea, abdominal pain, vomiting, fever
S. Typhimurium
134
SALMONELLA DISEASE STATES
● Caused by Salmonella Typhi
○ No animal reservoir; transmitted by carriers,
contaminated food
● Invades intestinal epithelial cells and invades lymph nodes and disseminates to other organs Facultative Intracellular Parasite
TYPHOID FEVER (ENTERIC FEVER)
135
SALMONELLA DISEASE STATES: TYPHOID FEVER (ENTERIC FEVER)
What week?
fever, dull frontal headache, malaise, body pain, constipated (“scybalous” stool)
1st Week
136
SALMONELLA DISEASE STATES: TYPHOID FEVER (ENTERIC FEVER)
What week?
intestinal tract, “rose spots” appear; diarrheic stools
2nd and 3rd Week
137
SALMONELLA DISEASE STATES: TYPHOID FEVER (ENTERIC FEVER)
What week?
Develop antibodies
5th week
138
SALMONELLA DISEASE STATES
● Most often caused by Salmonella Choleraesuis
● Usually seen among patients with underlying diseases or children with enterocolitis
BACTEREMIA (SEPSIS)
139
SALMONELLA DISEASE STATES
● Common sequelae: salmonella osteomyelitis
● Carrier State: harbored in the gallbladder
○ “Typhoid Mary”
BACTEREMIA (SEPSIS)
140
also associated with handling of reptiles, amphibians
Salmonella infections
141
● Closely related to Escherichia
● Humans are the only reservoir
SHIGELLA
142
● Biochemically inert members of Family
Enterobacteriaceae
● Causes shigellosis/bacillary dysentery (enterocolitis)
SHIGELLA
143
BC TESTS
-+--
SHIGELLA
144
BC TESTS
MR +
Citrate, Xylose Fermentation, H2S, LDC -
Lactose Fermentation exc. sonnei
Motility -
Gas Production -
SHIGELLA
145
MOT of Shigella
Fecal-oral, contaminated food/water
145
OMO: Shigella VF
● Shiga-toxin
● Pili
● Endotoxin
● Neurotoxin
● Invasive property
Pili
146
T/F: All Shigella possess O antigens, some species possess K antigen
T
147
● < 10 yrs are most affected, < 1 yrs most susceptible
● Low Infective Dose
● Manifestations: fever chills, cramps, diarrhea, pain and *tenesmus* 24-48 hrs after ingestion
○ Intestines then to colon
○ Bloody, with pus, and mucoid stool
SHIGELLA
148
SHIGELLA: SUBGROUPS
(based on O antigen groups)
Duval’s
D - S. sonnei
148
SHIGELLA: SUBGROUPS
(based on O antigen groups)
Endotoxin, enterotoxin, neurotoxin, invasiveness
A - S. dysenteriae
149
SHIGELLA: SUBGROUPS
(based on O antigen groups)
Strong’s bacillus
B - S. flexneri
150
SHIGELLA: SUBGROUPS
(based on O antigen groups)
Newcastle Manchester
C - S. boydii
151
Zoonotic; Disease of Rodents (tick bites or flea bites)
YERSINIA
152
BC TESTS
Indole -
Motility at 37 C -
MR +
Urease + exc. pestis
YERSINIA
152
YERSINIA
possess complete O-polysaccharide
Y. pseudotuberculosis and Y. enterocolitic
152
YERSINIA
lacks O-specific polysaccharide chain
Y. pestis
153
● Transmitted to humans by fleas : flea-rodent-flea life cycle
● Facultative Intracellular Parasite
Yersinia
154
● Causes: Plague/Bubonic Plague/Black Death
● Symptoms: high fever and buboes
Yersinia
155
OMO: Yersinia VF
● Fraction1
● V (protein)
● W (lipoprotein)
● Cytolysins
Cytolysins
155
YERSINIA FORM
● Incubation 1-7 days
● Most common
● S/S high fever, chills, weakness, headaches and
buboes (lymphadenitis), hemorrhages (blackish discoloration)
○ Buboes: Swelling of the armpits and groin
● Mildest form but high fatality if untreated
BUBONIC/GLANDULAR FORM
155
YERSINIA FORM
Proliferation in blood; S/S high fever, delirium, seizures (children), septic shock and DIC. Black hemorrhagic splotches
SEPTICEMIC FORM
155
YERSINIA FORM
S/S fever, malaise, cough chest pain, hemoptysis, that can lead to sepsis and death
PNEUMONIC FORM
156
YERSINIA
● Most commonly isolated species
● Main Reservoir: Pigs
● Causes Yersiniosis
YERSINIA ENTEROCOLITICA
157
YERSINIA
● S/S: mimics appendicitis, enteritis, arthritis, erythema
nodosum, septicemia (px with hemochromatosis)
● MOT: ingestion of contaminated food (pork meat, milk)
chitterlings (large intestines of pigs)
YERSINIA ENTEROCOLITICA
158
YERSINIA
● Survival in cold temperatures (4C) (cold enrichment)
● Most common contaminant in blood products
YERSINIA ENTEROCOLITICA
159
YERSINIA CULTURE
MAC SSA +
Cefsulodin Irgasan Novobiocin Agar : Bull’s eye colonies
YERSINIA ENTEROCOLITICA
160
YERSINIA
● Pathogen of rodents (guinea pigs), birds, rabbits
● Rare in humans
● Animals: S/S Caseous Swellings (Pseudotubercles)
● Humans: mesenteric lymphadenitis, septicemia
YERSINIA PSEUDOTUBERCULOSIS
