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infection > 6.2 enterobacteriae > Flashcards

6.2 enterobacteriae Flashcards

1
Q

What are enterobacteriaecea as medically important pathogens?

A

large, heterogeneous group

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2
Q

enterobacteriaceae :
1. gram staining
2. shapes ?

A
  1. gram negative
  2. rods or bacilli
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3
Q

How many genera and species are included in the Enterobacteriaceae family?

A

more than 50 genera and over 150 species.

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4
Q

What percentage of Enterobacteriaceae species are responsible for the majority of infections, and what percentage of these infections do they account for?

A

Fewer than 20 species of Enterobacteriaceae are responsible for more than 95% of infections.

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5
Q

< 20 species of enterobacteriaceae responsible for > 95% infection such as… (give examples of most common forms of infections)

A
  • UTIs
  • septicemia
  • intestinal infections
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6
Q

> 70% enterobacteriaecea responsible for what infections ?

A

urinary tract infections

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7
Q

where do infections with enterobacteriaceae originate from ?

A
  • animal resevoir
  • human carrier
  • endogenous spread of organisms
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8
Q

Enterobacteriaceae physiology ?
1. grow … ?
2. nutritional requirements are … ?
3. type of anaerobes ?

A
  1. slowly
  2. simple
  3. facultative
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9
Q

what do enterobacteriacea ferment and reduce ?

A
  1. ferment glucose
  2. reduce nitrate
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10
Q

enterobacteriaceae:
1. catalase test result ?
2. unlike other gram-negative rods it’s oxidase status ?
3. pathogenic members don’t ferment …. ?
4. pathogenic members are resistant to …?

A
  1. positive
  2. negative
  3. lactose
  4. bile salts
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11
Q

Differences on solid medium colour between lactose fermenting colonies and non-lactose fermenting colonies ?

A
  • fermenting = pink
  • non-fermenting = colorless
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12
Q

List some enterobacteriaceae pathogenic to humans ? all end in spp

[Citrobacter and Enterobacter went to Escherichia’s Kitchen, Making Salad with Yummy Honey, Providing Perfect Satisfaction = simplify !]

A
  • citrobacter
  • enterobacter
  • escherichia
  • klebsiella
  • morganella
  • salmonella
  • shigella
  • yersinia
  • hafina
  • plesiomonas
  • proteus
  • serratia
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13
Q

Name some common medically significant enterobacteriaceae
SPECKY MESS

Morgana escorts salmonella and serratia (MESS)

She flex son
Protect vulgar mira
Enter aero cloud
Citro friendly kose
Klebsiella pneumoniae needs oxygen
Yes pseudo pests enter

A
  • Citrobacter freundii, Citrobacter koseri
  • Enterobacter aerogenes, Enterobacter cloacae
  • Escherichia coli (opportunistic/pathogenic)
  • Klebsiella pneumoniae, Klebsiella oxytoca
  • Morganella morganii
  • Proteus mirabilis, Proteus vulgaris
  • Salmonella enterica (pathogenic)
  • Serratia marcescens
  • Shigella sonnei, Shigella flexneri (pathogenic)
  • Yersinia pestis, Yersinia enterocolitica, Yersinia pseudotuberculosis (pathogenic)
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14
Q

Examples of only primary pathogen of enterobacteriaceae

A

shigella
salmonela
uersina

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15
Q

Examples of only opportunistic pathogen of enterobacteriaceae

A
  • providencia
  • enterobacter
  • morganella
  • serratia
  • proteus
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16
Q

Example of an opportunistic / primary (mixed) pathogen of enterobacteriaceae

A

E. coli
K. pneumoniae

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17
Q

primary pathogens cause disease in ?

A

healthy host

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18
Q

opportunistic pathogen cause disease only in … ?

A

absence of normal host resistance (immunosuppressed host)

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19
Q

What are the virulence factors of enterobacteriaceae ?

O Core Lipid A has a resistance to 3 types of sides: Lips, Flag, Cap

or COSTAL LFC

A
  • Flagellar H antigen
  • Capsular K or Vi antigen
  • Liposaccharide (LPS)
  • O antigen
  • Core polysaccharide (present in all E.)
  • Lipid A (responsible for endotoxin activity)
  • Siderophores
  • Type III secretion system
  • Antimicrobial resistance
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20
Q

E. coli is a major componenet of the … ?

A

normal intestinal floar

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21
Q

what does E. coli cause by at least 6 mechanisms ?

A

diarrhoea

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22
Q

E. coli causes diarrhoea by at least 6 mechanisms, identified by the adjectives used to describe the respective strains…

what are these 6 mechanisms ?

A
  • STEC = shiga toxin producing strain
  • ETEC = enterotoxigenic strains
  • EIEC = enteropathogenic strains
  • EPEC = enteropathogenic strains
  • EAEC = enteroaggregative strains
  • DAEC = diffusely adherent E.coli
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23
Q

Most clinically relevant salmonella pathogens belong to what ?

A

Salmonella enterica spp

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24
Q

Most clinically relevant salmonella pathogens belong to salmonella enterica spp. with:
..1.. subspecies (I,II ,IIIa, IIIb, IV , VI)
over ..2… serovars differentiated based on the antignes ..3…

A
  1. 6
  2. 2500
  3. H,K,O
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25
Q

Salmonella:
1. Genus
2. Species
3. specific serovar / serotype designation of bacterium

A
  1. Salmonella
  2. Enterica
  3. Serotype Typhi
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26
Q

Salmonella enterica spp. causes …. ?

Give 2 examples of the types of what is caused ?

A

salmonellosis

  • gastroenteritis
  • enteric fever (typhoid fever)
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27
Q

Which Salmonella enterica serovars are commonly associated with gastroenteritis?

EW MOUNTAIN !

A

Salmonella:
* enteritidis
* wien
* montevideo
* typhimurium,

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28
Q

Which disease is commonly known as typhoid fever ?

A

enteric fever

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29
Q

salmonella typhi spp causes ?

A

typhoid fever

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30
Q

most common form of salmonellosis is ?

A

gastroenteritis

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31
Q

cause of salmonellosis ?

A

salmonella enteritidis

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32
Q

transmission of salmonellosis ?

A
  • contaminated food (poultry, dairy, eggs) or water
  • faecal-ocal route
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33
Q

symptoms (appear within 6-48 hours) of salmonellosis ?

A
  • nausea
  • vomiting
  • diarrhoea
  • fever
  • abdominal cramps
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34
Q

diagnosis of salmonellosis ?
what agar or media ?

A

stool sample analysis
(MacConkey agar or selective media)

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35
Q

Treatment of salmonellosis ?

A
  • rehydration
  • if in bloodstream = Cephalosporins
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36
Q

Where in the body are peyer’s patches found ?

A

While they are most prominent and abundant in the ileum, Peyer’s patches can also be found in the jejunum and sometimes extend into the proximal part of the colon (ileocecal region).

37
Q

Pathogenesis of gastroenteritis caused by salmonella (S. enterica)

A
  1. salmonella ingested in contaminated food / water
  2. bacteria attach to mucosa of small inestine and invade into the microfold (M-cells) of the peyer’s patches and endocytose into enterocytes
  3. bacterial invasion proteins are injected by type III secretion system
  4. production of salmonella enterotoxin which leads to local inflammation & diarrhoea
  5. pathogen kills host cells, triggering abdominal cramps & diarrhoea
38
Q

Complication of salmonellosis (S. enterica) gastroenteritis ?

A

if bacteria enters the bloodstream, can lead to septicaemia

39
Q

1 of the 4 key global causes of diarrhoeal disease is ?

A

salmonella

40
Q

Enteric (typhoid) fever is a acute , ….. illness ? caused by ?

A

life-threatening

Salmonella Typhi

41
Q

Transmission of enteric (typhoid) fever ?

A
  • ingestion of contaminated food / water
  • faecal-oral route
  • contact without carriers
42
Q

symptoms of enteric (typhoid) fever ?

occur within 10 - 14 days and persis for 3-4 weeks

A
  • high fever
  • headache
  • constipation or diarrhoea
  • abdominal pain
  • malaise
43
Q

Enteric (typhoid) fever has malaise within …1.. days following at least 1 week of ..2… ?

A
  1. 10 to 14 days
  2. constipation and abdominal cramping
44
Q

Enteric (typhoid) fever symptoms persist for duration ?

A

3-4 weeks

45
Q

diagnosis for enteric (typhoid) fever ?

A
  • stool sample analysis
  • blood
  • bone marrow
  • urine sample analysis
46
Q

treatment for enteric (typhoid) fever ?

A

antibiotics e.g.
* fluoroquinolones
* chloramphenicol
* cephalosporins

47
Q

Vaccination for enteric (typhoid) fever is recommended for people travelling to which countries ?

A
  • asia
  • africa
  • latin america
48
Q

Pathophysiology of S. Typhi infection (typhoid fever) ?

A
  1. ingestion of contaminated water / food
  2. Invasion of small intestine, enter bloodstream
  3. carried by WBC (phagocytosed NOT digested) to liver, spleen , bone marrow
  4. Bacteria multiply, re-enter bloodstream
  5. bacteria invade gallbladder, biliary system & lymphatic tissue of bowel
  6. bacteria pass into intestinal tract - can be identified for diagnosis in stool sample analysis (salmonella is shed in faeces) in lab
49
Q

Untreated typhoid fever is broken down into how many different stages ?

A

4

50
Q

In stage 1 of typhoid fever onset of symptoms is between …. days post-infection ?

A

5 - 14

51
Q

what is epistaxis ?

A

acute hemorrhage from the nostril, nasal cavity or nasopharynx

52
Q

what happens stage one of typhoid fever ?

A
  • stepwise fever
  • relative bradycardia
  • malaise (discomfort or uneasiness)
  • headache
  • cough
  • in 1/4 cases epistaxis can occur
53
Q

Stage 2 of typhoid fever ?

A
  • continuing high fever
  • bradycardia continue
  • extremely distended abdomen
  • abdominal pain
  • weight loss
  • dicrotic pulse wave
  • delirium is frequent, often calm and sometimes agitated
54
Q

stage 3 of typhoid fever is when …. what occurs ? list some :

A

complications
* intestinal hemorrhage
* intestinal perforation
* encephalitis (inflammation of the brain)
* fever persistence
* dehydration (increases delirium)
* increased delirium
* motionlessness (eyes half-opened)

55
Q

Stage 4 of typhoid fever ?

A

defervescence (very high fever) commences that continue into fourth week

56
Q

Death can occur from complications which arise from Typhoid fever.

Name these complications

A
  • overwhelming infection
  • pneumonia
  • intestinal bleeding (hemorrhage/perforation)
  • kidney failure
  • peritonitis (inflammation of peritoneum)
57
Q

Who are asymptomatic disease carriers of S. Typhi ?

A

healthy people who have survived typhoid fever, but in whom the bacteria are able to survive without causing further symptoms

58
Q

what’s the main source of chronic carriage of typhoid fever ?

A

infected gallbladders

59
Q

How are carriers of chronic carriage of typhoid fever treated ? and cured

A
  • long-term antibiotics
  • can be cured via = gallbladder removal surgery
60
Q

Shigella species are classified into four … ?

A

O - antigen-based serogroups

61
Q

What are the 4 O-antigen based serogroups that shigella species are classified into ?

A
  • A = S. dysenteriae
  • B = S. flexneri
  • C = S. boydii
  • D = S. sonnei
62
Q

Shigella spp. gram staining and shape ?

A

gram negative bacilli

63
Q

All 4 species of shigella spp. cause what ?

A

bacillary dysentry or shigellosis

64
Q
  1. Main mode
    and 2. can also be mode of transmission of Shigella ?
A
  1. direct person-person
  2. contaminated food/water
65
Q

symptoms of shigella ?

A
  • bloody diarrhea
  • intestinal pain
  • intestinal cramps
  • fever (sometimes)
66
Q

What members of enterobacteriaceae result in shigella ?

A

non-motile and non-capsulated

67
Q

Shigell only host is ?

A

human

68
Q

Incubation period for shigella ?

A

1-3 days

69
Q

Shigella spp. cause what illness ?

A

Shigellosis (baciliary dysentery)
* bacterial gastroenteritis
* caused by 4 shigella serogroups
* relatively few organisms can cause disease

70
Q

Describe pathogenesis of shigellosis infection

A
  1. shigella proliferate rapidly in small intestine, reach colon and attach to M-cells in Peyer’s patches
  2. following endocytosis, shigella replicates in cytosol
  3. rearrangement of actin filaments of host cells - so shigella can enter adjacent cells (spread)
  4. shigella produce shiga toxin (exotoxin) which kills host cells leading to symptoms (local inflammation, disease manifestation)
  5. shigella are quickly phagocytosed in the bloodstream
71
Q

Cause of shigellosis:
1. low/middle income countries =
2. high income countries =

A

1.Shigella flexneri
2.Shigella sonnei

72
Q

Transmission of Shigellosis?

A
  • faecal-oral route
  • ingestion of contaminated food/water/fomites
  • direct person-to-person contact
73
Q

symptoms of shigellosis occur within …. of infection ?

A

1-3 days

74
Q

symptoms of shigellosis ?

A
  • abdominal cramps
  • diarrhoea
  • fever
  • bloody stools
75
Q

diagnosis for shigellosis ?

A

stool sample analysis

76
Q

Treatment for shigellosis ?

A

Rehydration therapy
Antimicrobials

77
Q

List the examples of antimicrobials for shigellosis treatment

A

FACTS
* fluoroquinolones
* azithromycin
* ciprofloxacin
* trimethoprim
* sulfamethoxazole

78
Q

Yersinia infection leads to ?

A

enterocolitis (yersiniosis)

79
Q

cause of yersiniosis ?

A
  • Y. enterocolitica
  • Y. pestis
  • Y. pseudotuberculosis
80
Q

Transmission of yersiniosis ?

A
  • ingestion of contaminated foods (dairy, meat, poultry, fruits, vegetables, seafoods)
  • blood transfusions (higher mortality rate)
81
Q

symptoms of yersiniosis ?

A
  • watery of bloody diarrhoea
  • fever
  • abdominal pain (lasting up to 2 weeks)
82
Q

With yersinia symptoms present within …. days post-infection ?

A

4-6

83
Q

Yersinia disease can become … ?

A

chronic

84
Q

what can yersinia infection mimic ?

A

appendicitis

85
Q

How can yersinia infection mimic appendicitis ?

A

it affects terminal ileum and mesenteric lymph nodes are enlarged

86
Q

diagnosis of yersiniosis ?

A

stool sample analysis

87
Q

Treatment of yersiniosis

A

antimicrobial drugs can be used if required

88
Q

examples of antimicrobials that may be required for yersinia ?

A
  • Cephalosporins
  • Aminoglycosides
  • Chloramphenicol
  • Tetracyclines
  • Trimethoprim
  • Sulfamethoxazole

infection (33 decks)

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