8. Gram Negative Bacilli

Question 1

Which gram negative bacilli are lactose fermenters?

Answer 1

E coli

Klebsiella

Question 2

What E.coli serotypes are associated with UTIs and what virulence factor do they share?

Answer 2

Types 1, 2, 4

Type 1 fimrbiae

Question 3

What intra-abdominal infections can be caused by e.coli?

Answer 3

Cholecystitis
Appendicitis
Peritonitis
Sub-phrenic and liver abscesses

Question 4

What antibiotics are used to treat e.coli cystitis?

Answer 4

Nitrofuratoin

Trimethoprim

Question 5

What is the antibiotic treatment for klebsiella intra-abdominal infection?

Answer 5

Co-amoxiclav and gentamicin

Question 6

What is the classic presentation of klebsiella pneumonia?

Answer 6

Red currant jelly and alcoholics

Question 7

What is the appearance of proteus on agar?

Answer 7

Swarming

Fishy smell

Question 8

What antibiotics are EBSL producers resistant to?

Answer 8

Cephalosporins
Co-amoxiclav
Piptazo

Question 9

What infections are caused by EBSL producers?

Answer 9

UTIs and intra-abdominal infections in nursing home residents

Question 10

What antibiotic are CPEs resistant to?

Answer 10

Meropenem

Question 11

Where is the K antigen found?

Answer 11

Capsule

Question 12

Where is the O antigen found?

Answer 12

Cell wall (LPS)

Question 13

Where is the H antigen found?

Answer 13

Flagella

Question 14

Which strains of E.coli cause vertoxigenic e.coli gastroenteritis?

Answer 14

O157 or O26

Question 15

How is E. coli gastroenteritis contracted?

Answer 15

Contamination of food and water through agriculture

Spread person-to-person

Question 16

What is the management of E.coli gastroenteritis?

Answer 16

Notify public health
PCR of stool for verotoxin gene, can be confirmed with culture
Don’t give antibiotics

Question 17

How does the verotoxin cause the symptoms associated with vertoxigenic E.coli?

Answer 17

Adheres to intestinal epithelium and causes haemorrhagic colitis
Results in bloody diarrhoea and abdominal pain

Question 18

What happens if you give antibiotics to someone with vertoxigenic e.coli?

Answer 18

Haemolytic uraemic syndrome

• haemolytic anaemia
• acute renal failure
• thrombocytopaenia

Question 19

Where is pseudomonas typically found?

Answer 19

Sinks in hospitals

Question 20

What virulence factors does pseudomonas have?

Answer 20

Biofilm
Pyocyanin impairs cilia
Oxidase positive

Question 21

What patient group does pseudomonas cause BSIs in?

Answer 21

Burns patients

Question 22

What infection does pseudomonas cause in haematology/oncology patients?

Answer 22

Neutropaenic sepsis

Question 23

What other infections does pseudomonas cause?

Answer 23

NICU outbreaks
VAP, bronchiectasis, CF
UTI with catheters
Eye infections
Otitis externa (especially in diabetics)

Question 24

What infections does burkholderia cepacia cause?

Answer 24

Fatal necrotising pneumonia in CF

BSI

Question 25

What infections does burkholderia pseudomallei cause?

Answer 25

Melioidoses
-SE Asia and Australia
-Water is reservoir
Severe pneumonia and BSI

Question 26

What patient group does stenotrophomas maltophilia infect?

Answer 26

Hospitalised and CF

Following broad spectrum antibiotics

Question 27

What are the difficulties with acinetobacter baumannii?

Answer 27

Associated with hospital outbreaks

Multi-resistant