9-3 Enterobacteriaceae Flashcards

1
Q

[T or F] Enterobacteriaceae have [Type 3 Secretory Systems] AND [Iron Scavengers]

A

TRUE

  • Type III secretion systems facilitates secretion of bacterial virulence factors into host cells and Iron Scavengers
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2
Q

4 Unvarying Characteristics of Enterobacteriaceae Family

A
  1. [Facultative/Gram Negative/Rods]
  2. Reduce NitrATE β€”> nitrite
  3. Oxidase NEGATIVE
  4. Glucose Fermenters

β€œEnterobacteriaceae are all FROGs”

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3
Q

[T or F] E. Coli is considered an [Environmental Free Living Organism]

A

FALSE!! E.Coli in water indicates that that water was CONTAMINATED WITH SOMEONE’S FECES!

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4
Q

6 Clinical Dz that can RESULT FROM E.Coli

A

1.

  1. Gram negative sepsis.
  2. Neonatal Meningitis
  3. Wound infections
  4. PNA in [ImmunoCompromised] hospitalized patients
  5. UTI–MOST of community acquired UTIs are from E.Coli
  6. Gram Negative Sepsis
  7. Gastroenteritis

β€œE.Coli in the NW causes PUGG”

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5
Q

A: ETEC = __________

B: Pathogenesis

C: Sx

D: Sx are similar to what other bacteria?

E: Chemoprophylaxis with _____ or _____ Abx for ______􏰀 diarrhea is NOT recommended

A

A: E(T)EC = Entero(T)oxigenic E.Coli

B: Pathogenesis: (LT and ST) production but they do NOT damage mucosal epithelium

C: Sx: Profuse WATERY [(T)RAVELER’S] Diarrhea similar to [V.Cholerae]

E: Chemoprophylaxis with SXT or cipro for travelersτ°€ diarrhea NOT recommended β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”- Traveler’s Diarrhea

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6
Q

A: EpEC = __________

B: Pathogenesis

C: Sx (2)

A

A: EpEC = Enteropathogenic E.Coli

B: Pathogenesis: Causes [attaching/effacing lesions] by adhering to epithelial cells in microcolonies

C: Sx:

  • INFANT Vomiting and Diarrhea WITH NO GROSS BLOOD
  • Prominent mucous

β€œp” think β€œpediatrics”

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7
Q

A: EiEC = __________

B: Pathogenesis

C: Sx (4)

D: Sx are similar to what other bacteria?

A

A: EiEC = Enteroinvasive E.Coli

B: Epithelial Cell Invasion

C: Sx:

  1. Colitis
  2. MLB [Mucus/Leukocytes/Blood] in ur stool
  3. Fever
  4. Tenesmus

β€œEiECCanMakeFecesT**hick”

D: Sx are similar to Shigella

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8
Q

A: [EHEC STEC] = __________

B: Pathogenesis

C: Sx (4)

A

A: [EHEC STEC] = [EnteroHemorrhagic Shiga Toxin] E.Coli

B: Pathogenesis: [ShiGa Toxins 1 and 2] secreted by [EHEC STEC O157:H7] causes Dz especially of the Kidney and CNS endo/epithelium

C: Sx:

  1. [BLOODY OR NONBLOODY DIARRHEA w/No WBC]
  2. NO FEVER
  3. Hemorrhagic Colitis
  4. MAY PROGRESS TO HUS (Hemolytic Uremic Syndrome)
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9
Q

A: EAggEC = __________

B: Pathogenesis

C: Sx (2)

A

A: EAggEC = Enteroaggregative E.Coli

B: Pathogenesis: Adheres to GI epithelium in a β€œstacked brick” pattern

C: Sx:

  1. Watery Diarrhea WITH BLOOD AND MUCUS
  2. Vomiting
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10
Q

A. [EHEC STEC O157 H7 (ESOH)] is shed in feces of _____ and _____ and through _______ (5) [ESOH] can cause Human Infection.

B: Normal Reservoir for [EHEC STEC]

A

A. [EHEC STEC O157 H7] is shed in feces of Cattle and Sheep and through

  1. [water contaminated]
  2. [(undercooked ground beef]
  3. [DIRECT CONTACT w/infected pt]
  4. Milk Unpasteurized
  5. Apple Cider ..

[MAD WU] can cause Human infection β€œI’m [MAD at WU] for giving me ESOH”

B: Healthy Dairy Cows

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11
Q

A1: HUS = ______.

A2: What are the triad of sx that define HUS?

B: When is it Diagnosed

C: What pathogen specifically causes it?

A

A: Triad of Sx for HUS (Hemolytic Uremic Syndrome) -A2: Hemolytic Anemia -Acute Renal Failure -Thrombocytopenia β€œWear a [HUS H.A.T]”

B: Diagnosed 1 week after [Bloody/NonBloody Diarrhea] begins

C: [EHEC STEC: O157:H7] β€œESOH”

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12
Q

What’s the Leading cause of PEDIATRIC Acute Renal Failure?

A

**HUS from ESOH! ** (HUS (Hemolytic Uremic Syndrome) from [EHEC STEC: O157:H7] ) β€œWear a HUS H.A.T”

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13
Q

A: Describe the clinical course for infection with [EHEC STEC O157:H7] (ESOH) - (2)

B: What are the 2 possible outcomes when infected with ESOH

A

1st: 3-4 Days of NON-bloody Diarrhea w/Abd Pain
2nd: [BLOODY DIARRHEA] Onsets w/SEVERE Abd Pain

B:

-Diarrhea Resolves in 4-10 Days

OR

-[HUS H.A.T.] –> Death or [Renal impairment/HTN/CNS]

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14
Q

ESOH

A

[EHEC STEC O157 H7] Can cause [HUS H.A.T.]

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15
Q

A: Describe NON-Diarrheal HUS

B: What 3 things can cause it

A

Non-diarrheal HUS -

  1. much less common,

B: can occur in association with

● pneumococcal infection

● chemotherapy

● transplant immunosuppression

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16
Q

6 important RISK FACTORS (INC Probability) for developing HUS from ESOH

A

Risk Factors for Developing HUS after being infected with ESOH (EHEC STEC O157 H7)

  1. If ESOH produces [ShiGa toxin 2] only
  2. [Anti-motility agents]
  3. Mental Retardation
  4. Children/Elderly
  5. Antimicrobials (specific ones)
  6. [P-antigen] on RBC

β€œ2 AM CAPs of cola is RISK for coli”

17
Q

List the 3 T’s of Laboratory CARE for ESOH

A
  1. Timing = ESOH Load is HIGH in first 4 days of onset so Collect specimen in first 4 days of onset for any enteric illness and before Abx
  2. Type = Collect WHOLE STOOL since multiple specimens enhances recovery
  3. Transport = TRANSPORT ASAP and refrigerate at 4ΒΊC if it’s been more than 1-2 hours
18
Q

3 Ways to DIAGNOSIS ESOH in a Lab

A
  1. Antigenic Detection ([ShiGa toxin 1 and 2] or O157
  2. Direct Fecal detection
  3. [MORE SENSITIVE ENRICHED BROTH CULTURE] detection
19
Q

Tx for ESOH [EHEC STEC O157 H7] - (2)

A
  1. Dialysis for [HUS HAT] and Renal Failure pts
  2. Oral Rehydration (Gatorade and Pedialyte) with careful monitoring of renal function
20
Q

Contraindicated Tx for ESOH [EHEC STEC O157 H7] - (2)

A

ABX OR [ANTIMOTILITY AGENTS]!!!!!!!!

21
Q

Name the 5 genera of Enterobacteriaceae that can cause GI Dz

A

Genus:

  1. Escherichia
  2. Shigella
  3. Edwardsiella
  4. Salmonella/Shigella
  5. Citrobacter

[SEESiCK]

22
Q

4 Potential Clinical Manifestations of SALMONELLA Infection

A: [Asymptomatic Carrier]

  1. How long for Non-typhoid
  2. How long for [Salmonella Typhoid]

B: List All of the Sx (4)

A

5 Potential Clinical Manifestations of SALMONELLA Infection 1. [Asymptomatic Carrier] = [Non-typhoid Salmonella Typhi = 1 year] vs. [Salmonella Typhoid = DECADES] β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”

B:

  1. Septicemia
  2. [Asymptomatic Carrier]
  3. [Febrile Gastroenteritis] OR [Focal Infections]
  4. [Enteric Typhoid Fever]

β€œSalmonella is anything but SAFE”

23
Q

4 Potential Clinical Manifestations of SALMONELLA Infection

A: [Febrile Gastroenteritis] = _____[most/least] common

  • Incubation time
  • Sx (3) -Duration -

B: List All of the Sx (4)

A

5 Potential Clinical Manifestations of SALMONELLA

[Febrile Gastroenteritis =

  • MOST COMMON
  • 12-48 Incubation Time
  • NVD/abd pain/malaise -Self-limited = 3-5 day duration β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”-

B:

  1. Septicemia
  2. [Asymptomatic Carrier]
  3. [Febrile Gastroenteritis] OR [Focal Infections]
  4. [Enteric Typhoid Fever]

β€œSalmonella is anything but SAFE”

24
Q

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Enteric Typhoid Fever] is ____ and _____!

-What 2 strains is it caused by? *Incubation *Duration and symptom course *HR

A2: The Only known reservoir for Salmonella Typhi is _____ β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”

B: List All of the Sx (4)

A

5 Potential Clinical Manifestations of SALMONELLA

    • Caused by [Salmonella Typhi] and [Salmonella paraTyphi]
    • Incubation = 1-2 weeks
    • [4 Week duration] with [INC Fever for 2 of those weeks] and [GI sx for 1-2 weeks] that follow
    • HR = Bradycardia even tho pt body temp is elevated(happens with intracell infection)

A2: ONLY known reservoir of S.Typhi is Man (Transmission is from person-to-person for S.Typhi) β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”

B:

  1. Septicemia
  2. [Asymptomatic Carrier]
  3. [Febrile Gastroenteritis] OR [Focal Infections]
  4. Enteric Typhoid Fever

β€œSalmonella is anything but SAFE”

25
Q

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Septicemia] has no ____ involvement but has common _______

-3 Demographic of Pts who are at risk β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”

B: List All of the Sx (4)

A

5 Potential Clinical Manifestations of SALMONELLA

[Septicemia]

  • No GI Involvement
  • Pts with Immunocompromise
  • [Alcoholic Hepatitis]
  • [Sickle Cell Anemia]
  • Relapses are common

B:

  1. Septicemia
  2. [Asymptomatic Carrier]
  3. [Febrile Gastroenteritis] OR [Focal Infections]
  4. [Enteric Typhoid Fever]

β€œSalmonella is anything but SAFE”

26
Q

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Focal Infections]: List the 5 [FOCAL Infections] that can be caused by SALMONELLA β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”β€”

B: B: List All of the Sx (4)

A

5 Potential Clinical Manifestations of SALMONELLA

  1. Focal Infections = REMBO [Meningitis] [Osteomyelitis] [Brain Abscess] [Endocarditis]

[Rose Spots: Pink Macules/Prupuric Lesions] ———————————————————————————–

B:

  1. Septicemia
  2. [Asymptomatic Carrier]
  3. [Febrile Gastroenteritis] OR [Focal Infections]
  4. [Enteric Typhoid Fever]

β€œSalmonella is anything but SAFE”

27
Q

A: How is SHIGELLA Transmitted? (2)

B: What 3 Groups are at Highest Risk for SHIGELLA

A

A:

1`.Contaminated water

  1. Person to person via:
    - [food, flies, fingers, fomites, feces (5 f􏰀s)]

B: Highest risk

● Young children in day care center, nurseries, custodial institutions,

● Siblings and parents of these children

● Male homosexuals

28
Q

SHIGELLA Clinical Syndromes

A: Name the [Bacillary Dysentery] Sx (5)

B: Incubation period and how long does it last

C: How many viable organisms are required for Dz

A

Shigella Clinical Syndromes

  1. Bacillary Dysentery

β€œBD from Shigella includes [Ab cramps] + Pus BTW”

  • Abd Cramps
  • Pus
  • Bloody Diarrhea
  • Tenesmus
  • WBC in Feces

B: Incubation: 1-3 Days and will last 48 hours once sx onset

C: less than 200 viable organisms are needed to cause Dz

29
Q

Clinical Syndrome of [Edwardsiella Tarda]

  1. Characterize the associated Gastroenteritis (3)
  2. This Bacteria manifestation has been mistaken for what 3 Dz
  3. Natural Host (2)
A
  1. GASTROENTERITIS
    - watery diarrhea
    - [Typhoid-like illness] w/bloody diarrhea, [colonic ulcerations] and [terminal iLeum nodules]
    - rarely causes septicemia
  2. HAS BEEN MISTAKEN FOR SALMONELLOSIS AND IBD/Crohn’s Dz
  3. Cold blooded vertebrates and Catfish
30
Q

A: 3 Modes of Transmission for SALMONELLA

A

A: -Improper Food Handling of

  • [Chicken and Cows]
  • [reptiles and catfish]
  • Raw Eggs
31
Q

3 sx of Klebsiella OZAENAE

A

Klebsiella Ozaenae

  1. [Atrophic Ozena Rhinitis]
  2. Mucosa Destruction
  3. [Fetid Mucopurulent Discharge]

β€œFAM got sick from Kleb Ozaenae”

32
Q

2 sx of Klebsiella Rhinoscleromatis

A

Klebsiella Rhinoscleromatis

  1. Rhinoscleroma
  2. Chronic Granulomatous Dz involving Upper Resp tract mucosa
33
Q

Main Bacterial Cause of Endocarditis and Osteomyelitis in IV Drug Addicts

A

Klebsiella SERRATIA

34
Q

A: Yersinia Enterocolitica Molecular Mechanism (4)

B: Most common in _______

C: Symptoms and Course Duration

A

A: Orgs. adheres to and penetrates the ileum, causing MALT gastroentertitis

  • terminal ileitis,
  • lymphadenitis,
  • acute enterocolitis.
  • Mimics appendicitis.

B: Most common in children

C: Diarrhea, fever, abdominal pain lasting as long a 1-2 weeks. Chronic form can persist months to years

35
Q

D: Yersinia Enterocolitical can also be associated with ______, ______ and ________

D2: Why is Blood Contamination a problem with [Yersinia Enterocolitica]

E: Blood Storage for Yersinia Enterocolitica

A

D: Also associated w/ ΒΊtransfusion related sepsis, ΒΊarthritis, intraabdominal abscess, hepatitis, osteomyelitis

D2: Blood contamination occurs due to Asymptomatic Y. enterocolitica pt with bacteremia at time of blood donation

E: Y. enterocolitica can proliferate in blood stored at 4ΒΊ C after 2-3 weeks