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BACTE ENTEROBACTER Flashcards

1
Q

All Enterobacteriaceae are:

A

❖ Facultative anaerobe
❖ Non-spore former
❖ Glucose fermenters
❖ Cytochrome oxidase negative

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2
Q

✿ All members of enterobacter are motile except

A

❖ Kleibsella and Shigella
❖ Yersinia

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3
Q

✿ Motile members have ______________________

A

peritrichous flagella

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4
Q

❖ All members grow luxuriantly on BAP as __________________________________ colonies

A

moist, smooth, gray, shiny, entire, convex and opaque

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5
Q

Most common route of infection

A

Fecal-oral route

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6
Q

✿ Presumptive Identification is best done using selective and
differential media such as:

A

❖ MacConkey (MAC)
❖ Hektoen Enteric Agar (HEA)
❖ Xylose-lysine deoxycholate agar (XLD)
❖ Salmonella-Shigella Agar (SSA)

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7
Q
  • often part of the usual
    intestinal microbiota of both humans and animals
A

Opportunistics Pathogens

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8
Q

not present as commensal biota in
the GI tract of humans

A

Primary Pathogens

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9
Q

✿ The most significant species in the genus Escherichia
✿ previously considered as a harmless member of the colon
biota
✿ Primary marker of fecal contamination in water

A

Escherichia coli (COLON BACILLUS)

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10
Q

✿ Colony Morphology of E. coli in MAC

A

lactose fermenter(pink colony) with surrounding
area of precipitated bile salts

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11
Q

✿ Colony Morphology of E. coli in EMB

A

green metallic sheen

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12
Q

BIOCHEMICAL CHARACTERISTIC
of E. coli

A

✿ Fermenter of: Glucose, lactose, trehalose and xylose
✿ Indole +
✿ MR+, VP-
✿ Negative for H2S, DNAse, Urease and PAD
✿ Citrate -

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13
Q

most common cause of diarrheal disease referred to as Traveller’s diarrhea/Tourist’s diarrhea/Montezuma’s
revenge

A

ENTEROTOXIC Escherichia coli (ETEC)

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14
Q

ETEC infective dose of organism for
immunocompetent individual

A

10^6 - 10^10

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15
Q

ETEC MOT

A

Ingestion of contaminated food and water

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16
Q

Colonization of ETEC in the small intestine mediated by ___________________

A

fimbriae

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17
Q

serves as a protective mechanism
against colonization of ETEC

A

stomach acidity

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18
Q

ETEC toxin released in the small intestine

A

❖ Heat-labile toxin (LT)
❖ Heat-stable toxin (ST)

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19
Q

Manifestation: fever, severe abdominal cramps, malaise and
Bloody diarrhea

A

ENTEROINVASIVE Escherichia coli (EIEC)

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20
Q

EIEC MOT

A

fecal oral route

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21
Q

EIEC Virulence test

A

Sereny Test

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22
Q

Infective dose of EIEC and Shigella

A

EIEC- 10^6
Shigella- 10 Organisms

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23
Q

was the first diarrheagenic E.coli described

A

ENTEROPATHOGENIC Escherichia coli (EPEC)

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24
Q

causative agent of infantile diarrhea

A

ENTEROPATHOGENIC Escherichia coli (EPEC)

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25
Q

EPEC infective dose

A

10^8 - 10^10 viable cells

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26
Q

Manifestations: Low-grade fever, malaise, vomiting with
persistent watery diarrhea, typically in children younger than 2
years old

A

ENTEROPATHOGENIC Escherichia coli (EPEC)

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27
Q

EPEC Pathophysiology

A

❖ Bundle-forming pilus
❖ Tir (translocated intimin receptor)
❖ EspF (E.coli secreted protein F)

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28
Q

Refers to E. coli strains that produce Shiga toxin 1 (Stx1)
and/or Shiga toxin 2 (Stx2)

A

SHIGA TOXIN-PRODUCING Escherichia coli (STEC)

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29
Q

_____ is as referred to as verotoxin because this cytotoxin
produces damage to Vero cells

A

Stx

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30
Q

ENterohemorrhagic E.coli strain

A

0157:H7 strain

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31
Q

EHEC is a subset of STEC that causes ______

A

Hemolytic Uremic Syndrome

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32
Q

❖ Characterized by: Low platelet count, hemolytic
anemia and kidney failure
❖ Stool sample does not contain leukocytes

A

Hemolytic Uremic Syndrome

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33
Q

✿ considered a cause of diarrhea in patients with HIV
✿ White blood cells and red blood cells are often absent from
the stool

A

ENTEROAGGREGATIVE Escherichia coli (EAEC)

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34
Q

EAEC adhere packed in an aggregative ___________________ on the cells and between the cells by means of fimbriae
and can lead to biofilm formation

A

“stacked-brick” pattern

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35
Q

Pathophysiology: Diarrheal Symptoms
❖ Watery diarrhea,vomiting, dehydration, occasional
abdominal pain (mostly in children)
❖ Suggestive: “stacked brick growh pattern” on
monolayer cell culture
❖ Definitive: agDNA probes for virulence genes

A

ENTEROAGGREGATIVE Escherichia coli (EAEC)

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36
Q

✿ widely recognized as the most common cause of UTI
✿ originate in the Large intestine as resident flora

A

UROPATHOGENIC Escherichia coli Infections

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37
Q

UROPATHOGENIC Escherichia coli Infections Virulence Factors

A

Pili
Cytolysin
Aerobactin
flagella

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38
Q

allows UROPATHOGENIC Escherichia coli to adhere to the urinary
epithelial mucosa

A

Pili

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39
Q

UROPATHOGENIC Escherichia coli kill immune effector cells and inhibits
phagocytosis and chemotaxis of certain WBC’S

A

Cytolysin

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40
Q

allows UROPATHOGENIC Escherichia coli to chelate iron

A

Aerobactin

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41
Q

facilitate bacterial dissemination

A

Flagella

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42
Q

✿ Pathophysiology: Lower UTI and acute pyelonephritis

A

UROPATHOGENIC Escherichia coli Infections

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43
Q

one of the most common causes of septicemia and
meningitis among neonates

A

Escherichia coli

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44
Q

most documented virulence factor
associated with neonatal meningitis and septicemia infection

A

Capsular antigen K1

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45
Q

Escherichia coli Infections are acquired in the __________________ during delivery

A

birth canal

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46
Q

species isolated from urine, blood, wounds, feces and
gallbladder

A

✿ E. fergusonii

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47
Q

species associated with diarrheal disease; some strains
carry stx2f gene (Shiga-like toxin) and cdtB gene (toxin found
in Clostridium difficile)

A

✿ E. albertii

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48
Q

formerly called E. coli atypical or enteric
group II; yellow pigmented colonies; isolates from CSF,
wounds and blood

A

✿ E. hermannii

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49
Q

species isolated from humans with infected wounds;
half of the strains produced yellow pigmented colonies

A

✿ E. vulneris

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50
Q

✿ usually found in the G.I tract; free living in soil, water and
plants
✿ associated with various opportunistic and
health-care-associated infections, particularly pneumonia,
wound infections and UTIs

A

KLEBSIELLA

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51
Q

all KLEBSIELLA spp are ______________

A

encapsulated and nonmotile

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52
Q

the most commonly
isolated klebsiella spp. and has distinct feature of possessing a large polysaccharide capsule

A

✿ K. pneumoniae subsp. Pneumoniae

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53
Q

GENERAL CHARACTERISTICS of Klebsiella spp.

A

✿ Citrate (+) and can grow in KCN broth
✿ H2S (-), MR (-) and VP (+)
✿ Do not produce indole (except for some)
✿ Urease (+) and ornithine decarboxylase (-)
✿ They possess O and K antigens

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54
Q

___________________ aka FRIEDLANDER’S BACILLI

A

KLEBSIELLA PNEUMONIAE

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55
Q

✿ most common isolated species
✿ has a polysaccharide capsule (Distinct Feature)

A

KLEBSIELLA PNEUMONIAE

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56
Q

❖ Confers protection against phagocytosis and
antimicrobial absorption
❖ Responsible for the moist, MUCOID colonies

A

polysaccharide capsule

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57
Q

All Klebsiella spp. are lactose fermenters except ______________________________

A

K. ozaenae and K.
rhinoscleromatis

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58
Q

LABORATORY DIAGNOSIS of K. pneumoniae

A

✿ Gram stain: gram negative bacilli
✿ Culture: large, moist, mucoid colonies on EMB, MAC and
XLD
✿ Quellung reaction (+)
✿ Biochemical Test:
❖ A/A, gas (+), urease (+)
❖ IMVIC: - - ++

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59
Q

resemble K. pneumoniae in its disease
spectrum and biochemical properties; isolated from nasal
secretions and cerebral abscess. (IMVIC: + - + + )

A

K. oxytoca

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60
Q

may contribute to the condition called ozaena
which is a chronic atrophic rhinitis characterized by a fetid odor

A

K. ozaenae

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61
Q

causative agent of rhinoscleroma, a
chronic, granulomatous infection of the nasal passages,
pharynx and larynx

A

✿ K. rhinoscleromatis

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62
Q

species has been implicated in human urinary tract
and wound infections

A

K. planticola

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63
Q

species isolated only from the environment

A

K. terrigena

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64
Q

✿ Inhabits soil and water, to a lesser extent the large bowels
of man and animals
✿ Often confused with klebsiella in terms of growth in MAC

A

ENTEROBACTER spp.

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65
Q

ENTEROBACTER Must be differentiated from klebsiella ________________

A

BIOCHEMICALLY

66
Q

ENTEROBACTER Growth on EMB show _______________

A

“Fish Eye Colonies”

67
Q

All ENTEROBACTER are motile and with exception of ______________________

A

E. agglomerans

68
Q

ENTEROBACTER infection are usually ________________

A

Nosocomial

69
Q

most common clinical
isolates of Enterobacter

A

E. cloacae and E. hormaechei

70
Q

nonmotile member of Enterobacter

A

E. asburiae

71
Q

enterobacter associated with osteomyelitis after
traumatic wound

A

E. cancerogenus

72
Q

ENTEROBACTER BIOCHEMICAL TEST

A

✿ Simmon;s citrate (+)
✿ MR (-), VP (+)
✿ Ornithine and lysine decarboxylase (+)

73
Q

most common CRONOBACTER human
isolates

A

C. sakazakii and C. malonaticus

74
Q

❖ Isolated as a pathogen in neonates causing
meningitis and bacteremia
❖ Acquired often from powdered milk

A

Cronobacter (Enterobacter) sakazakii

75
Q

Cronobacter (Enterobacter) sakazakii Produces a ______________________ colonies

A

typical yellow pigmented

76
Q

✿ Motile, slow lactose fermenters; but sucrose fermenters

77
Q

✿ Majority of S. rubidaea and some strains of S. marcescens,
S. plymuthica produce a non-water soluble ___________________________ pigment

A

red to pink pigment (prodigiosin)

78
Q

serratia that produces a very musty, pungent odor

A

S. odorifera

79
Q

All Serratia species are associated with __________________

A

NOSOCOMIAL
OUTBREAKS

80
Q

All Serratia species produces _____________________ differentiates them from
other members of the tribe

A

extracellular DNAse

81
Q

All serratia species are Slow LF and positive for ONPG, except:

A

Serratia fonticola

82
Q

All serratia species _________________ to a wide range of antimicrobial agents

A

Resistance

83
Q

✿ Most significant Serratia species
✿ causes nosocomial UTI, respiratory tract infection and
bacteremia in nurseries and cardiac surgery and burn units

A

SERRATIA MARSESCENS

84
Q

SERRATIA MARSESCENS Biochemical test

A

❖ TSI: K/A or A/A
❖ IMVIC: - - + +

85
Q

serratia that causes osteomyelitis following a motorcycle
accident

A

S. plymuthica

86
Q

serratia that produces a very musty, pungent odor
resembling that of rotten potatoes. Isolated from sputum, blood
and urine

A

S. odorifera

87
Q

3 Species of HAFNIA

A

Hafnia alveli

Hafnia paralvei

Hafnia psychrotoleranas

88
Q

✿ Resembles Enterobacter but differentiated by its ability to
ferment lactose, sucrose, sorbitol and raffinose
✿ Differentiated from Serratia because it is DNAse and Lipase
(-)

89
Q

HAFNIA Major Characteristic: __________________

A

delayed (+) citrate rxn

90
Q

✿ Considered as opportunistic pathogens
✿ widely disseminated in the environment and are normal
intestinal microbiota

A

PROTEUS SPP.

91
Q

Distinguishing characteristic from other members of Enterobacterales

A

ability to deaminate the amino acid phenlalanine

92
Q

PROTEUS SPP. none of the members ferment ________

93
Q

PROTEUS SPP. 4 species

A

P. mirabilis
P. vulgaris
P. penneri
P. myxofaciens

94
Q

PROTEUS SPP. human pathogens

A

✿ P. mirabilis and P. vulgaris

95
Q

Urease (+) activity of P. mirabilis can lead to _______________________

A

struvite kidney stones (calculi)

96
Q

✿ can produce swarming on SBA
✿ Has burnt-chocolate or burnt-gunpowder odor
“CHOCOLATE CAKE”

A

PROTEUS SPP.

97
Q

✿ P. vulgaris and P. mirabilis can be differentiated by:

A

❖ Sucrose fermentation (+ P. vulgaris)
❖ Indole (+ P. vulgaris)
❖ Citrate ( + P. mirabilis)
❖ Ornithine decarboxylase (+ P. mirabilis)

98
Q

CITROBACTER SPP. All grow on _________________

A

Simmons citrates medium

99
Q

✿ Hydrolyze urea slowly; ferment lactose
✿ Considered inhabitants of the GI tract and are associated
with hospital-acquired infections (UT

A

CITROBACTER SPP

100
Q
  • CITROBACTER isolated in diarrheal stool cultures, associated
    with UTI’s, pneumonia, intraabdominal abscesses, endocarditis
    in IV drug abusers
A

C. freundii

101
Q
  • CITROBACTER that is the cause of nursery
    outbreaks of neonatal meningitis and brain abscesses
102
Q

CITROBACTER associated with community-acquired infectious
including septicemia with cervical cancer

A

C. braakii

103
Q

✿ CITROBACTER Can be mistaken for ____________________ when isolated from stool
cultures

A

Salmonella

104
Q

Differentiation of CITROBACTER and SALMONELLA

A

❖ C. freundii: +urease, -lysine decarboxylase
❖ Salmonella: -urease, +lysine decarboxylase

105
Q

a PROVIDENCIA pathogen of the urinary tract and implicated in
diarrheal disease among travelers

A

P. rettgeri

105
Q
  • MORGANELLA that was the documented cause of UTI and neonatal
    sepsis
A

M. morganii

105
Q

MORGANELLA SPP. Motile bt ______________

A

does not swarm

106
Q

PROVIDENCIA that is implicated in outbreaks in burn units and has bee
isolated from urine cultures

A

P. stuatii

107
Q

PROVIDENCIA that is most commonly found in the feces of children with diarrhea; however, its role as a cause of diarrhea
has been proven

A

P. alcalifaciens

108
Q

PROVIDENCIA rare isolate

A

P. rustigianii

109
Q

PROVIDENCIA that is yet to be isolated from any clinical
specimen

A

P. heimbachae

110
Q

EDWARDSIELLA SPP Biochemical Test

A

✿ Urea (-)
✿ Lysine Decarboxylase (+)
✿ H2S (+)
✿ Indole (+)

111
Q

EDWARDSIELLA SPP Do not grow on ____________

112
Q

EDWARDSIELLA SPP. It biochemically resembles ____________, except Edwardsiella is ____________________________

A

E. coli, H2S positive and lactose negative

113
Q

✿ Only OXIDASE-POSITIVE member of the Enterobacterales

A

PLESIOMONAS SPP.

114
Q

A glucose fermenter, facultatively anaerobic, gram-negative
bacill

A

PLESIOMONAS SPP.

116
Q

PLESIOMONAS SPP. is Susceptible to _________, does not have the ability to produce gas

A

agent O/129

117
Q
  • is the only species in PLESIOMONAS SPP.
A

P. shigelloides

118
Q

✿ Emerged as a potential cause of enteric disease in humans
(after consumption of undercooked seafood or untreated
water)

A

PLESIOMONAS SPP.

119
Q

The more common PLESIOMONAS SPP. disease lasts from _________ to _____________

A

14 days to 2-3 months

120
Q

✿ Do not ferment lactose
✿ Do not grow on Potassium cyanide (KCN)

A

SALMONELLA SPP.

121
Q

SALMONELLA SPP. Culture Characteristics

A

❖ MAC: non-lactose fermenters, NLF
❖ HE: Green, black center as a result of H2S production
❖ XLD: red with black center
❖ SSA: Colorless with black center

122
Q

Virulence factors of SALMONELLA SPP.

A

fimbriae
antigenic structures
enterotoxin

123
Q

allows the SALMONELLA SPP. the ability to traverse intestinal mucosa

124
Q

Acute gastroenteritis or food poisoning most common
manifestation of _________________

A

salmonella

125
Q

salmonella infective dose

A

10^6 bacteria

126
Q

Antimicrobial of choice for salmonella

A

Chloramphenicol,
Ampicillin and
Trimethoprim-sulfamethoxazole

127
Q

most severe form of enteric fever

A

Typhoid fever

128
Q

Typhoid fever Caused by ________________ a milk
borne disease of cow

A

Salmonella Typhi

129
Q

Typhoid fever 2nd week allows the appearance of _________

A

Rose Spots

130
Q

only solution to the chronic state
of enteric carriers of salmonella

A

Cholecystectomy

131
Q

gold standard
for the detection of Salmonella spp

A

Culture of Bone Marrow Aspirate

132
Q

detects the presence of serum
agglutinins (antibodies to H and O) in patients serum with
suspected typhoid and paratyphoid fever

A

WIDAL TEST

133
Q

High titer of H>(OR EQUAL TO) 1:160 suggests ________________________

A

past infection or immunization

134
Q

✿ Resemble Escherichia coli but are non-lactose fermenter

A

SHIGELLA SPP.

135
Q

✿ All Shigella spp. Can cause ____________________ Characterized by the presence of blood, mucus, and
pus in the stool

A

bacillary dysentery

136
Q

SHIGELLA SPP. is named after ______________

A

Kiyoshu Shiga

137
Q

_______________ are Susceptible to disinfectants and high concentrations of
acids and bile

A

SHIGELLA SPP.

138
Q

Shigella spp. Can generally be differentiated from E.coli
based on:

A

❖ Inability to ferment lactose
❖ Lack of motility
❖ Negative indole reaction

139
Q

✿ AKA: Bacillary dysentery
✿ Spread via fecal-oral route or through ingestion of
contaminated food and water

A

SHIGELLOSIS

140
Q

SHIGELLOSIS Incubate for _______

141
Q

SHIGELLOSIS Begin with fever, abdominal cramping and pain and diarrhea
accompanied by _____________

142
Q

YERSINIA spp. that is the causative agent plague

A

Yersinia pestis

143
Q

YERSINIA spp. associated with sporadic cases of gastroenteritis,
mesenteric lymphadenitis

A

Yersinia pseudotuberculosis and Y. enterocolitica

144
Q

YERSINIA spp. that mimic appendicitis

A

Y. enterocolitica

145
Q

YERSINIA spp. Exhibit “ __________” appearance under microscopy - show
marked bipolar staining when stained with “_________________”

A

safety pin, WAYSON STAIN

146
Q

YERSINIA spp. Optimal growth is observed at ____________________, and growth is enhanced by continued
incubation at room temperature

A

25 degrees celsius to 30
degrees celsius

147
Q

✿ Causative agent of plague, a disease primarily of rodents
✿ Class A bioterrorism agent

A

Yersinia spp.

148
Q

yersinia with swollen lymph nodes
(buboes) in axillary and inguinal area

A

Bubonic (granular) form

149
Q

yersinia with inhalation of organism

A

Pneumonic form

150
Q

when yersinia bacteria spread to the
bloodstream

A

Septicemic form

151
Q

✿ Can be acquired from contact with household pets
✿ Human infections most often occur after the ingestion of
contaminated food, often pork, and vacuum-packed deli meat,
beef, lamb, chicken, nd possibly chocolate milk and water

A

YERSINIA ENTEROCOLITICA

152
Q

Associated with the transfusion of contaminated Packed
RBC’S

A

YERSINIA ENTEROCOLITICA

153
Q

characterized by tender, red nodules
that may be accompanied by itching and burning and the areas
involved include the anterior portion of the legs; some patients
have reported nodules on their arms

A

Erythema nodosum

154
Q

_________________________ is used to increase the
recovery in fecal samples suspected of Yersinia enterocolitica

A

Cold enrichment technique

155
Q

Selective medium for YERSINIA ENTEROCOLITICA

A

Cefsulodin-irgasan-novobiocin agar
(CIN)

156
Q

Colony Characteristic of YERSINIA ENTEROCOLITICA

A

Bull’s eye colonies (colonies
containing a central dark red/pink zone surrounded by an outer
translucent zone)

157
Q

A yersinia pathogen primarily of rodents (guinea pigs)

A

YERSINIA PSEUDOTUBERCULOSIS

158
Q

YERSINIA PSEUDOTUBERCULOSIS natural reservoir

159
Q

YERSINIA PSEUDOTUBERCULOSIS causes a disease characterized by caseous swellings called
__________________

A

pseudotubercles

2A MIDTERMS (20 decks)

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