Bacterial GI 2 Flashcards
MacConkey agar tests for?
Lactose fermentation
MacConkey results are red indicates?
Lactose fermentation POSITIVE
E. coli, some others
MacConkey results are white indicates?
Lactose fermentation NEGATIVE
Salmonella, Shigella, and others
Indole test tests for?
Indole production
Indole test results red indicates?
Indole production POSITIVE
E. coli, Vibrio spp., and others
Indole test results in no color change indicates?
Indole production NEGATIVE
Salmonella
Hydrogen sulfite test used to differentiate?
Salmonella from Shigella
H2S production test for Salmonella
Results in a black precipitate, indicating H2S production
H2S production test for Shigella
No precipitate formed, indicating no production of H2S
Enteropathogenic E. coli (EPEC) features and disease
Gram-negative, facultative anaerobe, moderately invasive
Causes watery diarrhea, pediatric cases are big
EPEC pathogenesis
BfpA
Type III secretion system
NO toxins
BfpA
“Bundle-forming pilus”
Adhesins
Type III secretion system
Injection of bacterial protein
For EPEC, this protein is called Tir (receptor for another protein called intimin)
F actin polymerization occurs, which results in increased efflux of water
EPEC diagnosis and treatment
Culture and biochemical tests
MacConkey positive
Indole positive
PCR
Supportive therapy
Enterotoxigenic E. coli (ETEC) features and disease
Gram-negative, facultative anaerobe, non-invasive
“Travelers diarrhea” - watery diarrhea from contaminated water and ice
ETEC pathogenesis
Fimbriae (pili)
LT toxin
ST toxin
Fimbriae
Adherence to epithelial cells
LT toxin
Heat liable toxin
AB toxin
Increases cAMP, resulting in water efflux
Plasmid-encoded
ST toxin
Heat stable toxin
Non-AB toxin, does NOT enter cell
Increases cGMP
Plasmid-encoded
ETEC diagnosis and treatment
DNA probes to detect LT and ST encoding genes
Supportive therapy
Salmonella spp. two types
S. typhi
Non-typhoidal Salmonella
Non-typhoidal Salmonella
S. cholerasuis
S. enteritidis
S. typhimurium
S. typhi features
Gram-negative rods, non-motile, facultative anaerobes, intracellular pathogen
S. typhi transmission and resistance
Oral-fecal route
Acid tolerant
Incubation for S. typhi
~13 days
Progression of S. typhi
Fever with headache, with increasing fever for 3 days Typhoid fever (longer than ~4 weeks)
GI symptoms
Re-infection (shedding of S. typhi in stool)
S. typhi pathogenesis
Adherence to M cells
M cells
Found in the small intestine
Sample and present intestinal contents to immune cells
Associated with Peyer’s patches
S. typhi adherence to M cells and dissemination
Type III secretion system
Invade vacuoles of M cells and escapes into cytosol
Can then invade macrophage and escape into lymphatics, resulting in bacteremia
Diagnosis and treatment of S. typhi
Culture of stool samples
Antibiotics based on susceptibility profile
Prevention of S. typhi
Avoid potential sources of infection
Vaccinations for travelers - Ty21A and ViCPS
Nontyphoidal Salmonella features
Gram-negative rods, facultative anaerobe, motile/flagellated (H Ag), intracellular pathogens
Incubation period for nontyphoidal Salmonella
6-48 hours post-ingestion
Symptoms of nontyphoidal Salmonella
Nausea, vomiting, abdominal cramps, watery diarrhea with or without blood, sometimes fever
Nontyphoidal Salmonella pathogenesis
Same as typhoidal, up to macrophage infiltration; two options -
Rapid killing of the macrophage, resulting in massive inflammation response that confines the infection to intestines OR
(immunocompromised patients) systemic dissemintation, bacteremia, focal infections
Diagnose nontyphoidal Salmonella
Serology (anti-Vi Ag Ab)
Culture from blood and stool
MacConkeys negative
Production of H2S
Treatment for nontyphoidal Salmonella
Confined to intestines - replace electrolytes, antibiotics NOT recommended
Systemic - antibiotics, based on resistance profile
Campylobacter jejuni features and disease
Gram-negative curved rod, microanaerobic, invasive
Ulceration/acute enteritis, watery diarrhea, sepsis, Sequelae (Guillain-Barre syndrome)
Incubation time for Campylobacter jejuni
2-11 days
Pathogenesis of Campylobacter jejuni
Similar to Salmonella, but not much is known
Diagnosis and treatment of Campylobacter jejuni
Culture
Supportive therapy, or antibiotics (invasive disease only, based on susceptibility profile)