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micro > Enterobacterales - less clinically important > Flashcards

Enterobacterales - less clinically important Flashcards

1
Q

What are the culture characteristics of Proteus spp?

A

1) grow on MAC but do not swarm
2) May have intrinsic resistance features
TiNC
Tetracycline
imipenem
Nitrofurantoin
Colistin

*These are slightly more common pathogens

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2
Q

What disease is associated with Proteus spp?

A

UTIs
Formation of Kidney stones
They produce ammonia from urea

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3
Q

Do Proteus have intrinsic resistance?

A

yes, TiNC and They have AmpC beta lactamases

Tetracycline
imipenem (without carbapenemases) increased MICs but not intrinsically resistant
Nitrofurantoin
Colistin

Need to confirm with CLSI

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4
Q

What other antibiotics are Proteus resistant to?

A

Ampicillin
1st Gen Cephalosporins
2nd Gen Cephalosporins

*These are slightly more common pathogens

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5
Q

Who are the members of the Proteeae and what do they have in common?

A

Proteus
Providencia
Morganella

TNC intrinsic resistance

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6
Q

Clinically relevant Morganella and Providencia spp?

A

Providencia rettgeri
Providencia stuartii
Morganella morganii

*These are slightly more common pathogens

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7
Q

Which bacteria sometimes produces red pigment?

A

Serratia marcescens

*These are slightly more common pathogens

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8
Q

Enterobacter cloacae complex

A

Enterobacter cloacae, E. asburiae, E. hormaechei, E. kobei

*These are slightly more common pathogens

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9
Q

Who has chromosomal AmpC beta-lactamases?

SPACE-MK

A

SPACE-MK

Serratia marcescens
Proteeae (+), Pseudomonas
Acinetobacter, Aeromonas
Citrobacter freundii, Chromobacterium
Enterobacter cloace

Morganella morganii
Klebsiella aerogenes (prev enterobacter)

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10
Q

Which antibiotics do not work on bacteria with AmpC beta-lactamases?

A

1st, 2nd, and 3rd generation cephalosporins
most penicillins, and β-lactamase inhibitor-β-lactam combinations

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11
Q

AmpC possibilities

A

1) repressed, not expressed
2) expressed at low levels
3) expressed at high levels

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12
Q

How to isolate/culture Salmonella?

A

1) BAP
2) MAC - NLF
3) H2S positive hektoen enteric agar and Xylose lysine deoxycholate agar (XLD agar)

Bone marrow cells is the gold standard

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13
Q

How do distinguish Samonella from other spp?

A

Xylose lysine deoxycholate agar (XLD agar)
hektoen enteric aga

Based of hydrogen sulfide production

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14
Q

Who are natural reservoirs of Salmonella?

A

1) reptiles-specially turtles
2) birds

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15
Q

Important Salmonella serotypes?

A

Salmonella Typhi (typhoid fever)
Salmonella Paratyphi A, B, C (paratyphoid fever)

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16
Q

What are the Typhoid fever symptoms? and how is it diagnosed?

A

high fever (103 to 104°F )
headache
abdominal pain
GI illness
rash spots on abdomen, chest, back

Blood culture
Stool

17
Q

Salmonella spp not typhi are confirmed by which chemical reactions?

A

ODC ornithine decarboxylase +
Citrate +

18
Q

Salmonella Typhi is resistant to what?

A

1st and 2nd generation cephalosporins, and aminoglycosides

19
Q

Which bacteria is genetically indistinguishable from E. coli?

A

Shigella

MALDI cant differentiate them - > need to do an indole/motility test or run the biochemicals on the Vitek

20
Q

How is Shigella biochemically diff than E. coli?

A

Shigella can’t ferment lactose
Indole neg
Not motile

E. coli is positive for all 3

21
Q

What disease does Shigella spp cause?

A

Shigellosis

Self limiting diarrhea but may be a long course

risk factors include poor sanitation, contaminated food, young children in daycares, immune compromised ppl,

22
Q

Salmonella/Shigella/E. coli selective media

A

Hektoen Enteric Agar

Salmonella produce H2S = black

E. coli ferment lactose = orange

Shigella do not ferment lactose = colorless

23
Q

Salmonella/Shigella selective media

A

Xylose Lysine Desoxycholate Agar

Desoxycholate inhibits non-enterics

Salmonella = black H2S production

24
Q

Name the Yesernia spp and disease that they cause

A

Y. enterocolitica (most common)
Y. pseudotuberculosis (less common)

Foodborne and associated with undercooked pork
or acquired from animals

25
Q

Name other opportunistic GI pathogens (5 major ones) CAPEH

A

1) Citrobacter (plates small really bad) - strong lactose fermenter, UTI, meningitis
Citrobacter freundii strains have inducible ampC

2) Plesiomonas shigelloides - in freshwater fish, self-limiting GI disease

3) Aeromonas hydrophila- skin and soft tissue infection too, necrotizing fasciitis

4) Hafnia alvei-GI commensal but can cause disease in immunocompromised

5) Edwardsiella species

micro (11 decks)

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