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Micro Test 2 > Enterobacteriacae > Flashcards

Enterobacteriacae Flashcards

1
Q

where are Enterobacteriacea normal flora?

A

the GI tract and skin of GU tract

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2
Q

Where can Enterobac be found?

A

nature, soil, human

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3
Q

Which Enterobac are always a pathogenic source of infection?

A

Shigella, Salmonella, Yersinia, E. Coli

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4
Q

How can infection be caused by endogenous strains of Enterobac?

A

if normal flora is disrupted (immunocompromised or on antibiotics)

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5
Q

What is endotoxic shock

A

The endotoxin comes from the lipopolysaccharide in the cell wall. Bacteria are lysed (from antibiotics, aging bad cells, immune system complement) and the exotoxin is exposed.

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6
Q

What are the signs of septic shock?

A

fever, leukopenia, capillary hemorrhage, hypotension, circulatory collapse

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7
Q

Are there a lot of susceptibility patterns for Enterobac?

A

yes, they can vary greatly between strains of the same organism. empiric therapy is based on cumulative antibiogram data

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8
Q

Which genre of Enterobac have the ability to produce extended-spectrum beta-lactamase?

A

E. Coli, Klebsiella, Proteus

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9
Q

If they are an extended spectrum beta lactamase positive organism, what are they resistant to?

A

All PCNs, Cephalosporins (except cephamycins), and Aztreonam

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10
Q

What is the #1 agent of UTIs?

A

E Coli

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11
Q

What organism causes meningitis in ages 0-3 month age group?

A

E coli

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12
Q

What is the most common aerobic GNR in the intestine?

A

E Coli

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13
Q

What is the documented cause of nursery outbreaks of neonatal meningitis and brain abscesses?

A

Citrobacter diversus

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14
Q

What opportunistic infections can cause citrobacter divsersus?

A

UTI, bacteremia, and wound

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15
Q

What is Citrobacter intrinsically resistant to?

A

amp/amox and 1st gen cephalosporins, 3rd generation cephalosporins may develop resistance is 3-4 days.

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16
Q

What is enterobac that causes pneumonia?

A

Kelbsiella sp. (common in smokers and alcoholics). The sputum will look blood tinged.

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17
Q

What is Klebsiella sp intrinsically resistant to?

A

amp/amox and 1st gen cephalosporins, 3rd generation cephalosporins may develop resistance is 3-4 days.

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18
Q

Can kelbsiella produce extended spectrum beta-lactamase?

A

YES

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19
Q

Is Enterobacter sp an opportunistic pathogen? What can it cause?

A

Yes, it causes UTI, bacteremia, wounds, AND respiratory.

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20
Q

What is Enterobacter sp intrinsically resistant to?

A

amp/amox and 1st gen cephalosporins, 3rd generation cephalosporins may develop resistance is 3-4 days.

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21
Q

Serratia marcescens is intrinsically resistant to what?

A

amp/amox and 1st gen cephalosporins, 3rd generation cephalosporins may develop resistance is 3-4 days. AND TOBRAMYCIN!

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22
Q

Is Serratia marcescens an opportunistic pathogen?

A

YES! UTI, bacteremia, respiratory (no wounds)

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23
Q

What does proteus species cause?

A

kidney stones (it is a strong urea hydrolyzed: creates alkaline pH in urine).

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24
Q

What is proteus species intrinsically resistant to?

A

Tetracyline, Nitrofuratntoin

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25
Q

Does proteus sp have the ability to produce an extended spectrum beta lacatamase?

A

YES

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26
Q

What opportunistic pathogens does morgnella sp cause?

A

uti, bacteremia

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27
Q

What are the three criteria that are used to differentiate major gnr genera?

A
  1. utilization of glucose (F, O, I)
  2. oxidase (pos/neg)
  3. Ability to grow on MacConkey agar
28
Q

Glucose utlization?

A

glucose fermenters

29
Q

Cytochrome oxidase test?

A

oxidase negative

30
Q

MacConkey agar

A

They will grow!

31
Q

What species of enterobac are LFGNR?

A

Citrobacter freundii, E coli, Enterobacter aerogenese/cloacae, Klebsiella pnuemonia or K. oxytoca

32
Q

Does direct gram stain testing help with identifying the organism?

A

No, can only tell you its a GNR.

33
Q

What are the species of enterobac that most often cause gastroenteritis ?

A

E. Coli, Shigella sp, Salmonella, Salmonella Typhi, Yersinia entercolitica, and Yersenia pestis

34
Q

What are the enterobac antigens?

A

O= somatic, stimulates earliest antibody
K-capusular, heat labile
H=flagellar, heat labile

35
Q

What is the specific type of E. Coli that is a primary pathogen?

A

E. coli O157:H7 and other shiga toxin producing strains

36
Q

What is the transmission of E. coli O157:H7

A

ingestion of the organism through uncooked hamburger meat or other products, contaminated water, unpasteurized milk or fruit juices, unwashed produce; person-to-person spread is documented.

37
Q

what are the symptoms of E. coli O157:H7?

A

incubation is 3-4 days, then watery diarrhea with abdominal pain, vomiting, AND NO FEVER! complete resolution in 4-10 days in majority of patients.

38
Q

What is HUS?

A

acute renal failure, throbocytopenia, micorangiopathic hemolytic anemia

39
Q

What is the treatment for HUS?

A

Supportive!!!! antibiotics do NOT improve outcomes and may increase the risk of developing HUS

40
Q

what is the current recommendation for E.Coli and Shiga producing strains?

A

Perform tests to detect these strains on all stool specimens submitted for stool culture looking for enteric pathogens.

41
Q

What is gastroenteritis?

A

4 distinct syndromes caused by 4 distinct E. Coli strains (other than shiga-toxin producers). Usually not diagnosed by culture, not seen in the US.

42
Q

What are the four distinct E. Coli Strains that cause gastroenteritis?

A

Enterotoxigenic strains: traveler’s and infant diarrhea
Enteropathogenic strains: infant diarrhea
Enteroaggregative strains: travel’s and infant diarrhea
Enteroinvasive strains: diraahrea which may progress to dystentery.

43
Q

Is Shigella ever normal flora?

A

NO. There are four subgroups

44
Q

How does Shigella get transferred?

A

person to person!!! ingest fecally contaminated material. most common under the age of 10. the incubation period is 1-3 days. there is profuse watery diarrhea, fever, bloody stools with WBCs and mucus.

45
Q

How should you treat a child with shigella?

A

they are unable to return to school until culture comes back negative. They should be treated with FQ, SXT, or Axthromycin

46
Q

What can salmonella almost always colonize?

A

all animals

47
Q

How do you get salmonella?

A

ingestion of contaminated food, water, milk, etc. There is still human to human transfer. Can cause gastroenteritis, and doesn’t have to invade the bloodstream.

48
Q

What are the signs and symptoms of salmonella?

A

nausea, vomitting, fever, and non-bloody diarrhea. Organisms can spread to non-GI sites.

49
Q

Do you treat salmonella?

A

No, treatment is discouraged. WBC is usually negative

50
Q

Is WBC pos or neg for shigella?

A

usually pos

51
Q

What does salmonella typhi cause?

A

typhoid fever: septecemia

52
Q

How is salmonella typhi transmitted?

A

person to person

53
Q

What are the sx/sx of salmonella typhi?

A

fever, HA, anorexia for one week, then GI symptoms start. gallbladder can become infected.

54
Q

When should you start to suspect salmonella typhi?

A

in those who have a travel history.

55
Q

How should you culture for salmonella typhi?

A

weeks 1-3, culture the blood.

weeks 2-5: culture the stool

56
Q

What abx should salmonella be treated with?

A

FQ or cetriaxone

57
Q

Yersenia etercolitica is transmitted by…

A

consumption of meat, milk, water that has been contaminated.

58
Q

Symptoms of Yersenia entercolitica?

A

diarrhea, fever, abd pain, for up to 2 weeks!! often seen in children, can mimic appendicitis, antibiotic testing performed. Treat with SXT or FQ

59
Q

What laboratory procedures are required for Yersinia entercolitica?

A

must specifically request the stool culture, and it may take 1-3 weeks to recover the organisms.

60
Q

What culture is looked for as part of a blood culture workup in transfusion?

A

Yersinia entercolitica

61
Q

How does Yersinia pests get transmitted?

A

vector= flea or contact with infected animal.

62
Q

What is Yersinia pestis responsible for?

A

bubonic plague. can cause bubo in groin and axilla and bactermia can develop.

63
Q

What are the symptoms of Yersinia pestis pneumonia?

A

you inhale the organism, and it causes fever, malaise, and pulmonary symptoms. Patients are HIGHLY infectious, person to person transfer.

64
Q

Do you need to inform the lab if you are going to test for yersinia pestis?

A

yes, highly dangerous.
Bubonic plague= blood culture
pneumonic plague= sputum/blood culture.

65
Q

What is the abx treatment for yersinia pests?

A

doxycyline or gentamycin, you do treat prophyilacclty

Micro Test 2 (4 decks)

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