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Enterobacteriaceae Flashcards

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1
Q

What are the true pathogens?

A

Salmonella
Shigella
Yersinia
Pathogenic E. coli

SSYE

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2
Q

Serological characteristics - antigens for Enterobacteriaceae

A

O (somatic) - heat stable on cell wall

H (flagellar) - heat labile on surface of flagella

K (capsular) - heat labile polysaccharide
Associated with Salmonella enterica serotype Typhi

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3
Q

What are the H2S (+) organisms?

A

Salmonella
Edwardsiella
Citrobacter +/-
Proteus +/-

Edward Puts Citrus on Salmon
Or SPEC

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4
Q

VP (+) species

A

Klebsiella
Enterobacter
Serratia

KES

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5
Q

Phenylalanine deamination (+) species

A

Proteus
Morganella
Providencia

PMP

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6
Q

Urease (+) species

A

Proteus
Morganella
Providencia
Yersinia enterocolitica
Yersinia pseudotuberculosis
Klebsiella

PMPYK

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7
Q

Non-motile species

A

Shigella
Klebsiella
Y. pestis

SKY (non-motile cannot touch the SKY)

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8
Q

Y. pestis

A

Bubonic plague
Fleas
Fried egg colonies
Lacks O antigen

Non-motile
Urease negative

  • Think pests = fleas, eating eggs
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9
Q

Which organisms are A/A on TSI?

A

E. coli, Enterobacter, Klebsiella
Proteus vulgaris, arizonae

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10
Q

Lactose fermenters

A

Citrobacter
E. coli
Enterobacter
Klebsiella

CEEK

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11
Q

Late lactose fermenters

A

Shigella sonnei
Citrobacter

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12
Q

Oxidase (+) Enterobacteriaceae

A

Plesiomonas shigelloides

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13
Q

What does SMAC agar isolate?

A

E. coli 0157:H7

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14
Q

What color colonies is E. coli O157:H7 on SMAC?

A

Colorless
Does not ferment sorbitol (it would be pink)

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15
Q

What does CIN agar isolate?

A

Yersinia enterocolitica

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16
Q

What does Yersinia enterocolitica look like on CIN agar?

A

Bulls eye

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17
Q

What does Aeromonas look like on CIN11 agar?

A

Pink colonies, smooth, different edges, NOT bullseye like Yersinia enterocolitica

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18
Q

What color does a lactose fermenter look like on XLD?

A

Yellow (normally red agar)

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19
Q

What color do lactose fermenters look like on MAC?

A

Pink

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20
Q

What color do lactose fermenters look like on HE?

A

Orange (normally blueish green agar)

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21
Q

Virulence factors of Uropathogenic E. coli (UPEC)?

A

Primary: pili (adherence to epithelial cells to prevent flushing away)

Cytolysins: kill immune effector cells, inhibit phagocytosis so WBCs don’t go to site of infection

Aerobactin: binds iron to allow it to grow

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22
Q

4 toxins of Escherichia sp

A

Alpha-hemolysin
Shiga toxin
Labile toxin (LT)
Stable toxin (ST)

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23
Q

What are the 5 categories of diarrheagenic E. coli?

A

EnteroTOXIGENIC
EnteroINVASIVE
EnteroPATHOGENIC
EnteroHEMORRHAGIC (O157:H7)
EnteroADHERERENT

TIPHA

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24
Q

Enterotoxigenic E. coli (ETEC)

A
  • In tropical areas
  • Traveler’s diarrhea
  • Self limiting
  • Transmission: fecal/oral
  • Produce LT & ST toxins
  • Symptoms: watery diarrhea, nausea, abdominal cramps
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25
Q

Enteroinvasive E. coli (EIEC)

A
  • Rare in US
  • Dysentery (inflammation of intestines with bloody diarrhea)
  • Fever, abdominal cramps, malaise, watery diarrhea
  • Similar to Shigella but infectious dose is higher (not as infectious)
  • Can appear as non-pathogenic E. coli (can be non-motile and lactose neg)
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26
Q

Enteropathogenic E. coli (EPEC)

A
  • Infant diarrhea: associated with daycare and nurseries
  • Low grade fever, malaise, mucousy stools, v/d
  • Fimbriae adhesive qualities
  • Transmission: fecal/oral, fomites
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27
Q

Enterohemorrhagic E. coli (EHEC)

A

E. coli O157:H7
- Processed meat, unpasteurized dairy, etc.
- HUS (damaged small blood vessels, clots)
- Absence of leukocytes
- Low or no fever
- Often fatal, especially in immunocompromised
- Watery diarrhea

2 cytotoxins:
- Verotoxin I (Shiga like toxin - Stx1)
- Verotoxin II (Stx2)

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28
Q

How to identify EHEC?

A

SMAC (-)
MUG (-)

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29
Q

Enteroadherent E. coli (EAEC)

A

Stacked brick appearance
- Watery diarrhea, vomiting, dehydration, abdominal pain
- 2+ weeks
- WBC & RBC absent from stools
- Infants in US and HIV patients

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30
Q

Shigella subgroups

A

S. dysenteriae
S. flexneri
S. boydii
S. sonnei

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31
Q

Transmission of Shigella

A
  • Fecal/oral
  • Direct contact
  • 5 F’s: fingers, fomites, fecal, food, flies)
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32
Q

Most contagious (lowest infective dose)

A

Shigella
1-100 organisms for an infective dose

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33
Q

Shigella dysenteriae vs E. coli O157:H7

A

O157:H7 - no leukocytes in stools

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34
Q

Habitat of S. enterica subsp. enterica

A

Warm-blooded animals and humans

35
Q

S. flexneri

A

3rd world nations
Reiter’s chronic arthritis syndrome

36
Q

S. sonnei

A
  • Predominantly in USA
  • Gastroenteritis in men being with other men
  • Self limiting, fever, watery diarrhea, typically asymptomatic

ONPG and ODC (+) — remember late lactose fermenter

37
Q

Salmonella Typhoid Fever

A
  • Tropical disease
  • Transmission: fecal/oral, direct contact, fomites
  • Symptoms: 9-14 days after ingestion, malaise, anorexia, myalgia/muscle pain, headache, fever, bacteremia, dissemination to multiple organs
  • Isolated from blood (blood culture positive)
38
Q

Non-typhoidal Salmonella

A
  • Young children: bacteremia, fever
  • Adults: septicemia, septic arthritis
39
Q

Y. pseudotuberculosis

A

Close contact with animals and contaminated food

40
Q

Y. enterocolitica

A

Undercooked meat, contaminated milk, transfusion

Bullseye on CIN

Urease (+)

Non-motile at 35 C

41
Q

Y. pestis vs other Yersinia

A
  • Non-motile
  • Urease negative
42
Q

3 forms of plague

A
  • Pneumonic - bacteria inhaled, lungs
  • Bubonic - fleas
  • Septicemic - pneumonic and bubonic turn into this, manifests in the whole body
43
Q

Edwardsiella tarda

A

Gastroenteritis, wound infections, bacteremia in immunocompromised patients

K/A
Indole (+) vs salmonella indole (-)

iMViC ++–

44
Q

Citrobacter sp

A

GI tract, UTI
Cause healthcare associated infections (HAI)

45
Q

C. freundii

A

UTIs, pneumonia, endocarditis

Similar to Salmonella - ONPG and Citrate (+) compared to Salmonella paratyphi A

iMViC -+-+

46
Q

C. koseri

A

Neonatal meningitis, brain abscesses

iMViC ++-+

47
Q

Klebsiella pneumoniae vs Klebsiella oxytoca

A

Pneumoniae = Indole (-)
Oxytoca = Indole (+)

48
Q

Klebsiella pneumoniae

A

Normal flora in GI tract, nasopharynx
- Pneumonia, wound infections, UTI, bacteremia
- Pyrogenic liver abscess

Hyper-mucoid colonies
iMViC - - ++

49
Q

Morganella vs Providencia

A

Morganella: Citrate (-), ODC (+)
Providencia: Citrate (+), ODC (-)

50
Q

Proteus mirabilis vs Proteus vulgaris

A

P. mirabilis: ODC (+), Indole (-), K/A H2S+
P. vulgaris: ODC (-), Indole (+), A/A H2S+

  • Remember P. vulgaris on iMViC chart, indole (+). Then, ODC is the opposite
  • P. mirabilis and Morganella are both ODC (+)
51
Q

Proteus sp

A

Urease (+), can cause calculi (hard deposited of minerals and salts in the kidneys) in P. mirabilis

UTI

52
Q

Serratia marcescens

A
  • Nosocomial (originates in the hospital)
  • Cystitis, pneumonia, bacteremia, septic arthritis, osteomyelitis
  • DNase (+)
    iMViC - - ++

Red pigment on plate!

53
Q

Enterobacter sp

A

iMViC - - ++

Isolated in wounds, urine, blood, CSF
Mucoid colonies like Klebsiella

54
Q

What are the 3 organisms that are iMViC ++- -?

A

E. coli
Edwardsiella tarda
Proteus vulgaris

EEP

55
Q

What are the 3 organisms that are iMViC - - ++?

A

Klebsiella pneumoniae
Enterobacter sp
Serratia marcescens

KES

56
Q

Y. pseudotuberculosis vs Y. enterocolitica

A

Pseudotuberculosis - motile at 25 C
Enterocolitica - NON-motile at 35 C

57
Q

Enterobacter vs Serratia

A

Serratia = DNase (+)
Enterobacter = DNase (-)

58
Q

Salmonella vs E. tarda

A

Salmonella = Indole (-)
E. tarda = Indole (+)

  • iMViC for E. tarda
59
Q

C. freundii vs S. paratyphi A

A

C. freundii = ONPG (+)
S. Paratyphi A = ONPG (-)

60
Q

What are the differences between Pseudominas aeruginosa vs. P. putida and P. fluorescens vs. P. stutzeri and P. oryzihatibans?

A

P. aeroginosa: grows at 42 C, pyocyanin (blue-green pigment)

P. putida, P. fluorescens: Grows at 4 C, produces pyoverdin (yellow green or yellow brown pigment), fluorescent under UV. Produces acid from a xylose

P. stutzeri, P. oryzihatibans: no fluorescent pigments
P. stutzeri has wrinkly colonies
Grows at 42 C

61
Q

How to differentiate P. stutzeri?

A

Leathery wrinkled colonies with yellow pigment

62
Q

P. putida vs P. fluorescens

A

Gelatin hydrolysis

P. fluorescens (+)
P. putida (-)

63
Q

P. aeroginosa on SBA

A
  • Flat with serrated edges
  • beta hemolytic
  • grape or tortilla odor
  • mucoid when from a CF patient
64
Q

What are the 2 LDC (+) nonfermenters?

A

Burkholderia and Stenotrophomas

65
Q

Difference between Burkholderia and Stenotrophomonas?

A

DNase

Burkholderia = DNase (-)
Stenotrophomonas = DNase (+)

66
Q

Where is Burkholderia cepacia found in?

A

In the environment (soil, stream, water. Can be a plant pathogen

67
Q

What is the difference between Citrobacter koseri and Citrobacter freundii?

A

C. koseri: iMViC ++-+
C. freundii: iMViC -+-+

68
Q

What are the two LDC (+) non fermenters?

A

Burkholderia and Stenotrophomonas

69
Q

How do you differentiate Burkholderia and Stenotrophomonas?

A

DNase

Burkholderia (-)
Stenotrophomonas (+)

70
Q

Burkholderia pseudomallei

A

Found in soil, stream, rice paddies in other parts of the world

Affects lungs (meliodosis) and sacs that form tears

Bioterrorism agent

Smooth and mucoid to dry and wrinkled on SBA

Essential oil spray at Walmart, essential oil from India - first case in US

71
Q

What media is used to differentiate sucrose fermenting Vibrios with non sucrose fermenting?

A

TCBS - thiosulfate citrate bile salts

V. cholerae = yellow colonies since it ferments sucrose
Other Vibrios = green colonies since it doesn’t ferment sucrose

72
Q

Which organism is associated with Trench fever?

A

Bartonella quintana

73
Q

Cat scratch disease

A

Bartonella henselae

74
Q

Tularemia (rabbit fever)

A

Francisella tularensis

75
Q

Capnocytophaga

A

Cat no

From cat and dog bites
Spindle shaped, thin on both ends (think of cat nails)

C. canimorsus may cause amputation of leg/arm

Penicillin

76
Q

Aerobic organisms

A

PPBBSAA

Pseudomonas aeroginosa
Pseudominas stutzeri
Burkholderia cepacia
Burkholderia pseudomallei
Stenotrophomonas maltophilia
Acetinobacter baumanii
Alcaligenes

77
Q

Stomach ulcers and strong urease activity

A

Helicobacter

Urea breath test

78
Q

What is BYCE media used for?

A

Legionella

79
Q

What 3 ingredients in BCYE are specific for Legionella?

A

L-cysteine HCl
Ferric pyrophosphate
Alpha-ketoglutarate

80
Q

Which non-Enterobacteriaceae are oxidase negative?

A

Stenotrophomonas and Acinetobacter

81
Q

What is the disease for H. aegypticus?

A

Conjunctivitis/pink eye

82
Q

What is the disease for H. ducreyi?

A

Genital ulcer disease

83
Q

Bleach odor

A

Haemophilis influenzae
Eikenella

Microbiology (9 decks)

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