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Pathogenic Microbiology > Ex2-Enterobacteriaceae,Campylobacter,Helicobacter > Flashcards

Ex2-Enterobacteriaceae,Campylobacter,Helicobacter Flashcards

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1
Q

Enterobacteriaceae include which type of species?

A 
Enterobacter
Escherichia
 Salmonella
 Shigella
 Klebsiella
 Serratia
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2
Q

Are Enterobacteriaceae Gram negative or positive? And what is their carbon source?

A

gram negative rods
• facultative anaerobe
– oxidase negative

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3
Q

Enterobacteriaceae are opportunistic pathogens, what does that mean?

A

• community acquired
• cause disease in otherwise
healthy people

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4
Q

What syndromes are caused by Enterobacteriaceae?

A 
syndromes include
•  septicemia
•  pneumonia
•  meningitis
•  urinary tract infections •  gastrointestinal diseases
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5
Q

Which Enterobacteriaceae usually causes pneumonia?

A

Klebsiella pneumoniae

  • respiratory diseases
  • prominent capsule
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6
Q

Which Enterobacteriaceae causes urinary tract infections, and how does contamination occur?

A

Proteus spp.

  • urease (degrades urea)
  • alkaline urine
  • Fecal contamination of the urinary tract is the most common route that causes the bacteria to enter the urethra
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7
Q

Which Enterobacteriaceae are known to cause gastrointestinal diseases and are also excreted in feces?

A

– Escherichia-* Tests lactose positive and are apart of the normal flora of the GI tract.

*Lactose Negative
– Salmonella
– Shigella
– Yersinia entercolitica

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8
Q

Which organisms are known to cause Gastrointestinal disease but are not of the Enterobacteriaceae?

A
  • Campylobacter

- Helicobacter

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9
Q

What antigens are can be found on the surface of Enterobacteriaceae?

A

antigens include:

  • O (lipopolysaccharide) O1-O181
  • H (flagellar) H1-H56
  • K (capsular) 60
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10
Q

What species of E. colli are known to cause gastrointisis

A
  • Enterotoxigenic E. coli (ETEC)
  • Enteropathogenic E. coli (EPEC)
  • Enteroaggregative E. coli (EAEC)
  • Enterohemorrhagic E. coli (EHEC)
  • Enteroinvasive E. coli (EIEC)
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11
Q

What are the symptoms of Enterotoxigenic E. coli (ETEC)? And how are you able to diagnose it?

A 
•  acts in small intestine •  watery diarrhea
•  non-bloody stools 
•  vomiting
•  cramps
•  nausea
•  low-grade fever
•  diagnose by immunoassay
for ST or by PCR
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12
Q

What are the symptoms of Enteropathogenic E. coli (EPEC)? and how id it diagnosed?

A
  • acts in small intestine
  • watery diarrhea
  • non-bloody stools
  • vomiting
  • destruction of surface microvilli
  • diagnose by adherence to human HeLa or Hep-2 cells, presence of plasmid-encoded pili
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13
Q

What are they key features of Enterotoxigenic E. coli (ETEC)?

A 
•  “traveller’s” diarrhea, infant diarrhea
•  Heat labile toxin (plasmid)
 –  like choleragen
–  Adenyl cyclase activated
 –  cyclic AMP (up)
–  secretion water/ions (up)
•  Heat stable toxin (plasmid)
–  Guanylate cyclase activated
 –  cyclic GMP (up)
–  uptake water/ions (down)
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14
Q

What are the symptoms of Enterosggregative E. coli (EAEC)? How are you able to diagnose it?

A 
•  acts in small intestine
•  persistent watery diarrhea
•  non-bloody stools •  vomiting
•  dehydration
•  low-grade fever
•  aggregative adherence of rods •  diagnose by adherence to human
Hep-2 cells, presence of plasmid
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15
Q

What is the transmission route for Enterohemoryhagic E. coli (EHEC)?

A

• Contaminated meat, water, unpasteurized milk or fruit juice, raw vegetables, fruit

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16
Q

What are the key features known to identify and diagnose Enterohemoryhagic E. coli (EHEC)?

A

• Verotoxin (Stx-1, Stx-2) blocks protein synthesis
• Hemolysins
• Screen for O157:H7 on
sorbitol-MacConkey agar
• Confirm diagnosis by assay for presence of Stx toxins

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17
Q

What symptoms can be observed from a patient diagnosed with Enterohemoryhagic E. coli (EHEC)?

A 
•  hemorrhagic
–  initial watery diarrhea followed by
bloody, copious diarrhea with
abdominal cramps
 –  few leukocytes
–  little or no fever
•  may progress to hemolytic-uremic syndrome
–  hemolytic anemia
–  thrombocytopenia (low platelets) 
–  kidney failure
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18
Q

What are the symptoms of Enteroinvaasive E. coli (EIEC)? And how can it be diagnosed?

A 
•  acts in large intestine
 •  fever
•  cramping
•  watery diarrhea
•  non-bloody stools
•  may progress to dysentery
with scant, bloody stools
 •  diagnose by plaque assay in human HeLa cells (can’t be distinguished from Shigella species)
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19
Q

What is the common treatment when dealing with a Gastrointestinal Disease?

A

• fluid replacement
• antibiotics NOT used
– unless a systemic infection,
e.g. hemolytic-uremia syndrome

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20
Q

What is Salmonellosis (gastroenteritis) and what is the common route of transmission and incubation period for the disease to develop?

A 
–  the common salmonella infection of S. Enteritdis
 –  poultry, eggs
–  no human reservoir
–  gastroenteritis
•  nausea
•  vomiting
•  non-bloody stool
•  self-limiting (2 - 5 days)

Antibiotic therapy is not normally used unless the patient is immunocompromised.

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21
Q

What organism causes Typhoid Fever ?

A 
Salmonella typhi:
•  enteric fever
•  most severe salmonella disease
•  rare in US
•  epidemics
–  third world
–  Europe - historical

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22
Q

What are the common symptoms and incubation period that is associated with Typhoid fever?

A

Typhoid fever
• 10-14 day incubation period septicemia occurs
• initial symptoms (1 week or longer)
• gradually increasing fever
• headache,myalgias, malaise, anorexia
• these symptoms followed by GI symptoms
due to colonization of the gall bladder and reinfection of the intestines


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23
Q

What sis the capsular antigen located on the surface of S. Typhi?

A

S. typhi
• Vi (capsular) antigen
– protective antibodies made

24
Q

What is the common therapy given to patients who acquire S. Typhi?

A

Therapy
• Antibiotics – essential
• Vaccines
– ineffective

25
Q

What are the common symptoms associated with Shigella?

A 
•  bacterial dysentery
 •  shigellosis
- bloody feces
 -  intestinal pain 
-  pus
26
Q

What relevant are the most relevant species of Shigella?

A
  • S. flexneri
  • S. boydii
  • S. sonnei
  • S. dysenteriae
  • Shigella sonnei
27
Q

What is the transmission of Shiggellosis and what is its incubation period?

A 
•  humans the only "reservoir" •  mostly young children
–  fecal-oral contact
–  children to adults
•  transmitted by adult food handlers
–  unwashed hands
 •  within 2-3 days
–  epithelial cell damage
28
Q

What are the key features of the shiga toxin?

A

• enterotoxic
• cytotoxic
• inhibits protein synthesis
– lyses 28S rRNA

29
Q

How do you treat Shingellosis?

A

• manage dehydration
• patients respond to antibiotics
– disease duration diminished

30
Q

What are the common species of Campylobacter associated with human disease?

A
  • C. Jejuni
  • C. Coli
  • C. Fetus
  • C. Upsaliensis
31
Q

What is the common reservoir of C. Jejuni?What disease does it cause?

A
  • Poultry
  • Cattle
  • Sheep
  • Diseases include: Gastroenteritis, extraintestinal infections, Guillain-Barré syndrome, reactive arthritis
32
Q

What is the common reservoir of C. Coli? What disease does it cause?

A
  • Pork
  • Poultry
  • Sheep
  • Birds
  • Diseases Include: Gastroenteritis, extraintestinal infections
33
Q

What is the common reservoir of C. fetus? What disease does it cause?

A
  • cattle
  • sheep
  • Diseases include: Vascular infections (e.g., septicemia to multiple organs, septic thrombophlebitis, endocarditis), meningoencephalitis, gastroenteritis
34
Q

What is the common reservoir of C. Upsaliensis? What human Disease does it cause?

A
  • Dogs
  • Cats
  • Diseases include: Gastroenteritis, extraintestinal infections, Guillain-Barré syndrome
35
Q

what are some of the key features associated with a Campylobacter infection?

A

Most common disease is acute enteritis with diarrhea, malaise, fever, and abdominal pain
• Guillain-Barré syndrome believed to be an autoimmune disease caused by antigenic cross- reactivity between oligosaccharides in bacterial capsule and glycosphingolipids on surface of neural tissues
• Most infections are self-limited but can persist for a week or more

36
Q

What is are some key features regarding the epidemiology of Campylobacter?

A

• Zoonotic infection; improperly prepared poultry is a common source of human infections
• Infections acquired by ingestion of contaminated food, unpasteurized milk, or contaminated water
• Person-to-person spread is unusual
• Dose required to establish disease is high, unless
the gastric acids are neutralized or absent
• Worldwide distribution with enteric infections seen throughout the year

37
Q

How are you able to Detect and diagnose a Campylobacter infection?

A
  • Detection of thin, “S-shaped” gram-negative rods in stool specimens is insensitive but specific
  • Culture requires use of specialized media (e.g., Skirrow’s medium) incubated with reduced oxygen, increased carbon dioxide, and (for thermophilic species) elevated temperatures; requires incubation for 2 or more days
  • Detection of Campylobacter antigens in stool specimens is moderately sensitive and very specific compared with culture
38
Q

How are you able to treat,prevent and control a campylobacter infection?

A
  • For gastroenteritis, infection is self-limited and is managed by fluid and electrolyte replacement
  • Severe gastroenteritis and septicemia are treated with erythromycin or azithromycin
  • Gastroenteritis is prevented by proper preparation of food and consumption of pasteurized milk; preventing contamination of water supplies also controls infection.
39
Q

What are the Helicobacter species associated with human disease?

A
  • H. pylori
  • H. Cinaedi
  • H. Fenneliae
40
Q

What are the common reservoir and clinical diseases associated with H. pylori?

A
  • Humans
  • Pigs
  • primates

-Diseases include: Gastritis, peptic ulcers, gastric adenocarcinoma, mucosa-associated lymphoid tissue B-cell lymphomas

41
Q

What are the common reservoir and clinical diseases associated with H. Cinaedi?

A
  • Humans
  • Hamsters

Diseases include: Gastroenteritis, septicemia, proctocolitis

42
Q

What are the common reservoir and clinical diseases associated with H. Fenneliae

A

-Humans

Diseases include: Gastroenteritis, septicemia, proctocolitis

43
Q

What are most common virulence factors associated with the helicobacter species?

A
  • Urease production at very high levels is typical of gastric helicobacters (e.g., H. pylori) and uncommon in intestinal helicobacters (important diagnostic test for H. pylori)
  • Multiple factors contribute to gastric colonization, inflammation, alteration of gastric acid production, and tissue destruction
44
Q

Why is H. Pylori important to human disease?

A

• H. pylori is an important cause of acute and chronic gastritis, peptic ulcers, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma

45
Q

What are some key epidemiological features of the Helicobacter species?

A

• Infections are common, particularly in people in a low socioeconomic class or in developing nations
• Humans are the primary reservoir
• Person-to-person spread is important
(typically fecal-oral)
• Ubiquitous and worldwide, with no seasonal incidence of disease

46
Q

How are we able to diagnose H. pylori?

A
  • Microscopy: histologic examination of biopsy specimens is sensitive and specific
  • Urease test relatively sensitive and highly specific; urea breath test is a noninvasive test
  • H. pylori antigen test is sensitive and specific; performed with stool specimens
  • Culture requires incubation in microaerophilic conditions; growth is slow; relatively insensitive unless multiple biopsies are cultured
  • Serology useful for demonstrating exposure to H. pylori
47
Q

How are we able to treat, prevent and control H. Pylori infection?

A
  • Multiple regimens have been evaluated for treatment of H. pylori infections. Combined therapy with a proton pump inhibitor (e.g., omeprazole), a macrolide (e.g., clarithromycin) and a β-lactam (e.g., amoxicillin) for 2 weeks has had a high success rate
  • Prophylactic treatment of colonized individuals has not been useful and potentially has adverse effects, such as predisposing patients to adenocarcinomas of the lower esophagus
  • Human vaccines are not currently available
48
Q

Is H. Pylori or C. Jejuni a typical cause for diarrheal illness?e

A

C. Jejuni is common not H. Pylori

49
Q

What are the clinical manifestations associated with C. Jejuni?

A

Acute Gastroenteritis

50
Q

What are the clinical manifestations associated with H. pylori?

A

Gastroduodenal inflammation, ulceration, gastric cancer

51
Q

What is the common outcome of infection with C. Jejuni?

A

Usually self- limiting unless immunocomprimised

52
Q

What is the common outcome of infection with H. pylori?

A

Persistent low-grade inflammation

53
Q

What is the the affected host associated with C. Jejuni

A

IT is normal in all age groups often occurs in clusters.

54
Q

What is the affected hosts associated with H. pylori?

A

Chiefly found in adults and prevalence of infection usually occurs more frequently with age.

55
Q

what are the common Reservoir of C. Jejuni?

A

Birds and Mammals

56
Q

What is the common Reservoir of H. pylori?

A

Humans

57
Q

In what temperature range does C. Jejuni and H. pylori growand how is it isolated?

A
  • C. Jejuni 32-42ºC Feces

- H.pylori 35-42ºC by Gastric and Duodenal Biopsy specimen

Pathogenic Microbiology (11 decks)

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