Exam 5 Flashcards
(149 cards)
1
Q
What is true of all enterobacteriales
A
usually in GI tracts
GNR coccobacilli or straight rods
usually transmitted by food or water
all ferment glucose
oxidase negative except one
All reduce nitrate to nitrate
All motile except 2
2
Q
All Enterobacteriales are motile except for
A
Klebsiella and Shigella
3
Q
All enterobacteriales are oxidase negative except for
A
Pleseomonas
4
Q
What diseases do Salmonella and Shigella cause
A
typhoid fever and dysentery
5
Q
What pathogens in enterobacterials are in stool?
A
E. coli
P. shigelloides
Salmonella sp
Shigella sp
6
Q
What pathogens of enterbacteriales are in blood, wounds or respiratory
A
Y. pestis
Y. enterocolitica
Y. pseudotuberculosis
7
Q
Which organism is the most common cause of a UTI and kidney infections
A
E.coli
8
Q
What virulence factors can E. coli have
A
capsular antigen K1
adheres to epethelial cells
O antigen can cross react with Shigella
9
Q
What hemolysis and MAC results do E. coli give
A
Beta mostly
sometimes gamma
lactose fermenter- pink on MAC
10
Q
What does E. coli look like on EMB agar? and XLD?
A
EMB- shiny green
yellow- XLD
11
Q
Bloody watery diarrhea
A
E. coli O157:H7
12
Q
E. coli has a ___ infectious dose required for infection
A
low
13
Q
What genes did E.coli give to Shigella, which Shigella?
A
Stx1 and Stx2 created shiga toxin
14
Q
What other symptoms can E. coli O157:H7 cause
A
HUS hemolytic uremic syndrome
low plts, hemolytic anemia and kidney failure
15
Q
What other name does E. coli O157:H7 have
A
enterohemorrhagic E. coli
EHEC
16
Q
How can we distinguish O157 from other less harmful E. coli
A
MacConkey sorbitol- if clear, means O157 is present
if pink, normal E. coli
Also rapid test cards that look for Stx1 and 2
17
Q
What is ETEC
A
enterotoxigenic E. coli
18
Q
What virulence factors do ETEC have
A
toxins
heat stabile toxin (ST)
heat labile toxin (LT)
19
Q
Traveler’s Diarrhea
A
ETEC- non bloody
20
Q
ETEC- non bloody
A
Travelers diarrhea
21
Q
What is EIEC
A
enteroinvasive E.coli
22
Q
What does EIEC cause
A
dysentery, direct penetration of intestinal mucosa
23
Q
Watery diarrhea and scant stool with pus, mucous and blood
A
EIEC
24
Q
What are the unique biochemical features of EIEC
A
lactose -
non-motile
25
What is EPEC
P for pediatrics
infantile diarrhea
enteropathogenic E. coli
26
Stool with large amounts of mucus but no blood
EPEC
27
What is EAEC
enteroaggregative E.coli
a for adherence
adheres to mucosal surface, D, V, dehydration
28
What organism is normally not much of a problem but really bad for AIDS patients
EAEC
29
What organism has slow reactions to biochemical testing
Edwardsiella tarda
30
How is Edwardsiella tarda transmitted
person to person
fish or water
31
liver absesses
Edwardsiella Tarda
32
What do all citrobacter species have in common
all can use citrate as sole carbon source
33
What special virulence factors do citrobacter have and what resistance does it give them
Ampc plasmids
make them carbopenamase
resistance to B lactase antibiotics
34
Citrobacter can be confused for ____ in stool because it is H2S ___ on HE and XLD
Samonella
positive
35
Organisms that is slowly urea positive
Citrobacter
36
Organism that is a late lactose fermenter
citrobacter
37
What are the 2 distinguishing tests for Klebsiella
indole negative, non motile
38
very mucoid on BA
Klebsiella
39
What does Klebsiella cause?
pneumonia mostly
also UTI, bacteremia, infections in wounds
40
Which Klebsiella species is an exception with the indole test?
Oxytoca- indole positive
41
Klebsiella sp that is mostly Urinary infections
K. oxytoca
42
Organism that was formally known as Calymmatobacterium granulomatis
K. granulomatis
43
Kleb species found in scrapings of skin lesions
K. granulomatis
44
What term can be used to describe K. granulomatis if intracellular in epithelial cells
Donovan body
45
What are the biochemical test results for K. granulomatis
Citrate +
ONPG +
46
What biochemical testing do enterobacter species have
citate, VP, ornithine +
47
What body sites are enterobacter species found in
wounds, urine, blood, CSF
48
What are the most commonly isolated enterobacter species
E. aerogenes
E. cloacae
49
Mostly hospital acquired infection
Enterobacter
50
What does Serratia look like on BA and MAC
red on both
51
What is the main pathogen in the Serratia group
maracescens- healthcare issue
52
What biochemicals do Serratia have
motile, slow lactose fermente
ONPG+
Dnase +
53
What body sites can Serratia be found in
Urinary tracts, respiratory tracts, wounds
54
Organism that can survive under harsh environmental conditions
Serratia
55
Organism that made the Mary statue look like she was crying
Serratia marcescens
56
What antibiotics are Serratia resistant to
ampicillin and 1st gen cephalosporins because of AmpC beta lactamase
57
What special media is used to ID Serratia and what does it look like on it
DNAse
enriched agar
breaks down DNA and creates a clearing zone
58
What does Serratia look like on MacConkey
clear on MAC, eventually will become pink
59
Organism that is swarming, like waves on a beach
Proteus
60
What are the biochemical tests for proteus species
non lactose fermenter
GNR, Phe deaminase +
61
What body sites are proteus species in
urine, wounds, ears, blood infection
62
What are the 2 main species of interest in proteus
P. vulgaris
P. mirabilis
63
Biochemicals for P. mirabilis
indole neg
ornithine pos
H2S pos
64
If an organism is black on XLD and HE it could also be
could also be proteus
65
organism that makes dogs paws smell like frito/ corn chip smell
proteus
66
Biochemicals P. vulgaris
indole pos
ornithine pos
H2S pos
67
Which species is not technically enterobacteriales anymore
Morganella morganii
68
Emerging pathogen, for skin, soft tissue, UTIs as an HAI
Morganella morganii
69
What biochemicals Morganella morganii
ornithine, lysine, phe deaminase pos
urease pos
non lactose
70
What antibiotic resistance do Morganella have
AmpC genes sometimes
71
Biochemicals for providencia
motile, non lactose
phe pos
Orni neg
72
organism that is phe pos but not swarming
providencia
73
What are the 2 main providencia species
stuartii and alcalifaciens
74
motile GNR that lives in freshwater environments and causes infection through ingestion or direst contact
Plesiomonas shigelloides
75
Biochemicals for Plesiomonas
oxidase pos
DNAse neg
lysine, ornithine arginine pos
76
uncooked seafood
plesiomonas shigelloides
77
zookeepers often get it
Plesiomonas shigelloides
78
What antibiotics can be given to more severe cases of Plesiomonas
SXT sulfamethoxaole trimethorpim
79
non lactose GNR safety pin appearance
Yersinia
80
What are the 3 most important Yersinia species in order of most to least important
Y. pestis
Y. enterocolitica
Y. pseudotubersulosis
81
Organism that caused the black plague
Yersinia pestis
82
How is Yersinia pestis transmitted
rat fleas
83
survives cold temps
survives pRBC manufacturing processes
mimics acute appendicitis
Yersinia enterocolitica
84
Motility of Yersinia enterocolitica?
motile at 25C
non motile at 35C
85
Red bulls eye in CIN
Yersinia enterocolitica
86
What organisms are never motile
Kleb and Shigella
87
What natural reservoir does Yersinia pseudotuberculosis
GI flora for rodents, birds and rabbits
abdominal pain
88
What organism is never normal to see in any body part
Salmonella
89
What salmonella species are in warm blooded animals whereas all of the rest are in cold blooded animals
enterica enterica
90
What subspecies are in Salmonella enterica enterica
typhi and paratyphi
91
What virulence factors do Salmonella species have
O antigen
K or Bi antigen that hides O antigen
92
What color on HE and XLD for Salmonella
XLD- black
HE- black
Selenite
93
What color is the XLD plate and HE
XLD- pink
HE- green
94
Organism that does vertical invasion
Organism that does horizontal invasion
vertical- Salmonella
horizontal- Shigella
95
Salmonella has needs to be in ___ quantities to cause illness
large quantities
96
Some strains of Salmonella can be extra virulent and gain access into the bloodstream and cause
Typhoid fever
97
high fever, headache, loss of appetite, bloody stool, occasional rach
Typhoid fever
98
GI symptoms 8 to 36 hrs after ingestion
Salmonella
99
Why can't we use antibiotics on Salmonella
causes a carrier state that is prolonged and causes relapse, could need gall bladder removed
100
What organism is never normal flora and does not have an animal reservior
Shigella
101
Organism that can be transmitted through reptiles
Salmonella enterica enterica
102
How is Shigella spread
spread person to person due to poor hygiene
103
Causes bacillary dysentery
shigella
104
What species has to be sent to the state lab for tracing
Shigella
105
What does Shigella look like on XLD and HE agar
clear
106
How can we distinguish Shigella from E. coli
lysine neg
107
What organisms are in the 4 Shigella O antigen groups
A, B, C, D
flexneri
boydii
dysenteriae
sonnei
A- dysenteriae
B- flexneri- boys flex
C- boydii Chef Boyardee
D-sonnei Sunny D
108
What Shigella species is the most common
sonnei- Group D
109
Shigella needs to be in ____ quantities
small, very contagious
110
___ rarely invades the bloodstream
Shigella
111
Fever and chills, bloody diarrhea, blood, mucus, pus in stool
in 2-4 days, self limiting
Shigellosis
112
bacteremia, meningitis, necrotizing colitis in neonates, mucoid on routine culture
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter
oddball chronobacter
113
Meant and dairy, not pathogenic
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter
Hafnia alvei
114
Yellow on BAP, neg for all sugars, trauma contaminated with soil
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter
Pantoea
115
Plant pathogen
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter
Erwinia
116
utilizes sorbose,
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter
Raautella
117
What to do if Enteric pathogen is delayed in growth
Cary-Blair transport medium
118
What are the requirements of all enterobacteriaceae
grown on routine media
24hrs at 35C in CO2 or ambient air
119
Routine stool cultures are orders to look for mostly
Salmonella and Shigella
120
Physicians can order additional tests if they suspect pathogens like
E. Coli O157:H7
campy
pleseomonas
yersinia
aeromonas
viruses or parasites
121
What organism could have a yellow halo around it on HE agar
Salmonella
must be isolated
122
What are the 3 antigens that can be found on Salmonella and what do they each do
O- somatic on cell wall, heat stable
H- flagellar on flagella, heat labile
K- capsular, heat labile in some species could be Vi
123
How can we test for the O antigen specifically on Salmonella
boil it to leave only the O antigen
124
What organisms need to be serogrouped and tested on WellColex
Salmonella and Shigella
125
What 3 organisms come to mind that are citrate and VP pos
What rules out one of them?
What else distinguishes the remaining 2
entero motile
Kleb non motile
Serratia slow/ NLF
126
How to distinguish 2 main Kleb species
indole negative: pneumonia
indole positive: oxytoca
127
What should come to mind when there are 2 positives in ornithine and arginine
E. cloacae arg and orni +
E. aerogenes lys and orni +
128
What should come to mind if Phe is pos, what helps further distinguish them?
proteus- H2S pos
morganella- ornithine pos
providencia- orni, lys and arg pos
129
How to distinguish 2 main proteus species
mirabilis- indole neg
vulgaris indole pos
130
Biochemicals of E. coli
indole pos
motile
beta
lactose fermenter
dark flat
lysine pos
H2S. citrate, lysine neg
131
How to distinguish Citrobacter from E. coli
indole, H2S, motile, citrate pos
lysine neg
Late lactose fermenter
132
IMViC for
E. coli
Kleb pneumo
Citrobacter freundii
enterobacter
proteus mirabilis
proteus vulgaris
serratia marcescens
E. coli ++--
proteus vulgaris ++--
Kleb Oxytoca +-++
enterobacter --++
serratia marcescens --++
Kleb pneumo--++
Citrobacter freundii-+-+
proteus mirabilis -+- or +-
133
Is it necessary to do antimicrobial susceptibility on enterobacteriales?
allways
134
What are ESBL
extended spectrum beta lactamases
can hydrolize penicillins and cephalosporins
possible in Kleb, E. coli and P mirabilis
135
Pink disk +
ESBL
136
What special media is used to grow ESBL
Chromagar ESBL
137
What are CRE
carbapenem resistant enterobacteriales
138
What organisms can be CRE
Kleb pneumoniae
139
neutralizes meropenem, imipenem, ertapenem, doripenem
CRE kleb
140
What antigen allows for CRE
AmpC
141
What organisms can be CRE
K aerogenes and E cloacae
E. coli, Kleb pneumoniae, P. mirabilis
142
• Which members of Enterobacterales are lactose fermenters?
E. coli
Citro
Klebs
Enterobacter
143
• Which members of Enterobacterales are lactose non-fermenters?
Edwardsiella
Providencia
Morganella
salmonella
Shigella
Yersinia
144
• Which members of Enterobacterales are motile?
all except Klebsiella and Shigella
145
• Which members of Enterobacterales are phenylalanine positive?
Proteus
Morganella
Providencia
146
• Which members of Enterobacterales are H2S positive?
proteus
Citrobacter
Salmonella
147
• Which members of Enterobacterales swarm on BAP
proteus
148
• Which members of Enterobacterales are oxidase +?
pleseomonas
149
• Which members of Enterobacterales are indole positive?
citro
P. vulgaris
E. coli
Enterobacter
Klebsiella oxytoca
