Exam 5 Flashcards

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

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2
Q

All Enterobacteriales are motile except for

A

Klebsiella and Shigella

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3
Q

All enterobacteriales are oxidase negative except for

A

Pleseomonas

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4
Q

What diseases do Salmonella and Shigella cause

A

typhoid fever and dysentery

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5
Q

What pathogens in enterobacterials are in stool?

A

E. coli
P. shigelloides
Salmonella sp
Shigella sp

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6
Q

What pathogens of enterbacteriales are in blood, wounds or respiratory

A

Y. pestis
Y. enterocolitica
Y. pseudotuberculosis

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7
Q

Which organism is the most common cause of a UTI and kidney infections

A

E.coli

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8
Q

What virulence factors can E. coli have

A

capsular antigen K1
adheres to epethelial cells
O antigen can cross react with Shigella

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9
Q

What hemolysis and MAC results do E. coli give

A

Beta mostly
sometimes gamma
lactose fermenter- pink on MAC

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10
Q

What does E. coli look like on EMB agar? and XLD?

A

EMB- shiny green
yellow- XLD

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11
Q

Bloody watery diarrhea

A

E. coli O157:H7

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12
Q

E. coli has a ___ infectious dose required for infection

A

low

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13
Q

What genes did E.coli give to Shigella, which Shigella?

A

Stx1 and Stx2 created shiga toxin

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14
Q

What other symptoms can E. coli O157:H7 cause

A

HUS hemolytic uremic syndrome
low plts, hemolytic anemia and kidney failure

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15
Q

What other name does E. coli O157:H7 have

A

enterohemorrhagic E. coli
EHEC

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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

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17
Q

What is ETEC

A

enterotoxigenic E. coli

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18
Q

What virulence factors do ETEC have

A

toxins
heat stabile toxin (ST)
heat labile toxin (LT)

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19
Q

Traveler’s Diarrhea

A

ETEC- non bloody

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20
Q

ETEC- non bloody

A

Travelers diarrhea

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21
Q

What is EIEC

A

enteroinvasive E.coli

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22
Q

What does EIEC cause

A

dysentery, direct penetration of intestinal mucosa

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23
Q

Watery diarrhea and scant stool with pus, mucous and blood

A

EIEC

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24
Q

What are the unique biochemical features of EIEC

A

lactose -
non-motile

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25
Q

What is EPEC

A

P for pediatrics
infantile diarrhea
enteropathogenic E. coli

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26
Q

Stool with large amounts of mucus but no blood

A

EPEC

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27
Q

What is EAEC

A

enteroaggregative E.coli
a for adherence
adheres to mucosal surface, D, V, dehydration

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28
Q

What organism is normally not much of a problem but really bad for AIDS patients

A

EAEC

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29
Q

What organism has slow reactions to biochemical testing

A

Edwardsiella tarda

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30
Q

How is Edwardsiella tarda transmitted

A

person to person
fish or water

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31
Q

liver absesses

A

Edwardsiella Tarda

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32
Q

What do all citrobacter species have in common

A

all can use citrate as sole carbon source

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33
Q

What special virulence factors do citrobacter have and what resistance does it give them

A

Ampc plasmids
make them carbopenamase
resistance to B lactase antibiotics

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34
Q

Citrobacter can be confused for ____ in stool because it is H2S ___ on HE and XLD

A

Samonella
positive

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35
Q

Organisms that is slowly urea positive

A

Citrobacter

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36
Q

Organism that is a late lactose fermenter

A

citrobacter

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37
Q

What are the 2 distinguishing tests for Klebsiella

A

indole negative, non motile

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38
Q

very mucoid on BA

A

Klebsiella

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39
Q

What does Klebsiella cause?

A

pneumonia mostly
also UTI, bacteremia, infections in wounds

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40
Q

Which Klebsiella species is an exception with the indole test?

A

Oxytoca- indole positive

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41
Q

Klebsiella sp that is mostly Urinary infections

A

K. oxytoca

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42
Q

Organism that was formally known as Calymmatobacterium granulomatis

A

K. granulomatis

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43
Q

Kleb species found in scrapings of skin lesions

A

K. granulomatis

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44
Q

What term can be used to describe K. granulomatis if intracellular in epithelial cells

A

Donovan body

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45
Q

What are the biochemical test results for K. granulomatis

A

Citrate +
ONPG +

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46
Q

What biochemical testing do enterobacter species have

A

citate, VP, ornithine +

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47
Q

What body sites are enterobacter species found in

A

wounds, urine, blood, CSF

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48
Q

What are the most commonly isolated enterobacter species

A

E. aerogenes
E. cloacae

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49
Q

Mostly hospital acquired infection

A

Enterobacter

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50
Q

What does Serratia look like on BA and MAC

A

red on both

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51
Q

What is the main pathogen in the Serratia group

A

maracescens- healthcare issue

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52
Q

What biochemicals do Serratia have

A

motile, slow lactose fermente
ONPG+
Dnase +

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53
Q

What body sites can Serratia be found in

A

Urinary tracts, respiratory tracts, wounds

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54
Q

Organism that can survive under harsh environmental conditions

A

Serratia

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55
Q

Organism that made the Mary statue look like she was crying

A

Serratia marcescens

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56
Q

What antibiotics are Serratia resistant to

A

ampicillin and 1st gen cephalosporins because of AmpC beta lactamase

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57
Q

What special media is used to ID Serratia and what does it look like on it

A

DNAse
enriched agar
breaks down DNA and creates a clearing zone

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58
Q

What does Serratia look like on MacConkey

A

clear on MAC, eventually will become pink

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59
Q

Organism that is swarming, like waves on a beach

A

Proteus

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60
Q

What are the biochemical tests for proteus species

A

non lactose fermenter
GNR, Phe deaminase +

61
Q

What body sites are proteus species in

A

urine, wounds, ears, blood infection

62
Q

What are the 2 main species of interest in proteus

A

P. vulgaris
P. mirabilis

63
Q

Biochemicals for P. mirabilis

A

indole neg
ornithine pos
H2S pos

64
Q

If an organism is black on XLD and HE it could also be

A

could also be proteus

65
Q

organism that makes dogs paws smell like frito/ corn chip smell

A

proteus

66
Q

Biochemicals P. vulgaris

A

indole pos
ornithine pos
H2S pos

67
Q

Which species is not technically enterobacteriales anymore

A

Morganella morganii

68
Q

Emerging pathogen, for skin, soft tissue, UTIs as an HAI

A

Morganella morganii

69
Q

What biochemicals Morganella morganii

A

ornithine, lysine, phe deaminase pos
urease pos
non lactose

70
Q

What antibiotic resistance do Morganella have

A

AmpC genes sometimes

71
Q

Biochemicals for providencia

A

motile, non lactose
phe pos
Orni neg

72
Q

organism that is phe pos but not swarming

A

providencia

73
Q

What are the 2 main providencia species

A

stuartii and alcalifaciens

74
Q

motile GNR that lives in freshwater environments and causes infection through ingestion or direst contact

A

Plesiomonas shigelloides

75
Q

Biochemicals for Plesiomonas

A

oxidase pos

DNAse neg
lysine, ornithine arginine pos

76
Q

uncooked seafood

A

plesiomonas shigelloides

77
Q

zookeepers often get it

A

Plesiomonas shigelloides

78
Q

What antibiotics can be given to more severe cases of Plesiomonas

A

SXT sulfamethoxaole trimethorpim

79
Q

non lactose GNR safety pin appearance

A

Yersinia

80
Q

What are the 3 most important Yersinia species in order of most to least important

A

Y. pestis
Y. enterocolitica
Y. pseudotubersulosis

81
Q

Organism that caused the black plague

A

Yersinia pestis

82
Q

How is Yersinia pestis transmitted

A

rat fleas

83
Q

survives cold temps
survives pRBC manufacturing processes
mimics acute appendicitis

A

Yersinia enterocolitica

84
Q

Motility of Yersinia enterocolitica?

A

motile at 25C
non motile at 35C

85
Q

Red bulls eye in CIN

A

Yersinia enterocolitica

86
Q

What organisms are never motile

A

Kleb and Shigella

87
Q

What natural reservoir does Yersinia pseudotuberculosis

A

GI flora for rodents, birds and rabbits
abdominal pain

88
Q

What organism is never normal to see in any body part

A

Salmonella

89
Q

What salmonella species are in warm blooded animals whereas all of the rest are in cold blooded animals

A

enterica enterica

90
Q

What subspecies are in Salmonella enterica enterica

A

typhi and paratyphi

91
Q

What virulence factors do Salmonella species have

A

O antigen
K or Bi antigen that hides O antigen

92
Q

What color on HE and XLD for Salmonella

A

XLD- black
HE- black
Selenite

93
Q

What color is the XLD plate and HE

A

XLD- pink
HE- green

94
Q

Organism that does vertical invasion
Organism that does horizontal invasion

A

vertical- Salmonella
horizontal- Shigella

95
Q

Salmonella has needs to be in ___ quantities to cause illness

A

large quantities

96
Q

Some strains of Salmonella can be extra virulent and gain access into the bloodstream and cause

A

Typhoid fever

97
Q

high fever, headache, loss of appetite, bloody stool, occasional rach

A

Typhoid fever

98
Q

GI symptoms 8 to 36 hrs after ingestion

A

Salmonella

99
Q

Why can’t we use antibiotics on Salmonella

A

causes a carrier state that is prolonged and causes relapse, could need gall bladder removed

100
Q

What organism is never normal flora and does not have an animal reservior

A

Shigella

101
Q

Organism that can be transmitted through reptiles

A

Salmonella enterica enterica

102
Q

How is Shigella spread

A

spread person to person due to poor hygiene

103
Q

Causes bacillary dysentery

A

shigella

104
Q

What species has to be sent to the state lab for tracing

A

Shigella

105
Q

What does Shigella look like on XLD and HE agar

A

clear

106
Q

How can we distinguish Shigella from E. coli

A

lysine neg

107
Q

What organisms are in the 4 Shigella O antigen groups
A, B, C, D

flexneri
boydii
dysenteriae
sonnei

A

A- dysenteriae
B- flexneri- boys flex
C- boydii Chef Boyardee
D-sonnei Sunny D

108
Q

What Shigella species is the most common

A

sonnei- Group D

109
Q

Shigella needs to be in ____ quantities

A

small, very contagious

110
Q

___ rarely invades the bloodstream

A

Shigella

111
Q

Fever and chills, bloody diarrhea, blood, mucus, pus in stool
in 2-4 days, self limiting

A

Shigellosis

112
Q

bacteremia, meningitis, necrotizing colitis in neonates, mucoid on routine culture

Raoutella, Erwinia, Pantoea, Hafnia, chronobacter

A

oddball chronobacter

113
Q

Meant and dairy, not pathogenic

Raoutella, Erwinia, Pantoea, Hafnia, chronobacter

A

Hafnia alvei

114
Q

Yellow on BAP, neg for all sugars, trauma contaminated with soil

Raoutella, Erwinia, Pantoea, Hafnia, chronobacter

A

Pantoea

115
Q

Plant pathogen
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter

A

Erwinia

116
Q

utilizes sorbose,
Raoutella, Erwinia, Pantoea, Hafnia, chronobacter

A

Raautella

117
Q

What to do if Enteric pathogen is delayed in growth

A

Cary-Blair transport medium

118
Q

What are the requirements of all enterobacteriaceae

A

grown on routine media
24hrs at 35C in CO2 or ambient air

119
Q

Routine stool cultures are orders to look for mostly

A

Salmonella and Shigella

120
Q

Physicians can order additional tests if they suspect pathogens like

A

E. Coli O157:H7
campy
pleseomonas
yersinia
aeromonas
viruses or parasites

121
Q

What organism could have a yellow halo around it on HE agar

A

Salmonella
must be isolated

122
Q

What are the 3 antigens that can be found on Salmonella and what do they each do

A

O- somatic on cell wall, heat stable
H- flagellar on flagella, heat labile
K- capsular, heat labile in some species could be Vi

123
Q

How can we test for the O antigen specifically on Salmonella

A

boil it to leave only the O antigen

124
Q

What organisms need to be serogrouped and tested on WellColex

A

Salmonella and Shigella

125
Q

What 3 organisms come to mind that are citrate and VP pos
What rules out one of them?
What else distinguishes the remaining 2

A

entero motile
Kleb non motile
Serratia slow/ NLF

126
Q

How to distinguish 2 main Kleb species

A

indole negative: pneumonia
indole positive: oxytoca

127
Q

What should come to mind when there are 2 positives in ornithine and arginine

A

E. cloacae arg and orni +
E. aerogenes lys and orni +

128
Q

What should come to mind if Phe is pos, what helps further distinguish them?

A

proteus- H2S pos

morganella- ornithine pos
providencia- orni, lys and arg pos

129
Q

How to distinguish 2 main proteus species

A

mirabilis- indole neg
vulgaris indole pos

130
Q

Biochemicals of E. coli

A

indole pos
motile
beta
lactose fermenter
dark flat
lysine pos
H2S. citrate, lysine neg

131
Q

How to distinguish Citrobacter from E. coli

A

indole, H2S, motile, citrate pos
lysine neg
Late lactose fermenter

132
Q

IMViC for
E. coli
Kleb pneumo
Citrobacter freundii
enterobacter
proteus mirabilis
proteus vulgaris
serratia marcescens

A

E. coli ++–
proteus vulgaris ++–

Kleb Oxytoca +-++

enterobacter –++
serratia marcescens –++
Kleb pneumo–++

Citrobacter freundii-+-+

proteus mirabilis -+- or +-

133
Q

Is it necessary to do antimicrobial susceptibility on enterobacteriales?

A

allways

134
Q

What are ESBL

A

extended spectrum beta lactamases
can hydrolize penicillins and cephalosporins
possible in Kleb, E. coli and P mirabilis

135
Q

Pink disk +

A

ESBL

136
Q

What special media is used to grow ESBL

A

Chromagar ESBL

137
Q

What are CRE

A

carbapenem resistant enterobacteriales

138
Q

What organisms can be CRE

A

Kleb pneumoniae

139
Q

neutralizes meropenem, imipenem, ertapenem, doripenem

A

CRE kleb

140
Q

What antigen allows for CRE

A

AmpC

141
Q

What organisms can be CRE

A

K aerogenes and E cloacae
E. coli, Kleb pneumoniae, P. mirabilis

142
Q

• Which members of Enterobacterales are lactose fermenters?

A

E. coli
Citro
Klebs
Enterobacter

143
Q

• Which members of Enterobacterales are lactose non-fermenters?

A

Edwardsiella
Providencia
Morganella
salmonella
Shigella
Yersinia

144
Q

• Which members of Enterobacterales are motile?

A

all except Klebsiella and Shigella

145
Q

• Which members of Enterobacterales are phenylalanine positive?

A

Proteus
Morganella
Providencia

146
Q

• Which members of Enterobacterales are H2S positive?

A

proteus
Citrobacter
Salmonella

147
Q

• Which members of Enterobacterales swarm on BAP

A

proteus

148
Q

• Which members of Enterobacterales are oxidase +?

A

pleseomonas

149
Q

• Which members of Enterobacterales are indole positive?

A

citro
P. vulgaris
E. coli
Enterobacter
Klebsiella oxytoca