Gram negative bacteria Flashcards
What differentiates Shigella from E. coli and salmonella?
Shigella is non-motile, the rest are motile
What differentiates E. coli from Shigella and Salmonella and describe what the appearance of colonies on MacConkey agar would be
E. coli ferments lactose (lac+) so is red on MacConkey-lactose agar and the rest form yellow colonies
What are the three types of cell surface antigens of G- bacteria?
K, H, O antigen
What is K antigen?
the capsule of the bacteria
What is H antigen?
flagella
What is O antigen?
LPS
Does shigella have flagella?
No
What system do shigella, salmonella and E. coli all affect?
GIT
Give the principal infections caused by E. coli
wound infections UTIs gastroenteritis traveller's diarrhoea bacteraemia meningitis in infants
Why are some strains of E.coli pathogenic, even though E.coli is a commensal?
Pathogenicity islands - acquisition of genes (by lateral and horizontal transmission) from other pathogens or other organisms which confer and advantage and are maintained
How does heat labile toxin cause ETEC (traveller’s diarrhoea)
- E.coli adheres
- produces toxin
- toxin taken up by epithelial cell
- toxin modifies the G protein by adding ADP ribose group
- This locks the G protein into an active form that is on all the time
- stimulates adenylate cyclase continuously
- cAMP levels increase and protein kinase phosphorylates CFTR
- CFTR pumps chlorine into the gut lumen and Na and h20 follows
How does heat stable toxin lead to ETEC?
- ST binds to guanylyl cyclase on epithelial cell as mimics guanylyl
- results in formation of cGMP
- protein kinase activated and phosphorylates CFTR and causes Cl- to enter lumen of gut
- water and Na follow
How do EHEC and EPEC cause pathogenicity?
overall attachment and effacement
1. bundle forming pilli adhere to villi on epithelial cells
2. type 3 secretion system is switched on which injects toxins into the epithelial cell
3. rearrangement of actin filaments = effacement of microvilli
actin reorganised into a pedestal
How is Shigella related to E..coli?
Shigella = E.coli + virulence plasmid
What are the features/signs of shigellosis?
e.g. dystentery severe bloody diarrhoea frequent passage of stools pus, blood prostrating cramps, pain in straining fever self-limiting
How is shigella transmitted?
person-person
faeco-oral
contaminated water and food
Which cells in the colon sample antigens?
colonic M cells (overlay lymphoid follicles)
How does shigella damage the colonic mucosa?
- neutrophils - release mediators that cause damage and their migration through the mucosa damages cells too
- M cells transcytose antigens for macrophages to sample them. the macrophages apoptose so releases cytokines that damage the epithelium
- shigella can move laterally through the epithelium
How does the Shiga toxin work?
cleaves a bond in rRNA
so protein synthesis doesn’t work
eventually all ribosomes will be inactive
What is the main Salmonella sp that causes infection in humans?
S. enterica
Which serovars of Salmonella enterica cause gastroenteritis?
serovar Enteritidis
serovar Typhimurium
Which serovars of Salmonella cause enteric fever (typhoid)?
serovar Typhi
serovar Paratyphi
Describe the pathogenesis of Salmonellosis
- ingestion of contained food/water
- invasion of s. intestine epithelium
- transcytosed to basolateral membrane
- enters submucosal macrophages
- survival and replication in intracellular macrophages
- dissemination of macrophages –> systemic [ONLY in typhoid not gastroenteritis]
gastroenteritis also involves chemokine release that causes neutrophils to migrate and cause injury
Which damages the gut mucosa more initially - gastroenteritis or typhoid?
gastroenteritis
describe how enteric fever spreads around the body
- dissemination of macrophages
- enter lymph nodes
- enter blood through throacic duct (transient/primary bacteraemia)
- enter liver, spleen, bone marrow and multiply here
- secondary bacteraemia –> i.e. septicaemia causing fever and kidney infection
- reenters s.intestine from liver through the bile in gall bladder
What infection does Proteus mirabilis cause?
opportunistic UTIs
leads to pyelonephritis (kidney infection) and septicaemia
What is the virulence factor of Proteus mirabilis and what does this cause?
urease - causes kidney stones
What infections does Klebsiella pneumoniae cause?
opportunistic nosocomial infection: pneumonia wound/surgical infection meningitis very common in hospital ICU
How is Vibrio cholerae transmitted?
faecal-oral
e.g. faecal contaminated water or food
shellfish
the bacterium itself is found in water, but can also contaminate food
What is a key treatment in Vibrio cholerae?
ORS
What are the two virulence factors of V. cholerae
- TCP (toxin-coregulated pili) - colonisation
- cholera toxin - adds ADP ribose to to G protein, so its locked in the on state
uncontrolled cAMP production
protein kinases are activated that phosphorylate CFTR - loss of Cl- ions
i.e. like heat labile LT
Pseudomonas aeruguinosa is an opportunistic infection. T or F
T
Give examples of situations where Pseudomonas causes acute infections
- surgical wounds/ burns
- UTIs from catheters
- keratitis from contacts
- bacteraemia in neutropenic pts due to leukaemia, chemo, AIDS
- nosocomial pneumonia in ICU pts
Give 2 pt groups that are susceptible to chronic infection with Pseudomonas a.
CF
brochiectasis
What percentage of the population carrier H. inluenzae in their nasopharynx?
25-80%
Give examples of infections caused by H. influenzae
infant meningitis epiglotitis sinusitis otitis media bacteraemia CF and COPD lung infections
Who are most vulnerable to infection by H. influenzae?
young children and adult smokers
Which agar can H. influenza not grow on and so which agar has to be used?
cannot grow on blood agar so grown on chocolate agar
so fastidious