Gram Negative Bacteria Part 2 Flashcards
Types of Klebsiella
K. Pneumoniae/Friedlanders bacillus
K. Ozoenae
K. Rhinoscleromatis
K. Granulomatis
K. Pneumonia causes
Community acquired pneumonia, HAP, VAP
COPD (Superadded infection)
UTI (Catheter Associated)
Septicemia
K. Ozoenae is known to cause
Ozaenae or Atrophic Rhinitis
Foul smelly discharge
Merciful anosmia
K Rhinoscleromatis is known to cause
Rhinoscleroma
Gross and Microscopic Findings of Rhinoscleroma
Grossly - Hebra/woody nose
M/E - Mikulicz cells and Russell body
K. Granulomatis known to cause
AKA : Donovanosis
Painless Genital ulcers
Microscopic Findings of K. Granulomatis infection
Donovan bodies - Pund cells
Safety pin appearance
HVPK means
Hyperviscous Hypervirulent strain of K pneumoniae
Very virulent
CAP, Meningitis, Sepsis
Resistant to treatment
MacConkey agar finding for K pneumoniae
Lactose fermenter +
Pink + mucoid colony (String test +ve)
Klebsiella is Urease positive or negative
Positive
IMVIC test in case of K pneumoniae
–++
Urease positive organisms
PUNCH KISS
Proteus
Ureaplasma
Nocardia
Cryptococcus
Helicobacter
Kleibsiella
Staph Saprophyticus
Staph Epidermidis
Klebsiella mnemonic
KLEbsiELLA
Capsulated
Lactose fermenter
Enzyme urease +ve
Non motile
Treatment of K pneumoniae infections
Piperacillin + Tazobactam
For XDR strains - Only antibiotic useful is Colistin or Polymyxin (very expensive)
Serratia Marcescens used to transmitted by contaminated
Iv lines
Surgical instruments
Antiseptic solutions
Serratia Marcescens causes
Pneumonia (Pseudohemoptysis) - Red cough or sputum)
Contact lens keratitis (Pink hypopyon)
Meningitis
CVS Problems
Septicemia
Pigment seen in Serratia Marcescens
Non diffusible Red pigment at room temperature (Prodigiosin)
SeRRatia mnemonic
S - Swarming, surgical instruments
R - Red color pigment
R - Room temperature
Tribe Proteae includes
PPM
Proteus
Providencia
Morganella
Which Proteae Families are Urease positive
Proteus
Morganella
Which Proteae Families are PPA +ve
Phenyl pyuric acid testing
Proteus
Providencia
Morganella
Proteus features
Can take any shape (Pleomorphic bacteria)
Gram -ve bacilli
Non capsulated
Swarming motility
Swarming motility is seen in
PVCS
P - Proteus
V- Vibrio Parahemolyticus and Alginolyticus
C - C Tetani, B. Cereus
S - Serratia
Swarming can be inhibited by
Firm agar (5% agar)
Chemicals (boric acid and chloral hydrate)
MacConkey agar (bile salts +ve)
Epidemiological typing of Proteus shows which phenomenon
Diene’s phenomenon
In same strains - Swarming merge
In different strains - line of demarcation
Uses of Proteus
Non motile strains of Proteus (OX2, OX19 AND OXK) - used for Weil Felix test
Treatment of Proteus infection
Resistance ++
P. Mirabilis - Ampicillin, Cephalosporin sensitive
PrOteUS Mnemonic
PPA +ve, Diene’s Phenomenon
Odour - Fish
Urease +ve
Swarming
Morganella is known to cause
Food poisioning (Uncooked fish)
AKA - Scombroid food Poisioning
Tribe Erwinieae includes
Erwinieae herbicola - Yellow pigment, UTI
Yersinia includes
Yersinia pestis
Yersinia Enterocolitica
Yersinia Pseudotuberculosis
Which yersinia species belongs to Enterobacteriacea family
Y. Enterocolitica
Y. Pseudotuberculosis
Yersinia Shows which motility
Differential motility (motile at 22°C, non motile at 37°C) expect Y pestis - non-motile
Differential motility is shown by
Listeria
Yersinosis except Y pestis
Yersinosis causes which diseases
1)Self limiting gasteroenteritis
2)Mesenteric adenitis, Terminal ileitis(child) - mimics appendicitis (Pseudoappendicitis)
3)Adults - Systemic diseases
Culture findings for Yersinosis
MacConkey agar - Y. Enterocolitica can show Lactose fermentation
Differential motility
Cold enrichment is shown by
Yersinosis
Listeriosis
Yersinia pestis causes
Plague
Reservoir and vector of Plague
Reservoir - wild rodents
Vector - Rat flea
Life cycle of yersinia pestis
Flea gets infected from Rat - enters stomach - Multiplies(Replication) - come back and block proventriculus of flea - Regurgitates in blood meal
Virulence factors of Yersinia pestis
Protein envelope F1 antigen (Protein capsule)
V,W antigen
Toxin - Endotoxin Murine toxin
Cycles of Plague
Urban/domestic - Rodents and humans
Wild/Sylvatic - Wild rodents only
Types of Plague
Bubonic plague - painful Lymph node enlargement
Pneumonic Plague
Septicemic - Black death(DIC, Shock, multiple organ failure)
Microscopic Findings seen in Yersinia pestis infection
Safety pin appearance
Stain used for Yersinia pestis infection
Wayson stain(NMB stain) or Wright/Giemsa stain
Safety pin appearance can be seen in
Yersinia pestis
Vibrio Parahemolyticus
Burkholdiera Mallei and Pseudomallei
Hemophilus ducreyi
Klebsiella granulomatis
Culture finding of Y pestis on CIN Agar
Bull’s eye colonies
Culture finding of Y pestis on nutrient broth (Ghee broth)
Stalactite growth (hangs from surface)
Culture finding of Y pestis on blood/chocolate agar
Dark brown colonies
Yersinia pestis is Catalse and Oxidase
Catalase +ve
Oxidase -ve
Y. Pestis shows which fermentation
Glucose, Maltose and Mannitol
Acid +, Gas -
IMVIC Test result for Y pestis infection
-+–
Serological tests for Y pestis
Passive hemagglutination - antibodiy against F1
Vaccine used for Y. Pestis
Sokhey’s modification of Hoffkine vaccine
Recombinant F1V vaccine
Sokhey’s modification of Hoffkine vaccine
Given by s/c route
Formalin killed
Protects only against Bubonic plague
Protection for 6 months
Recombinant F1V vaccine is used for
Pre exposure prophylaxis
Treatment of Plague
Streptomycin
If CNS, lung, heart involvement - Fluoroquinolones
Which scheme is used to classify Salmonella
Kaufmann and white scheme
Antigens of Salmonella
O (Somatic)
H (Flagella)
Vi
Which antigen of Salmonella is more immunogenic
H antigen
O (Somatic antigen)
SomatiC
Slow reactions
Chalks granular clumps
H (Flagella) antigen
FLagella
Fast
Loose fluffy clumps
Vi Antigen
Envelops O antigen
Used for vaccination
Heat labile
O antigen in Salmonella species
Same for S. Typhi, Paratyphi A and Paratyphi B
H (Flagella) antigen in Salmonella species
Different In every species
Th (S. Typhi)
Ah (S. Paratyphi A)
Bh (S Paratyphi B)
If H antigen lost then
There will be loss of Flagella
If O Antigen is lost then
Smooth to rough variation - Loss of virulence
Salmonella typhi causes
Enteric fever or Typhoid fever
Mode of transmission of S. Typhi
Feco-oral route
Pathogenesis of S. Typhi
Enters intestine and binds to M cells - penetrates submucosa - Resist intracellular killing - mesenteric LN - via thoracic duct (1° bacteremia) - Organs - Again blood (2° bacteremia)
Types of Carriers of Salmonella
Shed bacilli in feces/urine
Convalescent Carrier (3 wk to 3 months)
Temporary Carrier ( 3 months to 1 year)
Chronic carrier (>1 year)
Clinical features of Typhoid or Enteric fever
SLeeP With FROSt
Step ladder pattern fever
Longitudinal ulcers (GIT)
Pea soup diarrhea
Fever with Bradycardia (Fagets sign)
Soft palpable spleen , liver
Rose spots (2nd-3rd wk) - fades on pressure
Wbc - relative lymphocytosis
Best Diagnostic tests for diagnosis of Typhoid fever on basis of weeks
BASU
wk 1 Blood culture
Wk 2 - Antibody (Widal test)
Wk 3 - Stool culture)
Wk 4 - urine culture
Blood culture for diagnosis of Typhoid fever
Bile broth or glucose broth can be used
Add SPS (Sodium Polyanethol sulfonate) to remove antibiotic effect
Medium used for blood culture in Typhoid fever
Castaneda medium
Biologically false Widal test can be seen in
Infectious mononucleosis
Malaria
SLE
Antibody titres against O and H Antigen in Widal test
O - >1:60
H - >1:180
Principle of Widal test
O antigen (same in all)
H antigen - ST, SPTa, SPTb
To Th Ah Bh
O-H-O-H
O - First appear
H - next appear
O - first disappear
H - last to disappear
To Positive in
S typhi
S Paratyphi A
S Paratyphi B
Early infection
Th Antigen positive in
S. Typhi
Late infection
Vaccine
Ah positive in
S Paratyphi A
Vaccine
Bh Positive in
Paratyphi B
Vaccine
New test for Typhoid fever
Typhidot
Dot blot test
Enrichment media and Selective media are same for Salmonella and Shigella except
Wilson and Blair media - best media for S. Typhi
Colonies produced on Wilson and Blair media
Jet black colonies
IMVIC test for Salmonella
-+-+
Vaccines against Typhoid fever
Live oral vaccine (Typhoral) - Ty21a
Vi vaccine (Typhim Vi) - Ty2 vaccine
Salmonella gastroenteritis is caused by
Non typhoidal salmonella
Most common cause of Salmonella gastroenteritis
S. Typhimurium > S. Enteritidis
Source and incubation period of Salmonella gastroenteritis
Source - Food (meat, milk)
Incubation period - <24 hrs
Clinical features of salmonella gastroenteritis
Fever
Vomiting
Invasive Diarrhea
Salmonella septicemia is caused by
S. Choleraesius
Motile organisms of Enterobacteriacea family
E Coli
Enterobacter
Citrobacter
Salmonella
Proteus
Yersinosis
Lactose and Non lactose fermenters of Enterobacteriacea family
Lactose fermenters - Ecoli, Klebsiella, Enterobacter, Citrobacter
Non lactose fermenters - Shigella, Salmonella, Proteus, Yersinia