GRAM NEGATIVE RODS - GIT AND GUT Flashcards
lactose fermenter
GREEN sheen
Escherichia coli
lactose fermenter
UREASE (+)
ESBL
Klebsiella pneumoniae
comma-shaped
motile
OXIDASE (+)
Vibrio cholerae
comma-shaped
microaerophilic
SKIRROW’S AGAR
Campylobacter jejuni
comma-shaped
UREASE (+)
Helicobacter pylori
LACTOSE FERMENTERS
KEEC
Klebsiella
Escherichia coli
Enterobacter
Citrobacter
WATERY DIARRHEA
MONTEZUMA’s REVENGE
TRAVELLER’s DIARRHEA
EnteroToxigenic E. coli ( ETEC)
heat labile - inc cAMP
heat stable - inc cGMP
bloody diarrhea, mucus, fever
INVASIVE - hemorrhagic diarrhea but WITHOUT HUS
EnteroInvasive E. colo (EIEC)
rare
enterotoxin
hemorrhagic colitis hemolytic uremic syndrome (HUS) *microangiopathic hemolysis *uremia *thrombocytopenia
children, elderly
EnteroHemorrhagic E. coli (EHEC)/Shiga like toxin (STEC)
O157.H7
shiga like toxin/verotoxins
*(-) mammalian protein synthesis via 60s ribosomal subunit
transmitted via UNDERCOOKED MEAT (burgers etc.)
watery diarrhea of long duration
INFANTS
DEVELOPING COUNTRIES
EnteroPathogenic E. coli (EPEC)
pediatric, poverty, Pinas
persistent watery diarrhea in children and patients infected w/ HIV
EnteroAdherent E. coli (EAEC)
AIDS
MCC of community acquired UTI
2nd MCC of neonatal meningitis
Escherichia coli
For attachment, colonization factor, associated w/ UTI
E. coli
PILI OR FIMBRIAE
Associated w/ PNEUMONIA and NEONATAL meningitis
capsule (K)
27/M develops severe abdominal cramping and bloody diarrhea. Patient reports consuming rare hamburger days prior to the onset of the symptoms.
This best describes the toxin-mediated mechanism of this disease process
(-) of 60s ribosomal subunit – decreased protein synthesis in GI mucosal cells
2nd MCC of gram (-) sepsis
PINK MUCOID COLONIES
Friedlander’s pneumonia
- fever, cough (productive), dyspnea
- thick and bloody sputum - CURRANT JELLY SPUTUM
Klebsiella pneumoniae
ALCOHOLICS
BULGING FISSURE SIGN
Vibrio cholera is cultured on
Thiosulfate Citrate Bile Salts (TCBS) agar
SHOOTING STAR MOTILITY
Vibrio cholerae
water,food
GASTROENTERITIS
Vibrio parahaemolyticus
shellfish, seawater
gastroenteritis, wound infection, bacteremia
V. vulnificus
shellfish, seawater
bacteremia, wound infection, cellulitis
Pathogenesis (Cholera)
ENTEROTOXIN (CHOLERAGEN)
- increased ADP ribosylation
- increased adenylate cyclase activity
- increased cAMP
- loss of water and electrolytes
MC presentation of cholera
ASYMPTOMATIC
Watery diarrhea in large volumes (RICE WATER STOOLS)
sunken eyes, dry mouth, cold clammy skin, decreased skin turgor or wrinkled hands and feet (washerwoman hands)
Cholera
COMPLICATIONS
- cardiac and renal failure
- non gap acidosis
- hypokalemia
Associated w/ H. pylori
gastritis
GASTRIC CANCER
gastric/duodenal ulcers
Pathogenesis of H. pylori
damages GOBLET CELLS of the gastric mucosa
production of large amt of AMMONIA from urea by organisms urease
Management of H. pylori
Amoxicillin Clarithromycin Metronidazole Tetracycline Bismuth compounds
MCC of duodenal ulcers and chronic gastritis
2nd leading cause of gastric ulcer
Helicobacter pylori
ASSOCIATIONS:
gastric carcinoma
MALT lymphoma
Types of PUD
TYPE I - body or antrum
TYPE 2 - antrum and duodenum
TYPE 3 - prepyloric
TYPE 4 - cardia
TYPE 5 - associated w/ NSAIDS; anywhere
MCC of bacterial gastroenteritis
Causes REACTIVE ARTHRITIS - can’t pee, cant’see, can’t climb a tree
Causes ASCENDING PARALYSIS and GUILLAIN BARRE
Campylobacter jejuni
undercooked chicken and meat
Antigenic cross-reactivity b/w oligosaccharides in bacterial capsule and glycosphingolipids on surface of neural tissues
Guillain Barre syndrome
5 As pf Klebsiella
Aspiration pneumonia Abscess in lungs and liver Alcoholics DiAbetics CurrAnt jelly sputum
20 y/o college student
(+) dysuria, frequency and urgency
sexually active
urinalysis: polymorphonuclear cells
E. coli
55 y/o homeless man
(+) alcoholism
severe multilobar pneumonia
Gram stain : numerous PMN leukocytes and gram (-) w/ capsule
lactose fermenter
very mucoid
non motile lysine decarboxylase (+)
Klebsiella pneumoniae
HIV positive man
developed acute watery diarrhea and abdominal pain w/o fever
3 days later – persistent of symptoms
(+) weight loss
A. enteroinvasive E. coli B. Salmonella typhi C. enteropathogenic E. coli D. Shigella flexneri E. Enteroaggregative E. coli
E. Enteroaggregative E. coli
Heat Labile toxin of ETEC acts by
activation of adenyl cyclase