L26 The Enterobacteriaceae II Flashcards
What are the 4 important species of Shigella and what serogroup do they belong to?
- Shigella dysenteriae (A)
- Shigella flexneri (B)
- Shigella boydii (C)
- Shigella sonnei (D)
Which species of Shigella accounts for 70% of U.S. isolates?
Shigella sonnei
How is Shigella similar to E. coli? How is it different?
Similar biochemically, antigenically, and genetically
Unlike E. coli, it is non-lactose fermenting, non-gas producing, and non-motile
What is the primary reservoir of Shigella?
Human intestines
___ cases of Shigella are reported annually in the US.
500,000
How is Shigella transmitted?
Person to person via the fecal oral route
Shigella can be found in what 6 locations?
Water, food, flies, fingers, fomites, feces
Which populations are at highest risk for Shigella?
Young children in day care centers/nurseries, siblings and parents of these children, MSM
What is the major clinical syndrome associated with Shigella?
Bacillary dysentery
What are the symptoms of bacillary dysentery?
Abdominal cramps, tenesmus, pus, blood, and leukocytes present in the stool
Which tissues do Shigella invade through in bacillary dysentery?
Epithelial cells and submucosa
What is the incubation period and the length of disease for bacillary dysentery?
Incubation: 1-3 days; length: 48 hours
True or false - bacillary dysentery is the most communicable of bacterial diarrheas.
True
What is the concentration of Shigella in the stool when a person has bacillary dysentery?
10^3-10^4 CFU/gram
Describe the pathogenesis of Shigella.
Virulent strains carry a plasmid for attachment and entry. They enter cells via a phagocytic vacuole. The organism escapes into the cytoplasm and replicates intracellularly. Organisms enter adjacent cells.
What drives Shigella through the cytoplasm?
An actin tail
S. dysenteriae strains produce ___ exotoxin.
Shiga toxin
Compare the toxins produced by E. coli in STEC and the toxin produced by S. dysenteriae.
Stx1 is identical
Stx2 is 60% homologous
How does Shiga toxin function?
Disrupts protein synthesis in the cell and leads to epithelial cell damage
Where is Edwardsiella tarda found?
Cold blooded vertebrates, fresh water, catfish
What are the clinical manifestations of Edwardsiella tarda?
- Gastroenteritis
2. Septicemia (rare)
What types of gastrointestinal disease does Edwardsiella cause?
- Acute, self-limiting gastroenteritis with water diarrhea
- Typhoid-like illness with bloody diarrhea and possible fever, nausea, vomiting, colonic ulcerations and terminal ileum nodularity
Edwardsiella tarda is sometimes mistaken for which diseases?
Salmonellosis and IBD (Chron’s disease)
What is the important species of Salmonella?
Salmonella enterica
All serotypes of Salmonella enterica are considered single species except S. bongori. Which of these are listed as separate species?
- S. typhi/paratyphi
- S. typhimurium
- S. enteritidis
What is the habitat for salmonella?
Lower animals for non-typhoid strains, humans for S. typhi (gall bladder)
What are the major characteristics of Salmonella?
Non-lactose fermenter, produces hydrogen sulfide (black)
How is Salmonella transmitted?
Improper food handling, secondarily from person-to-person
True or false - Salmonella requires a high inoculum for disease.
True, except for S. typhi
An estimated ___ cases of non-typhoidal salmonellosis occur in the U.S. annually, with ___ hospitalizations and ___ deaths.
1.4 million; 16,000; 600
___ cases of S. typhi are reported in the U.S. each year and are associated with ___.
500; travel (27 million cases and 200,000 deaths worldwide)
About half of salmonella epidemics are the result of contaminated ___. They are also associated with ___.
Poultry/poultry products; reptiles
What are the clinical syndromes associated with Salmonella?
- Asymptomatic carrier states
- Febrile gastroenteritis
- Septicemia without major GI inolvement
- Enteric fever
The carrier state of Salmonella is limited with which types and is chronic with which types?
Limited - non-S. typhi
Chronic - S. typhi
What is the most common presentation when infected with Salmonella?
Febrile gastroenteritis (found in 2/3 of patients with culture confirmed)