Lesson 11 Flashcards
All ferment glucose
ENTEROBACTERICEAE
WHAT ARE THE TWO CATEGORIES OF MEMBERS OF FAMILY
ENTEROBACTERIACEAE?
- OPPORTUNISTIC PATHOGENS
- PRIMARY INTESTINAL PATHOGENS
WHAT ARE THE OPPORTUNISTIC PATHOGENS OF FAMILY ENTEROBACTERIACEAE?
Citrobacter
Enterobacter
Edwardsiella
Hafnia
Klebsiella
Proteus
Providencia
Serratia
Morganella
Ewingella
Plesiomonas
Often part of the normal intestinal flora
May produce serious extraintestinal opportunistic
infections
OPPORTUNISTIC PATHOGENS
WHAT ARE THE PRIMARY INTESTINAL PATHOGENS OF THE FAMILY ENTEROBACTERIACEAE?
Salmonella
Shigella
Yersinia
True pathogens / Overt pathogens
Not part of the normal intestinal flora
PRIMARY INTESTINAL PATHOGENS
It is a normal bowel inhabitant but its pathogenic
classification is somewhere between overt pathogens and
opportunistic pathogens
Escherichia coli
ENTEROBACTERICEAE: VIRULENCE AND ANTIGENIC
FACTORS
o Ability to colonize, adhere and invade tissues
o Production of toxins
o Presence of plasmids that mediate resistance to
antimicrobials
What are the antigens used for identifying different serological
groups of ENTEROBACTERICEAE?
- Somatic Antigen (O Ag)
- Flagellar Antigen (H Ag)
- Capsular Antigen (K Ag)
What type of atigen is located in the cell wall
and heat stable?
Somatic Antigen (O Ag)
This type of antigen is Heat labile
only
Flagellar Antigen (H Ag)
This type of Antigen is heat labile, Capsule K1 Antigen of E. coli
and Vi Antigen of Salmonella typhi
Capsular Antigen (K Ag)
This type of agar can be used
when suspecting enteric pathogens, it is preferred to use selective and differential media
Chocolate Agar Plate (CAP) or Blood Agar Plate (BAP)
On BAP, colonies may be haemolytic. It is usually what type of hemolytic?
β or non haemolytic
WHAT ARE THE SELECTIVE AND DIFFERENTIAL MEDIA FOR ISOLATION OF
ENTEROBACTERIACEAE?
- MCA
o Mac Conkey Agar - EMB
o Eosin Methylene Blue Agar - XLD
o Xylose Lysine Desoxycholate Agar - SSA
o Salmonella-Shigella Agar - HEA
o Hektoen-Enteric Agar - Sel-F Broth
° Selenite F Broth
WHAT ARE THE BIOCHEMICAL TESTS OF ENTEROBACTERICEAE?
▪ TSI / KIA
▪ Indole
▪ Citrate Utilization
▪ Urease Production
▪ Motility Test
▪ Decarboxylase Test
▪ ONPG
▪ LIA
▪ MR-VP Test
▪ PAD
▪ Nitrate Reduction Test
o Inhabitants of the intestinal tract
o Most ferment lactose
o Colonies on MCA resembles those of E. coli
GENUS CITROBACTER
GIVE ME THE GENUS AND SPECIES OF THE CITROBACTER
Citrobacter freundii
Citrobacter diversus
Citrobacter amaloniticus
Citrobacter koseri
Citrobacter braakii
What are the associated with infectious diseases acquired in hospital settings of Citrobacter freundii?
➢ UTI
➢ Pneumonia
➢ Intraabdominal abscess
➢ Endocarditis
➢ Septicemia
➢ Meningitis
➢ Brain abscess and neurologic complications
Colonial morphology may be easily mistaken for that of Salmonella
May harbor inducible AmpC genes that encode
resistance to ampicillin and first generation
cephalosporins
Citrobacter freundii
Causes nursery outbreaks of neonatal meningitis and
brain abscess
Citrobacter diversus
Frequently found in feces (not a causative agent of
diarrhea)
and Have been isolated from blood and wound
Citrobacter amalonaticus
Formerly Aerobacter
Frequently associated with health-care associated
infections
May harbour plasmids that encode multiple antibiotic
resistance genes
GENUS ENTEROBACTER
A /A
Lysine (-)
Ornithine (+)
Motility (+)
IMVC: –+ +
Enterobacter cloacae
Formerly Enterobacter agglomerans
Associated with outbreak of septicemia due to
contaminated IV fluids
Pantoea agglomerans
Formerly Enterobacter sakazakii
Pathogen associated with bacteremia, meningitis and
necrotizing colitis in neonates
Isolated from brain abscesses, respiratory and wound
infections
Cronobacter sakazakii
Found in respiratory samples
Rarely isolated from blood cultures
Enterobacter gergoviae
Now called, Klebsiella aerogenes
Lysine (+)
Enterobacter aerogenes
Isolated from blood, wound, sputum
Enterobacter hormaechei
GIVE ME THE GENUS AND SPECIES OF THE ENTEROBACTER
Enterobacter cloacae
Pantoea agglomerans
Cronobacter sakazakii
Enterobacter gergoviae
Enterobacter aerogenes
Enterobacter hormaechei
Enterobacter taylorae
Enterobacter amnigenus
Enterobacter asburiae
Enterobacter intermedius
GIVE ME THE GENUS AND SPECIES OF THE EDWARDSIELLA
Edwardsiella tarda
Edwardsiella hoshinae
GIVE ME THE GENUS AND SPECIES OF THE HAFNIA
Hafnia alvei
GIVE ME THE GENUS AND SPECIES OF THE KLEBSIELLA
Klebsiella pneumoniae
Klebsiella oxytoca
Klebsiella terrigena
Klebsiella group 47
Give me the subspecies of Klebsiella pneumoniae
Klebsiella pneumoniae ssp. ozaenae
Klebsiella pneumoniae ssp. pneumoniae
Klebsiella pneumoniae ssp. rhinoscleromatis
Give me the 2 Klebsiella group 47
Klebsiella ornithinolytica
Klebsiella planticola
GIVE ME THE GENUS AND SPECIES OF THE PROTEUS
Proteus vulgaris
Proteus mirabilis
Proteus penneri
GIVE ME THE GENUS AND SPECIES OF THE PROVIDENCIA
Providencia rettgeri
Providencia stuartii
Providencia alcalifaciens
Providencia rustigianii
GIVE ME THE GENUS AND SPECIES OF THE SERRATIA
Serratia marcescens
Serratia rubidea
Serratia liquefaciens
Serratia odorifera
Serratia ficaria
Serratia grimesii
Serratia proteamaculans
Serratia fonticola
Serratia plymuthica
GIVE ME THE GENUS AND SPECIES OF THE MORGANELLA
Morganella morganii
Morganella psychrotolerans
GIVE ME THE GENUS AND SPECIES OF THE EWINGELLA
Ewingella americana
GIVE ME THE GENUS AND SPECIES OF THE PLESIOMONAS
Plesiomonas shigelloides
GIVE ME THE GENUS AND SPECIES OF THE SALMONELLA
Salmonella typhosa/typhi
Salmonella cholerasuis
Salmonella enteritidis
Salmonella enterica
Salmonella bongori
GIVE ME THE GENUS AND SPECIES OF THE SHIGELLA
Shigella dysenteriae
Shigella flexnerii
Shigella boydii
Shigella sonnei
GIVE ME THE GENUS AND SPECIES OF THE YERSINIA
Yersinia pestis
Yersinia enterocolitica
Yersinia pseudotuberculosis
Yersinia intermedia
Yersinia kristensenii
Yersinia frederiksenii
Yersinia aldovae
Yersinia ruckeri
GIVE ME THE GENUS AND SPECIES OF THE ESCHERICHIA
Escherichia coli
Escherichia hermannii
Escherichia vulneris
Escherichia fergusonii
Escherichia blattae
o Infrequently encountered in the clinical laboratory as
cause of gastroenteritis
o Associated with water harboring fish and turtles and
rarely on humans
o Opportunistic pathogen to immunocompromised hosts
that may develop serious wound infections and
myonecrosis
GENUS EDWARDSIELLA
It is the only recognized human pathogen in Genus Edwardsiella
Edwardsiella tarda
o Formerly Enterobacter hafniae
o Associated with gastrointestinal linfections
o Resides in GIT of humans and animals
GENUS HAFNIA
o Inhabitants of then asopharynx and GIT
o Absence of motility distinguishes this species from
other members of Enterobacteriaceae family
° Associated with variety of infections including liver
abscess, pneumonia, septicaemia and UTI
GENUS KLEBSIELLA
Most commonly isolated species in the genus Klebsiella
Friedlander’s bacillus
All strains are resistant to ampicillin
Klebsiella pneumonia
CLINICAL INFECTIONS OF KLEBSIELLA PNEUMONIAE
➢ Lower RT infections in hospitalized patients, newborns,
elderly and seriously ill patients on respirators
➢ Wound infections
➢ UTI
➢ Bacteremia
➢ Nosocomial outbreaks in newborn nurseries
➢ Severe enteritis
➢ Septicemia
➢ Meningitis
Only indole (+) member of Klebsiella
Disease is similar to K. pneumoniae
Same strains carry a heat-labile cytotoxin which has
been isolated from patients who have developed a self-
limiting antibiotic associated hemorrhagic colitis
Klebsiella oxytoca
A Klebsiella group 47 which is an environmental organism which also cause UTI and wound infection
Klebsiella planticola
o Normal in habitants of GIT
o Actively motile at 37°C
o NLF
o Able to deaminate phenylalanine
o “Swarming” appearance on BAP
GENUS PROTEUS
Different Proteus strain swarm but does not
swarm with each other leaving a demarcation
line between them
DIENES PHENOMENON
Has same antigenic structure as Rickettsiae. Ag of some strains of this species can be used
to diagnose (Weil Felix Test: OX2, OX19 and
OXk)
Proteus vulgaris
Formerly Proteus vulgaris strain
A newly recognized species
Proteus penneri
o Biochemically similar to Proteus
o Normal inhabitants of GIT
o Most commonly associated with UTI
o Associated with nosocomial outbreaks
o No clear clinical association exists when these
organisms are isolated
GENUS PROVIDENCIA
Formerly Proteus rettgeri
Pathogen of urinary tract
Has caused occasional nosocomial outbreaks
Providencia rettgeri
Nosocomial outbreaks in burn units
Isolated from urine cultures
Providencia stuartii
Associated with gastroenteritis especially in children
Providencia alcalifaciens
o Colonizers and are known to cause pathogenic
infections in health care settings
o Opportunistic pathogens associated with nosocomial outbreaks
o Capable of survival under very harsh environmental conditions
o Resistant to many disinfectants
GENUS SERRATIA