MT: ENTEROBACTERIACEAE Flashcards

1
Q

Enterobacteriaceae is Motile (except ___ and ____)

A

Shigella and Klebsiella

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2
Q

Enterobacteriaceae. Natural habitat in humans – gastrointestinal tract
referred to as “____” or “___”

A

“enteric bacilli” or “enterics”

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3
Q

Enterobacteriaceae Cause ___ diseases

A

Gastrointestinal Tract

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4
Q

Enterobacteriaceae. Important ANTIGENIC STRUCTURE

A

O: Outer membrane
H: Flagella
K: Capsule
Vi: Capsule of Salmonella

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5
Q

Important ANTIGENIC STRUCTURE. somatic ; heat stable; endotoxic activity

A

O-antigens

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6
Q

Important ANTIGENIC STRUCTURE. heat labile; Inhibits phagocytosis and the effects of serum antibody

A

K or capsular antigen

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7
Q

Important ANTIGENIC STRUCTURE. heat labile

A

H antigens or flagellar antigens

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8
Q

Important ANTIGENIC STRUCTURE. S. typhi; categorized as K Ag

A

Vi antigen

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9
Q

A. Major Intestinal Pathogen

A
  1. Salmonella
  2. Shigella
  3. Yersinia
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10
Q

Opportunistic Pathogens

A
  1. Citrobacter
  2. Edwardsiella
  3. Enterobacter
  4. Hafnia
  5. Klebsiella
  6. Morganella
  7. Proteus
  8. Providencia
  9. Serratia
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11
Q

C. Opportunistic/Pathogenic

A

Escherichia

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12
Q

Rapid Lactose Fermenter

A

Escherichia
Enterobacter
Klebsiella

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13
Q

Late Lactose Fermenter

A

Salmonella arizona
Shigella sonnei
Serratia
Hafnia
Yersinia
Citrobacter

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14
Q

Non Lactose Fermenter

A

Shigella (except sonnei)
Salmonella (except arizonae)
Proteus
Providencia
Morganella
Edwardsiella

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15
Q

Enterobacteriaceae. Culture media :

A

MacConkey Agar and Blood Agar
Eosin-Methylene Blue

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16
Q

Enterobacteriaceae. Culture media : (substitute for
MacConkey agar)

A

Eosin-Methylene Blue

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17
Q

Culture Media. selective for Yersinia sps

A

Cefsulodin-Irgasan-Novobiocin (CIN)

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18
Q

Culture Media. use for differentiation of Lactose from Non Lactose Fermenters

A

Eosin-Methylene Blue (EMB)

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19
Q

Culture Media. enrichment broth to enhance isolation of enteric pathogens

A

Gr (-) Broth

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20
Q

Culture Media used for isolation: for Salmonella and Shigella

A

Hektoen Enteric (HE) agar

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21
Q

Culture Media. diff Lactose from non lactose fermenters

A

MacConkey

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22
Q
A
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23
Q
A
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24
Q

Culture Media used for isolation. diff of Salmonella and Shigella

A

Salmonella-Shigella (SS)

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25
Q

Culture Media. use to enhance recovery of Salmonella and Shigella

A

Selenite broth
Tetrathionate broth:

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26
Q

Culture Media. use to isolate Salmonella and Shigella
and differentiate from other Enterobacteriaceae

A

Xylose-Lysine Desoxycholate (XLD)

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27
Q

Enterobacteriaceae
Colonial morphology in BLOOD AGAR PLATE

A
  • Moist, smooth, gray colonies
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28
Q

Escherichia coli. Colonial morphology in BLOOD AGAR PLATE

A

convex, circular, smooth with distinct edges

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29
Q

Enterobacter. Colonial morphology in BLOOD AGAR PLATE

A

similar but somewhat more mucoid

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30
Q

Klebsiella. Colonial morphology in BLOOD AGAR PLATE.

A

large and very mucoid and tend to coalesce with prolonged incubation

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31
Q

Salmonella and Shigella .Colonial morphology in BLOOD AGAR PLATE

A

similar to Escherichia coli but do not ferment
lactose

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32
Q

Serratia. Colonial morphology in BLOOD AGAR PLATE

A

reddish orange

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33
Q

Edwardsiella. Colonial morphology in BLOOD AGAR PLATE

A

yellowish white

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34
Q

Proteus. Colonial morphology in BLOOD AGAR PLATE

A

“SWARMING” motility (wavelike appearance)

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35
Q

Enterobacteriaceae on __%
sheep blood agar - -Large, dull, grey, nonhemolytic colonies

A

5%

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36
Q

E.coli is a lactose fermenter that gives off smooth __ (color) colonies

A

pink

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37
Q

Klebsiella pneumoniae on ___ agar appears pink, large, glistening, and mucoid

A

MacConkey agar

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38
Q

Serratia marcescens produce smooth,
raised, circular (2 to 4 mm), and non-lactose
fermenting ___ to __ colonies

A

pink to red

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39
Q

– to distinguish morphologically
similar bacteria of Enterobacteriacea all of which ferment glucose to an acid end product

A

Triple Sugar Iron Agar

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40
Q

Triple Sugar Iron Agar Components: sugars?

A

Glucose, Lactose, Sucrose

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41
Q

Triple Sugar Iron Agar. Components

A

Glucose, Lactose, Sucrose
Beef Extract
Peptone
Phenol red
FeSO4

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42
Q

Triple Sugar Iron Agar. Component which serves as the pH indicator

A

Phenol red

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43
Q

Triple Sugar Iron Agar. Component which serves as the H2S indicator

A

FeSO4

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44
Q

Principle: Fermentation of SUGARS to produce acid and production of H2S (Black)

A

Triple Sugar Iron Test

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45
Q

Escherichia, Klebsiella, and Enterobacter. TSI reaction?

A

A/A H2S-

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46
Q

Salmonella, Proteus, and Citrobacter. TSI reaction?

A

K/A H2S+

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47
Q

Shigella, Providencia, Serratia, anaerogenic Escherichia coli. TSI reaction?

A

K/A H2S-

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48
Q

Pseudomonas, Alcaligenes. TSI reaction?

A

K/K H2S-

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49
Q

Citrobacter freundii

A

A/A H2S+

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50
Q

for the identification of lactose-
fermenting members of Enterobacteriaceae.

A

IMViC reactions

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51
Q

IMViC means

A

Indole test
Methyl red test
Voges Proskaeur test
Citrate utilization

52
Q

Rapid Urease Producers

A

Proteus and Morganella

53
Q

Weak urease producers

A

Klebsiella and some enterobacter

54
Q

Deaminase reactions

A

Proteus, Providencia and Morganella

55
Q

Enterobacteria that is nonmotile at 37C but motile at 22C

A

Yersinia enterocolitia

56
Q

Nonmotile Enterobacteria

A

Shigella and Klebsiella

57
Q

Most abundant facultative anaerobe in the colon, Ferments lactose

A

Escherichia coli

58
Q

3 antigens of Escherichia coli

A

O - 150
H - 50
K - 90

59
Q
A
60
Q

Escherichia coli
Important Virulent Factors

A

Pili
Capsule
Endotoxin
exotoxin (enterotoxin)

61
Q

this strain of Escherichia coli causes traveler’s disease

A

Enterotoxigenic (ETEC) E. coli

62
Q

this strain of Escherichia coli does not ferment sorbitol (sugar alcohol), it causes bloody diarrhea (shigalite toxins)

A

EHEC strain: E. coli 0.157:H7

63
Q

Structures responsible for systemic disease are the ___ and ___

A

capsule and endotoxin

64
Q

E.coli. Lab Diagnosis on MacConkey agar

A

Lactose fermenters forming pink colonies

65
Q

E.coli. Lab Diagnosis on EMB agar

A

Greenish sheen (Green metallic sheen)

66
Q

E.coli. Lab Diagnosis. produces ___ from tryptophan

A

indole

67
Q

E.coli. Lab Diagnosis. Uses ___ as its only source of carbon

A

acetate

68
Q

E.coli. Lab Diagnosis. Ferments _____ (except E. coli 0.157:H7)

A

sorbitol

69
Q

E. coli treatment. Uncomplicated UTI

A

Co trimoxazole

70
Q

E. coli treatment. Complicated UTI and sepsis

A

Parenteral antibiotics (3rd gen cephalosporins with or without aminoglycosides)

71
Q

E. coli treatment. Toxigenic/traveler’s diarrhea

A

self-limited (no antibiotic, only fluid and electrolyte replacement)

72
Q

More than 2200 serotypes based on O and H antigen. Subdivided into Groups A, B, C, etc. and 1,2,3 etc

A

Salmonella

73
Q

Gram negative, encapsulated (Vi antigen),
nonsporulating rods
Motile gram-negative facultative anaerobes
Non-lactose fermenting
Resistant to bile salts
H2S producing

A

Salmonella

74
Q

Salmonella subgroup that is isolated from humans and highly pathogenic for humans

A

Subgroup 1

75
Q

Salmonella Subgroup 1 consists of?

A

Subgroup 1: S. typhi, S. paratyphi, S. choleraesuis, S.gallinarum

76
Q

Clinical diseases of Salmonella

A

Gastroenteritis
Enteric Fever
Septicemia

77
Q

Clinical Disease of Salmonella that exhibits Typhoid, Paratyphoid fever

A

Enteric Fever

78
Q

Clinical Disease of Salmonella wherein Salmonella org disseminates into the
bloodstream; can be an intermediate stage of the infection

A

Septicemia

79
Q

Most common form of Salmonella infection with major foodborne outbreaks and sporadic disease

A

Salmonella Gastroenteritis/Salmonellosis

80
Q

Salmonellosis cause of infection?

A

poultry, eggs

81
Q

Salmonellosis causes nausea, headache,
vomiting and profuse diarrhea with few leukocytes in the stools but rarely blood ____ after ingestion

A

8-48 hours

82
Q

Salmonella Gastroenteritis/Salmonellosis. recovery within ___ days

A

2-3 days

83
Q

Salmonella Gastroenteritis/Salmonellosis is caused by

A

S. enteritidis bioserotypes (e.g., S. typhimurium)

84
Q

Salmonella. Enteric fever route of transmission

A

fecal-oral route

85
Q

Salmonella. Enteric fever is gotten from ingestion of?

A

fecal-contaminated food or water

86
Q

Salmonella. Enteric fever incubation period

A

10-14 days

87
Q

Clinical disease of Salmonella. Assoc with the enlargement of Peyer’s Patches as a
result of the infiltration of mononuclear cell

A

Enteric Fever

88
Q

Salmonella. Enteric Fever
Clinical Findings:

A
  1. Fever extending up to 4 weeks
  2. Diarrhea
  3. Nausea and vomiting
  4. Abdominal pain
  5. “rose spots” on the abdomen (rare)
  6. Hepatosplenomegaly
89
Q

Salmonella. Enteric fever. 2 clinical forms:

A
  1. Typhoid fever
  2. Paratyphoid fever
90
Q

one of the clinical forms of enteric fever that is Not only an intestinal infection but a
general invasion particularly the lymphatic
system

A

Typhoid fever

91
Q

one of the clinical forms of enteric fever that is Relatively mild course with sudden chills but otherwise similar to a mild typhoid fever

A

Paratyphoid fever

92
Q

one of the clinical forms of enteric fever that is most often milk borne and transmitted by carriers and predominant in younger age groups

A

Paratyphoid fever

93
Q

causative agents of Paratyphoid fever

A

a. Salmonella paratyphi A – sewage contaminated food
b. Salmonella paratyphi B (Salmonella schottmulleri) – often in carriers
c. Salmonella paratyphi C (salmonella hirschfeldii) – tends to produce endocarditis

94
Q

Paratyphoid fever. Complications

A

intestinal hemorrhage
perforation and peritonitis
splenic rupture

95
Q

May occur as a sequelae of enteric fever or rarely from gastroenteritis or may have no intestinal focus
Characterized by rapid rise with spiking temperature

A

Septicemia

96
Q

Septicemia. Signs and symptoms

A

pneumonia
meningitis
conjunctivitis
sinusitis
suppurative arthritis
pyelonephritis

97
Q

Septicemia. Sources of infection

A

– food and drink contaminated
with salmonellae
water
milk and other dairy products (ice cream, cheese,custard)
shellfish
dried or frozen eggs
meats and meat products
recreational drugs
animal dyes
household pets

98
Q

Salmonella Specimens

A

Blood – culture (1st week)
Bone marrow – culture
Urine – culture ( after 2nd week)
Stool – culture

99
Q

Enrichment cultures of Salmonella

A

Selenite F broth
tetrathionate broth

100
Q

Differential media of Salmonella

A

MacConkey

101
Q

in Salmonella, what agar exhibits green with black centers (lactose negative; H2S positive)

A

Hektoen enteric agar

102
Q

in Salmonella, what agar exhibits rapid detection of Salmonella typhi producing jet black colonies, black sheen or with
dotted black or greenish gray

A

Bismuth sulfite agar

103
Q
A
104
Q

Indirect agglutination test
qualitative and quantitative measures

A

Widal Test

105
Q

Widal Test. POSITIVE: Antibody titer is ___

A

> 1:160

106
Q

EIA for the rapid detection of
specific IgM and IgG antibodies (60min)

A

Typhidot Test

107
Q

Four species of Shigella

A

Shigella sonnei
Shigella flexneri
Shigella boydii
Shigella dysenteriae

108
Q

Shigella causes __ diarrhea

A

Watery diarrhea with fever; changing to dysentery.

109
Q

This bacteria is the Major cause of bacillary dysentery (severe 2nd stage)
in pediatric age group (1-10 yrs) via fecal-oral route

A

Shigella

110
Q

this bacteria : Invade the epithelial lining of the L. intestine 🡪
destruction and death of the epithelial cells 🡪
BLOODY DIARRHEA (DYSENTERY)

A

Shigella

111
Q

Two stage disease of Shigella

A

Early stage
Second stage

112
Q

Shigella. What stage? Watery diarrhea attributed to the enterotoxic activity of Shiga toxin following ingestion and noninvasive
colonization, multiplication, and production of enterotoxin in the small intestine

Fever attributed to neurotoxic activity of toxin

A

Early stage

113
Q

Shigella. What stage? Adherence to and tissue invasion of large intestine
with typical symptoms of dysentery

Cytotoxic activity of Shiga toxin increases severity

A

Second stage

114
Q

Shiga Toxin Effects in Shigellosis

A
  1. Enterotoxic Effect
  2. Cytotoxic Effect
  3. Neurotoxic Effect
115
Q

Shiga Toxin Effects in Shigellosis.
-Adheres to small intestine receptors
- Blocks absorption of electrolytes, glucose, and amino
acids from the intestinal lumen

A

Enterotoxic Effect

116
Q

Shiga Toxin Effects in Shigellosis.
- B subunit of Shiga toxin binds host cell glycolipid
- A domain is internalized via endocytosis
- Causes irreversible inactivation of the 60S ribosomal subunit

A

Cytotoxic Effect

117
Q

Clinical symptoms of Shigella

A
  • Diarrhea, fever, nausea, vomiting, stomach cramps, and flatulence
  • Stools may have blood, mucus, pus
118
Q

Shigella. Specimen for culture

A

fresh stool, mucus flecks, rectal swab

119
Q

Shigella. Specimen for serology

A

Serum

120
Q

Shigella. Culture media with colorless colonies

A

EMB or MacConkey

121
Q

Shigella. Culture media with colorless colonies without black centers

A

Salmonella-Shigella agar

122
Q

Shigella. Culture media with green colonies without black center

A

Hektoen enteric agar

123
Q

Once known as “Friedlander’s Bacillus”

A

Klebsiella pneumoniae

124
Q

Klebsiella pneumoniae. Capsulated, mucoid colonies that tends to _____

A

“STRING”

125
Q

Normal flora of the URT and GIT.
Most likely to be a primary non-opportunistic pathogen (related to its antiphagocytic capsule)
10% of healthy people are carriers

A

Klebsiella pneumoniae

126
Q

Klebsiella pneumoniae Causes sever pneumonia 🡪 “____” like
sputum

A

“currant-jelly”

127
Q
A