TEST 2 Bugs 2 Part 1/2 Flashcards
Most gram negative rods are in what family and what is their respiration type?
Enterobacteriaceae
Facultative anaerobes
Gram Negative rods are normally found where and commonly cause what?
- Normal GI flora
- Diarrhea and UTI
Gram negative rods are resistant to what two common antibiotics due to their Outer membrane.
Vancomycin and Penicillin
Most gram negative enteric bacteria are resistant to ___________ compared to gram-positives.
Bile Salts
Enterobacteriaceae ferment what?
Oxidase?
Catalase?
Reduction?
- Glucose
- Oxidase: -ve
- Catalase: +ve
- Reduce: nitrates to nitrites (anaerobic respiration)
Which gram negative rods are lactose fermenters?
- Fecal Coliforms = CEEK
- Citrobacter
- Slow lactose fermenters
- Enterobacter
- Escherichia
- Klebsiella
- Citrobacter
Which gram negative rods are lactose nonfermenters?
- ShYPS
-
Non-motile, no H2S
- Shigella
- Yersina
- Motile, and produce H2S
- Proteus
- Salmonella
-
Non-motile, no H2S
Virulence factors for gram negative rods
- Surface antigens:
- O (PS part of LPS)
- H (flagellar)
- K (capsular, Salmonella’s is Vi)
- Fimbriae, endotoxin (lipid A)
What does E. Coli look like on different plates?
- Eosin-Methylene Blue: Green Metallic sheen
- MacConkey agar: Red colonies
- Triple Sugar iron (TSI): Lactose + Sucrose + Limited glucose fermentation + gas.
E. coli disease-causing strains:
-
Diarrhea-causing strains
- EnteroTOXIGENIC (ETEC)
- EnteroPATHOGENIC (EPEC)
- EnteroHEMORRHAGIC (EHEC)
- EnteroINVASIVE (EIEC)
-
UTI-Causing strain
- Uropathogenic (UPEC) - P Pili
-
Neonate meningitis
- K1 capsule
Describe ETEC:
- Traveler’s Diarrhea & infantile diarrhea in developing world
- Watery diarrhea
- Labile Toxin (LT) - ADP-ribosylates and stimulates Gsa → ^d cAMP.
- Stable Toxin (ST) stimulates cGMP.
- Both toxins cause loss of fluids and ions, causing water, non-inflammatory diarrhea.
Describe EPEC:
- Infantile (Pediatric) diarrhea.
- No toxin or inflammation
-
Pathogenicity Is. (PAI) encodes a type III secretion system and intimin adhesin.
- Results in blunt microvilli and prevent absorption → watery diarrhea.
Describe EHEC:
- (O157:H7)
- No ferment sorbitol.
- Do not invade host cell.
- In colon, produces shiga-like toxin that nicks 60S ribosomes.
- Bloody diarrhea
- can turn into Acute renal failure.
Describe EIEC:
- Dysentery: fever, diarrhea, vomiting, abdominal cramping, tenesmus.
- Often blood and pus in stools.
- Invades intestinal epithelium (invasion proteins)
- Similar to shigellosis.
Escherichia coli
UTIs details
-
UPEC - Cystitis - E. coli Type 1 fimbriae adhere to perineum.
-
Pyelonephritis - P fimbriae (Pili) adhere to uroepithelium
- High risk of septicemia and shock.
-
Pyelonephritis - P fimbriae (Pili) adhere to uroepithelium
Escherichia coli
Gram negative sepsis
- Most likely from UTIs:
-
Elderly patient, UTI (catheter, BPH), gram negative sepsis, + blood culture.
- Life threatening, due to endotoxin (lipid A).
-
Elderly patient, UTI (catheter, BPH), gram negative sepsis, + blood culture.
Shigella details
- Human pathogen (usually infants and children) Not normal flora.
- Fecal oral spread; low infectious dose
- Catalase +; Ferment Glucose
- Invade intestinal M cells and induce apoptosis.
- Shiga toxin - cleaves 60S rRNA = inhibits protein synthesis and damages intestinal epithelium and glomerular epithelium.
- Shigellosis: Most cases - self-limiting, does cause dysentery but bacteremia is rare.
Shigella mediums
- HMS
- Hektoen enteric (HE) agar
- MacConkey Agar
- Salmonella/Shigella Agar
Salmonella details
- Motile, encapsulated.
- Produce H2S
- Catalase +; Ferment Glucose
- S. typhi: Infects only humans; fecal-oral spread in food/water. Some people chronically carry it (gall bladder).
- S. enterica are found in animal reservoirs
- Extreme ages, cancer, immunocomp., and low stomach acid increase disease.
S. typhi Infection
-
Typhoid fever
- Rose spots on the trunk/abdomen
-
Pulse-temperature dissociation
- fever w/ low pulse
- Treatment: Ceftriaxone, Fluoroquinolones
- Vaccine: killed bacteria (orally) for travelers to high risk areas.
Salmonella Infections
Serotypes Typhimurium and Enteritidis
- Not normal flora
-
Gastroenteritis
- Invasive, but self-limiting.
- Spreads in families.
- Post infection reactive arthritis occurs.
-
Osteomyelitis
- Focal lesions in sickle cell patients (encapsulated strain).
Klebsiella:
K. pneumoniae
- Oppurtunist; Ferments lactose+glucose
- Weakly urease +ve
- Catalase+
- EMB agar and MacConkey agar.
- Lobar pneumonia, aspiration pneumonia, aspiration of GI contents.
- Red “currant jelly” sputum
- Resistant to many antibiotics
- Mixture of mouth anaerobes can be due to this bacteria.
Yersinia details
- Y. pestis: Common in prarie dogs
- Y. Enterocolitica: Can grow in the cold.
- Y. pseudotuberculosis = similar to Y. enteroc
Y. pestis details
- Responsible for several plagues:
- Bubonic Plague: rapidly enlarging bubboes (greek word, “groin”, swollen inguinal region lymph node), fever, conjunctivitis.
- Septicemic plague - 1st symptom → pulmonary emboli, pneumonic plague (highly contagious), shock with disseminated intravascular coagulation, organ failure.
- Pneumonic plague - fever, malaise, chest tightness, pneumonia. Cyanosis.
- Treatment: Streptomycin (Doxycycline)
Y. enterocolitica details
-
Invasive enterocolitis (yersiniosis):
- Contaminated pork, water or milk.
- Symptoms:
- Fever, abdominal pain, watery diarrhea.
- Mimick appendicitis or Crohn’s, or post-infectious reactive polyarthritis.
Proteus:
P. vulgaris and P. mirabilis
- Swarming motility:
- Found in water, GI tract and human feces.
- Opportunistic
- Produces H2S; Urease +ve; Cat+; Ferment glc.
- Swarming bulls eye on MacConkey agar.
- P. vulgaris - nosocomial oppurtunist: UTIs and Kidney stones.
- P. mirabilis causes UTIs and kidney stones.
Serratia:
Serratia marcescens
- Ubiquitous in environment.
- Salmon-red pigment
- Cat+
- MacConkey agar
- Nosocomial infections: catheter associated bacteremia, UTIs, wound infections
Bacteroides fragilis details:
- Short bacilli. Common intestinal bacilli.
- Anaerobe, but aerotolerant.
- Causes abscess if mucosal barrier is breached.
- Anti-phagocytic capsule that aides this.
- Usually part of the polymicrobial infections in the GI tract.
- Peritonitis and intraabdominal abscesses (diverticulitis). Lung abscess (aspiration).
- Appendicitis
- Treatment with metronidazole and quinolone for E. coli or B. fragilis.
Fusobacterium details:
- Slender, spindle shaped cells
- Found in oral cavity and GI tract.
- Have potent LPS.
- Abdominal abscesses
- Acute necrotizing ulcerative gingivitis (ANUG) - ulcerative oral disease.
Prevotella: Porphyromonas gingivalis details:`
- Normal oral and genital microbiota.
- Melanin production → black colonies.
- Periodontitis (gum infection)
- Difficult to treat.
Pseudomonas aeruginosa details:
- Major nosocomial and opportunistic pathogen:
- Burns cellulitis with bluegreen pus
- CF lung infection, pneumonia
- Wound infections, ulcers, UTIs
- Swimmer’s ear
- Malignant otitis externa (elderly/diabetics)
- septicemia (+/- ecthyma grangrenosum), shock/death.
Campylobacter: C. jejuni and C. coli
- Corkscrew, flagellated, nose-to-nose seagull wing appearance.
- Cat+, Ox+
- Enteritis or dysentery
- Guillain-Barre syndrome - leading cause
- Reactive arthritis can also follow.
Helicobactor pylori
- Infects human only - fecal-oral transmission
- Some asymptomatic carriers
- Gastritis - inflammation.
- Gastric and duodenal ulcers - epigastric pain and reflux.
- Adenocarcinomas, MALT lymphoma - increased inflammation, ulcer + cancer risk.
Vibrio
V. cholerae
- Noninvasive, prefers alkaline environment. Human fecal contamination of coastal waters.
- High infective dose.
- Toxin coregulated pili (TCP) for ileal attachment.
- Cholera toxin
- Cholera
- Vaccine: live, attenuated vaccine available.
Vibrio
V. parahaemolyticus details
- Coastal marine or estuarine halophile.
- Ingestion of undercooked/raw seafood.
-
Gastroenteritis
- Explosive, watery diarrhea (can be bloody), vomiting and fever.
- Wound infections mild.
Vibrio
V. vulnificus details
-
Wound infections/cellulitis in cuts from shucking oysters or water exposure.
- Can become necrotizing fasciitis
- Gastroenteritis ingesting raw oysters
- Septicemia, bullous skin lesions, death (in <24h) in patients with liver or iron-overload conditions.