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Flashcards in 9-3 Enterobacteriaceae Deck (35)
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1

[T or F] Enterobacteriaceae have [Type 3 Secretory Systems] AND [Iron Scavengers]

TRUE

  • Type III secretion systems facilitates secretion of bacterial virulence factors into host cells and Iron Scavengers

2

4 Unvarying Characteristics of Enterobacteriaceae Family

1.[Facultative/Gram Negative/Rods] 

2. Reduce NitrATE ---> nitrite

3. Oxidase NEGATIVE

4. Glucose Fermenters 

 

"Enterobacteriaceae are all FROGs"

3

[T or F] E. Coli is considered an [Environmental Free Living Organism]

FALSE!! E.Coli in water indicates that that water was CONTAMINATED WITH SOMEONE'S FECES!

4

6 Clinical Dz that can RESULT FROM E.Coli

1. 

2. Gram negative sepsis. 

1. Neonatal Meningitis

2. Wound infections

3. PNA in [ImmunoCompromised] hospitalized patients

4. UTI–MOST of community acquired UTIs are from E.Coli

5. Gram Negative Sepsis

6. Gastroenteritis 

"E.Coli in the NW causes PUGG"

5

A: ETEC = __________

B: Pathogenesis

C: Sx

D: Sx are similar to what other bacteria?

 

E: Chemoprophylaxis with _____ or _____ Abx for ______􏰀 diarrhea is NOT recommended

A: E(T)EC = Entero(T)oxigenic E.Coli

B: Pathogenesis: (LT and ST) production but they do NOT damage mucosal epithelium

C: Sx: Profuse WATERY [(T)RAVELER'S] Diarrhea similar to [V.Cholerae]

E: Chemoprophylaxis with SXT or cipro for travelers􏰀 diarrhea NOT recommended ------------------------------------------------------------------------------------- Traveler's Diarrhea

6

A: EpEC = __________

B: Pathogenesis

C: Sx (2) 

A: EpEC = Enteropathogenic E.Coli

B: Pathogenesis: Causes [attaching/effacing lesions] by adhering to epithelial cells in microcolonies

 

C: Sx:

-INFANT Vomiting and Diarrhea WITH NO GROSS BLOOD

-Prominent mucous 

 

"p" think "pediatrics"

7

A: EiEC = __________

B: Pathogenesis

C: Sx (4)

D: Sx are similar to what other bacteria?

A: EiEC = Enteroinvasive E.Coli

B: Epithelial Cell Invasion

C: Sx:

1. Colitis

2. MLB [Mucus/Leukocytes/Blood] in ur stool

3. Fever

4. Tenesmus 

"EiEC Can Make Feces Thick" 

 

D: Sx are similar to Shigella

8

A: [EHEC STEC] = __________

B: Pathogenesis

C: Sx (4)

A: [EHEC STEC] = [EnteroHemorrhagic Shiga Toxin] E.Coli

B: Pathogenesis: [ShiGa Toxins 1 and 2] secreted by [EHEC STEC O157:H7] causes Dz especially of the Kidney and CNS endo/epithelium

C: Sx:

1. [BLOODY OR NONBLOODY DIARRHEA w/No WBC]

2. NO FEVER

3.Hemorrhagic Colitis

4. MAY PROGRESS TO HUS (Hemolytic Uremic Syndrome)

9

A: EAggEC = __________

B: Pathogenesis

C: Sx (2)

A: EAggEC = Enteroaggregative E.Coli

B: Pathogenesis: Adheres to GI epithelium in a "stacked brick" pattern

C: Sx:

1. Watery Diarrhea WITH BLOOD AND MUCUS

2. Vomiting

10

A. [EHEC STEC O157 H7 (ESOH)] is shed in feces of _____ and _____ and through _______ (5) [ESOH] can cause Human Infection.

B: Normal Reservoir for [EHEC STEC]

A. [EHEC STEC O157 H7] is shed in feces of Cattle and Sheep and through

1. [water contaminated]

2. [(undercooked ground beef]

3. [DIRECT CONTACT w/infected pt]

4. Milk Unpasteurized

5. Apple Cider ..

[MAD WU] can cause Human infection "I'm [MAD at WU] for giving me ESOH"

B: Healthy Dairy Cows

11

A1: HUS = ______.

 

A2: What are the triad of sx that define HUS?

 

B: When is it Diagnosed

 

C: What pathogen specifically causes it?

A: Triad of Sx for HUS (Hemolytic Uremic Syndrome) -A2: Hemolytic Anemia -Acute Renal Failure -Thrombocytopenia "Wear a [HUS H.A.T]"

B: Diagnosed 1 week after [Bloody/NonBloody Diarrhea] begins

 

C: [EHEC STEC: O157:H7] "ESOH"

12

What's the Leading cause of PEDIATRIC Acute Renal Failure?

**HUS from ESOH! ** (HUS (Hemolytic Uremic Syndrome) from [EHEC STEC: O157:H7] ) "Wear a HUS H.A.T"

13

A: Describe the clinical course for infection with [EHEC STEC O157:H7] (ESOH) - (2)

B: What are the 2 possible outcomes when infected with ESOH

1st: 3-4 Days of NON-bloody Diarrhea w/Abd Pain

2nd: [BLOODY DIARRHEA] Onsets w/SEVERE Abd Pain

 

B:

-Diarrhea Resolves in 4-10 Days

OR

-[HUS H.A.T.] --> Death or [Renal impairment/HTN/CNS]

14

ESOH

[EHEC STEC O157 H7] Can cause [HUS H.A.T.]

15

A: Describe NON-Diarrheal HUS

 

B: What 3 things can cause it

Non-diarrheal HUS -

1. much less common,

 

B: can occur in association with

● pneumococcal infection

● chemotherapy

● transplant immunosuppression

16

6 important RISK FACTORS (INC Probability) for developing HUS from ESOH

Risk Factors for Developing HUS after being infected with ESOH (EHEC STEC O157 H7)

1. If ESOH produces [ShiGa toxin 2] only

2. [Anti-motility agents] 

3. Mental Retardation 

4. Children/Elderly 

5. Antimicrobials (specific ones) 

6. [P-antigen] on RBC

"2 AM CAPs of cola is RISK for coli"

17

List the 3 T's of Laboratory CARE for ESOH

1. Timing = ESOH Load is HIGH in first 4 days of onset so Collect specimen in first 4 days of onset for any enteric illness and before Abx

2. Type = Collect WHOLE STOOL since multiple specimens enhances recovery

 

3. Transport = TRANSPORT ASAP and refrigerate at 4ºC if it's been more than 1-2 hours

18

3 Ways to DIAGNOSIS ESOH in a Lab

1. Antigenic Detection ([ShiGa toxin 1 and 2] or O157

2. Direct Fecal detection

3. [MORE SENSITIVE ENRICHED BROTH CULTURE] detection

19

Tx for ESOH [EHEC STEC O157 H7] - (2)

1. Dialysis for [HUS HAT] and Renal Failure pts

2. Oral Rehydration (Gatorade and Pedialyte) with careful monitoring of renal function

20

Contraindicated Tx for ESOH [EHEC STEC O157 H7] - (2)

ABX OR [ANTIMOTILITY AGENTS]!!!!!!!!

21

Name the 5 genera of Enterobacteriaceae that can cause GI Dz

Genus:

1. Escherichia

2. Shigella

3. Edwardsiella

4. Salmonella/Shigella

5. Citrobacter

 

[ SEE  SiCK]

22

4 Potential Clinical Manifestations of SALMONELLA Infection

A: [Asymptomatic Carrier]

1. How long for Non-typhoid

2. How long for [Salmonella Typhoid]

--------------------------

B: List All of the Sx (4) 

5 Potential Clinical Manifestations of SALMONELLA Infection 1. [Asymptomatic Carrier] = [Non-typhoid Salmonella Typhi = 1 year] vs. [Salmonella Typhoid = DECADES] ------------------------------------------------------------------------------------

B:

1. Septicemia 

 

2. [Asymptomatic Carrier] 

3. [Febrile Gastroenteritis] OR [Focal Infections]

4. [Enteric Typhoid Fever] 

"Salmonella is anything but SAFE

23

4 Potential Clinical Manifestations of SALMONELLA Infection

A: [Febrile Gastroenteritis] = _____[most/least] common

-Incubation time

-Sx (3) -Duration -

 

B: List All of the Sx (4) 

5 Potential Clinical Manifestations of SALMONELLA

[Febrile Gastroenteritis =

-MOST COMMON

-12-48 Incubation Time

-NVD/abd pain/malaise -Self-limited = 3-5 day duration -------------------------------------------------------

B:

1. Septicemia 

 

2. [Asymptomatic Carrier] 

3. [Febrile Gastroenteritis] OR [Focal Infections]

4. [Enteric Typhoid Fever] 

"Salmonella is anything but SAFE

24

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Enteric Typhoid Fever] is ____ and _____!

-What 2 strains is it caused by? *Incubation *Duration and symptom course *HR

A2: The Only known reservoir for Salmonella Typhi is _____ ------------------------------------------------------------------------------------

B: List All of the Sx (4) 

5 Potential Clinical Manifestations of SALMONELLA

3. [Enteric Typhoid Fever]: -PROLONGED AND SERIOUS

-Caused by [Salmonella Typhi] and [Salmonella paraTyphi]

-Incubation = 1-2 weeks

-[4 Week duration] with [INC Fever for 2 of those weeks] and [GI sx for 1-2 weeks] that follow

-HR = Bradycardia even tho pt body temp is elevated(happens with intracell infection)

A2: ONLY known reservoir of S.Typhi is Man (Transmission is from person-to-person for S.Typhi) ------------------------------------------------------------------------------------

B:

1. Septicemia 

2. [Asymptomatic Carrier] 

3. [Febrile Gastroenteritis] OR [Focal Infections]

4. [Enteric Typhoid Fever] 

"Salmonella is anything but SAFE

25

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Septicemia] has no ____ involvement but has common _______

-3 Demographic of Pts who are at risk ------------------------------------------------------------------------------------

B: List All of the Sx (4) 

5 Potential Clinical Manifestations of SALMONELLA

[Septicemia]

-No GI Involvement

-Pts with Immunocompromise

- [Alcoholic Hepatitis]

-[Sickle Cell Anemia]

-Relapses are common

------------------------------------------------------------------------------- 

B:

1. Septicemia 

2. [Asymptomatic Carrier] 

3. [Febrile Gastroenteritis] OR [Focal Infections]

4. [Enteric Typhoid Fever] 

"Salmonella is anything but SAFE

26

5 Potential Clinical Manifestations of SALMONELLA Infection

A: [Focal Infections]: List the 5 [FOCAL Infections] that can be caused by SALMONELLA ------------------------------------------------------------------------------------

B: B: List All of the Sx (4)

5 Potential Clinical Manifestations of SALMONELLA

5. Focal Infections = REMBO [Meningitis] [Osteomyelitis] [Brain Abscess] [Endocarditis]

[Rose Spots: Pink Macules/Prupuric Lesions] -----------------------------------------------------------------------------------

B:

1. Septicemia 

2. [Asymptomatic Carrier] 

3. [Febrile Gastroenteritis] OR [Focal Infections]

4. [Enteric Typhoid Fever] 

"Salmonella is anything but SAFE" 

27

A: How is SHIGELLA Transmitted? (2)

 

B: What 3 Groups are at Highest Risk for SHIGELLA

A:

 1`.Contaminated water

2.  Person to person via:  

- [food, flies, fingers, fomites, feces (5 f􏰀s) ]

 

B: Highest risk

● Young children in day care center, nurseries, custodial institutions,

● Siblings and parents of these children

● Male homosexuals

28

SHIGELLA Clinical Syndromes

A: Name the [Bacillary Dysentery] Sx (5)

B: Incubation period and how long does it last

C: How many viable organisms are required for Dz

Shigella Clinical Syndromes

1. Bacillary Dysentery

"BD from Shigella includes [Ab cramps] + Pus BTW"

-Abd Cramps

-Pus

-Bloody Diarrhea

-Tenesmus

-WBC in Feces

 

B: Incubation: 1-3 Days and will last 48 hours once sx onset 

C: less than 200 viable organisms are needed to cause Dz

29

Clinical Syndrome of [Edwardsiella Tarda]

1. Characterize the associated Gastroenteritis (3)

2. This Bacteria manifestation has been mistaken for what 3 Dz

 

3. Natural Host (2)

1. GASTROENTERITIS

-watery diarrhea

-[Typhoid-like illness] w/bloody diarrhea, [colonic ulcerations] and [terminal iLeum nodules]

-rarely causes septicemia

 

2. HAS BEEN MISTAKEN FOR SALMONELLOSIS AND IBD/Crohn's Dz

 

3. Cold blooded vertebrates and Catfish

30

A: 3 Modes of Transmission for SALMONELLA

A: -Improper Food Handling of

-[Chicken and Cows]

-[reptiles and catfish]

-Raw Eggs