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Enterobacteriaceae Flashcards

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1
Q

What are the true pathogens?

A

Salmonella
Shigella
Yersinia
Pathogenic E. coli

SSYE

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2
Q

Serological characteristics - antigens for Enterobacteriaceae

A

O (somatic) - heat stable on cell wall

H (flagellar) - heat labile on surface of flagella

K (capsular) - heat labile polysaccharide
Associated with Salmonella enterica serotype Typhi

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3
Q

What are the H2S (+) organisms?

A

Salmonella
Edwardsiella
Citrobacter +/-
Proteus +/-

Edward Puts Citrus on Salmon
Or SPEC

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4
Q

VP (+) species

A

Klebsiella
Enterobacter
Serratia

KES

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5
Q

Phenylalanine deamination (+) species

A

Proteus
Morganella
Providencia

PMP

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6
Q

Urease (+) species

A

Proteus
Morganella
Providencia
Yersinia enterocolitica
Yersinia pseudotuberculosis
Klebsiella

PMPYK

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7
Q

Non-motile species

A

Shigella
Klebsiella
Y. pestis

SKY (non-motile cannot touch the SKY)

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8
Q

Y. pestis

A

Bubonic plague
Fleas
Fried egg colonies
Lacks O antigen

Non-motile
Urease negative

  • Think pests = fleas, eating eggs
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9
Q

Which organisms are A/A on TSI?

A

E. coli, Enterobacter, Klebsiella
Proteus vulgaris, arizonae

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10
Q

Lactose fermenters

A

Citrobacter
E. coli
Enterobacter
Klebsiella

CEEK

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11
Q

Late lactose fermenters

A

Shigella sonnei
Citrobacter

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12
Q

Oxidase (+) Enterobacteriaceae

A

Plesiomonas shigelloides

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13
Q

What does SMAC agar isolate?

A

E. coli 0157:H7

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14
Q

What color colonies is E. coli O157:H7 on SMAC?

A

Colorless
Does not ferment sorbitol (it would be pink)

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15
Q

What does CIN agar isolate?

A

Yersinia enterocolitica

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16
Q

What does Yersinia enterocolitica look like on CIN agar?

A

Bulls eye

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17
Q

What does Aeromonas look like on CIN11 agar?

A

Pink colonies, smooth, different edges, NOT bullseye like Yersinia enterocolitica

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18
Q

What color does a lactose fermenter look like on XLD?

A

Yellow (normally red agar)

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19
Q

What color do lactose fermenters look like on MAC?

A

Pink

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20
Q

What color do lactose fermenters look like on HE?

A

Orange (normally blueish green agar)

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21
Q

Virulence factors of Uropathogenic E. coli (UPEC)?

A

Primary: pili (adherence to epithelial cells to prevent flushing away)

Cytolysins: kill immune effector cells, inhibit phagocytosis so WBCs don’t go to site of infection

Aerobactin: binds iron to allow it to grow

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22
Q

4 toxins of Escherichia sp

A

Alpha-hemolysin
Shiga toxin
Labile toxin (LT)
Stable toxin (ST)

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23
Q

What are the 5 categories of diarrheagenic E. coli?

A

EnteroTOXIGENIC
EnteroINVASIVE
EnteroPATHOGENIC
EnteroHEMORRHAGIC (O157:H7)
EnteroADHERERENT

TIPHA

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24
Q

Enterotoxigenic E. coli (ETEC)

A
  • In tropical areas
  • Traveler’s diarrhea
  • Self limiting
  • Transmission: fecal/oral
  • Produce LT & ST toxins
  • Symptoms: watery diarrhea, nausea, abdominal cramps
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25
Enteroinvasive E. coli (EIEC)
- Rare in US - Dysentery (inflammation of intestines with bloody diarrhea) - Fever, abdominal cramps, malaise, watery diarrhea - Similar to Shigella but infectious dose is higher (not as infectious) - Can appear as non-pathogenic E. coli (can be non-motile and lactose neg)
26
Enteropathogenic E. coli (EPEC)
- Infant diarrhea: associated with daycare and nurseries - Low grade fever, malaise, mucousy stools, v/d - Fimbriae adhesive qualities - Transmission: fecal/oral, fomites
27
Enterohemorrhagic E. coli (EHEC)
E. coli O157:H7 - Processed meat, unpasteurized dairy, etc. - HUS (damaged small blood vessels, clots) - Absence of leukocytes - Low or no fever - Often fatal, especially in immunocompromised - Watery diarrhea 2 cytotoxins: - Verotoxin I (Shiga like toxin - Stx1) - Verotoxin II (Stx2)
28
How to identify EHEC?
SMAC (-) MUG (-)
29
Enteroadherent E. coli (EAEC)
Stacked brick appearance - Watery diarrhea, vomiting, dehydration, abdominal pain - 2+ weeks - WBC & RBC absent from stools - Infants in US and HIV patients
30
Shigella subgroups
S. dysenteriae S. flexneri S. boydii S. sonnei
31
Transmission of Shigella
- Fecal/oral - Direct contact - 5 F’s: fingers, fomites, fecal, food, flies)
32
Most contagious (lowest infective dose)
Shigella 1-100 organisms for an infective dose
33
Shigella dysenteriae vs E. coli O157:H7
O157:H7 - no leukocytes in stools
34
Habitat of S. enterica subsp. enterica
Warm-blooded animals and humans
35
S. flexneri
3rd world nations Reiter’s chronic arthritis syndrome
36
S. sonnei
- Predominantly in USA - Gastroenteritis in men being with other men - Self limiting, fever, watery diarrhea, typically asymptomatic ONPG and ODC (+) — remember late lactose fermenter
37
Salmonella Typhoid Fever
- Tropical disease - Transmission: fecal/oral, direct contact, fomites - Symptoms: 9-14 days after ingestion, malaise, anorexia, myalgia/muscle pain, headache, fever, bacteremia, dissemination to multiple organs - Isolated from blood (blood culture positive)
38
Non-typhoidal Salmonella
- Young children: bacteremia, fever - Adults: septicemia, septic arthritis
39
Y. pseudotuberculosis
Close contact with animals and contaminated food
40
Y. enterocolitica
Undercooked meat, contaminated milk, transfusion Bullseye on CIN Urease (+) Non-motile at 35 C
41
Y. pestis vs other Yersinia
- Non-motile - Urease negative
42
3 forms of plague
- Pneumonic - bacteria inhaled, lungs - Bubonic - fleas - Septicemic - pneumonic and bubonic turn into this, manifests in the whole body
43
Edwardsiella tarda
Gastroenteritis, wound infections, bacteremia in immunocompromised patients K/A Indole (+) vs salmonella indole (-) iMViC ++--
44
Citrobacter sp
GI tract, UTI Cause healthcare associated infections (HAI)
45
C. freundii
UTIs, pneumonia, endocarditis Similar to Salmonella - ONPG and Citrate (+) compared to Salmonella paratyphi A iMViC -+-+
46
C. koseri
Neonatal meningitis, brain abscesses iMViC ++-+
47
Klebsiella pneumoniae vs Klebsiella oxytoca
Pneumoniae = Indole (-) Oxytoca = Indole (+)
48
Klebsiella pneumoniae
Normal flora in GI tract, nasopharynx - Pneumonia, wound infections, UTI, bacteremia - Pyrogenic liver abscess Hyper-mucoid colonies iMViC - - ++
49
Morganella vs Providencia
Morganella: Citrate (-), ODC (+) Providencia: Citrate (+), ODC (-)
50
Proteus mirabilis vs Proteus vulgaris
P. mirabilis: ODC (+), Indole (-), K/A H2S+ P. vulgaris: ODC (-), Indole (+), A/A H2S+ - Remember P. vulgaris on iMViC chart, indole (+). Then, ODC is the opposite - P. mirabilis and Morganella are both ODC (+)
51
Proteus sp
Urease (+), can cause calculi (hard deposited of minerals and salts in the kidneys) in P. mirabilis UTI
52
Serratia marcescens
- Nosocomial (originates in the hospital) - Cystitis, pneumonia, bacteremia, septic arthritis, osteomyelitis - DNase (+) iMViC - - ++ Red pigment on plate!
53
Enterobacter sp
iMViC - - ++ Isolated in wounds, urine, blood, CSF Mucoid colonies like Klebsiella
54
What are the 3 organisms that are iMViC ++- -?
E. coli Edwardsiella tarda Proteus vulgaris EEP
55
What are the 3 organisms that are iMViC - - ++?
Klebsiella pneumoniae Enterobacter sp Serratia marcescens KES
56
Y. pseudotuberculosis vs Y. enterocolitica
Pseudotuberculosis - motile at 25 C Enterocolitica - NON-motile at 35 C
57
Enterobacter vs Serratia
Serratia = DNase (+) Enterobacter = DNase (-)
58
Salmonella vs E. tarda
Salmonella = Indole (-) E. tarda = Indole (+) - iMViC for E. tarda
59
C. freundii vs S. paratyphi A
C. freundii = ONPG (+) S. Paratyphi A = ONPG (-)
60
What are the differences between Pseudominas aeruginosa vs. P. putida and P. fluorescens vs. P. stutzeri and P. oryzihatibans?
P. aeroginosa: grows at 42 C, pyocyanin (blue-green pigment) P. putida, P. fluorescens: Grows at 4 C, produces pyoverdin (yellow green or yellow brown pigment), fluorescent under UV. Produces acid from a xylose P. stutzeri, P. oryzihatibans: no fluorescent pigments P. stutzeri has wrinkly colonies Grows at 42 C
61
How to differentiate P. stutzeri?
Leathery wrinkled colonies with yellow pigment
62
P. putida vs P. fluorescens
Gelatin hydrolysis P. fluorescens (+) P. putida (-)
63
P. aeroginosa on SBA
- Flat with serrated edges - beta hemolytic - grape or tortilla odor - mucoid when from a CF patient
64
What are the 2 LDC (+) nonfermenters?
Burkholderia and Stenotrophomas
65
Difference between Burkholderia and Stenotrophomonas?
DNase Burkholderia = DNase (-) Stenotrophomonas = DNase (+)
66
Where is Burkholderia cepacia found in?
In the environment (soil, stream, water. Can be a plant pathogen
67
What is the difference between Citrobacter koseri and Citrobacter freundii?
C. koseri: iMViC ++-+ C. freundii: iMViC -+-+
68
What are the two LDC (+) non fermenters?
Burkholderia and Stenotrophomonas
69
How do you differentiate Burkholderia and Stenotrophomonas?
DNase Burkholderia (-) Stenotrophomonas (+)
70
Burkholderia pseudomallei
Found in soil, stream, rice paddies in other parts of the world Affects lungs (meliodosis) and sacs that form tears Bioterrorism agent Smooth and mucoid to dry and wrinkled on SBA Essential oil spray at Walmart, essential oil from India - first case in US
71
What media is used to differentiate sucrose fermenting Vibrios with non sucrose fermenting?
TCBS - thiosulfate citrate bile salts V. cholerae = yellow colonies since it ferments sucrose Other Vibrios = green colonies since it doesn’t ferment sucrose
72
Which organism is associated with Trench fever?
Bartonella quintana
73
Cat scratch disease
Bartonella henselae
74
Tularemia (rabbit fever)
Francisella tularensis
75
Capnocytophaga
Cat no From cat and dog bites Spindle shaped, thin on both ends (think of cat nails) C. canimorsus may cause amputation of leg/arm Penicillin
76
Aerobic organisms
PPBBSAA Pseudomonas aeroginosa Pseudominas stutzeri Burkholderia cepacia Burkholderia pseudomallei Stenotrophomonas maltophilia Acetinobacter baumanii Alcaligenes
77
Stomach ulcers and strong urease activity
Helicobacter Urea breath test
78
What is BYCE media used for?
Legionella
79
What 3 ingredients in BCYE are specific for Legionella?
L-cysteine HCl Ferric pyrophosphate Alpha-ketoglutarate
80
Which non-Enterobacteriaceae are oxidase negative?
Stenotrophomonas and Acinetobacter
81
What is the disease for H. aegypticus?
Conjunctivitis/pink eye
82
What is the disease for H. ducreyi?
Genital ulcer disease
83
Bleach odor
Haemophilis influenzae Eikenella

Microbiology (9 decks)

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