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Enterobacteriaceae II Flashcards

(45 cards)

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1
Q

T/F Shigella is lactose and indole positive

A

FALSE

Shigella is lactose NEGATIVE, even though many enterobacteriaceae do ferment lactose

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2
Q

Shigella has no H antigen, and is therefore _____

A

Non-motile

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3
Q

What are the four important species of Shigella?

A
  • S. dysenteriae (A)
    • Most dangerous - shiga toxin and neurotoxin
  • S. flexneri (B)
  • S. boydii (C)
  • S. sonnei (D)
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4
Q

What is the route of transmission for Shigella?

A

Fecal oral

F’s: Fecal oral, fingers, flies, feces, food, fomites, fornication (MSM)

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5
Q

Shigella adheres to _____ in gut lymphoid tissue

A

M cells

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6
Q

Shigella moves laterally between cells by _____

A

Polymerizing actin (kinda like listeria)

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7
Q

Due to its _____ existence, cell mediated immunity to Shigella is important

A

Intracellular (taken up by macrophages)

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8
Q

When taken up by macrophages, Shigella causes the production of pro-inflammatory cytokines, causing the formation of _____ that cause its bloody diarrhea

A

Ulcers

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9
Q

Some Shigella species secrete Shiga toxin. Because of this, infected kids may develop _____, a serious sequelae of infection

A

Hemolytic Uremic Syndrome

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10
Q

What is the treatment for Shigellosis?

A
  • Rehydration (pedialyte)
  • Cipro
  • Ceftriaxone
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11
Q

The most severe form of Shigellosis is known as _____. What is the cause of its symptoms? What species causes it? What is the characteristic lesion seen?

A
  • Bacillary Dysentery
  • Symptoms caused by systemic effects of Shiga toxin and neurotoxin
  • Caused by S. dysenteriae (Serogroup A)
  • Characteristic “flask shaped” ulcers seen
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12
Q

Salmonella, like Shigella, is both _____ and _____ negative

A

Indole and Lactose negative

(For comparison, E. Coli is POSITIVE for both indole and lactose, useful bit for diagnosis)

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13
Q

T/F Salmonella is motile

A

TRUE

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14
Q

T/F Salmonella produced hydrogen sulfide

A

TRUE

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15
Q

Gastroenteritis is caused by Salmonella enterica subspecies other than _____.

A

Typhi (Typhimurium is the most important gastroenteritis causing form for us)

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16
Q

How is Salmonella transmitted to humans?

A
  • Consumption of contaminated food products
    • Raw chicken and eggs
  • Reptile contact
    • Baby turtles
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17
Q

T/F Salmonella is similar to Shigella in that is acid resistant

A

FALSE

Salmonella is sensitive to stomach, in contrast to Shigella

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18
Q

The symptoms of Salmonella infection include nausea, vomiting, cramps, diarrhea, and sometimes fever appearing _____ after ingestion

A

8-12 hours

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19
Q

T/F Like Shigella, Salmonella adheres to M-cells

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A

TRUE

Adhere to M-cells via at least four different types of pili

20
Q

In Salmonella, there is no _____ because there is no damage to the epithelial lining

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A

No blood or ulceration

21
Q

What is the treatment for Salmonella?

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A
  • Oral-rehydration +/- Pepto Bismol
    • Self limiting disease
  • Ciprofloxacin in severe cases
22
Q

What subspecies of Salmonella enteritica causes Typhoid Fever?

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A

S. enteritica Typhi

Makes sense

23
Q

T/F S. enteritica typhi has the same animal reservoir as other subspecies of S. enteritica

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A

FALSE

S. enteritica typhi ONLY has a human reservoir

24
Q

How is S. enteretica typhi transmitted?

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A

Fecal-oral from human carriers (sits in the gallbladder)

25
The symptoms of typhoid fever (dehydration, anorexia, lethargy, cough, ***constipation***, abdominal pain, high fever, and delirium) are all due to S. enteritica typhi \_\_\_\_\_\_
Toxins
26
What is a cutaneous manifestation of Typhoid Fever that appears in some patients?
Rose-colored spots/rash
27
What are the treatment options for Typhoid Fever?
* Fluoroquinolones * Ciprofloxacin * Macrolides * Azithromycin * Cephalosporins * Ceftriaxone
28
Y. enterocolitica is lactose _____ and urease \_\_\_\_\_
Lactose negative, urease positive
29
How is Y. enterocolitica transmitted?
* Fecal-oral * Pet feces * Milk or pork * Day care centers
30
Y. enterocolitica incades through what kind of cells? Where does it multiply?
* Invades M cells * Multiplies in macrophages
31
How does Yersinosis present in kids \< 5, older kids/adults, women, and the Immunocompromised?
* Kids \< 5 * Enteritis with *prolonged diarrhea* (inflammatory, bloody) * Older Kids/Adults * Gastroenteritis, mesenteric lymphadenitis, terminal ileitis * Women * Diarrhea w/ arthritis, *erythema nodosum* * Immunocompromised * Liver abscess
32
What are the treatment options for Yersinosis?
* Rehydration * Abx * Fluoroquinolone (Ciprofloxacin) * Cephalosporin (Ceftriaxone) * Sulfa-trimethoprim (Bactrim)
33
What are the three extraintestinal infxns caused by E. Coli?
* Cystitis * Pyelonephritis * Opportunistic infxns * Lung, wound, neonatal meningitis
34
What are the symptoms of E. coli cystitis? How is it diagnosed? Treatment?
* Symptoms * Dysuria * Increase in frequency/urgency * +/- hematuria * Diagnosis * Urinalysis → Gram stain (Gram-negative rods) * Symptomology/history * Treatment * Bactrim or fluoroquinolones * Nitrofurantoin or fosfomycin as second line drugs * Best way to clear infection is to increase fluid intake to increase urination and flush bacteria * E. coli is *resistant to penicillin, ampicillin, or amoxicillin*
35
\_\_\_\_\_ occurs when E. coli ascend the the ureters and access the parenchyma of the kidneys. How can sepsis occur? Tx?
* Pyelonephritis * Secretion of hemolysin can damage renal cells and lead to sepsis * Tx: Same as cystitis (Fluoroquinolone, Bactrim) but for longer course
36
Aside from Group B Strep, what is the leading cause of neonatal meningitis
E. coli
37
Klebsiella pneumonia/oxytoca appear as gram _____ \_\_\_\_\_ with a large \_\_\_\_\_
Gram negative rods with a large polysaccharide capsule
38
Like E. coli, Klebsiella is lactose \_\_\_\_\_
Positive
39
Klebsiella is urease \_\_\_\_\_
Positive
40
T/F Klebsiella is susceptible to beta-lactams
FALSE They are resistant to all beta-lactams Tx: Polymyxin
41
What are the infections caused by Klebsiella?
* UTI * Soft tissue infxns * Sepsis * Liver abscesses * K1 strains
42
The sputum of patients with Klebsiella pneumonia is a characteristic \_\_\_\_\_
Red currant jelly sputum
43
What are the 4 A's of Klebsiella?
* Aspiration pneumonia * Abscesses in lung/liver * Alcoholics * Di-A-betics
44
Serratia marcescens produces a characteristic bright red pigment due to its _____ pigment
Prodigiosin
45
What species of enterobacteriaceae produces a lot of urease that alters pH and promotes stone formation?
Proteus mirabilis & vulgaris

Bacteriology (19 decks)

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