Lesson 11 Flashcards by Juvinette Buenafe

All ferment glucose

ENTEROBACTERICEAE

How well did you know this?

Not at all

Perfectly

WHAT ARE THE TWO CATEGORIES OF MEMBERS OF FAMILY
ENTEROBACTERIACEAE?

OPPORTUNISTIC PATHOGENS
PRIMARY INTESTINAL PATHOGENS

How well did you know this?

Not at all

Perfectly

WHAT ARE THE OPPORTUNISTIC PATHOGENS OF FAMILY ENTEROBACTERIACEAE?

Citrobacter
Enterobacter
Edwardsiella
Hafnia
Klebsiella
Proteus
Providencia
Serratia
Morganella
Ewingella
Plesiomonas

How well did you know this?

Not at all

Perfectly

Often part of the normal intestinal flora
May produce serious extraintestinal opportunistic
infections

OPPORTUNISTIC PATHOGENS

How well did you know this?

Not at all

Perfectly

WHAT ARE THE PRIMARY INTESTINAL PATHOGENS OF THE FAMILY ENTEROBACTERIACEAE?

Salmonella
Shigella
Yersinia

How well did you know this?

Not at all

Perfectly

True pathogens / Overt pathogens
Not part of the normal intestinal flora

PRIMARY INTESTINAL PATHOGENS

How well did you know this?

Not at all

Perfectly

It is a normal bowel inhabitant but its pathogenic
classification is somewhere between overt pathogens and
opportunistic pathogens

Escherichia coli

How well did you know this?

Not at all

Perfectly

ENTEROBACTERICEAE: VIRULENCE AND ANTIGENIC
FACTORS

o Ability to colonize, adhere and invade tissues
o Production of toxins
o Presence of plasmids that mediate resistance to
antimicrobials

How well did you know this?

Not at all

Perfectly

What are the antigens used for identifying different serological
groups of ENTEROBACTERICEAE?

Somatic Antigen (O Ag)
Flagellar Antigen (H Ag)
Capsular Antigen (K Ag)

How well did you know this?

Not at all

Perfectly

What type of atigen is located in the cell wall
and heat stable?

Somatic Antigen (O Ag)

How well did you know this?

Not at all

Perfectly

This type of antigen is Heat labile
only

Flagellar Antigen (H Ag)

How well did you know this?

Not at all

Perfectly

This type of Antigen is heat labile, Capsule K1 Antigen of E. coli
and Vi Antigen of Salmonella typhi

Capsular Antigen (K Ag)

How well did you know this?

Not at all

Perfectly

This type of agar can be used
when suspecting enteric pathogens, it is preferred to use selective and differential media

Chocolate Agar Plate (CAP) or Blood Agar Plate (BAP)

How well did you know this?

Not at all

Perfectly

On BAP, colonies may be haemolytic. It is usually what type of hemolytic?

β or non haemolytic

How well did you know this?

Not at all

Perfectly

WHAT ARE THE SELECTIVE AND DIFFERENTIAL MEDIA FOR ISOLATION OF
ENTEROBACTERIACEAE?

MCA
o Mac Conkey Agar
EMB
o Eosin Methylene Blue Agar
XLD
o Xylose Lysine Desoxycholate Agar
SSA
o Salmonella-Shigella Agar
HEA
o Hektoen-Enteric Agar
Sel-F Broth
° Selenite F Broth

How well did you know this?

Not at all

Perfectly

WHAT ARE THE BIOCHEMICAL TESTS OF ENTEROBACTERICEAE?

▪ TSI / KIA
▪ Indole
▪ Citrate Utilization
▪ Urease Production
▪ Motility Test
▪ Decarboxylase Test
▪ ONPG
▪ LIA
▪ MR-VP Test
▪ PAD
▪ Nitrate Reduction Test

How well did you know this?

Not at all

Perfectly

o Inhabitants of the intestinal tract
o Most ferment lactose
o Colonies on MCA resembles those of E. coli

GENUS CITROBACTER

How well did you know this?

Not at all

Perfectly

GIVE ME THE GENUS AND SPECIES OF THE CITROBACTER

Citrobacter freundii
Citrobacter diversus
Citrobacter amaloniticus
Citrobacter koseri
Citrobacter braakii

How well did you know this?

Not at all

Perfectly

What are the associated with infectious diseases acquired in hospital settings of Citrobacter freundii?

➢ UTI
➢ Pneumonia
➢ Intraabdominal abscess
➢ Endocarditis
➢ Septicemia
➢ Meningitis
➢ Brain abscess and neurologic complications

How well did you know this?

Not at all

Perfectly

Colonial morphology may be easily mistaken for that of Salmonella
May harbor inducible AmpC genes that encode
resistance to ampicillin and first generation
cephalosporins

Citrobacter freundii

How well did you know this?

Not at all

Perfectly

Causes nursery outbreaks of neonatal meningitis and
brain abscess

Citrobacter diversus

How well did you know this?

Not at all

Perfectly

Frequently found in feces (not a causative agent of
diarrhea)
and Have been isolated from blood and wound

Citrobacter amalonaticus

How well did you know this?

Not at all

Perfectly

Formerly Aerobacter
Frequently associated with health-care associated
infections
May harbour plasmids that encode multiple antibiotic
resistance genes

GENUS ENTEROBACTER

How well did you know this?

Not at all

Perfectly

 A /A
 Lysine (-)
 Ornithine (+)
 Motility (+)
 IMVC: –+ +

Enterobacter cloacae

How well did you know this?

Not at all

Perfectly

 Formerly Enterobacter agglomerans  Associated with outbreak of septicemia due to contaminated IV fluids

Pantoea agglomerans

 Formerly Enterobacter sakazakii  Pathogen associated with bacteremia, meningitis and necrotizing colitis in neonates  Isolated from brain abscesses, respiratory and wound infections

Cronobacter sakazakii

 Found in respiratory samples  Rarely isolated from blood cultures

Enterobacter gergoviae

 Now called, Klebsiella aerogenes  Lysine (+)

Enterobacter aerogenes

Isolated from blood, wound, sputum

Enterobacter hormaechei

GIVE ME THE GENUS AND SPECIES OF THE ENTEROBACTER

Enterobacter cloacae Pantoea agglomerans Cronobacter sakazakii Enterobacter gergoviae Enterobacter aerogenes Enterobacter hormaechei Enterobacter taylorae Enterobacter amnigenus Enterobacter asburiae Enterobacter intermedius

GIVE ME THE GENUS AND SPECIES OF THE EDWARDSIELLA

Edwardsiella tarda Edwardsiella hoshinae

GIVE ME THE GENUS AND SPECIES OF THE HAFNIA

Hafnia alvei

GIVE ME THE GENUS AND SPECIES OF THE KLEBSIELLA

Klebsiella pneumoniae Klebsiella oxytoca Klebsiella terrigena Klebsiella group 47

Give me the subspecies of Klebsiella pneumoniae

Klebsiella pneumoniae ssp. ozaenae Klebsiella pneumoniae ssp. pneumoniae Klebsiella pneumoniae ssp. rhinoscleromatis

Give me the 2 Klebsiella group 47

Klebsiella ornithinolytica Klebsiella planticola

GIVE ME THE GENUS AND SPECIES OF THE PROTEUS

Proteus vulgaris Proteus mirabilis Proteus penneri

GIVE ME THE GENUS AND SPECIES OF THE PROVIDENCIA

Providencia rettgeri Providencia stuartii Providencia alcalifaciens Providencia rustigianii

GIVE ME THE GENUS AND SPECIES OF THE SERRATIA

Serratia marcescens Serratia rubidea Serratia liquefaciens Serratia odorifera Serratia ficaria Serratia grimesii Serratia proteamaculans Serratia fonticola Serratia plymuthica

GIVE ME THE GENUS AND SPECIES OF THE MORGANELLA

Morganella morganii Morganella psychrotolerans

GIVE ME THE GENUS AND SPECIES OF THE EWINGELLA

Ewingella americana

GIVE ME THE GENUS AND SPECIES OF THE PLESIOMONAS

Plesiomonas shigelloides

GIVE ME THE GENUS AND SPECIES OF THE SALMONELLA

Salmonella typhosa/typhi Salmonella cholerasuis Salmonella enteritidis Salmonella enterica Salmonella bongori

GIVE ME THE GENUS AND SPECIES OF THE SHIGELLA

Shigella dysenteriae Shigella flexnerii Shigella boydii Shigella sonnei

GIVE ME THE GENUS AND SPECIES OF THE YERSINIA

Yersinia pestis Yersinia enterocolitica Yersinia pseudotuberculosis Yersinia intermedia Yersinia kristensenii Yersinia frederiksenii Yersinia aldovae Yersinia ruckeri

GIVE ME THE GENUS AND SPECIES OF THE ESCHERICHIA

Escherichia coli Escherichia hermannii Escherichia vulneris Escherichia fergusonii Escherichia blattae

o Infrequently encountered in the clinical laboratory as cause of gastroenteritis o Associated with water harboring fish and turtles and rarely on humans o Opportunistic pathogen to immunocompromised hosts that may develop serious wound infections and myonecrosis

GENUS EDWARDSIELLA

It is the only recognized human pathogen in Genus Edwardsiella

Edwardsiella tarda

o Formerly Enterobacter hafniae o Associated with gastrointestinal linfections o Resides in GIT of humans and animals

GENUS HAFNIA

o Inhabitants of then asopharynx and GIT o Absence of motility distinguishes this species from other members of Enterobacteriaceae family ° Associated with variety of infections including liver abscess, pneumonia, septicaemia and UTI

GENUS KLEBSIELLA

 Most commonly isolated species in the genus Klebsiella  Friedlander’s bacillus All strains are resistant to ampicillin

Klebsiella pneumonia

CLINICAL INFECTIONS OF KLEBSIELLA PNEUMONIAE

➢ Lower RT infections in hospitalized patients, newborns, elderly and seriously ill patients on respirators ➢ Wound infections ➢ UTI ➢ Bacteremia ➢ Nosocomial outbreaks in newborn nurseries ➢ Severe enteritis ➢ Septicemia ➢ Meningitis

 Only indole (+) member of Klebsiella  Disease is similar to K. pneumoniae  Same strains carry a heat-labile cytotoxin which has been isolated from patients who have developed a self- limiting antibiotic associated hemorrhagic colitis

Klebsiella oxytoca

A Klebsiella group 47 which is an environmental organism which also cause UTI and wound infection

Klebsiella planticola

o Normal in habitants of GIT o Actively motile at 37°C o NLF o Able to deaminate phenylalanine o “Swarming” appearance on BAP

GENUS PROTEUS

Different Proteus strain swarm but does not swarm with each other leaving a demarcation line between them

DIENES PHENOMENON

Has same antigenic structure as Rickettsiae. Ag of some strains of this species can be used to diagnose (Weil Felix Test: OX2, OX19 and OXk)

Proteus vulgaris

 Formerly Proteus vulgaris strain  A newly recognized species

Proteus penneri

o Biochemically similar to Proteus o Normal inhabitants of GIT o Most commonly associated with UTI o Associated with nosocomial outbreaks o No clear clinical association exists when these organisms are isolated

GENUS PROVIDENCIA

 Formerly Proteus rettgeri  Pathogen of urinary tract  Has caused occasional nosocomial outbreaks

Providencia rettgeri

 Nosocomial outbreaks in burn units  Isolated from urine cultures

Providencia stuartii

Associated with gastroenteritis especially in children

Providencia alcalifaciens

o Colonizers and are known to cause pathogenic infections in health care settings o Opportunistic pathogens associated with nosocomial outbreaks o Capable of survival under very harsh environmental conditions o Resistant to many disinfectants

GENUS SERRATIA

 Usually considered clinically important  Frequently found in hospital acquired infections of the UT and RT  Also associated with bacteremic outbreaks in nurseries, cardiac surgery and burn units

Serratia marcescens

A non-water soluble red pigment known as

PRODIGIOSIN

 Also produces PRODIGIOSIN  Have also been isolated from human sources

Serratia rubidea

Have also been isolated from human sources

Serratia liquefaciens

Gives off a characteristic dirty, musty, pungent odor like potatoes

Serratia odorifera

What biogroup in Serratia odorifera that is Isolated from RT and Ornithine (+), Sucrose (+), may be indole + (60%)

Biogroup 1

What biogroup in Serratia odorifera that is Isolated from RT and Ornithine (-), Sucrose (-), may be indole + (50%)

Biogroup 2

o Found ubiquitously throughout the environment o Normal in habitants of GIT o Often associated with stool specimens from patients with symptoms of diarrhea o Commonly isolated in clinical laboratory, however its clinical significance has not been clearly defined o Biochemically similar to Proteus o Can cause UTI o Has been implicated in post operative infections and other nosocomial infections

GENUS MORGANELLA

Formerly Proteus morganii

Morganella morganii

WHAT ARE THE TRIBE PROTEAE?

Genus Proteus Genus Providencia Genus Morganella

 Has been identified from blood and wound isolates  Organism is biochemically inactive  Currently, no recommended identification scheme has been identified

GENUS EWINGELLA

This Genus now has been included in the family Enterobacteriaceae. Fresh water in habitant Can cause gastroenteritis, most frequently, in children

GENUS PLESIOMONAS

o Facultative anaerobe o Motile o Non-encapsulated o NLF o Motile with peritrichous flagella except for 2 species o Isolated from intestines of humans and animals

GENUS SALMONELLA

ID of Genus Salmonella is primarily based on?

✓ Ability of organism to use citrate as the sole source of carbon ✓ Ability of organism to use lysine as nitrogen source in combination with H2S production

According to Kauffmann-White Antigenic Scheme

There are 2000 species of Salmonella because of its antigenic type

According to Ewing

Proposed only 3 species

Eberth’s Bacillus

Salmonella typhosa / typhi

Standard test organism for determining the efficacy of disinfectants

Salmonella cholerasuis

- All other serotypes are defined as serotype of Salmonella enteritidis - Salmonella typhimurium became Salmonella enteritidis serotype typhimurium

Salmonella enteritidis

WHAT ARE THE TWO PRIMARY SPECIES OF GENUS SALMONELLA?

i. Salmonella enterica (human pathogen) ii. Salmonella bongori (animal pathogen)

What are the 6 subspecies of Salmonella enterica?

✓ Salmonella enterica subspecie enterica ✓ Salmonella enterica subspecie salamae ✓ Salmonella enterica subspecie arizonae ✓ Salmonella enterica subspecie diarizonae ✓ Salmonella enterica subspecie houtenae ✓ Salmonella enterica subspecie indica

What are the serogroups with unique vilurence properties of Salmonella enterica subspecie enterica?

➢ Salmonella typhi ➢ Salmonella paratyphi ➢ Salmonella choleraesuis

What are the serogroups with unique vilurence properties of Salmonella enterica subspecie enterica?

✓ Salmonella enterica subspecie enterica ➢ Further subdivided into serogroups with unique virulence properties ➢ Salmonella typhi ➢ Salmonella paratyphi ➢ Salmonella choleraesuis

Most serious pathogens for humans causing enteric fever

Salmonella enterica subspecie enterica

Formerly Arizona hinshawii Associated with human infections acquired from pet turtles, snakes and fish

Salmonella enterica subspecie arizonae

VIRULENCE FACTORS OF GENUS SALMONELLA

➢ Fimbriae for adherence ✓ Ability to traverse intestinal mucosa ➢ Enterotoxin ✓ Causes gastroenteritis

ANTIGENIC STRUCTURE OF GENUS SALMONELLA

1. Heat –Stable Somatic O Antigens 2. Heat-Labile Flagellar H Antigens 3. Heat-Labile Capsular K Antigens

Treatable with ethanol or acid

Heat-Labile Flagellar H Antigens

What are the two phases of Heat-Labile Flagellar H Antigens?

Phase 1/Specific Phase Phase 2/Non-specific Phase

✓ Occur only in small number of serotypes ✓ Agglutinate only with homogenous antisera ✓ Determine the immunologic identity of the particular serotype

Phase 1 / Specific Phase

✓ Occur among several strains ✓ React with heterogeneous antisera ✓ Shared by numerous serotypes

Phase 2 / Non-specific Phase

What are the Clinical infections of Genus Salmonella?

Gastroenteritis Typhoid Fever

➢ Designated as Vi antigen (Virulent Ag) ➢ Found in S. typhi and few other strains ➢ Helps evade phagocytosis ➢ Most often blocks the O Ag during serologic typing

Heat-Labile Capsular K Antigens

➢ Results from ingestion of the organism through contaminated food ➢ Strains associated are usually found in animals (serotypes of S. enteritidis) ➢ Sources of infection poultry, milk, eggs and egg products as well as handling pets ➢ Occurs when sufficient number of organism contaminate food that is maintained under inadequate refrigeration, thus allowing growth and multiplication of the organism

GASTROENTERITIS

What is the Infective Dose of Salmonella in Gastroenteritis?

10,000,000 bacteria

What are the antimicrobials of choice for salmonella?

Chloramphenicol Ampicillin Trimethoprim Sulfamethoxazole

➢ Enteric Fever caused by S. typhi ➢ Results from the ingestion of food contaminated with the organism originating from infected individuals as carriers

TYPHOID FEVER

What are the Clinical Features of Typhoid Fever?

✓ Prolonged fever ✓ Bacteremia ✓ involvement of RES (particularly liver, spleen, intestines and mesentery) ✓ dissemination to multiple organs ✓ develops approximately 9-14 days after ingestion of the organism depending on the number of organisms ingested

➢ Caused by non-typhoidal Salmonella ➢ Characterized primarily by prolonged fever and intermittent bacteremia ➢ Most commonly associated strains are; S. typhimurium, S. paratyphi A and B, S. cholerasuis

BACTEREMIA

Individuals who recover from the infection may harbour the organisms in the gallbladder which becomes the site of chronic carriage

CARRIER STATE

- Very closely related to Escherichia, belongs to tribe Escherichieae - All species can cause bacillary dysentery but vary in epidemiology, mortality rate and severity of disease produced - Highly communicable because of the low infective dose required to produce the disease

GENUS SHIGELLA

It is characterized by the presence of blood, mucus and pus in the stool ✓ Occurs in an epidemic dimension

Dysentery

______ with shigellosis may transiently lose the reflexive closing of the anal canal with external pressure as from a cotton swab

Infants

The only reservoir of Shigella

Humans

WHAT ARE THE CLASSIFICATION OF SHIGELLA BASED ON MANNITOL FERMENTATION?

A. NON-MANNITOL FERMENTERS B. MANNITOL FERMENTERS

- Dysentery Bacillus or Shiga's Bacillus - Very Infectious

Shigella dysenteriae

Two types of Toxin of Shigella dysenteriae

Exotoxin- neurotoxin Enterotoxin- similar to cholera toxin

what Shigella species are Non-Lactose Fermenters?

Shigella flexnerii Shigella boydii

Strong's Bacillus

Shigella flexnerii

Boyd's Bacillus or Newcastle-Menchester Bacillus (new name)

Shigella boydii

what are the two types of Mannitol Fermenters?

Non-Lactose Fermenters Late Lactose Fermenters

Sonne Duval Bacillus or Sonne's Bacillus

Shigella sonnei

Suspected strains that cannot be typed by serologic methods should be referred to a ________ for further testing

reference laboratory

Remains the most virulent species with significant morbidity and high mortality

Shigella dysenteriae

What are the COMPLICATIONS of Shigella dysenteriae?

➢ Obstruction in the intestines with marked abdominal dilatation possibly leading to toxic mega colon ➢ Bacteremia ➢ Seizures : may occur during Shigella strain infection ➢ HUS (Hemolytic Uremic Syndrome), exclusively associated with S. dysenteriae type 1 shigellosis

Leading isolate in “GAY BOWEL SYNDROME”

Shigella flexneri

✓ Predominant isolate in the US followed by S. flexneri ✓ Infection is usually short ✓ Self-limiting disease characterized by fever and watery diarrhea

Shigella sonnei

GENUS YERSINIA was named after a French Microbiologist and who isolated the plague bacillus 1894

Alexander Yersin

Microaerophilic and Short Gram (-) coccobacillus

Genus Yersinia

A Causative agent of plague that shows intense staining at each end of the bacillius referred to as ”bipolar staining” using Wayson Stain or Methylene Blue giving a “safety pin” appearance

Yersinia pestis

A life –threatening disease of rodents transmitted to humans by bites of fleas

PLAGUE

This type of vector fleas that normally infest brown and black rats

Xenopsylla cheopsis

THREE (3) PLAGUE PANDEMIC

1. Started near Egypt in 542 AD, ravaged Europe for 50 years, killing 100 M people 2. Started in the 14thCentury –The Black Death, killing 25 M Europeans, ¼ of the population at that time 3. Started in Burma in 1890’s and spread to many parts of the world

WHAT ARE THE FORMS OF PLAGUE?

A. BUBONIC PLAGUE / GLANDULAR PLAGUE B. PNEUMONIC PLAGUE C. SEPTICEMIC PLAGUE

➢ Usually results form the bite of an infected insect vector ➢ Characteristic symptoms appear 2 –5 days after infection ➢ Symptoms include high fever with painful regional lymph nodes as buboes begin to appear

BUBONIC PLAGUE / GLANDULAR PLAGUE

Occurs secondary to the bubonic plague when organisms proliferate in the blood stream and respiratory tract Fatality rate is high if patients remain untreated 90% mortality rate

PNEUMONIC PLAGUE

➢ 97-99% Mortality Rate ➢ Black Death – black purpuric lesions all over the body called as “Generalized Schwartzman Phenomenon”

SEPTICEMIC PLAGUE

LABORATORY DIAGNOSIS OF A YERSINIA PESTIS

➢ Stained Smear ➢ Culture ➢ Transport Medium ➢ Animal Inoculation Test ➢ Fluorescent Antibody Test

 Most commonly isolated species of the genus  Morphologically resembles other Yersinia species: g(-) coccobacilli, bipolar staining  Also grows on routine media, BAP, MCA  Has optimal growth temperature of 25°C –30°C  Motility is clearly noted at 25C but not at 35 C  Cold enrichment has provided better recovery

Yersinia enterocolitica

A selective medium to detect the presence of Yersinia enterocolitica

CIN Agar

Yersinia enterocolitica infection manifest in several forms

Acute Enteritis Mesenteric Lymphadenitis Arthritis Erythema Nodosum

 Appears as atypical looking plague bacillus  May be differentiated from Y. pestis by its motility at 18 C-22 C, production of urease and the ability to ferment rhamnose

Yersinia pseudotuberculosis

Yersinia pseudotuberculosis causes a disease characterized by caseous swelling called

pseudotubercles

Most significant species in the genus Associated with GIT, UT, Meningeal (newborns), Wound and Bacteremic Infections Most strains are motile Possess both sex pili and adhesive fimbriae

Escherichia coli

FIVE MAJOR CATEGORIES OF DIARRHEAGENIC E. COLI

1. Enteropathogenic E coli (EPEC) 2. Enterotoxigenic E. coli (ETEC) 3. Enteroinvasive E. coli (EIEC) 4. Enterohemorrhagic E. coli (EHEC) 5. Enteroaggregative/ Enteroadherent E. coli (EAEC)

TWO CATEGORIES OF EXTRAINTESTINAL E. COLI INFECTIONS

UROPATHOGENIC E. COLI (UPEC) MENINGITIS/ SEPSIS-ASSOCIATED E.. COLI (MNEC)

OTHER EXTRAINTESTINAL E. COLI INFECTIONS

1. BACTEREMIA 2. Nosocomial Infections of other body sites

➢ coli atypical or enteric group ll ➢ Has been isolated from spinal fl

Escherichia hermannii

➢ Isolated from wound ➢ May also produce yellow pigmented colonies (more than half of the strains)

Escherichia vulneris

➢ From scientist William Ferguso ➢ Multiple abscesses following a gunshot to the abdomen

Escherichia fergusonii

Has only been isolated from the intestine of cockroach

Escherichia blattae

ANTIMICROBIAL SUSCEPTIBILITY TESTING GROUP A

✓ Ampicillin ✓ *Cefazolin ✓ Gentamicin ✓ Tobramycin

ANTIMICROBIAL SUSCEPTIBILITY TESTING GROUP B

✓ Amikacin ✓ Amoxicillin-clavulanate ✓ Ampicillin-Sulbactam ✓ Piperacillin-tazobactam ✓ Ticarcillin-clavulanate ✓ Cefuroxime ✓ Cefepime ✓ Cefoxitin ✓ Cefotaxime or Ceftriaxone ✓ Ciprofloxacin ✓ Levofloxacin ✓ Imipenem ✓ Meropenem ✓ Trimethoprim-sulfamethoxazole

ANTIMICROBIAL SUSCEPTIBILITY TESTING GROUP C

✓ Aztreonam ✓ Ceftazidime ✓ Chloramphenicol ✓ Tetracycline

ANTIMICROBIAL SUSCEPTIBILITY TESTING GROUP O

✓ Aztreonam ✓ Ceftazidime ✓ Chloramphenicol ✓ Tetracycline GROUP O ✓ Cefamandole ✓ Cefoperazone ✓ Ceftizoxime ✓ Cefaclor ✓ Cefixime ✓ Cefpodoxime ✓ Kanamycin ✓ Netilmicin ✓ Streptomycin ✓ Doxycycline ✓ Minocycline ✓ Gatifloxacin ✓ Cinoxacin ✓ Nalidixic Acid

ANTIMICROBIAL SUSCEPTIBILITY TESTING GROUP U

✓ *Cefazolin ✓ Lomefloxacin or ✓ Ofloxacin ✓ Norfloxacin ✓ Nitrofurantoin ✓ Trimethoprim

An adhesion known as ___________ is a major virulence factor of Enteropathogenic E coli (EPEC)

INTIMIN

For definitive ID, enteroinvasiveness must be demonstrated:

a. Serenty Test – bioassay with a positive result of Keratoconjunctivitis in guinea pig b. Monolayer cell cultures with Hep-2 cells

Also known as Verotoxin-Producing E. coli (VTEC) and Serotoxigenic E. coli (STEC)

Enterohemorrhagic E. coli (EHEC)

WHAT ARE THE TWO CYTOTOXINS OF Enterohemorrhagic E. coli (EHEC)?

a. Verotoxin I ➢ Serologically cross-reactive with Shiga toxin b. Verotoxin II ➢ Not neutralized by the Ab to Shiga toxin

- Associated with diarrhea in both adults and infants in tropical and sub tropical climates - Major cause of infant diarrhea in developing countries - Major cause of “travellers diarrhea” among persons from developed countries visiting third world countries

Enterotoxigenic E. coli (ETEC)

- Actual pathogenic mechanism is unknown - Mode of transmission not well understood

Enteroaggregative/ Enteroadherent E. coli (EAEC)

Major cause of E. coli associated UTI

UROPATHOGENIC E. COLI (UPEC)

Causes neonatal meningitis resulting to high morbidity and moratlity

MENINGITIS/ SEPSIS-ASSOCIATED E.. COLI (MNEC)

Lesson 11 Flashcards

(156 cards)