PC 2 mod 2.1 lec 3-6

genera escheria has which species...

coli

distinguishable features of escheria (2)

- produce indole from tryptophan (indole+)

- hemolysis +

E. Coli

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- facultative

- lactose +

- oxidase -

- hemolysis +

- VP -

- normal microbiota (GI)

pathogenesis of E.coli is...

diarrhea

3 main virulence classifications of E.coli

- enteropathogenic E.coli

- enterotoxigenic E.coli

- shiga toxin-producing E.coli

enteropathogenic E.coli (EPEC) is usually found in ____ age in _____ countries causing _____ symptoms and HAS/HAS NOT acquires plasmid for extrinsic resistance

- infant

- developing

- watery diarrhea, vomiting, fever

- has

EPEC acquired ______ for adherence to ______ cell of SI

- pilus

- MUCOSAl

EPEC adheres to mucosal cell of SI and injects ______ to form ______ to bind or anchor it

- effector protein

- actin pedestal

enterotoxigeneic E.coli (ETEC) is called ______ and has developed _____ to adhere to _____ cell of SI that is ____-mediated

- traveler's diarrhea

- pili

- epithelial cell

- plasmid

ETEC contains ______ that are heat labile or heat stable

--> which is more common?

- enterotoxins

- heat labile (inactive at high temp)

ETEC uses ______ to colonize factors that cause tighter adherence and excrete enterotoxins

flagella

______ e.coli uses pilus as adherence factor to mucosal cell lining to form actin pedestal

EPEC

______ e.coli uses flagella to colonize factors for adherence to epithelial cells and releases enterotoxins

ETEC

shiga toxin producing E.coli (STEC) can cause diarrhea that leads to death from ______ and IS/IS NOT normally found

- hemorrhagic colitis

- is not

virulence factor of STEC comes from ____ called _____ and _____

- cytotoxins

- shiga-like toxin 1

- shiga-like toxin 2

cytotoxins of shiga block _____ and induce _____ and are released in ______ conditions

- protein synthesis

- host cell apoptosis

- stress (antibiotic)

STEC is found in ______ and is HEAT STABLE/HEAT LABILE

- cattle

- stable (even if e.coli is killed, toxin release)

most common serotype of E.coli (STEC) responsible for large outbreaks

--> occurred due to...

O157-H7

undercooked and cooked beef patties

E.coli have INTRINSIC resistance which is ______

can they have extrinsic?

penicillinase

yes if acquired plasmids

3 types of infectious disease attributable to E.coli

- diarrhea

- UTI

- intra-abdominal infection

2 best treatments for E.coli

- cefuroxime

- ceftriaxone

5 options for treatment for E.coli

- ampicillin/sulbactam *

- cefazolin *

- cefuroxime

- ceftriaxone

- ciprofloxacin *

_____ is most common cause of UTI due to _____

- E.coli

- pilus

Is E.coli: encapsulated or unencapsulated?

encapsulated

is klebsiella common in community or hospital?

both

3 species of Klebsiella

- pneumoniae

- oxytoca

- aerogenes

klebsiella

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- facultative

- lactose +

- oxidase -

- hemolysis -

- VP +

- normal microbiota GI

klebsiella distinguishing features is it exhibits _____ growth and IS/IS NOT motlie

- mucoid

- non-motile (ex aerogenes)

EXCEPTION to klebsiella being non-motile

aerogenes

klebsiella aerogenes IS/IS NOT motile

is motile

which virulence factors does klebsiella have?

a. capsule

b. adhesins

c. toxins

d. LPS

e. plasmids

f. fimbiral type-pili

a. capsule (70 variations)

b. adhesin

d. LPS

e. plasmid

f. pili (adhesion)

what is responsible for mucoid phenotype in klebsiella?

capsule

mucoid prevents recognition of ______ to inhibit phagocytosis

- LPS

does klebsiella have intrinsic resistance? if so which one

yes, penicillinase

nosocomial isolates of klebsiella may have resistance to other organisms and this would be ______ mediated

plasmid

which plasmid-mediated resistance could klebsiella have if nosocomial? (4)

- ESBL

- klebsiella producing carbapenemase

- fluroquinilone resistance

- aminoglycoside resistance

klebsiella producing carbapenemase is INTRINSIC/EXTRINSIC resistance to ______ and ______

- extrinsic

- cephalosporins

- carbapenems

4 disease attributable to klebsiella

- UTI

- respiratory

- intra-abdominal

- wound infections

liver abscess, biliary tract infections, and peritonitis could happen with....

klebsiella

treatment options for klebsiella (6)

- cefazolin *

- cefuroxime *

- ceftriaxone *

- cefepime *

- piperacillin/tazo *

- meropenem

*cannot be used in ESBL

cefazolin, cefuroxime, ceftriaxone, cefepime, and pip/tazo would not be options for klebsiella if...

ESBL producing

which treatment would be best of klebsiella if it was ESBL producing?

meropenem

enterobacter family contains which species ... (1)

- cloacae

enterobacter is mostly found in the ______ setting

hospital

enterobacter cloacae

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- faculatative anaerobe

- lactose +

- oxidase -

- hemolysis -

- VP +

- normal microbiota GI

distinguishing factors of enterobacter cloacae are it is ______ and exhibits _____

- motile

- mucoid growth

which organisms exhibit mucoid growth? (2)

klebsiella and enterobacter cloacae

cloacae is under...

enterobacter

which species are under citrobacter? (2)

- koseri

- freundii

distinguishing feature of citrobacter is ability to produce ______ and ability to use _____ as carbon source

- H2S

- citrate

which enterobacterales produces H2S

citrobacter

citrobacter koseri and freundii

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- facultative anaerobe

- lactose +

- oxidase -

- VP -

- normal microbiota GI AND soil and water (ubiquitous)

distinguishing features of citrobacter koseri and freundii (1)

produce H2S

which species is under serratia?

marcesens

marcesens is under...

serratia

serratia is more commonly found in...

environment

serratia produces exotoxin called...

Dnase

serratia produces exotoxin ______ that produces a ______ pigment called _______

- Dnase

- red

- prodigosin

______ produces an exotoxin Dnase that produces a red pigment called prodigosin

serratia

serratia marcesens name comes from the latin word...

to decay

serratia marcesens

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- facultative anaerobe

- lactose +

- oxidase -

- hemolysis -

- VP +

- environment

distinguishing feature of serratia marcesens (1)

Dnase red pigment

virulence factors the enterobacter, citrobacter, and serratia all have...(2)

- ampC gene

- plasmid

is ampC chromosomal/intrinsic or extrinsic

chromosomal/intrinsic

which resistance does ampC gene carry? (4)

- ampicillin

- cefazolin

- cefuroxime

- ceftriaxone

(1-3rd gen cephalosporins)

3 virulence factors specific to serratia

--> _____

--> ability to survive _____

--> ______ produce higher levels during ______

- fimbriae

- harsh conditions

- ampC --> therapy

fimbriae in serratia allows adherence to ______ and cytotoxic to _____

uroepithelial cells

tissue cells

do disinfectants kill serratia?

no, need hands to be washed

infectious diseases attributable to enterobacter (4)

which is most common?

- respiratory tract infection (most common)

- UTI

- intra-abdominal

- wound/burn related infection

infectious disease attributable to citrobacter (5)

which is most common?

- UTI (most common)

- respiratory tract infection

- intra-abdominal

- wound infection

- osteomyelitis

infectious diseases attributable to serratia (5)

which is most common?

- UTI (most common)

- respiratory tract

- wound infection

- osteomyelitis

- intra-abdominal

most common reason for UTI for serratia, citrobacter, and enterobacter is due to...

indwelling catheter

which of the following do not cause osteomyelitis?

a. citrobacter

b. enterobacter

c. serratia

b. enterobacter

3 different treatment options for citrobacter, enterobacter, serratia

- cefepime

- meropenem

- ciprofloxacin

why is cefepime acceptable to citrobacter, enterobacter and serratia infection if the have ampC?

it is 4th gen

meropenem is used for citrobacter, enterobacter and serratia if...

ESBL

which 4 families are under enterobacteriaceae genera?

- salmonella

- shigella

- proteus

- morganella

salmonella is found in ______ and is adapted to humans through salmonella _____ causing ______ disease

- animals

- typhi

- typhoid/enteric fever

two salmonella species

- salmonella enterica (in USA)

- salmonella bongori

under salmonella enterica, what 4 serotypes can cause enteric fever

- s. paratyphi A

- s. paratyphi B

- s. choleraesuis

- s. typhi

s. typhi and s. paratyphi

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE -

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- faculatative anaerobe

- LACTOSE -

- oxidase -

- hemolysis -

- VP-

- not found in human microbiota

unique feature of s. typhi and s.paratyphi... (2)

- non- spore forming

- produce H2S

salmonella is diagnosed with ______ cultures and sent to _____ lab for ______ confirmation

- stool/blood

- state/regional

- serotype (4 common)

how does salmonella cause infection?

enter oral route from food or drink

what host factors can protect from salmonella infection?

--> gastric ______

--> normal intestinal ______

--> local intestinal ______

- acidity (PPI and H2RA prevent this)

- microbiota

- immunity

3 infectious disease attributable to salmonella

which is most common?

- enteric fever (typhoid)

- bacteremia with focal lesions

- enterocolitis (MOST COMMON)

enteric fever from salmonella occurs from s. enteric serotype ______ and enters _____ and ______

- typhi

- lymphatics and blood

bactermia with focus lesions occur from which salmonella?

s. enterica serotype choleraesuis

salmonella can cause ______ that results in N/V and profuse diarrhea

enterocolitis

how is entercolitis salmonella treated?

nonpharm (rehydrate)

which salmonella requires treatment with antibiotics?

enteric fever or bactermia

3 antibiotics used to treat salmonella causing enteric fever or bacteremia?

- ciprofloxacin

- ceftriaxone

- trimeth-sulfa

can salmonella carry plasmid mediated with multiple drug resistance?

yes

4 species of shigella family

- dysenteriae

- flexneri

- boydii

- sonnei

shigella

--> gram negative ______ rod

--> AEROBIC/ANAEROBIC/FACULTATIVE

--> LACTOSE +/LACTOSE - BUT ______

--> OXIDASE +/OXIDASE -

--> hemolysis on blood agar +/-

--> voges-proskauer test +/-

--> commonly found in...

- small

- facultative anaerobe

- lactose - (DELAYED)

- oxidase -

- VP -

- not human microbiota

shigella IS/IS NOT motile and IS/IS NOT spore forming

- is not

- is not

shigella releases ...

endotoxins and sometimes exotoxin

shigella releases endotoxins upon ______ from _____

autolysis

LPS

endotoxin release from shigella causes irritation to ______

intestinal wall

which shigella species releases an exotoxin?

s. dysenteriae