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32 Cards in this Set

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Enterobacteriaceae: morphology
1) gram stain
2) sporulation
3) motility
(1) gram-neg
(2) no sporulation
(3) most have flagella
Enterobacteriaceae: biochem
1) metabolism
2) oxidase
3) nitrate reduction
(1) facultative anaerobes
(2) oxidase-neg
(3) reduces nitrate --> nitrite
Enterobacteriaceae: lactose fermentation
1) lac-pos: MacConkey color, examples
2) lac-neg: MacConkey color
(1) lac-pos: pink (E coli, Klebsiella, Enterobacter)
(2) lac-neg: tan/gray
Enterobacteriaceae:
major surface antigens (5)
(1) flagella (H antigen)
(2) fimbriae (pili)
(3) capsule (K antigen)
(4) somatic (O antigen)
(5) LPS
What does LPS consist of (3)?
(1) lipid A -> outer memb
(2) core oligosacs -> KDO sugar
(3) O polysacs -> antigenic
REST STOP:
LPS Inflammatory Response
(1) release blebs of outer memb
(2) antibiotics cause further LPS release
(3) LPS binds LBP in serum
(4) taken up by macrophage via CD14
(5) CD14 passes LPS to TLR4 (transmemb)
(6) macrophages -> TNF-a and IL-1
(7) septic shock
Enterobacteriaceae:
virulence factors (5)
(1) adhesins (fimbriae)
(2) toxins (hemolysin)
(3) iron acquisition (siderophores)
(4) capsule (LPS)
(5) plasmids (R plasmid)
Enterobacteriaceae:
common infections (5)
(1) enteric
(2) UTI
(3) abd/pelvic
(4) pneumonia
(5) bacteremia
***Misc: neonatal meningitis, surgical wounds, decubitus ulcers, brain abscesses
E. coli:
common infections (3)
(1) UTI - 90% cases
(2) pneumonia - nosocomial
(3) bacteremia - can lead to sepsis, shock
Klebsiella (pneumoniae, oxytoca):
common infections
(1) catheter-assoc UTI
(2) Freelander's pneumonia: classic lobar, immunocomp'd pts --> pulmonary necrosis, pleural effusion, empyema
Klebsiella (pneumoniae, oxytoca):
(1) unique feature of capsule
(2) resistance
(1) mucoid -> inhibit phagocytosis
(2) ampicillin-resistant
Proteus (mirabilis):
(1) usu pts?
(2) enzyme production
(3) appearance on blood agar
(1) urinary catheters
(2) urease -> crystals -> pyelonephritis, bacteremia
(3) swarms (b/c motile)
Morganella (morganii):
(1) related to what?
(2) usu pts?
(1) Proteus, Providencia
(2) catheterized urinary tracts
Providencia:
(1) related to what?
(2) usu pts?
(1) Proteus, Morganella
(2) catheterized urinary tracts
Enterobacter (cloacae, aerogenes)
(1) usu pts?
(2) source?
(3) resistance
(1) ICU, comorbidity, antibiotics
(2) source: GI flora
(3) highly resistant
Serratia (marcescens):
(1) usu setting?
(2) favors what kind of environ?
(3) endocarditis in which pts?
(4) characteristic color?
(1) nosocomial
(2) moist, wet
(3) IV drug users
(4) red pigment
Citrobacter (freundii, koseri):
(1) usu assoc infection
(2) two infections in neonates
(1) catheter-assoc UTI
(2) meningitis, brain abscess
Enterotoxigenic E. coli (ETEC):
(1) leading cause of...?
(2) pathogenesis
(3) enterotoxins (2)
(4) pos sx?
(5) neg sx (usu)?
(1) childhood diarrhea, traveler's diarrhea
(2) fimbriae adhere to GI epithelium
(3) heat-stable (ST), heat-labile (LT)
(4) watery diarrhea, nausea, cramps
(5) no fever, no vomit, no bloody/mucoid stools
Enterohemorrhagic (EHEC) +
Shiga Toxin-producing E. coli (STEC):
(1) major cause of...?
(2) sources of outbreak
(3) disease in <5 + elderly?
(4) most common serotype
(5) shiga-like enterotoxins
(6) pos sx?
(7) neg sx?
(1) bloody diarrhea
(2) beef, H2O, petting zoos
(3) HUS
(4) O157
(5) SLT-1, SLT-2 -> attach + efface
(6) bloody diarrhea, abd cramps
(7) usu no fever
Enteropathogenic E. coli (EPEC):
(1) leading cause of...?
(2) effect on intestinal epithelia?
(3) what can protect infants?
(1) acute diarrhea in infants
(2) attach + efface -> lose microvilli
(3) breastfeeding
HUS
(1) stands for...?
(2) triad of...?
(3) usu pts?
(1) hemolytic uremic syndrome
(2) thrombocytopenia, hemolytic anemia, nephropathy
(3) children <5 + elderly
Enteroaggregative E. coli (EAEC):
(1) pattern of adherence
(2) causes what disease?
(1) stacked bricks
(2) travelers' diarrhea
Enteroinvasive E. coli (EIEC):
(1) why similar to shigellosis?
(2) seen in what pts?
(1) invade GI epith cells -> take over host actin-filament assembly
(2) travelers
Diffuse Adhering E. coli (DAEC):
(1) similar to what kind of E. coli?
(1) EAEC (traveler's diarrhea)
Enterobacteriaceae:
Which E. coli strain is indigenous to U.S.?
EHEC
(bloody diarrhea, HUS, O157, Shiga-like toxins)
Shigella (sonnei, flexneri, dysenteriae, boydii):
(1) common settings
(2) pos sx
(3) pathogenesis
(4) toxins
(5) diagnosis
(6) treatment
(1) overcrowded: military camps, daycare
(2) watery -> dysentery, abd pain, fever
(3) invasive -> ulcer (~pseudomemb)
(4) Shiga-toxin (AB)
(5) stool culture, fecal WBCs
(6) avoid antibiotics b/c could be EHEC/STEC
Salmonella (enterica, typhi):
(1) pathogenesis
(2) characteristic infections
(3) high-susceptible host factors
(1) invade enterocytes, M cells -> enter Peyer's -> multiply within macrophages -> infected macros disseminate
(2) gasteroenteritis, typhoid fever, bacteremia
(3) AIDS, sickle cell, hypo-HCl
Gastroenteritis (Salmonella):
(1) sources
(2) role of enterotoxin
(3) pos sx?
(4) neg sx?
(5) diagnosis
(6) treatment
(1) poultry, eggs
(2) hypersecretion of H2O
(3) nausea, vomit, diarrhea, fever, chills, cramps, myalgias
(4) no bloody diarrhea
(5) agar color change
(6) self-limiting, NO antibiotics
Typhoid fever (Salmonella):
(1) common strains
(2) pos sx
(3) neg sx
(4) lab findings
(5) diagnosis
(6) source of chronic asymptomatic?
(7) treatment
(1) S. typhi, S. paratyphi
(2) fever, abd pain, hepatosplenomegaly, headache, delirium, chills, ROSE SPOTS
(3) usually no diarrhea
(4) leucopenia, anemia, elevated liver enzymes
(5) blood/bone marrow culture
(6) infected gall bladder
(7) fluoroquinolones, 3* cephalosporins
Bacteremia (Salmonella):
(1) %risk from gastro?
(2) %risk endovasc infection in elderly?
(3) persistent bacteremia suggests?
(1) 1-4%
(2) 10-25%
(3) endovasc (aortitis)
Yersinia enterocolitica:
(1) enterotoxin + role
(2) reservoirs?
(3) inhib by refrigeration?
(4) pos sx?
(5) possible sequelae?
(6) N Europe: causes what?
(7) US: winter peak w/...?
(8) where are mucosal ulcers?
(9) what increases risk?
(1) ST -> watery diarrhea
(2) domestic animals, springs/streams
(3) no, grows at 4 C
(4) fever, diarrhea, abd pain, nausea, vomit
(5) reactive polyarthritis, erythema nodosum
(6) diarrhea
(7) chitterlings
(8) terminal ileum (incl appendix)
(9) iron overload
Yersinia pestis:
(1) two diseases + transmission
(2) grows best at what temp?
(3) US: which states?
(4) bubonic sx
(5) pneumonic sx
(6) treatment + success
(1) rodent fleas (bubonic), inhalation (pneumonic)
(2) 28 C
(3) southwest
(4) fever, chills, weakness, painful bubo -> shock
(5) resp failure, bloody sputum -> DIC
(6) streptomycin, gentamicin (fatality 15-50%)