Microbiology B4 Lecture 13

Front 1

Enteropathogenic bacteria:

1) Gram categorization and shape
2) 4 major groups

Back 1

1) Gram negative rods
2) Enterobacteriaceae, vibrionaceae, campylobacteriaceae, helicobacteriaceae

Front 2

2 divisions of enterobacteriaceae and their subgroups

Back 2

1) Pathogens: E. coli, Shigella, Salmonella, Yersenia Pestis, Enterocolitica

2) Opportunists: Klebsiella (klebsiella pnuemoniae), Serratia, Proteus (UTI), Pseudomonas (cystic fibrosis, burn patients)

Front 3

Enterobacteriaceae:

1) Gram categorization and shape
2) Special features
3) Culture
4) Respiration
5) Virulence factors

Back 3

1) Gram negative rods
2) Motile (peritrichous flagella), capsulated
3) Simple media
4) Facultative anaerobic, characteristic FERMENTATION patterns
5) FACEE:
- Flagella (H antigens),
- Adhesion/colonization factors (fimbriae-pili, capsular proteins)
- Capsules
- Endotoxin - O antigen
- Exotoxin - enterotoxin

Front 4

Coliforms:

1) 4 organisms belonging to this group
2) Used for?
3) Regulatory standard

Back 4

1) E. coli, Klebsiella, Citrobacter, Enterobacter
2) Indices of fecal contamination of water
3) <500 CFU/mL of water

Front 5

E. Coli

1) Respiration
2) Culture
3) What special products identify it? What two tests would you use?
4) Virulence factors
5) Most common cause of?

Back 5

1) Facultative anaerobe
2) MacConkey agar (stains colonies red below pH 6.8)
3) Lactose fermentors, produces INDOLE from tryptophan. Lactose test and indole test.
4) E. coli HAtES adhesion factors
- hemolysins
- anti-phagocytic capsules (KI sialic acid capsule)
- enterotoxins
heat-labile LT-I and II, similar to cholera toxin
heat stable (ST), causes increase of intracellular cGMP
- Shigatoxin (verotoxin), also produced by Shigella dysenteriae type I
5) Uncomplicated UTI in women

Front 6

UTI:

1) Caused by what organism?
2) Symptoms?
3) Flank pain + fever = ?
4) What is cystitis? Caused by?
5) What is pyelonephritis? Caused by?
6) Diagnosis?
7) DOC?

Back 6

1) E. Coli
2) Frequency, dysuria, nocturia, hematuria, cystitis
3) Pyelonephritis
4) Bladder infection, specific O antigen that acts as adhesion factor
5) Kidney infection - strains with unique P fimbrial antigens
6) >100,000 CFU/mL of urine, PMN, casts in pyelonephritis
7) Trimethoprimsulfamethoxazole (Septa), susceptibility test if complicated

Front 7

4 major types of E. Coli

Back 7

1) EHEC - enterohemorrhagic E. coli
2) ETEC - enterotoxigenic E. coli
3) EPEC - enteropathic E. coli
4) EIEC - enteroinvasive E. coli

Front 8

EHEC

Back 8

Enterohemorrhagic E. Coli
Shigatoxin coded by lysogenic phage
Food borne, undercooked beef, spinach
Hemorrhagic colitis, Hemolytic uremic syndrome

Front 9

ETEC:

Back 9

Enterotoxogenic E. coli
LT, ST, colonization factor. Traveler's and infants watery, non-invasive diarrhea

Front 10

EPEC

1) What is it?
2) What does it cause?

Back 10

Enteropathic E. coli. Watery diarrhea in infants, children

Front 11

EIEC

Back 11

Enteroinvasive E. coli. Rare in US, identical to shigallosis but no toxin, highly invasive, inflammation, necrosis, ulceration, profuse diarrhea, high fever

Front 12

Hemorrhagic colitis:

1) Caused by what strain?
2) Incubation period
3) Symptoms
4) Cases/year
5) Transmission
6) Therapy

Back 12

1) EHEC strain: O157:H7
2) 3-4 days
3) bloody diarrhea + no fever, 1 week
4) 73,000 cases/year
5) Oral - ground beef, contaminated water, unpasteurized milk and juice, sprouts, lettuce, spinach, salami
6) Rehydration, antibiotics (for extraintestinal infection)

Front 13

Hemolytic uremic syndrome:

1) Caused by what strain?
2) What happens in this disease?
3) Virulence factors and what do they do?
4) Symptoms?
5) Principal cause of?
6) Death rate

Back 13

1) E. coli O157:H7 (EHEC)
2) Acute renal failure, thrombocytopenia (low # of platelets), hemolytic anemia (patient's own RBCs are lysing)
3) Shiga toxin, LPS - cause disseminated endothelial damage, including glomerular endothelium
4) Abdominal cramps, bloody diarrhea, nausea, vomiting
5) Acute kidney failure in children in US
6) 5-10% of children

Front 14

Principle cause of acute kidney failure in children in the US

Back 14

Hemolytic uremic syndrome caused by EHEC

Front 15

Klebsiella pnuemoniae:

1) Member of what group?
2) Where are they found?
3) Motility?
4) Virulence factor?
5) Causes what disease in who?
6) How is it contracted?

Back 15

1) Opportunistic enterobactericaea
2) Ubiquitous normal GI flora
3) Non-motile
4) Prominent capsule, endotoxin
5) Lobar pnuemonia in immunocompromised patients (alcoholics, COPD),
6) wound, soft tissue, UTI

Front 16

Proteus mirabilis

1) Member of what group?
2) Motility?
3) Produces what?
4) Most common disease caused?
5) Associated with formation of?
6) How is it contracted?
7) What do colonies look like?

Back 16

1) Opportunistic enterbactericaea
2) Highly motile
3) Urease
4) UTI
5) Kidney stones
6) Wound infections, nosocomial septicemia
7) Swaming colonies

Front 17

Pseudonomas aeruginosa:

1) Enterobacteriaceae?
2) Respiration
3) Gram type and shape
4) Produces?
5) Virulence factors
6) Antibiotics
7) Where are they found
8) Special functions
9) Who's susceptible
10) Diseases caused

Back 17

1) NO
2) Aerobic
3) Gram - rod
4) Pigment (pyocyanin, fluorescein, pyorubin)
5) SLIME layer (abundant anti-phagocytic capsule), pili, flagella, endo/exotoxin
6) HUGELY resistent to antibiotics, likes to grow in soap
7) everywhere
8) Nucleator of ice crystals in clouds
9) Cystic fibrosis patients (alteration of respiratory epithelium = colonization), BURN PATIENTS, HIV/AIDS
10) Pneumonia, lung abscesses, bacteremia, skin/wound infection

Front 18

Serratia

1) Member of what group
2) Causes what diseases in who?
3) Produces
4) Grows well on what?

Back 18

1) Opportunistic enterobacteriaceae
2) Nosocomial infections in neonates/immunocompromised
3) Bright red pigment
4) Moist bread

Front 19

Vibrio cholera:

1) Gram categorization and shape?
2) Possesses what special enzyme?
3) Main pathogenic strain?
4) Transmission?
5) Main virulence factor and how it works?
6) Disease caused?
7) Symptoms?
8) Diagnosis?
9) Treatment?
10) DOC?
11) Vaccine?
12) Mortality?

Back 19

1) Gram negative COMMA SHAPED rod
2) Oxidase
3) OI(classic and El Tor subtypes)
4) Fecal oral, food and water
5) Cholera toxin - ADP ribosylation of G alpha subunit, inhibit GTPase, activate adenylate cyclase - osmotic imbalance
6) Cholera
7) Profuse watery diarrhea (rice water stool)
8) Clinical
9) Rehydration
10) CAT - cephalosporin, azithromycin, tetracycline
11) Killed vaccine available
12) 60% if untreated

Front 20

Vibrio parahaemolyticus:
1) Acquired how?
2) Symptoms?

Vibrio vulnificus
1) Acquired how?
2) Symptoms?
3) Mortality?
4) Seen predominantly in who lately?

Back 20

1) Ingestion raw/improperly cooked shellfish
2) Self limiting diarrhea

1) Open wounds/ingestion of raw shellfish (oysters)
2) Gangrenous wounds, gastroenteritis
3) 50%
4) Katrina

Front 21

Campylobacter jejuni

1) Gram categorization and shape
2) Transmission
3) Disease caused

Back 21

1) Gram negative curved rods in pairs (gull wing)
2) Fecal oral (human and animal)
3) Acute gastroenteritis

Front 22

Helicobacter pylori

1) Gram categorization and shape
2) Respiration
3) Produces what, which causes what?
4) Virulence factors?
5) Transmission
6) Diseases caused
7) Diagnosis
8) Treatment + DOC
9) Vaccine

Back 22

1) Gram negative comma shaped rod w/ polar flagellum
2) Capnophilic, microaerophilic
3) Urease, lower pH in gastric environment
4) Adhesins to attach to gastric mucosa
5) Person to person?
6) Chronic gastritis, gastric peptic ulcer, gastric carcinoma
7) Urease test, gastric biopsy fragment (ammonia produced), breat test C14 urea -> C14 CO2
8) At least 2 antibiotics for 1-3 weeks. TACM - tetracycline, amoxicillin, clarithromycin, metronidazole. PROTON PUMP INHIBITOR (Prilosec)
10) Approved for trial

Front 23

Yersinia pestis:

1) Gram categorization and shape
2) Staining
3) Virulence factor
4) Motility
5) Disease caused
6) Two types of urban plague
6) Treatment

Back 23

1) Gram negative coccobacillus
2) Bipolar staining (safety pin)
3) Anti-phagocytic capsule
4) Non-motile
5) Urban plague - epidemic, fleas, aerosol inhalation
Sylvatic plague - sporadic, wild infected animals (marmot)
6) Bubonic plague - flea, lymphadenopathy, high fever, 90% mortality
Pnuemonic plague - Aerosol, person to person, 100% mortality, highly contagious
6) Tetracyclines

Front 24

Typhoid fever:

1) Transmission
2) Carriers
3) Infection - incubation times, symptoms of early stage, symptoms in second week
4) Diagnosis
5) Treatment

Back 24

1) Fecal oral, food water
2) Asymptomatic carriers (gallbladder)
3) 10-14 day, early stage - fever, malaise, constipation. Second week - BACTEREMIA, high fever (endotoxemia), tender abdomen, rash, diarrhea
4) Blood culture/bone marrow culture, antibiotic susceptibilities
5) Chloramphenicol, ciproflaxin

Front 25

Salmonella sp.
1) Lactose fermenter?
2) Special product
3) Major virulence factors
4) Diseases caused

Back 25

1) NO
2) H2S from thiosulfate
3) Endo/enterotoxin, Vi antigen (S. typhi) - antiphagocytic capsule polysaccharide
4) Acute gastroenteritis (enteriditis), typhoid fever/septicemia (typhi).

Front 26

Salmonella enteritis

1) Most common form of?
2) Caught from?
3) Incubation period
4) Symptoms
5) Comes from what species of salmonella?

Back 26

1) Salmonella
2) Eating poultry, eggs, raw eggs
3) 6 - 48 hrs
4) Nausea, vomiting, non-bloody diarrhea, fever, headaches, myalia
5) Enteriditis (most common), Saintpaul (tomatoes), typhimurium (peanut butter)

Front 27

Shigella

1. Reservoir
2. Biogroups within
3. How many species, most important?
4. Fermentation
5. Motility
6. Where do they invade, how
7. Mode of transmission
8. Infectious dose
9. Incubation
10. Early stage shigellosis
11. Second stage shigellosis
12. Major cause of what kind of disease?
13. What syndrome can occur in small subset of patients?
14. Diagnosis
15. Treatment
16. DOC:
17. Preventaion

Back 27

1. No reservoir, true human pathogen
2. E. coli
3. 4, many serogroups. SHIGELLA SONEI - USA. S. DYSENTERIAE - epidemic dysentery
4. Do not ferment lactose.
5. Non-motile
6. Gut, through M cells
7. Fecal oral, contaminated food and water
8. Low
9. 1-3 days
10. Watery diarrhea b/c of enterotoxin Shiga toxin, fever
11. Dysentary - adherence to/invasion of large intestine, due to cytotoxic activity of Shiga toxin
12. Bacterial shigatoxin
13. Hemolytic-uremic syndrome (S. dysenteriae)
14. Culture feces - see PMN (indicates invasive infection, but not specific for shigellosis
15. Supportive fluid replacement
16. Amoxicillin/ampicillin
17. Sanitation, personal hygiene

Front 28

Shigella virulence factors

Back 28

1) Shiga toxin 1&2
Phage gene, A and 5 B subunits. Binds to gut, kidney, lungs vascular endothelial cells. Binding to small intestine receptors block absorption of electrolytes, glucose, AA = diarrhea

A subunit inactivates ribosomes, halt protein synthesis, cell death -0 dysentery

Large Virulence Plasmid - encodes factors in adhesion, invasion, cell-cell spread

Front 29

Dysentery

1. Caused by
2. Symptoms

What is bacillary dysentery?

Back 29

1. Shigella dysenteriae
2. Inflammation of intestines (esp. colon), cramps, tenesmus, frequent low volume stools w/ blood, mucus, PMNs

Dysentary caused by bacterial infection w/ invasion of host cells/tissues and/or production of exotoxin

Front 30

Hemolytic Uremic Syndrome classification

2 types:

Back 30

1. Shigatoxin-associated - E. coli O157:H7 (most common), Shigella dysenteriae type I (tropics). Primary endemic form in 90% of cases, usually in children 2-3 years, 75% have diarrhea.

Non-Shigatoxin associated - Sporadic or familial, defect in complement regulation. Worse prognosis, mortality 50%. 40% from Strep pnuemoniae, others from cancer, drugs, pregnancy, etc.