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    Icrobiology: Pathogenic Gram-Negative Bacilli (Enterobacteriaceae)

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    Drashua Ashua
    The document discusses various Gram-negative bacteria of the family Enterobacteriaceae, including Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, Proteus, Morganella, Providencia, and Edwardsiella. It covers their properties, habitats, diseases caused, and importance as opportunistic pathogens particularly in hospital settings.

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    Icrobiology: Pathogenic Gram-Negative Bacilli (Enterobacteriaceae)

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    Drashua Ashua
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    The document discusses various Gram-negative bacteria of the family Enterobacteriaceae, including Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, Proteus, Morganella, Providencia, and Edwardsiella. It covers their properties, habitats, diseases caused, and importance as opportunistic pathogens particularly in hospital settings.

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    The document discusses various Gram-negative bacteria of the family Enterobacteriaceae, including Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, Proteus, Morganella, Providencia, and Edwardsiella. It covers their properties, habitats, diseases caused, and importance as opportunistic pathogens particularly in hospital settings.

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    Icrobiology: Pathogenic Gram-Negative Bacilli (Enterobacteriaceae)

    Uploaded by

    Drashua Ashua
    The document discusses various Gram-negative bacteria of the family Enterobacteriaceae, including Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, Proteus, Morganella, Providencia, and Edwardsiella. It covers their properties, habitats, diseases caused, and importance as opportunistic pathogens particularly in hospital settings.

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    MICROBIOLOGY

    Pathogenic Gram-Negative Bacilli (Enterobacteriaceae)

    Gram-Negative Bacteria
    Constitute the largest group of human pathogens
    Due in part to the presence of lipid A in the bacterial cell wall

    Triggers fever, vasodilatation, inflammation, shock, and disseminated intravascular coagulation (blood clots within blood vessels)

    Almost every Gram-negative bacterium that can breach the skin or mucous membranes, grow at 37C, and evade the immune system can cause disease and death in humans

    Diversity of Activities Associated with LPS

    Enterobacteriaceae
    Members of the intestinal microbiota of most animals and humans Ubiquitous in water, soil, and decaying vegetation

    Enteric bacteria are the most common Gram-negative pathogens of humans

    General Properties of Enterobacteriaceae


    Gram negative bacilli Aerobes and facultative anaerobes Grow on ordinary media Ferment glucose with production of acid or acid and gas Reduce nitrates to nitrites Catalase positive Oxidase negative

    Motile (peritrichous flagella) or non-motile

    Medium: Nitrate Broth

    The Medium: Nitrate Broth

    Glucose Fermentation

    Antigens and virulence factors

    Plasmid
    Figure 20.8

    Antigenic Structure of Enterobacteriaceae

    Diagnosis, Treatment, and Prevention


    Diagnosis
    Enterobacteriaceae are cultured using selective and differential media

    Commercially available biochemical tests can rapidly identify enteric bacteria

    Treatment
    Treatment of diarrhea involves treating the symptoms with fluid and electrolyte replacement
    Antimicrobial drugs are not usually needed since diarrhea is self-limited

    Diagnosis, Treatment, and Prevention


    Prevention
    Preventing enteric infections is almost impossible since they are a major component of the normal microbiota Good personal hygiene and proper sewage control are important in limiting the risk of infection

    Enterobacteriaceae Classification
    Pathogenic Enterobacteriaceae are often classified into three groups
    Coliforms, which rapidly ferment lactose, are part of the normal microbiota, and may be opportunistic pathogens Noncoliform opportunists, which do not ferment lactose True pathogens

    Incidence of Enterobacteriaceae Associated with Bacteremia

    Coliform Opportunistic Enterobacteriaceae


    Aerobic or facultatively anaerobic, Gram-negative, rod-shaped bacteria Commonly found in soil, on plants, and on decaying vegetation Colonize the intestinal tracts of animals and humans Examples: Escherichia, Klebsiella, Enterobacter, Citrobacter, Serratia Presence of coliforms in water is indicative of impure water and of poor sewage treatment (i.e. one of the indicators of fecal pollution of water: E. coli, Clostridium perfringens, Enterococcus fecalis)

    Indicator Concept
    Impossible to monitor for all pathogens Indicator organisms signal recent fecal contamination Indicator organisms always present in fecal material Indicator organisms persistence similar to pathogens Detection methods relatively simple

    Technical issues related to pathogen detection


    Low number of pathogens Human or non-human strains Pathogens difficult to detect Cannot determine viability Need large sample volumes

    Few water labs equipped or staffed


    Days to weeks for results

    Bacteria in water

    Escherichia coli
    The most common and important of the coliforms (found in 100% of human intestines) Virulent strains have genes located on virulence plasmids that allow the bacteria to colonize human tissue Gastroenteritis is the most common disease associated with E.coli (enteropathogenic, enterotoxigenic and enteroinvasive strains)
    Often mediated by exotoxins that produce the symptoms associated with gastroenteritis

    Most common cause of non-nosocomial urinary tract infections (cystitis & pyelonephritis) Wound infections, meningitis in neonates

    Escherichia coli
    E.coli O157:H7 is the most prevalent strain of pathogenic E.coli in developed countries (enterohemorrhagic)
    Causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome, a severe kidney disorder
    Most epidemics associated with undercooked ground beef or unpasteurized milk or juice

    Nosocomial infections

    Klebsiella
    Found in the digestive and respiratory systems of humans and animals( Klebsiella pneumoniae, aerogenes, ozaenae, rhinoscleromatis)

    Can cause opportunistic infections


    No waterborne disease ever associated with Klebsiella in drinking water, all hospital acquired (nosocomial)

    Produce a capsule that protect the bacteria from phagocytosis (mucoid colonies)

    K.pneumoniae is the most commonly isolated


    pathogenic species
    Causes pneumonia May be involved in bacteremia, meningitis, wound

    The Methyl Red reagent.

    MRVP Broth--The Methyl Red Test Left: uninoculated control Left: uninoculated control Right: positive (red color) Right: negative (copper color)

    The VP reagents MRVP broth--Voges-Proskauer Test

    Serratia
    Produce a red pigment when grown at room temperature Can grow on catheters, in saline solutions, and other hospital supplies Can cause life-threatening opportunistic infections in the urinary and respiratory tracts of immunocompromised patients Difficult to treat due to resistance to various antimicrobial drugs

    Serratia marcescens

    Enterobacter, Hafnia, and Citrobacter


    Found in soil, water, decaying vegetation, and sewage Reside in the digestive tracts of animals and humans All can be opportunistic pathogens Frequently involved in nosocomial infections of immunocompromised patients Difficult to treat due to resistance to various antimicrobial drugs

    Enterobacter on MacConkey

    Enterobacter on EMB

    Noncoliform Opportunistic Enterobacteriaceae


    Include a number of opportunistic pathogens

    Proteus
    Gram-negative, facultative anaerobe, urease positive

    Proteus mirabilis is the most common species


    associated with human disease Can cause urinary tract infections in patients with long-term urinary catheters Infection-induced kidney stones can develop Resistant to many antimicrobial drugs

    Proteus
    Proteus mirabilis is one of the common species of Enterobacteriaceae isolated in clinical laboratories. It is well known as a pathogen in urinary tract infections and has been implicated in hospital outbreaks and cases of cross-infection The characteristic feature of Proteus in culture is swarming. Methods to inhibit swarming Dienes phenomenon

    Weil-Felix reaction: Proteus Ox19, Ox2, OxK & Rickettsia antibodies.

    Noncoliform Opportunistic Enterobacteriaceae

    Morganella, Providencia, and Edwardsiella


    Cause nosocomial infections in immunocompromised patients

    Primarily involved in urinary tract infections

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