Bacteria

Enterobacteri
aceae
a)Lactose
fermenters
E.coli,
Klebsiella,
Enterobacter
b)non lactose
fermenters
H2S
shigella,
serratia,
Yersernia,
Morganella,
Providencia
c)Non ferm
H2S +
Salmonella,
Proteus,
Citrobacter
Escherichia
coli
(coliforms)
Enterococci

Caracteristica
s

Lactose ferm

Epidemiologi
a

Normal flora of
GIT

O157 H7
Enterohemorr

Reservoir:

Diagnostico

Lactose +
Motile
IMViC ++- -

Virulencia
Somatic O
antigen (LPS)
Capsule K
Vi (capsular
antigen of
S.typhi)
Flagellar H
antigen
Fimbrial
antigens
Endotoxin:
-lipid A of LPS
-thermostable
-fever, shock
Enterotoxin:
cAMP or
cGMP
Cytotoxins,
bacteriocins
adhesins
Endotoxin,
colicins,
adhesins,
cytotoxin
(verotoxinhemorrhagic)
Enterotoxin
(plasmid)
Heat labile (LT
> cAMP,
cholera like)
Heat stable (ST
> cGMP)

Enfermedade
s

Vac, trat

Notas
Clinical samples:
Urine, feces,
CSF, blood,
biopsies,
sputum, pus
Quantitative
culture: urine
Media:
Enrichment,
differential,
selective
(MacConky)
Susceptibility
test

UTI (can result

in sepsis),
nosocomial or
community
Neonatal
meningitis
Enteric disease
a)ETECtravelerss
b)EIEC-watery,
may progress
to dysentery
(shigella like)
c)EPEC-chronic
diarrhea in
infants
d)EAEC- infant
diarr

Antibiotics for
UTI/meningitis
Enteric disease:
Most are self
limiting
Prphylaxis for
ETEC: bismuth
subsalicylate
Antibiotics if
recommended

ANTIBIOTICS
ARE

Used to detect
fecal
contamination of
H2O

hagic E.coli

cattle,
vegetables,
non
pasteurized
fruit juices

Klebsiella
pneumonia
(Coliforme)

Serratia
marcescens
Non lactose
fermenter
H2S
Proteus
Non lactose
fermemter
H2S +

Salmonella sp

Salmon red
pigmented
colonies at
room temp

Multiple toxins
(shiga)
Most are
sorbitol

Acquired respi
flora in hospital
(nosocomial)

Lactose +
NON motile
IMViC - - ++

Opportunistic
pathogen of
respi
nosocomial
infect

Highly
resistant to
antibiotics

Most are

Swarming
motility
Rapid users of
urea with
ammonia
production (UTI
puede tener tb
piedras)
Motile

Capsule

Deaminate aa
(Phe)

e)EHEC- O157
H7
Severe diarrea
Hemolytic
uremic
sndrome (HUS)
-kidney
damage,
hemolytic
anemia,
thrombocytope
nia
Thrombocytope
nic purpura,
hemorrhagic
colitis
Pneumonia
with
hemorrhagic
necrotizing
consolidation of
the lungs
Dark red
bloody sputum
(currant jelly)

CONTRAINDICA
TED
risk of 2ry
complication
(HUS in
children)
Hydration

UTI
(nosocomial,
community)

Enterocolitis

O antigens
puede cross rxn
with rickettsiae

Gastroenteritis

Carriers

Non lactose
fermemter
H2S +

Shigella sp
Non lactose
fermenter
H2S

Anaerogenic
Highly virulent

zoonotic:
Poultry, cattle,
pets (turtle,
iguanas,
snakes)

NO K antigen
(capsule) but
S.typhi has Vi
(envelope)

(gastroenteritis
)
-(S.entiriditis)
(S.typhimurium
, most
common)
Enteric fever
(human only
reservoir)
-typhoid fever
(S.typhi)
-Paratyphoid
fever
(paratyphoid
strains)
Sepsis with
metastatic
infect
-S.cholerasuls
(osteomyelitis
in SCD pt)
-S. typhi,
S.paratyphi

(self limiting)
Gatorade
Yogurt
Avoid antibiotic
and lomotilor
immodium
Typhoid fever:
antibiotics
(chloramphenic
ol, ampicillin)

(gallbladder)

Only hosts:
human and
primates
Transmission: 6
Fs
Fingers, food,
fould H20,
fomites, flies,
STD

NON motile
NO capsule
Shiga toxin:
- enterotoxic
(V.cholera like)
-neurotox
(vascularity of
CNS)
-cytotox (inh
prot synthesis,
cleaves 60S)

Mild diarrheal
Bacilliary
dysentery
-large intestine
(erosion, ulcer)
-fever, cramps,
low volume
frequent stools,
blood, mucus in
feces

Most are self

limiting
Fluid,
electrolyte
replacement
Antibiotic treat

4 species:
S.dysenteriae
(Shiga bacillus)
-the most severe
disease, rare in
USA
S.flexneri,
S.boydii,
S.sonnei (most
common)
-less severe

Other Shigella
-sonnei and
flexneri
develop
antibodies that
neutralize
dysenteriae
toxin in vitro
Yersinia
Enterocolitica
Non lactose
fermenter
NON
FERMENTERS

Facultative
Grows best at
25C, CAN
GROW at 4C
Alkaline rxn in
TSI
AEROBES!
(some can use
NO3 as eacceptor)

Zoonotic
Food-borne
Direct contact

Intracell
parasite
Cytotoxic

Gastroenteritis
Mesenteric
lymphadenitis

Opportunistic,
ubiquitous

Oxidative +

Highly
resistant to
antimicrobials

Pseudomonas

Use organic
compounds
Grow 4C to 43C

Vegetables,
soil, whirlpools,
hot tubs
Hospital:
Respirators,
soaps
desinfectants,
water (tap,
bottled,
distilled)
Fomites
(telephones,
faucets)

Most are
oxidative +
Motile by polar
flagella

Biofilms in
plastic

Y.pseudotubercul
osis
-rare enteric
pathogen

Burkholderia
pseudomallei
(meliodiosis,
respi, SE Asia!)
B.mallei
(glanders
-respi disease:
horses, mules,
donkeys
-diff diseases in
humans)
Stenotrophomon
as maltophilia
(nosocomial,
chronic
infections)
Burkholderia
cepacia
(nosocomial,
CF )

Pseudomonas
aeruginosa

Only organism
to produce blue
pigment
pyocianin
Pyoverdin
(greenish
fluorescein)

Flora of the
skin and GIT

Oxidase +
Grape like odor
Several
pigments
(green
colonies)

Alcaligenes
sp ( =
Achromobact
er)

Most are nonsaccharolytic,

except
A.xylosoxidans

May be normal
flora
Nosocomial
-respirators
-sepsis,
pneumonia, ear
infections

Motile by
peritrichous
flagella

Endotoxin,
hemolysins
Retractable pili
Slime in strains
from cystic
fibrosis
patients
Exotoxin A
-diphteria like
(affects ADP
ribosylation of
EF-2, inh prot
synthesis)

UTI, meningitis,
ulcers,
swimmer;s ears
Pneumonia (CF
pt)
Abscesses (blugreen pus)
Hot-tub
folliculitis
(public baths)

Double
therapy:
penicillin and
aminoglycoside

LEADING CAUSE
OF DEATH IN
BURN PT: FEVER,
CELLULITIS,
SEPSIS
ECHTHYMA
GANGRENOSUM

Penicillin
except
M.catarrhalis

M.lacunata
(blepharoconjuntivitis)
M.osloensis
(osteoarthritis)

Neisseria-Like
coccobacilli
Moraxella sp

Normal flora of
mucous
membranes

Acinetobacter
baumanii

Normal flora
(GT, skin,
pharynx)
Nosocomial
(respi, UT)
Highly resistant
to
antimicrobials
Nosocomial
(faucets, ice,
water)

Previous
Flavobacteriu
m

Yellow colonies,
Weak
fermenter

Indole +

Meningitis,

Chryseobacte
rium
meningosepti
cum

sepsis of the
newborn
Adult:
pneumonia,
endocarditis,
sepsis,
meningitis, only
G bacillus S to
vancomycin

Other
Uncommon
Organism

Vibrionaceae

Curved bacilli

Vibrio

Comma shaped
bacilli
One polar
flagella
Most species
are halophilic
Classified by
the O antigen

Vibrio cholera

Capnocytophaga
gingivalis
Chromobacteriu
m violaceum
HACEK group
(oral flora,
associated to
endocarditis)
H.aprophilus
Actinobacillus
actinomycetemc
o
-mitans
Cardiobacterium
hominis
Eikenella
corrodens
Kingella kingae
Vibrio
Campylobacter
Helycobacter
Pleisomonas
Aeromonas
Oxidase +

No animal
reservoir,marin

Oxidase +
Resists alkaline

Cholera, other
food borne
diseases
Wound
infections
Sepsis
Cholera Enteric
Disease

Toxin causes
in cAMP and

01, 0139
(Benga) cause

Non halophilic!

e and surface
waters
(transmitted by
human fecal
contamination
of water and
food)
Endemic in
India and SE
Asia (Tx, Ls)

Vibrio
parahaemolyt
icus

Coastal marine
salt waters
(halophilic)

Vibrio
vulnificus

Halophilic

Contaminated
undercooked or
raw sea-food
(shellfish, raw
fish, sushi)
Trasnmitted
from wounds
by eating the
oysters

Campylobacte
r jejuni

Microaerophylic
grows at 42C

Zoonotic,
Normal flora on
many animals

pH
Selective TCBS
alkaline
medium for
isolation

Darting
motility

-heat labile
enterotoxin
(choleragen)
No fever,
profuse watery
diarrhea
No pus or blood
Vomiting,
dehydration,
loss of
electrolytes,
renal failure,
metabolic
acidosis and
death

efflux in ions
and water into
the small
intestine lumen
Treatment:
replace water
and electro to
prevent
hypovolemic
shock
Antibiot not
necessary but
reduce duration
of illness
After recovery
long lasting
immunity
Vaccines NOT
effective as an
epidemic
control

Mild to
explosive
diarrhea, fever,
vomiting

Self-limiting,
lasts a few
days

Gastroenteritis
(raw oysters)
Cellulitis,
hemorrhagic,
bullous lesions
Sepsis,
gangrene as a
result of
intrvascualr
coagulation
Gastritis,
colitis, diarrhea
with blood and

Doxycycline

Usually lasts a
week, selflinited

epidemic
disease
01 has 2
biotypes (El Tor,
Classic) and 3
serotypes
(Ogawa, Inaba,
Hikijima)
Non01/non0139
cause sporadic
disease or no
pathogenic

Assoc with
water, meat,
shellfish
Helicobacter
pylori

Microaerophilic
urease

Stomach of
45% adults,
also in some
animals

Gastric biopsy
Urea breath
test
H.pylori
antigens in
stool
IgG in serum

pus, enteric
fever
Guillain-Barre
may follow
Gastritis,
gastroduodenal
ulcers (risk
factor for
gastric
carcinoma)

Bismuth salts
Antibiot
(metronidazole)