Enterobacteriaceae
Vibrionaceae
Helicobacter
Nonfermenters
Anusorn Boonthum
Micro311241
E. coli Shigella Salmonella Vibrio Helicobacter Pseudomonas Burkholderia
Acinetobacter E. coli (ETEC, EIEC, EHEC)
Shigella Salmonella Vibrio
E. coli Shigella Salmonella Vibrio Helicobacter Pseudomonas
Burkholderia Acinetobacter 2
MCQ 10
FAMILY ENTEROBACTERIACEAE
0.5 - 2 m
2 - 4 m
Morphology
3
FAMILY ENTEROBACTERIACEAE
E. coli
Klebsiella
Enterobacter
Proteus, Morganella
Citrobacter
Serratia
Intestinal flora
Coliform
4
FAMILY ENTEROBACTERIACEAE
E. coli causing diarrhea
Salmonella
Shigella
Yersinia enterocolitica
5
Enteric pathogens in human
- Salmonella - Enterobacter
- Proteus
- E. coli
peritrichous flagella
6
Cell Wall of Gram-Negative Bacteria
Lipopolysaccharide (LPS)
7
Physiologic Action of LPS from the Gram-Negative Cell Wall
8
Endotoxin
Exogenous pyrogen
IL-1 TNF-a
Endogenous pyrogen
Platelet aggregation
factor Membrane attack complex
Toll-like receptor
Animation
9
Facultative anaerobe
10
Escherichia coli
11
Escherichia coli
MacConkey agar
Ferment lactose
Pink, red colony
12
(Intestinal flora)
(Faecal contamination Index)
Faecal E.coli
Escherichia coli
13
1. Enteropathogenic E. coli (EPEC)
1
14
2. Enterotoxigenic E. coli (ETEC)
(travelers diarrhea)
(watery diarrhea)
15
Shigella
3. Enteroinvasive E. coli (EIEC)
16
4. Enterohemorrhagic E. coli (EHEC)
E. coli O157:H7
V e r o t o x i n
17
4. Enterohemorrhagic E. coli (EHEC) E. coli O157:H7
18
hemolytic uremic syndrome (HUS)
(3-5% HUS)
4. Enterohemorrhagic E. coli (EHEC)
5-8
19
The 2011 E. coli O104:H4 outbreak
(E.coli )
20
Urethra
Vagina Anus
E.coli
Shigella
21
Shigella
(Nonlactose fermenter on MacConkey agar)
MacConkey agar
Nonlactose ferment
Colorless
22
(Classic bacillary dysentery)
Infective dose 200 - 1000 cells 23
24
peritrichous flagella
Salmonella
25
Salmonella
Nonlactose fermenter
MacConkey agar
SS agar
26
3 1. (Enteric fever)
Salmonella Typhi
Salmonella Paratyphi A, B, C
Systemic disease originating in the GI tract
Salmonella Typhi
BLOOD STREAM
MESENTERIC LYMPH NODES
Typhoid
Infective dose 103 - 105
Invade mucus layer and
attach the
intestinal
epithelium cell
(IEC) by
fimbriae
28
Diarrhea;
hemorrhage;
perforation
Cholecystitis;
carrier state
Fever;
kidney and
other organs
infected
Ingestion of S.Typhi
Inflammation and
ulceration of
Peyers patches Small
intestine Lymphatics
MLN
Thoracic duct
Transient
(primary)
bacteremia Multiplication
in macrophages
in
liver,
spleen, and
bone marrow
Septicemia
Bile
Signs and
symptoms
Gallbladder
Incubation
period
1. Enteric fevers : Typhoid & Paratyphoid
MLN = Mesenteric lymph nodes 29
1. (Enteric fever) macrophage (mesenteric lymph nodes) thoracic duct (Transient, Primary bacteremia) macrophage (Septicemia) 7-20 30
1. (Enteric fever)
31
1. (Enteric fever)
4-6
1 2%
32
Typhoid fever
http://bestpractice.bmj.com/best-
practice/monograph/221/basics/epide
miology.html
2. (Septicemia)
S. Choleraesuis
33
3. Gastroenteritis
Salmonella S. Typhi S. Paratyphi S. Choleraesuis
8-48 2-5
34
Lactose fermenter, mucoid colony
Klebsiella
35
Pathogenicity
Pneumonia
enterotoxin
Urinary tract infection (UTI)
etc
Klebsiella pneumoniae
36
Bubo
1. Yersinia pestis
(Zoonosis)
(Bubo)
37
Sci 4 Oct 2001
Plague ()
38
Differentiation of family Vibrionaceae from
Enterobacteriaceae
Characters Vibrionaceae Enterobacteriaceae
Curved rod +/- -
Oxidase + + + -
Motility + +/-
Flagella locations Polar Peritrichous
39
VIBRIO CHOLERAE
flagella
40
Yellow colony on Thiosulfate Citrate
Bile salt Sucrose agar (TCBS)
41
Fecal-oral route of transmission
Infective dose : 106 - 108
1-4
42
10-20
40
: tetracycline, quinolone Oral Rehydration Solution (ORS)
44
VIBRIO CHOLERAE
Classical
El Tor
O1
Ogawa
Inaba
Hikojima
Hikojima
Inaba
Ogawa
O139
NonO1/non O139
45
99 % of isolates
is V. Cholerae
El Tor Inaba
Cholera 2547
V. Cholerae El Tor Ogawa 982
V. Cholerae El Tor Inaba 11
Cholera 2553
1-100
3 9 993
V. parahaemolyticus
3-8%
TCBS
Gastroenteritis
: 4 - 48 ( 8 - 10) 46
V. vulnificus
2-3% V. parahaemolyticus
47
V. vulnificus
2
4 4 12
48
V. vulnificus
12-72
50
49
CAMPYLOBACTER
Corkscrew-like motion with single
polar flagellum at one or both
Microaerophilic
Growth at 42 oC
50
PATHOGENICITY
C. fetus Septicemia
C. coli Diarrhea
C. jejuni Enteritis
51
Helicobacter pylori
52
PATHOGENICITY
53
http:// nobelprize.org/medicine/laureates/2005/index.html 54
15%
2/3 Pseudomonas aeruginosa
Nonfermenters
Opportunistic pathogens
54
Pseudomonas aeruginosa
Polar flagella (1-2)
Nonsporulation
Noncapsulated
Gram negative bacilli
55
Pyocyanin Pigment
Grape-like odor
Pseudomonas aeruginosa
56
P. aeruginosa
1.
54
Nosocomial infection:
Urinary tract infections (UTI)
P. aeruginosa
1.
54
P. aeruginosa
1.
2.
3. 4.
54
Burkholderia pseudomallei
Burkholderia pseudomallei
- Bipolar
staining or
safety pin
- Polar tuft flagella
- Oxidase positive 58
Musty or earthy odor
18 24 h incubation
Smooth colony
> 48 h incubation
Wrinkle colony
Burkholderia pseudomallei
59
Geographic distribution of B. pseudomallei
Melioidosis = Severe disease
60
CLINICAL FEATURES
1) Wound infection
2) Pulmonary infection
3) Septicemia
abscesses in internal organs
:- liver abscess
Person-at risk : Farmer, Diabetes mellitus (DM)
61
Acinetobacter
Hospital-acquired infection ventilator-associated pneumonia
Aerobic gram-negative coccobacilli, non-motile
A. baumannii
Acinetobacter
Hospital-acquired infection ventilator-associated pneumonia
antibiotic A. baumannii . gentamicin, amikacin, piperacillin, imipenem, ceftazidime, ciprofloxacin
Aerobic gram-negative coccobacilli, non-motile
A. baumannii
Antibacterial drugs % Susceptibility
Colistin 99
Gentamicin 25
Amikacin 28
Cefoperazone-sulbactam 31
Ceftazidime 23
Cefepime 21
Imipenem 26
Meropenem 27
Ciprofloxacin 23
Percentage of Susceptible A. baumannii
MAHARAJ NAKORN CHIANG MAI HOSPITAL, JAN-DEC 2009
Differentiation of enteric bacteria
Characters Vibrio Campylobacter Pseudomonas Enterobacteriaceae H. pylori
Curved rod + + - -
Oxidase + + + -
Motility + + + +/-
Flagella locations Polar Polar Polar Peritrichous
Growth charac- Facultative Micro- Strickly Facultative teristic anaerobe aerophile aerobe anaerobe
63
Obligate
aerobes
Obligate anaerobes
Facultative anaerobes
Microaerophiles
Aero-
tolerance
Bacteria
Brooks GF et al. Jawetz, Melnick & Adelbergs Medical Microbiology. 25th ed.
New York : McGrawhill, 2010.
Murray PR, Rosenthal KS, and Pfaller MA. Medical Microbiology. 6th ed.
St.Louis : Mosby/Elsevier, 2009.
Bacteriology 9 Enterobacteriaceae
Bacteriology 10 Vibrionaceae and Nonfermenters
64