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

 MCQ 10

FAMILY ENTEROBACTERIACEAE

Morphology

0.5

2-4

2m

FAMILY ENTEROBACTERIACEAE
Intestinal flora
E. coli
Klebsiella

Coliform

Enterobacter

Proteus, Morganella
Citrobacter
Serratia
4

FAMILY ENTEROBACTERIACEAE
Enteric pathogens in human
E. coli causing diarrhea
Salmonella
Shigella

Yersinia enterocolitica


- Salmonella
- Enterobacter
- Proteus
- E. coli

peritrichous flagella

Cell Wall of Gram-Negative Bacteria

Lipopolysaccharide (LPS)

Physiologic Action of LPS from the Gram-Negative Cell Wall

Endotoxin
Exogenous pyrogen

Toll-like receptor

IL-1 TNF-a
Endogenous pyrogen

Platelet aggregation
Membrane attack complex

factor

Animation

Facultative anaerobe

10

Escherichia coli

11

Escherichia coli
MacConkey agar
Ferment lactose

Pink, red colony

12

Escherichia coli

(Intestinal flora)


(Faecal contamination Index)

Faecal E.coli
13


1. Enteropathogenic E. coli (EPEC)

1

14

2. Enterotoxigenic E. coli (ETEC)

(travelers diarrhea)

(watery diarrhea)
15

3. Enteroinvasive E. coli (EIEC)

Shigella

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

4. Enterohemorrhagic E. coli (EHEC)

5-8

hemolytic uremic syndrome (HUS)

(3-5% HUS)
19

The 2011 E. coli O104:H4 outbreak







(E.coli
)

20

Urethra

Anus

Vagina

Shigella
E.coli

21

Shigella

(Nonlactose fermenter on MacConkey agar)
MacConkey agar
Nonlactose ferment

Colorless
22

(Classic bacillary dysentery)

Infective dose 200 - 1000 cells

23

24

Salmonella

peritrichous flagella

25

Salmonella
MacConkey agar

SS agar

Nonlactose fermenter
26

 3
1. (Enteric fever)

Salmonella Typhi

Salmonella Paratyphi A, B, C

Systemic disease originating in the GI tract

Salmonella Typhi

Typhoid

Invade mucus
layer and
attach the
intestinal
epithelium cell
(IEC) by
fimbriae

Infective dose 103 - 105

MESENTERIC LYMPH NODES

BLOOD STREAM

28

1. Enteric fevers : Typhoid & Paratyphoid

Ingestion of S.Typhi

Diarrhea;
hemorrhage;
perforation

Inflammation and
ulceration of
Peyers patches

Small
intestine

Incubation
period

Lymphatics

Bile

MLN
Cholecystitis;
carrier state

Gallbladder

Thoracic duct

Fever;
kidney and
other organs
infected

Septicemia

Multiplication
in macrophages
in
liver,
spleen, and
bone marrow

Transient
(primary)
bacteremia

Signs and
symptoms
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-

2. (Septicemia)
S. Choleraesuis

33

3. Gastroenteritis
Salmonella
S. Typhi S. Paratyphi S. Choleraesuis
8-48

2-5
34

Klebsiella

Lactose fermenter,
mucoid colony
35

Pathogenicity
Klebsiella pneumoniae

Pneumonia
enterotoxin

Urinary tract infection (UTI)

etc
36

1. Yersinia pestis

(Zoonosis)

(Bubo)

Bubo
37

Plague ()
Sci 4 Oct 2001

38

Differentiation of family Vibrionaceae from

Enterobacteriaceae
Characters

Vibrionaceae

Curved rod

+/-

Oxidase

Motility

Flagella locations

Polar

Enterobacteriaceae

+/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

Ogawa
Inaba

Hikojima

O1
El Tor
O139

Ogawa
Inaba

Hikojima

NonO1/non O139
45

Cholera 2547

99 % of isolates
is V. Cholerae
El Tor Inaba

Cholera 2553

1-100

3 9 993

V. Cholerae El Tor Ogawa 982

V. Cholerae El Tor Inaba

11

V. parahaemolyticus

3-8%
TCBS
Gastroenteritis

: 4 - 48 ( 8 - 10)

46

V. vulnificus

2-3%
V. parahaemolyticus

47

V. vulnificus

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. jejuni Enteritis
C. coli

Diarrhea

C. fetus

Septicemia
51

Helicobacter pylori

52

PATHOGENICITY

53

http:// nobelprize.org/medicine/laureates/2005/index.html

54

Nonfermenters
Opportunistic pathogens

15%
2/3 Pseudomonas aeruginosa
54

Pseudomonas aeruginosa
Gram negative bacilli

Polar flagella (1-2)

Nonsporulation
Noncapsulated
55

Pseudomonas aeruginosa

Pyocyanin Pigment
Grape-like odor
56

 P. aeruginosa
1.

54

 P. aeruginosa
1.

Nosocomial infection:

Urinary tract infections (UTI)

54

 P. aeruginosa
1.

2.
3.

4.

54

Burkholderia pseudomallei

Burkholderia pseudomallei
- Bipolar

staining or
safety pin
- Polar tuft flagella
- Oxidase positive
58

Burkholderia pseudomallei
Musty or earthy odor

18 24 h incubation

> 48 h incubation

Smooth colony

Wrinkle colony
59

Geographic distribution of B. pseudomallei

Melioidosis = Severe disease

60

CLINICAL FEATURES
Person-at risk : Farmer, Diabetes mellitus (DM)

1) Wound infection
2) Pulmonary infection
3) Septicemia
abscesses in internal organs

:- liver abscess
61

Acinetobacter
Aerobic gram-negative coccobacilli, non-motile

A. baumannii
Hospital-acquired infection ventilator-associated

pneumonia

Acinetobacter
Aerobic gram-negative coccobacilli, non-motile

A. baumannii
Hospital-acquired infection ventilator-associated

pneumonia
antibiotic A. baumannii

. gentamicin,
amikacin, piperacillin, imipenem, ceftazidime, ciprofloxacin

Percentage of Susceptible A. baumannii

MAHARAJ NAKORN CHIANG MAI HOSPITAL, JAN-DEC 2009
Antibacterial drugs

% Susceptibility

Colistin

99

Gentamicin

25

Amikacin

28

Cefoperazone-sulbactam

31

Ceftazidime

23

Cefepime

21

Imipenem

26

Meropenem

27

Ciprofloxacin

23

Differentiation of enteric bacteria

Characters

Vibrio

Campylobacter Pseudomonas Enterobacteriaceae

H. pylori

Curved rod

Oxidase

Motility

+/-

Flagella locations

Polar

Growth characteristic

Facultative
anaerobe

Polar
Microaerophile

Polar

Peritrichous

Strickly
aerobe

Facultative
anaerobe

63

Bacteria
Obligate
aerobes

Microaerophiles

Aerotolerance
Facultative Obligate
anaerobes anaerobes


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