Microbiology The Gram-Negative Bacilli of Medical Important

The Gram-Negative Bacilli of Medical Important

Key Concepts:

1- Gram-negative Bacilli (Gram-negative rods) KWCa Families mYyd¾FM nig man Genus CaBYk
Non-spore-forming, cell walls rbs;vaman Lipo polysaccharide EdlCa Endotoxine

bgáreGayman Fever, Cardiovascular disruptions, shock nig Septicemia EdlCa

Complication d¾F¶n;F¶r .

2- Medically significant gram-negative rods EckecjCa 3 Rkum KWGaRs½yeTAtamtMrUvkar

rbs; Oxygen . BBYkbgáeraK (Pathogenic) Species manBYk Aerobic nig Facultative

anaerobes . cMENk Opportunistic pathogens GacekitmaneLIgTaMg 3 Rkum .

Virulence factor rbs;BBYk Gram-negative rods enaHKW LPS (Lipopolysaccharide)

EdlCa Component rbs; Cell wall .

3- Aerobic gram-negative bacilli rYmbBa©ÚlTaMg Opportunistic pathogen Pseudomonas,

zoonotic pathogen Brucella, human pathogen dUcCa Bordetella, nig Legionella .

4- Pseudomonas CaFmμtars;enAkñúgTwk nig dI . Pseudomonas aeruginosa KWCa Common

nosocomial opportunist EdlbNþaleGayGñkCMgWmansPaBF¶n;F¶r . Infections enH ekItman

bEnßmeTAelIGñkCMgWEdl Sever burns, neoplastic diseases, nig Cystic fibrosis .

5- Brucella infections GacekItmanedaysarkarb:HBal;edaypÞal;enAelIeKa (Cattle) rWbriePaK

TwkedaHeKaEdlBuM)ancMhuyRtwmRtUv (Unpasteurized milk) . Brucellosis maneraKsBaØa

Fever, sweating, nig Chills .

6- Bordetella pertussis CaPñak;garbgçMCMgWk¥kman; (Whooping cough rW Pertusis) . EdlCaCMgW

bNþaleGaymanxUcxateTAelIRbdab;dkdegðIm nig bNaleGaykUnekμgenaHsøab;/ karcMlg

eFVIeLIgtamry³ Droplets .

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1 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

7- Legionella EdlCaPñak;garbgáCMgW Legionellosis . CaCMgWEdlb:HBal;eTAelIRbdab;dkdegðIm/

EdlkarcMlgeFVIeLIgedaysarkarsayPayénénxül; (Aerosols) ecjmkGMBIma:suInRtCak;
(Air-conditioner) . vaCaCMgWd¾kacsahavEdlbNþaleGaysøab;)anya:grh½s .

8- Facultative anaerobe gram-negative rods rWBBYk Family enterobacteriaceae

(oxidative negative), EdlCaBBYk Family d¾FMmYyEdlrs;enAedayesrIenAkñúg Enterics rWCa

Normal flora rbs; Intestin .

9- Enteric Species EckecjCa 2 Rkum KW Coliforms nig Nonocoliforms GaRs½yeTAtam

Fermentation rbs; Lactose . Virulence factor énBBYk Pathogenic Species man ³

Enter toxins, exotoxins, capsule, fimbriae, hemolysins, nig Endotoxin .

10- Pathogen E.coli bgáeraKCaTUeTAeRcInEtmanenAelI Intestin nig Unirary tract . elIkElgEt

E.coli 0157 : H7 EdlbgáeGayman Hemolytic anemia nig xUcxatenAelI Kidney .

Virulence factor rbs;vaKW Exotoxins EdlbNþaleGay)at;bg; Fluid ya:gxøaMg nig eFVIeGay

Fimbriae EdlGacetagP¢ab;eTAnwg Intestin mucosa .

11- Enteric Species man Klebsiella, Enterobacter, Serratia nig Citrobacter vaminbgáeGay

manCa Harmful cMeBaH Healthy host, b:uEnþvabNþaleGaysøab;)anRbsinebIvaenAbgáeGayman

Infection enATIkEnøg Non intestinal . Klebsiella CaPñak;garcMbgCageK .

12- Non coliform enterics man Proteus, Morganella nig Providencia EdlCaPñak;ga

Opportunistic pathogen EdleRcInEtbgáeGaymanCa Septicemia, Wound Infection,

Urinary tract infection and Pneumonia .

13- Salmonella nig Shigella CaBYk Noncoliform Pathogens EdlCaPñak;garbgáeGayman

Intestine Infection d¾F¶n;F¶r . Salmonella Ca Genus mYyEdlGaccMlgedaypÞal; rW minpÞal;

tamry³Gahar rW Twk . Salmonella Typhi CaPñak;garénCMgWRKuneBaHevon (Typhoid fever).

Salmonella Species epSg²eTotCamUlehtuén Food Poisoning, Gastroenteritis, nig

Enteric fever . mnusSKWCa Host EtmYyKt;én S.Typhi .

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2 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

14- Shigellosis, rW Bacillary dysentery CaCMgWEdlekItmanenARKb;TIkEnøg . vaeRcInbNþalmk

GMBI Species én Shigella epSg²Kña . mnusSKWCa Reservoir EtmYyKt;én Shigella .
Virulence rbs; Shigella KW Endotoxin nig Enterotoxins EdleFVIeGayb:HBal;dl; Colon.

15- Yersinia Species CaPñak;garén Zoonotic infection ¬CMgWbgáeraKtamry³stV¦ . Yersinia

enterocolitica nig Yersinia Pseudotuberulosis CamUlehtuén Enteric infections cMeBaH

kumar . vacMlgtamry³cMNIGahar nig Twk . cMENkÉ Species Yersinia Pestin CamUlehtuén

CMgW Plague EdlTMrg; 3 ya:g ³ Bubonic, Pneumonic, nig Septicemic . CaTUeTAkarcMlg
RtUveFVIeLIgtamry³stVl¥itTic b¤ xaM (Flea bits) . kNþúr nig BBYkGMbUrkNþúr (Rodents) KWCa
Reservoir én Yersinia pesties, cMENkÉstVl¥it (Amplifying host) CaGñkcMlgeTAeGay

mnusS .
16- Pasteurella KWCaPñak;garbgáeraK Opportunistic zooneses . Pasteurella multocida Ca

Pñak;garbgáeraKdl;mnusS/ qøgtamry³karxaM RkejA (Seratches) rbs;stV .

17- Genus Haemophilus manTaMg Species Commensals nig Pathogens . Hoemophilus

influenzae CamUlehtuén Upper and lover respiratory infection . Haemophilus

meningitidis CaPñak;garénCMgWrlakeRsamxYr . Haemophilus ducreyi CaPñak;garénCMgW Soft

chancre EdlCaCMgW S.T.D . cMENkÉ Haemophilus parainfluenzae CaPñak;garén

Endocarditis .
Generality:
Gram-negative bacilli (Rods) EckecjCa 3 Rkum GaRs½yeTAtamesckþIRtUvkarén Oxygen,
Rkum Aerobes, Rkum Facultative anaerober (Family Enterobacteriaceae, Oxidase negative
nig Family Pasteurellaceae, Oxidase positive), Rkum Obligate Anaerobes .
Component rbs; Gram-negative rods Ca Complex cell wall Edlman Outer-

membrane man Lipopylysaccharide (LPS) EdlmanlkçN³Ca Endotoxin . Endotoxin enH

cUleTAkñúgQambgáeGaymanCMgWF¶n;F¶redaysarlT§PaBén Pathophysiology énCMgWenAelIsrIragÁ

epSg² . Gram-negative Septicmia CamUlehtuén Iatrogenic rW Nosocomial infection .
__________________________________________________________________________________________
3 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

Aerobic Gram-Negative Non enteric Bacilli

The aerobic gram-negative bacteria Edlmansar³sMxan;enAkñúgevC¢sa®sþenaHrYmman

Pseudomonas, (Opportunistic pathogen), Brucella (Zoonotic Pathogens) nig Bordetella,

Legionella ¬Ca Human Pathogens) .

I- Pseudomonas:
Pseudomonas KWCa Family mYyd¾FM Edlrs;enAedayesrIenAkñúgTwk/ dI/ nig smuRT CaedIm Edl
GaceFVIkarcMlgmkelImnusS)anya:ggay . vaCa Gram negative rods Edlman Polar flagellum
EtmYyKt;/ vabeBa©jmknUv Oxidase nig Catalase, Etvamin Ferment Carbohydrate eT .
Pseudomonas Species epSg²Kña plitnUv Pigments green, brown, red rW Yellow EdleFVI

eGayfñalbNþHú (Medium) pøas;brÚþ BN’ . Pseudomonas GaceFVkI arsMrbxønÜ ya:ggayCamYymCÄdæan

xageRkAEdlRtUvkarcMNIGahard¾sþÜcesþIg . dUecñHvagayRsYlrs;enAkñúgmCÄdæanxageRkA nig eRtom
cMlgmkmnusS)any:aggay . Pseudomonas eFVI Metabolism )anya:ggay/ edaybgáeGayman
Degrade intracellular Substance edaysar Enzyme mYycMnYndUcCa Protease, amylase,

Pectinase, Cellulase CaedIm .

Pseudomonas aeruginusa Ca Species manenAkñúgTwk/ dI nigkñúg Intestin én 10° rbs;

RbCaCnTUeTA . eBlxøHeKGaceXIjvamankñúg Saliva . Ps. aeruginosa Ca Species mYyEdl

Resistant CamYy Soaps, Dyes, amonium disinfectants, drugs, drying, nig sItuNðPaBx<s;/

CaehtueFVIeGaymankarBi)akkñúgkar Control eTAelI Chronic nosocomial pathogen . karcMlg

eRcInEtekItmaneLIgenAeBl Humifiers, Ventilators, Intravenous solutions, anesthesia nig
Resuscitation equipment .

Ps. aeruginosa CaPñak;gar Typical opportunist EdlbgáeraKenAeBlEdlman Weak host

defense CaBiesscMeBaH Dibilitating illness, injury, immunosuppressant medications, .

Ps.aeruginosa beBajnUv Virulence factors dUcCa Exotoxins, resistant CamYy Phagocytosis,

enzyme nig Hemolysins EdlGacbMEbkekasika)an/ cMENk Endotoxin CamUlehtuén Shock .

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4 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

Ps.aeruginosa EdlCa Common nocosomial infection ekItmancMeBaH Compromised

host Edlmankarrlak (Burns) F¶n;F¶r/ Neoplastic desease, nig Cystic fibrosis .

Complication rbs;varYmman Pneumonia, Urinary tract infections, Abscenes, Otitis,

Corneal disease CaedIm . Ps.aeruginosa Septicmia GacbgáeGayman Endocarditis

meningitis nig Bronchopneumonia EdlmanGaRtasøab;x<s; (80%) . GñkEdlBak; Contact

lenses GacbgáeGayman Infection F¶n;F¶redaysar Ps. aeruginosa, KWvabNþaleGayman

Corneal ulcers .

Ps.aeruginosa infection bNþaleGaymankøin Grapelike nig xÞúHrbs;vamanBN’exov-ébtg

(Blue-green) rW BN’ Greenish-yellow (Pyocianin) . Ps.aerugnosa eFVIkarvivtþn_eTArkPaBsauM

(Multiple drug-resistance) CamYy Antibiotics . Antibiotics EdlmanRbsiT§iPaBcMeBaH

Ps.aeruginosa KW Third-generation cephalosporins, aminoglycosides, carbenicillin,

polymyxin, Quinolone, nig Monobactams .

II- Brucella and Brucellosis:
Brucellosis rWehAfaCMgW Malta fever, Undulant fever, rW Bang disecne KWCaCMgW Zoonosis
¬CMgWrbs;stV¦ EdlGacqøgeTAeGaymnusStamry³stVEdl Infected edaysar Brucella .
Brucella man 2 Species KW B. abortus ¬eRcInekItmanelI eKa/ Cattle¦ nig B. suis ¬eRcInekIt

manelI Pig) . CMgW Brucellosis enAelIstVenHeRcInEt Infected enAelI Placenta nig Fetus Edl
bNþalman Abortion ¬rlUt¦ . k¾bEu: nþceM BaHmnusSvijGñkCMgmW an Severe febrile EtBuMbNþaleGay
rlUteT .
Brucellosis enHeRcInekItmanesÞIrBaseBjBiPBelak Europs, Africa, India, Mexico, nig

Central-south America . karcMlgmkmnusSGacekItmanenAeBlEdlmankarb:HBal;edaypÞal;

CamYy Blood, Urine, placenta nig Aerosols rbs; Animal infected . pÞúyeTAvijkarcMlgGMBI
mnusSeTAmnusSBuMTan;rkeXIjenAeLIgeT .
Brucella cUlenAkñúgsrIragÁkaymnusS qøgkat;tamry³ Damaged Skin, mucous membrane

rbs; Digestive tract, conjunctiva, nig Respiratory tract . emeraKenHcUltamry³RbB½n§

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5 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

Lymphatic fluid eq<aHeTAkan; Regional lymph nodes, rWk¾ Phagocytes infected )anbeBa©j
emeraKenHenAkñúg Blood stream bgáeGayman Infection local enA Liver, Spleen, Bone
marrow, nig Kidney . eraKsBaØaRKunekþAén Brucellosis KWCakareLIgcuHénsItuNðPaBrvageBl

éf¶-yb; EdleKehAfa Undulant fever, eRkABIenaHmaneraKsBaØa Chills, Profuse sweating,

headache, muscle pain, nig Weakness RBmTaMg Weight loss . karvivtþn_eTArkesckþIsøab;min

eTogTat; BI b:unμanGaTitürhUtdl;mYyqñaM eTaHbICaTTYlkarBüa)alk¾eday .

karBüa)alRtUveFVIeLIgeday Combination én Antibiotic Tetracycline nig Streptomycin
kñúgry³eBl 3 eTA 6 GaTitü . sMxan;bMputRtUveFVIkarRtYtBinitüenAelIstVBahn³ cMeBaHkarnaMcUl nig
RtUvcMhuy (Pasteurization milk) TwkedaH . manRbePT Vaccin cMeBaHstV/ EtBumM ancMeBaHmnusSeT.
III- Bordetella pertussis and Whooping Cough
Bordetella pertussis KWCa Encapsulated coccobacillus EdlCaPñak;garEtmYyKt;énCMgW
Pertussis rW Whooping Cough KWCa Communicable disease ekItmancMeBaHkUnekμg Edlbgá

eGaymanCa Acute respiratory Syndrome . CMgWenHF¶n;F¶r nig man Complication severe cMeBaH
babies . cMeBaH Bordetella parapertussis GacbgáeGaymanCa Infection mYyminsUvF¶n;F¶reT .

Primary source énemeraKenHKW Children EdlmanpÞúkemeraKraMér: (Chronic carriers) .

karcMlgGaceFVIeLIgedaypÞal;tamry³karb:HBal;CamYy Droplets rW Inhalation of infection

aerosols . PaKeRcInén Pertusis eRcInekItmancMeBaH Babies GayuticCag 6 Ex BIeRBaHvaBuM)an

TTYl Antibodies protection rbs;mþayEdl antibodies . enaHBuMGacqøgkat;enAkñúg Uterus )an

. edaysar Vaccin RbqaMgnwg Pertussis )aneFVIeGayCMgWenHfycuHya:gxøaMg .
Virulence factor én B. pertussis TI1 KWCa Receptor EdlmanlkçN³ Specific Gac

Recognize nig etagP¢ab;eTAnwg Ciliary respiratory epithelial cells, TI2 KW Toxin Edl

Destroy ciliary cells. dUecñHenAeBlEdl Mechanism Ciliray RtUv)anxUcxat CaehtueFVIeGay

begáIn Mucus ya:gxøaMg nig blockage the airways . dMNak;kaldMbUgén Pertussis KW Catarrhal
Stage EdlvabNþaleGaymaneraKsBaØa ³ Nasal drainage and congestion, Sneezing and

occasional cough . dMNak;kalTI 2 KW Paroxysmal stage maneraKsBaØa Cough Cab;Kña 10 eTA

20 nig EdltMrUveGaydkdegðImcUlya:g xøaMgqøgkat; Larynx d¾ceg¥ótbNþaleGaymansMelg "Whoop".

Complication ekItmanya:gF¶n;F¶r eTAelIRbdab;degðIm .
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6 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

bc©úb,nñenHmanRbePT Vaccin EdlRbqaMgnwg Whooping cough, vaccin enH Combined

CamYy Diphtheria nig Tetanus (DPT) . eBlxøaH Vaccine enHbgáCaRbtikmμF¶n;F¶rcMeBaH olds
children nig mnusScas;/ dUecñHehIy)anCaeK min)ankMNt;eGaycak; Vaccine enHcMeBaHkumarGayu
elIsBI 7 qñaMeLIy . cMeBaHkarkarBarenAeBlEdlman Epidemics GaceRbI Erythromycins .
IV- Legionella and Legionellosis:

Legionella KWCaemeraKEdleKeTIbrkeXIjenAkMLúgqñaM 1940 / ehIymkdl;qñaM 1976 eTIbeK

kMNt;fa Legionella GacbgáeraKeTAelImnusS . EdleBlenaHmanCMgW Pneumonia EdlbgáreLIg
eday Legionella manlkçN³Ca Epidemic enA America . manGñkCMgWRbmaN 200 nak;ehIy
eRcInCag 15° RtUv)ansøab; .
Legionella Ca Weakly gram-negative motil rods . vaRtUvkarenAfñalbNþúH (Media)
Specific (Charcoal extract medium) sMrab;eFVIkarbNþúH Legionella . Legionella enHman
Species CaeRcInmanCaGaT× L. pneumophila EdlCYbRbTHjwkjab;enAkñúg Infection .
lT§PaBrs;enAkñúgmCÄdæanxageRkArbs; Legionella BuMGackMNt;Cak;lak;enAeLIyeT . RKan;Et
RbEhlCaemeraKEdlrs;enAkñúgTwk (Agueous habitats) dUcCa Tap water, cooling waters,
spas, ponds nig Other fresh wates . fμI²enHeKrkeXIjfa Legionella rs;enACamYy Free-
living amebas .
Legionellosis KWCaCMgWmYymanBaseBjBiPBelak/ vaeRcInEtmanlkçN³Ca Sporadic .
Nosocomial infection bNþalmkBI Legionella eRcInEtekItmancMeBaHGñkCMgWcas;Cra sMrakeBTü
CamYyGñkCMgW Diabetes, malignant diseases, transplant, alcoholism, nig Lung disease .
k¾b:uEnþvaminEmnCa Communicable disease qøgBImnusSmñak;eTAmnusSmñak;eToteT .
Legionellosis manTMrg; Clinic 2 Ebb KW Pneumonia nig pontiac fever . vamaneraKsBaØa
rYmKW high fever (up to 40 ºC), cough, diarrhea nig Abdominal pain . Legionella
pneumonia manlkçN³F¶n;F¶r EdlmanGaRtasøab;BI 10 to 20% . pÞúyeTAvij Pontiac fever
BuMbNþaleGayman Pneumonia eT ehIyk¾BuMbNþal eGaysøab;Edr .
kareFVIeraKvinicä½yenAmnÞIrBiesaFn_KW ³ karbNþúHrk Legionella edayeRbI BCYE agar medium
rW DNA probes rW Fluorescent staining . karBüa)al Legionellosis edayeRbI Antibiotic,
Erythromycine EtÉkÉg rW Combined Erythromycine nig Rifampin .

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7 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

Identification and Differential Characteristics

of the Enterobacteriaceae
Enterobacteriaceae KWCa Family d¾FMmYyénBBYk Bacteria gram negative . mYyEpñkén
BBYkenHRtUv)aneKrkeXIjpgEdrenAkñúg dI/ Twk/ nig PaKeRcInBYkvaRtUv)anrkeXIjenAkñúgeBaHevon
(Bowel) rbs;mnusS nig stVpgEdr .

vaCaRbePT Bacteria manTMhMtUc (Average is 1 μm by 2 to 3 μm ) CaBBYk Non-spore-

forming rods, EdlvaeFVIkarrIklUtlas;)anl¥enAeBlEdlmanxül;/ b:uEnþvamanlkçN³ Facultative

én Ferment cabohydrate tamry³ Anaerobic pathway . vaCa Group mYyEdl Most

commune isolated in clinical specimens TaMg Normal flora rW Agent of diseases .

Enteric pathogens ¬Pñak;garbgáeraKkñg

ú eBaHevon¦ bgáeGaymanCMgW EdlCYbRbTHjwkjab;CageKKW
Diarrhea EdlCamUlehtubNþaleGayGRtasøab;RbcaMqñaMRbEhl 5 lannak;enAkñúgBiPBelak/ vaCa

GRtasøab;lMdab;TI2 bnÞab;GMBICMgWsésQam ebHdUg (Cardiovascular) . Enteric pathogens enH

rYmbBa©ÚlTaMg Salmonella, shigella, nig Escherichia EdlmanmnusSCaGñkpÞúk .
müa:gvijeTot Enteric pathogens ¬rYmbBa©ÚlTaMg Pseudomonas¦ GacekItman 50° én BBYk
emeraKEdlbgáeGayman Nosocomial infection . Enteric pathogens enHGacBinitüeXIj
manelI Soap disher, Sinks, fiberoptic, tracheal, cannulas, catheters CaedIm . BBYk Enteric
pathogens opportunist manCaGaT× E.coli, Klebsiella, Proteus, Enterobacter, Serratia, nig

Citrobacter . vaCaBBYkEdlGacbgáeraKenAelIeBaHevon/ sYt/ Urinory tract .

lkçN³rbs; Genus Enteric pathogens enHKWva Ferment glucose, reduce nitrate to

nitrite, nig Oxidase Negative . eKEbgEckBBYk Enteric pathogens enHCaBIr Subcategaries :

KW Coliform nig Non coliforms .

1- Coliform Ca normal enteric flora Edl Ferment lactose )anrh½senAkñúgry³eBl 48ema:g

ehIyvaGacbgánUv Opportunistic infection . BBYk Coliforms enHmanCaGaT× ³

- Escherichia coli
- Klebsiella
- Serratia
- Citrobacter
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8 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

2- Non coliform KWCaBBYkEdlminGac Ferment lactose )aneLIy/ vaGacCa Normal flura

rWk¾ Pathogenic enteric Etmþg . BBYkenHk¾GacbnþeGayman Opportunistic infection Edr.
vamanCaGaT× ³
- Proteus
- Morganella
- Providencia
- Salmonella typhi, S. cholerae, S.enteritidis
- Shigella dysenteriae, Sh. flexneri, Sh. boydii, Sh. sonnei
- Yersinia enterocolitica, Y. pseudotuber culosis, Y.pestis.
BBYk Coliform nig Noncoliform enH manlkçN³sMrab;eFVI Identify dUcCa ³ Non-spore-
forming, straight rods Edlmanclna (motile) elIkElgEt Shigella nig Klebsiella, man

Catalase positive, oxidase negative .

eKGacykvaecjGMBI (Isolated) Stool Edlman normal flora ya:geRcInelIslb; . eKGac

eFVIkarbNþúHvaenAelI Medium enrich rW Non fecal specimens and selective dUcCa Mac
Conkey, EMB, Hectoen agar, ehIy Incubated for 24-48 hours .

Colonis EdlduHenAelI agar medium enH nwgbgðajeGayeXIjnUvlkçN³ Lactose- fementers

rW non lactose-fementers . bnÞab;mkeKcab;yk Single colonies eTAeFVI Sub culture enAelI

Triple sugar iron (TSI) agar edIm,IbnþkareFVIviPaK . karviPaKeFVIeLIgGaRs½yeTAtam Level rbs;

Rbtikmμ Indole, methyl red, voges - Proskaurer, nig Citrate (IMV,C) EdlGaceGayeKeFVIkar
EbgEck Genus rbs;va)an . müa:gvijeTotman Commercial identification systems dUcCa Api
206, ID 32E, Enterotube CaedImEdlsMrYldl;kareFVI Identification of genus .
I- Antigenic Structures and Virulence Factors
The gram-negative man Antigen surface Edlmansar³sMxan;enAkñúg Pathogenecity
¬karbgáeraK¦ nig enAkñúg Immune response . Antigens TaMgenaHrYmman H Ca antigen flagella,
K Ca Capsule and/or fibrial antigen, nig O Ca Somatic rW Cell wall antigen . RKb;BYk

Gram- negative enteries man O antigen, cMENk H nig K antigens GacmanrWKμan .

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9 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

eKGackMNt; Serotypes rW Some species gram-negative entierics GaRs½yeTAtam Chemical

structure én HKO antigens .

karbgáeraK (The pathogenesis) rbs;emeraK Enterics KWGaRs½yeTAelI Endotoxins,

Exotoxins, host defenses, nig lT§PaB Multiply ¬karbMEbkxøÜn¦ rbs;emeraKenAkñúg Tissus nig

Blood . PaKeRcInemeraK Enterics CaBYkemeraK Commensal Edlman Potential s¶at;es¶óm

(Latent) eTACa Potential xøaMgkøakñúgkarpøas;bþÚrnUvlT§PaBbgáeraK (Pathogenenicity) . KWvaGac

Transfer chromosomal rW plasmid genes dlbNþaleGayvagay Resistance CamYy

Antibiotics, toxigenicity ¬bgáeGay toxic) rW PaBsMrbsMrYlCamYymCÄdæanCuMvij . dUecñHehIy

emeraKEdlmanenAkñúglamk (Fecal residents) EdlCaBYk Nonpathogenic rW Less pathogenic

EtvaGackøayeTACakacsahav (Aquire greater virulence) . Viralence genes TaMgenaHmanCa
Enterotoxins, capsuls, hemolysins, nig Fimbriae EdlmanRbmUlpþúMenAelI Colonis mankñúg

Intestinal rW Urinary epithelial .

II- Coliform Organisms and Diseases:
A- Escheri chia coli (I.Coli):
E. Coli CaemeraK Coliform Edll,IeQμaHeRBaHvaCaemeraKEdleKCYbRbTHCajwkjab;enAkñúg
mnÞIrBiesaFn_ . eKGacehAmüa:geTotfa Colon bacillus . vaCa Bacteria EdlmanenAkñúgeBaHevon
nig Aerobic . mYyPaKtUcén E.coli CaBYk Pathogen, nig PaKeRcInCaBBYk Harmless commensal,
EtvagayRsYl Developed enA Virulence ya:gkacsahavedaysarkarpøas;bþÚrén Plasmid rW k¾
eBlxøHvaCaBBYk Opportunists .
1- Pathogenic strains of E.coli :
enAkñúgcMeNamBBYk Pathogenic strains vaEckecjCa ³
- E.coli enterotoxigenic (ETEC) EdlbgáeGayman severe diarrhea bNþalmkGMBI
Exotoxins Ca Heat-labil toxin (LT) nig heat-stable toxin (ST), EdlvaCMrujeGayman

Secretion fluid y:agxøaMg nig Fluid loss . vabNþaleGaymankarPan;RcLMCamYy

Cholera . emeraKRbePTenHxøHbeBa©j Fibriae bNþaleGayman Adhesion to the small

intestine .
__________________________________________________________________________________________
10 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

- E.coli enteroinvasive (EIEC) CaemeraKEdlbgáeGayman Inflammatory disease man

lkçN³Rbhak;RbEhleTAnwg Shigella dysentery, Edl E.coli Gac Invasion nig bgá
eGayman ulceration eTAelI Mucosa of large intestine .
- E.coli enteropathogenic (EPEC) Ca E.coli EdlbgáeGayman Diarrhea ya:gF¶n;F¶rCa

BiesscMeBaHkumar/ Edl Pathogenesis rbs;vaBuMTan;rkeXIjc,as;las;enAeLIyeT .

- E.coli enterohemorrhagic (EHEC) Ca E.coli EdleTIbEt Identify ehIykMNt;lkçN³

CaGñkbgáeraK/ CaBiessKW E.coli 0157:H7 EdlbNþaleGayman Hemorrhagic

syndrome rYmCamYy Diarrhea, vaqøgmkGMBIsac;eKa .

- E.coli enteroaggredation (EAEC) Ca E.coli EdlrkeXIjfμI²enH/ ehIylkçN³

Pathogenesis rbs;vaBuMTan;kMNt;enAeLIyeT .
2- Clinical diseases of E.coli:
PaKeRcInénCMgWbgáeGay E.coli eFVIkarcMlgya;gxøaMgkøarvagmnusS nig mnusS . Pathogenic
strain rbs; E.coli KWCaPñak;garénCMgW Diarrhea infentile ¬CMgWraKrUskUnekμg¦ EdlCamUlehtuén

esckþIsøab;rbs;Tark . enAkñúgBiPBelak RbmaNBI 15° eTA 25° énkUnekμg eRkamGayu 5 qñaM

RtUv)ansøab;edaysar Diarrheer enH . GaRtaénesckþsI aø b;rtw Etx<se; TAeTotenAkñgú RbeTs tropical
EdlmanGnam½yTab (Sanitary facilitierar poor) RbPBTwkmanemeraK nig manmnusScas; GñkpÞúk
emeraKenaHeRcInenAkñúg Community .
müa:gvijeTotmankrNI Travel-associated gastro intestinal diseases bNþalmkGMBI
Exotic pathogens . CaBiess traveler's diarrhea eRcInEtbNþalmkGMBI Enterotoxigenic

strains E.coli . PaKeRcIn Traveler cab;yk E.coli man Virulence xøaMgkøa ecjGMBI Local

food-drink kñúgry³eBl 5 eTA 7 éf¶eRkay bNþaleGayman Dicrrhea profuse ¬raKQUr²¦ ekþA

xøÜnbnþicbnþÜc ¬Low-grade fever), Nausea, nig Vomiting . Travelers xøHbnþeTA Chromic

enteroinvasive dysentery EdlmanlkçN³dUcnwgCMgW bNþalmkBI Shigella rW Salmonella .

vaBuMman Antimicrobials (antibiotics) NamYyc,as;las;sMrab;karBar Travelers )aneLIy .

__________________________________________________________________________________________
11 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

eRkABIbgáeraKenAkñúgeBaHevon/ E.coli GacCaPñak;garbgáeraK Urinary tact infection (UTI)

RbmaNCa 50° eTA 80° énmUlehtu . UTIs enHekItmaneRkayeBlEdl E.coli EdlmanenAkñúg
eBaHevonGac Invaded cUleTAkñúg urethra, ehIyvaGac Promote eGayman Infection eTAdl;
Bladder ¬epøakenam¦ bgáeGayman Cystitis, eBlxøHeTotvaGacbnþdl; Kidneys eTotpg . elIs

BIenHeTAeTot E.coli GacbgáeGayman Neonatal meningitis, pneumonia septicemia, nig

Wound infections . vaCamUlehtuén Complication én Surgery, endoscopy, tracheostomy

catheterization, renal dialysis, nig Immunosuppressant therapy .

B- Other Coliforms:
BBYk Coliform Edlmansar³sMxan;enAkñúg Clinical medical KWmanCaGaT× Klebsiella,
Enterobacter, nig Citrobacter . BBYkemeraKTaMgenHmanenAkñúgeBaHevon/ vanwgkøayeTACaGñk

bgáeraKenAeBlvabgáeraKenAelITItaMgepSg . eRkAGMBIeBaHevon . BBYkemeraKTaMgenHbgáeGayman

Primary infection RbsinebI Host defense rbs;buKÁlenaHRtUvfycuH . BBYkemeraKTaMgenH Gac

bgáeraKenAesÞIrRKb;srIragÁTaMgGs;énsarBagÁkay/ nig Complication d¾F¶n;F¶rKW Endotoxemia nig

Septicemia .
1- Klebsiella:
Ca Genus Edlrs;enAkñúgeBaHevonrbs;mnusS nig stV . b:uEnþvak¾manenAkñúg Respiratory tract
rbs;buKÁlFmμtaEdr (normal host) . emeraKenHGacbgáeGaymanCa Chronic lung infection,
CaBiessKW Species Klebsiella pneumoniae . karbgáeraKrbs;emeraKenH bNþalmkGMBI Capsule
rbs;vaEdlGacraraMgdl; Phagosytosis . Klebsiella strains xøHbeBa©jnUv Toxin . Klebsiella
pneumoniae KWCa Species EdlCYbRbTHCajwkjab;énmUlehturbs; Nosocomial infection dUcCa

Pneumonia, meningitis, bacteremia, would infection nig Urinary tract infection (UTI) .

2- Enterobacter:
Enterobacter Ca Genus EdleKGacrkeXIjmanenAkñúg Soil ¬dI¦/ TwklU ¬Sewage) nig
plitpleFVGI BM TI kw edaH (Dairy products) . vaCaemeraKEdleRcInEtbgáeGayman UTIs, müa:geTot
vaCaemeraKEdlbgáeGayman Infection eTAelIGñkCMgWvHkat;/ Spinal fluid, Sputum, nig Blood .
vabNþaleGaysøab;)anRbsinebIvaratt,atenAkñúg Blood Stream .
__________________________________________________________________________________________
12 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

3- Citrobacter:
Citrobater CaemeraKEdlmanenAkñúgdI Twk nig lamkmnusS . vaGacbgáeGayman
Opportunities én Urinary tract infection nig Bacteria énGñkCMgW Debilitated .
4- Serratia:
vaCaemeraK manCaFmμtaenAkñúgTwk dI nig enAkñúgeBaHevon . Species mYyRbePTKW Serratia
marcescens beBa©jmknUv Red prigment enAeBlEdlvaeFVIkarlUtlas;kñúg room temperature .

75° én Serratia EdleKrkeXIjenAkñúg Clinic vaBuMman Red progments eT . vaRtUv)anrkeXIj

enAkñúg Nosocomial infection manlkçN³Ca Serratia pneumonia, Wound infection,
meningitis, fatal septicemia . emeraKenHPaKeRcInmanPaBsauMCamYyRkum Autibiotics CaeRcIn.

III- Non coliform lactose - negative Enterics

A- Opportunists : Proteus and Its Relatives

3 genus énemeraK Non-coliform EdlmanlkçN³Rbhak;RbEhlKñaKW Proteus, Morganellc

nig Providencia, EdlCaemeraKmanenAkñúgdI/ TwklU/ TwkmanCatiBul rWCa Commensal genus rbs;
mnusS nig stV . vaCaBBYk Harmless cMeBaHmnusSsuxPaBFmμta .
1- Proteus:
Proteus species KW Proteus mirabilis colonis manTMrg;ralrIkFM Concentric enAelIfñal
bNþúHEdlesIm (Moist agar) . vaeRcInEtbgáeGayman UTIs, Would Infection, pneumonia,
Septicemia, eBlxøHKW Diarrhea rbs;kUnekμg . Proteus EdlbgáeGayman UTIs GacCMrujeGay

mankarbMEbk Renal Stones edaysar karbeBa©j Urease rbs;va nig eBlenaH pH rbs;Twkenam
RtUvekIneLIg .
2- Morganella / Providencia:
Morganella morganii nig Procidencia stuartii eFVIkarbgáeraKmanlkçN³Rbhak;RbEhleTA
nwg ProteuspgEdr . elIsBIenH P.stuartii bgáeGayman Infection enAeBlEdlmanrlak (Burns)
vaCa Genus EdlmanPaBsauMCamYy Antibiotics x<s; .

__________________________________________________________________________________________
13 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

B- Non coliform pothogens:

manCaGaT×KW Salmonellae nig Shigellae EdlGaceFVIkarEbgEckecjGMBIBBYk Coliform nig
BBYk Proteus edaysar Genus Salmonellae nig Shigelae mankarvivtþn_xøaMgeTAelI virulence
factor nig manlkçN³Ca Primary pathogen cMeBaHmnusS . CMgWEdlbgáedaysar Salmonellae KW

Salmonellosis, cMENkÉ Shigellae KW Shigellosis, suT§EtbgáeGaymaneraKsBaØaeTAenA

Gastrointestinal tracts bNþaleGayman Diarrhae nig b:HBal;eTAdl;srIragÁepSg²eTotpg .

1- Salmonellae: Typhoid fever and other Salmonellosis:

Salmonellae species Edl bgáeraKF¶n;F¶rCageKenaH KW Salmonellae typhi EdlbgáeGayman
Typhoid fever . cMENkÉ Species d¾éTeTot EckecjCa 2 Subgroups : KW S.cholerae suis

EdleRcInEtbgáeraKeTAenAk¶an (Swine) enA S.enteritidis EdlCa Subgroups d¾FMrYmbBa©ÚlRbmaN

Ca 1700 Serotypes epSg²Kña GaRs½yeTAtamRbePTén Antigen O, H, nig Vi (Vi enHkMBugEt
manlkçN³Ca Virulence rW Capsule Antigen rbs; Salmonella) . Serotype rbs; Salmonellae
RtUv)anbMBak;eQμaHeTAtamRbPBEdlrkeXIj ]TahrN_ ³ S. typhimurium ¬EdlrkeXIjenAelI
Rat nig Mice¦ nig S. newport ¬rkeXIjenATIRkug Newport¦ . karkMNt;lkçN³rbs; Serotype

enHPaKeRcIneFVIenA CDC (Centers for Disease Control) .

Salmonellae CaemeraKEdleFVIbMlas;TI ¬manclna¦ enA Ferment glucose eTACa Acid nig

Gaz, müa:geTotvaplitnUv H S / EtBuMplit Urease eT . vaGacduH)anenAelIesÞIrEtRKb;RbePT

2

fñalbNþúH/ ehIyeTArs;enA)anya:ggayenAxageRkAxøÜnGñkCMgW rW xøÜn Host, CaBiesskñúgTwk nig Twkkk

CaedIm . vaCaemeraKEdlGac Resistance CamYy Dyes, nig vamingay)at;bg; Virulence eT
eRkayeBleFVIkarbNþúHtamEbbsb,nimitþ .
Typhoid fever: CaCMgWEdleQμaHRbEhlnwg Typhus EdlCa Rickesial diseases EtCakarBit

vaCaCMgW 2 xusKñaTaMgRsug . enAkñúgBiPBelak Typhoid fever CabBaðasMxan;sMrab;suxPaB Edl

bNþaleGayman mnusSsøab;RbEhlCa 25>000 krNICaerogral;qñaM nig manGñkCMgW Typhoid fever
rab;lannak; .
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14 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

emeraK S.typhi cUleTAkñúgsrIragÁkayrbs;mnusStamry³bMBg;Gahar EdlnaMmknUvcMNIGahar

nig Twk EdlmanpÞúkemeraK/ eBlxøHvaGacqøgenAeBlEdlb:HBal;pÞal;CamYyGñkCMgW . mnusSCaKWCa
Host EtmYyKt;én S. typhi, dUecñHGñkpÞúk Asymptomatic KWCaGñkcMlgemeraKenH . eTaHbICa

Gs;ry³eBl 6 s)aþh_eRkayBI)at;bg;eraKsBaØa Typhoid fever k¾eday/ manRbmaNCaBak;kNþal

énGñkCMgWEdleKenAEtcab;ykemeraKenaH)an . mYyPaKtUcénGñkCMgW Chronic GacpÞúkemeraKenH)an
ya:gyUrenAkñúgfg;TwkRbmat; (Gallbladder) ehIyemeraKenH RtUvbeBa©jenAkñúgeBaHevontamlamk .
Typhoid fever nig GacekItmaneLIgenAeBlEdl buKÁlenaHelbcUleTA S.typhi RbmaNCa

1000 enA 10.000 emeraK . enAelI Mucosa én Small intestine, emeraK S. typhi )an Adhere

ehIyRCatcUlbnþicmþg bgáreGayman Invasion infection nig Gaceq<aHeTAdl; Septicemia .

S. typhi )an Infiltrate ¬RCatcUl¦ enAkñúg Mesenteric lymph nodes, liver nig Spleen .

enAeBlEdlemeraK enaH)ancakecj Lymphoid tissue infection, vak¾)anbegáItcMnYnenAkñúgQam

begáItCa Bacteremia nig e)aHTItaMgenAkñúgsrIragÁepSg² .
eraKsBaØarbs; Typhoid fever KW Fever, diarrhea, nig abdominal pain .
enAkñúgdMNak;kal én Enteric phase progressive, eBlenaH Lymphoid tissue én Small
intestin )ankøayeTACa tMbn; ulcere nig man Hemorrhage, cMeBaHGñkCMgWxøHvaGacnivtþn_eTA

CadMe)ArlYy (Deep erosion), Føay (Perforation) CaehtubNþaleGayman Peritonitis .

krNIxøH Urinary tract nig Liver GacTTYl Infected køayCa Abscesses . RbsinebImineFVIkar
Büa)aleTenaH/ GaRtasøab;Gacman RbEhlCa 10° eTA 15° . ebIeKeFVIkarBüa)alTan;eBlevla
vaGacbnßyGaRtasøab;)an .
Preliminary diagnosis én Typhoid fever KWGaRs½yeTAelI Patient's history,

symptomes nig Supported eTAelIkarekIteLIgén Antibodie titer .

k¾b:uEnþ Definitive diagnosis KWCakarcab;rkemeraK S.typhoid . Chloramphenicol,

Ampicillin CaCMerIs antibiotics d¾sMxan; . fμI²enHBBYk Quinolone KWCa Antibiotic d¾RbesIr

__________________________________________________________________________________________
15 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

sMrab;eFVIkarBüa)al Typhoid fever . Vaccin RbqaMgnwg Typhoid fever ¬CaRbePT Killed

Whole-cell vaccine) GaceFVIkarkarBarmYyry³/ eKGnuvtþn_cMeBaHEt Traveler and military

personnel .
2- Other Salmonellosis:
Salmonellosis eRkAGMBI Typhoid fever KW Entenic fever, salmonella food poisoning
nig gastroenteritis . vaCaCMgWEdlmansPaBFUrRsalCag Typhoid fever, vabgáeLIgedaysarBBYk
S.enteritidis manCaGaT× ³ S. paratyphi, S.schottmulleri (Paratyphi B), S. hirschfeldii

(paratyphi C), nig S. typhimurium CaedIm .

3- Animal origin salmonella:
CMgW Non typhoidal salmonellose RtUv)aneKCYbRbTHjwkjab;Cag typhoid fever . mindUc
Typhoid fever eT/ KW non typhoidal salmonellose manemeraKbgáeraK EdlmanRbPBenAelIstV

(Zoonohs origine), cMeBaHmnusSGackøayCaGñkpÞúkemeraKenHenAkñúgsßanPaBxøHEtb:ueNÑaH . Salmonella

TaMgenaHGacmanenAkñúg Intertinal flora rbs;stVBahn³ (Cattle), bkSI (Powtry) nig GMbUrstVkNþúr

(Rodents) . karcMlgGMBIstVTaMgenaHmkmnusStamry³karbriePaKcMNIGahar sac;rbs; Cattle rW

sac;bkSIEdlcMGinmin)anRtwmRtUv/ TwkedaHeKaEdlcMhuyBuM)anl¥/ rWk¾cMNGahar Edl Contaminated

by rodent feces .
4- Shigella and Bacillary Dysentery:
Shigella CaemeraKbgáeraK Dysentery rW Shigellosis, EdlbgáeGaymankareQIeBaHya:gxøaMg
Abdominal cramps nig eTAbenÞabg;lamkjwkjab;Calamk mansMe)arlayQam . BBYk

Shigella EdlbgáeraK Dysentery enaHrYmman S.dysenteriae, S.sonnei, S.flexneri, nig

S.boydii . Shigella CaemeraK Bacilli nonmotile, noncapsalated, vaBuMGacplit H S rW 2

Urease )aneLIy . Shigella enHmanlkçN³ Pathogenic Rbhak;RbEhleTAnwg E. coli,

EdlCaehtueFVIeGayeKGaccMNat;fñak; Shigella Ca Subgroup CamYy E.coli .

Shigella enHPaKeRcInCa S. dysenteriae, S. sonnei, S.flexneri CamUlehtu cMbgén Severe

dysentery . vaeRcInekItmanenAelIkumarCaBiessenAcenøaHGayu 1 qñaM eTA 10 qñaM . karcMlgrbs;

__________________________________________________________________________________________
16 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

vaeFVIeLIgtamry³ Oral route, rW edaysar Contact direct person-to-person . vaKWCaCMgWEdl

ekItmkGMBIkarKμanGnam½y/ malnutrition, nig Crowding . vaeFVIkarratt,atCaBiessenA
Daycare center, Prisons, Mental institutions, Nursing home, nig Military camps .

dUcKñanwg Enteric infection déTepSgeTotEdr KWvabgáeGayman Chronic carrier ry³eBlBIr bI

s)aþh_eTA eRcInEx .
Shigellosis mankarxusKñaGMBI Salmonellosis, KW Shigella eFVIkarQøanBaneTAelI Large

intestine, vaBuMGaceFVIeGayman Perforation intestine rWkarratt,atenAkñúgQam)aneLIy . eraK

sBaØarbs;vaKWbNþalmkGMBI Shigella beBa©j Toxins enAelITItaMgpÞal;EdlvarIklUtlas; (Site of

multi Phication) . Endotoxin bNþaleGayman Fever, Enterotoxin bNþaleGay Inflammation

enAelIPñasxagkñúg Intestine, kMeTc Villi (Degeneration villi) bgáreGayman Erosion

CaehtueFVIeGay Bleeding nig Heavy secretion mucous . Abdominal cramps and pain
bNþalmkGMBI Disruption of muscular function of intestine . müa:gvijeTot Shigella
dysenteriae beBa©jnUv Heat-labil exotoxine (Shiga-toxin) EdlGaceFVIeGayrbYsdl; Nerve

cells nig Damage intestine .

kareFVIeraKvinicä½y Shigellosis manPaBsμúKsμajNas;/ eRBaHvaGacPan;RcLMCamYy Bloody

diarrhea bNþalmkGMBI E.coli nig bNþalmkGMBI Protozoans Entamoeba histolitica nig

Giardia lambia . dUecñHkareFVIvinicä½ytMrUveGayeFVIkarbNþúH (Culture) nig kMNt;lkçN³

(Identification) enAelIemeraKEdl Isolated )anmk .

karBüa)altMrUveGaybMeBjkgVHxatCatiTwkEdl)at;bg; nig Antibiotics dUcCa Ampicillin, nig

Sulfatrimethroprim, cMeBaHemeraKEdl Resistance, eKGaceRbIBBYk Quinolone, Cephalos

porines CaedIm . karkarBarmanlkçN³Rbhak;RbEhl nig Salmonellosis, Et Shigella Bum M an

Vaccin eT .

__________________________________________________________________________________________
17 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

5- The Enteric Yesinia Pathogens:

Yersinia RtUv)ancMNat;bBa©Úlmkkñúg Family Enterobactericcea. GaRs½yeTAtamlkçN³
Culture, Biochemical nig Serologic characteristics . Species TaMgLayrbs; Yersinia

EdlCamUlehturbs; Zoonotic infection dUcCa Y.enterocolitica nig Y. psendotuberculosis

suT§swgCaBYkrs;enAxageRkAeBaHevonrbs;stV/ EtvabgáeGayman Enteric infection enAelImnusS .
elIkElgEt Y.pestis mYyecjEdlminbgáeGayman Enteric infection enAelImnusSeT KWvabNþal
eGaymanCa Bubonic plague eTAvij .
mnusScMlgyk Y. enterocolitica tamry³briePaKcMNIGahar EdlmanemeraKenaH .
enAkñúgry³eBl Incubation RbEhlCa 4 eTA 10 éf¶/ emeraK)anratt,atcUleTAkñúg Small
intestinal mucosa, emeraKxøH)anRCatcUlenAkñúg Lymphatics . eBlenaHvabgáeGayman
Inflammation enAelI ileum nig Mesenteric lymph nodes CaehtubNþaleGayman Serves

abdominal pain manlkçN³RcLMCamYy Appendicitis . cMENkÉ Y. psendotubeculosis vij

man lkçN³bgáeraKRbhak;RbEhlnwg Y. enterocolitica Edr/ b:uEnþvaeRcInEtratt,at enARtwm

Inflammation enAelI Lymph node Etb:ueNÑaH .
C- Nosenteric Yersinia pestis and plague
CMgW Plague KWCaCMgWmYyEdlekItmantaMgBIbuersm½ymkemøH . enAstvtSTI 6 man Pandemics
TI1 énCMgW Plagues EdleFVIkarratt,atya:gsahav nig raMér: EdlbNþaleGaymnusSsøab;RbmaNCa
100 lannak; . mkdl;stvtSTI 19 KWenAkMLúgqñaM 1800s KWCa Pandemics d¾sahavmYyeTot
EdlbNþaleGaymankarratt,atBaseBjBiPBelak EdlbNþalmkGMBIkarcMlgtamry³stVkNþúr
(Rat-infected) . CMgW Plagus )ancMlgcUleTA United Stats tamry³kMBg;Ep San Francisco enA

qñaM 1906 ehIybnþ Infected enAelI Rats nig Rodents EdlvaGacratt,ateBseBjshrdæEtmþg.

Pñak;garbgáeraKenH KW Yersinia pastis EdlCa Rod gram negative, bipolar nig man Capsular .
1- Virulence factors :
nig Envelope proteins KWCa Virulence factures rbs; Y. Pertusis, vaGacTb;Tl;
Capsular

CamYy Phagocytosis )anya:ggay . müa:gvijeTotemeraKenH plitnUv Coaigulase EdlvaGac

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18 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

bgáeGayraMgsÞHeTAdl; Esophagus rbs; Flea ¬stVlit¦ nig raMgsÞHdl; Blood Vessels rbs;mnusS.
Factor virulence mYyeTotKW Endotoxin EdlTb;Tl;CamYy Phagocytosis )an .

2- The Complex epidemidogy and life cycle of plague:

emeraK Y. pestis manenAkñúgFmμCati enAelI Animal host CaeRcIn . EdlvaGacEckcayemeraK
enH)anya:ggaytamry³ Vectors mYyeTotKW Flea ¬stVl¥it¦ . Plague CaCMgWmYyEdlbnþemeraK
ratt,atteTAeTot enA Africa, South America, Midest, Asia nig Est Europe . fμI²enA India
manbnþ Epidemic Gs;ry³ 3 TsSvtS . BuMmankrNIEdlbgðajepSgnUv Human-to-human
transmision eLIytaMgBIqñaM 1924 mkemøH . mnusSEdlRbQmmux nwgCMgW Plague enaHPaKeRcInCa

Veterinarians, backpackers, nig GñkEdlrs;enAEk,réRBeQI .

Epdemiology rbs; Plague mansPaB Complex KWvaRtUvqøgkat;enAelI Animal host CaBBYk

Rodents nig man Vectors stVlit (Flaea) CaGñkcMlgmkmnusS . mnusSekItCMgW Plague enH)an

edaysar Contact CamYy Aminal TaMgenaHEdlmanenAkñúgéRB (Sylvatic plague) rW Animal

manenAkñúgpÞH (urban plague) .
a- Animal Resources:
Primary long-term endemic reservoirKWBBYk Rodents, manCaGaT_ kNþúr EdlCa Host .
emeraKenHGacratt,atecjGMBI Animal host enaHeq<aHeTAkan; Animal epSgeTot EdleKehAfa
Amplifying host enAeBlEdlman Endemics .
b- Flea Vectors:
Flea CaGñkPñak;garya:gsMxan;sMrab;cMlgemeraKGMBI Reserves host enAelI Amplifying hosts
nigeTAkan;mnusS . Flea KWCa Blood- Suking insects . eRkayBI Flea bWtykQamEdlman
emeraKecjGMBI Animal-host, emeraK Y. pestis eFVIkarbMEbkxøÜnenAkñúgeBaHevon bnÞab;mkeLIgmk
kñúg Esophagus EdlvaGac Regurgitation ¬Ek¥recj¦ emeraKenH edIm,I Inoculated emeraKenaH
eTAkan;mnusSenAeBlEdlvaxaM .

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19 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

3- Pathology of Plague:
vaRtUvkarBI 3 eTA 50 emeraK b:ueNÑaH KWvaGacbgáeGayman Infection )an EdleKehAfa Initial
plague infection . Manifestation of infection bNþaleGayman Bubonic

¬CaBiessmnusSRbus¦/ Septicemia, rW Pneumonic plague .

Bubonic plague KWemeraK)anRCatcUlenAkñúg Lymph eRkayBIeBlEdl Flea xaMrYc .

emeraKenaH)anRCatcUlenAkñúg Local lymph node EdlbNþaleGay Necrosis, ehIm (Swelling)

lymph node EdleKehAfa Bubo PaKeRcInmanenA Groin ¬Knøan¦ . ry³eBl Incubation man

RbmaNCa 2 eTA 8 éf¶/ GñkCMgWmanmkCamYynUv Fever, Chills, headache, nausea, weakness nwg
Tenderness of the bubo .

bnÞab;mk Bubonic plague enHGacvivtþn_eTACakarratt,atrbs;emeraKya:gxøaMgkøa EdleKehAfa

Septicemia plague . edaysarkarbeBa©j Factor virulence coagulase bNþaleGaman

Disseminated intravascular coagulation, man Subcutaneous hemorrhage, purpura Edl

GackøayeTACa Necrosis nig Gangrene eBlenaHEs,keLIgBN’exμA EdleKehAfa Black death.

Pneumonic plague KWCakarbgáeraKenAelIsYtEdlemeraK)anmkRbmUlpþúMKñaya:geRcInenAkñúg

Sputum nig Aerosols . ebIKμankarBüa)aleTenaH GñkCMgWRtUvsøab; .

4- Diagnosis, Treatment and Prevention:
karsøab;GacekItya:grh½senAkñúgry³eBl 2 eTA 4 éf¶ eRkayBIeBlEdleraKsBaØaekItman dUecñH
kareFVI Diagnosis nig Treatment CaerOgsMxan; nig bnÞan; .
RbvtþiCMgWrYmbBa¢ÚlTaMgRbvtþiénkareFVIdMeNIreTAtMbn; Endemic, eraKsBaØa/ lT§plénmnÞIrBiesaFn_
Edl)anviPaKeTAelI Bubo aspirates, GacCaCMnYy dl; Diagnosis .
Streptomycin, Tetracycline nig Chloranphenicol KW Antibiotiques cMbgsMrab;eFVIkarBüa)al)an

plague . karBüa)al)anRtwmRtUv GñkCMgWCasHes,Iy 90 eTA 95° .

Plague KWCaCMgWtMrUveGayeFVIkarraykarN_kñúgkMritGnþrCatibnÞab;BI Cholera nig Yellow fever.

__________________________________________________________________________________________
20 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

IV- Oxidase-Positive Non enteric Pathogens:

A- Pasteusella Multocida:
PasteurellaKWCa Genus én Zoonotic infection, KWmanEt Species P.multocida CaPñak;gar
bgáeraKén Opportunists infection . ]TahrN_vaGacbNþaleGaymanlkçN³Ca Cholera-like
outbreak enAelIbkSI/ rWmYybgáeGayman Outbreaks én Hemorrhagic septicemia rW
Pneumonia EdleKehAfa "Shipping fever" enAelIBBYkeKa RkbI . müa:gvijeTot P.multocida

GacmanenACa Normal flora enAkñúg Nasopharynse rbs;Eqá qμa . enAeBlEdlEqá qμa enaH xaM
(Bites) rWRkejA (Scratched) vabNþaleGayman Abscess EdlGacraldaleTAdl; Joints,

bones, nig Lymph nodes . GñkCMgEEdlmansPaBexSayenAelI Immune function EdlbNþal

mkGMBI Liver cirrhosis rW Rheumatoid arthritis suT§EtCaGñkRbQmmuxén Septicemia Edlbgá

eGayman Complication enAelI Central nervous system nig Heart . GñkCMgWEdlman
Chronic bronchitis, Emphysema, pneumonia rW CMgWpøÚvdegðImepSgeTot suT§Etvivtþn_eTArk

Pulmonary failure . P.multocida Ca Species Edl Susceptible CamYy Penicillin, nig

Tetracycline .
B- Haemophilus (Blood-loving bacilli)
Haemophiles CaemeraKmanTMhMtUc/ vaCa Gram negative nods manrUbragmineTogTat;/
eBlxøHeFVeI GayeyIgPan;RcLMCamYy Genus Nessezia . Haemophilus Ca Genus EdlmanPaBsauM
CamYy Drying, temperature extremes nig Disinfectants . vaCa Genus emeraKEdlGacduHelI
fñalbNþúHEdlmanQam . Species xøHrbs; Haemohpilus manenACa Normal flora én Upper
respiratory tract or vigina, ehIyman Species xøHeTotEdl Virulence EdlCaPñak;garbgáeraK

Meningitis, Chancroid, pneumomia, CaedIm . lkçN³sMxan;sMrab; Identify genus

Haemophilus KWvatMrUvkarnUv Factor xøHrbs;Qam edIm,IbMeBjnUv Metabolic syntheses . dUcCa

X-factor (hemin) EdlCa Component én Cytochromes, catalase nig Peroxidase, V-factor

(Nicotinamide adenine dinucleotids: NAD) EdlCa Important coenzymes .

1- Haemophilus influnzae
Species EdlmaneQμaHeRkayBIeBlEdleK)ancab;yk (Isolates) ecjmkGMBIGñkCMgW Flu
RbEhlCa 100 qñaMmunenH . k¾b:uEnþtamBiteTAknøgGs;ry³eBl 40 qñaM eRkaymkeTIbeKrkeXIjfa
Flu enHRtUv)anbgáeraKedaysar Influenza virus .
__________________________________________________________________________________________
21 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition
Microbiology The Gram-Negative Bacilli of Medical Important

karBiteTAKW H.influenzae CaPñak;garbgáeraK Acute bacterial meningitis enAelImnusS .

vaCaTMrg; Severe én Meningitis EdleRcInEtbgáeLIgeday Serotype B . CaBiess Meningitis
enHeRcInekItmanenAelIkumarBIGayu 3 Ex eTA 5 qñaM . Haemophilus influenzae meningitis
enHRtUv)anfycuH enAkñúgry³eBl 10 qñaMcugeRkayenHedaysar Vaccin RbqaMgnwg H. inflenzae
enHRtUv)anGnuvtþn_eLIg . dUecñH\LÚvenH H.influenzae meningitis eRcInekItmancMeBaHmnusScas;/
cMENkÉ Meningococcal mueningitis eRcInekItmanenAelIkumar . karcMlgrbs;vaKWeFVIedaypÞal;
enAeBlEdlb:HBal;eTAelI Discharge nose nig Thoat rbs;GñkpÞúkemeraK .
eraKsBaØa Haemophilus influenzae meningitis KWman Fever, Vomiting, stiff neck, nig
Neurological impairment . RbsinebIKμankarBüa)aleT KWvabNþaleGaysøab; 90° .
eRkABIenaH H. influenzae k¾GacCaPñak;garén Pneumonia otitis media, sinusitis nig
Bronchitis .
karBüa)alKWCakarBüa)alrYmbBa©ÚlKña (Combination) én Chloramphemicol nig
Ampicillin . Vaccin rbs;vaKWeFVIeTAelI Subunit B KWGaRs½yeTAtam Type B polysaccharde
(Vaccin Hib) .
2- Haemohpylus ducreyi
H. ducreyi CaPñak;garbgáeraK Chancroid (Soft chancre) KWCa STD, EdleRcInekItmaneLIg
enAelImnusSRbus . karcMlgrbs;vaKWeFVIeLIgedaysar Direct contact CamYy Infection lesion .
eRkayBI Period incubtion 2 to 14 days eBlenaH Lesion rbs;va)ankrekIt nig vivtþn_enAtMbn;
Genital rW Anal . tMbUgeLIg KWvabNþaleGayman Inflammatory CamYykEnøgEdlmankarQWcab;
Necrotic ulcere EdlmanlkçN³Rbhak;RbEhlnwg Lymphogranuloma rW Syphilis . CaerOy²
Regonal lymph nods manlkçN³Ca Bubolike, ehIm/ ehIyEbkFøay . Antibiotics TaMgLay
manRbsiT§PaBenAelIkarBüa)al Infections enH .
3- Haemophilus para-influenzae:
Ca Normal oral nig Nasopharyngeal flora, EtvaGacbNþaleGayekItman Endocarditis
cMeBaHmnusScas; EdlmanbBaðaeTAelI Congenital rW rhumatic heart diseases . vak¾GacbgáeraK
pgEdr eRkayBIeBlEdleFVIeGaymanrbYsenAkñúgmat; .

&*
__________________________________________________________________________________________
22 Borann SAR, MD, Ph.D.
Ref.: Foundation in Microbiology
K. Talaro, A Talaro,
WCB. Publishers, Second Edition