Enterobacteriaceae A.K.A. Enterics 3.

K / Capsular antigen
-heat-labile polysaccharide found in certain species such
Culture Media as the
non-selective media: K1 Ag of E. coli & Vi Ag of Salmonella typhi.
General Characteristics
1. Sheep’s blood agarhave little
4 major features: 2. Chocolate agarvalue in ID The O Agforms the outer part of the cell membrane.
1. All ferment glucose. The K Ag wraps around the cell like a capsule.
2. All reduce nitrates to nitrites. differential & selective media:-for presumptive The arms of the H Ag become wavy flagella.
3. None produce cytochrome oxidase. identification
4. All are motile with flagellararrangement as peritrichous 1. MAC Clinical Significance
2. HE agar / Hektoen –highly selective
Characteristics E. Coli * Most members of the Family Enterobacteriaceaeare
3. XLD agar/Xylose-Lysine-Desoxycholate
Ferment Trehalose present in the intestinal tract of animals and humans as
HE & XLD–contain Na thiosulfate & Fe+3 ammonium citrate,
Glucose COMMENSAL FLORA.
which produce blackening of H2S-producing colonies.
Lactose
Xylose Classification 2 Categories of Enterobacteriaceae based on the
Indole + –Ewing (1963) –proposed the use of tribes in classifying clinical infections they produce:
Methyl Red X the members in the family Enterobacteriaceae
H2S X 1. Opportunistic pathogens
DNAse X –Edwards & Ewing’s Identification of -part of the normal intestinal flora of both humans and
Phenylalanine Deaminase X Enterobacteriaceae animals
-subsequent editions -[outside their habitat] ➔may produce serious extra-
KCN No Growth intestinal opportunistic infections
X
Citrate as Sole Carbon Source Can’t Virulence & Antigenic Factors 2. Primary intestinal pathogens
X -E.g.Salmonella, Shigella, Yersiniaenterocolitica
Factors that control virulence of Enterobacteriaceae:
Motility Both -considered true pathogens
1. the ability to colonize
Vogues Proskauer — -not commensal flora in the gastrointestinal tract of
2. the ability to adhere
humans
3. the ability to produce various toxins
-produce infections that result from the ingestion of
4. the ability to invade tissues
Non-motile enterics: contaminated food and water.
Plasmids–mediate resistance to antimicrobials
1. Klebsiella
2. Shigella Antigens Used in Identifying different serologic Clinical Infections
3. Yersinia groups:
1. O / Somatic antigen Theodore Escherich(1885)
Microscopic & Colonial Morphology -heat-stable Ag located in the cell wall
2. H / Flagellar antigen -first described E. coli as a non-harmful member of the
-gram negative
-heat-labile Ag found in the flagellum colon flora
-non spore-forming
-facultative anaerobe bacilli
 5 Major Categories of diarrheogenic E. coli:
Types EPEC ETEC EIEC EHEC 0517:H7 EAEC/EAggEC
Description • Outbreak • Infant and Adults • Similar to dse by Shigella • N/A • N/A
o Hospital
o Daycare • Children and Adults
Disease • Infantile • Traveler’s Diarrhea • Dysentery • N/A • Diarrhea by
Diarrhea adherence to
int mucosa
MOT • N/A • Visitors of Third World • N/A • associated with •
Countries hemorrhagic diarrhea,
• Consume cont food and colitis, and hemolytic
water uremic syndrome
(HUS)
• Factors:
• Poor Hygiene
• Inadequate DW source
• Lack Proper Sanitation
Special • N/A • Toxin: • N.A • HUS •
• low platelet count
• LT/Heat Labile Toxin • hemolytic anemia
• Same to V. cholerae • kidney failure
• B FRAGMENT: Receptor
Site on GM1 Ganglioside
of Int Mucosa
• Entry of A Frag
• A FRAGMENT: –acts on
adenyl cyclase
• -activates conversion of
ATP to cyclic adenosine
monophosphate(cAMP).
The accumulation of
Camp in the intestinal
mucosa initiates the
hypersecretion of
 electrolytes and fluids
into the lumen, resulting
in a watery diarrhea.

• ST / Heat-stable toxin
• -stimulates guanylate
cyclase, causing the
increased production of
cyclic guanosine
monophosphate(cGAMP)
and subsequent
hypersecretion
Types EPEC ETEC EIEC EHEC 0517:H7 EAEC/EAggEC
Laboratory • N/A • N/A • Sereny Test: determines the • N/A • N/A
Findings organisms’ ability to produce
keratoconjunctivitis in the guinea pig
• -one of the assays previously used to
determine the virulence of both EIEC
and Shigella

• -non-motile
• -do not ferment lactose
• -cross-reactions between Shigella
• -O Ag is seen

S/sx • Diarrhea • N/A • severe abdominal cramps • Dehydration

• Stool with • malaise • watery diarrhea • Abdominal
mucus • watery diarrhea accompanied by • bloody diarrhea Pain
• Malaise toxemia • crampy abdominal pain • Vomiting
• Vomiting • scanty stool containing pus, mucus • low-grade fever / no • Dehydration
• Low Fever and blood fever at all
• stool contains no
leukocytes
 Other E. Coli Infections UTI
Descriptions
adhesins–mediates the adherence of urethrogenic
E. coli to the epithelial cells lining the urinary tract
hemolysins–kill leukocytes and inhibit phagocytosis
and chemotaxis
aerobactin–an extracellular iron chelator
Septicemia and Meningitis
-newborns acquire the infection in the birth canal
before or during delivery when the mother’s vagina
is heavily colonized
-infection also result if contamination of the amniotic
fluid takes place
K1 Ag –the most documented virulence-associated
factor in neonatal meningeal infections