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How do you contract salmonella?
Contaminated food (chicken, eggs, etc.)
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Salmonella invades and replicates in the _____ of the _________ in the small intestine
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Salmonella's Pathogenesis includes initial invasion of the intestinal mucosa via a __________ encoded on a _________
- Type III SS
- Pathogenicity Island (SPI-1)
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What Salmonella apparatus secretes invasion proteins (Sips or Ssps) into M cells? What does this cause?
SPI-1, causes host membrane ruffling and engulfment of bacteria
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Salmonella are resistant to acidic pH due to?
Acid Tolerance Response gene
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What type of bacteria has an ATR gene?
Salmonella
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Subsequent systemic Salmonella disease occurs by a _____ encoded on a ________
Type III secretion system, Salmonella pathogenicity island 2 (SPI-2)
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What replicates within the vacuole and what replicates once its escaped the vacuole?
- Inside vacuole: Salmonella
- After they escape vacuole: Shigella
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Serovars of Salmonella that cause typhoid and paratyphoid fever pass through the cells lining the _____ and are _____.
Serovars replicate after transport to the ____, ____, and ____
- intestinal mucosa
- engulfed by macrophages
- liver, spleen, and bone marrow
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Fever, headache, malaise, and anorexia set in ____ days after ingestion of Salmonella.
One week or longer after symptom onset: GI symptoms, bacteremic phase, colonization of the gallbladder and reinfection of the intestines occurs.
10-14
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S. typhi and S. paratyphi are ____
strict human pathogens
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Salmonella:
Asymptomatic colonization (usually by S. typhi or S. paratyphi) occurs in 1-5% of patients. These patients harbor it in the _____ and shed it in the feces.
gallbladder
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Name the 3 things that cause paratyphoid fever.
S. parathyphi A, S. schottmuelleri, and S. hirschfeldii
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Most common form of salmonellosis.
Common culprits?
- Gastroenteritis
- S. typhimurium
- S. eteritidis
Symptoms in 6-48 hrs: nauseau, vomiting, non-bloody diarrhea
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Serovars of Salmonella that are more commonly associated with bacteremia.
S. choleraesuis, S. paratyphi, S. typhi
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Salmonella on TSI
- Red slant
- black line
- yellow butt
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Salmonella tx:
1) Enteritis
2) S. typhi, S. paratyphi
- 1) Antibiotics NOT recommended
- 2)Choose an antibiotic based on susceptibility testing (fluoroquinolones, chloramphenicol, sulfa-trimethoprim, broad-spectrum cephalosporin)
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Shigella:
1) How many species?
2) All species contain?
- 1) 4 species: S. dysenteriae, S. flexneri, S. boydii, S. sonnei
- 2) 45 O-antigen-based serogroup
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What type of Shigella is most common in developed countries?
S. sonnei
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What type of Shigella is most common in underdeveloped countries?
S. flexneri
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Shigella invades and replicates in the
colonic mucosa.
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Shigella virulence factor genes are carried on a _____ but are regulated by _______
- large plasmid
- chromosomal genes
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What type of flagella:
E. coli
Shigella
- E. coli= peritrichous
- Shigella= none
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Like Salmonella, Shigella first attaches to the ____ on ____
M Cells on Peyer's Patches
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Shigella Pathogenesis:
1) Shigella Type III Secretion System allows secretion of _____ into epithelial cells and macrophages.
2) Host membrane ruffling occurs and the bacteria are engulfed within the cell in a phagocytic-like vacuole
3)Bacteria lyse the vacuole, escape into the cytoplasm, and replicate.
four invasion plasmid antigens (IpaA, IpaB, IpaC, and IpaD)
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Since Shigella don't have a flagella and are nonmotile, they induce _____ in the host and use the ______ to move within the cell and to adjacent cells.
- Actin polymerization
- actin tails
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Shigella survive phagocytosis by
- 1) Residing intracellularly
- 2) Inducing apoptosis of macrophages
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When Shigella induces macrophage apoptosis, ____ is released. This attracts _____, which destabilizes the intestinal wall.
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Which Shigella produces Shiga toxin? Which E.coli produces Shiga toxin?
- Shigella dystenteriae
- EHEC
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Shigella primarily affects?
Children
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Shigellosis is characterized by what symptoms?
Symptoms start ____ after ingestion
First sign:
- Abdominal cramps, diarrhea, high fever, bloody stools
- 1-3 days
- Profuse watery diarrhea
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Shigella Diagnosis is made by:
- Isolation from stool
- Selective media
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Shigella on TSI
- Yellow butt, red slant (doesn't ferment lactose, doesn't produce H2S)
- Urea -
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Treat Shigella by
Antibiotic therapy (fluroquinolones, sulfa-trimethoprim)
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Gram-N enteric that causes the plague and gastroenteritis.
Yersinia
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Prominent characteristic virulence factor of Klebsiella:
Copious mucoid capsule
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Which enterobacteriaceae has a copious mucoid capsule?
Klebsiella
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What people are at higher risks for Klebsiella?
- Alcoholics
- People w/ compromised pulmonary function
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Name 2 common types of Klebsiella.
- K. pneumoniae
- K. oxytoca (CA-primary lobar pneumonia)
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NDM-1 (metallo-beta-lactamase-1) was first detected in?
K. pneumoniae
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Klebsiella causes
- Pneumonia (what it is most known for)
- Liver abscesses in alcoholics
- UTIs
- Granulomatous disease of nose or genitals
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K. pneumonia:
Necrotic destruction of ____
Formation of ____
Production of _________
- alveolar spaces
- cavities
- blood-tinged sputum
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What bacteria causes liver abscesses in alcoholics?
Klebsiella
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1) What disease is transmitted after repeated exposure through sexual intercourse or nonsexual trauma to the genitalia.
2) How long is incubation?
3) Presents as?
- 1) K. granulomatis (granuloma inguinale or donovanosis)
- 2) weeks or months
- 3) Subcutaneous nodules which break down into granulomatous lesions
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Which bacteria does not grow outside of cells in vitro, and therefore requires tissues or scrapings?
What do you stain these with?
What do you see?
- K. granulomatis (K. pneumonia can be grown on culture media)
- Giemsa or Wright's stains
- Appearance of small rods in the cytoplasms of histiocytes, PMNs, and plasma cells (Donovan Bodies)
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What disease are Donovan bodies present in? What do they look like?
- Klebsiella graulomatis
- Appearance of small rods inthe cytoplasms of histiocytes, PMNs or plasma cells
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K. pneumoniae on MacConkey:
Lactose fermenting: + or -
What color
Positive for fermenting lactose (pink)
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Klebsiella Tx:
Tetracycline, erythromycin, sulfa-trimethoprim (antibiotic prophylaxis is useless)
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2 Forms of Proteus:
- 1) Swimmers (8-10 flagella)
- 2) Swarmers (Peritrichous flagella), form concentric patern on semi-solid agar surface, big problem for people with catheters
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Most common Proteus disease
UTI
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Name the 3 most common types of Proteus.
- P. mirabilis
- P. vulgaris
- P. penneri
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Which bacteria has urease that splits urea into CO2 and ammonia, thus raising urine pH and causing renal stones?
Proteus
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Which bacteria is urease +?
Proteus
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Which 2 bacteria have phase variation?
E. coli, Proteus
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Nitrofurantoin (commonly given for UTIs) is not effective for what common cause of UTI?
Proteus
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Tigecycline is not effective for Proteus alone. It must be combined with?
Amikacin
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Enterobacter is multiple antibiotic resistant. Name 2 types and what they cause.
- E. cloaceae: HA neonatal sepsis
- E. sakazakii: Food-borne in powdered baby formula --> necrotizing enterocolitis, meningitis, and sepsis in neonates
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What bacteria causes splenic abscess and neonatal meningitis?
Citrobacter freundii
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What bacteria causes sepsis, meningitis, and brain abscesses in neonates?
Citrobacter
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Name 2 ways citrobacter can be transmitted.
Nosocomial or vertically
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Causes bacteremia in hospital patients, UtIs, wound infections, and is resistant to B-lactams
Morganells morganii
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What bacteria can cause Contact lens induced acute red eye (CLARE)?
Serratia
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Serratia color:
In incubator=
In room temp=
- Incubator = white
- Room= red
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