7/23/2019 1. Enterobacteriaceae (Upload)
1/48
Gram Negative
Bacteria:
INTRODUCTIONINTRODUCTION
TOTO
ENTEROBACTERIACEAE
7/23/2019 1. Enterobacteriaceae (Upload)
2/48
Study Outline /Review
uic! A""e""ment #For Residual Knowledge GNB # Types & Short overview, Position of
Enterobacteriaceae among them, ut picture!
Enter$%acteriaceae # "istory, #e$nition,
%haracteristics, %lassi$cation, mportance,#iseases, 'ntigenic structures & (irulencefactors!
GI di"ea"e" # Terminologies, )rief
mechanisms of pathogenesis! &a% D' # 'pproach for the & other disorders
*with em()a"i"on Enterobacteriaceae+!
7/23/2019 1. Enterobacteriaceae (Upload)
3/48
Categories of GNB
*+ Related t$ Enteric tract:
Enterobacteriaceae - Esch coli, Salmonella (ibrionaceae - Vibrio cholerae Pseudomonadaceae - Pseudomonas aeroginosa )acteroidaceae - Bacteroides fragillis Helicobactor. Campylobacter
,+ Related t$ Re"(irat$ry tract: Haemophilus, Legionella, Bordetella,
Acinetobacter Enterobacteriaceae - Klebsiella
-+ Related t$ Ur$genital tract:
ardnerella, Haemophilus ducreyi,Acinetobacter Enterobacteriaceae - Proteus, /PE%, C!granulomatis
.+ Related t$ Nerv$u" Sy"tem: Haemophilus, Pseudomonas Enterobacteriaceae - 01E%, Klebsiella, Serratia
7/23/2019 1. Enterobacteriaceae (Upload)
4/48
Categories of GNB (contd.)
+ Related t$ 0u"cul$"!eletal "y"tem: Pseudomonas,Acinetobacter Enterobacteriaceae - E! coli, Klebsiella, Serratia
1+ Related t$ C2S: 3ACE4 gr$u( 2Haemophilus,Actinobacillus
actinomycetemcomitans, Cardiobacteriumhominis, Ei"enella corrodensand Kingellaspp!3
N$n53ACE4 gr$u(- Pseudomonas,
Enterobacteriaceae 6Enterobacter, Citrobacter,
Pro#identia, Serratia, Proteus, Salmonella, E!coli7
8+ Related t$ 9$$n$"i" 2'nimal sources3: Brucella, $rancisella, pasteurella,
Enterobacteriaceae - %ersinia
7/23/2019 1. Enterobacteriaceae (Upload)
5/48
7/23/2019 1. Enterobacteriaceae (Upload)
6/48
Enter$%acteriaceae
Scienticcla""icati$nD$main: Bacteria
;)ylum: ;r$te$%acteria
Cla"": Gamma(r$te$%acteria
Order: Enter$%acteriale"
7/23/2019 1. Enterobacteriaceae (Upload)
7/48
n the 4899s, the $rst member Serratiamarcescenswas discovered by )i:io in 48;6 ona dish of talian barley 2Polenta3!
Klebsiella and Proteus were discovered in4889s!
n 4856, Theobald Smith distinguished
7/23/2019 1. Enterobacteriaceae (Upload)
8/48
n 4567, =tto Rahn $rst proposed the
name Enterobacteriaceae family with asingle genus, Enterobacter and 44;species!
n 45>>, )orman, Stuart & ?heeler
de$ned the family characteristics!
n 457;, there were 44 genera and ;@species!
n 458A, ;; genera, @5 species! n ;99>, >9 genera, and ;99 species!
't present, >.8 genera and ?,@@
"(ecie"+
7/23/2019 1. Enterobacteriaceae (Upload)
9/48
Enter$%acteriaceae is a compleB andheterogeneous bacterial family
consisting of large number of relatedgenera that are found in the small &mostly large intestines 2colons3 ofhuman, animals & insects, and also in
soil, plants, water, foods & decayingmatters having the following
di"tingui")edc)aracteri"tic":5
DE
7/23/2019 1. Enterobacteriaceae (Upload)
10/48
4! 0)C ram 0egative )acilli.Rods ;! Facultative anaerobes 5555 Cf+Pseudomonas,
Helicobacter pylori
6! Either 1otile2peritrichous Dagella3ORnon
motile 5555555 Cf+ Vibrio, Pseudomonas,H! pylori>! Ferment #glucose *#eBtrose+ 2with production
of
7/23/2019 1. Enterobacteriaceae (Upload)
11/48
1+ Reduce 0itrate *NO-5+ to 0itrite 2NO,532(ery few eBceptions, e!g! Photorhabdusspp!3
555 &ycobacteriaalso reduce Nitrateto 0itrite+
7! Some have capsule 2Klebsiella3 or slimelayer!
8! Some erment &act$"e along with orwithout other substances!
5! 0on sporeforming!
49! "ave pili or $mbriae!
44! Sharing and de$nitive antigenic
characteristics!
C)aracteri"tic"
6c$ntd+7
7/23/2019 1. Enterobacteriaceae (Upload)
12/48
0em%er" $Enter$%acteriaceae
T)ere are >.8genera and ?,@@"(ecie"
Num%er" are increa"ing r$m time t$ time
1. Escherichia Esch. coli2. Salmonella S. typhi S. paratyphi.
3. Shigella S. dysentery S! sonni,
4. Klebsiella K. pneumonae
5. ProteusP. mirabilis'!%ersinia %! pestis,%! enterocolitica
(!Enterobacter E! cloacae
)! Citrobacter C! freundi
7/23/2019 1. Enterobacteriaceae (Upload)
13/48
Ot)er mem%er":
*! Serratia S! marcescens+! Hafnia H! al#ei
! &organella &! morganii
-! Calymmatobacterium C!granulomatis
.! Er/inia
'! Pectinobacterium
(! Ed/ard siella
)! Plesiomonas etc!
*@species cause F@ of the humandiseases, whereas ,-5, species consist
FFof all Enterobacteriaceae isolatesfrom human
7/23/2019 1. Enterobacteriaceae (Upload)
14/48
Shigellawith no Flagella (Atrichous)
7/23/2019 1. Enterobacteriaceae (Upload)
15/48
Escherichia coli with PeritrichousFlagella
7/23/2019 1. Enterobacteriaceae (Upload)
16/48
Vibrio choleraewith Polar MonotrichousFlagella
7/23/2019 1. Enterobacteriaceae (Upload)
17/48
Campylobacter jejuni
with Amphitrichous flagella
7/23/2019 1. Enterobacteriaceae (Upload)
18/48
Helicobacter curved rod with Lophotrichous Flagella
7/23/2019 1. Enterobacteriaceae (Upload)
19/48
Traditi$nal Cla""icati$n: )ased on disease production, )ased on site of the disease
6Clinical cla""icati$n7 )ased on
7/23/2019 1. Enterobacteriaceae (Upload)
20/48
On The Basis of Disease
ProductionNormal floraOROpportunistic (potential)
pathogen :
Most of them, e.g.E.coli,Enterobacter,
Citrobacter,Proteus
Primary pathogen:
Salmonella,Shigella,Yersinia,
7/23/2019 1. Enterobacteriaceae (Upload)
21/48
7/23/2019 1. Enterobacteriaceae (Upload)
22/48
Clinical Classification
Primarily Intestinal Pathogen
Shigella,Yersinia enterocolitica
Intestinal & Extra-intestinal PathogenSalmonella,Esch. coli,
Extra-intestinal Pathogen-
Klebsiella,Proteus, Yersinia pestis
7/23/2019 1. Enterobacteriaceae (Upload)
23/48
On The Basis of
Lactose Fermentation
Lactose fermenters LF!:Esch coli, Klebsiella(except K.
rhinoscleromatis),Enterobacter,
Citrobacter,
Late Lactose ferments LLF! :Shigella sonni,Providencia, Serratia,
Lactose non"fermenters NLF!:Salmonella, Shigella (except S. sonni),
Proteus,Klebsiella rhinoscleromatis,Yersinia
7/23/2019 1. Enterobacteriaceae (Upload)
24/48
On The Basis of #otility
$anging drop, %oft agar!
#otile:
Salmonella, Esch. coli, Proteus
Non"motile:
Shigella, Klebsiellaetc.
7/23/2019 1. Enterobacteriaceae (Upload)
25/48
#otility in %oft %emi"solid! &gar #edia
Left 'Right: #otile( Center:Non"motile
7/23/2019 1. Enterobacteriaceae (Upload)
26/48
Modern Classification
TRIBES
E'am(le" $Enter$%acteriaceaeN$ NA0E
IE"c)eric)ie
ae Escherichia,Shigella
II Edward"ieleae
Ed/ardsiella
IIISalm$nellac
eae Salmonella
I2Citr$%acter
eae Citrobacter
24le%"iellace
aeKlebsiella, Enterobacter,
Hafnia, Serratia
2I ;r$teeae
Proteus, &organella,
Pro#idencia
7/23/2019 1. Enterobacteriaceae (Upload)
27/48
The antigenic structures are used todiGerentiate organisms within a genus orspecies!
Three maHor classes of antigens are foundI O 2=hne "auch3 # Somatic or cell wall
antigens, 3 2"auch3 #Flagellar antigens and 4 2Kapsel3 # %apsular 6or 2irulence7
antigens!
Plays important role in epidemiology,classi$cation as well as serotyping!
Antigenic
Structure"
7/23/2019 1. Enterobacteriaceae (Upload)
28/48
7/23/2019 1. Enterobacteriaceae (Upload)
29/48
"eat stable =uter component 2polysaccharide part or
side chain3 of the
7/23/2019 1. Enterobacteriaceae (Upload)
30/48
"eat labile!
%onstructed from proteins!
'ntigenic variation is due to the diGerence in'mino 'cid seJuences!
'ntibody against " proteins - IgG+
The Dagellar $lament is composed of a singleprotein, Flagellin!
1olecular weights of Flagellin range from 66,999to @9,999 among diGerent bacterial species!
n some bacterial genera, such as Salmonella,many varieties of Dagellar antigen have beenidenti$ed!
7/23/2019 1. Enterobacteriaceae (Upload)
31/48
3eat la%ile$rrelatively heat stable 67!
Polysaccharides in nature 2antiphagocytic3!
Found on the surface of many bacterialspeciesI
Klebseilla %ertain strain of Esch! Coli
Salmonella typhi2Klie 'g3,
certain Citrobacter2Klie 'g3 etc
=ften constitutes the outermost layer of thecell!
)oiling for 4A minutes to 4 hour would destroythe K antigen and unmas = antigens!
Ca("ular 4 $r2i Antigen"
7/23/2019 1. Enterobacteriaceae (Upload)
32/48
4 $r2iAntigen" 6c$ntd+7
7/23/2019 1. Enterobacteriaceae (Upload)
33/48
Determinant" $;at)$genicity
'bility to coloni:e, some coloni:ation factors areI
'dhesins, Pili or Fimbria En:ymesI g' protease, /rease etc!
nvasiveness
ToBinsI EndotoBin 2
7/23/2019 1. Enterobacteriaceae (Upload)
34/48
7/23/2019 1. Enterobacteriaceae (Upload)
35/48
)irulence Factors contd(!
'ntigenic phase variationI
'bility to alternately eBpress or not eBpresseither capsule or Dagella
Thus avoid host immune response!
Susceptibility of the host 6NOT a virulence
factor7:astric acid suppression
'nomalies, circumcision etc!
=ther factorsI
En:ymes 2e!g! /rease,0lactamases3Resistance plasmid 2#rug resistance3
)ile solubility 2)ile salt tolerance3
'bility to resist illing inside the cells etc!
7/23/2019 1. Enterobacteriaceae (Upload)
36/48
1echanisms inovlved
0('S=0 Salmonella, Shigella, Campylobacter,
Escherichia coli, Entamoeba histolytica!
0=00('S(E 1E%"'0S1ToBin production
Vibrio cholerae, ETE%
#ecreased absorption
Rotavirus, norwal agent, giardia lamblia
E0L1ES
Proteus
7/23/2019 1. Enterobacteriaceae (Upload)
37/48
Di"ea"e" ;r$duced4! TI Salmonella, Shigella, Esch! %oli,
Lersinia
;! /TI Esch! %oli, Proteus, Klebsiella,%itrobacter, Providentia!
6! ?ound infectionI Esch! %oli, Proteus,Klebsiella, Enterobacter!
>! PneumoniaI Esch! %oli, Klebsiella, Proteus!
A! )acteraemiaI Salmonella, Klebsiella,
Esch! %oli, Proteus!@! 1eningitisI Esch! %oli, Klebsiella,
Salmonella, Proteus 2rare3
7/23/2019 1. Enterobacteriaceae (Upload)
38/48
S(ectrum $ GIT
7/23/2019 1. Enterobacteriaceae (Upload)
39/48
S(ectrum $ GITdi"ea"e"
#iarrhea FreJuent &.or loose.Duid stool 2smallintestine3!
#ysentery Stool with blood.pus 2M fever3accompanied by pain, abdominal cramps
2inDammatory disorder of large intestine3! Oranybloody diarrhea!
astroenteritis Syndrome with T symptomsnausea.vomiting, diarrhea, abdominal discomfort!
astritis Syndrome with stomach symptoms i!e!nausea, vomiting, upper abdominal discomfort!
7/23/2019 1. Enterobacteriaceae (Upload)
40/48
S(ectrum $ GIT di"ea"e"
Enteritis Syndrome associated withinDammation of small intestine!
Enterocolitis Syndrome associatedwith inDammation of both intestines!
%olitis Syndrome associated withinDammation of large intestine!
Food poisoning - Syndrome of infectionassociated with consumption ofcontaminated food Food associatedinfection!
7/23/2019 1. Enterobacteriaceae (Upload)
41/48
DIARR3EA&DISEASES
Em()a"iJing $nENTEROBACTERIACEA
E
&a%+
Diagn$"i"
7/23/2019 1. Enterobacteriaceae (Upload)
42/48
;RINCI;&E
t is based on demonstration of thecausative agent by 1.E and isolation
& identi$cation by standardmicrobiological techniJues and alsoby immunological tests and somespecial tests! 1olecular techniJuesare also employed!
7/23/2019 1. Enterobacteriaceae (Upload)
43/48
STE;S5*:STE;S5*:
*+ S(ecimen: Acc$rding t$ t)e "ite $
t)e le"i$n:Freshly passed stool or rectal swab, Urine,Sputum, )lood, Pus, %SF & other body Duids
etc!
,+ 0icr$"c$(ic E'aminati$n 60/E7:CRUCIA&
Saline I$dine and 95N (re(arati$n:
For E! histolytica, iardia, Cryptosporidium! iardia & Cryptosporidium both are acidfast in modi$ed 0 staining!
;u" Cell" 0acr$()age RBC:
"elps to detect type of diarrhea
7/23/2019 1. Enterobacteriaceae (Upload)
44/48
STE;SSTE;S 6c$ntd+7 # ,:
-+ I"$lati$n K Identicati$n 6Culture7:
Specimen should either be immediatelycultured OR should be placed in transportmedia 2Stuart, 'mies, %ary)lair etc!3 incase of stool!
ORin case of urine, should be stored at .@C,if not inoculated in the media within -@minutes!
ncubation at -8@C aerobically for usualpathogens & at .,@C microaerophilically forCampylobacter!
Selection of culture media depends on
provisional diagnosis&.or information provided bythe referrin h sician! St$$l culture i" $
7/23/2019 1. Enterobacteriaceae (Upload)
45/48
STE;SSTE;S 6c$ntd+7 # -:
Culture 0edia:
1ac %onKeyNs 'gar 60A7ShigellaSalmonella 6SS7 Agar
Triple Sugar ron 6TSI7 etc+
L
Thiosulfate %itrate )ilesalts Sucrose 2TCBS3,Cam(y5BAetc! Additi$nally
7/23/2019 1. Enterobacteriaceae (Upload)
46/48
STE;SSTE;S 6c$ntd+7 # .:
I"$lated c$l$nie" are identied %y:
1orphology & rowth on the Type of 1edia Staining & 1.E, )iochemical tests 6
7/23/2019 1. Enterobacteriaceae (Upload)
47/48
STE;SSTE;S 6c$ntd+7 # :
Immun$l$gical te"t:Serogrouping by antisera,#etection of rota viral 'g, C! di2cile toBin fromstool by
7/23/2019 1. Enterobacteriaceae (Upload)
48/48
AN=
UESTION
Top Related