Enterobacteriaceae

Family Enterobacteriaceae

Morphology

Rod-shaped (bacili) 1-5 m in length Gram-negative All aerobes (but can be facultative anaerobes) Glucose fermented Non-spore forming Most have flagella (few non-motile) Endotoxin producer Fimbriated Capsulated, slime layer or neither Complex cell wall Antigenic structure

Specimen Collection
Specimens whether pus, tissue, sputum, fluids, rectal swabs, or feces should be cultured immediately or placed on special media to prevent overgrowth Diagnosis by microscopic and cultural examination of urine Diagnosis by microscopic and cultural examination of cerebrospinal fluid Diagnosis by blood culture

Sites of Infections with Members of the Enterobacteriaceae

Phatogenicity

Endotoxin: important virulence factor with wide-ranging effects on host Capsule: antiphagocytic Antigenic phase variation: capability to alternately express or not express either capsule or flagella and thus avoid host immunity Sequestration of nutritional factors, in particular, iron by production of siderophores which are extracellular iron-chelating compounds (e.g., enterobactin, aerobactin) Iron is important compound for both host and pathogen and is limited in supply and thus must be competed for Much of iron in host body is sequestered in heme proteins (e.g., hemoglobin, myoglobin) and in ironchelating proteins (e.g., transferrin, lactoferrin)

Resistance to serum killing: many bacteria are inherently sensitive to nonspecific bloodborne components and to circulating complement and the resultant complementmediated clearance, but Enterobacteriaceae and other bloodborne pathogens can resist such killing Antimicrobial resistance True pathogenic members of the Enterobacteriaceae may possess specific virulence features, which are unique to individual genera or species Adhesins Exotoxins, (e.g., enterotoxins which act in the small intestine) Antigens which stimulate antibody production by the host include:
K - polysaccharide capsular antigens H - flagellar antigen O - somatic polysaccharide antigen (associated with LPS)

Lab Diagnosis

Special isolation media: contain various substances including indicators, inhibitors, etc. Media and tests to differentiate the genera of the family Tests that divide species of the genera, e.g., patterns of acid production from various carbohydrates Various species differ in the carbohydrates from which acid may be produced and end products that may be formed from various substrates Culture: Colony morphology: moist, gray (except Serratia marcescans which appears red) smooth colonies on non-selective media Special differential and selective media used for separation of genera and species Some strains are beta hemolytic on blood agar

Pseudomonas aeruginosa

Morphology

gram-negative, rod-shaped, asporogenous, and monoflagellated bacterium 1-5 m long and 0.5-1.0 m wide aerobic respiration (with oxygen) anaerobically on nitrate or other alternative electron acceptors.

Specimen Collection
Depending on the nature of infection, an appropriate specimen is collected

Pathogenicity
nosocomial infection opportunistic human pathogen. Mostly in cystic fibrosis, cancer, or AIDS patients
exhibits

intrinsic resistance to chemotherapeutic agents and antibiotics - capsule

secrets

many virulent factors - exotoxin A, which inhibits the protein synthesis of the hosts cells.

It

also breaks down human immunoglobin proteins and serum alpha body organs, such as the lungs, the urinary tract, and kidneys

Lab diagnosis
MacConkey

agar - clear colonies (as it does not ferment lactose)

Oxidase

- test positive

Confirmatory

tests - production of the blue-green pigment pyocyanin on cetrimide agar and growth at 42C.

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