Agent

Defining
Characteristics

Growth
Requirement

Determinants of
Pathogenicity

ENTEROBACTERIA
CEAE

CHARACTERISTICS
- gram (-) rods
- non spore forming
- facultative ANaerobe
- grow in simple media
- ferment glucose and
produce acid
- motile: some have
peritrichous flagella
(Pseudomonas and
Vibrio), others have polar
flagella; non-motile:
Shigella, Klebsiella)
- some have capsule (K.
pneumonia)
- some have slime layer
(E. coli)
- most are piliated
- reduce nitrate to nitrite
- H2S production is
variable (S. typhi)
- Some have
extrachromosomal
elements that code for
production of bacteriocins
or colicins that kill other
organisms
- destroyed easily by heat
and disinfectants
- tolerates cold tem and
sensitive to drying.

Typical colonies:

DETERMINANTS OF
PATHOGENICITY

LABORATORY
DIAGNOSIS

Major antigens

1. Microscopic
- urine, blood, stool,
CSF, pus

a. large gray, watery,

mucoid colonies
- capsulated
organisms (K.
pneumoniae)
b. thin film/waves with
swarming growth
- motile organisms
(Proteus)

1. K antigen
polysaccharide capsule
2. H antigen
flagellar antigen
3. O antigen
somatic antigen
Virulence Factors:

c. pigmented colonies
- green metallic sheen
in EMB (E. coli)
- pink colonies on
SSA by E. coli
- non-pigmented
nonlactose fermenters
pathogenic
(Salmonella and
Shigella)
3 general types of
culture media
a. nonselective media for
isolation
-BAP
b. selective and

1. endotoxin LPS
- Polysaccharide
core
- destroys cell
- O antigen
(immunogenic)
- Lipid A fever
production
2. exotoxins
- Shiga toxin (S.
dysentery)
- Choleragen (V.
cholerae)
Adhesion Colonization
Factors
1. Pili

Clinical Diseases

Laboratory
Diagnosis

2. Culture and isolation

- colonial morphology

Treatment

differential culture media.

* selective only gram

negative
- XLD (Xylose
Lysine Desoxycholate)
- HA (Hektoen Agar)
* selective and
differential
- SSA
- EMB
- MacConkey Agar
c. Enrichment Broth
- Selenite F in HA:
8-12 hours
- Gram Negative
broth in HA: 4 hours

* incubate all plates @

35-37 degrees for 24-48
hours
3. Biochemical Testing:

SALMONELLA

a. H2S production
black pigment
H2S prodn in TSI
(butt/slant)
Salmonella
b. utilization of

2. O antigen
3. Other membrane
proteins
:Capsule and
other protective surface
antigen

S. typhi

carbohydrate
- lactose, glucose,
sucrose
- TSIA or KIA
- TSIA 1: red
yellow = acid
production
- TSIA 2:
crack gas production
c. IMViC Test
c.1. INDOLE
INDOLE prodn - SIM
medium
c.2. METHYL RED
RXN ACID prodn
RED!!
c.3. VOGESPROSKAUER
ACETOIN
production RED!
c.4. CITRATE UTIL.
CITRATE util. SCA
GREEN
d. Urease Production
- Urea Agar Slant
- Urea
Ammonia + CO2
e. Decarboxylation of
Lysine, Ornithine and
Arginin

f. Production of
Phenylalanin
4. Motility study
1. Agar block
technique
2. Hanging drop
3. Semi-solid medium

- nonlactose fermenters
- colorless colonies
- gas prodn when
fermenting glucose
- H2S produces from
thiosulfate
- motile: peritrichous

SHIGELLA

- gram 9 (-)
- NON encapsulated
- NON-spore forming
-motile: peritrichous
- resistant to:
* Brilliant Green
* Sodium
tetrathionate
* Sodium
desoxycholate

DISEASE:
SALMONELLOSIS

DETERMINANTS OF
PATHOGENICITY

1. Enterocolitis
- S. enteritidis, S.
typhimurium
- self-limited,lasting
2-5 days
-diarrhea
- Cx: dehydration and
electrolyte imbalance

- Endotoxin
- INVASINS:
- attachment and
penetration of intestinal
epithelium
- target: Ileum

2. Osteomyelitis
- S. enteritidis with
sickle cell anemia
- bone marrow
3. Typhoid Fever

PREVENTION AND
CONTROL
- adequate sanitation
- immunization
- proper food preparation
- health education
LABORATORY
DIAGNOSIS
1. Culture and Isolation
-Specimen:
- 1st week: blood,
bone marrow aspiration
- 2nd week: stool/
rectal swab
- 3rd week: urine
- chronic

(peyers patches)
- ANTI-PHAGOCYTIC
FACTORS:
-a. catalases and
superoxide dismutase:
Both can
neutralize active oxygen
-b. definsin:
- small cationic
proteins that facilitate
bacterial killing by
phagolysosome.
-Vi or VIRULENCE
ANTIGEN
- anti phagocytic
activity
ANTIGENIC
STRUCTURES
1. H antigen
- inactivated by
heating of 60
degress,alcohols and acids
-best prepared for
serological testing by
addition of formalin to
gram negative motility
broth.

YERSINIA

2. O antigen
- surface
- resistant at 100

- S. typhi
- 1st week of
infection: fever, malaise,
aches, pains
CONSTIPATION is the
rule at this stage
- 2nd week: bacteremia
- ROSECOLORED SPOTS on
skin
- 3rd week of
infection: Ab test
- best is
serological test

asymptomatic carriers
lodge in
GALLBLADDER
- CM used for
isolation
- XLD, BSA,
EMB, SSA, SF.
2. Citrate Utilization (+)
3. TSIA (Alk/Alk) with
H2S production
- some strain can
produce glucose but all
are non-lactose
Fermenters.

TRASMISSION
- Salmonellosis
- animal pathogen
transferred to humans
through
contaminated food
(poultry and eggs)
- typhoid fever
- fecal-oral route
- contaminated H2O
or food prepared by
asymptomatic
Carriers

4. Phenylalanine
Deaminase Test
5. Serotyping with use of
anti-sera
6. Typhoid Test
- ELISA
- High sensitivity
with relatively low
specificity
- affected by:
chronic infections (false +
rxn)
7. Widal Test
tither of 1:160
Vi carrier

Y. pestis / Plague
Bacillus

degrees,alcohol and
diluted acids
- non-motile with
treatment, heat and
alcohol
- LPS-free proteins

O active
infection
H past infection

CLINICAL DISEASE
3.Vi antigen
- destroyed by heat
for 1 hour at 60 degrees,
acids & phenol
- present in virulent
strains

Y. enterolytica

- nonmotile
- non-lactose fermenters
- do not produce gas
-non-H2S production
-non-encapsulated
-non-spore former
- mannitol fermentation:
* non-mannitol
fermenter:
- S. dysenteriae
* mannitol fermenter:
- S. sonnei
- S. boydii
- S. flexneri
- According to Somatic O
Ag (A-D)

DETERMINANTS OF
PATHOGENICITY
1. Invasion plasmid
antigen
- attachment to and
penetration of mucosal
epithelium but until
submucosa only.
2. Intercellular spread
proteins
- attachment to
cytoskeleton proteins
- transfer of bacteria
to adjacent cells not to
tissues
3.Shiga toxin
- inactivates 60s
ribosomal subunit of

1. Bacillary Dysentery
- bloody stool
- severe abdominal
pain, frequently painful
passage of low volume
stools with blood and
mucus
- infection limited to
colonic mucosa and
submucosa

2. Shigellosis
- no systemic
manifestation
TRANSMISSION
- fecal-oral mode
- direct contact (increased
sexual contact)
- contaminated food and
water

TREATMENT
- fluid replacement
- antibiotic average
- fluoroquinolones

LABORATORY
DIAGNOSIS
1. cultural isolation
- SSA, EMB
(colorless)
- stool and rectal
swab
- S. dysenteriae
- pink to yellow
- Colombia Agar
2. microscopic: gram (-)
bacillus
3. Biochem: TSIA rxn
(Alk/Alk)
a. IMVic Test: - + + (Citrate difference to
Salmonella)

CONTROL AND
PREVENTION
- personal hygeine
- environmental
sanitation.

mammalian cell
ribosomes > inhibit
protein synthesis
- heat labile
- cytotoxic exotoxin

b. Urease Prodn (-)

4. Methylene Blue
Staining of Fecal
Leukocytes
- mucosal invasion
but non-specific

CLINICAL DISEASE
2 forms:
1. Bubonic plague
- lymphadenopathy
(buboes) in the area
drainage of the
flea bite
CHARACTERISTICS
- gram (-) coccobacillus
with bipolar staining
pattern
(SAFETY PIN)
- non-motile
- catalase (+)
- facultative anaerobe
- grows best at 28 degrees,
colonies may take 2-5
days to develop
- carried by a RAT FLEA
known as Xenopsylla
cheopis

DETERMINANTS OF
PATHOGENICITY
- somatic Ag
1. F1: anti-phagocytic
capsule (glycoprotein)
2. P1a: activate
PLASMINOGEN, C3b
and C5a

2. Pneumonic plague
- sever with mortality
rate of 100%
- acquired by human
to human transmission
through
infected droplets

CLINICAL DISEASE
- gastroenteritis
- reactive arthritis
- ankylosing spindylitis
- nausea
- vomiting

5. Sereny Test
- invasiveness of
organisms
- A S drop of invasive
strain and placed on the
cornea of
guinea pig or
rabbit
- (+) severe
keratoconjunctivitis
followed by ulceration

LABORATORY
DIAGNOSIS
1. Gram Staining
2. Culture and Isolation
3. Broth Culture
- Stalactite streamers
- pellicle-like
4. Biochem
a. TSIA (Alk/Acid)
b. IMVic: _- + - -

TREATMENT
- antibiotic coverage
- streptomycin
- chloramphenicol
- tetracycline

TREATMENT
- streptomycin
- chloramphenicol
- tetracycline

VIRULENCE FACTOR
- adhesins and invasins
- anti-phagocytic
- enterotoxins: similar to
ST of E. coli

RESERVOIRS:
-domestic animal, rodents
- isolated also in lakes and
well waters
TRANSMISSION
- contaminated food and
water