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Objectives
students will become familiar with
a range of tests designed to identify Enterobacteriaceae a range of diseases caused by these organisms Know where they fit into the classification schemes
Anaerobic
Veillonella sp.
Others (non-enteric) misc GNBs Pseudomonas spp. Aeromonas sp. Plesiomonas shigelloides Vibrio cholerae Vibrio parahaemolyticus Vibrio vulnificus
sugar fermented is hugely important:
Enterobacteriaceae
What are they? Where do you find them? Are they medically important? Which are most commonly encountered? How to recognise and identify
some strains have acquired additional genetic information from plasmids, transposons, and phages which allows them to be pathogenic
EHEC 0157(Enterohaemorrhagic)
http://video.google.com/videoplay?docid=6673841890662551798
Salmonella
http://video.google.com/videosearch?q=whale&emb=0#emb=0&q=beached%20whale%20new%20zealand&src=2
Eg Salmonella enterica serovars (e.g., Enteritidis, Typhi, Typhimurium) Ie Salmonella ser. Typhimurium (not italicized) Some books: S. Typhimurium S. Typhi
Subgroup 2 : salamae Subgroup3a: arizonae Subgroup3b: diarizonae Subgroup 4: houtenae Subgroup 5: bongori Subgroup 6: indica
Clinical Aspects:
two distinct diseases enteric fever (typhoid), S. typhi only carried by humans Role of carriers About 5% of patients clinically cured from typhoid remain carriers for months or even years. Antibiotics are usually ineffective on Salmonella carriage because the site of carriage (gall bladder) may not allow penetration by the antibiotic.
chicken and eggs reservoir. implicated in more than 50,000 cases of bacterial food poisoning in the United States every year
Outbreak of salmonella
http://video.google.com/videoplay?docid=623 8435932617357831&q=&hl=en
Shigella
KLEBSIELLA
Klebsiella pneumoniae Common cause of nosocomial pneumonia and UTI(second only to E. coli) Produces a heat-stable enterotoxin
contain resistance plasmids (R-plasmids) can be transferred to other enteric bacteria (not necessarily of the same species)
P. mirabilis
Proteus: urinary pathogens Can form stones caused by infection of the urine with ureasplitting bacteria.
Yersinia pestis
Yersinia pestis rodent pathogen, The flea draws viable Y. pestis organisms into its intestinal tract. These organisms multiply in the flea. humans an accidental host
Others.
NF gut can all cause opportunistic infections EDWARDSIELLA E. tarda known to cause gastroenteritis and wound infections CITROBACTER C. freundii is suspected to cause diarrhea C. diversus has been linked to a few cases of meningitis in newborns. ENTEROBACTER E. aerogenes and E. cloacae are sometimes associated with UT & RT infections SERRATIA Serratia marcescens is considered a harmful human pathogen known to cause urinary tract infections, wound infections, and pneumonia. also have many antibiotic resistance properties
Identification
Uses biochemistry of bacteria Think about what they do and where they live
ESCHERICHIA SHIGELLA EDWARDSIELLA SALMONELLA CITROBACTER KLEBSIELLA ENTEROBACTER SERRATIA PROTEUS MORGANELLA PROVIDENCIA YERSINIA
Diagnostic microbiology
Most useful tests for quick ID Empirical: Ist stage tests
Identification: GNR
E.coli, a vibrio & a pseudomonad Which is which??
Nitrate reduction
+ve for Enterobacteriaceae Detects whether bacteria uses nitrate (NO3) as electron acceptor (ie) Nitrate reduced to nitrite (or other compounds) via nitrate reductase NO3 ----> NO2 ----> NH3 or N2 Grow organism in nitrate broth: test for end products
reagents: a-naphthylamine and sulfanilic acid Formation of red color after addition of the
Nitrate reduction
What about 1?
Reactions on Mac
Have a guess?
XLD
selective and differential medium designed for the isolation of Gram-negative enteric pathogens from clinical specimens. contains xylose, lysine, sodium desoxycholate, sodium thiosulfate and ferric ammonium citrate.
Principle:
Differentiation of Shigella and Salmonella from nonpathogenic bacteria is accomplished by three reactions: 1) xylose fermentation, 2) lysine decarboxylation, and 3) hydrogen sulfide production. Xylose: enterics (except Shigella) ferment xylose rapidly. Salmonella rapidly exhaust xylose and decarboxylate lysine, and revert to alkaline conditions (simulates the Shigella reaction). Lactose and sucrose, added in excess, prevent lactose fermenters from similarly reverting. The production of hydrogen sulfide under alkaline conditions results in the formation of colonies with black centers, whereas, under acidic conditions, this black precipitation is inhibited
Salmonella on XLD agar: lysine positive, xylose fermented, positive H2S (colonies with black centers)
E. coli coli XLD agar: lactose and sucrose E. on on XLD agar: lactose fermented, lysine and H2S negative. and sucrose fermented, lysine and H2S negative.
Proteus on XLD agar: swarming inhibited, xylose only fermented, lysine negative.
Reactions on XLD
EMB:
Peptones 10.0; di-potassium hydrogen phosphate 2.0; lactose 5.0; sucrose 5.0; eosin Y; methylene blue 0.07; agar-agar 13.5.
KIA formula
Meat extract...........................................................................3,00 Yeast extract..........................................................................3,00 Peptone.................................................................................20,00 Lactose..................................................................................10,00 Sodium chloride..................................................................... 5,00 Dextrose................................................................................ 1,00 Ammonium Ferrous citrate......................................................0,50 Sodium thiosulfate................................................................... 0,50 Phenol red.............................................................................0,03 Agar.......................................................................................15,00 Final pH 7,4 0,2
1. Fermentation of glucose, lactose 2. Production of gas during fermentation 3. Production of H2S from the sulfur source Phenol red is used as PH indicator: yellow in acid, red in alkaline
KIA interpretation
Lactose glucose
SOME COMMON SUGAR REACTIONS IN KIA E. coli, Yersinia, Aeromonas, Vibrio Salmonella, Edwardsiella, Shigella nonfermenters such as Pseudomonas and others erroneously inoculated a Gram + or some other weird thing
KIA interpretation
If the butt of tube is yellow (A): glucose fermenter If the slant of tube is yellow (A): lactose fermenter If the slant is red (K): non-lactose fermenter Black ppt: H2S prodn Gas: gaps in agar A/A, K/A and K/K Could you get A/K?????? (If the butt of tube is red (K): non-glucose fermenter)
Carbohydrate fermentation
Single CHO Test Result 1.Control Negative 2. S. aureus ? 3. P. vulgaris ?? 4. P.aeruginosa 5. E. coli ??
+ve Acid prodn: color change from red to yellow
.
Motility test
A non-motile organism will have a clearly defined edge as it grows on the stab line Motile organisms will be turbid throughout the tube or have fuzzy, diffuse growth at the edges. Some organisms are so motile that the entire tube becomes very turbid (cloudy).
tests the ability of organism to split indole from tryptophan (ie have tryptophanase) Indole reagents: Kovac's reagent: Pdimethylaminobenzaldehyde in alcohol Positive reaction: formation of red color at the interface of the broth and reagent
tryptone broth
MR-VP
All enterics oxidize glucose for energy end products vary depending on bacterial enzymes MR and VP tests are used to determine what end products result
peptone broth
MR-VP media buffered-dextrose tests are read from a single inoculated tube of MR-VP broth. After 24-48 hours of incubation the MR-VP broth is split into two tubes.
Methyl red:
It tests the ability of organism to produce and maintain strong, mixed acid from buffered-dextrose peptone broth E. coli is one of the bacteria that produces acids, causing the pH to drop below 4.4. When the pH indicator methyl red is added to this acidic broth it will be cherry red (a positive MR test)
Vogues Proskauer
Klebsiella and Enterobacter produce more neutral products from glucose (acetoin) pH rises above 6.2. The reagents: alpha-napthol and potassium hydroxide. If acetoin is present reagents turn a pink-burgundy color (a positive VP test). color may take 20 to 30 minutes to develop.
yellow at acidic pH's (around 6), and blue at more alkaline pH's (around 7.6). positive citrate: blue Enterobacter and Klebsiella + E.coli -
Bacteria that use citrate also utilize the ammonium salt as a nitrogen source and create ammonia as a result.
IMViC Interpretation
E.coli gives ++-Enterobacter and Klebsiella give the reverse: --++
ONPG test
Principle Lactose utilization requires 2 main enzymes, permease and b-galactosidase Enzymes ONLY induced in the presence of the lactose substrate (inducer) Need high lactose medium Regular LFs produce both permease enzyme and bgalactosidase True NLFs lack both of these enzymes Late LFs produce b-galactosidase but lack permease (eg Shigella sonnei) ONPG: (Ortho-nitrophenyl-b-D-galactopyranoside ) Artificial substrate turns yellow in the presence of beta-galactosidase.
http://vcell.ndsu.nodak.edu/animations/lacOperon/index.htm
Urease test
Some bacteria produce urease: Urease splits urea into ammonia and carbon dioxide Organisms that produce urease will turn hot pink due to ammonia prodn
SERRATIA
Characteristics shared by all Enterobacteriaceae Gram negative rods oxidase negative All can ferment glucose Facultative anaerobes reduce nitrate to nitrite
Decarboxylase reactions H2S production IMViC reactions: I: indole M: methyl red V: Voges-Proskauer C: citrate
And others
+
95 5
+
95 30
+
98 50
Could be either E.coli or Shigella, but E. coli more probable. More tests in your panel = better probability.
Mechanics of identification
Do the 10 or 20 tests. +--++-+++--+++--++ Number? 137436 Now compare your results with a table of expected results for over 100 different organisms. This could be a table of 30 x 100!
Automation
Many systems now available. organism in diluent. aspirates into black box Distributes inoculum into wells with dehydrated substrates and incubates. Instrument reads results with spectro. Determines + or -, and compares with database. Prints out name of organism.
Major ID tests
GNB After growth on Mac, do oxidase test. If oxidase negative, do biochemical tests. Carbohydrate fermentation KIA agar/TSI IMViC Urease Decarboxylase reactions ONPG H2S Motility
End of lecture
Review questions