ENTEROBACTERIACEAE

General Characteristics
Gram negative rods
- Normal flora of the GIT of humans and
animals
- Facultative anaerobes
- Also called coliforms
Pathogenesis
Virulence Factors:
Antigens
- O antigens - resistant to heat and alcohol
- K antigens - responsible for attachment to
epithelial cells
- H antigens - located on flagella
Colicins (Bacteriocins)
Toxins and Enzymes
- Endotoxin
- Exotoxin

Escherichia coli
urinary tract infection
- S/S: urinary frequency, dysuria, hematuria,
pyuria

traveler's diarrhea
- Enterotoxigenic E. coli (ETEC) - produces
exotoxin which leads to hypermotility and
dirrhea
- Enterohemorrhagic E. coli (EHEC) - produces
verotoxin which causes hemorrhagic colitis;
e.g. E. coli 0157:H7

Escherichia coli
Sepsis
- Most often affected are the newborns
- Secondary infection to UTI

Meningitis
- E. coli is the leading cause of meningitis in
infants
Klebsiella pneumoniae
Causes pneumonia
May also cause UTI

Enterobacter aerogenes
- Causes UTI and sepsis

Serratia marcescens
- Most common opportunistic pathogen in the
hospital
- Causes pneumonia, bacteremia and
endocarditis

Proteus sp.
- Causes UTI, pneumonia, bacteremia, and
focal lesions
- P. mirabilis causes UTI
Providencia sp.
- Causes UTI

Citrobacter sp.
- Causes UTI and sepsis

Treatment
- No single therapy is available

- Drug treatment includes sulfonamides,
ampicillin, cephalosporin, chloramphenicol,
tetracyclin and aminoglycosides

- Problem: multiple drug resistance
Epidemiology, Prevention and
Control

- E. coli accounts for 90% of UTI in young
women

- K. pneumoniae causes 3% of pneumonia

Escherichia
coli
Salmonella Group
Motile with
peritrichous
flagella
Pathogenesis and Clinical
Findings
Enteric fever
(typhoid fever)
Septicemia Enterocolitis
Causative agent S. typhi S. choleraesuis S. tyhimurium
Incubation period 7-20 days Variable 8-48 hrs
Duration of disease Several weeks Variable 2-5 days
S/S Gradual then high
plateau fever,
malaise, headache,
constipation,
bradycardia, myalgia
Rapid rise then
spiking temperature
Low-grade fever,
nausea, headache,
vomiting, profuse
diarrhea
Treatment
- Chloramphenicol
- Ampicillin

Epidemiology, Prevention and Control
- Reservoir of infection: poultry, pigs, rodents,
cattles, pets
- Mode of transmission; oral-fecal route
- The organisms usually persists in the gall
bladder
The Shigella
General
Characteristics
- Natural habitat is
GIT
- Slender Gram
negative rods
- Facultative
anaerobes

The Shigella
Pathogenesis
- Infection is limited to the GIT
- Virulence factors:

Endotoxin - contributes to irritation of bowel

Shigella dysenteriae exotoxin - produces
diarrhea; inhibits absorption in the small
intestine

The Shigella
Clinical Findings
- Incubation period: 1-2 days

- S/S: abdominal pain, fever, watery diarrhea,
bleeding and ulceration
The Shigella
Treatment
- Chloramphenicol
- Ampicillin
- Tetracycline

Epidemiology, Prevention and Control
- Highly communicable
Shigella is transmitted by "food, fingers,
feces, and flies" from person to person