Kleb & Proteus

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Enterobacteriaceae

Enterobacteriaceae: 

Enterobacteriaceae Escherichia Klebsiella Proteus Providencia Morganella Serratia Citrobacter Enterobacter Classification – more than15 different genera

Klebsiella: 

Klebsiella Morphology: Gram Negative Non-motile Short stout rods Usually diplobacilli Capsulated Capsule may be seen even in Gram staining

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Grow on ordinary media (mucoid colonies) Occur as commensals in intestine and as saprophytes in soil & water Classified on biochem. reaction & K Ag.

Antigenic structure: 

Antigenic structure About 80 capsular (K) antigens 5 somatic O antigens Capsular Ag are detected by ‘Capsule swelling’ reaction Also by CIE & ELISA Capsular types 1-6 occur most frequently in the respiratory tract

Biochemical reactions: 

Biochemical reactions GLSM: + + + + IMViC: - - + + (E. Coli: IMViC: + + - -) Urease positive

Virulence factors: 

Virulence factors Capsule Adhesions Iron capturing ability

Pathogenic species: 

Pathogenic species Klebsiella pneumoniae Klebsiella ozaenae Klebsiella rhinoscleromatis

Klebsiella pneumoniae (Friedlander’s bacillus): 

Klebsiella pneumoniae (Friedlander’s bacillus) Second most common member of aerobic bacterial flora of human intestine Causes: Pneumonia UTI Pyogenic infections (abscess, meningitis etc.) Septicemia Diarrhoea (rarely) Important cause of nosocomial infections

Klebsiella pneumoniae: 

Klebsiella pneumoniae 1. Pneumonia: In middle aged & older persons Predisposing factors – DM, c/c bronchopulm. diseases, alcoholism Massive mucoid inflammatory exudate Necrosis and abscess formation Permanent lung damage (rare in other types of bacterial pneumonia) High case fatality Blood culture positive in 25% cases

Klebsiella pneumoniae: 

Klebsiella pneumoniae 2. UTI: Strains resistant to antibiotics 3. Diarrhoea: Strains produce plasmid mediated enterotoxin (similar to E. Coli)

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Klebsiella ozaenae Cause ozena ( disease with foul smelling nasal discharge) Klebsiella rhinoscleromatis Cause rhinoscleroma (c/c granulomatous hypertrophy of nose) Bacilli intracellularly

Proteus bacilli: 

Proteus bacilli 3 genera: Proteus Morganella Providencia

Proteus bacilli: 

Proteus bacilli Pleomorphic (Greek god Proteus) Motile, Non-capsulated Urease (urea → ammonia + CO 2 ) PPA test positive Phenyl alanine deaminase (PA → PPA) Lactose not fermented MR (+) ; VP (-)

Proteus bacilli: 

Proteus bacilli Somatic O and flagellar H Ag Weil & Felix (1916) Flagellated strains - H auch form Non flagellated - O hne Hauch form ( O & H extended to other bacilli as well) O agglutination - fine granular H agglutination - loose fluffy masses

Wel Felix Reaction: 

Wel Felix Reaction Heterohilic agglutination ‘X’ strains (non-motile Pr. Vulgaris ) & Sera from typhus fever patients Serologic diagnosis of rickettsial infections OX2, OX19 and OXK strains used

Proteus bacilli: 

Proteus bacilli Saprophytes – sewage, decomposing animal matter, soil, excreta Commensal – moist skin Opportunistic pathogen – UTI, septic inf. Nosocomial infections

Proteus bacilli: 

Proteus bacilli 2 medically important species: Pr. mirabilis – UTI, Nosocomial - Indole (-) Pr. vulgaris – less common - Indole (+)

Proteus bacilli: 

Proteus bacilli Cultures have putrefactive odour (fishy, seminal) Swarming on solid agar Motile cells spread in successive waves → a thin filmy layer in concentric circles ↑ concentration of agar (6%) chloral hydrate, sodium azide, alcohol, sulphonamide inhibit swarming

Morganella morganii: 

Morganella morganii No swarming Infrequent infections UTI Nosocomial wound infections

Providentia: 

Providentia Prov. inconstans - diarhhoea Prov. stuartii - UTI, Infection in burns Prov. rettgerii – UTI, Wound & burns inf.

Proteus bacilli: 

Proteus bacilli Resistant to common antibiotics But, Pr. mirabilis sensitive to: Ampicillin Cephalosporins Providentia resistant to disinfectants chlorhexidine, cetrimide, silver sulpha So, major pathogen in burns unit

Enterobacteriaceae: 

Enterobacteriaceae Citrobacter: Motility + Urea + H 2 S + Opportunistic pathogens UTI Respiratory tract infections Occasionally wound infections, osteomyelitis, endocarditis, and meningitis Antigenic sharing with Salmonella

Enterobacteriaceae: 

Enterobacteriaceae Enterobacter: Normal flora of GI tract Motile Capsulated IMViC: - - + + (Kleb: IMViC: - -+ +, but non-motile) Citrate + Clinical significance: Nosocomial infections Bacteremia in burn patients

Enterobacteriaceae: 

Enterobacteriaceae Serratia : A free-living saprophyte Motility + Pink, red or magenta non diffusible pigment Prodigiosin Has been found in RT and UT infections Meningitis, endocarditis, peritonitis, septicemia Nosocomial infections Multiple drug resistance

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