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1、ENTEROBACTERIACEAE Morphology Identification Gram negativenon sporeformingrods Whenmotile byperitrichousflagella Primarilynormalfloraofgastrointestinaltract E coli Klebsiella Proteus EnterobacterFreeliving alsotransientcolonizersofskin Facultativeanaerobes mixedacidfermentationAllfermentglucose allr
2、educenitratestonitrites alloxidasenegative Lactosefermentation normalflorapositiveandpathogensnegative Primaryisolationmediaincludeeosin methylene blue EMB andMacConkeyagar Differentialselectivemediaforspecificorganismsincludingdyesandbilesalts Salmonella Shigella SS medium bismuthsulfitemedia Class
3、ification 29genera over100species EscherichiaShigellaEdwardsiellaSalmonellaCitrobacterKlebsiellaEnterobacterHafniaSerratia ProteusProvidenciaMorganellaYersiniaErwiniaPectinobacterium AntigenicStructure Mostaremotilebyperitrichousflagella Hantigens Capsule Kantigen ViforSalmonella Cellenvelope wall L
4、PS endotoxin Oantigen variousoutermembraneproteins Pili variousantigentypes someencodedbyplasmids 鞭毛抗原 H 菌体抗原 O K或Vi抗原 septicemia pneumonia meningitisurinarytractinfections CitrobacterEnterobacterEscherichiaHafniaMorganellaProvidenciaSerratia Opportunisticdiseases Enterobacteriaceae Enterobacteriace
5、ae gastrointestinaldiseases EscherichiacoliSalmonellaShigellaYersiniaentercolitica Histocompatibilityantigen HLA B27EnterobacteriaceaeSalmonellaShigellaYersinia NotEnterobacteriaceaeCampylobacterChlamydia Reiter ssyndrome communityacquiredotherwisehealthypeopleKlebsiellapneumoniaerespiratorydiseases
6、prominentcapsuleurinarytractinfectionfecalcontaminationE coliProteusurease degradesurea alkalineurine Enterobacteriaceae Enterobacteriaceae gramnegativefacultativeanaerobicrods oxidasenegative nocytochromeoxidase Emon healthyintestineShigella Salmonella Yersinialactosenegativeidentified Feces others
7、itesidentifiedbiochemically Enterobacteriaceae Serotypes referencelaboratoryantigensO lipopolysaccharide H flagellar K capsular Escherichiacoli Escherichiacoli Toxins twotypesofenterotoxin Shiga typetoxin EnteroaggregativeST liketoxin Hemolysins EndotoxinTypeIIIsecretionsystemAdhesions colonizationf
8、actors bothpiliorfimbriae non fimbrialfactorsinvolvedinattachment Thereareatleast21differenttypesofadhesions Virulencefactorsthatprotectthebacteriafromhostdefenses Capsule Ironcapturingability enterochelin Outermembraneproteins E colifimbriae mannose Type1 galactoseglycolipidsglycoproteins P E coli
9、urinarytractinfectionIstheleadingcauseofurinarytractinfectionswhichcanleadtoacutecystitis bladderinfection andpyelonephritis kidneyinfection E coli MeningitisandSepsis Neonatalmeningitis istheleadingcauseofneonatalmeningitisandsepticemiawithahighmortalityrate UsuallycausedbystrainswiththeK1capsulara
10、ntigen EnteropathogenicE coli feverinfantdiarrheavomitingnauseanon bloodystoolsDestructionofsurfacemicrovillilooseattachmentmediatedbybundleformingpili Bfp Stimulationofintracellularcalciumlevel rearrangementofintracellularactin EnterotoxigenicE coli Awaterydiarrhea nausea abdominalcrampsandlow grad
11、efeverfor1 5days TravellersdiarrheaanddiarrheainchildrenindevelopingcountriesTransmissionisviacontaminatedfoodorwater EnterotoxigenicE coli diarrhealikecholeramildernurserytravellersdiarrheacausedbyLT ST orLT ST EnterotoxigenicE coli HeatlabiletoxinlikecholeragenAdenylcyclaseactivatedcyclicAMPsecret
12、ionwater ionsHeatstabletoxinGuanylatecyclaseactivatedcyclicGMPuptakewater ions LTvsSTactivity E coli Enteroinvasive EIEC TheorganismattachestotheintestinalmucosaviapiliOutermembraneproteinsareinvolvedindirectpenetration invasionoftheintestinalcells anddestructionoftheintestinalmucosa Thereislateralm
13、ovementoftheorganismfromonecelltoadjacentcells Symptomsincludefever severeabdominalcramps malaise andwaterydiarrheafollowedbyscantystoolscontainingblood mucous andpus resemblesshigellosis EnteroinvasiveE coli EIEC Dysenteryresemblesshigellosiselderchildrenandadultdiarrhea E coli c Enteropathogenic E
14、PEC Malaiseandlowgradefeverdiarrhea vomiting nausea non bloodystoolsBundleformingpiliareinvolvedinattachmenttotheintestinalmucosa Thisleadstochangesinsignaltransductioninthecells effacementofthemicrovilli andtointimateattachmentviaanon fimbrialadhesioncalledintimin Thisisaproblemmainlyinhospitalized
15、infantsandindaycarecenters E coli d Enterohemorrhagic EHEC Hemorrhagicbloody copiousdiarrheafewleukocytesafebrilehemolytic uremicsyndromehemolyticanemiathrombocytopenia lowplatelets kidneyfailure EnterohemorrhagicE coli UsuallyO157 H7 Transmissionelectronmicrograph EnterohemorrhagicE coli Verotoxin
16、shiga like Hemolysinsyoungerthan5yearsold causinghemorrhagiccolitis EnteroaggregativeE coli肠集聚型大肠杆菌 acauseofpersistent waterydiarrheawithvomitinganddehydrationininfants Thatisautoagglutinationina stackedbrick arrangement thebacteriaadherestotheintestinalmucosaandelaboratesenterotoxins enteroaggregativeheat stabletoxin EAST Theresultismucosaldamage secretionoflargeamountsofmucus andasecretorydiarrhea E coli Enteroaggregative EAggEC Mucousassociatedautoagglutininscauseaggregationofthebacteriaatthe
