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General Bacteriology

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General Bacteriology GENERAL BACTERIOLOGY ANTIMICROBIAL SUSCEPTIBILITY TESTING: Medium used: Mueller Hinton agar/broth Prepare Standard inoculum of test bacterium with turbidity 0.5 McF MC used method: Disc diffusion method---- > o Kirby Bauer (MC) ---- > Comparison done using standardised tables o Stoke's method ----- > Along with test organism, control organism also put Less commonly used method but BEST METHOD: As gives exact estimate of MIC is Dilution method: Broth (can be Macrobroth or Microbroth) & agar E (Epsilometer) test:-Combination of Disc diffusion method and Dilution method MICROBROTH DILUTION METHOD MACROBROTH DILUTION METHOD AGAR DILUTION METHOD KIRBY BAUER METHOD STOKE’S METHOD EPSILOMETER TEST BACTERIAL GROWTH CURVE: LAG PHASE: o Stage of adaptation o No replication takes place o Metabolically active LOG PHASE: o Stage of active replication o Increase in viable count o Metabolically most active STATIONARY PHASE: o Gradual depletion of nutrients o Bacteria multiplying = Bacteria dying o Exotoxins formed o Spores formed DECLINE PHASE: o Viable count decreasing o Total count constant BACTERIAL CELL: o Capsule/slime may or may not be formed o Cell wall contains peptidoglycan/ muramic acid o CM doesn’t contain sterols o 70S ribosomes o Mesosomes--- Invaginations of plasma membrane Respiratory chain enzymes present o Pili helps in adhesion o Flagella helps in motility o Unique amino acid in bacterial cell wall----- > Diaminopimelic acid o Polymers of NAG and NAM o Linked by peptides o Teichoic acid present of 2 types GRAM POSITIVE CELL WALL o Periplasmic space contains two layers of murein monomers o Porins present o LPS/ endotoxin present, released on lysis of cell----recognised by TLR-4 on human cells GRAM NEGATIVE CELL WALL Mechanism of β lactams: “β lactams bind to transpeptidase(PBP) and inhibit crosslinking leading to lysis of cell.” Mechanism of Vancomycin: “Vancomycin binds to D-ala- D-ala terminal of cell wall precursors and blocks action of transglycolase---leading to no crosslinking.” o Yersinia pestis o S.aureus o Bacteroides , Bordetella o Pneumococcus o Haemophilus influenza o Vibrio parahemolyticus o Klebsiella pneumoniae o Bacillus anthracis (polypeptide capsule) o Meningococcus o Clostridium perfringens, Cryptococcus neoformans Demonstrated by Quellung reaction- > Swelling of capsule in presence of AntiCapsular Ab o Bacteriophages can follow either lytic or lysogenic cycle. o In lysogenic bacterium, integrated phage DNA is called prophage. o Induction of Prophage: Disintegration of phage DNA spontaneously or d/t triggers o A bacterium can never be in both cycles simultaneously o Temperate phages first enters lysogenic cycle and then lytic cycle. o Eg. Gamma phage of E.coli GENE TRANSFER: TRANSFORMATION VIA PHAGES CONJUGATION Picking up DNA fragments Phage carrying bacterial genes First demonstrated in E.coli K12 through cell wall infects another bacterium- strain Eg. Pneumococcus Transduction Through sex pilus encoded by -MC form of gene transfer in plasmid genes bacteria Horizontal transfer Phage encoding genes expressed by lysogenic bacterium- Lysogenic conversion Can only be mediated by temperate phage LYSOGENIC CONVERSION: o Prophage encoded genes o Ability of Salmonella to express various antigens o Ability to produce Toxins---Phage mediated toxins DT, CT, Verotoxin of EHEC, Botulinum toxin C & D, Pyrogenic toxins A and C, Panton Valentine Leucocidin toxin ENTEROBACTERIACEAE: GN rods Facultative anaerobes Motile by Peritrichous flagella except o Klebsiella o Atypical E. coli o Shigella o S. gallinarum-pullorum o Yersinia pestis Catalase +ve except S. dysenteriae I Oxidase -ve Nitrate reduction +ve All Ferment glucose (As facultative anaerobe-can utilize glucose both aerobically and anaerobically): aerogenic (acid with gas)/ anaerogenic(only acid) NON-FASTIDIOUS Selective Media: Mac Conkey Agar-either LF/NLF Catalase negative- STASH o STreptococcus o All Anaerobes o S. dysenteriae type 1 CATALASE TEST Oxidase negative-CESS o Corynebacterium o Enterobacteriaceae o Staphylococcus o Streptococcus OXIDASE TEST Aerogenic bacteria SEEK-(gas bubble) o Salmonella o E. coli o Enterobacter o Klebsiella SUGAR FERMENTATION TEST (Arrow shows Durham’s tube) TUBE 1: Aerogenic TUBE 2: Anaerogenic TUBE 3: Uninoculated sugar solution Lactose fermenting pink colonies: E. coli Klebsiella Enterobacter Citrobacter o MAC CONKEY AGAR: LF Non Lactose fermenting pale colonies: Salmonella Shigella Proteus Yersinia MAC CONKEY AGAR: NLF SHIGELLA: NM, NC 4 spp. (Serotyping based on O Ag) Anaerogenic IMViC -+-- NLF S. dysenteriae: o only Non-Mannitol Fermenting species o Produces most severe disease o Type l- only serotype to produce Shiga toxin—so called SHIGA’S bacillus S. flexneri: MC in India S. sonnei: o LLF o only 1 serotype o MC in world o Mildest shigellosis S. boydii: Rarely reported species in world SHIGELLOSIS: Most communicable bacterial diarrhea ID50---->10-100 Virulence factor: Plasmid encoded-T3SS & Ipa A-D, VirA — cause Actin polymerisation Basolateral invasion of colon & rectal mucosa I.P: 2 days Invasive Diarrhoea, fever, abd pain; dysentery, tenesmus. Shiga toxin-inhibits protein syn in endothelial cells S.dysenteriae Type I---MC cause of HUS In India (EHEC in world) Complications: Toxic megacolon, Reactive arthritis DIAGNOSIS: o Stool microscopy: lots of pus cells seen o Detection of Ag: DFAT, ELISA o Culture on selective media---MOST SPECIFIC o Sereny test---to prove invasive nature, demonstrate keratoconjunctivitis in expt animal o NAATS--- MOST SENSITIVE Rx: o Ciprofloxacin x 5 D o If EMPIRICAL Rx: Ceftriaxone X 5D Cefixime x 5 D o Resistance reported to FQ, Macrolides, TMP-SMX E.coli: Motile except Atypical E.coli Serotyping done on basis of O K & H Ag Aerogenic except Atypical E.coli IMVIC++-- LF on MCA Normal GI flora---but if enter extraintestinal site and have acquired special virulence factors can lead to infections Single MC cause of UTI----> UPEC UPEC Virulence Factors: Type 1 fimbriae, P fimbriae MC cause of neonatal Meningitis: NMEC-K12 capsule DIARRHOEAGENIC E.COLI: Never normal flora EIEC EPEC Atypical E. coli o MCC of diarrhoea in infants---typical EPEC NM o Diarrhea regardless of age---atypical EPEC NLF Anaerogenic VIRULENCE FACTORS: o EAF plasmid (tEPEC) Also Cause Bacillary dysentery but o LEE plasmid infective dose very high Both lead to Attachment-Effacement effect (ID--- >104-105) o Watery non-bloody diarrhoea o DIAGNOSIS: Isolating them from stool "Localized adherence" on Hep2 adherence assay NAAT ETEC MCC Of Diarrhoea ---- Pediatric & adult MCC Of Traveller's Diarrhoea VIRULENCE FACTORS(plasmid coded): Heterogenous adhesins:- Colonization factor Ag TOXINS: LT (acts by increasing cAMP) & ST (acts by increasing cGMP) ID50--- >109 (only food and water associated) Acute non bloody diarrhea DIAGNOSIS: PCR for toxin genes STEC/EHEC Shiga toxin/ Verotoxin Zoonoses (beef animal exposure) ID50---- > 10-100 bacteria only VIRULENCE FACTORS: o LEE plasmid----- >A-E effect o Phage mediated Verotoxin (Stx1 and Stx2 variant)---- > inhibit protein syn MCC of HUS in the world I.P:-3-8 Days Bloody diarrhoea, HUS (fever-nt ) Most dangerous strain : E.coli O157:H7 On Sorbitol Mac---- > E.coli O157:H7 produces pale colonies unlike others NAATS to detect verotoxin in stool directly Never give antibiotics as they worsen the disease EAEC MC cause of persistent diarrhoea Can cause Traveller's diarrhoea Plasmid mediated virulence factors: AAF, EAST-1(acts by increasing cGMP) Acute non bloody diarrhoea DIAGNOSIS: "stacked brick" adherence on Hep 2 adherence assay DAEC Pediatric diarrhea in somewhat older children Acute non bloody diarrhea Diffused/Random/ individual adherence on Hep-2 adherence assay AIEC Possible pathobiont in multifactorial etiology of Crohn's disease A-E EFFECT ON MUCOSAL CELLS Klebsiella pneumonia subsp. pneumoniae: Non-motile capsulated O & K typing, No H type as no flagella Aerogenic IMViC --++ Urease +ve LF on MCA Mucoid colonies due to thick capsule Normal GI, nasopharynx flora Important Community Acquired Infection : Friedländer disease: Severe type of pneumonia Alcoholism history Other risk factors: Diabetics, COPD, Chronic renal failure Upper lobe involvement Abscess formation Currant jelly sputum Bulging fissure sign on X-ray Can cause UTIs, pneumonia, bacteremia, liver abscess, intraabdominal abscess, splenic abscess All Resistant to Ampicillin (chromo. encoded β lactamase); MDR plasmids K. granulomatis Causes Granuloma inguinale(Donovanosis) K pneumoniae rhinoscleromatis Causes CGD called rhinoscleroma K pneumoniae ozaenae Causes Atrophic rhinitis (ozaenae) MUCOID COLONIES ON BLOOD AGAR DUE TO THICK CAPSULE Yersinia pestis: Category A Bioterrorism agent NM Capsulated bipolar staining---safety pin appearance pH range--- 5-9.6 temp range---2-45 degree Celsius, optimum temp-27 degree celsius Anaerogenic IMVIC-+-- Urease -ve NLF Stalactite growth on Ghee broth Selective media: CIN Reservoir: Rodents Vector: Rat flea TYPES OF PLAGUE: BUBONIC PNEUMONIC SEPTICEMIC Due to bite of rat Due to inhalation of Generally secondary to flea bacteria other two Associated with 80-90% mortality Symptoms of severe bubos rates endotoxemia If untreated, 50% If untreated,go to go to septicemic septicemic plague plague DIAGNOSIS: Wayson stain---Safety pin appearance Ag detection---DFAT NAAT Culture---only done in special labs Serology---demonstrate 4 fold increase in Ab one week after symptoms start
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