1. Identification of Enterobacteriaceae coliforming
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Identification of Enterobacteriaceae coliforming
organisms and related diseases
Identification of Enterobacteriaceae coliforming organisms and related diseases

2. contents Family Enterobacteriaceae Identification
Antigenic Structures & Virulence Factors
Coliform organism
& disease
Other coliforms

4. Family Enterobacteriaceae

5. Enterobacteriaceae Characteristics : - Small and straight rods
- Gram negative
- Resident of Soil, water, decaying
matter, large bowel of humans and
animals
- spore (x),
- Most motile
(except Shigella & Klebsiella & Yersinia )
- Facultative anaerobe
- Oxidase (-), Catalase (+)
- Glucose ferment, Nitrate reduction
- ferment Carbohydrates
(anaerobic pathway)

6. Enterobacteriaceae Diarrheal illnesses : two basic mechanism
1. Toxigenic infection – (a)
2. Invasive infection – (b)
Enterics : more than 50% of nosocomial infection
-E.coli, Klebsiella, Proteus, Enterobacter, Serratia, Citrobacter.

7. Enterobacteriaceae
Coliforms : Rapid lactose-fermenting enteric bacteria
E.coli, Klebsiella, Enterobacter, Hafnia, Citrobacter, Serratia
Non-coliforms : Non-lactose-fermenting
or Slow lactose-fermenting bacteria
- Opportunistic, normal gut flora
- Pathogenic enterics
- Pathogenic nonenterics

8. Identification Enrichment media : selenite or GN broth Selective media
-MacConkey agar
-EMB agar(Eosin Methylene Blue agar)
-Hektoen enteric agar
TSI agar
IMViC(Indole test, MR test, VP test, Citrate test)
Urease test
Motility test

9. Identification Coliform : Pink MacConkey agar EMB agar
Non- coliform : 반투명
EMB agar
Coliform : 검은색
Non – coliform : 옅은 연보라색
Hektoen enteric agar
Coliform : orange, salmonpink
Non – coliform : green, blue-green

10. Identification
TSI agar
IMViC
Urease test
Motility test

11. + - Genus Indole Methy red Voges-Proskauer Citrate TSIA Motility
Escherichia + -
A/A G
MOTILE
Klebsiella
SPECIES VARIABLE
NON-MOTILE
Enterobacter
Citrobacter
H2S
Serratia
K/A

12. Antigenic Structures Complex surface antigens H : flagellar antigen
K : capsule and/or
fimbrial antigen
O : somatic or cell wall
antigen

13. Antigenic Structures Variety of subspecies or serotypes Serotyping
- Classifying some species
- Pinpoint the source of outbreaks
- Epidemiological tool

14. Antigenic Structures Endotoxin (lipopolysaccharide,LPS) Exotoxin
Capacity to overcome host defenses
Multiply in the tissues and blood

15. Virulence Factors
Gram-negative bacteria freely transfer chromosome or plasmid
- Drug resistance
- Toxigenicity
- Adaptive traits
- Alter their pathogenicity
Virulence genes : code for enterotoxins, capsules, hemolysins, fimbriae

17. Coliform organism
& disease

18. Escherichia coli The most prevalent enteric basillus Colon bacillus
The best known coliform
facultative anaerobic & non-fastidious bacterium in the gut

19. Pathogenic Strains of E. coli
(1) Enterotoxigenic E. coli (ETEC)
severe diarrheal illness(similar to cholera)
two exotoxins
-LT(heat-labile toxin)
-ST(heat-stable toxin)
heightened secretion, fluid loss
fimbriae : adhesion to the small intestine
(2) Enteroinvasive E. coli (EIEC)
Invasion and ulceration of the mucosa of the large intestine
Inflammatory disease

20. Pathogenic Strains of E. coli
(3)Enteropathogenic E.coli (EPEC)
infantile diarrhea
(4)Enterohemorrahgic E.coli (EHEC)
E.coli O157:H7
hemorrhagic colitis
hemolytic uremic syndrome(HUS) , severe damage to the kidney

21. Clinical diseases of E. coli
(1) infantile diarrhea
the greatest single cause of mortality among babies
crowded tropical regions : poor sanitary facilities , contaminated water supplies
malnourished, further loss of body fluids and electrolytes → fatal
(2) traveler's diarrhea
70% exotic pathogen(ETEC)
Within 7-8days : profuse, watery diarrhea, low grade fever, nausea, vomiting

22. Clinical diseases of E. coli
(3) urinary tract infections(UTI)
50%~80% of UTI in healthy people
-more common in women - short urethras →(promote) ascending infection to bladder(cystitis) & kidneys
(4) other extraintestinal infections
-neonatal meningitis, pneumonia, septicemia, wound infections
(complicate surgery, enndoscopy, tracheostomy, catheterization,
Renal dialysis, immunosurpessant therapy,)

23. E. coli and the Coliform Count
the indicator
present in larger numbers, can survive in the environment, easier & faster to detect than true pathogens
if E. coli is present in a water sample → fecal pathogens Salmonella, viruses, pathogenic protozoa →judge unsafe to drink

24. Other coliform

25. Other coliform
Klebsiella, Enterobacter, Serratia, Citrobacter
natural host defenses fail
septicemia, endotoxemia

26. Other coliform 1) Klebsiella pneumoniae respiratory tracts
- chronic lung infections
large capsule : prevents phagocytosis
nosocomial pneumonia, meningitis, bacteremia, wound infections, and UTIs(urinary tract infections)

27. Other coliform 2) Enterobacter & Hafnia spp. 3) Citrobacter spp.
inhabit : soil, sewage, dairy products
surgical wounds, spinal fluid, sputum, blood
Urinary tract infections(UTIs)
lethal when introduced into the bloodstream.
3) Citrobacter spp.
inhabit : soil, water, human colon
opportunist in urinary tract infections , bacteremia in debilitated persons

28. Other coliform 4) Serratia marcescens inhabit : soil, water, intestine
produces an intense red pigment
Serratia pneumonia (prevalent in alcoholics), burn and wound infections, fatal septicemia, meningitis .

29. Q&A

30. QUIZ

31. QUIZ 1. What is NOT true about Enterobacteriaceae ? 1. spore-forming
2. Glucose ferment
3. Nitrate reduction
4. Oxidase (-)
5. Catalase (+)

32. QUIZ 2. what does the following next
colifrom : Creates nuclear black, sometimes tinged with a metallic luster on the surface
1. MacConkey agar
2. EMB agar
3. Hektoen enteric agar
4. TSI agar

33. QUIZ
4. How can E. coli cause infantile diarrhea in infants but not in their mothers?

34. QUIZ 5. What are two basic mechanisms of diarrheal illness?
①toxigenic infection
②invasive infection
③aerial infection
④contact infection

35. QUIZ 6. Which is not surface antigen? 1.H antigen 2.K antigen
3.O antigen
4. None of above.
5. All of these.

36. QUIZ 7. Which strain of E.coli causes HUS? a. EHEC b. EAEC c. EPEC
d. EIEC

37. Reference 임상미생물학 실습/전국임상병리학과 교수 협의회/ 고려의학/ 2010/ 4판
임상미생물학 실습/전국임상병리학과 교수 협의회/ 고려의학/ 2010/ 4판
미생물학/ 최호형/ 아카데미서적/ 2004/ 1판
Foundations in microiology/ Talaro Chess/ McGraw-Hill/ 2012/ 8th
아카데미 생명과학 사전/생명과학사전위원회/아카데미서적
미생물학/willey,, sherwood/7판/김영민 외 8명/라이프 사이언스
미생물학 실습/김선희 외 7명/고려의학
밀레니엄 미생물학/김관천 외 10명/ 정문각
MICROBIOLOGY/Kathleen Park Talaro/McGraw Hill/ p

38. Thank you