Other Enterobacteriaceae

Tribe Genus

I Escherichiae Escherichia,Shigella

II Edwardsielleae Edwardsiella

III Salmonelleae Salmonella

IV Citrobactereae Citrobacter

V Klebsiellaea Klebsiella,
Enterobacter, Serratia

VI Proteeae Proteus, Morganella,

Providencia

VII Yersineae Yersinia

VIII Erwineae Erwina

Tribe Proteeae

• Proteus, Providencia and Morganella

spp.
Morphology
• GNR

• Size- 1-3 µm X 0.6 µm

• Actively motile by peritrichous flagella

• Note:
• Hauch – Motile (Flagellar antigen)
• Ohne Hauch – Nonmotile (only somatic antigen)
Virulencefactors
• Production of urease
• Siderophores are essential for bacteria to acquire
iron
EPIDEMIOLOGY
• Habitat
▫ Found in the faeces of animals and humans as well
as in associated materials such as decomposing
meat and sewage
HUMAN INFECTIONS
• Urinary tract infection
• This bacterium has the ability to produce high
levels of urease, which hydrolyzes urea to
ammonia and thus makes the urine more
alkaline.
• If left untreated, the increased alkalinity can lead
to the formation of crystals of struvite, calcium
carbonate, and/or apatite.
LABORATORY DIAGNOSIS
• Nutrient, blood and MacConkey’s agar
• Fishy or seminal odour
Test P. mirabilis P. vulgaris Morganella Providencia Providencia
morganii rettgeri spp.

Indole - + + + +

Citrate + - - + +

Urease + + + + -

Ornithine + - + - -
decarboxylase
H2S + + - - -
Proteus spp. exhibits Swarming

Swarming inhibted by
Increase conc of agar(6%)
Add chloral hydrate
Sodium azide
Boric acid
Bile salt
RESISTANCE TO ANTIMICROBIALS
• Proteus bacilli are usually resistant to commonly used
antibiotics, but P. mirabilis is generally very susceptible to
antibiotics
• Most isolates of Proteeae are susceptible to
aminoglycosides
• Proteeae are usually intrinsically resistant to the
polymyxins and nitrofurantoins
• Resistance to trimethoprim and fluoroquinolones are
increasing
ENTEROBACTER SPECIES
• Enterobacter spp. differ from Klebsiella spp. in
being motile
• There are 15 species in the genus:
▫ E. cloacae,
▫ E. aerogenes,
▫ E. agglomerans (now Pantoea agglomerans)
ENTEROBACTER SPECIES
• They ferment glucose with production of acid
and gas and are
• Methyl red negative and Voges-Proskauer
positive.
• Enterobacter (Pantoea) agglomerans and E.
sakazakii produce a yellow diffusible pigment
at 20 °C on agar
PATHOGENICITY
• Enterobacter spp. are important nosocomial
and opportunistic pathogens.
EPIDEMIOLOGY
• Normal Habitat
▫ Enterobacter spp. are found in soil and water but
E. cloacae and E. aerogenes can be a minority
component of the intestinal flora of human and
other animals
ANTIMICROBIAL SUSCEPTIBILITY
• Resistant to cephradine, cefuroxime and
amoxycillin, but most isolates remain sensitive
to cefotaxime, ceftazidime, cefpirome,
imipenem, gentamicin and ciprofloxacin
SERRATIA SPECIES
• The red pigment produced by S. marcescens is
water insoluble, and is called prodigiosin
• Responsible for the appearance of ‘blood’ on
foodstuffs throughout history
• Its presence in sputum has also led to a
misdiagnosis of bronchiectasis or even bronchial
carcinoma
Biochemical reactions
• Serratia spp. are indole negative, produce
lecithinase and lipase and are more likely to be
gelatinase and DNAase positive
• Voges-Proskauer positive
Species
• S. marcescens, S. liquefaciens and S. rubidaea
are most often associated with human infection
DESCRIPTION
• Straight rods
• Motile by means of peritrichous flagella
• Fishy-urinary odour
PATHOGENICITY
• Class 3 fimbriae - virulence determinants
• Ability to survive in disinfectant solution, to
grow at relatively low temperatures and to
adhere to plastics can provide a reservoir for
infection
• Pore-forming haemolysin, allows the bacterium
to acquire haemoglobin and haem using an
extracellular scavenger protein
EPIDEMIOLOGY AND INFECTIONS
• Normal Habitat
▫ Serratia spp. are widely distributed in the
environment and can be found in the rodent gut
and occasionally in the human intestinal tract.
▫ Colonize the premature neonate’s intestinal tract -
red diaper syndrome
• Serratia spp. are nosocomial and opportunistic
pathogens
CLINICAL FEATURES
• Serratia spp. can cause urinary tract infection,
pneumonia, meningitis (rarely),
endophthalmitis, bacteraemia and wound
infections
Antimicrobial Susceptibility
• As for Enterobacter spp., Serratia spp. are
generally resistant to cefuroxime, cephradine
and amoxycillin but sensitive to ceftazidime,
• imipenem, cefpirome and ciprofloxacin
THANKS