# 04 Gm Negative Enteric Bacilli

## Klebsiella, Enterobacter, Serratia

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/klebsiella,%20enterobacter,%20serratia%20common%20diseases,%20features,%20agars/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Sun4iKS.jpg)

* O2 mask: Pneumonia
* bag of urine: Urinary tract infection
* Pills on ground: Multidrug resistant, treatment with carbapenem
* hospital room: nosocomial infections, thus multi drug resistance
* milk: Lactose fermenter
* pink milk cartoon: Pink on MacConkey Agar

### Enterobacter cloacae

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/enterobacter%20cloacae%20features/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Sun4iKS.jpg)

* enterodactyl
* flying: motile

### Serratia marcescens

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/serratia%20marcescens%20features/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Sun4iKS.jpg)

* triceratops
* charging with arm up: Motile
* red color: Produces red pigment on culture
* **catalase positive**

### Klebsiella pneumoniae

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/klebsiella%20pneumoniae%20features/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Sun4iKS.jpg)

* ankylosaurus with clubbed tail/ kleb tail
* mucous on back: polysaccharide capsule
* NH3 bottle spraying kleb: Urease positive
* all 4 feet: Immotile

![](https://f001.backblazeb2.com/file/wikiFiles/UpcYxjG.jpg)

* clear zone and thick capsule

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/klebsiella%20pneumoniae%20symptoms,%20demographics,%20can%20be%20mistaken%20for/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Sun4iKS.jpg)

* 3 A's: Alcoholics, abscesses, aspiration (started from aspiration)
* knocked over jar of currant jelly: "Currant" jelly sputum
* Xray: Cavitary lesion, may look like TB
* Liver abscess via ascending cholangitis
* The hallmark of _Klebsiella_ pneumonia is a thick, mucoid, blood-tinged sputum (**currant jelly sputum**) and lung tissue necrosis with early abscess formation.

## Salmonella

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/salmonella%20overview%20features.%20Resides%20in,%20motility,%20acid,%20agar,%20capsule.%20Common%20disaease)..

![](https://f001.backblazeb2.com/file/wikiFiles/gGF7rOk.jpg)

* macrophage cage: Facultative intracellular within macrophages
* fish tail floppy: Salmonella is motile
* lemon cut: Acid-labile
* black plate: H2S positive, black colonies on Hektoen Agar plate
* fish bone: Osteomyelitis
* capsule: vi Capsule, inhibit phagocytosis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/salmonella%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/gGF7rOk.jpg)

* flower: Fluoroquinolones treatment (ie Cipro)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/salmonella%20vaccine.%20Which%20type%20and%20which%20salmonella)..

![](https://f001.backblazeb2.com/file/wikiFiles/gGF7rOk.jpg)

* syringe: Live attenuated vaccine

### Enteritidis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/salmonella%20enteritidis%20reservoir,%20symptoms,%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/gGF7rOk.jpg)

* left chicken: The reservoir for Salmonella enteritidis is the chicken
* match: Inflammatory diarrhea
* syringe bulb: Type III secretion system

### Typhi

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/salmonella%20typhi%20risk,%20resides%20in,%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/gGF7rOk.jpg)

* right: Salmonella typhi
* sickle: In Sickle Cell disease
* seagull: Salmonella typhi in the gallbladder of chronic carriers
* cook drape: Typhoid Mary
* drape: Rose colored macules
* Green pea: "Pea soup" diarrhea

![](https://f001.backblazeb2.com/file/wikiFiles/fApcaNR.jpg)

## Shigella

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/shigella%20acid,%20agar,%20motility/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ok2z2WN.jpg)

* standing on acid: Acid stable
* green shirt: Green colonies on Hektoen agar
* chained to stone: Immotile

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/shigella%20resides%20in%20what%20cell,%20how/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ok2z2WN.jpg)

* actin projectile: Use of actin filaments
* M: Invasion of M cells

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/shigella%20symptoms%20and%20demographics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ok2z2WN.jpg)

* Flame all around: Inflammatory diarrhea
* Red stool: blood in stool

HUS:

* whip: Glomerular damage first
* plates: thrombosis with platelet, drop in platelet counts
* popped balloon: platelet aggregation lyse RBC, Red blood cell hemolysis
* young kid: HUS common in young children

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Shigeela%20toxin%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ok2z2WN.jpg)

* 60a timer: Toxin binds to 60S subunit of ribosomes
* syringe with bulb: Type III Secretion System

## E. Coli

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/E.%20coli%20features,%20fermentation,%20agar,%20capsule)..

![](https://f001.backblazeb2.com/file/wikiFiles/9rcTuwI.jpg)

* cat: Catalase positive
* milk bottle: Lactose fermenter
* pink milk bottle: Pink on MacConkey Agar
* capsule with cake: Encapsulated
* K cake: K Antigen
* green drink holder: Green on EMB agar
* type III secretion

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/E.%20coli%20common%20problems%20and%20cause)..

![](https://f001.backblazeb2.com/file/wikiFiles/9rcTuwI.jpg)

* milkshake with red strawberry: leading cause of sepsis via LPS
* hair bow: Fimbriae, pili like, cause for UTI
* UTI cup with #1: Most common cause of UTI
* neonate with helmet: Neonatal meningitis
* neonate points to cake: Only if it has K antigen

### EHEC

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/EHEC%20toxin,%20antigen,%20transmission,%20fermentation,%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/9rcTuwI.jpg)

* shiga toy: Shiga-like toxin can cause HUS
* Only $1.57: O157:H7 antigen is associated with outbreaks
* hamburger: Transmitted by eating undercooked meat
* ketchup on table and red stool: Bloody diarrhea
* sorbitol bottle: Does NOT ferment sorbitol
* balloon string: Damages endothelial cells in the glomerulus
* plates: Platelet aggregation follows and decrease in platelet count
* Popped balloon: Red blood cell hemolysis via the thrombosis

### ETEC

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/ETEC%20demographics,%20transmission,%20toxins,%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/9rcTuwI.jpg)

* traveller truck: Traveler's diarrhea
* water truck: Transmitted via water
* LA: L = Labile, A = cAMP
* SG: S= Stable G = cGMP
* water truck: Watery diarrhea

## Yersinia

### Yersinia Enterolitica

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20enterolitica%20gram%20stain,%20temperature,%20capsule/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* English terrier: yersinia enterolitica
* ice on window: Resistant to cold temperatures
* Safety pin: Bipolar staining, sometimes described as having a safety pin appearance
* glass capsule: Encapsulated

![](https://f001.backblazeb2.com/file/wikiFiles/QihJ6iS.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20enterolitica%20demographics,%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* poop in cage: Y. enterocolitica transmitted through puppy feces
* milk bottle: May be transmitted through contaminated milk products
* baby: Toddlers are commonly affected by Y. enterocolitica

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20enterolitica%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* red stool: bloody stool
* right abdomen toddler : Infection can mimic appendicitis symptoms

### Yersinia Pestis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20pestis%20gram%20stain,%20reservoir,%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* Pink color: Gram negative organism
* Rodents in cage: Prairie dogs main reservoir in United States
* flea sign: Transmitted by flea bites

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20pestis%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* sai: Streptomycin (with tetracycline) for treatment
* mouse wheel:  Tetracyclines (with streptomycin) for treatment

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20pestis%20antigen%20and%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* syringe bulb: Yops (yersinia outer protein) secreted via type III secretion systems, stops phagocytosis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20pestis%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* guy with buboes: Characteristic buboes form on skin
* Uncontrolled spread can cause organ abscess, cutaneous hemorrhage, and tissue necrosis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/yersinia%20pestis%20vaccine/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ufastLT.jpg)

* killed vaccine sign: Killed vaccine can be used to prevent transmission

## Campylobacteria Jejuni

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/campylobacteria%20jejuni%20features,%20temperature,%20reservoir/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GKh1xdT.jpg)

* curved moustache: Curved/spiral gram negative rod
* flame: Grows at 42 degrees C
* chicken roasted: Poultry reservoir. Can be transmitted from domestic animals (pet dog)
* ring: Oxidase positive

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/campylobacteria%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GKh1xdT.jpg)

* red stool: Causes bloody diarrhea
* bear cub invading cooler: Invasive, bacteremia, sepsis
* slapping knee: Reactive arthritis, seronegative
* bear playing with sausages: Guillain-Barre syndrome - Ascending paralysis

## Vibrio

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/vibrio%20features,%20acid,%20agar/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/c59pdSJ.jpg)

* blue ring: Oxidase positive
* comma mustache: Comma shaped
* red boat: Gram negative
* lemon sliced: Acid labile because grows on alkaline media
* base camp map: Grows on alkaline media

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/vibrio%20cholera%20toxin%20and%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/c59pdSJ.jpg)

* boat attached: Fimbrae attachment, does not invade
* Base camp map: Increases cAMP
* Gs bottle: Toxin activates Gs pathway and cAMP, increase water secretion

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/vibrio%20cholera%20transmission,%20symptoms,%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/c59pdSJ.jpg)

* bathroom: Fecal-oral transmission
* rice farms: Rice water stools
* water: Watery diarrhea
* general drinking water: Oral rehydration therapy

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/vibrio%20vulnificus/parahemolyticus%20cause/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/c59pdSJ.jpg)

* Vibrio vulnificus/parahemolyticus: oysters on plate, contaminated sea food

## Helicobacter

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/H.%20pylori%20features,%20motility,%20morphology)..

![](https://f001.backblazeb2.com/file/wikiFiles/Ga5m8mT.jpg)

* ammonium bottle: Urease positive, splits urea into ammonia and CO2, reduce acidity for invasion (urease breath test)
* helicopter blade: Motile, spins around with flagellum
* curved mustache: Curved/spiral gram negative rod
* blue ring: Oxidase positivex
* silver headphones: **silver stain**
* **catalase positive**

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/H.%20pylori%20causes)..

![](https://f001.backblazeb2.com/file/wikiFiles/Ga5m8mT.jpg)

* bullet holes and duodenum letters: Duodenal ulcers
* crab: Increased risk of gastric adenocarcinoma
* pile of tissues with mucous: Mucosa associated lymphoid tissues (MALT)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/H.%20pylori%20treatment)..

![](https://f001.backblazeb2.com/file/wikiFiles/Ga5m8mT.jpg)

* gasoline pump: Proton Pump Inhibitor (PPI)
* ammo box: Amoxicillin
*   keep clear crows: Clarithomycin

    ​

## Pseudomonas

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/pseudomonas%20features,%20thrives%20in,%20odor,%20O2,%20color/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/lEniPtx.jpg)

* cat: Catalase positive
* red bathtub: Gram negative rod
* blue ring: Oxidase positive
* glass capsule: Encapsulated
* grapes on table: Produces fruity grape odor
* air bellow: Obligate aerobe
* water in red tub: Thrives in aquatic environment
* blue/green residue: Produces blue-green pigment (from pyocyanin and pyoverdin)
* **motile**
* **type 3 secretion**

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/pseudomonas%20causes%20what%20problems,%20demographics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/lEniPtx.jpg)

* Nurse coughing and pouring Cl water: Nosocomial pneumonia and respiratory failure in cystic fibrosis patients due to Cl mutation
* fish bone next to candy and mortar: Osteomyelitis in diabetics (traumatic injury) and IV drug users (directly introduce via needles)
* maid on fire: Infection associated with burn patients
* chamber pot: Nosocomial urinary tract infections
* Hot tub folliculitis: red, itching, pustular folliculitis association with hot tub
* dog with black spot: Ecthyma gangrenosum - black necrotic lesions on skin (from toxins)
* Maid listening with trumpet outside ear: Otitis externa. Swimmer's ear

![](https://f001.backblazeb2.com/file/wikiFiles/HdRtX0I.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/pseudomonas%20toxin%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/lEniPtx.jpg)

* Guy wearing green with bow: Toxin inactivates EF-2 by ribosylation (Same mechanism as Diphtheria toxin)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/pseudomonas%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/lEniPtx.jpg)

* Piper: Piperacillin for treatment
* flower:  Fluoroquinolones, great for UTI
* sai: Aminoglycosides, good with tetracycline

## Proteus mirabilis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/proteus%20features,%20motility,%20odor/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/7VPoneQ.jpg)

* red: gm negative
* NH3: Urease positive, makes ammonium/CO2, alkaline environment, responsible for struvite stones precipation
* octopus: Swarming motility when plated
* Fish all around: Fishy odor

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/proteus%20causes/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/7VPoneQ.jpg)

* horn of stag: Forms staghorn calculi in renal stones
* Stone in hand: Alkaline environment can cause struvite stone production
* Guy urinating: May cause UTI

![](https://f001.backblazeb2.com/file/wikiFiles/8Ye77sO.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/proteus%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/7VPoneQ.jpg)

* Eggs: Treat with sulfonamides
