Microbiology Lab Block 7

metalloproteinase acetylcholine

Botulism toxin, a potent neurotoxin, is a ______ that acts on the presynaptic membranes at neuromuscular junctions. This proteinase binds and cleaves proteins involved in the release of _____ at the synapse, causing flaccid paralysis. There are multiple types of botulism toxins, A-G. Neutral, anaerobic conditions present in canned green beans, mushrooms and fish make these types of foods hazardous if they have not been heated to a temperature sufficient to kill spores during the canning process. Another source of (infant) botulism is honey, which may contain Clostridium botulinum spores and should not be given to infants.

Lactobacillus acidophilus

Because the vagina is a moist, warm area of the body it provides an ideal environment for the growth of many microorganisms including bacteria, yeast and parasites. The bacterial species _______ is the predominant vaginal organism after puberty and before menopause and is responsible for maintaining the normal acidic pH of the vagina.

Proteus, Enterobacter, Klebsiella and Citrobacter Proteus swarming

Besides E. coli, other members of the Enterobacteriaceae family that cause UTIs include ___4___ species. Enterobacteriaceae are facultatively anaerobic, glucose positive and oxidase-negative. Urease-producing members of the ______ genus are associated with a high urine pH (due to ammonia production) and urinary stones, which are a predisposing factor for infection. Highly motile Proteus species form waves of growth on agar surfaces. This phenomenon is known as _____

nc k a ag h2s+

= no change (same color as control - orange). = alkaline reaction red (or definitely pink). = acid reaction (yellow). = acid reaction (yellow) and gas formation (bubbles present in medium or between the medium and bottom of tube or wall of tube). = H2S formation (black butt or black spot in butt).

thiosulfate citrate bile salts sucrose (TCBS) yellow

A selective and differential medium, _________, is used to culture Vibrio cholerae. Its alkaline pH promotes growth of this organism, while bile salts selectively inhibit the growth of gram-positive bacteria. Sucrose is the fermentable carbohydrate and bromothymol blue is the pH indicator. Colonies of Vibrio cholerae appear ______ on this medium because of sucrose fermentation, which produces acidic end products turning the indicator yellow.

Gardnerella vaginalis clue cells

A small pleomorphic gram-variable rod, ______s, causes vaginosis, a term preferred to vaginitis as there is infection without inflammation. Infections with are characterized by frothy discharge with a fishy odor and the presence of ______, which are epithelial cells covered with bacteria

reticulate bodies and elementary bodies monoclonal antibodies

Chlamydia are obligate intracellular bacteria with an unusual life cycle involving _____ and _____. They don't grow on laboratory media so other methods of identification of detection are necessary. Kits containing ______ against Chlamydia are commercially available. These kits detect Chlamydial antigen present in cervical or urethral specimens. Other methods include the ligase chain reaction or polymerase chain reaction, which detect Chlamydial DNA and are extremely sensitive.

Methyl Red Test

Determine if bacteria perform mixed acids fermentation when supplied glucose. Useful in identification of enteric bacteria Interpretation Positive: Red Negative: Yellow

Voges-Proskauer Test

Determine if bacteria utilize the butylene glycol pathway, an alternative pathway for Pyruvic Acid. Useful in identification of enteric bacteria. Positive: Red/Pink Ring at top Negative: no red/pink ring

Neisseria gonorrhoeae Chlamydia trachomatis Treponema pallidum Haemophilus ducreyi Ureaplasma urealyticum

Diseases of the genital system include sexually transmitted diseases caused by bacteria such as _________ (gonorrhea), _____ (nongonococcal urethritis or NGU), _____ (syphilis), ______(chancroid or soft chancre) and the LGV (lymphogranuloma venereum) serogroup of Chlamydia trachomatis. _______ causes NGU and has been associated with infertility.

1) ferment glucose (with or without the formation of gas) 2) oxidase negative 3) catalase positive 4) reduce nitrates to nitrites

Enterobacteriaceae must possess the following four characteristics:

Clostridium perfringens, Salmonella, Shigella, Campylobacter and Vibrio parahaemolyticus.

Examples of bacteria causing food infections are

Bacillus cereus, Staphylococcus aureus and Clostridium botulinum

Examples of bacteria causing food intoxication are 3

Enterococcus Staphylococcus Staphylococcus saprophyticus resistant Staph epidermidis

Gram-positive cocci causing UTIs include _____ species and ______. Enterococci are problematic because they are sometimes highly resistant to many different antibiotics. ______, a coagulase-negative, novobiocin-______ Staphylococcus, causes UTIs predominantly in young females. The novobiocin disk distinguishes Staph saprophyticus from ______ because the latter is novobiocin sensitive. Staph aureus is coagulase positive and ferments mannitol.

glucose but neither lactose nor sucrose both glucose and lactose and/or sucrose

If an organism ferments glucose _____ only a small amount of acid will be produced, and the butt portion will be acidic (yellow) while the slant remains alkaline (K/A). If the organism ferments______, there will be a large quantity of acid produced making both the butt and slant acidic (yellow)

pelvic inflammatory disease (PID) gram-negative diplococci

In females, acute gonorrhea usually exists as a cervicitis or urethritis, but the disease frequently is chronic or unapparent so that no disease symptoms exist. The infected woman, however, serves as a focus for infection and transmission of the disease to her sexual partner. Besides urethritis and endocervicitis, other problems may include rectal, pharyngeal infections, opthalmia neonatorum, salpingitis and pelvic peritonitis. The latter two conditions may result in scarring and infertility. About 10-20% of women with gonorrhea develop ______. The finding of ______ in genital tract smears of females is not diagnostic for gonorrhea (sensitivity for gram stain is only 50-70%), because the female genital tract is colonized by non-pathogenic gram-negative diplococci and certain other gram-negative rods that look like gram-negative diplococci in normal smears.

Ureaplasma urealyticum Mycoplasma hominis

It is estimated that ______ causes about half of the non-gonococcal, nonchlamydial urethritis in men. It derives its name from being urease-positive. _______ is associated with postpartum fever, chorioamnionitis and PID. A member of the same genus, Mycoplasma pneumoniae causes "walking pneumonia" which represents about 10% of all cases of pneumonia.

Salmonella and Shigella and yersinia

Lactose fermentation is an important test for the Enterobacteriaceae because _____3_____ are lactose negative, while most of the other members of the Enterobacteriaceae family (normal flora in the feces) are lactose positive

Motility: Positive: Turbid (cloudy) Negative: Clear Ornithine: Positive: Purple Deep Negative: Yellow Deep

Motility, Indole, Ornithine Agar (MIO) interpretation

chocolate or Thayer-Martin agar CO2

Neisseria gonorrhoeae is a very fastidious bacterium requiring a nutritionally complex medium (e.g., _____), increased _____ concentration (5 - 10%) and high humidity for growth. Gonococci rarely survive outside the human body (or away from an agar plate) for more than 15-30 minutes under conditions where they can become dehydrated

Hektoen enteric Agar (HE) MacConkey (MAC) MAC (Sorbitol)

Non-lactose fermenting colonies (clear or green) are worked up for Salmonella and Shigella. These colonies may or may not have black centers indicating H2S production Non-lactose fermenting colonies (clear) are worked up for Salmonella and Shigella. Non-sorbitol fermenting colonies (clear) are worked up for E. coli O157:H7

blood Cefsulodin-Irgasan-Novobiocin Agar (CIN) Xylose Lysine deoxycholate agar (XLD)

Observed for the predominance of Staph aureus, Enterococcus or Yeast species. Pink or clear colonies with darker pink to red centers are worked up for Yersinia species. Clear to red colonies are worked up for Salmonella and Shigella. These colonies may or may not have black centers indicating H2S production

chancre 3 weeks 4-6 weeks

Primary stage: The disease is diagnosed by demonstration of T. pallidum in preparations made from the _____ (typical ulcer of syphilis) which is usually present on the external genitalia or cervix but can be found on other areas of the body depending upon the type of sexual contact. This lesion appears about _____ after infection is contracted, but time varies from 3-90 days. The chancre heals spontaneously after _____.

positive glucose pyocyanin fruity (grape-like) odor

Pseudomonas aeruginosa differs from the Enterobacteriaceae in that it is oxidase-_____, does not ferment ______ and sometimes produces a blue-green pigment known as _____. Colonies of Pseudomonas aeruginosa are "ground-glass" in appearance and have a characteristic ______. Pus from infections caused by Pseudomonas aeruginosa may have a blue-green color from the pigment produced by this organism.

Lysine Iron Agar (LIA)

can be used to determine the ability of the organism to deaminate lysine, decarboxylate lysine, and produce H2S gas. It is useful in the identification of Salmonella, Proteus, Providencia, and Morganella. Members of the Proteus group (Proteus, Providencia, and Morganella) are the only members of the Enterobacteriaceae that are deaminase positive

Staph aureus

can tolerate high salt conditions so it causes food poisoning from salty foods such as ham

S. mansoni, S. haematobium and S. japonicum Schistosoma haematobium

Schistosomiasis is an important helminthic infection in the world today infecting 200-300 million people in Africa, the Middle East, Southeast Asia, the Caribbean and South America. The three species which commonly infect humans are _____3____. _____ lives in the veins surrounding the bladder and the eggs of the parasite are shed in the urine, with egg counts being in highest in urine specimens collected around midday. Schistosomiasis results in bladder lesions, blood in the urine and obstruction affecting the kidneys and ureters. Kidney failure and bladder cancer may occur.

maculopapular rash lymph node enlargement trunk and extremities, palms, soles of feet and face

Secondary stage: Also known as disseminated syphilis, this stage develops 2-8 weeks after the chancre appears. The secondary stage is characterized by a ______ and generalized nontender _______ with fever and malaise. The rash is distributed on the ____5____. In about one third of the patients the disease resolves spontaneously, but in the remaining two thirds of patients, the illness progresses to the latent state. T. pallidum may be demonstrated, as above, in material from mucous patches or from skin lesions, but antibodies are present by this stage so serological testing should be performed.

O H negative sorbitol test

Serotypes of E. coli and Salmonella are commonly typed using antisera. The _____ refers to the identity of the somatic antigen and the _____ refers to the flagellar antigen type. E. coli O157:H7 is distinguished from other E. coli strains by a ________ and/or serotyping. Lettuce and other vegetables can become contaminated when food handlers do not follow good hygiene. E. coli is a facultatively anaerobic gram-negative rod that is lactose positive. MacConkey media, which is selective for gram-negative organisms and differential for lactose fermentation, is commonly used to isolate E. coli

reagin cardiolipin VDRL (venereal disease research laboratory) test and the RPR (rapid plasma reagin)

Syphilis infections stimulate the production of at least two types of antibodies in man. One antibody is specific for the spirochetes, although it cross-reacts with species of Treponema other than T. pallidum. The antibodies are anti-treponemal antibodies and react directly with the spirochetes. The other type of antibody is a nontreponemal antibody known as _______ that is not specific for the syphilis organism, but reacts with certain lipid antigens prepared from normal tissues, primarily from beef heart. This antigen, commonly known as _____, is obtained from an alcoholic extract of beef heart and forms the basis of the ____ and ____ test. In these tests, reagin combines with cardiolipin absorbed to carbon particles in an antibody-antigen interac-tion to form an agglutination-like reaction, which is observed as clumps of material either macroscopically or through the low power (10X) objective lens.

Gummas Neurosyphilis spinal fluid

Tertiary stage: _____, which are destructive, localized granulomas, are present. ______ is characterized by mental and behavioral changes and a characteristic "syphilis gait", a wide based gait with foot slap. When CNS involvement is suspected, the ______ must be examined in every case of tertiary syphilis. No case of syphilis should be considered cured until the spinal fluid as well as the blood has been examined and found normal. Cardiovascular syphilis can result in aortic aneurysms.

Vancomycin Trimethoprim Colistin Nystatin Anisomycin Amphotericin B

Thayer-Martin (TM), Modified Thayer-Martin (MTM), Martin-Lewis (ML), New York City (NYC), and Improved New York City (INYC) media all are examples of the many formulations available to microbiologists for the selective isolation of Neisseria gonorrhoeae. The antibiotics used in these media include ______, (inhibits gram positive bacteria), ______ (inhibits numerous gram positive and gram negative bacteria and prevents swarming by Proteus), ______ (inhibits gram negative bacteria including saprophytic Neisseria), _____(inhibits molds and some yeasts), _____ (inhibits molds and some yeasts), and ______ (inhibits molds and yeasts). The various media contain different combinations and concentrations of these antibiotics. All media and growth systems contain provisions for maintaining high humidity, to protect the organisms from drying, and generation of CO2 to allow growth under in vitro conditions.

Treponema pallidum darkfield microscopy

The causative agent of syphilis is the spirochete _______. (A "spirochete" is an elongated, motile, internally flagellated, flexible organism twisted spirally around its long axis). These spirochetes are thin and delicate, measuring 0.2 microns in width by 4 to 14 microns in length. They rotate around their longitudinal axis and exhibit both forward and backward motion. They are so difficult to stain that the common bacteriological stains such as the gram stain are inapplicable. They are made visible by special techniques such as _______ and negative staining, in which the organisms appear white against a black background, or by staining procedures in which some material (usually silver salts) is precipitated onto the cell making it visible in the light microscope.

e coli Enterobacter and Klebsiella Positive: Blue slant - organism can use citrate as sole source of carbon Negative: Green slant

The citrate reaction is used to determine if a member of the Enterobacteriaceae is capable of utilizing citrate as the sole source of carbon. No other protein or carbohydrate that might provide another carbon source must be present in the medium. The reaction is useful in identification of the lactose-fermenting Enterobacteriaceae. ______ is citrate negative, whereas _______ are positive. interpretation?

giardia

The disease is characterized by prolonged diarrhea, malaise, nausea, flatulence, weakness, weight loss and abdominal cramps. There may be a distinctive odor of hydrogen sulfide in the breath and stools. The parasites may occupy so much of the intestinal wall space that food absorption is hampered. The cyst stage of the parasite is resistant to chlorination and outbreaks commonly occur from contaminated water

Klebsiella, Enterobacter, Escherichia, Proteus, Providencia, Citrobacter, Edwardsiella, Serratia, Yersinia, Salmonella and Shigella

The family Enterobacteriaceae consists of a closely related group of gram-negative, aerobic or facultatively anaerobic, non-sporulating rods found in the gastrointestinal tract of humans and animals, and include the following genera 11

Taenia saginata and Taenia solium

The mature proglottids contain eggs and are shed in the feces. Most patients are asymptomatic. When symptoms do appear, they are typically abdominal pain, nausea, and/or anorexia

enterohemorrhagic E. coli O157:H7 (EHEC) hemolytic uremic syndrome (HUS)

The most severe cases of E. coli infections are caused by ________, which produces a cytotoxin (toxin that kills or harms a cell) associated with hemorrhagic colitis (bloody diarrhea) and _________. Blood is found in the urine in HUS because of damage to the kidney from the bacterial cytotoxin. E. coli O157:H7 is an inhabitant of the GI tract of cattle and causes food poisoning when beef is contaminated with fecal material, and the beef is eaten without proper cooking. Unpasteurized apple juice became a source of an E. coli O157:H7 outbreak after the apples were picked from the ground where cattle had roamed.

Chlamydial

The presence of N. gonorrhoeae, Group B streptococci, Chlamydia trachomatis and Herpes simplex type II in the female genital tract introduces the possibility of contaminating newborns during childbirth. Antibiotic eye drops are added to the eyes of all newborns to prevent infection, especially blindness, due primarily to gonococcal (ophthalmia neonatorum) or Chlamydial infections acquired from the birth canal. In Third World Countries, the leading cause of blindness is from ______ eye infections contracted during passage through the birth canal.

urea slant Positive: 4+ Hot pink slant/hot pink butt 2+ Hot pink slant only (or pink broth) Negative: Hot pink absent (peach color remains)

The reaction is useful in the identification of rapid producers, such as Proteus and Morganella, as well as weak urease producers, such as Klebsiella pneumoniae and some species of Enterobacter. interpretation?

Ascaris lumbricoides

These intestinal roundworms may become very large with the female reaching 30 cm. Diagnosis is often made when an adult worm emerges from the anus, mouth or nose. The eggs hatch in the upper intestine and pass into the bloodstream and then into the lungs. They migrate to the throat and are swallowed. These worms live on digested food and may cause problems when the block the intestine, bile duct or pancreatic duct. The tiny larvae may cause pulmonary symptoms. The parasite is passed to other hosts when eggs are shed in the feces and are contracted under poor sanitary conditions.

Ancyclostoma duodenale/Necator americanus (hookworms)

This parasite feeds on blood and tissue rather than partially digested food. Pica (craving for peculiar items such as laundry starch or soil containing a particular type of clay) may occur due to the iron deficiency anemia.

indole test e coli Enterobacter and Klebsiella Positive: Red or Pink ring Negative: Colorless

To distinguish Enterobacteriaceae based on the ability to produce indole from tryptophan. The test is particularly useful for the identification of lactose-fermenting members of Enterobacteriaceae. _____ is indole positive, whereas ______ are indole negative. Indole is also useful in the speciation of Proteus: P. mirabilis is indole negative, whereas P. vulgaris is positive interpretation?

Cryptosporidium hominus (recent taxonomy change from Cryptosporidium parvum

causes cholera-like diarrhea for 10-14 days. In immunocompromised patients, the diarrhea becomes progressively worse and is life-threatening. The person becomes infected when they ingest water contaminated with oocysts often from cattle feces. This protozoan parasite survives chlorination and sometimes even filtration systems for water purification.

entamoeba histolytica

causes amoebic dysentery. The disease is characterized by abdominal pain, frequent bowel movements, with blood and mucus in the stools. Ingestion of red blood cells by this protozoan parasite is diagnostic for this amoeba. In the intestine, this parasite uses lectins to attach to the galactose of the cell membrane resulting in cell lysis

Bacillus cereus rice bulky meats motile, beta hemolytic on sheep's blood agar and is resistant to penicillin

_____, an aerobic endospore-forming gram-positive rod, produces two toxins. One toxin causes vomiting about 2-5 hours after ingestion, while the other causes diarrhea 8-14 hours after ingestion. It is likely that the symptoms depend upon which toxin is produced by the Bacillus species. The toxin commonly causes food-borne illness from consumption of ______ dishes in Asian restaurants and contaminated _____ that remain at ambient temperatures long after refrigeration or heating, so microbes have a chance to grow and produce toxins. Both forms of the disease are self-limiting. Although they cause different diseases, Bacillus cereus and Bacillus anthracis (anthrax) are similar morphologically and metabolically. A few tests can distinguish the two species. B. cereus is ___, ___ and _____ and many of the other cell-wall antibiotics (ampicillin, cephalothin, methicillin). B. anthracis is nonmotile, nonhemolytic on sheep's blood agar and is susceptible to penicillin.

Salmonella typhoid fever Salmonella typhi Salmonella enterica

______ is a lactose-negative gram-negative rod whose presence is always considered significant. Symptoms range all the way from the asymptomatic carrier state to the systemic, life-threatening disease, ______. Various Salmonella serotypes cause diarrhea, gastroenteritis, dysentery and systemic infections such as enteric or typhoid fever. Salmonella species, except for Salmonella typhi, are found in a broad range of hosts including humans and most mammals, birds, and cold-blooded animals such as amphibians. _______i, which causes typhoid fever, is strictly a human pathogen. ______ serotypes cause gastroenteritis while Salmonella typhi and Salmonella paratyphi cause enteric fever. Cold adaptive Salmonella species pose a life-threatening hazard to newborns, so new parents should be cautioned about having a pet such as an iguana in the same house as an infant. The broad range of hosts for Salmonella species can make it difficult to track down the source of infection in outbreaks.

Campylobacter jejuni

a motile, curved gram-negative rod similar to the vibrios, is one of the most common causes of lower abdominal pain and diarrhea. It requires an atmosphere of reduced oxygen and grows slowly, sometimes requiring a week to grow. Pets such as puppies and many other mammals and poultry act as reservoirs of infection. Symptoms appear 1-7 days after infection and may mimic appendicitis. Stools contain blood and pus. Antimicrobial therapy does not help in over half the patients so antibiotics are not administered unless the disease is severe or lasts over a week.

Yersinia enterocolitica

a severe enteritis, which can be acquired from milk, water, seafood, chitlins (pork intestines- a southern delicacy), fruits and vegetables, even if foods have been refrigerated. This organism grows more rapidly at refrigerator temperature than at body temperature. Abdominal pain can be severe and the white blood count can be elevated, so sometimes a misdiagnosis of appendicitis is made. This organism is problematic in units of blood for transfusion. Potential blood donors who exhibit any gastrointestinal problems are deferred, because serious endotoxic shock can result in the recipient of the blood even if blood was properly refrigerated

Fasciolopsis buski

acquired by eating infected aquatic plants, causes ulcers, bleeding, or abscesses in the jejunal and duodenal site

Clostridium perfringens vomiting or fever 24 hrs double zone of beta hemolysis

an anaerobic endospore-forming gram-positive rod, causes gas gangrene as well as food-borne illness. It is normal flora of the colon so it causes food-borne illness in food that has been contaminated with feces. Food-borne illness occurs 8-24 hours after consumption of the contaminated food, and is characterized by diarrhea without ___ or ___. Patient usually recovers spontaneously within _____. Testing has been used to detect fecal contamination in food or water. Clostridium perfringens produces a characteristic _____ on blood agar. The inner zone of complete hemolysis is caused by theta toxin, and an outer zone of incomplete hemolysis is caused by alpha toxin. Alpha toxin is also known as lecithinase and damages cell membranes

Vibrio cholerae adenylate cyclase camp rice water

are curved gram negative-rods found in saltwater that grow under alkaline conditions. ______cause epidemic cholera, an acute toxin-mediated diarrheal disease. This organism produces cholera toxin (CT), which causes __________ to become locked in the active state. Hyperproduction of _______ results in large amounts of water and electrolytes to be lost from the cell in the form of watery diarrhea. In severe cases patients may secrete several liters of fluid per hour amounting to up to 20 liters per day. If untreated the patient ends up with severe electrolyte depletion and may die from hypovolemic shock. The stools of a severely ill cholera patient resemble _______ and may contain 108 V. cholerae organisms/ml. Cholera is a common problem after flooding if the water supply becomes contaminated, or wherever there is poor sanitation or improper sewage disposal. Other Vibrio species cause diarrhea after a person ingests raw or undercooked seafood such as oysters. Oysters are filter feeders so they filter large amounts of water to obtain food. If raw sewage has been dumped in the sea where the oysters are feeding, the bacteria become concentrated in the oysters.

Shigella and Klebsiella

are the only nonmotile Enterobacteriaceae 2

Trichuris trichura (whipworm)

attach to the colon leading to ulceration which provides an entry point to the bloodstream for bacteria. Light infections may be asymptomatic. In heavy infections there may be diarrhea, dysentery, abdominal discomfort, anemia and growth retardation due to varying degrees of malabsorption. Rectal prolapse may occur in children, which has been described using the term "coconut cake" prolapse because the adult worms are visible to the naked eye.

Clostridium botulinum flaccid antitoxins

causes food poisoning in home-canned products such as green beans and meats. The deadly toxin can cause _____ paralysis long after the bacteria producing the toxins have died. The toxin is heat labile and rapidly inactivated at 100 degrees C, so boiling food destroys the toxin and renders the food safe to eat. ____ rather than antibiotics are given to the patient with botulism poisoning, as it is the toxin that must be neutralized.

Clostridium difficile

causes pseudomembranous colitis, often following antimicrobial therapy. Antimicrobial therapy eradicates the normal flora of the colon, but it survives and produces a toxin, which causes the hospital-associated diarrhea also referred to as antibiotic-associated diarrhea (AAD). See computerized image of pseudomembranous colitis.

Triple Sugar Iron (TSI) Slants

contains protein sources (peptones, beef extracts, etc.), three sugars- glucose, lactose and sucrose, phenol red indicator and an iron salt to detect hydrogen sulfide (H2S) production. Glucose is in a concentration one-tenth that of the other carbohydrates. TSI is a two-reaction chamber with an aerobic slant portion and an anaerobic deep ("butt") portion. The slant portion of the tube is exposed to atmospheric oxygen and will become alkaline due to oxidative decarboxylation of peptides and amino acids. Amino acid degradation is minimal in the deep (anaerobic) portion, and thus a small quantity of acid produced can be detected because few amines are being formed from amino acids.

FTA-ABS (fluorescent treponemal antibody absorption)

diagnostic test depends upon a) the interaction of antitreponemal antibodies in serum with nonviable T. pallidum on a test slide, and b) the subsequent interaction of fluorescent anti-human globulin (antibody) with any anti-treponemal antibody from the serum that was bound by the T. pallidum cells during the first incubation period. Fluorescence is observed through a fluorescence microscope.

MHA-TP (microhemagglutination)

diagnostic test, solubilized T. pallidum antigens absorbed to erythrocytes to detect serum antibodies. Antibodies to Treponema pallidum form bridges between erythrocytes coated with T. pallidum antigens causing agglutination of the erythrocytes.

dysentery hemolytic uremic syndrome (HUS)

gastrointestinal infections caused by Shigella, Campylobacter jejuni, enteroinvasive E. coli (EIEC) and enterotoxigenic E. coli (ETEC) are associated with ______ referring to painful and frequent defecation resulting from inflammation of the colon or other intestines with blood and pus in the stool. Enterohemorrhagic E. coli O157:H7 (EHEC) can cause an additional complication called _____ in young children. Vibrio cholera causes cholera, characterized by copious amounts of dilute diarrhea ("rice water stools")

Trichinella spiralis

included with the gastrointestinal parasites because the parasite is contracted by eating undercooked pork, and gastrointestinal symptoms such as nausea, diarrhea and abdominal cramps are the first symptoms to appear. Larva end up encysted in muscle tissue resulting in pain, swelling and weakness of the infected muscles. Peripheral blood eosinophilia may reach 50% during the muscle invasion stage. Periorbital edema is a diagnostic sign, as extraocular muscles are commonly involved. Difficulties in chewing, swallowing and breathing may occur depending on the muscles involved. CNS involvement may occur with symptoms resembling polyneuritis, myasthenia gravis or paresis of localized muscle groups. Acute myocarditis may occur in heavy worm loads and may result in death

Helicobacter pylori

is a slender curved gram-negative rod with polar flagella. Its claim to fame is that it survives in the mucosa of the stomach and is associated with gastritis, gastric ulcers and duodenal ulcers. Certain strains have been associated with gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma.

Clonorchis sinenses

is typically associated with eating raw fish. The fluke takes up residence within the capillaries of the biliary tree and causes an inflammatory reaction locally. Long term inflammation is thought to contribute to development of cholangiosarcoma.

Enterobium vermicularis (pinworm)

live in the large intestine. The female migrates to the anus to deposit eggs on the perianal skin. The movement of the worms can cause intense itching. Diagnosis is made by pressing sticky tape on the anal area and examining microscopically for the presence of eggs

k/k k/a r/a h2s+

lysine decarboxylase positive lysine decarboxylase negative lysine deaminase positive H2s

Listeria monocytogenes refrigeration transplacentally stillbirth or fulminant neonatal sepsis

non-endospore-forming gram-positive rod that causes food-borne illness after consumption of contaminated dairy products and meats. Two unusual characteristics s are (1) the organism can grow at ______ temperatures so low numbers of bacteria present initially can grow to infective levels during cold storage and (2) the organism can be transmitted ______ to the fetus and transmitted to the newborn in the birth canal and may result in ___ or _____. Listeriosis in adults is usually mild and characterized by fever and malaise associated with bacteremia, but infant mortality associated with CNS infections involving Listeria is 50- 60%

Trichomonas vaginalis

sexually transmitted and characterized by a copious greenish yellow frothy discharge from the vagina. In men it may be asymptomatic or may cause urethritis or prostatitis. Coinfections of gonorrhea are common. Diagnosis is typically by microscopic examination of discharge, semen, or urine (male carriers). New diagnostic tests utilize DNA probes and monoclonal antibodies.

Shigella Shigella dysenteriae Shigella flexneri and Shigella sonnei

species are lactose-negative gram-negative rods that cause dysentery. They are closely related to E. coli and have been described as "E. coli with an attitude"! Unlike the invasive Salmonella species, Shigella rarely spreads outside the intestinal tract. Shigella species include ______, which causes bacillary dysentery, _____and _____