‫بسم هللا الرحمن الرحيم‬

ENTEROBACTERIACEAE
 Leading Causes of UTIs and Bacteraemia.
 Divided Into:

1. True Enteric Pathogens:

– Salmonella, Shigella and Yersinia* species.
2. Opportunistic Pathogens:
– Klebsiella, Enterobacter, Proteus, Citrobacter, Serratia,
etc...

– Escherichia coli: >> Both.

*See lecture.
 ‫بسم اهلل الرحمن الرحيم‬

Escherichia coli
Prof. Khalifa Sifaw Ghenghesh
 ANTIGENIC STRUCTURE:
– O- Antigens
– H-Antigens
– K-Antigens
> Examples:
– E. coli O111a: H2,
– E. coli O111b: H2
– E. coli O6:?
– E. coli O157: H7

 -------------------------------------------------------------
 Escherichia coli
Gram-negative rods
 Escherichia coli
Gram-negative bacilli
A micrograph of E. coli O157 (Gram stain)
 VIRULENCE FACTORS:
1. Surfce Antigens:
- K1- antigen
- Fimbriae

2. Enterotoxins:
i. Heat - Labile (LT).
ii. Heat - Stable (ST).
3. Verotoxins (VT): Shiga-like Toxins (SLT).
4. Invasiveness:
5. Haemolytic E. coli:
 CLINICAL INFECTIONS:
1. UTIs:
2. Pulmonary Infections:
3. Neonatal Meningitis:
4. Wound Infections:
5. Sepsis:
6. Diarrhoeal Disease:
– Enteropathogenic E. coli (EPEC).
– Enterotoxigenic E. coli (ETEC).
– Enteroinvasive E. coli (EIEC).
– Enterohaemorrhagic E. coli (EHEC).
– Enteroadherent E. coli (EAEC).
EPEC congregate soon after they've
reached the intestine.
Intestinal cells form pedestals in response to injected E coli
proteins. Filaments project from the surface of the
enteropathogenic E. coli, which sits atop the pedestals.
SOURCE:

LAB. DIAGNOSIS:

TREATMENT:
1. UTIs:
– Antibiotic Sensitivity Is Necessary.
2. Children Diarrhoea:
3. Traveller's Diarhhoea:
Escherichia coli
UTI specimen
Salmonella (left) and E. coli (right)
on MacConkey agar
 E. coli O157
MacConkey agar
Serogroups of enteropathogenic E. coli isolated from
children with diarrhoea and from controls in Tripoli-Libya.
-------------------------------------------------------------------------------------------
No. (%) of isolates in
Serogroup Diarrhoeic children Controls
(n=157) (n=157)
-------------------------------------------------------------------------------------------
O1 1 (0.6) 1 (0.6)
O18 1 (0.6) --
O44 -- 1 (0.6)
O55 2 (1.3) --
O114 2 (1.3) --
O119 5 (3.2) 1 (0.6)
O125 1 (0.6) 1 (0.6)
O126 4 (2.5) 2 (1.3)
O127a -- 1 (0.6)
O128 2 (1.3) 1 (0.6)
O146 1 (0.6) 2 (1.3)
O166 -- 1 (0.6)
------------------------------------------------------------------------------------------
Total 19 (12.1)* 11 (7.0)
------------------------------------------------------------------------------------------
*Two different serogroups were isolated from one child
with diarrhoea.
Resistance of Escherichia coli isolated from
urinary tract infections in Benghazi to antibiotics.
-------------------------------------------------------------------------------------
Hospital Community
Antibiotic acquired acquired
(n=62) (n=148)
-------------------------------------------------------------------------------------
Ampicillin 52(84)* 111(75)
Carbenicillin 53(85) 117(79)
Cephaloridine 22(35) 53(36)
Chloramphenicol 37(60) 67(45)
Gentamicin 19(31) 27(18)
Nalidixic acid 3(5) 15(10)
Nitrofurantoin 4(6) 10(7)
Tetracycline 45(73) 121(82)
Trimethoprim 52(84) 120(81)
sulphamethoxazole *(%)
-------------------------------------------------------------------------------------
Resistance of 371 Gram-negative bacilli isolated from
urinary tract infections in Benghazi to antibiotics
-----------------------------------------------------------------------------
Antibiotic No. (%) resistant
-----------------------------------------------------------------------------
Ampicillin 315 (85)
Carbenicillin 305 (82)
Cephaloridine 144 (39)
Chloramphenicol 196 (53)
Gentamicin 127 (34)
Nalidixic acid 45 (12)
Nitrofurantoin 81 (22)
Tetracyclines 289 (78)
Trimehtoprim- 321 (87)
sulphamethoxazole
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