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  1. May 2017
    1. erious gram-negative bacillary infections (especially those due to Pseudomonas aeruginosa) Aminoglycosides are active against most gram-negative aerobic and facultative anaerobic bacilli but lack activity against anaerobes and most gram-positive bacteria, except for most staphylococci; however, some gram-negative bacilli and methicillin-resistant staphylococci are resistant.

      gram negative antibiotic

    2. oglycosides (see Table: Aminoglycosides) have concentration-dependent bactericidal activity. They bind to the 30S ribosom

      aminoglycosides

    1. e inhibited by the dyes eosin and methylene blue added to the agar. Based on a moderate rate of lactose fermentation and acid production, Enterobacter species produces large, muco

      EMB example

    1. . A diffuse slime layer of variable thickness (the M antigen) also may be produced but, unlike the K antigens, it is nonspecific and is serologically cross-reactive among different organisms.

      slime layer

    2. he outer membrane also contains lipopolysaccharide (LPS), of which the lipid A portion is endotoxic and the O (somatic) antigen is serotype specific.

      lipid A

    1. Enterobacter species account for a small fraction of postsurgical endophthalmitis and posttraumatic cases. [18] Most ophthalmic infections are caused by gram-positive organisms, but Enterobacter species and Pseudomonas species are among the most aggressive pathogens.

      low prevalence

    1. Enterobacter cloacaeATCC 13047 Growth good to excellent; colonies medium-sized, deep blue, with or without violet halos

      enterobacter on chromagar orientation

    1. n ofNitroreductase(Phenotypic & genotypic detection)The results of nitrate reduction test revealed that , all isolates (100%) of Enterobacterwere able to red

      nitroreductase

    2. URL:http://www.uokufa.edu.iq/journals/index.php/ajb/indexEmail: biomgzn.sci@uokufa.edu.iqISSN: 2073-8854Magazin of Al-Kufa University for Biology/ VOL.5/ NO.2 / year: 2013It was found low percentages of Enterobacterisolates (E. cloacae , E. sakazakii) are able to produce bacteriocin only against sensitive bacteria E.coli. This low production of bacteriocin may be due to siderophore production that can inhibit the activity of bacteriocin such receptor for the uptake siderophore also functions as receptor for the bacteriocin (cloacin)[18].Enterobacterbacteriocin were active against E.coli, but were inactive against Klebsiella pneumoniae, this may be due to the growth inhibitor products of the Enterobacter strains for typing are different in nature [18,24].-Production of RpoSA-Detection of rpoS gene in Enterobacterspp. by PCR.Twenty six isolates (31%) out of 84 isolates of Enterobacter

      rpos

    3. e( 1): Virulence factors of Enterobacterspeci

      virulence

    4. hemolysin and extracellular protease

      virulence - lack these

    5. ut all isolates of Enterobacterspecies had a polysaccharide capsule surrounding the bacterial cell except one isolate of E.cloacaethat lack capsule structure (98.8% versus 1.2%) [

      polysaccharide capsule

    6. wo species of Enterobacterwere grew efficiently on CHROMTMagar medium and yield

      chromagar

    7. lass 1 fimbriae

      virulence

    8. eing able to chelate iron to survive and spread within the ho

      virulence

    9. hey produce acid upon glucose fermentation , methyl red negative ,

      test

    1. cter, and Serratia: Biochemical Differentiation and Susceptibility to Ampicillin and

      tests and antibiotics

    2. Cephalosporins at 20 μg/ml or less inhibited 90% of the Klebsiella strains but only 15% of the Enterobacter strains. Ampicillin inhibited 27% of Enterobacter strains

      resistance

    1. R and VP tests are particularly useful in the identification of the Enterobacteriacea

      test explanation

    1. Chemicals in water such as those used in swimming pools may irritate the cornea and weaken the delicate surface tissue of the cornea (corneal epithelium),

      risk

    1. Fortunatelytheinfectionwascontrolledbytopicalsulphacetamideandgentamicindrops.Enterobactercloacaeisusuallyresistanttoampicillinandcanproduceacephalosporinasewhichmaydeactivatesomecephalosporins.'4Aminoglycosideshavebeenthemosteffectivedrugsagainsttheorganismandsepsishasbeentreatedwithcarbenicillinandanaminoglycoside.'H

      antibiotics

    2. nterobactercloacaewaspresentin4-12%ofallcasesofGram-negativebacteraemia.6I

      prevalence in bacteraemia

    3. terobacteriaceaesuchasKlebsiellacausecornealulceration.2AcaseofcornealulcerationduetoEnterobacterc

      rarely causes corneal ulcers

    1. On postoperative day 3, the organism was isolated to be an Enterobacter species, sensitive to ciprofl oxacin and gentamicin

      antibiotics

    2. Gram-negative organisms were found to be a rare cause of infectious keratitis, with only one case (due to Pseudomonas aeruginosa) in the literature. In an ASCRS survey of 338,550 LASIK pro-cedures, only 2 of 116 cases of infectious keratitis due to Gram-negative organisms were reported.

      rare

    1. produce acid upon glucose fermentation, are methyl red negative, and Voges-Proskauer positive, with an optimal growth temperature of 30 °C(1). 80 % are encapsulated(1).

      tests

    2. are susceptible to cefepime(7), aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole(8). Tigecycline has been shown effective in vitro

      antibiotics

    3. Gram-negative bacilli, 0.6-1 μm in diameter and 1.2-3 μm long, motile by means of peritrichous flagella and have class 1 fimbriae

      morphology

    4. Enterobacter spp. are resistant to ampicillin; first- and second- generation cephalosporins(7); and cephalothin

      resistance

    5. Person to person transmission can occur through the fecal-oral route

      outbreak transmission

    6. Enterobacter spp. are commonly found in soil and water;

      naturally occuring

  2. www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
    1. The patient was treated topically with moxifloxacin (0.5%) and tobramycin (15 mg/ml) drops every hour and cyclopentolate 2% three times daily in the right eye. N-acetylcysteine eye drops were administered four times per day.

      treatment for the case

    2. Gram-negative bacteria include opportunistic enterobac­teria (such as Serratia spp. and Klebsiella spp.) that can survive in contact lens fluid and on plastic surfaces, which explains their increased numbers in contact-lens-induced corneal infections.6
    3. enterobac-teria (such asSerratia spp.andKlebsiella spp.) that can survive in contact lens fluid and onplastic surfaces, which explains their increased numbers incontact-lens-induced corneal infectio

      growth in this certain environment by enterobacteria

    4. CASE REPORTContact-lens-related corneal ulcer caused byklebsiella pneumoniae

      the case report with the information from this case

    1. β-lactam antibiotics are bacteriocidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms, being the outermost and primary component of the wall.
    1. Beta-lactams: Carbapenems are the most reliable beta-lactam drugs for the treatment of severe Enterobacter infections; fourth-generation cephalosporins are a distant second choice Aminoglycosides: Aminoglycoside resistance is relatively common and varies widely among centers Fluoroquinolones: Resistance to fluoroquinolones is relatively rare but may be high in some parts of the world Trimethoprim-sulfamethoxazole (TMP-SMZ): Resistance to TMP-SMZ is more common
    2. 38°C or below 36°C

      usually present with a fever or chills

    1. With few exceptions, the major classes of antibiotics used to manage infections with these bacteria include the beta-lactams, carbapenems, the fluoroquinolones, the aminoglycosides, and TMP-SMZ.
    1. DRUG RESISTANCE: Enterobacter spp. are resistant to ampicillin; first- and second- generation cephalosporins(7); and cephalothin(6).
    2. Plants(6), humans, and animals(1). Enterobacteriaceae are primarily colonizers of the lower gastrointestinal tract of humans and animals(10).
    3. From 1970 to 1971, there was an epidemic of septicemia caused by contaminated IV products that affected 378 patients across the United States(9).
    4. They produce acid upon glucose fermentation, are methyl red negative, and Voges-Proskauer positive, with an optimal growth temperature of 30 °C(1). 80 % are encapsulated(1).
    5. Enterobacter spp. are commonly found in intensive care units and are responsible for 8.6 % of nosocomial infections according to the US Centers for Disease Control and Prevention

      Possible PH concern

    1. multidrug-resistant Enterobacteriaceae (mostly Escherichia coli) that produce extended-spectrum β lactamases (ESBLs), such as the CTX-M enzymes, have emerged within the community setting as an important cause of UTIs.

      PH concern

    1. Glucose fermentation and acid production Lactose and/or sucrose fermenta-tion and acid production GYellow with bubbles or cracksGas production from glucos

      TSI test results