TAILIEUCHUNG - Chapter 143. Diseases Caused by Gram-Negative Enteric Bacilli

Edwardsiella, and Acinetobacter are components of the normal animal and human colonic flora and/or of the flora of a variety of environmental habitats, including long-term-care facilities (LTCFs) and hospitals. As a result, except for certain pathotypes of intestinal pathogenic E. coli, these genera are global pathogens. In healthy humans, E. coli is the predominant species of gram-negative bacilli (GNB) in the colonic flora. GNB (primarily E. coli, Klebsiella, and Proteus) only transiently colonize the oropharynx and skin of healthy individuals. In contrast, in LTCF and hospital settings, a variety of GNB emerge as the dominant flora of both mucosal. | Chapter 143. Diseases Caused by Gram-Negative Enteric Bacilli Escherichia coli Klebsiella Proteus Enterobacter Serratia Citrobacter Morganella Providencia Edwardsiella and Acinetobacter are components of the normal animal and human colonic flora and or of the flora of a variety of environmental habitats including long-term-care facilities LTCFs and hospitals. As a result except for certain pathotypes of intestinal pathogenic E. coli these genera are global pathogens. In healthy humans E. coli is the predominant species of gram-negative bacilli GNB in the colonic flora. GNB primarily E. coli Klebsiella and Proteus only transiently colonize the oropharynx and skin of healthy individuals. In contrast in LTCF and hospital settings a variety of GNB emerge as the dominant flora of both mucosal and skin surfaces particularly in association with antimicrobial use severe illness and extended length of stay. This colonization may lead to subsequent infection for example oropharyngeal colonization may lead to pneumonia. Structure and Function GNB possess an extracytoplasmic outer membrane a feature shared generally among gram-negative bacteria. This outer membrane consists of a lipid bilayer with associated proteins lipoproteins and polysaccharides capsule lipopolysaccharide LPS . The outer membrane interfaces with the bacterial environment including the human host. A variety of components of the outer membrane are critical determinants in pathogenesis and antimicrobial resistance. Pathogenesis Multiple bacterial virulence factors are required for the pathogenesis of infections caused by GNB. Possession of specialized virulence genes defines pathogens and enables them to infect the host efficiently. It is becoming clear that hosts and their cognate pathogens have been co-adapting throughout evolutionary history and it has been speculated that infection is just one point on the spectrum of evolved relationships between microbes and hosts. At one end of this spectrum is a .

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