Enterobacteriaceae Diagnostic Laboratory Tests

Study Notes

Specimens include urine, blood, pus, spinal fluid, sputum, or other material depending on the disease location.
Morphologically, Enterobacteriaceae resemble each other, with large capsules suggesting Klebsiella species.
Specimens are plated on both blood agar and differential media for rapid preliminary identification.
Nucleic Acid Amplification Tests (NAATs) detect Enterobacteriaceae in specimens such as positive blood cultures, cerebrospinal fluid, respiratory specimens, and stool, and may also detect resistance markers.

Specific antibodies develop in systemic infections, but it is unclear if significant immunity to the organisms follows.

No single specific therapy is available for Enterobacteriaceae.
Sulfonamides, ampicillin, cephalosporins, fluoroquinolones, and aminoglycosides have marked antibacterial effects, but susceptibility varies and laboratory tests are essential.
Multiple drug resistance is common and controlled by transmissible plasmids.
Treatment of gram-negative bacteremia and impending septic shock requires rapid institution of antimicrobial therapy and restoration of fluid and electrolyte balance.

Enteric bacteria establish themselves in the normal intestinal tract within a few days after birth and form a main portion of the normal aerobic microbial flora.
Control measures are not feasible for normal endogenous microbiota.
Enteropathogenic E.coli serotypes should be controlled like salmonellae.
Enterics are a major problem in hospital infection, particularly in debilitated patients.
Control depends on handwashing, rigorous asepsis, sterilization of equipment, disinfection, and strict precautions in keeping the urinary tract sterile.