04 Gm negative enteric bacilli

  • O2 mask: Pneumonia
  • bag of urine: Urinary tract infection
  • Pills on ground: Multidrug resistant, treatment with carbapenem
  • hospital room: nosocomial infections, thus multi drug resistance
  • milk: Lactose fermenter
  • pink milk cartoon: Pink on MacConkey Agar

Enterobacter cloacae

  • enterodactyl
  • flying: motile

Serratia marcescens

  • triceratops
  • charging with arm up: Motile
  • red color: Produces red pigment on culture
  • catalase positive

Klebsiella pneumoniae

  • ankylosaurus with clubbed tail/ kleb tail
  • mucous on back: polysaccharide capsule
  • NH3 bottle spraying kleb: Urease positive
  • all 4 feet: Immotile

  • clear zone and thick capsule

  • 3 A's: Alcoholics, abscesses, aspiration (started from aspiration)
  • knocked over jar of currant jelly: "Currant" jelly sputum
  • Xray: Cavitary lesion, may look like TB
  • Liver abscess via ascending cholangitis
  • The hallmark of Klebsiella pneumonia is a thick, mucoid, blood-tinged sputum (currant jelly sputum) and lung tissue necrosis with early abscess formation.

Salmonella

  • macrophage cage: Facultative intracellular within macrophages
  • fish tail floppy: Salmonella is motile
  • lemon cut: Acid-labile
  • black plate: H2S positive, black colonies on Hektoen Agar plate
  • fish bone: Osteomyelitis
  • capsule: vi Capsule, inhibit phagocytosis

  • flower: Fluoroquinolones treatment (ie Cipro)

  • syringe: Live attenuated vaccine

Enteritidis

  • left chicken: The reservoir for Salmonella enteritidis is the chicken
  • match: Inflammatory diarrhea
  • syringe bulb: Type III secretion system

Typhi

  • right: Salmonella typhi
  • sickle: In Sickle Cell disease
  • seagull: Salmonella typhi in the gallbladder of chronic carriers
  • cook drape: Typhoid Mary
  • drape: Rose colored macules
  • Green pea: "Pea soup" diarrhea

Shigella

  • standing on acid: Acid stable
  • green shirt: Green colonies on Hektoen agar
  • chained to stone: Immotile

  • actin projectile: Use of actin filaments
  • M: Invasion of M cells

  • Flame all around: Inflammatory diarrhea
  • Red stool: blood in stool

HUS:

  • whip: Glomerular damage first
  • plates: thrombosis with platelet, drop in platelet counts
  • popped balloon: platelet aggregation lyse RBC, Red blood cell hemolysis
  • young kid: HUS common in young children

  • 60a timer: Toxin binds to 60S subunit of ribosomes
  • syringe with bulb: Type III Secretion System

E. Coli

  • cat: Catalase positive
  • milk bottle: Lactose fermenter
  • pink milk bottle: Pink on MacConkey Agar
  • capsule with cake: Encapsulated
  • K cake: K Antigen
  • green drink holder: Green on EMB agar
  • type III secretion

  • milkshake with red strawberry: leading cause of sepsis via LPS
  • hair bow: Fimbriae, pili like, cause for UTI
  • UTI cup with #1: Most common cause of UTI
  • neonate with helmet: Neonatal meningitis
  • neonate points to cake: Only if it has K antigen

EHEC

  • shiga toy: Shiga-like toxin can cause HUS
  • Only $1.57: O157:H7 antigen is associated with outbreaks
  • hamburger: Transmitted by eating undercooked meat
  • ketchup on table and red stool: Bloody diarrhea
  • sorbitol bottle: Does NOT ferment sorbitol
  • balloon string: Damages endothelial cells in the glomerulus
  • plates: Platelet aggregation follows and decrease in platelet count
  • Popped balloon: Red blood cell hemolysis via the thrombosis

ETEC

  • traveller truck: Traveler's diarrhea
  • water truck: Transmitted via water
  • LA: L = Labile, A = cAMP
  • SG: S= Stable G = cGMP
  • water truck: Watery diarrhea

Yersinia

Yersinia Enterolitica

  • English terrier: yersinia enterolitica
  • ice on window: Resistant to cold temperatures
  • Safety pin: Bipolar staining, sometimes described as having a safety pin appearance
  • glass capsule: Encapsulated

  • poop in cage: Y. enterocolitica transmitted through puppy feces
  • milk bottle: May be transmitted through contaminated milk products
  • baby: Toddlers are commonly affected by Y. enterocolitica

  • red stool: bloody stool
  • right abdomen toddler : Infection can mimic appendicitis symptoms

Yersinia Pestis

  • Pink color: Gram negative organism
  • Rodents in cage: Prairie dogs main reservoir in United States
  • flea sign: Transmitted by flea bites

  • sai: Streptomycin (with tetracycline) for treatment
  • mouse wheel: Tetracyclines (with streptomycin) for treatment

  • syringe bulb: Yops (yersinia outer protein) secreted via type III secretion systems, stops phagocytosis

  • guy with buboes: Characteristic buboes form on skin
  • Uncontrolled spread can cause organ abscess, cutaneous hemorrhage, and tissue necrosis

  • killed vaccine sign: Killed vaccine can be used to prevent transmission

Campylobacteria Jejuni

  • curved moustache: Curved/spiral gram negative rod
  • flame: Grows at 42 degrees C
  • chicken roasted: Poultry reservoir. Can be transmitted from domestic animals (pet dog)
  • ring: Oxidase positive

  • red stool: Causes bloody diarrhea
  • bear cub invading cooler: Invasive, bacteremia, sepsis
  • slapping knee: Reactive arthritis, seronegative
  • bear playing with sausages: Guillain-Barre syndrome - Ascending paralysis

Vibrio

  • blue ring: Oxidase positive
  • comma mustache: Comma shaped
  • red boat: Gram negative
  • lemon sliced: Acid labile because grows on alkaline media
  • base camp map: Grows on alkaline media

  • boat attached: Fimbrae attachment, does not invade
  • Base camp map: Increases cAMP
  • Gs bottle: Toxin activates Gs pathway and cAMP, increase water secretion

  • bathroom: Fecal-oral transmission
  • rice farms: Rice water stools
  • water: Watery diarrhea
  • general drinking water: Oral rehydration therapy

  • Vibrio vulnificus/parahemolyticus: oysters on plate, contaminated sea food

Helicobacter

  • ammonium bottle: Urease positive, splits urea into ammonia and CO2, reduce acidity for invasion (urease breath test)
  • helicopter blade: Motile, spins around with flagellum
  • curved mustache: Curved/spiral gram negative rod
  • blue ring: Oxidase positivex
  • silver headphones: silver stain
  • catalase positive

  • bullet holes and duodenum letters: Duodenal ulcers
  • crab: Increased risk of gastric adenocarcinoma
  • pile of tissues with mucous: Mucosa associated lymphoid tissues (MALT)

  • gasoline pump: Proton Pump Inhibitor (PPI)
  • ammo box: Amoxicillin
  • keep clear crows: Clarithomycin

Pseudomonas

  • cat: Catalase positive
  • red bathtub: Gram negative rod
  • blue ring: Oxidase positive
  • glass capsule: Encapsulated
  • grapes on table: Produces fruity grape odor
  • air bellow: Obligate aerobe
  • water in red tub: Thrives in aquatic environment
  • blue/green residue: Produces blue-green pigment (from pyocyanin and pyoverdin)
  • motile
  • type 3 secretion

  • Nurse coughing and pouring Cl water: Nosocomial pneumonia and respiratory failure in cystic fibrosis patients due to Cl mutation
  • fish bone next to candy and mortar: Osteomyelitis in diabetics (traumatic injury) and IV drug users (directly introduce via needles)
  • maid on fire: Infection associated with burn patients
  • chamber pot: Nosocomial urinary tract infections
  • Hot tub folliculitis: red, itching, pustular folliculitis association with hot tub
  • dog with black spot: Ecthyma gangrenosum - black necrotic lesions on skin (from toxins)
  • Maid listening with trumpet outside ear: Otitis externa. Swimmer's ear

  • Guy wearing green with bow: Toxin inactivates EF-2 by ribosylation (Same mechanism as Diphtheria toxin)

  • Piper: Piperacillin for treatment
  • flower: Fluoroquinolones, great for UTI
  • sai: Aminoglycosides, good with tetracycline

Proteus mirabilis

  • red: gm negative
  • NH3: Urease positive, makes ammonium/CO2, alkaline environment, responsible for struvite stones precipation
  • octopus: Swarming motility when plated
  • Fish all around: Fishy odor

  • horn of stag: Forms staghorn calculi in renal stones
  • Stone in hand: Alkaline environment can cause struvite stone production
  • Guy urinating: May cause UTI

  • Eggs: Treat with sulfonamides