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Lab 10 BACTERIOLOGY OF THE GASTROINTESTINAL TRACT Lab Manual (p.67-82) THE GASTROINTESTIONAL TRACT THE GASTROINTESTINAL TRACT HOST DEFENSE MECHANISMS Anatomical characteristics/mechanisms to prevent/fight infection: •High acidity of stomach prevents most microbes from surviving, making it almost sterile. •Normal microbiota – a variety of microorganisms that compete with each other for space and nutrients, aid in digestion, immunity and preventing infection from pathogens. – Enterobacteriaceae (enteric Gram-negative rods), Staphylococcus spp., Streptococcus spp., Enterococcus spp. and various anaerobic bacteria ENTEROBACTERIACEAE (ENTERIC Gram-negative RODS) • Enterobacteriaceae are a family of Gramnegative rods that include both harmless and pathogenic bacteria: – Characteristics: • Gram-negative rods • Facultative anaerobic • Ferment glucose • Oxidase negative • If motile, peritrichious flagella ENTEROBACTERIACEAE (ENTERIC Gram-negative RODS) • Enterobacteriaceae are commonly found as 1.) Normal flora or 2.) Pathogenic in the gastrointestinal tract (termed “enterics”) • Non-pathogenic in the gastrointestinal tract: – E.coli (exception: Shiga toxin-producing E. coli) – Klebsiella spp. – Proteus spp. – Citrobacter spp. • Pathogenic in the gastrointestinal tract: – Salmonella sp. – Shigella sp. INFECTIONS OF THE GASTROINTESTINAL TRACT Colitis Diarrhea or Gastroenteritis Cholera THE GASTROINTESTINAL TRACT Specimens & Diagnosis • Fresh stool or stool in preservative (CaryBlair transport) – Routine Pathogens detected: • Salmonella, Shigella, Campylobacter, and Shiga toxin-producing bacteria – Toxigenic Clostridium difficile (CDIFF) – Special bacteria requests: Yersinia enterocolitica, Aeromonas spp., Vibrio spp. THE GASTROINTESTINAL TRACT Specimens & Diagnosis • Parasites (requires special preservative [EcoFix]): – Ova and Parasite screening: • Giardia spp. and Cryptosporidium spp. – Ova and Parasites extended testing: • Other than above, including all protozoa, eggs and worms in stool. • Viruses – Not routinely tested BIOCHEMICAL TESTS BIOCHEMICAL TESTS • SIM (Sulfide, Indole and Motility • MRVP (Methyl Red and Voges Proskauer) • Citrate • TSI (Triple Sugar Iron) Agar SIM TEST • This is a multipurpose medium that can evaluate 3 different physiological characteristics in one tube • The SIM (Sulfur Indole Motility) test is used to determine if the bacteria: – (S): to determine the production of sulfide – (I): to determine the presence of an enzyme tryptophanase, which is responsible for producing the end product indole – (M): to determine if the bacterium is motile METHYL RED / VOGES PROSKAUER (MRVP) TEST • 2 Biochemical tests performed in the same media (MRVP broth) that contains glucose MR – Methyl red VP – Voges-Proskauer • Both of these tests are performed on MR-VP Medium (contains glucose) METHYL RED TEST • The MR TEST determines if a bacterium is capable of mixed acid fermentation • Mixed acid fermentation results when glucose is fermented to produce acids, which lowers the pH of the media • The isolate is inoculated to a MRVP broth and incubated overnight • Methyl Red is added to the tube to detect whether or not large amounts of acid has been produced VOGES-PROSKAUER TEST • The VP TEST determines if a bacterium ferment sugars to produce the neutral alcohol end products acetoin and butanediol • The isolate is inoculated to a MRVP broth and incubated overnight • Barritt’s reagents are added to the tube to detect whether the neutral products have been produced CITRATE TEST • Citrate agar contains citrate (carbon source), ammonium phosphate (nitrogen source), and bromthymol blue (pH indicator) – Used to determine if a bacterium can transport citrate into their cell to utilize citrate as a source of energy – Nitrogen (from a source such as ammonium - NH4+) is also a requirement for growing bacteria • Utilization of citrate and nitrogen release alkaline by-products which raise the pH that is detected by a color change in the citrate agar slant CITRATE TEST TSI (Triple Sugar Iron agar) • Triple-Sugar Iron agar is a differential medium used to identify Gramnegative enteric bacteria based on their ability to ferment selected carbohydrates and produce hydrogen sulfide (a metabolic by-product) • Many biochemical tests are performed simultaneously in a single tube TSI (Triple Sugar Iron agar) Each TSI slant contains: • 1 part glucose and another carbohydrate/sugar • 10 parts glucose • 10 parts lactose • 10 parts sucrose) • Phenol Red (pH indicator) • Two sources of sulfur (used to detect the production of sulfur) • Cysteine and thiosulfate • An iron salt • Peptone TSI (Triple Sugar Iron agar) The bacterium is inoculated and incubated overnight at 35C • Glucose utilized within 8 – 12hrs • Butt remains acidic after 18 –24 hrs • Slant reverts to alkaline (red) due to oxidation of the fermentation products under aerobic conditions on the slant results in: • CO2 and H20 and the oxidation of peptones in the medium to alkaline amines • Slant reverts back to yellow • This means that the fermentation of lactose and/or sucrose has occurred, yielding acidic products • Slant stays red • No fermentation of lactose and/or sucrose TSI (Triple Sugar Iron agar) • Production of gas • Positive for gas (CO2 or H2) - Cracks or bubbles in the agar • Negative for gas – No cracks or bubbles in the agar • Black precipitant in the butt • Desulfurization of sulfur-containing amino acids • Indicates the production of ferrous sulfide and H2S gas BIOCHEMICAL TESTS SET UP SETUP: SIM TEST SETUP: MR-VP TEST SETUP: CITRATE TEST SETUP: TSI SLANT Loose cap on all tubes! BIOCHEMICAL TESTS RESULTS RESULTS: SIM TEST RESULTS: MR-VP TEST METHYL RED TEST – POSITIVE MR TEST: Large amounts of acid = medium remains RED (pH below 4.4) – NEGATIVE MR TEST: Neutral products produced = medium turns YELLOW (pH above 6.2) VOGES-PROSKAUER TEST – POSITIVE TEST: Production of RED color – NEGATIVE TEST: No RED color RESULTS:CITRATE TEST IMViC (Indole, Methyl Red, Voges-Proskaeur, Citrate) • The IMViC tests to identify enteric Gram-negative rods to the Genus or even Species level RESULTS: TSI SLANT 1. Slant (Lactose and/or sucrose) Acid = yellow Alkaline = red 2. Butt (Glucose) Acid = yellow Alkaline = red 3. Gas production Positive = bubbles or cracks in the media Negative = intact agar with no air bubbles 4. Hydrogen sulfide production Positive = black to dark charcoal gray insoluble precipitate Negative=no black color detected