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