Enterobacter

I'm going to try not to look this up.

Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species.

Nice work.

I was in full panic mode.

You can see it in E. coli, in Klebsiella.

Some centers, they see it more commonly in Enterobacter than anything else.

You can find it in Providentia and Proteus, so on and so forth.

So you find this enzyme in a lot of different bacterial hosts, which I think make it pretty unique and also somewhat surprising when you find it in a bug that you wouldn't necessarily anticipate to find it for.

That's according to Dr. Joanna Daly, a professor in the Department of Medicine of Infectious Disease and Microbiology and Immunology at Montfiori Einstein.

Now, then the two remaining urgent threats of the top four is carbapenem-resistant Enterobacter bacteria and carbapenem-resistant Acinetobacter.

These can also cause severe infections and resistant to some of the strongest antibiotics available.

So the carbapenem-resistant like enterobactors,

So that's what the first test tests for.

The direct stool sample test, the swab culture tests, tests for E. coli, Klebsiella, Vibrio cholerae, Citrobacter, Proteus, Campylobacter, Clostridium, um, Enterobacter, Enterococcus, Streptococcus, Coagulas- uh, and, and so on.

So we have two sets of, of pathogenic organisms, each has its own separate test for, and our combined test, uh, covers the full spectrum of anything that is possibly be in your intestine.

This way, we're not missing anything.

But on today's episode, we are focusing on bacterial groups.

So we hear the term group complex, for example, Enterobacter cloacae complex, Acinetobacter calcoaceticus-baumanii complex, Citrobacter freundii complex, and we think, "Okay, what do we mean by complex," right? So we'll be talking about that.

But first, most of you or some of you that are listening, you probably use MALDI-TOF MS as part of the identification of your organisms, right? So I want to give you an example.

So you have this Gram-negative run.

You put it on the MALDI, right? You spot it on your slide, and then when it comes to the identification, it gives you multiple choices.

For example, you get three choices, Enterobacter cloacae, Enterobacter hormaechei, and Enterobacter asburiae.

Or let me give you another example.

You have another Gram-negative run.

Uh, and this drought gave rise to what infectious disease specialists call the ESKAPE pathogens.

That's an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumonia, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species.

The heavy hitters.

Yeah.

This is the basis for the methyl red test, which detects organisms that perform mixed acid fermentation like E. coli.

In contrast, organisms like Enterobacter and Klebselia use butanediol fermentation that creates neutral end products like acetoins, and 2,3-butanediol that we detect with the Vogues-Proskauer VP test.

Together, these tests help distinguish between organisms that produce strong acids and those that shift towards more neutral fermentation pathways.

In human cells, fermentation is more of a short-term backup system.