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The Merck Manual--Second Home Edition logo
 
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Chapter 190. Bacterial Infections
Topics: Introduction | Actinomycosis | Anthrax | Bejel, Yaws, and Pinta | Campylobacter Infections | Cholera | Gas Gangrene | Enterobacteriaceae Infections | Haemophilus Infections | Leptospirosis | Listeriosis | Lyme Disease | Plague | Pneumococcal Infections | Pseudomonas Infections | Salmonella Infections | Shigellosis | Staphylococcal Infections | Streptococcal Infections | Tetanus | Toxic Shock Syndrome | Tularemia | Typhoid Fever
 
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Enterobacteriaceae Infections

Enterobacteriaceae is a group of gram-negative bacteria that can cause infections of the digestive tract or other organs of the body.

The group Enterobacteriaceae includes the bacteria Enterobacter, Escherichia, Klebsiella, Morganella, Proteus, Providencia, Salmonella, Serratia, Shigella, and Yersinia. Although Escherichia coli (E. coli) normally inhabits the intestines, certain strains of E. coli can cause intestinal infections that produce bloody, watery, or inflammatory diarrhea (traveler's diarrhea). In children, diarrhea caused by certain strains of E. coli may lead to destruction of red blood cells and kidney failure (hemolytic-uremic syndrome). E. coli can also cause urinary tract infections (particularly in women) and bacteremia and meningitis in newborns (particularly premature newborns). Infections caused by E. coli are diagnosed by finding the bacteria in cultures of blood or body fluids. The infection is treated with antibiotics, such as trimethoprim-sulfamethoxazole or, for more serious infections, ceftriaxone.

Klebsiella, Enterobacter, and Serratia infections are usually acquired in the hospital, mainly by people who have a reduced ability to fight infections. These bacteria typically infect the urinary or respiratory tract, although burns and wounds are sometimes infected. Pneumonia caused by Klebsiella is an uncommon, but severe, lung infection that is most common in alcoholics, older people, and people with diabetes. Typically, people with this infection cough up sticky sputum that is dark brown or dark red. The pneumonia may lead to the formation of abscesses (collections of pus) in the lung or in the lining of the lungs (empyema). If treated early enough, this pneumonia can be cured with intravenous antibiotics, usually cephalosporins or quinolones.

Proteus is normally present in soil, water, and stool. It can also cause deep infections, particularly in the urinary tract and the abdominal cavity. Doctors treat Proteus infections with intravenous antibiotics such as quinolones.

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