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The pathogenic species, , , and , are zoonotic agents that cause disease in humans ranging from mild gastroenteritis to life-threatening plague. Several dozen virulence genes, their environment- dependent expression control, and the complex mechanisms of their product action and coordination, which enable immune system evasion and disease progression, have been actively investigated and described. Several species can be differentiated by a number of phenotypic methods, and the four biovars of can be separated based on differential reactivity with glycerol, nitrate, and arabinose. Recent evidence suggests that biovars based on phenotypic methods do not show a strict correlation to groupings as determined by genotyping methods. Methods used for the evaluation of the relatedness of species include a number of different phenotypic methods, including serotyping, biotyping, antibiogram analysis, and bacteriophage typing. Genotyping methods include pulsed-field gel electrophoresis (PFGE), which has long been considered the gold standard for typing of species. Isolation rates vary based on geographic locations, with the highest incidence in temperate regions, so the decision to routinely rule out these organisms in stool cultures should be evaluated in individual laboratories after consultation with the infectious disease physicians.

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36
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Image of FIGURE 1

(A) Giemsa stain of a blood smear from a patient with infection. Note the bipolar-staining “closed safety pin”-shaped cells. (B) Direct fluorescent antibody (F1 conjugate) staining of .

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36
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Image of FIGURE 2

Typical fried-egg-shaped colonies of on sheep blood agar.

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36
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Generic image for table

Biochemical reactivity of species

From references and .

Incubation is at 35°C except where indicated. VP, Voges-Proskauer; V, variable; ND, not done; –, negative; +, positive.

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36
Generic image for table

Reactions of biotypes of after incubation at 25°C for 48 h

Modified from reference with permission of the publisher, S. Karger AG, Basel, Switzerland.

+, ≥90% of strains are positive; d, 11 to 89% of strains are positive; –, ≥90% of strains are negative; (+), weakly positive reaction.

According to Kandolo and Wauters ( ).

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36
Generic image for table

Biochemical identification of biovars

Citation: Schriefer M, Petersen J. 2011. , p 627-638. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch36

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