Morgenella morganii: Introduction, Pathogenecity, Lab Diagnosis and

Morgenella morganii: Introduction, Pathogenecity, Lab Diagnosis and Treatment

Introduction of Morgenella

Morgenella morganii is a member of the family Enterobacteriaceae which was earlier called Proteus morganii. This genus Morgenella has only one species, M. morganii. It can be found in human and animal tissues and sewage, soil, and water.

Pathogenecity of Morgenella

It cause rarely urinary tract infections (UTI),hospital-acquired infections and it has also been reported as causing diarrhea in infants.

Laboratory Diagnosis of Morgenella

Gram stain: Gram-negative bacilli

Culture: Non-lactose fermenting colonies on MacConkey agar. Blood agar is lacking swarming type growth i.e. having individual colonies.

Biochemical Reaction:

In triple sugar iron agar (TSI) test-

Red slant, yellow butt

No hydrogen sulfide (H2S) production

About gas formation- different strains give different results

Motility indole and urease (MIU) test –

Generally motile ( a few strains may be non-motile)

Indole test- positive

Urea hydrolyzation test-Positive

Citrate utilization test

Negative

Phenylalanine deaminase (PDA) also called phenyl pyruvic acid (PPA) test

Positive

Treatment of Morgenella

M. morganii strains are intrinsic resistant to penicillin, ampicillin, ampicillin, and combination of sulbactam, oxacillin, first-generation and second-generation cephalosporins, erythromycin, tigecycline, colistin, and polymyxin B and susceptible to piperacillin, ticarcillin, mezlocillin, third-generation, and fourth-generation cephalosporins, carbapenems, aztreonam, fluoroquinolones, aminoglycosides, and chloramphenicol. Even the widespread use of third-generation cephalosporins has been associated with the emergence of highly resistant M. morganii.

Case report

A 47 years old female patient having signs and symptoms of urinary tract infection (UTI) so the clinician requested a urine routine examination. The report was suggestive for UTI having plenty of pus cells and few red blood cells and thus clinician finally ordered urine culture and sensitivity.

Report:

Morgenella morganii isolated (>10⁵CFU/ml)

Sensitivity –

Ampicillin-Resistant

Nitrofurantoin-Intermediate

Ciprofloxacin-Intermediate

Ofloxacin-Sensitive

Gentamycin-Sensitive

Amikacin-Sensitive

Co-trimoxazole-Intermediate

Ceftriazone -Sensitive

Meropenem- Sensitive

The patient was treated with ofloxacin and finally, she was cured of UTI.

Note:

Supportive features of lab diagnosis as shown above figure.

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