Morganella is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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MICROBIOLOGY

  • Facultative anaerobic Gram negative rod.
    • Non-lactose fermenter in the same family as Proteus.
    • Environmentally ubiquitous, part of normal colonic flora.
    • "Urea splitter," but stones seen less frequently than Proteus due to less effective urease enzyme.
  • Morganella only has single member in its genus M. morganii, and two subspecies: M. morganii and M. sibonii, which differ only in trehalose fermentation.
  • Antimicrobial susceptibility:
    • Naturally resistant to penicillin, 1st-2nd generation cephalosporins, macrolides, sulfamethoxazole .
    • Beta-lactamase is inducible, chromosomal AmpC type. May confer resistance to imipenem in some isolates.
    • Tigecycline not reliably effective due to ArcAB efflux pump, although may show synergy in vitro with other antimicrobials [1].
    • Extended spectrum beta-lactamases, inducible beta-lactamases, carbapenemases including New Delhi metallo-β-lactamase 1 (NDM-1) and fluoroquinolone resistance reported.

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