The purpose of this presentation is to summarize from an academic point of view Helicobacter pylori (H. pylori) and Campylobacter infections.

1. Group 4:-
1-‫أحمد‬ ‫محمد‬ ‫علي‬ ‫سيد‬ ‫ايه‬17043
2-‫شرف‬ ‫محمد‬ ‫عبدهلل‬ ‫علي‬ ‫ايه‬17044
3-‫زعفراني‬ ‫أحمد‬ ‫محمود‬ ‫ايه‬17045
4-‫بالل‬ ‫محمد‬ ‫كامل‬ ‫سعيد‬ ‫هللا‬ ‫عبد‬17095
5-‫خليل‬ ‫محمد‬ ‫السالم‬ ‫عبد‬ ‫عصام‬ ‫عبير‬17096
6-‫اسماعيل‬ ‫الحميد‬ ‫عبد‬ ‫اسماعيل‬ ‫عالء‬17097
7-‫الشريف‬ ‫ابراهيم‬ ‫مصطفي‬ ‫محمد‬17134
8-‫عدالن‬ ‫عبيد‬ ‫جمعان‬ ‫سمير‬ ‫خالد‬17188
9-‫مندو‬ ‫الهادي‬ ‫عبد‬ ‫رضا‬17190
10-‫ادريس‬ ‫القاسم‬ ‫ابو‬ ‫ادريس‬ ‫روان‬17191
11-‫عجيل‬ ‫حميد‬ ‫مهيب‬ ‫رؤى‬17231
12-‫غازي‬ ‫حيدر‬ ‫مرتضي‬17216
13-‫جيجان‬ ‫رعد‬ ‫ايه‬17184
14-‫حامد‬ ‫امجد‬ ‫سجاد‬17192
15-‫محمود‬ ‫احمد‬ ‫مصطفي‬ ‫محسن‬17113
16-‫ربيع‬ ‫احمد‬ ‫اسامه‬ ‫محمد‬17114
17-‫توفيق‬ ‫الحميد‬ ‫عبد‬ ‫طارق‬ ‫الدين‬ ‫نور‬17164
18-‫محفوظ‬ ‫محمد‬ ‫محمود‬ ‫أشرف‬ ‫نورهان‬17165
19-‫عبدهللا‬ ‫ممدوح‬ ‫طارق‬ ‫نورهان‬17166
20-‫عنيزان‬ ‫خير‬ ‫احمد‬ ‫عمار‬17207
21-‫ناصر‬ ‫باقر‬ ‫عمار‬17208
22-‫سيد‬ ‫احمد‬ ‫سالمه‬ ‫فاطمه‬17104
23-‫طلعت‬ ‫عبدالرحمن‬ ‫حسين‬ ‫ميرنا‬17154
24-‫سعد‬ ‫سليمان‬ ‫عادل‬ ‫مينا‬17155
The Leader: Alaa Ismail Abd El-Hameed ‫الحميد‬ ‫عبد‬ ‫إسماعيل‬ ‫عالء‬
ID: 17097
The Team Members:

2. Helicobacter pylori
&
Campylobacter

6. Objectives
 Describe Morphology of H.pylori and
Campylobacter.
 Identify cultural characters and biochemical
reactions of H.pylori and Campylobacter.
 Recognize pathogenesis , virulence factors and
clinical picture of H.pylori and Campylobacter
infections.
 Explain Laboratory Diagnosis & treatment of
H.pylori and Campylobacter infections.

7. Helicobacterpylori
(H-Pylori)

8. Introduction:-
 Cause:
- Chronic gastritis.
- Peptic and duodenal ulcers.
 Risk factor for:
- Gastric carcinoma and linked to mucosa-
associated lymphoid tissue (MALT) lymphoma and
iron deficiency anemia
 Categorized as group 1 carcinogen by the
WHO.

10. Morphology:-
• Small gram negative rods with comma, S, or “gull-wing”
shapes.
• Motile and have multiple flagella at one pole.

13. Histological sections stained with special stains

14. Cultural Characters:-
 Microaerophilic.
(5-10% CO2, 2-5% O2 and high humidity).
 34 to 40°C, optimum 37°C.
 Cultures should be inspected from day 3
to day 14 (average 3-7 days).
 H. pylori forms small (0.5-2 mm), round,
convex, translucent smooth colonies.

15.  Fastidious organism requires enriched &
selective growth media as:
- Blood agar.
- Chocolate agar.
- Modified Skirrow’s blood agar (selective
medium, blood agar with antibiotics) containing
vancomycin, polymyxin & trimethoprim.

19. Biochemical Reactions :-
Highly urease positive
(unlike campylobacter).
Oxidase positive.
Catalase positive.

20. - Urease .... Highly positive.

21. -Oxidase ..... positive

22. -Catalase ..... positive

23. Pathogenesis and Virulence Factors :-
 Man is the only reservoir.
 Transmission:
- Oral-oral or faecal-oral route.
 Flagellae……….Penetration.
 Adhesins……..…Attachment.
 Urease………….Colonization.
 Vacuolating cytotoxin (VacA) and a cytotoxin-
associated protein (CagA)………….Mucosal
damage.

27. Diagnosis :-
-Gastric biopsy specimens.
- Rapid urease test.
Non-invasive methods for diagnosis:
-Urea breath test.
-Direct detection of H. pylori antigen in
stools by ELISA.
-PCR.
-Serologic detection of H. pylori antibodies
by ELISA.

30. Treatment :-
Triple therapy : one week course that
includes:
clarithromycin + amoxicillin or
metronidazole + the acid lowering proton
pump inhibitors (PPI) omeprazole
(Prilosec) or lansoprazole (prevacid),
results in eradication of Pylori in 90% of
patients and decreases recurrence rate of
peptic ulcers.

32. Campylobacter

33. Introduction:-
 Have emerged as common human pathogens.
 Species:
- C.fetus: causes systemic infections , bacteremia
,cholecystitis and meningitis (immunocompromised
patients).
- C.jejuni: causes 95% of Campylobacter enterocolitis
(children) ……….. Guillian-Barre syndrome.

35. Morphology :-
 Small gram negative rode with comma , S , or “gull-
wing” shapes .
 Motile with a single flagellum at one or both poles.
 Motility is darting with cork screw-like movement.

37. Cultural Characters:-
Microaerophilic.
(10% CO2, 5%O2).
42°C (C.jejuni, thermophilic).
Skirrow’s medium.
2-5 days.

38. Filtration method:
- How?
- For isolation of Campylobacter other than
C.jejuni (Why?).
- The filtrate is then inoculated on a non-
selective medium e.g. blood agar, chocolate
agar and incubated as mentioned above.

43. Biochemical Reactions :-
Urease negative.
Oxidase positive.
Catalase positive.
Hippurate positive.
Non-proteolytic and unable
to attack carbohydrates.

44. -Urease ....negative

45. -Oxidase ..... positive

46. -catalase .....positive

47. -Hippurate ..... positive

48. Pathogenesis and clinical picture :-
 Transmission:
- Infection by the oral route.
- Untreated water and food e.g raw milk , meat ,
poultry, contaminated with domestic animal
faeces, is the major source of human infection.
- Contact with infected animals e.g puppies with
Diarrhea are a common source for children.
- Human to human transmission occurs less
frequently.

50.  Clinical picture:
- Enteritis begins as watery foul-smelling Diarrhea
followed by bloody stools accompanied by fever and
severe abdominal pain.
- Bacteraemia occurs occasionally mainly in neonates or
debilitated adults.
-The illness is usually self limited in 7-10 days.
 Virulence factors:
- Localized tissue invasion.
- Toxic activity ( enterotoxin and cytotoxin ).

53. Methods of bacteriological diagnosis
1- Specimen collection.
2- Smear preparation.
3- Cultivation:
A-Colony morphology..
B- Film preparation.
C- Biochemical reactions.

54. Laboratory diagnosis :-
 Specimen: Stools.
 Smears stained by gram or wet preparation to show
morphology and motility
 Stools are inoculated on Skirrow’s medium, and
incubated at 42 C at microaerophilic atmosphere.
 Colonies are identified by:
- morphology.
- Biochemical reactions.
- sensitivity to antibiotics.
 Serologic detection of antibodies by ELISA is useful
in patients with Arthritis or Guillain-Barre
syndrome.

55. Treatment:-
Mainly fluid and electrolyte
replacement.
C-jejuni is sensitive to
erythromycin and ciprofloxacin.

57. The Flagellae
The
Virulence
Factor:
Vaculating
cytotoxin
(VacA)Adhesins
The
Virulence
Factor:
Cytotoxin-
associated
protein(Cag A)
Urease

58. Summary: H.pylori

59. Summary: C.jejuni

60. H.pylori C.jejuni
-Motile with multiple flagella at one
pole.
-Motile with single flagellum at one or
both poles.
-Highly urease positive. -urease negative.
-Culture: - High humidity.
- 37°C.
- 7 days.
-Culture:
- 42°C.
- 5 days.
-Chronic gastritis,………………. -Enterocolitis,……………
-Man is the only reservoir host. -Animals are the major source of
infection.
-Human to human less common.