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10.vibrio

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10.vibrio

  1. 1. Vibrio cholerae
  2. 2. Famiglia Vibrionaceae <ul><li>Bacilli ricurvi </li></ul><ul><li>Gram-negativi </li></ul><ul><li>Il loro habitat naturale comprende acque dolci e salate </li></ul>
  3. 3. Vibrio cholerae <ul><li>Forma a virgola (V.comma) </li></ul><ul><li>Gram negativi </li></ul><ul><li>Oxidase + </li></ul><ul><li>Mobili </li></ul><ul><ul><li>Flagello polare - mezzo liquido alcalino </li></ul></ul><ul><ul><li>Flagellazione mista - agar </li></ul></ul><ul><li>Isolamento definitivo </li></ul><ul><li>Robert Koch 1883 </li></ul>
  4. 4. -Poor sanitation and flooding in Mozambique. -Patients being treated for Cholera in Africa.
  5. 5. Malattia clinica <ul><li>Da leggera gastroenterite a colera </li></ul><ul><li>Semplici ferite infette a setticemia fatale </li></ul><ul><li>Fattori di rischio: </li></ul><ul><ul><li>Pesce crudo, es., frutti di mare </li></ul></ul><ul><ul><li>Viaggi o immigrazioni </li></ul></ul><ul><ul><li>Traumi accidentali e contatti con acqua contaminata </li></ul></ul>
  6. 6. Che cosa è il Colera? <ul><li>Infezione intestinale acuta causata da Vibrio cholerae. </li></ul><ul><li>Breve periodo di incubazione (< 2-5 gg ), produce una enterotossina che provoca crampi addominali, diarrea profusa, acquosa, contenente fiocchi di muco ( feci come acque di riso ). </li></ul><ul><li>90% di casi moderati, 10% morte. </li></ul><ul><li>Mancanza di trattamento causa perdita di elettroliti e di fluidi, disidratazione, shock, acidosi, rapida morte. </li></ul>(World Health Organization)
  7. 7. (Clark, 1999) Intestino infettato dal Vibrio cholerae.
  8. 8. Vibrio cholerae
  9. 9. Enterotossina <ul><li>Organismo </li></ul><ul><ul><li>Colonizza l’intestino breve </li></ul></ul><ul><ul><li>Si moltiplica e produce enterotossina </li></ul></ul><ul><li>Attivazione di adenilato ciclasi causa accumulo di cyclic adenosine monophosphate ( cAMP ) e quindi ipersecrezione di cloruro e bicarbonato nel lume intestinale e quindi efflusso di acqua per osmosi. </li></ul>
  10. 11. Enterotossina
  11. 12. Fattori di virulenza <ul><li>Enterotossina colerica </li></ul><ul><li>Motilità </li></ul><ul><li>Proteasi </li></ul><ul><li>Idrolisi di glicoproteine </li></ul><ul><li>Adesine fimbriali </li></ul><ul><li>TCP (tossina connessa al pilo) </li></ul><ul><li>ACF </li></ul><ul><li>Un solo gene regolatore toxR assicura la produzione coordinata della tossina colerica di TCP e ACF durante la fase di infezione. </li></ul>
  12. 13. Enterotossina <ul><li>TRATTAMENTO </li></ul><ul><ul><li>Reintegrazione massiva di liquidi ed elettroliti </li></ul></ul><ul><ul><li>Antibiotici abbreviano la durata, es., tetraciclina, gentamicina, cloramfenicolo </li></ul></ul>
  13. 14. Trattamento <ul><li>Reidratazione </li></ul><ul><li>1 liter of clean H 2 O </li></ul><ul><li>Sodium Chloride: 3.5 grams </li></ul><ul><li>Sodium Bicarbonate: 2.9 grams </li></ul><ul><li>Potassium Chloride: 1.5 grams </li></ul><ul><li>Glucose: 20 grams </li></ul>
  14. 15. Vibrio cholerae <ul><li>Il colera è comune nelle regioni tropicali/semitropicali , specialmente lungo fiumi e coste. </li></ul><ul><li>Aumento di casi di colera </li></ul><ul><ul><li>Viaggi in zone con epidemie </li></ul></ul><ul><ul><li>Aumento del consumo di pesce crudo ( sushi ) </li></ul></ul><ul><ul><li>Aumento dell’uso di piscine </li></ul></ul><ul><ul><li>Aumento della temperatura del pianeta </li></ul></ul>
  15. 16. Vibrio cholerae <ul><li>Epidemiologia </li></ul><ul><ul><li>Maggior parte delle epidemie in paesi in via di sviluppo </li></ul></ul><ul><ul><li>Aumento dei casi in USA (Gulf coast) ed in S. America </li></ul></ul><ul><li>Transmissione </li></ul><ul><ul><li>Principalmente acqua contaminata </li></ul></ul><ul><ul><li>Cibi impropriamente conservati o distribuiti </li></ul></ul>
  16. 17. Storia del Colera in tempi recenti <ul><li>1 st Pandemic- 1817-1823- Began in India and spread to Southeast Asia. </li></ul><ul><li>2 nd - 1829-1851-Began in Russia and spread to England across Atlantic into the St. Lawrence and NY. </li></ul><ul><li>3 rd -1852-1859 </li></ul><ul><li>4 th -1863-1879 </li></ul><ul><li>5 th -1881-1896 </li></ul><ul><li>6 th -1899-1923 </li></ul>
  17. 18. Most Recent Reports <ul><li>7 th Pandemic- Began in 1961, and is present on 6 continents. (Colwell, 1996) </li></ul><ul><li>10 African Nations - 41.159 cases, 3.488 deaths. South America - 251,553 cases, 2,618 deaths. Afghanistan - 14,402 in May-June of 1999 </li></ul><ul><li>(World Health Organization) </li></ul><ul><li>Vibrio cholerae 01, biotype El Tor and other new serogroups have developed. (Borroto, 2000) </li></ul>

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