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Enterobacteriaceae2 43

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Enterobacteriaceae2 43

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Enterobacteriaceae2 43

  1. 1. Faculty: Dr. Alvin Fox ENTEROBACTERIACEAE, VIBRIO, CAMPYLOBACTER AND HELICOBACTER (2) www.freelivedoctor.com
  2. 2. Typhoid <ul><li>enteric fever </li></ul><ul><li>severest salmonella disease </li></ul><ul><li>Salmonella typhi </li></ul><ul><li>rare in US </li></ul><ul><li>epidemics </li></ul><ul><ul><li>third world </li></ul></ul><ul><ul><li>Europe </li></ul></ul><ul><ul><ul><li>historical </li></ul></ul></ul>www.freelivedoctor.com
  3. 3. Salmonella typhi <ul><li>human reservoir </li></ul><ul><ul><li>carrier state common </li></ul></ul><ul><li>contaminated food </li></ul><ul><li>water supply </li></ul><ul><li>poor sanitary conditions </li></ul>www.freelivedoctor.com
  4. 4. Typhoid <ul><li>acute phase, gastroenteritis </li></ul><ul><li>gall bladder </li></ul><ul><li>shedding, weeks </li></ul><ul><li>septicemia </li></ul><ul><li>- occurs 10-14 days </li></ul><ul><li>lasts 7 days </li></ul>gastroenteritis macrophage www.freelivedoctor.com
  5. 5. S. typhi <ul><li>Vi (capsular) antigen </li></ul><ul><ul><li>protective </li></ul></ul>www.freelivedoctor.com
  6. 6. Typhoid -Therapy <ul><li>Antibiotics </li></ul><ul><ul><li>essential </li></ul></ul><ul><li>Vaccines </li></ul><ul><ul><li>ineffective </li></ul></ul>www.freelivedoctor.com
  7. 7. Yersiniosis <ul><li>Yersinia entercolitica </li></ul><ul><ul><li>gastroenteritis </li></ul></ul><ul><ul><li>Scandinavia common </li></ul></ul><ul><ul><li>US </li></ul></ul><ul><ul><ul><li>colder regions </li></ul></ul></ul>www.freelivedoctor.com
  8. 8. Yersiniosis <ul><li>transmission </li></ul><ul><ul><li>fecal contamination, domestic animals </li></ul></ul><ul><ul><ul><li>water </li></ul></ul></ul><ul><ul><ul><li>milk </li></ul></ul></ul><ul><ul><li>meat </li></ul></ul>www.freelivedoctor.com
  9. 9. Yersinia -isolation cold enrichment www.freelivedoctor.com
  10. 10. <ul><li>similar </li></ul><ul><li>less severe disease </li></ul>Y. pseudotuberculosis www.freelivedoctor.com
  11. 11. Vibrio cholerae www.freelivedoctor.com
  12. 12. Vibrio s <ul><li>Gram negative rods </li></ul><ul><li>comma shaped </li></ul><ul><li>facultative anaerobes </li></ul><ul><li>oxidase positive </li></ul><ul><li>simple nutritional requirements </li></ul><ul><li>readily cultivated </li></ul>www.freelivedoctor.com
  13. 13. Occurrence -cholera <ul><li>third world </li></ul><ul><li>US </li></ul><ul><ul><li>uncommon </li></ul></ul><ul><ul><ul><li>traveler </li></ul></ul></ul><ul><ul><ul><li>ingestion of sea-food </li></ul></ul></ul>www.freelivedoctor.com
  14. 14. <ul><li>food </li></ul>feces <ul><li>water </li></ul><ul><li>fresh </li></ul><ul><li>salt </li></ul>Transmission - V. cholerae www.freelivedoctor.com
  15. 15. Cholera - attachment Gut lumen www.freelivedoctor.com
  16. 16. Cholera toxin- Choleragen <ul><li>B binds to gangliosides </li></ul><ul><li>provides channel for A </li></ul><ul><li>A catalyses ADP-ribosylation </li></ul><ul><ul><li>regulator complex </li></ul></ul><ul><ul><li>activates adenylate cyclase </li></ul></ul>www.freelivedoctor.com
  17. 17. <ul><li>massive secretion of ions/water into </li></ul><ul><li>gut lumen </li></ul><ul><li>dehydration and death </li></ul><ul><li>therapy </li></ul><ul><ul><li>fluid replacement </li></ul></ul><ul><ul><li>antibiotic therapy </li></ul></ul><ul><li>vaccination </li></ul><ul><ul><li>partially effective </li></ul></ul><ul><ul><li>not generally used </li></ul></ul><ul><ul><li>international travelers </li></ul></ul>Cholera -therapy www.freelivedoctor.com
  18. 18. <ul><li>raw sea-food </li></ul><ul><li>grows best in high salt </li></ul><ul><li>not common in US </li></ul><ul><li>diarrhea </li></ul>Vibrio parahemolyticus www.freelivedoctor.com
  19. 19. CAMPYLOBACTER & HELICOBACTER <ul><li>Gram negative rods </li></ul><ul><li>curved or spiral </li></ul><ul><li>genetically related </li></ul>www.freelivedoctor.com
  20. 20. Campylobacter jejuni pleomorphic www.freelivedoctor.com
  21. 21. Transmission <ul><li>infects the intestinal tract of animals </li></ul><ul><li>chickens, cattle, sheep </li></ul><ul><li>Transmitted </li></ul><ul><ul><li>milk </li></ul></ul><ul><ul><li>meat products </li></ul></ul>www.freelivedoctor.com
  22. 22. Campylobacter Gut lumen www.freelivedoctor.com
  23. 23. Isolation - Campylobacter <ul><li>microaerophilic </li></ul><ul><li>grows best 42 o C </li></ul>www.freelivedoctor.com
  24. 24. <ul><li>diarrhea </li></ul><ul><li>malaise </li></ul><ul><li>fever </li></ul><ul><li>abdominal pain </li></ul><ul><li>usually self-limiting </li></ul><ul><li>antibiotics occassionally </li></ul><ul><li>bacteremia </li></ul><ul><ul><li>small minority </li></ul></ul>Campylobacter - symptoms www.freelivedoctor.com
  25. 25. <ul><li>stomach mucosa </li></ul><ul><li>ulcers </li></ul>Helicobacter pylori www.freelivedoctor.com
  26. 26. Urease <ul><li>Important in neutralizing stomach acid </li></ul>www.freelivedoctor.com
  27. 27. <ul><li>Culture </li></ul><ul><li>- urease NH 4 + CO 2 </li></ul>Diagnosis -Helicobacter www.freelivedoctor.com
  28. 28. Therapy - Helicobacter <ul><li>Antibiotics </li></ul><ul><ul><li>cures ulcers </li></ul></ul>www.freelivedoctor.com
  29. 29. Summary statement <ul><li>sanitary measures </li></ul><ul><ul><li>protect the water supply </li></ul></ul><ul><li>food/water borne epidemics </li></ul><ul><ul><li>rare US </li></ul></ul><ul><ul><li>common third world </li></ul></ul><ul><li>zoonotic infections </li></ul><ul><ul><li>contaminated animal products </li></ul></ul><ul><ul><li>less well controlled </li></ul></ul><ul><ul><li>common US and elsewhere </li></ul></ul>www.freelivedoctor.com
  30. 30. Therapy <ul><li>severe diarrhea </li></ul><ul><ul><li>fluid replacement essential </li></ul></ul><ul><li>antibiotic therapy sometimes used in local </li></ul><ul><li>infection but always in systemic disease </li></ul>www.freelivedoctor.com

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