enterobac05

Slide1: 

Faculty: Dr. Alvin Fox ENTEROBACTERIACEAE, VIBRIO, CAMPYLOBACTER AND HELICOBACTER

Key Words: 

Key Words Opportunistic diseases Shigella Diarrhea Bacillary dysentery Diarrhea Shiga toxin Urinary tract infections Salmonella enteritidis Lactose positive/negative Salmonellosis Enteropathogenic E. coli Salmonella cholerae-suis Enterotoxigenic E. coli Salmonella typhi Heat stable toxin Typhoid Heat labile toxin Vi Enteroinvasive E. coli Yersinia entercolitica Enterohemorrhagic E. coli Vibrio cholerae Vero toxin (Shiga-like) Choleragen (cholera toxin) Hemolysin Campylobacter jejuni pili Helicobacter pylori

Slide3: 

septicemia, pneumonia, meningitis urinary tract infections Citrobacter Enterobacter Escherichia Hafnia Morganella Providencia Serratia Opportunistic diseases -Enterobacteriaceae

Enterobacteriaceae: 

Enterobacteriaceae gastrointestinal diseases Escherichia coli Salmonella Shigella Yersinia entercolitica

Slide5: 

Histocompatibility antigen (HLA) B27 Enterobacteriaceae Salmonella Shigella Yersinia Not Enterobacteriaceae Campylobacter Chlamydia Reiter's syndrome

Slide6: 

community acquired otherwise healthy people Klebsiella pneumoniae respiratory diseases prominent capsule urinary tract infection fecal contamination E. coli Proteus urease (degrades urea) alkaline urine Enterobacteriaceae

Enterobacteriaceae: 

Enterobacteriaceae gram negative facultative anaerobic rods – oxidase negative (no cytochrome oxidase)

Slide8: 

E. coli lactose positive not usually identified lactose positive sp. common, healthy intestine Shigella, Salmonella,Yersinia lactose negative identified Feces

Slide9: 

other sites identified biochemically Enterobacteriaceae

Serotypes: 

Serotypes reference laboratory antigens O (lipopolysaccharide) H (flagellar) K (capsular)

Diarrhea and Dysentery: 

Diarrhea and Dysentery

Escherichia coli: 

Escherichia coli

Slide13: 

E. coli and Shigella genetically very similar many similarities in diseases Escherichia coli

Slide14: 

Enteropathogenic E. coli destruction of surface microvilli fever diarrhea vomiting nausea non-bloody stools

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Enterotoxigenic E. coli diarrhea like cholera milder travellers diarrhea

Enterotoxigenic E. coli : 

Enterotoxigenic E. coli Heat labile toxin like choleragen Adenyl cyclase activated cyclic AMP secretion water/ions Heat stable toxin Guanylate cyclase activated cyclic GMP uptake water/ions

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Dysentery - resembles shigellosis Enteroinvasive E. coli (EIEC )

Slide18: 

Enterohemorrhagic E. coli Usually O157:H7 Flagella

Meat: 

Meat Hemorrhagic bloody, copious diarrhea few leukocytes afebrile hemolytic-uremic syndrome hemolytic anemia thrombocytopenia (low platelets) kidney failure

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Vero toxin “shiga-like” Hemolysins Enterohemorrhagic E. coli

Treatment -gastrointestinal disease: 

Treatment -gastrointestinal disease fluid replacement antibiotics not used usually unless systemic e.g. hemolytic-uremia syndrome

E. coli fimbriae: 

E. coli fimbriae mannose Type 1 galactose glycolipids glycoproteins P

Shigella: 

Shigella S. flexneri, S. boydii, S. sonnei, S. dysenteriae bacillary dysentery shigellosis bloody feces intestinal pain pus

Shigellosis: 

Shigellosis within 2-3 days epithelial cell damage

Shigella sonnei: 

Shigella sonnei

Shiga toxin: 

Shiga toxin enterotoxic cytotoxic inhibits protein synthesis lysing 28S rRNA

Shigellosis: 

Shigellosis man only "reservoir" mostly young children fecal to oral contact children to adults transmitted by adult food handlers unwashed hands

Treating shigellosis: 

Treating shigellosis manage dehydration patients respond to antibiotics disease duration diminished

Salmonella : 

Salmonella Flagella

Salmonella: 

Salmonella 2000 antigenic "types” genetically single species S. enterica disease category S. enteritidis many serotypes S. cholerae-suis S. typhi

Salmonellosis: 

Salmonellosis S. enteritidis the common salmonella infection poultry, eggs no human reservoir Gastroenteritis nausea vomiting non-bloody stool self-limiting (2 - 5 days)

Salmonellosis: 

Salmonellosis uncomplicated cases (the vast majority) antibiotic therapy not useful

S. cholerae-suis: 

S. cholerae-suis much less common septicemia antibiotic therapy essential

Typhoid: 

Typhoid enteric fever severest salmonella disease Salmonella typhi rare in US epidemics third world Europe historical

Salmonella typhi: 

Salmonella typhi human reservoir carrier state common contaminated food water supply poor sanitary conditions

Typhoid: 

Typhoid acute phase, gastroenteritis gall bladder shedding, weeks septicemia - occurs 10-14 days lasts 7 days gastrointenteritis

S. typhi: 

S. typhi Vi (capsular) antigen protective

Typhoid -Therapy: 

Typhoid -Therapy Antibiotics essential Vaccines ineffective

Yersiniosis: 

Yersiniosis Yersinia entercolitica gastroenteritis Scandinavia common US colder regions

Yersiniosis: 

Yersiniosis transmission fecal contamination, domestic animals water milk meat

Yersinia: 

Yersinia Diarrhea fever abdominal pain antibiotic therapy recommended occassional bacteremia

Yersinia -isolation: 

Yersinia -isolation cold enrichment

Slide43: 

similar less severe disease Y. pseudotuberculosis

Vibrio cholerae: 

Vibrio cholerae

Vibrios: 

Vibrios Gram negative rods comma shaped facultative anaerobes oxidase positive simple nutritional requirements readily cultivated

Occurrence -cholera : 

Occurrence -cholera third world US uncommon traveler ingestion of sea-food

Slide47: 

food feces water fresh salt Transmission - V. cholerae

Cholera - attachment: 

Cholera - attachment

Cholera toxin- Choleragen: 

Cholera toxin- Choleragen B binds to gangliosides provides channel for A A catalyses ADP-ribosylation regulator complex activates adenylate cyclase

Slide50: 

massive secretion of ions/water into gut lumen dehydration and death therapy fluid replacement antibiotic therapy vaccination partially effective not generally used international travelers Cholera -therapy

Slide51: 

raw sea-food grows best in high salt not common in US diarrhea Vibrio parahemolyticus

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CAMPYLOBACTER & HELICOBACTER Gram negative rods curved or spiral genetically related

Campylobacter : 

Campylobacter

Slide54: 

C. jejuni infects the intestinal tract of animals cattle and sheep major cause of abortions

Transmission: 

Transmission milk meat products

Campylobacter: 

Campylobacter

Isolation - Campylobacter: 

Isolation - Campylobacter microaerophilic grows best 42oC

Slide58: 

diarrhea malaise fever abdominal pain usually self-limiting antibiotics occassionally bacteremia small minority Campylobacter - symptoms

Helicobacter pylori: 

stomach mucosa ulcers Helicobacter pylori

Urease: 

Urease Important in neutralizing stomach acid

Slide61: 

Culture - urease NH4+ CO2 mucosal endoscopy NH4 radioactive CO2 breath after feeding radioactive urea Diagnosis -Helicobacter

Therapy -Helicobacter: 

Therapy -Helicobacter Antibiotics cures ulcers

Summary statement: 

Summary statement sanitary measures protect the water supply food/water borne epidemics rare US common third world zoonotic infections contaminated animal products less well controlled common US and elsewhere

Therapy: 

Therapy severe diarrhea fluid replacement essential antibiotic therapy sometimes used in local infection but always in systemic disease