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Enterobacteriaceae II V ibrio , Campylobacter, Helicobacter (Gram negative, enteric tract), Lecture 43. Faculty: Dr. Alvin Fox. Typhoid. enteric fever severest salmonella disease Salmonella typhi rare in US epidemics third world Europe historical . Salmonella typhi.

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slide1

EnterobacteriaceaeII

Vibrio, Campylobacter,Helicobacter (Gram negative, enteric tract), Lecture 43

Faculty: Dr. Alvin Fox

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
typhoid4
Typhoid
  • septicemia
  • - occurs 10-14 days
  • lasts 7 days

macrophage

  • gall bladder
  • shedding, weeks
  • acute phase, gastroenteritis

gastroenteritis

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
yersiniosis8
Yersiniosis
  • transmission
    • fecal contamination, domestic animals
      • water
      • milk
    • meat
yersinia
Yersinia

Gut lumen

Diarrhea

fever

abdominal pain

antibiotic therapy recommended

occassional bacteremia

yersinia isolation
Yersinia -isolation

cold enrichment

slide11

Y. pseudotuberculosis

  • similar
  • less severe disease
vibrio s
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
slide15

Transmission - V. cholerae

feces

  • water
  • fresh
  • salt
  • food
cholera toxin choleragen
Cholera toxin- Choleragen
  • B binds to gangliosides
  • provides channel for A
  • A catalyses ADP-ribosylation
    • regulator complex
    • activates adenylate cyclase
slide18

Cholera -therapy

  • massive secretion of ions/water into
  • gut lumen
  • dehydration and death
  • therapy
    • fluid replacement
    • antibiotic therapy
  • vaccination
    • partially effective
    • not generally used
    • international travelers
slide19

Vibrio parahemolyticus

  • raw sea-food
  • grows best in high salt
  • not common in US
  • diarrhea
slide20

Vibrio vulnificus

  • Wound infections
  • Most common Vibrio infection in the US
slide21

CAMPYLOBACTER& HELICOBACTER

  • Gram negative rods
  • curved or spiral
  • genetically related
transmission
Transmission
  • infects the intestinal tract of animals
  • chickens, cattle, sheep
  • Transmitted
    • milk
    • meat products
campylobacter
Campylobacter

Gut lumen

isolation campylobacter
Isolation - Campylobacter
  • microaerophilic
  • grows best 42oC
slide27

Campylobacter - symptoms

  • diarrhea
  • dysentery common
  • malaise
  • fever
  • abdominal pain
  • usually self-limiting
  • antibiotics occasionally
  • bacteremia
    • small minority
helicobacter pylori
Helicobacter pylori
  • stomach mucosa
  • ulcers
urease
Urease
  • Important in neutralizing stomach acid

- pathogenesis

slide30

Diagnosis -Helicobacter

  • Culture
  • - urease NH4+ CO2
  • Direct detection of urease
  • CO2 derivedfrom labeled urea
therapy helicobacter
Therapy -Helicobacter
  • Antibiotics
    • cures ulcers
summary statement
Summary statement
  • sanitary measures
    • protect the water supply
  • food/water borne epidemics
    • infrequent, US
    • common third, world
  • zoonotic infections
    • contaminated animal or vegetable products
    • less well controlled than man-to-man
therapy
Therapy
  • severe diarrhea
    • fluid replacement essential
  • antibiotic therapy sometimes used in local
  • infection but always in systemic disease