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ENTEROBACTERIACEAE,

VIBRIO, CAMPYLOBACTER
AND HELICOBACTER (1)

Faculty: Dr. Alvin Fox

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Key Words
Opportunistic diseases Shigella
Diarrhea Bacillary dysentery
Dysentery 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
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Opportunistic diseases
-Enterobacteriaceae
– septicemia,
– pneumonia,
– meningitis
– urinary tract infections

Citrobacter
Enterobacter
Escherichia
Hafnia
Morganella
Providencia
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Serratia
Enterobacteriaceae
• gastrointestinal diseases
– Escherichia coli
– Salmonella
– Shigella
– Yersinia entercolitica

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Reiter's syndrome
• Histocompatibility antigen (HLA) B27

– Enterobacteriaceae
*Salmonella
*Shigella
*Yersinia
– Non-Enterobacteriaceae
*Campylobacter
*Chlamydia

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Enterobacteriaceae
• community acquired
• otherwise healthy people
– Klebsiella pneumoniae
* respiratory diseases
* prominent capsule

–urinary tract infection


–fecal contamination
*E. coli
*Proteus
– urease (degrades urea)
– alkaline urine
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Enterobacteriaceae

• gram negative facultative anaerobic rods


– oxidase negative (not cytochrome oxidase)

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

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Enterobacteriaceae

• other sites
– identified biochemically

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

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Diarrhea and Dysentery

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Caption: E. coli

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

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Enteropathogenic E. coli

destruction of surface microvilli

• fever
• diarrhea Gut lumen
• vomiting
• nausea
• non-bloody stools

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Enterotoxigenic E. coli

• diarrhea like cholera


• milder
• travellers diarrhea

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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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Enteroinvasive E. coli (EIEC )
• Dysentery
- resembles shigellosis

Gut lumen

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Enterohemorrhagic E. coli
• Usually O157:H7

Flagella Transmission electron


micrograph

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Transmission – meat products or
sewage-contaminated vegetables
• Hemorrhagic
– bloody, copious diarrhea
– few leukocytes
– afebrile
• hemolytic-uremic syndrome
– hemolytic anemia
– thrombocytopenia (low platelets)
– kidney failure

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Enterohemorrhagic E. coli

• Vero toxin
– “shiga-like”

• Hemolysins

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

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E. coli fimbriae
Type 1

mannose

galactose
– glycolipids
– glycoproteins

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Shigella

Modified from Fig, Dennis Kunkel


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

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Shigellosis
• within 2-3 days
– epithelial cell damage

Gut lumen

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Shiga toxin
• enterotoxic
• cytotoxic
• inhibits protein synthesis
– lysing 28S rRNA

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

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Treating shigellosis
• manage dehydration
• patients respond to antibiotics
– disease duration diminished

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Salmonella

[417]

Caption: Salmonella typhi - Gram-

negative, enteric, rod prokaryote (dividing); causes typhoid fever.


Magnification*: x5,530
Type: SEM
Keywords: 96430B.TIF bacilli bacillus bacteria bacterial pathogen bacterium division Gram-negative human disease infection prokaryote rod Salmonella typhi typhoid fever
enteric bacterial pathogen intestinal tract infection SEM |

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

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

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Salmonellosis

Gut lumen

uncomplicated cases (the vast majority)


antibiotic therapy not useful

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

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