BAKTERI PENYEBAB

GASTROENTRITIS DAN
HELICOBACTER PYLORI
OLEH :
MUHAMMAD ASAAD MAIDIN
BAGIAN MIKROBIOLOGI, FAKULTAS
KEDOKTERAN UNHAS
Enterohemorrhagic
( EHEC, VTEC )
Enteroadherent ( EAEC )

Shigella dysentriae, S. flexnery,
S.boydii, S.sonnei
Salmonella typhi
Salmonella enteritidis*

Vibrionaceae

Vibrio cholerae
Vibrio Parahaemolyticus

Campylobacter and Helicobacter

Campylobacter fetus, C.jejuni
Helicobacter pylori
Human carriers, possibly
catle
Human carriers
Human GI tract

Human GI tract
Cattle, poultry


Human GI tract
Seawater, seafood




Animals, human carriers
Unknown
Diarrhea, hemorrhagic colitis,
hemolytic-uremic syndrome
Diarrhea
Dysentery, diarrhea

Typhoid fever, bacteremia
Gastroenteritis


Profuse, watery diarrhea
Watery diarrhea




Diarrhea, septicemia
Chronic gastritis, peptic, ulecer,
gastric cancer
EAEC=enterodherent E.coli; EHEC=enterohemorrhagie; ETEC= enterotoxigenic; E.coli;
G1=gastrointestinal; VTEC= verotoxin-producing E.coli. S. enteritidis is subclassified into hundreds
of serotypes




Gastrointestinal









Urinary tract infections
Klebsiella pneumoniae
Pseudomonas aeruginosa
Staphylococcus aureus
Anaerobic bacteria
Vibrio cholerae
Vibrio parahaemolyticus
Escherichia coli
Salmonella species *
Shigella species
Campylobacter species
Helicobacter pylori
Clostridium perfringens
Clostridium difficile
Bacillus cereus
Escherichia coli
Pseudomonas aeruginosa
Enterobacter species
Kl;ebsiella species
Proteus species
Table 52-1. Noninvasive Versus Invasive Diarrhea

Noninvasive Invasive ( Bacterial / Parasitic )

Stool Profuse secretory Dysentery (blood,mucus,PMN lukocytes
( Severe, watery )

Fever No Yes
Systemic No Yes
Abdominal pain Mild Severe ( carmping, tenesmus )
Site of infection Small intestine Colon


PMN = polymorphonucleaR
Tabel 52.2 . Features of specific Types of Noninvasive Bacterial diarrhea
Vibrio
Cholerae
Escherichia
coli
Clostridium
prefringens
Bacillus
cereus*
Staphylococcus
aureus+
Incubation (
hours )

Duration (
Housr )

Abdominal
cramps

Vomiting
12 72



48 120

0

+
24 72



24 48

+


6 12



12 24

++++

+
3 8



12 24

++

++
1 6



6 12

++

++++
Diarrhea can be caused by performed toxin or by toxin elaborated in the intestine by proliferating bacteria
+ Diarrhea can be caused by ingestion of toxin contaminated food
Table 52-3. Features of Specific Types of Invasive Bacterial Diarrhea
Shigella Escherich
i coli
Salmonella Yersinia
enterocoliti
ca
Incubation
( hours )
Duartion
(hours)
Abdominal
pain
Vomiting
Fever
24 72

48 120

++++

++
++
24 72

24 48

++++

+
++
8 48

12 24

+

+
++++
1 6

6 12

++

++
++
Table 52-4. Clinical and Epidemiological Features of Bacterial Food Poisoning

Cause
Percentage
of Reported
Outbreaks
Incubatio
n Period
( hours )
Clinical
Presentation
Characteristic
Foods
Intoxication
Bacillus cereus
Clostridium
botolinum
Staphylococcus
aureus
Vibrio

parahaemolyticus
Infections
Bacillus cereus

clostridium
perfringens
Salmonella

Shigella

1 2
5 15

15 25

1 2


1 2

5 15

10 30

2 5

1 6
12 27

2 4

10 24


6 24

9 15

6 48

12 48

Vomiting
Neuromuscular
Paralysis
Vomiting
diarrhea

Watery diarrhea


Watery diarrhea

Watery diarrhea

Dysentery

Dysentery

Re-warmed fried
rice
Canned foods of all
types
Metas, custrad,
Salads

Shellfish


Meat, poultry,
vegetables
Meat, poultry

Poultry, eggs, meat,
vegetables

Variable
HELICOBACTER PYLORI
# Spiral shaped or curved negative gram
rod similar in appearance to
campylobacters, but differ sufficiently in
certain biochemical and flagellar
characteristics.
# Motile active
# On media skirrow or cocolate medium,
growing with in 3-6 hari, 37C,
# microaerofilic.
# Oxidase positive
# Catalase positive
# Strongly urease positive
(Campylobacter urtease negative)
# Flagella positive

The environment found in the mucous layer
of the gut, a transitional zone between the
anaerobic lumen and the oxygenated mucosa
Size 3.5x o,6 um, with 1.5 wave lengths and 4
to 7 sheated flagella at one end of the
organism.
HP causes gastritis and peptic ulcer.
Infection with HP is a risk factor for gastric
carcinoma.
Transmission : person to person because
there is clustering with in families.
Laboratory diagnosis:
= Gram stained smears(endoscopy or
biopsy)
=


HELICOBACTER PYLORI
# Batang gram negative, bentuk spiral
# Motile aktif
# Pada media skirrow atau media coklat,
tumbuh dlm 3-6 hari, 37C, mikroaerofilik
# Oksidase positive, Katalase positive
#Memproduksi Urease ( aktifitas urease
yang potensial)
# Memiiki Flagella
. Related with gastritis,ulcus duodenum,
gastric ulcus and gastric carsinoma.
H.P memiliki banyak ciri yang sama dengan
Campylobacter yeyuni.
Media selektip untuk isolasi HP, biasanya
ditambah dengan antibiotik tertentu.
Cukup motile , meski di mukus mampu
menembus kepermukaan epithel.
H.P menjadi faktor resiko terbesar bagi
kanker lambung.