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Enteric Bacteria

Enteric Bacteria. Prof. Dr. Asem Shehabi Faculty of Medicine University of Jordan. Enteric Bacteria.

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Enteric Bacteria

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  1. Enteric Bacteria Prof. Dr. Asem Shehabi Faculty of Medicine University of Jordan

  2. Enteric Bacteria • General Characteristics: Gram-ve Bacilli, Facultative Anaerobes, Oxidase-negative.. Part Intestinal Normal Flora.. Humans, Animals, Birds.. Common Waste water, Natural Water, Soil, Vegetation. • OpportunisticPathogens/Obligate Pathogens.. Enterotoxins, Endotoxins, Capsules, Flagella, Pili • Coliform Group: 1. Escherichia coli: Urinary Tract Infect (40-70%)..Single Organism, Septicemia, Neonatal Meningitis, Wounds. Diarrheagenic E coli strains: - Enteropathogenic:Infants.. mild-chronic diarrhea, Enterotoxigenic.. Heat-Labile/Stable Enterotoxin, Watery diarrhea.. More Children than Adults.. Travelers diarrhea..Contamination Water/Vegetables / Fresh food

  3. Coli-form group-2 dairy products ..Mostly Self-limited.. No need for Antibiotics treatment. - Enterohaemorrhagic .. Common in intestinal Cattels, verotoxins.. Contamination Ground meat/Hamburger,Dairy products..Bloody diarrhea.. Haemolytic-ureamic syndrome, pertonitis, Kidney failure..Outbreaks of infections. • E. coli is used as indicator for detection of water & Food fecal contamination. 2. Klebsiella-Enterobacter –Serratia species: UTI, Septicemia, Wounds.. Rare Meningitis.. Common Hospitalized patients. • K. pneumoniae.. Large polysaccharide.. capsule.. Nosocomial Pneumonia.

  4. E. coli Culture – Red color on MaConkey agar indicates Lactose-positive & Gram-stain

  5. E.coli-Flagella-Fimbriae-Pili Klebsiella pneumonia-Capsule

  6. Coliform group-3 • E.coli, Klebsiella-Enterobacter –Serratia spp.. Lactose+ve , urease-ve & oxidase-negative.. • Klebsilla spp. often encapsulated.. Non-motile • 3. Proteus-Providencia-Morganella species:Lactose-ve & urease positive.. cause UTI, Septicemia, Wounds.. Commonly in Hospitalized patients. • Lab Diagnosis:All Enteric bacteria grow on MacCokeny-, Blood-, CLED-agar. Full identification done using Biochemical Tests.. Antibiotic Susceptibility must be done.

  7. 4. Pseudomonas group • Gram-ve bacilli, Oxidase-positive, Single polar flagellum,Fimbriae, obligate aerobe, widely distributed in human intestine, animal, plants, environment & water. Survive in disinfection solutions.. 70% Alcohol..contaminate Hospital sinks & equipments. • P. aeruginosa: Most common causes of human & animal infections.. Produce several hemolytic-protolytic enzymes, toxins, fluorescent pigments-pyocyanin / Burn-Blue Green Pus.. can overcome host defenses.. Wounds,, External Otitis Media, Septicemia, Pneumonia, UTI, Nosocomial Infection, Mutlidrug Resistance.. Intrinsic-R to many antibiotics..Common Nosocomial/ opportunistic Pathogen.

  8. 5-Salmonella group • Gram-ve bacilli.. Lactose-ve, urease-ve, Motile, Facultative Anaerobes.. Endotoxin/LPS, Cytotoxin.. common in Nature.. Humans, most domestic & wild Animals, Birds, Reptiles ..Develop of specific antibodies during invasive infection against their O/H- Antigens.. • Salmonellosis: • 1-Gastroenteritis/ Food-poisoning Salmonella: S. enterica/ enteritidis.. Numerous Serotypes.. Common Farm Chickens, Pets.. Contamination Chicken Meat-Eggs, Water.. Fecal-Oral Infection.. Incub. 8-24 h.. Mild-Severe Diarrhea, Vomiting, Fever.. Mostly Self-Limited in Adults. More severe infection in children.. Septicemia-Meningitis in Immuno-compromised Pat.

  9. V. cholerae – Salmonella/ Flagella

  10. Hekton–Enteric agar for Isolation of Salmonella (E.coli-Salmonella growth)

  11. Typhoidal Salmonella 2- Typhoidal Salmonella:Human Enteric Fever.. Salmonella enterica /subtype Typhi & Paratyhi A, B, C., Fecal-Oral route, Fecal water contamination or drinks/ Fresh Food.. Intestine..Blood, Meningis,Urinary tract.. Incubation Period 1-3 Weeks, high Fever up to 42, Diarrhea, constipation, Septicemia, Meningitis, Hepatospenomegaly, Intestinal Perforation.. Healthy Carriers.. Mostly females in Gallbladder.. Less Intestine.. Repeat chronic infection.. Stool Excretion..single cases and community water outbreaks. • Lab Diagnosis:Culture Feces, blood, Urine, CSF, Selective Media.. Serological Widel Test for detection of specific antibodies against O & H antigens ( Titer > 160 ).. Antibiotic, Human vaccine available.

  12. 6-Shigella group • Shigella species.. Gram-ve bacilli, cause Only human disease.. Endo/Enterotoxins.. Susceptible to Dryness, Acid, Low-High Tempt.Fecal-Oral infection.. Water, fresh Vegetations,Common serotypes, S. Sonnei, Sh.boydii Sh. flexneriPurulent-Bloody-Diarrhea..Fever abdominal pain..Recovery 2-4 days with treatment.. No chronic healthy Carriers. • S.dysenteriae.. Enterotoxin (Neurocytotoxin), Severe Necrosis, high Fever, Severe Purulent-Bloody-Diarrhea & Abdominal Cramps, CNS affection.. Rare Septicemia. • Lab Diagnosis:Feces Culture.. S-S Agar, Hecton–Enteric Agar.. Recommended Antibiotic Treatment, Control Sanitation & hygiene.. water, fresh Food.

  13. 7-Vibrio cholerae • Gram-veVibrios.. Oxidase-positive & Motile, AerobicAlkaline Medium (pH >8-9)..Killed in low acidity.. Survive in saline water for long time.. Endemic In India/Bangladish.. Highlyinfectious.. EpidemicHuman Outbreaks.. Water, Fresh Green leaves & Food • V. cholera-01: Type V. cholera El-Tor.. Only Human.. Fecal-Oral Infection, multiply small intestine..release Cholera-toxin.. Heat-labile enterotoxin, Incub. 8-48 h.. Severe Watery Diarrhea, Dehydration, Shock.. Death. Within 24 hrs..No invasive infection. • Lab Diagnosis: Feces Culture.. Selective TCBS agar. • Treatment: Replacement Fluids & Electrolytes.. Antibiotic.. Public Heath Measurements.. Human Vaccine recommended for Refuges & Army.

  14. Cholera

  15. TCBS agar for isolation of V.cholerae/Salmonella–Shigella agar (Lactose-negative)

  16. 8-Brucella species • Brucellosis/Malta Fever..Gram-vecoccobacilli..Non-motile,Intracellular, Endotoxins.. Primarily a Pathogens of Animals (Zoonosis), Localized Infection in reproductive Organs.. Sepsis, Abortions. • Br. abortus(Cattel), Br. melitensis(Goats/Sheep). • Human Brucellosis/Malt Fever : Mostly Br. melitensis.. Rare Other species in Jordan. • Transmitted to Humans.. Unpasteurized Milk/Milk Products.. Cheese, Direct Animal Contact.. Few Cells Enter Through GI, Skin Abrasions, Eye, Inhalation/Droplets.. Intracellular ..Lymphatic System.. Septicemia, Meningitis, Chronic disease

  17. Brucella-2 • Clinical Features:Incub. 1-6 Weeks.. Intermittent fever, headaches, fatigue, joint and bone pain, GI Symptoms, Sweats, Back Pains, Acute- Subacute-Chronic Infections. • Common Complications: Arthritis, Meningitis-CNS, Osteomylitis, Localized Lesions in any body part. • Lab Diagnosis:Culture Blood, CSF, Bone marrow (Chronic Infection).. Brucella agglutination Test.. Specific Antibodies • Treatment: 6-8 Weeks with Antimicrobial drugs • Prevention:Control Brucella in Animals by slaughtering infected animals .. Animal Vaccination, Pasteurization Milk/ Milk Products

  18. 9-Campylobacter Species • Campylobacter jejuni, is Gram-negative slender, curved, motile by one/ two polar Flagellium, Spiral form, Grow Microaerophilic at 37-42..Normal Intestines flora all Birds, Animal..dogs, cats.. contaminated often Chicken Meat, Milk, food, water. • It is primarily an animal pathogen causing abortion and enteritis in sheep and cattle. • Common cause of food-poisoning, important enteric pathogen since 1976.. In Western Countries. • C. jejuni .. Incubation 2-5 days..release Cytotoxins.. Intestinal inflammation..causes mild-moderate bloody-water diarrhea, Children.. , Other symptoms often present are fever, abdominal pain, nausea, headache and muscle pain..Rare Sepsis & complication Arthritis, • Diagnosis: Stool culture .. Selective culture Media

  19. Cambylobacter Cell morphology

  20. 10-Helicobacter Species • Helicobacter pyloriis a spiral shaped bacterium..One polar flagella.. Colonize only mucus lining cover mucosa of Gastric Antrim.. and duodenum.. Produce extensive Urease..Split urea to Ammonia..release Cytotoxin.. Mild-sever ulceration • The stomach is protected from its own gastric juice by a thick layer of mucus that covers the stomach lining. • Helicobacter colonize and infect only humans worldwide, where up to 10% of children & 80% of adults can have evidence of an H. pylori infection - usually without having any clinical signs or symptoms.

  21. Helicobacter

  22. Helicobacter Species-2 • Common symptoms: gastritis or peptic ulcer /Stomach.. duodenal ulcers ..burning, Abdomen Pain, Nausea, Vomiting. • Persistence of ulcers .. Development of Stomach Cancer and Lymphoma..1-3% • H. pylori can be successfully eradicated using a combination of certain antibiotics and medicines that suppress stomach acid production. Common Re-occurrence of infection & disease • Diagnosis: Urea Breath Test, Culture Stomach Biopsy.. Culture on Selective Medium.. 42C.. • Serological test for specific antibodies is not significant

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