VIBRIO CHOLERAE CHOLERA
CHARACTERISTICS • GRAM-NEGATIVE, COMMA SHAPED BACILLI • MOTILE – POLAR FLAGELLA • OXIDASE – POSITIVE • CATALASE – POSITIVE • ALKALNE PH ( 6.8 – 10.2) • SELECTIVE MEDIA ( TCBS ) • ALKALINE PEPTON WATER
ANTIGENICITY • SOMATIC – O ANTIGE • VIRIO CHOLERAE O-1 • NON- O-1 V. CHOLERAE • V. CHOLERAE O-139 ( BENGAL) - 1992 • BIOTYPES: 2 • CLASSICAL (MORE SEVERE) • EL-TOR • SEROTYPES: 3 • INABA , OGAWA , HIKOJIMA
HABITAT • HUMAN • MAIN SOURCE • NATURALLY • IN ACQUATIC ENVIRNMENT
PATHOGENESIS • INGESTION OF CONTAMINATED DRINK WATER , FOOD • ID - 10 – 10 • MULTIPLY IN SMALL INTESTINE , ILEUM ENTEROTOXIN SIMILAR TO HLET OF E. COLI • ACTIVATE ADENYLATE CYCLASE CAMP FLUIDS , EECTROLYTES DIARRHOEA , VOMITING
NO INTESTINAL INVASION • NO BACTEREMIA • NO SEPTICAEMIA • LESIONS ARE PATHOPHYSIOLOGICAL
CLINICAL PICTURE • INCUBATIN PERIOD (IP) • 1 – 4 DAYS • ACUTE ONSET • EFFORTLESS VOMITING • PROFUSE WATERY DIARRHOEA (RICE – WATER ) • RAPID DEHYDRATON (10 – 20 L/ DAY) • HYPOVOLAEMIC SHOCK - DEATH
IMMUNITY • VERY SHORT • REINFECTIONS(REPEATED ATTACKS) ARE COMMON
EPIDEMIOLOGY • HUMAN (ONLY HOST ) • POOR ENVIROMENTAL SANITATION • POOR WATER SUPPLY • CONTAMINATED WATER • INDIAN SUBCONTINENT,BANGLADESH • PANDEMICS - EL-TOR BIOTYPE • OUTBREAKS • EPIDEMICS ( PILGRIMAGES ) • EL- TOR PROLONGED CARRIAG (ENDEMIC INFECTION)
LABORATORY DIAGNOSIS • SPECIMENS : • STOOLS • RECTAL SWAB • MICROSCOPY: • DARTING MOVEMENT • CULTURE : • TCBS ( YELLOW COLONIES) • ALKALINE PEPTONE WATER(6 – 8 h) • SEROLOGICAL IDENTIFICATION • SLID AGGLUTINATION FOR SEROTYPES
TREATMENT • REHYDRATION • REPLACEMENT : FLUID , ELECTROLYTES • ANTIBIOTIC • TETRACYCLINE
PREVENTIONCONTROL • PATIENTS • ISOLATION , TREATMENT • CONTACTS • PROPHYLAXIS (TETRACYCLINE) • WATER • PURE SUPPLY , PROPER TREATMENT • SEWAGE • PROPER DISPOSAL • HEALTH EDUCATION
VACCIN • NO EFFECTIVE VACCINE AVAILABLE • KILLED (INJECTION) • LIVE ATTENUATED (ORAL) • REACTOGENIC • SHORT IMMUNITY
V.PARAHAEMOLYTICUS • FOOD POISONING • SEA FOODS (RAW , UNDERCOOKED) • HALOPHILIC (NACL) • GROWS ON TCBS AGAR • (GREEN COLONIES) • TREATMENT : • REHYDRATION
CAMPYLOBACTER • GRAM – NEGATIVE BACILLI • S- SHAPED (SPIRAL) • ACTIVELY MOTILE • OXIDASE POSITIVE • CATALASE POSITIVE • MICROAEROPHILIC ( 5 – 10% CO ) • NON CAPSULATED
SPECIES • C.JEJUNI • MOST COMMON • THERMOPHILIC (42C – NOT 25C ) • HIPPURATE HYDROLYSIS + • SELECTIVE MEDIA (SKIRROW’S ) • C. COLI • C. FETUS • GROW AT 25 C
DISEASES • ENTERITIS • 80 – 90% ( C. JEJUNI ) • C. COLI • SEPTICAEMIA , MENINGITIS,ENDOCAR. • C. FETUS • IMMUNOCOMPROMISED • EXTREME OF AGE
SOURCE • INTESTINE OF BIRDS ( CHIKEN ) • DOMESTIC ANIMALS , CATTELE(BEEF) • UNPASTEURISED MILK • CONTAMINATED WATER
CHARACTERISTICS • GRAM NEGATIVE SPIRAL SHAPED BACILLI • MICROAEROPHILIC • OXIDASE POSIIVE • UREASE POSITIVE
PATHOGENESIS • INVASIVE DISEASE ( COLON ) – ID:100 • DYSENTERIC LIKE ILLNESS • BLLODY DIARROEA • FEVER • ABDOMINAL PAIN • WATERY DIARROEA (ENTERTOXIN) • ILEUM • SEPTICAEMIA (IMMUNOCOMPROMISED)
TREATMENT • REHYDRATION • ELECTROLYTES • FLUIDS • ANTIBIOTIC : • ERYTHROMYCIN • CIPROFLOXACIN • GENTAMICIN ( SEPTICAEMIA )
HALICOBACTER PYLORI
HABITAT • GASTRIC MUCOSA ( MUCUS LAYER )
TREATMENT • AMOXACILLIN • METRONIDAZOLE + BISMUTH SUBCITRATE FOR 1 - 2 WEEK OR • CLARITHROMYCIN + AMOXACILLIN + OMEPRAZOLE FOR 1 WEEK
DISEASES • CHRONIC ACTIVE GASTRITIS • PEPTIC ULCER • ASSOCIATED WITH GASTRIC CARCINOMA • LYMPHOMA ( MALT )
