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Faculty: Dr. Alvin Fox

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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Faculty: Dr. Alvin Fox

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  1. EnterobacteriaceaeII Vibrio, Campylobacter,Helicobacter (Gram negative, enteric tract), Lecture 43 Faculty: Dr. Alvin Fox

  2. Typhoid • enteric fever • severest salmonella disease • Salmonella typhi • rare in US • epidemics • third world • Europe • historical

  3. Salmonella typhi • human reservoir • carrier state common • contaminated food • water supply • poor sanitary conditions

  4. Typhoid • septicemia • - occurs 10-14 days • lasts 7 days macrophage • gall bladder • shedding, weeks • acute phase, gastroenteritis gastroenteritis

  5. S. typhi • Vi (capsular) antigen • protective

  6. Typhoid -Therapy • Antibiotics • essential • Vaccines • ineffective

  7. Yersiniosis • Yersinia entercolitica • gastroenteritis • Scandinavia common • US • colder regions

  8. Yersiniosis • transmission • fecal contamination, domestic animals • water • milk • meat

  9. Yersinia Gut lumen Diarrhea fever abdominal pain antibiotic therapy recommended occassional bacteremia

  10. Yersinia -isolation cold enrichment

  11. Y. pseudotuberculosis • similar • less severe disease

  12. Vibrio cholerae

  13. Vibrios • Gram negative rods • comma shaped • facultative anaerobes • oxidase positive • simple nutritional requirements • readily cultivated

  14. Occurrence -cholera • third world • US • uncommon • traveler • ingestion of sea-food

  15. Transmission - V. cholerae feces • water • fresh • salt • food

  16. Cholera - attachment Gut lumen

  17. Cholera toxin- Choleragen • B binds to gangliosides • provides channel for A • A catalyses ADP-ribosylation • regulator complex • activates adenylate cyclase

  18. 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

  19. Vibrio parahemolyticus • raw sea-food • grows best in high salt • not common in US • diarrhea

  20. Vibrio vulnificus • Wound infections • Most common Vibrio infection in the US

  21. CAMPYLOBACTER& HELICOBACTER • Gram negative rods • curved or spiral • genetically related

  22. Campylobacter jejuni pleomorphic

  23. Transmission • infects the intestinal tract of animals • chickens, cattle, sheep • Transmitted • milk • meat products

  24. Campylobacter Gut lumen

  25. Isolation - Campylobacter • microaerophilic • grows best 42oC

  26. Campylobacter - symptoms • diarrhea • dysentery common • malaise • fever • abdominal pain • usually self-limiting • antibiotics occasionally • bacteremia • small minority

  27. Helicobacter pylori • stomach mucosa • ulcers

  28. Urease • Important in neutralizing stomach acid - pathogenesis

  29. Diagnosis -Helicobacter • Culture • - urease NH4+ CO2 • Direct detection of urease • CO2 derivedfrom labeled urea

  30. Therapy -Helicobacter • Antibiotics • cures ulcers

  31. 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

  32. Therapy • severe diarrhea • fluid replacement essential • antibiotic therapy sometimes used in local • infection but always in systemic disease

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