ENTEROBACTERIACEAE,

VIBRIO, CAMPYLOBACTER
AND HELICOBACTER (1)

Faculty: Dr. Alvin Fox

1
 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
2
Opportunistic diseases
-Enterobacteriaceae
– septicemia,
– pneumonia,
– meningitis
– urinary tract infections

Citrobacter
Enterobacter
Escherichia
Hafnia
Morganella
Providencia
3
Serratia
Enterobacteriaceae
• gastrointestinal diseases
– Escherichia coli
– Salmonella
– Shigella
– Yersinia entercolitica

4
 Reiter's syndrome
• Histocompatibility antigen (HLA) B27

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

5
 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
6
 Enterobacteriaceae

gram negative facultative anaerobic rods

– oxidase negative (not cytochrome oxidase)

7
 Feces
• E. coli
– lactose positive
– not usually identified
– lactose positive sp. common, healthy intestine
• Shigella, Salmonella,Yersinia
– lactose negative
– identified

8
Enterobacteriaceae

• other sites
– identified biochemically

9
 Serotypes
• reference laboratory
– antigens
• O (lipopolysaccharide)
• H (flagellar)
• K (capsular)

10
Diarrhea and Dysentery

11
Caption: E. coli

12
 Escherichia coli
• E. coli and Shigella
– genetically very similar
– many similarities in diseases

13
Enteropathogenic E. coli

destruction of surface microvilli

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

14
Enterotoxigenic E. coli

• diarrhea like cholera

• milder
• travellers diarrhea

15
 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
16
Enteroinvasive E. coli (EIEC )
• Dysentery
- resembles shigellosis

Gut lumen

17
Enterohemorrhagic E. coli
• Usually O157:H7

Flagella Transmission electron

micrograph

18
Transmission – meat products or
sewage-contaminated vegetables
• Hemorrhagic
– bloody, copious diarrhea
– few leukocytes
– afebrile
• hemolytic-uremic syndrome
– hemolytic anemia
– thrombocytopenia (low platelets)
– kidney failure
19
Enterohemorrhagic E. coli

• Vero toxin
– “shiga-like”

• Hemolysins

20
 Treatment -gastrointestinal
disease
• fluid replacement
• antibiotics
– not used usually unless systemic
– e.g. hemolytic-uremia syndrome

21
 E. coli fimbriae
Type 1

mannose

galactose
– glycolipids
– glycoproteins

22
 Shigella

Modified from Fig, Dennis Kunkel

23
 Shigella
• S. flexneri, S. boydii, S. sonnei, S.
dysenteriae
– bacillary dysentery
– shigellosis
• bloody feces
• intestinal pain
• pus
24
 Shigellosis
• within 2-3 days
– epithelial cell damage

Gut lumen

25
 Shiga toxin
• enterotoxic
• cytotoxic
• inhibits protein synthesis
– lysing 28S rRNA

26
 Shigellosis
• man only "reservoir"
• mostly young children
– fecal to oral contact
– children to adults
• transmitted by adult food handlers
– unwashed hands

27
 Treating shigellosis
• manage dehydration
• patients respond to antibiotics
– disease duration diminished

28
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 |

29
 Salmonella
• 2000 antigenic "types”
• genetically single species
– S. enterica
• disease category
– S. enteritidis
– many serotypes
– S. cholerae-suis
– S. typhi

30
 Salmonellosis
• S. enteritidis
– the common salmonella infection
– poultry, eggs
– no human reservoir
– Gastroenteritis
• nausea
• vomiting
• non-bloody stool
• self-limiting (2 - 5 days)

31
 Salmonellosis

Gut lumen

uncomplicated cases (the vast majority)

antibiotic therapy not useful

32
 S. cholerae-suis
• much less common
• septicemia
• antibiotic therapy essential

33