ENTEROBACTERIACEAE,

VIBRIO, CAMPYLOBACTER
AND HELICOBACTER (2)

Faculty: Dr. Alvin Fox

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

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

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 Typhoid septicemia
- occurs 10-14 days
– lasts 7 days
macrophage

gall bladder
–shedding, weeks
acute phase, gastroenteritis

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gastroenteritis
 S. typhi
• Vi (capsular) antigen
– protective

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 Typhoid -Therapy
• Antibiotics
– essential
• Vaccines
– ineffective

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 Yersiniosis
• Yersinia entercolitica
– gastroenteritis
– Scandinavia common
– US
* colder regions

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 Yersiniosis
• transmission
– fecal contamination, domestic animals
• water
• milk
– meat

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 Yersinia

Gut lumen
Diarrhea
fever
abdominal pain
antibiotic therapy recommended
occassional bacteremia
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Yersinia -isolation

cold enrichment

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Y. pseudotuberculosis

• similar
• less severe disease

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Vibrio cholerae

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 Vibrios
• Gram negative rods
• comma shaped
• facultative anaerobes
• oxidase positive
• simple nutritional requirements
• readily cultivated
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 Occurrence -cholera
• third world
• US
– uncommon
* traveler
* ingestion of sea-food

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Transmission - V. cholerae
feces

water
– fresh
– salt

food 15
Cholera - attachment

Gut lumen

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

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 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
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 Vibrio parahemolyticus

• raw sea-food
• grows best in high salt
• not common in US
• diarrhea

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CAMPYLOBACTER & HELICOBACTER

• Gram negative rods

• curved or spiral
• genetically related

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Campylobacter jejuni

pleomorphic

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

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Campylobacter

Gut lumen

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Isolation - Campylobacter

• microaerophilic
• grows best 42oC

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Campylobacter - symptoms
• diarrhea
• malaise
• fever
• abdominal pain
• usually self-limiting
• antibiotics occassionally
• bacteremia
–small minority

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 Helicobacter pylori
• stomach mucosa
• ulcers

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 Urease
• Important in neutralizing stomach acid

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 Diagnosis -Helicobacter
• Culture
- urease NH4+ CO2

• Direct detection of urease

•CO2 derived from labeled urea

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 Therapy -Helicobacter
• Antibiotics
– cures ulcers

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 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

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 Therapy
• severe diarrhea
– fluid replacement essential

• antibiotic therapy sometimes used in local

infection but always in systemic disease

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