CAMPYLOBACTER & Helicobacter Gram negative curved rods Gram negative curved rods Dr. H.Gh.Safaei.
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Transcript of CAMPYLOBACTER & Helicobacter Gram negative curved rods Gram negative curved rods Dr. H.Gh.Safaei.
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CAMPYLOBACTER & HelicobacterCAMPYLOBACTER & Helicobacter
• Gram negative curved rodsGram negative curved rods
Dr. H.Gh.Safaei
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To be familiar with Camylobacter & Helicobacter species
To describe the characteristic of those To understand the pathogenesis of
those To explain the diseases , Clinical
finding, diagnosis , treatment and prevention
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Dr. H.Gh.Safaei
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Cause enteritis Occasionally systemic infection
C. jejuni & C. coli infections indistinguishable
2 million case / year in USA
Dr. H.Gh.Safaei
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• Gram negative Gram negative • Curved or spiral , comma, S , gull wing Curved or spiral , comma, S , gull wing • Motile single polar flagellum Motile single polar flagellum • Thermophile Thermophile
Dr. H.Gh.Safaei
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1. Temperatures > 55 deg. C destroy
2. Sensitive to desiccation3. Salt, ascorbic acid4. Disinfectants, chlorinated water5. UV radiation
Dr. H.Gh.Safaei
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Toxin Invasion motility, flagellar attachment, adhesion to cells, iron acquisition, inflammation actively secretion epithelial disruption serosal fluid leakage
Dr. H.Gh.Safaei
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Endotoxin Cytopathic extracellular toxin
Enter toxin
Dr. H.Gh.Safaei
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Oral route , food , drink , contact infected animals, sexual activity
Sensitive to gastric acid 104 organism should ingested Multiply in small intestine ----invade
epithelial ----inflammation ----white & red blood cell in stool
Occasionally blood stream is invaded Enteritis
Dr. H.Gh.Safaei
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•incubation 2 to 5 days •Abdominal painAbdominal pain• DiarrheaDiarrhea• Malaise, fever, headacheMalaise, fever, headache•Usually self-limiting 5-8 days 5-8 days • Antibiotics erythromycin
SymptomsSymptomsDr. H.Gh.Safaei
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DIAGNOSIS DIAGNOSIS Specimen ; stoolSpecimen ; stool Smear Smear Culture Culture Selective media Skirrow , Selective media Skirrow ,
Vancomycin, Polymyxin B, Vancomycin, Polymyxin B, Trimethoprime Trimethoprime
microaerophilic 5-10 % Co2 microaerophilic 5-10 % Co2 C. jejuni grows best 42-43 C. jejuni grows best 42-43 ooCC Oxidase , Catalase positive Oxidase , Catalase positive
Dr. H.Gh.Safaei
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Sources - human – faecal-oral person-to-person - animal – cats, dogs, flies,chickenschickens, ,
cattle, cattle, sheepsheep Transmitted
milk meat productsPublic health control
Dr. H.Gh.Safaei
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Dr. H.Gh.Safaei
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Opportunistic pathogen Systematic infection Occasionally cause diarrhea Gastrointestinal tract entry ----bacterimia Death
Capsule like structure ( S protein )
Dr. H.Gh.Safaei
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C. Lari seagull occasionally diarrhea in human
C. upsaliesis occasionally diarrhea in human
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TREATMENTTREATMENT• Severe diarrheaevere diarrhea
– fluid replacement essentialfluid replacement essential
• Antibiotic therapy sometimes Antibiotic therapy sometimes used in local infection but used in local infection but always in systemic diseasealways in systemic disease
Dr. H.Gh.Safaei
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Gram negative Gram negative Spiral shape Spiral shape GastritisGastritis Peptic ulcer Peptic ulcer Gastric UlcerGastric Ulcer CarcinomaCarcinoma
Dr. H.Gh.Safaei
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Optimal PH 6-7 Gastric mucosa impermeable to acid Lumen side PH 1-2 Epithelial side 7.4 Produce protease modifies mucus Urease activity Motile Invade to epithelial cell Toxin & endotoxin Risk factor for cancer
Dr. H.Gh.Safaei
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Gasteritis Duodenal ulcer Asymptomatic
Dr. H.Gh.Safaei
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Specimen Gasteric Biopsy Blood , serology Smear Culture Special tests ; Urease activity ; Rapid
Urease test In vitro Biopsy In vivo Labeled urea13 C , 14C Detect
labeled CO2
Dr. H.Gh.Safaei
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1. Culture selective Media2. Skirrow ( Vancomycin , Polymyxin
B, Trimethoprim )3. 3-6 days 37°C 4. Microaerphilic5. Oxidase positive 6. Catalase Positive 7. urease NH4+ CO2
DiagnosisDiagnosisDr. H.Gh.Safaei
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IgM Antibody IgG Antibody
Dr. H.Gh.Safaei
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TREATMENTTREATMENT •Triple therapy Metronidazole , Bismuth, Amoxicilline , Tetracycline for 14 days • severe diarrheasevere diarrhea
– fluid replacement essentialfluid replacement essential
Dr. H.Gh.Safaei
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20% of patients under 30 40-60 % age 60 80-90% developing country Person to person transmission
Intra familial
Dr. H.Gh.Safaei
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H. cinaedi primary cause of bacteremia in AIDS patients
H.fennelliae Homosexual men with enteritis, &
bacteremia Rectal swab Culture Urease negative
Dr. H.Gh.Safaei
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CONTROL CONTROL
1.1. Sanitary measures Sanitary measures
1.1. protect the water supply protect the water supply
2.2. Food/water borne epidemics Food/water borne epidemics
1.1. common third worldcommon third world
3.3. zoonotic infections zoonotic infections
1.1. contaminated animal contaminated animal products products
Dr. H.Gh.Safaei
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Dr. H.Gh.Safaei