Case Study One: The Peanut Butter is

Tainted

Manufactured by: Ambika Sharma, Erica Choi and Kimberly Balao

Patient Situation:

Symptoms• Diarrhea• Fever• Abdominal Pains• Lasts About 4-7 Days• Some cases of Diarrhea was

so bad that some had to be hospitalized.

By the Numbers!• 425 People from 44 States

experienced these symptoms.

• Out of the 351 persons with clinical information, 71 of them had to be hospitalized.

Affected System

DIGESTIVE SYSTEM!

Our Specific Patient:

• Experienced Stomach Cramping, Diarrhea, and Moderately High Temperature.

• Sixteen Hours Prior: He consumed a peanut butter sandwich.

• Could this be the answer to our patient’s problem? LET’S FIND OUT!– We cultured our patient’s fecal matter to find the

etiological agent of his illness.

Possible Culprits:

1. Escherichia coli(-)2. Pseudomonas aeruginosa (-)3. Salmonella enterica (-)4. Staphylococcus aureus(+)5. Streptococcus pyogenes (-)6. Haemophilus influenzae (-)

How Do We Determine Which Bacteria?

http://www.youtube.com/watch?v=FWrjQoRcp1g&feature=channel_video_title

Find if the patient bacteria is gram (+) or gram (-)o Why?: The culprits are either known as gram (+) or gram (-).

Know the patients gram, and we can eliminate answers.o Through methods of staining, we are able to

conclude that our bacteria is gram (-)

WE WILL BE USING MCONKEY AGAR as our differential media.

Staphylococcus aureus(+) Escherichia coli(-)

Patient(-)

Results ofMacConkey Agar

http://www.youtube.com/watch?v=4BF5WsU7I6A

•Agar had Patient Sample & E. coli.•E. Coli was very pink in agar.

•Why?: E. coli is capable of fermenting lactose in the agar.

•Our patient had no bright pink color, we are looking for a gram (-) bacteria that is incapable of fermenting bacteria.

Possible Culprits:

1. Escherichia coli(-)2. Pseudomonas aeruginosa (-)3. Salmonella enterica (-)4. Staphylococcus aureus(+)5. Streptococcus pyogenes (+)6. Haemophilus influenzae (-)

Salmonella Enterica• Salmonella is a rod-shaped motile

bacteria.• This can be classified in the bacilli group

of bacteria, and it has a flagella which makes it motile.

• Salmonella is arranged in a cluster-tetrad form which can be seen under a microscope.

• This bacteria has a unique way of infecting host cells, it uses a “syringe” technique in which it injects a protein called SipA. This protein essentially ruffles the outside of the cell, allowing the salmonella bacteria to enter and then replicate.

• Salmonella is an anaerobic bacteria that can survive under low Oxygen conditions

Epidemiology of Salmonella Enterica

• It can be found usually in food or water, and it affects the gastrointestinal region of humans

• Salmonella can also affect deeper parts of the human body like bone marrow due to their unique way of invading cells.

• Spread through the fecal-oral route (once excreted it in released into the environment and can infect it’s surrounding)

Salmonella Enterica Cont.

Symptoms• Patient might have

typhoid fever. • This bacterium is a

causative of typhoid fever.

• Symptoms include:– Abdominal Cramps– Vomiting– Nausea– Usually lasts up to seven

days.

How It Affects the Body• Salmonella, after it is ingested,

produces hydrogen sulfide which causes the cells of the intestinal walls to become disorganized so that the the bacteria is engulfed

• The protein SipA then is injected into these cells via salmonella to “staple” actin filaments together and make curtain-like folds which allows it to engulf the bacteria

• It is then taken to the liver or the spleen.

• Salmonella has many evolved mechanisms that prevent our immune system from doing their job efficiently.

ResultsAntibiotic Diameter Sensitive/Resistant

TE 20mm Sensitive

SIO 12mm Resistant

GM 17mm Sensitive

P 16mm Resistant

VA 0mm Resistant

C 27mm Sensitive

Our Antibiotic Results:

1.Chloramphenicol2.Gentamicin3.Penicillin4.Streptomycin5.Tetracyclin6.Vancomycin

Chloramphenicol

• A prototypical broad-spectrum antibiotic – Bacteriostatic antimicrobial– Inhibits growth of

microorganisms– Interfers with bacterial

protein production, DNA replication, and several aspects of their cellular metabolism

– Effective against gram negative bacteria and anareobes

Preventative measures:

• Pay attention to cleanliness (proper cleaning)• Proper cooking of food like poultry and meat• Crack eggs with a knife and not on the bowl• Scald eggs in boiling water• Properly prepare fresh meats and vegetables

Real Salmonella Outbreaks!

• http://injurylawblog.the-injury-lawyer-directory.com/2011/03/10/skippy-peanut-butter-recalled-for-salmonella-contamination/