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Biotypes V. cholerae
Family: Vibronaceae 1) El tor – most frequent causative agent of cholera
3 Genera: (Philippines)
A) Vibrio 2) Classical
B) Aeromonas
rarely cause disease in man V. cholerae
C) Plesiomonas V. cholerae
El Tor Classical
1)
Genus Vibrio 1) Voges – Proskawer test +
Species: -
1) V. cholerae 2) Agglutination to chicken rbc. + -
2) V. parahaemolyticus 3) Sensitivity 50u Polymixin B R S
4) Choleraphage sensitivity R S
V. Cholerae
- most important human pathogen
Disease – Asiatic Cholera:
Morphology: = food and waterborne disease
= acquired fecal – oral route (contaminated
+ short gram negative rod (0.5u X 1.5u to 3.0u) food/H2O)
+ curved/comma – shaped (Kommabacillus) = man only host infection
+ on stained smear – appear lying parallel to one = incubation period 2-3 days
another®”fish in the stream“ arrangement ==== = serious disease charac. sudden onset of
+ motile ® single, thick polar flagellum voluminous, non–bloody watery diarrhea (rice
- water stool) containing
scintillating/darting flakes of mucus, non-odorous accompanied with
severe
dehydration (hallmark of disease)
Biochemical/Cultural Charac.: = no fever, untreated cases 60% die
= high attack rate – children
= organism non – invasive (remains localized GIT)
= facultative anaerobe
= opt. temp. 18 – 370C
= grow best at alkaline ph Determinant of Pathogenicity:
(extremely basophilic up to pH 9) 1) Cholera enterotoxin/Choleragin (heat labile)
= Sensitive to acid ph → kill organism = resp. watery diarrhea
= Non – lactose fermenter but ferment sucrose and = activate adenylcyclase of intestinal
mannose mucosal cell
= Metabolism both respiratory and fermentative ↓
increase intracellular
cyclic adenosine
CM: monophosphate (CAMP)
MEA (Meat Extract Agar) ↓
hypersecretion of H2O
= Translucent colony with iridescent & Cl into the
green → red bronze color intestinal lumen
(viewed on ↓
oblique light) inhibition of
Selective CM: +
Na absorption
TCBS (Thiosulfate Citrate Bile Sucrose) ↓
diarrhea = virulence may be associated with prod. heat
stable
hemolysin (kanagawa) that hemolyze
2) Invasiveness of organism human
+ ability to adhere or attached to microvilli red blood cell which is cytotoxic and
of brush border of epithelial cells. cardiotoxic
Disease:
Serological types – based on antigenic differences Gastroenteritis/Foodpoisoning
1) Ogawa – A & B = self-limiting disease
2) Inaba – A & C = charac. nausea, vomiting, explosive,
3) Hikojima – A, B, C watery diarrhea (cholera – like)
↓
MOT
= ingestion of raw or improperly cooked
Lab. Diagnosis: seafoods(shellfish)
Lab. Diagnosis:
1) Direct stool exam.– Alkaline Peptone broth 1) Rectal – Swab
incubated transport medium Cary – Blair/Amies
for 6 hours (darkfield microscopy → motility) ↓
2) Stool culture – MEA / TCBS incubated 2 – 3 days TCBS &
3) Direct Fluorescent Antibody Test Alkaline Peptone broth
Treatment: Treatment: Chloramphenicol, Kanamycin,
= Prompt replacement of fluid and Tetracycline
electrolytes
= Tetracycline/Furazolidone
(shorten the course of disease and
decrease) bacterial
secretion Differentiation:
Prevention: V. Cholera V. Parahaemolyticus
↓ Habitat:
colorless convex colonies = gastric mucosa where it invade tissues and
watery and spreading causes gastritis and ulcers
= grows at ph 6 –7
Determinants of Pathogenicity:
1) heat – labile enterotoxin Disease:
Anthral Gastritis/Chronic Gastritis
= activate adenylcyclase enzyme →
Duodenal ulcers (no direct evidence that H. pylori)
increase CAMP → split of Cl → causes duodenal ulcers but there is strong
prevent absorption of Na+ → evidence between the presence of H. pylori and
massive diarrhea duodenal ulcer
(bloody mucoid stool)
MOT
Disease: = fecal–oral route (contaminated food & H2O)
Enterocolitis
= self – limiting disease lasting less than 7 days Lab. Diagnosis:
= one of the most common cause of infectious 1) Microaerophilic culture of biopsy material incub.
disease
370C
= symptoms includes: acute crampy abdominal
2) Histologic Examination
pain,
3) Urease test
vomiting, bloody diarrhea with pus, malaise
and fever 4) Culture – Skirrous agar (selective CM) 370C
= incubation period 1 – 7 days ↓
Determinants of Pathogenicity:
1) Endotoxin
= LPS of the cell wall®toxicity resides in lipid
A
= heat - stable
= effect of endotoxin causes:
Fever, Fatal shock, Leucocytic alteration,
Disseminated intravascular coagulation
(DIC), Shwartzman reaction
2) Enterotoxin
= heat-labile usually affect small intestine
causing
transduction of fluid into intestinal
lumen→diarrhea
Laboratory Diagnosis:
Treatment:
= remains a major therapeutic problem
= several factors contribute to the difficulty
of
treating these infection
= one of the most important factor is: