Pathogenic Enteric Bacteria I Dr A. Aziz Djamal MSc.DTM&H.SpMK(K)

Topics Escherichia . Vibrio Klebsiella Proteus Enterobacter

Escherichia Klebsiella Proteus Enterobacter All are member of Enterobacteriaceae family Rod shape Gram negative Facultative anaerob

Genus Vibrio belong to the family of Vibrionaceae Curve rod shape Gram negative Facultative anaerob One single polar flagel

Escherichia coli Found by Theodor Escherich ( Austrian ) 1882 Bacteria coli commune Normal inhabitant of intestinal human and warm blooded animal By the time proceed it is also in process of adaptation and change

It is used as standard for fecal contamination. Water quality for household purpose. MPN test / Index. Lactose fermenter

Pathogenic strains EPEC ( Enteropathogenic ) ETEC ( Enterotoxigenic ) EIEC ( Enteroinvasive ) EHEC( Enterohaemorrhagic ) EAEC ( Enteroadherent )

Enteropathogenic E coli Infantile diarrhea Attachment to immature intestinal mucosal cells Destruction of mucosal villi Causing diarrhea followed by fever and icteric Fatal infection especially on neglected labor.

Enterotoxigenic E. coli (ETEC) Produced Enterotoxin. Plasmid mediated enterotoxin production. There are 2 kind of Toxins : Lt ( Labile toxin ) St ( Stable toxin)

Lt ( Labile toxin ) Big Molecule. Antigenic. Cross reaction with Cholera toxin. Activate Adenylate cyclase enzyme -- Cascade reaction-end product cyclic -5--AMP ( Adenosine Mono Phosphate )--Profuse watery diarrhea. Dehydration--Electrolyte and Acid-Base derangement—metabolic acidosis –renal failure –death.

Stable toxin (St) Smaller molecule Non Antigenic. Activate Guadenylate cyclase enzyme system—cascade reaction—end product cyclic –5– GMP (Guadenosin Mono Phosphate ) –Low quality energy resouces– mild diarrhea.

Enteroinvasive Escherichia coli (EIEC) Site of infection mucosal cells layer of Colon. Shigella like infection. Shiga like toxin – toxic to colonic mucosal cells- necrosis—ulcers—bleeding ( Blooded diarrhea), fever – tenesmus ani ( Trias Bacillar Dysentery)

Enterohemorrrhagic E coli EHEC Firstly dairy product contamination, meat on refrigerator—Produce toxin ( Shiga like toxin )—strain O157 H7—Fever, diarrhea, abdominal cramp-Hemolytic uremic syndrome. Newly strain O104 H4, outbreak in German ,May 31 found 470 cases with HUS---9 deaths. Raw lettuce, cucumber and tomatoes.

Enteroadherent E coli Multilayer colonization on intestinal mucose. Biofilm formation Inhibit water and nutrition absorbtion. Malabsorbtion syndrome.