VIBRIO CHOLERAE CHOLERA

CHARACTERISTICS GRAM-NEGATIVE, COMMA SHAPED BACILLI MOTILE – POLAR FLAGELLA OXIDASE – POSITIVE CATALASE – POSITIVE ALKALNE PH ( 6.8 – 10.2)  SELECTIVE MEDIA ( TCBS )  ALKALINE PEPTON WATER

ANTIGENICITY SOMATIC – O ANTIGE  VIRIO CHOLERAE O-1  NON- O-1 V. CHOLERAE  V. CHOLERAE O-139 ( BENGAL) BIOTYPES: 2  CLASSICAL (MORE SEVERE)  EL-TOR SEROTYPES: 3  INABA, OGAWA, HIKOJIMA

HABITAT HUMAN  MAIN SOURCE NATURALLY  IN ACQUATIC ENVIRNMENT

PATHOGENESIS INGESTION OF CONTAMINATED DRINK WATER, FOOD ID - 10 – 10 MULTIPLY IN SMALL INTESTINE, ILEUM ENTEROTOXIN SIMILAR TO HLET OF E. COLI ACTIVATE ADENYLATE CYCLASE CAMP FLUIDS, EECTROLYTES DIARRHOEA, VOMITING

NO INTESTINAL INVASION NO BACTEREMIA NO SEPTICAEMIA LESIONS ARE PATHOPHYSIOLOGICAL

CLINICAL PICTURE INCUBATIN PERIOD (IP)  1 – 4 DAYS  ACUTE ONSET EFFORTLESS VOMITING PROFUSE WATERY DIARRHOEA (RICE – WATER ) RAPID DEHYDRATON (10 – 20 L/ DAY) HYPOVOLAEMIC SHOCK - DEATH

IMMUNITY VERY SHORT REINFECTIONS(REPEATED ATTACKS) ARE COMMON

EPIDEMIOLOGY HUMAN (ONLY HOST ) POOR ENVIROMENTAL SANITATION POOR WATER SUPPLY CONTAMINATED WATER INDIAN SUBCONTINENT,BANGLADESH PANDEMICS - EL-TOR BIOTYPE OUTBREAKS EPIDEMICS ( PILGRIMAGES ) EL- TOR PROLONGED CARRIAG (ENDEMIC INFECTION)

LABORATORY DIAGNOSIS SPECIMENS :  STOOLS  RECTAL SWAB MICROSCOPY:  DARTING MOVEMENT CULTURE :  TCBS ( YELLOW COLONIES)  ALKALINE PEPTONE WATER(6 – 8 h) SEROLOGICAL IDENTIFICATION  SLID AGGLUTINATION FOR SEROTYPES

TREATMENT REHYDRATION  REPLACEMENT : FLUID, ELECTROLYTES ANTIBIOTIC  TETRACYCLINE

PREVENTION CONTROL PATIENTS  ISOLATION, TREATMENT CONTACTS  PROPHYLAXIS (TETRACYCLINE) WATER  PURE SUPPLY, PROPER TREATMENT SEWAGE  PROPER DISPOSAL HEALTH EDUCATION

VACCIN NO EFFECTIVE VACCINE AVAILABLE  KILLED (INJECTION)  LIVE ATTENUATED (ORAL) REACTOGENIC SHORT IMMUNITY

V.PARAHAEMOLYTICUS FOOD POISONING SEA FOODS (RAW, UNDERCOOKED) HALOPHILIC (NACL) GROWS ON TCBS AGAR  (GREEN COLONIES) TREATMENT :  REHYDRATION

CAMPYLOBACTER GRAM – NEGATIVE BACILLI S- SHAPED (SPIRAL) ACTIVELY MOTILE OXIDASE POSITIVE CATALASE POSITIVE MICROAEROPHILIC ( 5 – 10% CO ) NON CAPSULATED

SPECIES C.JEJUNI  MOST COMMON  THERMOPHILIC (42C – NOT 25C )  HIPPURATE HYDROLYSIS +  SELECTIVE MEDIA (SKIRROW’S ) C. COLI C. FETUS  GROW AT 25 C

DISEASES ENTERITIS  80 – 90% ( C. JEJUNI )  C. COLI SEPTICAEMIA, MENINGITIS,ENDOCAR.  C. FETUS  IMMUNOCOMPROMISED  EXTREME OF AGE

SOURCE INTESTINE OF BIRDS ( CHIKEN ) DOMESTIC ANIMALS, CATTELE(BEEF) UNPASTEURISED MILK CONTAMINATED WATER

CHARACTERISTICS GRAM NEGATIVE SPIRAL SHAPED BACILLI MICROAEROPHILIC OXIDASE POSIIVE UREASE POSITIVE

PATHOGENESIS INVASIVE DISEASE ( COLON ) – ID:100 DYSENTERIC LIKE ILLNESS  BLLODY DIARROEA  FEVER  ABDOMINAL PAIN WATERY DIARROEA (ENTERTOXIN)  ILEUM SEPTICAEMIA (IMMUNOCOMPROMISED)

TREATMENT REHYDRATION  ELECTROLYTES  FLUIDS ANTIBIOTIC :  ERYTHROMYCIN  CIPROFLOXACIN  GENTAMICIN ( SEPTICAEMIA )

HALICOBACTER PYLORI

HABITAT GASTRIC MUCOSA ( MUCUS LAYER )

TREATMENT AMOXACILLIN METRONIDAZOLE + BISMUTH SUBCITRATE FOR WEEK OR CLARITHROMYCIN + AMOXACILLIN + OMEPRAZOLE FOR 1 WEEK

DISEASES CHRONIC ACTIVE GASTRITIS PEPTIC ULCER ASSOCIATED WITH GASTRIC CARCINOMA LYMPHOMA ( MALT )