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

2. Topics Escherichia . Vibrio Klebsiella Proteus Enterobacter

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

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

5. 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

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

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

8. 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.

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

10. 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.

11. 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.

12. 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)

13. 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.

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