1. Gastrointestinal Tract Infections

2. Content Bacterial Food Poisoning
Bacterial Enteritis and Enteric Fevers
Bacterial infection of the stomach, esophagus and intestines
Gastrointestinal disease caused by other pathogens

3. Bacterial Food Poisoning

4. Food poisoning By ingestion of food contaminated with preformed toxins
Also might contain metals, pesticides and other toxic substance
The symptoms more rapid compared to infections

5. Bacterial entering food
S.aureus – food handler
Soil organisms such as water, feces, sewage (nature food contamination)
Others: Campylobacter jejune, Staphylococcus aureus, Clostridium perfringens, C.botulinum and Bacillus cereus

6. Samples
Feces – physical determination, isolation and component analysis
Food – contaminated
Gastric juice / fluid

7. Staphylococcus Enterotoxicosis
Basically in uncooked or inadequate cooked food. And unrefrigerated.such as??
Releasing endotoxin A or D
Bacteria producing toxin instead of multiply
Causing symptoms – abdominal pain, diarrhea, nausea n vomiting

8. Other causes
Clostridium perfringens – undercooked meats and gravies, late onset and lasting, only during sporulation, gas gangrene and anaerobic cellulitis
Clostridium botulinum – minor in GI but major in nervous system
Bacillus cereus – contaminated rice / meat dishes, vomiting, short time onset and period of infection
Pseudomonas cocovenenans – bongkrek disease (coconut) – cause fatal

9. Bacterial Enteritis and Enteric Fevers

10. Introduction
Enteritis – an inflammation of intestine; not intoxication
Invade and damage the intestinal mucosa or deeper tissue
Small intestine – diarrhea
Large intestine – dysentery (severe including mucus, blood and pus)
Leading to enteric fever such as typhoid fever

11. Salmonellosis
By genus Salmonella – typhi, choleraesuis and enteritidis
Detection using serotype identification – molecular/special test
Other than typhi can cause typhoid fever
Normal flora of poultry, wild birds and rodents
The particular animal infected seriously / just carrier – 90% pet reptiles carrier

12. Source of infection Normal flora of poultry, wild birds and rodents
The particular animal infected seriously / just carrier – 90% pet reptiles carrier
Infected hen to the laying eggs
Trace from contaminated food and water
In daily life – improper preparation of food (uncooked egg and meat/dairy product)

13. Pathogenesis Abdominal pain, fever and diarrhea with blood and mucus
Onset 8 – 48 hours after ingestion
Fever – endotoxin release during lysis
Self-limiting lasts 1 – 4 days
No need of antibiotic
Infant and elderly more severe

14. Other species
S.typhimurium and S. paratyphi cause more serious condition – enterocolitis
Incubation period up to 10 days
Cause fever and chills for 1 – 3 weeks
No antibiotic suitable – increase spectrum of normal flora of GIT
Maintain the sanitary water and food supplies

15. Typhoid fever Primarily – caused by S.typhi
In faulty and sewage system- uncooked shellfish, raw fruit and raw vegetable
Bacteremia and septicemia
Patient having headache, malaise and fever due to toxication
Invade mucosa and excrete thru stool
Infect lymphoid tissue such as Peyer’s patches (rose spots)
Antibiotic – fluoroquinolones, chloramphenicol

16. Salmonella typhi

17. Shigellosis
Bacillary dysentery – serovar A (dysenteriae), B (flexneri), C (boydii) and D (sonnei)
In day-care-centre, 10 organisms enough to cause infection
Contaminated food, finger, flies, feces and fomites

18. Asiatic cholera Vibrio vulnificus and V. Parahemolyticus
In poor country
Mild and not true cholera
If caused by Vibrio cholerae – rice water stool – chronic cholera
Test of microscopic observation until serological test - IgA

19. Vibriosis Largely caused by V. parahemolyticus
Contaminated fish and shellfish
Endotoxin released
12 hr after entering body
Last fo 2 -5 days

20. Traveler’s diarrhea Caused by E.coli O157:H7
Others are Campylobacter, rotavirus, Giardia, Entamoeba, Salmonella
Strain that is enterotoxigenic (ETEC) or enteroinvasive (EIEC), enterohemorrhagic (EHEC) (also cause hemorrhagic uremic syndrome-HUS)

21. Bacterial infection of the stomach, esophagus and intestines

22. Peptic ulcer and Chronic Gastritis
Caused by Campylobacter pylori
Is a cofactor for stomach cancer
Penetration so called as perforation

23. Peptic ulcer

24. Causes Drinking too much alcohol
Regular use of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). Taking aspirin or NSAIDs once in awhile is safe for most people.
Smoking cigarettes or chewing tobacco
Being very ill, such as being on a breathing machine
Radiation treatments

25. Symptoms Feeling of fullness -- unable to drink as much fluid
Hunger and an empty feeling in the stomach, often hours after a meal
Mild nausea (vomiting may relieve symptom)
Pain or discomfort in the upper abdomen
Upper abdominal pain that wakes you up at night

27. Diagnosis
Esophagogastroduodenoscopy (EGD) is a special test performed by a gastroenterologist in which a thin tube with a camera on the end is inserted through your mouth into the GI tract to see your stomach and small intestine. During an EGD, the doctor may take a biopsy from the wall of your stomach to test for H. pylori.
Upper GI is a series of x-rays taken after you drink a thick substance called barium.

28. Viral gastrointestinal diseases

29. Viral Entritis Aslo known as rotavirus Infecting infants and children
Causing watery diarrhea within 2 days
3rd virus causing fatality in children
Contain dsRNA and observe using EM
Diagnosis of stool using ELISA
Also caused by species of Enterovirus, Clostridium difficile and can inflammed nervous system

30. Contagious
 In the United States, rotavirus infection outbreaks are common during the winter and spring months. It is particularly a problem in childcare centers and children's hospitals because rotavirus infection is very contagious.
Usually this happens when kids don't wash their hands often enough, especially before eating and after using the toilet.

31. Rotavirus

32. Symptoms
have fever, nausea, andvomiting, often followed by abdominal cramps and frequent, watery diarrhea.
Kids may also have a cough and runny nose.
Some rotavirus infections cause few or no symptoms, especially in adults.

33. Hepatitis An inflammation of liver, caused by viruses
Can also caused by amoeba and toxic chemical substance
Hep A – infectious hepatitis (fecal-oral route)
Hep B – serum hep (blood)
Hep C – NANB hep (parenterally – blood) – liver transplant
Hep D – delta hep (blood)along wt HBV
Hep E – NANBNC hep (enterically – fecal oral)

34. Hep A

35. Hep A

37. Hep B

41. Protozoan Giardiasis Amoebic Dysentery and chronic amebiasis
Balantidiasis
Cryptosporidiosos
Cyclosporiasis

42. Fungal toxin
Penicillin and Aspergilus

43. Helminths Strongyloidiasis Tapeworms Fluke Trichinosis Hookworm
Ascariasis
Trichuriasis
Pinworm
Helminths