1. CAMPYLOBACTER & Helicobacter Gram negative curved rods Gram negative curved rods Dr. H.Gh.Safaei

2.  To be familiar with Camylobacter & Helicobacter species  To describe the characteristic of those  To understand the pathogenesis of those  To explain the diseases, Clinical finding, diagnosis, treatment and prevention

3. CAMPYLOBACTER ; 18 SPECIES JEJUNI, COLI; HUMAN FETUS, LARI UPSALIENSIS Dr. H.Gh.Safaei

4.  Cause enteritis  Occasionally systemic infection  C. jejuni & C. coli infections indistinguishable  2 million case / year in USA Dr. H.Gh.Safaei

5. Gram negative Gram negative Curved or spiral, comma, S, gull wing Curved or spiral, comma, S, gull wing Motile single polar flagellum Motile single polar flagellum Thermophile Thermophile Dr. H.Gh.Safaei

6. 1. Temperatures > 55 deg. C destroy 2. Sensitive to desiccation 3. Salt, ascorbic acid 4. Disinfectants, chlorinated water 5. UV radiation Dr. H.Gh.Safaei

7. Toxin Invasion motility, flagellar attachment, adhesion to cells, iron acquisition, inflammation actively secretion epithelial disruption serosal fluid leakage Dr. H.Gh.Safaei

8.  Endotoxin  Cytopathic extracellular toxin  Enter toxin Dr. H.Gh.Safaei

9.  Oral route, food, drink, contact infected animals, sexual activity  Sensitive to gastric acid  10 4 organism should ingested  Multiply in small intestine ----invade epithelial --- -inflammation ----white & red blood cell in stool  Occasionally blood stream is invaded  Enteritis Dr. H.Gh.Safaei

10. incubation 2 to 5 days Abdominal painAbdominal pain Diarrhea Diarrhea Malaise, fever, headache Malaise, fever, headache 5-8 daysUsually self-limiting 5-8 days Antibiotics erythromycin Symptoms Dr. H.Gh.Safaei

11. DIAGNOSIS  Specimen ; stool  Smear  Culture  Selective media Skirrow, Vancomycin, Polymyxin B, Trimethoprime  microaerophilic 5-10 % Co2  C. jejuni grows best 42-43 o C  Oxidase, Catalase positive Dr. H.Gh.Safaei

12.  Sources - human – faecal-oral person-to-person chickens, cattle, sheep - animal – cats, dogs, flies, chickens, cattle, sheep  Transmitted  milk  meat products Public health control Dr. H.Gh.Safaei

14.  Opportunistic pathogen  Systematic infection  Occasionally cause diarrhea  Gastrointestinal tract entry ---- bacterimia Death  Capsule like structure ( S protein ) Dr. H.Gh.Safaei

15.  C. Lari seagull occasionally diarrhea in human  C. upsaliesis occasionally diarrhea in human Dr. H.Gh.Safaei

16. TREATMENT evere diarrhea S evere diarrhea – fluid replacement essential Antibiotic therapy sometimes used in local infection but always in systemic disease Antibiotic therapy sometimes used in local infection but always in systemic disease Dr. H.Gh.Safaei

17.  Gram negative  Spiral shape  Gastritis  Peptic ulcer  Gastric Ulcer  Carcinoma Dr. H.Gh.Safaei

18. Optimal PH 6-7 Gastric mucosa impermeable to acid Lumen side PH 1-2 Epithelial side 7.4 Produce protease modifies mucus Urease activity Motile Invade to epithelial cell Toxin & endotoxin Risk factor for cancer Dr. H.Gh.Safaei

19.  Gasteritis  Duodenal ulcer  Asymptomatic Dr. H.Gh.Safaei

20.  Specimen  Gasteric Biopsy  Blood, serology  Smear  Culture  Special tests ; Urease activity ; Rapid Urease test  In vitro Biopsy  In vivo Labeled urea13 C, 14C Detect labeled CO2 Dr. H.Gh.Safaei

21. 1. Culture selective Media 2.Skirrow ( Vancomycin, Polymyxin B, Trimethoprim ) 3. 3-6 days 37°C 4.Microaerphilic 5.Oxidase positive 6.Catalase Positive 7. urease NH 4 + CO 2 Diagnosis Dr. H.Gh.Safaei

22.  IgM Antibody  IgG Antibody Dr. H.Gh.Safaei

23. TREATMENT Triple therapy Metronidazole, Bismuth, Amoxicilline, Tetracycline for 14 days severe diarrhea – fluid replacement essential Dr. H.Gh.Safaei

24.  20% of patients under 30  40-60 % age 60  80-90% developing country  Person to person transmission  Intra familial Dr. H.Gh.Safaei

25.  H. cinaedi primary cause of bacteremia in AIDS patients  H.fennelliae  Homosexual men with enteritis, & bacteremia  Rectal swab  Culture  Urease negative Dr. H.Gh.Safaei

26. CONTROL 1. Sanitary measures 1. protect the water supply 2. Food/water borne epidemics 1. common third world 3. zoonotic infections 1. contaminated animal products Dr. H.Gh.Safaei