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V.

1.General characteristic of the family Enterobacteriace


Short rods, non-sporing, noncapsulated or capsulated and motile or non-motile

Gram negative

Mesophiles

Facultative anaerobs

Growth on simple and complex media

Fermentation of sugars (acid or acid and gas produced)

Mechanism of transmission is fecal-oral (in general)

consist of 5 type

Tribe I : Escherichieae
Tribe II : Klebsiellea
Tribe III : Proteae
Tribe IV : Yersiniae
Tribe V : Erwineae

2.Microbiological diagnosis of bacillary dysentery (day by day)


V.2

1.Categories of pathogenic E.coli. Characteristic of different representatives.


Tribe : Escherichiae
Family : Enterobacteriaceae
Genus : Escherichia
Species: E. Coli
Pathogen Factors of virulence Disease
Enterotoxigenic E.coli (ETEC)
The disease vary from minor Pili, fimbrial adhesins, Watery diarrhea in infants and
discomfort to a severe cholera- production of tozin: LT / ST travelers
like syndrome
Enteroinvasive E.coli (EIEC) Nofimbrial adhesins,possibly
colsely resemble Shigella in outer membrane protein
Dysentery-likediarrhea
their pathogenic mechanism invasive(penptrate and
(mucous, blood) sever
and the kind of clinical illness multiplywithin epithelial cells)
they produce. does not produce shiga toxin
Enteropathogenic E.coli
Nofimbrial adhesins (intimin) Usually infantile similar to
(EPEC) are destroy
moderately invasive (not as ETEC, some inflammation, no
microfimbriae and cause
invasive, as Shigella or EIEC), fever; symptoms probably
damage of apical part of
does not produce LT or ST; result mainly from invasion
epithelium cells of small
some reports of shige-like toxin rather than toxigenesis
intestine
Enteroaggregative E.coli
(EaggEC) The distinguishing
Adhesins not characterized, non
feature of EaggEC atrains is Persistent diarrhea in young
invasive, produce ST-like toxin
their ability to attach to tissue children
(EAST) and hemolysin
culture cells in an aggregative
manner
Adhesins not characterized,
Enterohemorrhagic E.coli
probebly fimbria moderately Pediatric diarrhea, copious
(EHEC) are represented by a
invasive, does not produce LT bloody discharge (hemorrhagle
single strain (serotype
or ST but does produce shiga colitis)
O157:H7)
toxin
2.Microbiological diagnosis of cholerae (methods of rapid diagnosis)
V.3

1.Classification of Salmonella by antigenic structure (Kauffman Wait sceme)


Antigen
Serological group Name H
O
Phase 1 Phase 2
A S.paratyphi A 1, 2, 12 a -
S.derbi 1, 4, 5, 12 f, g 1, 2
S.haifa 1, 4, (5), 12 Z10 1, 2
B
S.paratyphi B 1, 4, 5, 12 b 1, 2
S.typhimurium 1, 4, 5, 12 i 1, 2
S.infants 6, 7 R 1, 5
C1 S.choleraesuis 6, 7 c 1, 5
S.virchov 6, 7 R 1, 5
C2 S.newport 6, 8 eh 1, 2
S.dublin 1, 9, 12(vi) g, p -
S.enteritidis 1, 9, 12 g, m -
D
S.panama 1, 9, 12 e, v 1, 5
S.typhi 9, 12(vi) d -
E1 S.anatum 3, 10 ch 1, 6
2.Describe laboratory diagnosis of coli-infection (day by day)
V.4

1.Classification of E.coli pathogens. Characteristic of different group representatives.


Genus Escherichia was named after Escherich who was the first to describe the colon bacillus
under the name bacillus coli. There are 7 species of genus Escherichia but E. coli is the most
medically important species because;
E. coli causes diseases of different localization.
E. coli plays the important role as pathogenic agent of diarrheal infections.
E. coli is indicator of fecal contamination of tap water and soil.

2.Describe laboratory diagnosis of enteric fever pathogen (stool culture,day by day)


V.5

1.Salmonella genus:it's characteristic. Latin name of enteric fever pathogens. Their morphology.
Culture properties, factors of pathogenicity.
Classification of Salmonella genus
Salmonella genus classified into 2 species
1) S.enterica - has been divided into 6 subspecies.(serotypes)
- cause infection in men and animals.
2) S.bongori - has been subdivided into6 subspecies. (serotypes)
Cause infection in animals only.
Latin name :: Salmonella enterica

Morphology
Salmonella morphologically short, gram negative rods, non-sporing, non-capsulated but flagellated.
These microorganism are mesophiles (37 temperature growth), facultative anaerobs, can grow in
simple media.
Cultural properties
Salmonella can grow in MPA / MPB
Selective media to cultivate Salmonella are:
Bile broth (liquid medium)
MacConkey media
Salmonella-Shigella agar (SSA)
Eosin Methylene Blue (EMB)
Bismuth-containing agar
Rapaports medium (this medium consist of 10%bile broth, 1%glucose, indicator)
Factor of virulence
Salmonella possess following antigens: O, H, Vi antigens.
2.Describe microbiological diagnosis of bacillary dysentery (day by day)
V.6

1.Shigella:specimen, classification, factors of pathogenicity

Specimen :: Stool mass, rectal swabs

Family : Enterobacteriaceae
Genus : Shigella
Species: S. dysenteriae
S. flexneri
S. boydii
S. Sonnei

Shiga-like toxin is released by Shigella species which have not shiga toxin( all except S. dysenteriae
Type 1). It causes cytotoxic action in cultured cells but action is not as powerful as Shiga toxins.
Endotoxin causes common intoxication and stimulates motility of the intestine.

2.Blood culture isolation:specimen, investigation (day by day)


V.7

1.Campylobacter:disease, morphology, classification

Campylobacter are slender, spirally curved, Gram (-) rods. They have typically coma shaped but
may occur as letter S or multi spiral chains. In old cultures, Campylobacters are pleomorphic in
shape.
They are non-sporing, motile, and non-capsulated.
Growth occurs under micoaerophilic conditions. Only 5% of O2 is enough for optimal growth.

C.jejuni and C.coli, are thermophilic. (optimum t= 42C)


C.fetus is mesophilic (t=37C)

Campylobacter do not grow in simple media. They grow only in complicated media with blood,
amino acids, salts, gemine and protein hydrolasate. Optimum pH=7.0.
For example: campi BAP medium.
They cant destroy carbohydrates, oxidase and catalase tests are positive, H2S is formed.
2.Salmonella food poisoning:specimen, medical diagnosis, serological investigation, nutrient media,
classification of pathogen.

Main Salmonella gastroenteritis pathogen(Food poisoning)


S. enteritidis
S. typhimurium
S. Dublin
S. Choleraesuis

Factor of virulence
Liable toxin (LT)
Stable toxin (ST)
Shigella toxin (SLT)
Endotoxin

Ability to release toxin regulated by plasmid. No plasmid, no exotoxin.


Infection is cause by ingestion of contaminated food . The most frequent sources of
Salmonella food poisoning are meat, milk, creams and eggs.
The max of infection last for 5 days.

Clinical manifestation
1) Abdominal pain
2) Diarrhea
3) Vomiting
4) Fever

Features of Salmonella gastroenteritis diagnosis


1) Usage of special media.
2) Samples or materials must be taken from liquid part of stool mass.
3) Stool mass is diluted (1:5)
4) Usage of MacConkey and EMB media.
5) Blood inoculation in glucose bile broth.
6) Preliminary identification of colony O1 Salmonella bacteriophage.
7) For complete identification use different O and H antisera.

Prophylaxis
There is no specific prevention, no vaccine. Only by following hygiene procedures and proper
cooking of food.

Treatment
Evacuation of all food from GIT
Drink KMnO4 (in order to absorb toxin, neutralize toxin and avoid vomiting)

Diagnosis is done by serological test only:


1) Widal test
2)Passive agglutination test (PHAT)

V.10
1.Antigenic structure of Salmonella. Localisation og antigens in bacterial cell
Antigenic structure of Salmonella
Salmonella possess following antigens: O, H, Vi antigens.

1) Somatic O antigen is phospholipid-protein-polysaccharide complex which forms integral


part cell wall. This is mosaic structure composed of 2 or more antigens. O antigen is affected
by boiling, alcohol and weak acid. Salmonella are classified into a numbers of groups. This
classification is based on the presence of characteristic O-antigen on bacterial surface.

Serological group Group specific antigen


A O2
B O4
D O9

2) Flagella H antigen It is affected by boiling and alcohol. H-antigen exists 1 or 2 phases:


a) Phase 1 Antigens are either species specific or shared by few species only. Phase 1
is called specific phase and designated by letters: a,b,c.
b) Phase 2 Antigens are widely shared, so named non-specific phase. They are
designated by numbers: 1,2,3.

3) Surface antigen Vi It is analogous to the K-antigen of coliforms. It is heat liable antigens,


destroying by HCl, NaOH. It can be inactivated by alcohol and 0.2% formaldehyde. It
provides antiphagocytic property. Only in carrier state, we can detect it by haemagglutination
test.

Antigen
Serological group Name H
O
Phase 1 Phase 2
A S.paratyphi A 1, 2, 12 a -
S.derbi 1, 4, 5, 12 f, g 1, 2
S.haifa 1, 4, (5), 12 Z10 1, 2
B
S.paratyphi B 1, 4, 5, 12 b 1, 2
S.typhimurium 1, 4, 5, 12 i 1, 2
S.infants 6, 7 R 1, 5
C1 S.choleraesuis 6, 7 c 1, 5
S.virchov 6, 7 R 1, 5
C2 S.newport 6, 8 eh 1, 2
S.dublin 1, 9, 12(vi) g, p -
S.enteritidis 1, 9, 12 g, m -
D
S.panama 1, 9, 12 e, v 1, 5
S.typhi 9, 12(vi) d -
E1 S.anatum 3, 10 ch 1, 6
2.Complete cholera diagnosis (step by step)