Agent

Defining
Characteristics

VIBRIONACEAE

gram (-),comma shaped

rods
oxidase (+)
motile, polar flagellum
highly pleomorphic with
many typical forms of
colonies

Growth
Requirement

Determinants of
Pathogenicity

Clinical Diseases

Laboratory
Diagnosis

Treatment

1. ENTEROTOXIN
- choleragen
- 2 major noncovalently associated signs:
a. A (active)
region: biologic activity
b. B (binding)
region: facilitates binding
of toxin to
intestinal cells
via cyclase-AMP system
2. ADHESION FACTORS
- Mucinase: dissolve
glycoprotein coating
(mucin) of
the intestinal cells

Disease: CHOLERA
- passing out RICE
WATER stool
- increased fluid loss and
electrolyte imbalance
- mortality: severe
dehydration

Laboratory Diagnosis
1. stool exam
- charactersitic rice
water stool
2. motility studies
a. hanging drop
method
b. DARTING motility
due to polar flagellum
3. Dark Field Microscopy
- using live wet mount

Treatment
1. HYDRATION in
DOUBLE LINE
a. replacement line
b. maintenance line
2. ANTIBIOTIC
COVERAGE
a. tetracycline
b. chloramphenicol
c. cephalosporin

Species:
* V. cholerae
* V. parahemolyticus

Vibrio cholera

school of fishes
Biotypes:
1. eltor
- (+) Voges-Proskauer
Reaction
- Agglutinates RBC of
chickens
- sensitive to
Polymixin B (anti-fungal
agent)
2. cholerae
-serotype:
a. inaba
b. ogawa
c. hikojima

Epidemiology
Mode of Transmission
- fecal-oral route by eating
contaminated food and
water
- seasonal flooding causing
contamination of water
supply

Main Diagnostic Test

* STOOL CULTURE AND
ISOLATION
1. tellurite taurocholate
gelatin agar
colonies with
surrounding cloudy zone
due to
hydrolyzed gelatin

(GELATINASE ENZYME)
2. TCBS (Thiosulfate
Citrate Bile Salt Sucrose
Agar)
microorganisms
developed small yellow
colonies
with opaque centers
and transparent periphery
colony: FRIED
EGG appearance
Biochemical Test
1.CHOLERA RED TEST
- peptone water +
tryptophan +organism
- broth + nitrate +
sulfuric acid
- (+) result: red color in
peptone water
2. ANIMAL
INCOLUATION STUDIES
a. inject mo in
abdomen of lab animal
b. oral route
3. SEROLOGICAL TESTS
a. slide agglutination
test
b. fluorescent antibody
test
c. immobilization test
of live organism

Vibrio
parahemolyticus

- food poisoning:
DIARRHEA
- HALOPHILIC marine
organismsseafood

1. ENTEROTOXIN
- similar with
choleragen

poisoning
- requires at least 2% NaCl
grow
- inhabits in brackish water
and infect coastal water
mollusks and
crustaceans (raw or
improperly cooked)
- INTRAVASCULAR
HEMOLYSIS
cardiogenic shock

HELICOBACTER
PYLORI

- gram (-) spiral-shaped

rods
- capnophilic
- microaerophilic
- urease producer (used for
biochem test)

2. CYTOTOXIN
-thermostable toxin
that causes hemolysis and
is cardiac
toxic in certain animals

1.CYTOTOXIN
- main virulence factor
- vacuolation in
cultured gastric cells
- Type 1 strains
isolated in gastric ulcers
and carcinoma
- chronic gastritis
carcinoma

1. chronic gastritis
2. peptic ulcer
- transferred from
person to person (family
clustering)
- affect mucosa of
stomach

- endoscopy with biopsy

(get from edge of ulcer)
a.gram staining
b. histologic analysis
c. culture on BAP
Biochemical Testing
1. INVASIVE
CAMPYLOBACTERLIKE ORGANISM (CLO)
TEST
- based on urease
activity
- direct test for urease
production
- gastric mucosa
(biopsy)
+
Urea containing
broth
+

1. ANTACID (PPIs)
- no acid production
a. omeprazole
b. lazoprazole
c. pantoprazole
2. ANTIBIOTIC
a. clarithromycin
b. tetracyclin
c. amoxicillin
d. metronidazole

Indicator
- (+) result: dark pink
color formation
- read within 20-60
minutes to increase
specificity
2.NON-INVASIVE TEST
- principle: infected
patient allowed to drink
ureacontaining
solution
- urea will be
hydrolyzed into
ammonia(excreted in
urine) + CO2
(eliminated in the lungs)
- Urine test + Urea
breath test

CAMPYLOBACTER

Species
1. C. jejuni
2. C. fetus
- associated with
systemic febrile infection in
debilitated patients
Zoonotic with reserviors
at:
1. poultry

- gram (-) curved rods in

pairs
- GULL WING
appearance
- capnophilic (10%CO2 for
growth)
- thermophilic (best growth
2 42C)
- microaerophilic

1. erythromycin
2. tetracycline

1. Acute gastroenteritis
(sever ulcer)
2. associated with
Guillaine-Barre Syndrome
- due to cross reaction
with LPS and neuron
- ascending paralysis
- diaphragmatic
paralysis respiratory
arrest

1. gram staining
2. culture and isolation of
stool

2. cattle
Mode of Transmission
- fecal-oral route with
contaminated water and
food
1