Sunday, April 5, 2009
12 - Facultative anaerobes part 2 ( ENTEROBACTERIACEAE )
• Salmonella :
o 2000 serotypes based on H (flagella protein), O (outer membrane protein) & K (Capsular protein)
o Antibodies obtained commercially for serotyping using Kauffmann-White scheme.
o Some Salmonella serotypes are host specific (humans= S. typhi S. paratyphi; animals (S. cholerae-suis but cause severe disease if transmitted to humans) & some others not host specific (affect humans & animals)
o Food borne disease mainly thro' poultry, eggs & dairy products
o Exposure to Salmonella is frequent but requires a high dose of 1 to 100 million (eg improperly refrigerated foods; low dose for immunocompromised, very young and the elderly or with decreased gastric acidity
o Disease is due to microbial growth in body tisssue & not by ingestion of foods contaminated with toxins as a result of microbial growth
o Salmonella infections occurs in one of four forms:
Gastoeneteritis (S. enteritis) most common form; eating contaminated foods; elevated temperatures, cramps & head ache. Symptoms disappear spontaneously in 2 to 7 days
Septicimia--All Salmonella can cause bacterimia (S. cholera-suis, S. typhi & S. paratyphi)
Enetric fever (S. typhi- typhoid fever & S. paratyphi- paratyphoid fever)-- Similar symptoms but paratyphoid fever milder; Transmission by consumption of contaminated foods --> multiplication in intestine (endothelial cells)--> invades lymphatic tissues to blood stream & kidneys (excreted in urine)
Asymptomatic carriage-- Establishes in gall bladder (ressists bile & bile salts); continuous feedback into intestine; known as carrier state (2-5% typhoid patients become carriers & excrete 1 to 1000 million S. typhi /gm feces & also in urine); Carrier state is important in transmission of the disease. Mary Mallon (1901), aka Typhoid Mary, was the first carrier case to be detected; In 15 years infected 200 & jailed to prevent spred of typhoid fever. Disease has declined due to curative & preventative measures (heat killed injectable vaccines or the new live oral vacciine; same efficacy but later has less side effects
• Shigella :
o Simple taxonomy (4 species & 32 serotypes) unlike Salmonella
o Found in humans, apes & monkey only unlike Salmonella
o Cause bacillary dysentry (shigellosis); S. sonnei (industrialized nations) & S. flexneri (developing nations); S. sonnei mild but S. dysenteriae (aka Shiga bacillus produces Shiga toxin) severe.
o Shigella enter endothelial cells (intestine) & multiply causing tissue damage; exotoxins stop host cell protein synthesis. Rarely (with the exception of S. dysenteriae) cause septicimia. 20 bowel motions a day.
o Transmission by fecal-oral route thro' contaminated hands & usually not by food-water
o Low dose required-- 200 Shigella cells can establish disease
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