Professional Documents
Culture Documents
GASTROENTRITIS DAN
HELICOBACTER PYLORI
OLEH :
MUHAMMAD ASAAD MAIDIN
BAGIAN MIKROBIOLOGI, FAKULTAS
KEDOKTERAN UNHAS
Enterohemorrhagic
( EHEC, VTEC )
Enteroadherent ( EAEC )
Shigella dysentriae, S.
flexnery, S.boydii, S.sonnei
Salmonella typhi
Salmonella enteritidis*
Vibrionaceae
Vibrio cholerae
Vibrio Parahaemolyticus
Campylobacter and
Helicobacter
Campylobacter fetus,
C.jejuni
Helicobacter pylori
Human carriers,
possibly catle
Human carriers
Human GI tract
Human GI tract
Cattle, poultry
Human GI tract
Seawater, seafood
Animals, human
carriers
Unknown
Diarrhea, hemorrhagic
colitis, hemolytic-uremic
syndrome
Diarrhea
Dysentery, diarrhea
Typhoid fever,
bacteremia
Gastroenteritis
Profuse, watery diarrhea
Watery diarrhea
Diarrhea, septicemia
Chronic gastritis, peptic,
ulecer, gastric cancer
EAEC=enterodherent E.coli; EHEC=enterohemorrhagie; ETEC= enterotoxigenic; E.coli; G1=gastrointestinal;
VTEC= verotoxin-producing E.coli. S. enteritidis is subclassified into hundreds of serotypes
Gastrointestinal
Urinary tract infections
Klebsiella pneumoniae
Pseudomonas aeruginosa
Staphylococcus aureus
Anaerobic bacteria
Vibrio cholerae
Vibrio parahaemolyticus
Escherichia coli
Salmonella species *
Shigella species
Campylobacter species
Helicobacter pylori
Clostridium perfringens
Clostridium difficile
Bacillus cereus
Escherichia coli
Pseudomonas aeruginosa
Enterobacter species
Kl;ebsiella species
Proteus species
Table 52-1. Noninvasive Versus Invasive Diarrhea
Noninvasive Invasive ( Bacterial / Parasitic )
Stool Profuse secretory Dysentery
(blood,mucus,PMN lukocytes
( Severe, watery )
Fever No Yes
Systemic No Yes
Abdominal pain Mild Severe ( carmping, tenesmus )
Site of infection Small intestine Colon
PMN = polymorphonucleaR
Tabel 52.2 . Features of specific Types of Noninvasive Bacterial
diarrhea
Vibrio
Cholerae
Escherichia
coli
Clostridiu
m
prefringen
s
Bacillus
cereus*
Staphylococc
us aureus+
Incubation
( hours )
Duration
( Housr )
Abdominal
cramps
Vomiting
12 72
48 120
0
+
24 72
24 48
+
6 12
12 24
++++
+
3 8
12 24
++
++
1 6
6 12
++
++++
Diarrhea can be caused by performed toxin or by toxin elaborated in the intestine by proliferating bacteria
+ Diarrhea can be caused by ingestion of toxin contaminated food
Table 52-3. Features of Specific Types of Invasive
Bacterial Diarrhea
Shigella Escherich
i coli
Salmonella Yersinia
enterocoliti
ca
Incubation
( hours )
Duartion
(hours)
Abdominal
pain
Vomiting
Fever
24 72
48 120
++++
++
++
24 72
24 48
++++
+
++
8 48
12 24
+
+
++++
1 6
6 12
++
++
++
Table 52-4. Clinical and Epidemiological Features of Bacterial Food
Poisoning
Cause
Percentage
of Reported
Outbreaks
Incubatio
n Period
( hours )
Clinical
Presentation
Characteristic
Foods
Intoxication
Bacillus cereus
Clostridium
botolinum
Staphylococcus
aureus
Vibrio
parahaemolyticus
Infections
Bacillus cereus
clostridium
perfringens
Salmonella
Shigella
1 2
5 15
15 25
1 2
1 2
5 15
10 30
2 5
1 6
12 27
2 4
10 24
6 24
9 15
6 48
12 48
Vomiting
Neuromuscular
Paralysis
Vomiting
diarrhea
Watery diarrhea
Watery diarrhea
Watery diarrhea
Dysentery
Dysentery
Re-warmed fried
rice
Canned foods of all
types
Metas, custrad,
Salads
Shellfish
Meat, poultry,
vegetables
Meat, poultry
Poultry, eggs, meat,
vegetables
Variable
HELICOBACTER PYLORI
# Spiral shaped or curved negative gram
rod similar in appearance to
campylobacters, but differ sufficiently in
certain biochemical and flagellar
characteristics.
# Motile active
# On media skirrow or cocolate medium,
growing with in 3-6 hari, 37C,
# microaerofilic.
# Oxidase positive
# Catalase positive
# Strongly urease positive
(Campylobacter urease negative)
# Flagella positive
The environment found in the mucous
layer of the gut, a transitional zone
between the anaerobic lumen and the
oxygenated mucosa
Size 3.5x o,6 um, with 1.5 wave lengths
and 4 to 7 sheated flagella at one end
of the organism.
HP causes gastritis and peptic ulcer.
Infection with HP is a risk factor for
gastric carcinoma.
Transmission : person to person
because there is clustering with in
families.
Laboratory diagnosis:
= Gram stained smears(endoscopy or
biopsy)
=