microbial diseases of the digestive system
DESCRIPTION
MICROBIAL DISEASES OF THE DIGESTIVE SYSTEM. MOUTH. Over 300 types of bacteria Dental caries Periodontal disease Gingivitis Periodontitis. DENTAL CARIES. Dental plaque Accumulation of microorganisms and their products (dental plaque) Streptococcus mutans Actinomyces spp. - PowerPoint PPT PresentationTRANSCRIPT
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MICROBIAL DISEASES OF THE DIGESTIVE
SYSTEM
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MOUTH• Over 300 types of bacteria• Dental caries• Periodontal disease
–Gingivitis
–Periodontitis
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DENTAL CARIES• Dental plaque
–Accumulation of microorganisms and their products (dental plaque)
–Streptococcus mutans
–Actinomyces spp.
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DENTAL CARIES (cont.)
• Attachment• Colonization• Sugar (glucose+fructose)• Glucose > dextran• Fructose > lactic acid
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Enamel
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DENTAL CARIES (cont.)• Lactic acid softens enamel• Initial, S. mutans• Advance, Lactobacillus spp.• Pulp infection
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DENTAL CARIES (cont.)• Treatment
– Root canal therapy– Penicillin
• Prevention– Fluoride– Reduced sucrose in diet– Brushing and flossing– Professional cleaning
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PERIODONTAL DISEASE
• Inflammation of teeth-supporting tissue• Gingivitis
– Gums inflammation (bleeding)
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PERIODONTAL DISEASE (cont.)
• Streptococci, actinomyces and gram-negative bacteria
• Prevented by brushing & flossing
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PERIODONTITIS• Chronic gingivitis• 10% of teeth loss• Affects bone• Surgery and cleaning
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LOWER DIGESTIVE SYSTEM
• Infections
–Salmonellosis• Intoxications
–Staphylococcus aureus
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Practice that contributed to food-borne disease (1988-1992)
1. Improper holding temperature2. Poor personal hygiene of food
handlers3. Food obtained from an unsafe
source was the least commonly reported factor
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Syndrome
• A group of symptoms that together are characteristic of a specific disease
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Gastrointestinal Syndrome• Gastroenteritis associated with
nausea, vomiting and diarrhea
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Dysentery syndrome
• Any infectious disease of the large intestine marked by ulceration, hemorrhagic diarrhea with mucus and often blood
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GASTROENTERITIS• Inflammation of the stomach and
intestinal mucosa
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GASTROENTERITIS (cont.)
• Abdominal cramps• Nausea• Vomiting• Dehydration
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GASTROENTERITIS (cont.)
• E. coli• Shigella spp.• Salmonella spp.• Campylobacter spp.• Staphylococcus aureus• Rotavirus• Norwalk virus (Noro virus)
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Routes of exposure to enteric pathogens
• Fecal contamination (human/animal)
–Food
–Water
–Fomites (doorknobs, telephones)
–Direct contact
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Non-traditional pets
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Pest animals
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Population at risk
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Occupational risk
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STAPHYLOCOCCAL FOOD POISONING
• S. aureus survives 30 min at 60o C (140o F)
• High salt concentration• Skin and nasal mucosa• Facultative anaerobes
-Coagulase positive
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STAPHYLOCOCCAL FOOD POISONING
(cont.)• Temperature abuse
–Food let to cool slowly
–Organisms grow producing toxin
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STAPHYLOCOCCAL FOOD POISONING
(cont.)• High risk foods
–Custards
–Cream pies
–Ham
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STAPHYLOCOCCAL FOOD POISONING (cont.)
• Toxin affects brain’s vomiting reflex
• Abdominal cramps• Diarrhea
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SALMONELLOSIS
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Salmonella spp.
• Gram negative rods• Facultative anaerobe• 2000 serovars
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SALMONELLOSIS (cont.)
• S. dublin• S. enteritidis• S. typhimurium• S. cholerasuis
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SALMONELLOSIS (cont.)
• Domestic animals
–Poultry
–Swine
–Cattle
–Dogs and cats
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SALMONELLOSIS (cont.)
• Wild animals
–Rodents
–reptiles
–Terrapins (turtles)
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SALMONELLOSIS (cont.)
• Incubation of 12 - 36 h• Intestinal mucosa• Lymphatic and cardiovascular
systems
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SALMONELLOSIS (cont.)
• Fever• Nausea• Abdominal pain• Cramps• Diarrhea
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SALMONELLOSIS (cont.)
• Mortality among infants and the elderly
• Many shed Salmonella for 6 months
• Many animals are chronic carriers
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SALMONELLOSIS (cont.)
• Treatment
–Rehydration
–Antibiotics prolong carrier state and increase resistance
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TYPHOID FEVER
• Salmonella typhi
–Rare in animals!• Incubation
–2 weeks
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TYPHOID FEVER (cont.)
• High fever (104o F)• Continual headache• Constipation more common
than diarrhea• 10% fatality rate
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TYPHOID FEVER (cont.)• Many recovered patients become
carriers (Typhoid Mary)• Obligatory case report in most
states and countries• Lifelong immunity
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TYPHOID FEVER (cont.)• Treatment
–Cephalosporins
–Chloramphenicol
–Amoxillin
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Shigellosis
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SHIGELLOSIS (Bacillary dysentery)
• Shigella spp.• Gram negative facultative anaerobic
rod• Only infects humans• Low infectious dose
–Resistant to low stomach pH
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SHIGELLOSIS (cont.)• S. sonnei
– Most common in the USA– Least severe
• S. dysenteriae –Uncommon in the USA –Most severe
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SHIGELLOSIS (cont.)• Shiga toxin
–Inhibits protein synthesis
–Diarrhea with blood and mucus (dysentery)
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SHIGELLOSIS (cont.)• 20,000- 25,000 cases/year• 5 to 15 deaths• Treatment
–Rehydration
–Fluoroquinolones (severe cases)
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Cholera
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CHOLERA• Vibrio cholerae• Aquatic organism• Gram-negative rod • Non-invasive
–toxin producing
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Cholera epidemicSouth America1991-1994• 1 million cases• 9,600 deaths
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CHOLERA (cont.)• Enterotoxin• Rice-water stools• 20 liters of liquid lost/day• Occasional outbreaks in Gulf coast
(seafood)
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CHOLERA (cont.)• 50% mortality if untreated• 1% mortality if treated
–Rehydration
–Tetracycline
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Vibrio gastroenteritis• Vibrio parahaemolyticus• Salt water estuaries• Resembles cholera• Often foodborne (seafood)
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E. coli
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Escherichia coli gastroenteritis
• Enterotoxigenic E. coli• Enteroinvasive E. coli• Enterohemorrhagic E. coli
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Enterotoxigenic E. coli
• Specialized fimbriae
–Attachment• Not invasive• Toxins• Severe diarrhea
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Enteroinvasive E. coli• Specialized fimbriae
–Attachment• Toxins (cholera-like)• Traveler’s diarrhea (?) • Penetrate intestinal lining
–Shigellosis-like dysentery
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Enterohemorrhagic E. coli• O157:H7 strain• Foodborne (hamburgers, milk,
apple cider)• Verotoxins (colon bleeding)
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Enterohemorrhagic E. coli (cont.)
• Cattle carrier• Hemolytic uremic syndrome
–Blood in urine
–Kidney failure
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Campylobacter jejuni gastroenteritis
• Gram-negative microaerophilic spirally curved rods
• Common in (healthy) domestic animals
–May be shed in milk• Small infectious dose• Dysentery
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Yersinia spp. gastroenteritis
• Common in domestic animals• Grows at refrigeration temperature• Acute pain
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Clostridium perfringens gastroenteritis
• Gram-positive, spore-forming anaerobic rod
• Contaminated-cooked meat• Temperature abuse• Mild diarrhea
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Bacillus cereus gastroenteritis
• Gram-positive, spore-forming anaerobic rod
• Common in soil and vegetation• Gastroenteritis is similar to Cl.
perfringens
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VIRAL GASTROENTERITIS
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ROTAVIRUS• Most common viral gastroenteritis• 1,000,000 cases/year (USA)• 100 deaths/hour• (developing countries)
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NORWALK VIRUS• Common among adults• More resistant to chlorine than
other viruses• No animal models or cell culture
available