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بسم الله الرحمن الرحيم. GENUS: CAMPYLOBACTER Prof. Khalifa Sifaw Ghenghesh. Slender, Helically Curved Rods. Corkscrew-Darting Motility. Oxidase: +ve Microaerophilic > Campy. jejuni Campy. coli Campy. lari (Campy. laridis) Campy. Fetus Arcobacter >> A. butzleri.
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بسم الله الرحمن الرحيم GENUS: CAMPYLOBACTER Prof. Khalifa Sifaw Ghenghesh
Slender, Helically Curved Rods. • Corkscrew-Darting Motility. • Oxidase: +ve • Microaerophilic > • Campy. jejuni • Campy. coli • Campy. lari (Campy. laridis) • Campy. Fetus • Arcobacter >> A. butzleri
Campylobacter jejunithin, comma-, S-, or gull-winged shaped forms (48 h culture)
VIRULENCE FACTORS • Motility • Adherence • Invasion • Toxin Production • Cytotoxins: • Enterotoxins
DISEASE • in Animal: • in Man: • Diarroeal Illness: • Guillain-Barre Syndrome (GBS):
LABORATORY DIAGNOSIS • Specimen: • Culture: • Selective media >> Skirrow's > • Incubation: • Temp. • microaerobic gas generation packs • Identification: • Oxidase, Gram stain, Hippurate hydrolysis
Blood agar plate culture of Campylobacter fetus s. intestinalis
TREATMENT • Campylobacter enteritis • Self-limiting • Fluid and electrolyte replacement • Erythromycin • Fluoroquinolones • Ciprofloxacin
EPIDEMIOLOGY • Incidence • Source of Transmission • Poultry and Raw Meats • Other routes of Infection
CONTROL • Education: • Keep food that will be eaten raw, such as vegetables, from becoming contaminated by raw animal-derived food products. • Thoroughly cook all food products from animals, especially poultry, and avoid consuming unpasteurized milk, or other unpasteurized products. • Cases should not prepare food for other individuals or attend child care until diarrhea has resolved. • Educate case and household contacts on proper hand washing techniques. • Always wash hands thoroughly with soap and water before eating or preparing food, after using the toilet, after changing diapers, and after touching pets or other animals (especially puppies and kittens with diarrhea). • After changing diapers, wash your hands AND the child’s hands. • In a childcare setting, dispose of stool and soiled diapers in a sanitary manner.
CONTROL • Food Handlers: • Food handlers should be excluded from work until diarrhea has resolved. • While individual circumstances may vary, cases are generally not required to provide two negative stools to return to work. • If a case has questionable hygienic practices or there are other concerns, a food handler should be excluded from work until two negative stool cultures have been obtained at least 24 hours apart. • In an outbreak situation, negative cultures may be required to return to food handling.
Information on children with Campylobacter- associated diarrhoea in Tripoli. ________________________________________________ Pt. Age/ Stool with Vomiting Fever dehyd- Sex mucus blood ration --------------------------------------------------------------------------------- 1. 3/F -- + -- -- + 2. 7/M -- -- + + -- 3. 8/F + -- -- -- -- 4. 9/F -- -- -- -- + 5. 4/M + -- + -- -- 6. 14/M + -- -- + -- ---------------------------------------------------------------------------------
بسم الله الرحمن الرحيم GENUS: HELICOBACTER Prof. Khalifa Sifaw Ghenghesh
Spiral, curved/straight G-ve rods. • Motile. • Microaerophilic / 37oC. • Oxidase +ve • > 15 species of Helicobater • H. pylori
Helicobacter pylorishowing typical thin, comma- or S-shaped forms (72 h culture).
1. H. pylori • Natural Habitat: - Human gastric mucosa. - Dental plaque. - Human faeces. • Transmission: - Faecal-oral or Oral-oral route. - Flies ???
Virulence Factors: • Urease, Phospholipase A, etc. • Clinical Significance: • Duodenal Ulcer & Gastritis. • Gastric adenocarcinoma.
LABORATORY DIAGNOSIS 1. Invasive Tests: • Specimen: Gastric mucosa. • Microscopy: • Culture: Selective media • Biopsy urease test: 2. Non-Invasive Tests: • Serology: Abs to HP • Urease breath test:
Twice-Daily PPI-Based Triple Therapies • Cure rate 90%: 2 weeks (? 10 days) in U.S., 1 week outside U.S. • Omeprazole 20 mg bid or Lansoprazole 30 mg bid • Clarithromycin 500 mg bid • Amoxicillin 1 g bid or Metronidazole 500 mg bid Twice-Daily RBC-Based Triple Therapy • Cure rate 90% in 2 weeks • Ranitidine bismuth citrate 400 mg bid • Clarithromycin 500 mg bid • Amoxicillin 1 g bid (?metronidazole 500 mg bid)
FDA-Approved (USA) Dual Therapies • Cure rate 70% at 2 weeks • Omeprazole 40 mg qd • Clarithromycin 500 mg tid • Cure rate 80% at 2 weeks • Ranitidine bismuth citrate 400 mg bid • Clarithromycin 500 mg tid
H. cinaediH. fennelliae • Natural Habitat: • Intestinal tract in rodents. • Human faeces & rectal cultures. • Clinical significance: • Proctocolitis, Proctitis, Enteritis, Bacteraemia.
