Microbiology Diseases Of The Gastrointestinal And Genitourinary Tracts

Front 1

Usual Flora

Back 1

- stomach and small intestine have few resident microflora
- large intestine --> lactobacillus, E. coli, bacteriodes, enterobacter, klebsiella, proteus, and other enterics
- large numbers of bacteria colonize the mouth
- up to 40% of fecal mass is composed of microbial cells

Front 2

Bacterial Diseases of the Mouth

Back 2

- dental caries
- periodontal disease

Front 3

Structure & Function of the Digestive System

Back 3

- Gastrointestinal Tract
- Accessory Structures

Front 4

Gastrointestinal Tract

Back 4

mouth, pharynx, esophagus, stomach, small intestine, and large intestine

Front 5

Accessory Structures

Back 5

teeth, tongue, salivary glands, liver, gallbladder, and pancreas

Front 6

Dental Caries

Back 6

- plaque
- role of streptococcus mutans

Front 7

Periodontal Disease

Back 7

- chronic gum disease
- streptococcus, actinomces, and various anaerobic bacteria
- acute necrotizing ulcerative gingivitis caused by Prevotella intermedia & spirochetes

Front 8

Bacterial Diseases of the Lower Digestive System

Back 8

- G.I. tract infecvtion --> caused by growth of a pathogen in the intestine
- incubation times vary (12 hours to 2 weeks); is time factor that allows it to grow
- intoxication --> results from ingestion of preformed bacterial toxins
- symptoms of intoxication appear in one to 48 hours after ingestion
- diff bt infection and intoxication
- intoxications and infections commonly cause diarrhea, dysentery, or gastroenteritis

Front 9

Staphylococcal Food Poisoning

Back 9

- caused by toxin-producing strains of s. aureus
- ingestion of preformed toxin (true intoxication)
symptoms: nausea, vomiting, diarrhea, cramping

Front 10

Staphylococcal Food Poisoning Process

Back 10

1. Food containing protein is cooked (bacteria usually killed)
2. Then food is contaminated by worker with staphylococci on hands (competign bacteria have been eliminated)
3. Organisms incubate in food

Front 11

Salmonellosis

Back 11

- more than 2000 serotypes of salmonella
- numerous animal sources
- a true bacterial infection
- 12-36 hr incubation period
- nausea, abdominal pain, diarrhea
- serious infections seen in infants and the elderly
- very common infection

Front 12

Salmonella typhi

Back 12

- specific salmonella species
- causative agent of Typhoid Fever
- a systemic disease from the onset
- incubation period --> two weeks
- fever, malaise, and characteristic rash (have systemic systems)
- may localize in the gallbladder (imp bc able to take stool samples from indls and not be able to isolate the organisms)
- found only in humans

Front 13

Bacillary Dysentery

Back 13

- caused by shigella spp.
- blood and mucous in stool
- abdominal cramps, fever (fever tells us is invasive rather than toxin-producing)
- found in humans only
- four species, closely related to E. coli
- Sh. dysenteriae - most virulent
- Sh. flexneri (common in U.S.)
- Sh. boydii
- Sh. sonnei (most common species in the US)

Front 14

Salmonella vs. Shigella

Back 14

see handout

Front 15

E. coli Gastroenteritis

Back 15

- caused by invasive or toxigenic strains of Escherichia coli (we all have E. coli in our intestinary tract)
- Epidemic diarrhea in hospital nurseries (EPEC - enteropathogenic E. coli-strains of E. coli that caused epidemics of severe diarrhea in infants)
- Traveler's diarrhea (Montezuma's revenge)

Front 16

Enterohemorrhagic E. coli

Back 16

- Escherichia coli O157:H7
- hemorrhagic colitis
- hemolytic uremic syndrome (progresses to kidneys, could lead to permanent kidney damage and/or death)
- acquired from specific toxigenic serotypes
- undercooked hamburger, apple cider, and many other foodstuffs

Front 17

Yersinia enteritis

Back 17

- casued by Yersinia enterocolitica and Yersina pseudotuberculosis (see in Europe)
- Y. enterocolitica is seen in the US (not seen in this area, mostly in cold areas)
many animal sources (just like salmonella)
- unique to this: intestinal symptoms may mimic acute appendicitis
-

Front 18

Cholera

Back 18

- caused by Vibrio cholerae
- V. cholerae serotypes O:1 (produces disease cholera; other VC don't produce the toxin or the disease) and O:139
- symptoms due to elaboration of toxin
- vomiting and diarrhea lead to extreme fluid loss
- mortality rate may approach 50% in outbreaks

Front 19

Other Vibrio Species

Back 19

- Vibrio parahaemolyticus --> most common cause of gastroenteritis in Japan (due to raw seafood)
- associated with ingestion of raw seafood
- Vibrio vulnificus --> gastroenteritis and wound infections

Front 20

Campylobacter Enteritis

Back 20

- Campylobacter jejuni & C. coli
- leading cause of foodborne illness in US
- fever, cramping abdominal pain, diarrhea
- numerous animal sources --> poultry, beef, many other foods
- associated with Guillain-Barre Syndrome (an immune response involves nervous system, muscles become flaccid, paralyzed, sometimes associated with vaccines, viral infections)

Front 21

Peptic Ulcer Disease

Back 21

- caused by Helicobacter pylori (used to be a campylobacter)
- organism resides in the stomach
- leading cause of duodenal and gastric ulcers (found in upper intestine and stomach)
- may lead to gastric carcinoma (may lead to stomach cancers if are exposed to Helicobacter pylori)
- can be treated with antibiotics (if get rid of organism, got rid of ulcers)

Front 22

Other Types of Food Poisoning

Back 22

- Clostridial Food Poisoning
- Bacillus cereus

Front 23

Clostridial Food Poisoning

Back 23

- clostridium perfringens --> spore forming anaerobe
- meat and meat products

Front 24

Bacillus cereus

Back 24

- toxin producer
- spore-forming aerobic bacillus
- associated with contaminated rice dishes
- nausea, vomiting

Front 25

Viral Diseases of the Digestive System

Back 25

- mumps
- hepatitis
- viral gastroenteritis

Front 26

Mumps

Back 26

- inflammation of the parotid glands
- fever, pain on swallowing, orchitis (?) may occur
- MMR vaccine has been very effective

Front 27

Hepatitis

Back 27

- inflammation of the liver
- symptoms --> jaundice, loss of appetite, malaise, fever, etc.

Front 28

Viral Gastroenteritis

Back 28

- Rotavirus
- Norwalk agent

Front 29

Hepatitis Virus

Back 29

- Hepatitus A B C D

Front 30

Hepatitis A

Back 30

- infectious hepatitis A
- acquired from contaminated food or water
- virus is eliminated in feces
- vaccine is available

Front 31

Hepatitis B

Back 31

- serum hepatitis
- transmitted by blood, contaminated syringes, saliva, sweat, breast milk, semen
- HBV infection is frequently serious
- HBsAg is most common serological test
- vaccine is available

Front 32

Hepatitis C

Back 32

- transmitted via blood
- "silent epidemic" -- may incubate for 20 years before symptoms appear
- results in more deaths than from AIDS
- most cases eventually lead to chronic hepatitis
- blood for transfusions is tested for HCV

Front 33

Hepatitis D

Back 33

- Delta hepatitis
- uses HBsAg as a coat
- only seen in patients concurrently infected with HBV
- progressive liver disease and higher fatality rate than present when infected with HBV alone

Front 34

Hepatitis E

Back 34

- infectious NANB (non-A, non-B) hepatitis
- transmitted via fecal-oral route
- high mortality rate in pregnant women

Front 35

Other Hepatitus Viruses

Back 35

- Types F & G? (they are being characterized right now)- E, F & G are fairly rare
- may be others we don't know about

Front 36

Characteristics of Viral Hepatitis

Back 36

look at handout
- if look at slides, we'll be fine
- antibody prevalence: highest is Hep A at 33%

Front 37

Fungal Diseases of the Digestive System

Back 37

- Ergot Poisoning
- Aflatoxin Poisoning

Front 38

Ergot Poisoning

Back 38

- Claviceps purpurea
- Mycotoxin on cereal grains
- don't see this as much anymore

Front 39

Aflatoxin Poisoning

Back 39

- Asgergillus flavus
- Mycotoxin on peanuts
- the fungi we are talking about are found on plant and organisms, are Eukaryotes

Front 40

Protozoal Diseases of the Digestive System

Back 40

- Giardiasis --> Giardia lamblia (most commonly found here, in lakes and streams)
- Amoebic dysentery - Entamoeba histolytica
- Cryptosporidiosis - Cryptosporidium parvum
- Cyclospora diarrheal infection - Cyclospora cayetanensis

Front 41

Helminthic Infestations

Back 41

- tapeworm infestations
-- Taenia saginata - beef tapeworm
-- Taenia solium - pork tapework
- Dydatid disease
-- Echinococcus granulosis

Front 42

Taenia spp.

Back 42

- can get to 20-30 feet in length
- grow in intestine
- acquire from eating beef and pork that have tapeworm

Front 43

Nematode Infestations

Back 43

- pinworm (most common health concern in this area) - Enterobius vermicularis (study in LL, almost 1/3 of kids carried pinworm, in intestinal tract)
- hookworm - Necator americanus (found in US) and Ancyclostoma duodenale (found in Europe); eggs look similarly, so can distinguish by looking at worm
- Ascariasis - Ascaris lumbricoides
- Trichinosis -- Trichinella spiralis (an intestinal worm, meat has larvae in it)

Front 44

Ascaris lumbricoides

Back 44

- 10-14 inches in length
- 10-20K death/year due to blockage

Front 45

Enterobius

Back 45

- adult lives in intestines
- pinworm
- mostly seen with kids, at nite, female crawls out of anal opening and deposits eggs near anus and crawl back in. Eggs are sticky and cause irritation
- diagnosed with pinworm paddle; sticky tape on one side; press paddle against anal opening and look for pinworm eggs

Front 46

Trichonosis

Back 46

see handout
- didn't spend too much time with this

Front 47

Diseases of the Urinary System

Back 47

- structure and function -- kidneys, ureters, urinary bladder, urethra

Front 48

Cystitis

Back 48

- inflammation of the urinary bladder and ureters (usually just the bladder)
- dysuria: painful urination
- pyuria: white blood cells (pus) in the urine
- Escherichia coli - is the main cause of cystitis
- Staphylococcus saprophyticus

Front 49

Diseases of the Urinary System

Back 49

- pyelonephritis
- Glomerulonephritis
- Leptospirosis

Front 50

Pyelonephritis

Back 50

- involvement of one or both kidneys
- E. coli

Front 51

Glomerulonephritis

Back 51

- immune complex hypersensitivity
- Streptococcus pyogenes

Front 52

Leptospirosis

Back 52

- occupational disease
- transmitted via infected urine, affects kidneys
- Leptospira interrogans

Front 53

Diseases of the Reproductive System

Back 53

- gonorrhea
- nongonococcal urethritis
- pelvic inflammatory disease
- syphilis
- lymphogranuloma venereum
- chancroid
- bacterial vaginosis
- genital herpes
- genital warts
- candidiasis
- trichomoniasis

Front 54

Gonorrhea

Back 54

- sexually transmitted
- hi incidence in women
- most females not aware they have this

Front 55

Nongonnococcal Urethritis

Back 55

- if affects urethra and is not gonorrhea
- Chlamydia trachomitis
- Genital mycoplasmas - Mycoplasma hominus and Ureaplasma urealyticum

Front 56

Pelvic Inflammatory Disease

Back 56

- can become permanently sterile and even death
- complication of some of these STDs
- Neisseria gonorrhoeae
- Chlamydia trachomatis

Front 57

Syphilis

Back 57

- lesion forms on genitals, anal opening
- primary lesion called shanker, then disappears. Period of time later, come up with secondary phase (rash, generalized symptoms); tertiary syphilis is very devastating

Front 58

Syphilis (cont.)

Back 58

- Treponema pallidum
- primary, secondary, and tertiary (any organ in body can be infected, like heart or brain, e.g.: go insane, suffer damage to heart muscle) stages
- latency beteween stages
can never get rid of it
- treatment: penicillin
characteristic lesions: chancre and gumma
- congenital syphilis: if preganant woman has, will cause malformation in fetus, MR, hearing loss, blindness

Front 59

Lymphogranuloma venereum

Back 59

- STD
- chlamydia trachomatis (usually think of eye infections but here is sexual)

Front 60

Chancroid

Back 60

- haemophilus ducreyi

Front 61

Bacterial Vaginosis

Back 61

- Gardneralla vaginalis
- inflammatory area in vagina
- Mobiluncus spp.

Front 62

Genital Herpes

Back 62

- very infectious, even during periods of outbreaks of legions
- Herpes simplex type 2

Front 63

Genital Warts

Back 63

- papillomavirus

Front 64

Candidiasis

Back 64

- a fungal infection caused by the yeast Candida albicans
- CA is what we usually carry in our intestinal tract, but if take over, can get yeast infection
- very common among females

Front 65

Trichomoniasis

Back 65

- a protozoan infection with Trichomonas vaginalis
- causes itching, irritation in vaginal area
- can be carried by men, don't see symptoms presented as much but sexual partner can be infected

Front 66

Vaginitis and Vaginosis

Back 66

see handout
- if PH is above alkaline, get diff exchange in microbial flora and has big factor in terms...