Microbiology with Lab

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Microbiology with Lab

• Denver School of Nursing General Education
  Classes
• Lecture Friday 700am 1124am
• Laboratory Friday 1200 200pm
• Instructor Micah Hughes, MS Biotechnology, BA
  Bio / Anthro

BIO 205 CH 23 24 GI GU Micro
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Not so Microbiological
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Cholinergic Pharm
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Chapter 23Infections of the Digestive System
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The Digestive System
Figure 23.1
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Dental diseases

• Caries
• S. mutans
• produces glucan
• mesh for dental plaque
• lactic acid
• damages enamel
• Periodontal disease
• gingivitis
• inflammation of gums
• periodontitis
• damage to tissue
• Bacteriodes gingivalis, B. intermedius

Figure 23.2
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Mumps

• Mumps virus
• inflammation-salivary gland/other organs
• bilateral parotitis
• pathogenesis
• incubation up to 18 days
• upper respiratory tract
• move into salivary glands
• complications--spread to other areas
• orchitis (testes)
• deafness
• vaccine (MMR)

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Shigellosis

• Shigella species
• bacillary dysentery
• Pathogenesis
• penetrate mucosa cells--phagocytosis
• produce toxin--Shiga toxin
• intense inflammation
• bleeding/ulceration
• mucous and blood in excreta
• normally self-limiting
• recovery in 2-7 days
• severe dehydration--shock/death in children

Figure 23.5
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Typhoid Fever

• Salmonella typhi
• Pathogenesis
• contaminated food or water
• infections at other sites
• low infectious dose
• involve lymphatic and circulatory systems
• Symptoms
• about a month
• severe fever/headache
• apathy, weakness, abdominal pain and rash

Figure 23.6
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Salmonellosis

• Salmonella species
• pili adhere to GI tract
• invasive growth
• epidemiology
• ingestion of contaminated food
• poultry/eggs/meats/other foods
• inadequate cooking
• improper thawing
• symptoms
• abdominal pain, fever, diarrhea, last 3-5 days
• complications in old, young, immunosuppressed

Figure 23.8
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Escherichia coli

• Enterotoxigenic strains
• Travelers diarrhea
• Enterohemorrhagic strains
• E. coli O157H7
• hemolytic uremic syndrome
• bloody diarrhea
• severe anemia
• kidney failure
• shigalike toxin

• Many strains nonpathogenic
• Enteroinvasive strains
• Diarrhea in all ages
• Enteropathogenic strains
• diarrhea in infants
• Enteroaggregative strains
• Chronic diarrhea in infants

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Cholera

• Vibrio cholerae
• Asia, S. America, Africa
• Pathogenesis
• multiply within small intestines
• enterotoxin produce symptoms
• production of cyclic AMP in mucosal cells
• secretion of water/electrolytes into lumen
• loss of liters in hours
• sudden nausea, vomiting, abdominal pain, diarrhea
• rice-water stools
• severe dehydration
• need IV to replace fluids
• oral rehydration therapy

Figure 23.9
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Gastrointestinal infections

• Vibrio parahaemolyticus
• Gastroenteritis
• self-limited diarrhea or cholera-like illness
• fish from contaminated waters
• Yersinia enterocolitica
• Enterocolitis
• acute abdominal pain
• resemble appendicitis
• cause of unnecessary appendectomy

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Gastrointestinal infections

• Campylobacter spp.
• Campylobacteriosis
• Bloody diarrhea
• abdominal pain
• fever
• Clostridium difficile
• result of antibiotic therapy
• usually resolves when therapy ends
• cause of nosocomial infection

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Peptic Ulcer Disease

• Helicobacter pylori
• gastric and duodenal ulcers
• growth in stomach
• damage to mucosal lining--specific products
• survival in low pH
• organism produces urease
• urea--gtammonia
• increases pH in microenvironment
• allows growth
• Treatment
• antibiotics

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Staphylococcal food poisoning

• S. aureus (enterotoxin)
• absorbed in bloodstream (via digestive tract)
• 1-6 hours after eating
• nausea, vomiting, abdominal pain, diarrhea
• epidemiology
• from skin of food handlers
• incubate and grow
• custard-filled bakery goods
• dairy products
• processed meats
• potato salad
• various canned goods

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Other food poisoning

• Clostridium perfringes
• less severe
• absorption of toxin
• cooked meats and gravy
• spores not killed by cooking meat
• spores germinate when gravy incubates
• heat lamps, warmers
• toxin produced
• symptoms appear with 10-24 hours
• recovery within 24 hours

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Other food poisoning

• Bacillus cereus
• spore former
• vegetative cells incubate
• two different enterotoxins
• heat-stable vomiting
• rice
• heat-labile diarrhea
• meat and vegetables

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Rotavirus

• Gastroenteritis
• damages intestinal epithelial
• watery diarrhea
• fever
• vomiting
• nausea
• fecal/oral route
• infants and children

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Norwalk agents

• Gastroenteritis
• fecal-oral route
• symptoms
• nausea
• vomiting
• diarrhea
• crampy abdominal pain
• older children and adults
• incubation--48 hrs
• self-limiting disease

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Protozoan infections

• Amoebic dysentery
• Entamoeba histolytica
• invasive colitis
• extraintestinal amoebiasis
• widespread infection
• bloody mucoid stools
• fever abdominal pains
• Giardiasis
• Giardia lamblia
• transmission of cyst
• contaminated water
• person-person contact

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Protozoan infections

• Balantidiasis
• Balantidium coli
• invade epithelium of colon
• diarrheal stools
• blood and pus
• Cryptosporidiosis
• Cryptospridium
• abdominal pain
• watery, bloodless diarrhea
• municipal outbreaks

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Helminthic infections

• Pinworm
• small, white, roundworm
• females leave intestine to lay egg
• Ascaris lumbricoides
• roundworm
• lifecycle includes intestine, blood, lungs
• Hookworm
• suck blood from host
• Strongyloides stercoralis
• warm, moist climates
• multiple reinfection

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Helminthic infections

• Whipworm
• Trichuris trichiura
• whiplike roundworm
• Trichinosis
• Trichinella spiralis
• fever, muscle pain, malaise
• larvae migrating through tissues
• Tapeworms
• Taenia spp.
• Flatworms

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Hepatitis A virus

• Hepatitis A virus
• RNA virus
• fecal-oral spread
• infectious hepatitis

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Hepatitis B virus

• DNA virus
• three antigens
• HBsAg
• HBcAg
• HBeAg
• three forms
• Dane particles
• full virion
• spherical
• empty envelope
• tubule
• empty envelope

Figure 23.17
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Hepatitis B virus

• serum hepatitis
• contaminated blood or blood products
• 50 no symptoms
• most survive
• fulminant hepatitis
• total liver failure
• associated with liver cancer
• prevention
• HBV vaccine
• recombinant HBsAg

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Other Hepatitis viruses

• Hepatitis C
• Blood or sexual contact
• long incubation period
• six months
• 50 develop hepatitis
• Hepatitis Delta agent
• coinfection with Hepatitis B
• Hepatitis E virus
• infectious hepatitis
• serious during pregnancy

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Helminthic Infections

• Liver Fluke
• Fasciola hepatica
• sheep liver fluke
• Opisthorchis sinensis
• Chinese liver fluke

Fig 23.18
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Break Time!!!
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Chapter 24Infections of the Genitourinary System
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Urinary Tract Infections

• Urinary tract infection (UTI)
• any or all parts of urinary tract
• Cystitis common bladder inflammation
• E. coli--most common
• Urethritis urethra
• many organisms
• Pyelonephritis kidneys
• E. coli 75

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Leptospirosis

• Leptospira interrogans
• Spirochete
• kidney or liver disease
• Weils syndrome
• animals to humans
• urine contaminated water
• entrance
• mucous membrane
• break in skin
• difficult to diagnose
• small cells
• special media for culturing

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Sexually Transmissible Diseases

• Increase in STDs
• antibiotic resistance
• newly recognized pathogens
• multiple sexual partners

Two sexual partners per month
Three sexual partners per month
Figure 24.3
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Gonorrhea

• N. gonorrhoeae
• sexually transmitted disease urethra
• 300,000 cases/60 age 15-24
• males--80 symptoms urination/discharge
• females--asymptomatic
• leads to pelvic inflammatory disease
• potential for systemic infection
• gonorrheal endocarditis
• gonorrheal meningitis
• gonorrheal arthritis
• infants ophthalmia neonatorum

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Syphilis

• Treponema pallidum
• spirochete
• Primary stage several weeks
• hard based chancre
• infectious serous exudate
• Secondary stage 6-8 weeks
• skin rash
• loss of hair
• malaise, mild fever
• Latent period
• Tertiary phase years later
• untreated cases
• T-cell immunity--gummus (rubbery mass)

Figure 24.5
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Chlamydia

• Chlamydia trachomatis
• coinfection with N. gonorrhoeae
• most prevalent STD
• many cases go untreated
• leading cause
• infertility
• ectopic pregnancy
• transmit to infant at birth
• neonatal eye infection

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Other STDs

• Lymphogranuloma venereum (LGV)
• Chlamydia trachomatis
• invasive strain
• infects lymphoid tissue
• tropical regions
• Chancroid
• Haemophilus ducreyi
• tropical areas
• Africa, Asia, Latin American
• becoming more common in US
• linked to crack cocaine epidemic
• ulcer on genitals

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Other STDs

• Nongonococcal urethritis
• inflammation of urethra
• other than N. gonorrhoeae
• Granuloma Inguinale
• Calymmatobacterium granulomatis
• not highly communicable
• raised lesions
• open draining ulcers

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Viral STDs

• Genital herpes
• Herpes simplex virus
• HSV-2 normally genital tract
• HSV-1 normally mouth and face
• cold sores, fever blisters
• latency
• moves from nerve ending to nerve ganglion
• reactivates to epithelial tissue
• Neonatal herpes
• brain and internal organs
• lifelong disabilities
• No cure--treatment with acyclovir

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Viral STDs

• Genital warts
• Papilloma virus
• Over 65 types--based on DNA
• Diseases
• benign wart
• cervical carcinoma
• Replication
• proliferation of cells
• basal layer of epithelium
• no progeny virus in these cells
• cells differentiate
• virus replicates in later cells--shed from surface

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Female reproductive tract

• Vaginitis
• vaginal secretion
• Gardnerella vaginalis
• decrease in lactobacilli
• increase in pH
• fishy-smelling discharge
• diagnosis
• vaginal wet mount
• Gram stain
• absence of other bacteria

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Female reproductive tract

• Toxic Shock Syndrome
• strains of Staphylococcus aureus
• produce toxin
• toxic shock syndrome-associated toxin (TSST)
• bacteria reproduce
• tampons
• enters bloodstream causing symptoms

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Female reproductive tract

• Pelvic inflammatory disease
• infection beyond vagina
• uterus
• fallopian tubes
• ovaries
• increased risk if not treated
• infertility
• ectopic pregnancy

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Female reproductive tract

• Candidiasis
• Candida albicans
• yeast infection
• thick white vaginal discharge
• severe vaginal itching
• predisposition
• changes in hormone levels
• broad-spectrum antibiotic therapy
• alter normal microbiota
• treatment
• nystatin or terconazole

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Female reproductive tract

• Trichomoniasis
• Trichomonas vaginalis
• flagellate protozoan
• copious vaginal discharge
• estimated 25 women in US
• diagnosis
• microscopic analysis of vaginal discharge

Figure 24.15
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Infections of newborns

• Listeriosis
• Listeria moncytogenes
• infect placenta or during birth
• meningitis
• septicemia
• endocarditis

• Group B streptococcal infection
• Streptococcus agalactiae
• transmitted during birth
• pneumonia
• meningitis
• sepsis

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Infections of newborns

• Cytomegalic Inclusion Disease
• Cytomegalovirus
• herpesvirus family
• Transmission
• close contact, saliva, blood
• Symptoms
• healthy children and adults
• asymptomatic or brief mononucleosislike illness
• prenatal infections
• spontaneous abortion, stillbirth, severe birth
  defects

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