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Gastrointestinal Infections: DR Alia Abdel Monaem Lecturer of Medical Microbiology & Immunology Zagazig University

This document discusses gastrointestinal infections, including definitions of related terms like gastroenteritis, diarrhea, and dysentery. It outlines the common causative agents of gastroenteritis like bacteria (Salmonella, E. coli), viruses (Rotavirus), fungi (Candida albicans), and protozoa (Entamoeba histolytica). The document describes how to diagnose gastroenteritis through specimen collection and examination, culture, and identification of isolated colonies. It also discusses common causes of bacterial food poisoning like Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, and methods to trace the source of food poisoning outbreaks.

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Alia Abdelmonem
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107 views29 pages

Gastrointestinal Infections: DR Alia Abdel Monaem Lecturer of Medical Microbiology & Immunology Zagazig University

This document discusses gastrointestinal infections, including definitions of related terms like gastroenteritis, diarrhea, and dysentery. It outlines the common causative agents of gastroenteritis like bacteria (Salmonella, E. coli), viruses (Rotavirus), fungi (Candida albicans), and protozoa (Entamoeba histolytica). The document describes how to diagnose gastroenteritis through specimen collection and examination, culture, and identification of isolated colonies. It also discusses common causes of bacterial food poisoning like Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, and methods to trace the source of food poisoning outbreaks.

Uploaded by

Alia Abdelmonem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Gastrointestinal

Infections
Prepared by
Dr Alia Abdel Monaem
Lecturer of Medical Microbiology & Immunology
Zagazig university
Learning objectives
How to collect stool sample
Enumerate different causes of gastroenteritis
Define the following terms: diarrhea, dysentery,
food poisoning
How to diagnosis case of gastroenteritis
Enumerate common causes of bacterial food
poisoning
Tracing source of food poisoning in epidemics
Definitions
Gastroenteritis : Inflammation of mucous membrane of
stomach & intestine resulting in frequent loose motions with or
without mucous & with or without blood, pain abdomen and with
or without fever.

Diarrhea : Passage of 3 or more loose or liquid stools per day,


or more frequently than is normal for the individual.

Dysentery : Passage of blood and mucous with motion, often


associated with tenesmus.

Food poisoning : Acute gastroenteritis, characterized by


vomiting & diarrhea in a group of people sharing same food
A) Gastroenteritis
Causative agents of
gastroenteritis
1) Bacterial:
Salmonella other than S. typhi
E. coli
Shigella spp
Campylobacter jejuni
V. cholera
Cl. difficile
Yersinia enterocolitica
Diarrhea also due to food poisoning i.e. Staph aureus,
Bacillus cereus, Cl. Perfringens, V. parahaemolyticus,
Listeria monocytogenes
2) Viral
Rotavirus (most common of infantile
gastroenteritis)
Enteroviruses, Adenoviruses 40&41, Norwalk virus,
Coronavirus & Astrovirus

3) Fungal: Candida albicans

4) Protozoal: Entamoeba histolytica,Giardia


lamblia,Cryptosporidium
Diagnosis of
gastroenteritis
1) Specimen collection & transport
2) Macroscopic examination of stool
3) Microscopic examination of stool
4) Stained smears (candida,
campylobacter)
5) Culture
6) Identification of isolated colonies
7) Detection of toxin production
8) Serological diagnosis
Specimen collection( 1

Clean,dry,
disinfectant
free wide
mouth
container
Specimen transport

Delay > 1 hr or
suspect salmonella,
shigella or
campylobacter

Carry- Blair transport


medium
2) Macroscopicexamination of stool for
blood, mucous, warms
3) Microscopicexamination of stool for
pus, RBCs, ova, cysts, motile
bacteria
Stained smears (candida,( 4
campylobacter)
Click icon to add picture

Gram stain of a direct fecal smear show WBCs


indicative of an invasive process and not an
enterotoxin.
Culture of stool( 5
Inoculation on Subculture on
Salmonella,
selenite, tetrathionate MacConkey, XLD,
Shigella broth 6-18 hrs DCA, S-S agar

V. Inoculation on
choler alkaline peptone water Subculture on TCBS
a 6-18 hrs

Culture on
EHEC
Sorbitol MacConkey agar

Culture on
Campylobacter jejuni Skirrows medium
42C ,5% O2, 10% CO2
Culture on
Cl. difficle egg yolk agar medijm
anaerobically
Cultural characters of
Salmonella & Shigella

A- Pale yellow non lactose fermenting colonies on MacConkey


B- Pale yellow non lactose fermenting colonies on DCA
C-Pink colonies on XLD (Shigella)
D-Pink colonies with black center on XLD (Salmonella)
Cultural characters of
Vibrio cholera
Click icon to add picture

(A) E. coli O157:H7 growing on MacConkey agar.


(B) E. coli O157:H7 on sorbitol MacConkey agar. E.
coli O157:H7 does not ferment sorbitol
Triple sugar
iron
Click icon to
add picture

A- Uninoculated
B- Salmonella producing H2S (S.
typhimurium & S. enteritidis )
C- Salmonella or Shigella
D- E.coli
6) Identification of isolated colonies
by morphology, BR & serologically by
slide agglutination tests

7) Detection of toxin production (ETEC,


EHEC, Cl. difficile) by ELSA & gene
probes

8) Rota vius detection in stool by ELISA


&gene probes

9) serological diagnosis by detection of


rising Ab titre (salmonella, virus
B) Bacterial food poisoning
Outcome Pathogenesis Food ClP IP Organism

Recovery in 1-2 Enterotoxin CHO , milk & V.,D. 1-6 hrs S.aureus
days its
products

Recovery after Multiplication Meat or egg V. , D., fever 12-48 hrs Salmonella
treatment S. typhimurium &
S. enteritidis

Recovery in 1-2 Enterotoxin & Reheated D. 6-18 hrs CL. perferingins


days multiplication meat

High mortality Neurotoxin Canned food Neurological 18-24 hrs CL. botulinum

Recovery in B. cereus
few days Enterotoxin Reheated rice V. 1-5 hrs a- Emetic
Enterotoxin Meat & D. 8-24 hrs b- Diarrheal
sauces

Recovery in Hemolysis & Sea food V. , D. , fever 6-36 hrs V. parahaemolyticus


few days multiplication

Recovery in Multiplication Cheese & D. , fever 8-48 hrs L. monocytogenes


few days under
cooked
meat
Diagnosis of food
poisoning
1) Depend on C/P, type of food,
detection of organism or toxin in
food remnant, vomitus or stool.

2) Tracing source of food poisoning


2) Tracing source of food poisoning by
typing isolated organism from food,
patients & food handlers by
a-Biochemical typing
b-Antibiotic resistance patterns
c-Serological typing
d-Phage typing S aureus,
Salmonella.
e-Molecular typing by plasmid
profile anaylsis, pulsed field gel
electrophoresis, restriction
Phage typing

Lysis occurred in six areas corresponding to phages


no. 6, 47, 53, 42E, 54, 77
Restriction
endonuclease analysis
Plasmid profile
anaylsis

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