Chapter 25 = Microbial Diseases of the Digestive System

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Normal Microbiota of the Digestive System Normal Microbiota in Large Intestine Bacterial Diseases of the Mouth Dental Carries

- The Mouth = millions per ml of saliva - The Stomach = sterile - The Small Intestine = just a few! - The Large Intestine = billions and billions - Symbionic Relationship - Anaerobes: Lactobacillus and Bacteroides - Facultative anaerobes: Enterics - Dental Carries - Periodontal Disease - cavities - Dental plaque = calcified bacteria and their waste products - bacteria = Streptococcus mutans - Disease of supporting structures of teeth 2 kinds: - Gingivitis = gum inflammation - Periodontitis = structures that hold teeth get inflamed. (Acute narcotizing ulcerative gingivitis also called Vincent's Disease or trench mouth) - Infection - Intoxication - Gastroenteritis

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Process of Staphylococcal Food Poisoning

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1. Food containing protein is cooked (bacteria usually killed). 2. Then food is contaminated by worker with staphylococci on hands (competing bacteria have been eliminated). - temperature room holding 3. Organisms incubate in food (temperature abuse) long enough to form and release toxins. (Reheating food will eliminate staphylococci but not the toxin). 4. Food containing toxin is eaten 5. In 1 to 6 hrs, intoxication occurs. - Shigella sonei - traveler's diarrhea (few days) - Shigella dysentaria - more serious - Symptoms - Tissue damage and dysentery - Infection, Endotoxin, Shiga exotoxin - Caused by Salmonella typhi - Only found in human and their feces - High fever, and severe diarrhea (significant mortality) - Associated with poor sanitation and sewage treatment - A substantial number of recovered patients become carriers - Infection, Endotoxin - Salmonella enterica - Symptoms: Nausea and diarrhea - Symptoms 12-36 hrs after incubation - Associated with chicken, eggs, and reptiles - In bloodstream - end up with gram negative sepsis - Infection, Endotoxin - Vibrio cholerae serotypes that produce cholera toxin (0:1 & 0:139), eltor - Toxin causes host cels to secrete Cl-, HCO, and water - Causes very severe dysentery - Cholera toxin (exotoxin) - Usually from contaminates crustaceans and mollusks (bad oysters) - get diarrhea 2 types: - V. parahaemolyticus = Cholera-Like diarrhea but gently milder, Infection, enterotoxin - V. vulnificus = Rapidly spreading tissue destruction, Infection, siderophores - Also, from V. cholerae stereotypes other than 0:1, 0:139, eltor

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Shigellosis (Bacillary Dysentery)

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Periodontal Disease

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Typhoid Fever

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Types of Diseases of Lower Digestive System Infection

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Salmonellosis

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- Growth of a pathogen - Incubation is from 12 hrs to 2 weeks - Fever - Causes gastroenteritis - Treatment: oral rehydration therapy - Ingestion of toxin - Symptoms appear 1 to 48 hrs after ingestion - Causes gastroenteritis - Treatment: oral rehydration therapy diarrhea, dysentery - dysentery = very severe form of diarrhea with huge amount of fluid loss. - Also called Staphylococcal enterotoxicosis - Caused by Staphylococcus aureus - Incubation of Staph aureus on food is called temperature abuse - Staph aureus also produces toxins which are not destroyed by cooking. - Symptoms: Nausea, vomiting, diarrhea - Intoxication, Enterotoxin (superantigen)
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Intoxication

Cholera

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Gastroenteritis

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Noncholera vibrios

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Staphylococcal Food Poisoning

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Escherichia coli Gastroenteritis

- E.coli that attaches to intestinal cells with fimbriae - Produce toxins 2 types: - Traveler's diarrhea (E.coli 0157:H7): Enterotoxigenic, Enteroinvasive (inflammation and fever), Infections, Watery diarrhea - STEC: Shiga-toxin-producing-E.coli, Shigella-like dysentery, hemorrhagic colitis, and hemolytic uremic syndroms, Infections. - Campylobacter jejuni - Symptoms: Fever, abd. pain, diarrhea - Infection - Reservoir: Chickens, cow's milk - H.Pylori Disease - Helicobacter pylori - Symptoms: Peptic Ulcers - Infection - It doesn't cause peptic ulcers. It takes advantage of people who already have them. (It secretes ammonia to survive stomach acid). - Y. enterocolitica, Y. pseudotuberculosis - Symptoms: abd. pain, mild diarrhea, may be confused with appendicitis - Infection, Endotoxin - Transmitted: meat, milk 1. C. perfringens -Symptoms: diarrhea - Infection, Exotoxin 2. C. difficile - Symptoms: diarrhea to colitis - Infection, Exotoxin 3. B. cereus - Symptoms: Nausea, vomiting, diarrhea - Intoxication 1. Mumps 2. Viral Gastroenteritis 3. Hepatits - Mumps virus - Symptoms: Swollen parotid glands, Orchitis "stomach flu" 1. Rotavirus - Symptoms: Vomiting, diarrhea, 1 wk 2. Norovirus - cruise ships - Symptoms: Vomiting, diarrhea, 2-3 days1

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Hepatitis

- inflammation of the liver - 2nd most frequently reported infectious disease in the US - At least 5 different viruses: HAV, HBV, HCV, HDV, HEV - 50% sub-clinical - Transmission: fecal-oral - Chronic Liver Disease? No. - Vaccine? Inactivated virus - Transmission: Parenteral, STI - Chronic Liver Disease? Yes. - Vaccine? Recombinant - Transmission: Parenteral - Chronic Liver Disease? Yes. - Vaccine? No. - deadliest of them all - Transmission: Parenteral, HBV coinfection - Chronic Liver Disease? Yes. - Vaccine? HBV vaccine - Mostly sub-clinical - Transmission: fecal-oral - Chronic Liver Disease? No. - Vaccine? HAV vaccine "there are several pathogenic protozoa that can cause human digestive diseases" 1. Giardiasis 2. Amoebic Dysentery 3. Cryptosporidiosis - Giardia lamblia - Symptoms: Protozoan adheres to intestinal wall, diarrhea, upset stomach - Reservoir: Water or mammals - Most common water-borne - Entamoeba histolytica - Symptoms: Abscess, significant mortality rate - Reservoir: Humans - Very serious infection - Cryptosporidium hominis - Symptoms: Self-limiting diarrhea, may be life-threatening in immunosuppressed people - Reservoir: Cattle, water - Tapeworms - Nematodes

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Hepatitis A Virus (HAV)

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Hepatitis B Virus (HBV) Hepatitis C Virus (HCV)

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Campylobacter Gastroenteritis

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Helicobacter Peptic Ulcer Disease

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Hepatitis D Virus (HDV)

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Hepatitis E Virus (HEV)

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Yersinia Gastroenteritis

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Protozoan Diseases of the Digestive System

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Clostridium and Bacillus Gastroenteritis

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Giardiasis

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Amoebic Dysentery

Viral Diseases of the Digestive System Mumps

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Cryptosporidiosis

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Viral Gastroenteritis

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Helminthic Diseases of the Digestive System

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Tapeworms

(flatworms) - Ingestion of cysticerci (eggs) from under-cooked pork, beef, or fish. 1. Tapeworms - Taenia saginata (beef) - Taenia solium (pork) - Diphyllobothrium latum (fish) - Symptoms: Neurocysticercosis 2. Hydatid Disease - Echinococcus granulosus - Symptoms: Tissue damage - Contact with dog feces (roundworms) 1. Pinworms 2. Hookworms 3. Ascariasis 4. Trichinellosis - Enterobius vermicularis - Symptoms: itching around the anus - Necator americanus - Ancyclostoma duodenale - Ascaris lumbricoides - from undercooked meat also - Trichinella spiralis - from undercooked meat also

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Nematodes

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Pinworms Hookworms Ascariasis Trichinellosis

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