12/18/2013

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Bacterial pathogens in water
Important causes of waterborne disease.
We dont always know the distribution of causes of
diarrheal disease, but bacteria are major contributors.
Can be endemic or epidemic.
Epidemic disease is often found where people are
crowded, hygiene and sanitation are poor.
isaster situations
isplaced populations
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Categories of waterborne disease
iseases contracted by ingestion of contaminated water
"ost are diarrheal diseases, but not all
#he largest burden of these diseases is in countries that
lack water infrastructure
But they are $%# gone e&en in countries that ha&e
infrastructure
'ehydration from diarrhea is still a constant threat to
the sur&i&al of the worlds children, accounting for
almost ( million deaths each year). *+,-I.
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Categories of waterborne disease
iseases contracted by ingestion of contaminated water
Escherichia coli
Shigella spp.
Vibrio cholerae
Salmonella typhi
Compylobacter
Helicobacter pylori
Shigella
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Escherichia coli
Indi&idual organism is rod shaped *bacilli.
0ods may form chains
Capsule may present
"otile
$on1spore forming
2ram $egati&e
"acConkeys "edium *iff. media.
3ink colonies on "acConkeys agar *lactose fermenter.
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Escherichia coli
5actose6glucose fermenter, fac anaerobes, (7 C.
% *,omatic. antigen
3art of cell wall *53,.
"ore than 89/ different % antigens
0esistant to heat and alcohol
: *Capsular. antigen
3olysaccharides en&elope
Co&ers % antigen and heat labile
"ore than 8;; : antigens
< *=lagellar. antigen
3resent on flagella as proteins and heat labile
#wo phases, organisms can change from one to
another, known as phase &ariation.
"ore than 4; < antigens
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Toxins
Endoto>ins
53, of outer membrane
=e&er, hypotension, shock etc.
<eat15abile e>oto>in *5#.
By enteroto>igenic E. coli
#wo subunits, - and B
,ubunit B facilitates entry of subunit-into epithelial
cells, which induces hypersecretion of chlorides and
water? and inhibits sodium reabsorption thus leading
to diarrhea.
<eat1,table enteroto>in *,#.
By enteroto>igenic E. coli
,timulates fluid secretion by inhibiting $aCl
reabsoption.
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Toxins
Coloni@ation factors *=imbriae.
By E#EC and E<EC *$3EC also.
=acilitates attachment to 2I# or +# epithelium
,higa1like #o>in18 *Aerocytoto>in18.
By E<EC
! subunits i.e. - and B
,ubunit B facilitates entry of the subunit -.
,ubunit - inacti&ates 9;, ribosomal unit
#hus stops protein synthesis, and leading to
sloughing of dead cells *Bloody diarrhea..
$ameB #o>in to &ero cells and ,higa to>in like.
,higa1like #o>in1! *Aerocytoto>in1!.
Biologically similar but antigenically distinct.
C
Escherichia coli
D Commensal enteric bacterium, but some strains are pathogenic
E enteropathogenic E. coli
D watery diarrhea with mucus, fe&er, dehydration
D common in infants in less de&eloped countries *4;F mortality rate.
D high IG 8;
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18;
H
E enteroto>igenic E. coli
D cramping, &omiting, profuse diarrhea, dehydration
D disease caused by the production of two to>ins *5# and ,#.
D common in tra&ellers *tra&ellers diarrhea. and children in less
de&eloped countries
E enteroin&asi&e E. coli
Dse&ere cramping, watery diarrhea, fe&er
Ddisease caused by in&asion of epithelium of intestine by the bacterium,
much like Shigella
Dcommon in less de&eloped countries
H
E enterohemorrhagic E. coli *e.g. %847G<7.
D se&ere cramping and &ery, &ery bloody diarrhea, 418; days
D &ery young and elderly can de&elop hemolytic anemia and acute renal
failure *<+,, !17F incidence.
D disease due to the production of two prophage1encoded to>ins shared
with Shigella dysenteriae *Aerocytoto>in186!.
D Enteroaggregati&e *E-EC.
D iffuse -dherant *-EC.
D 7(,;;; cases of infection and 98 deaths each year in the +.,.
D #here ha&e been multiple outbreaks of E. coli ;847G<7 since !;;(
affecting from ( to !/ people each.
D waterborne outbreaks occur, but usually due to contaminated meat
*especially hamburger., milk, fruit juice, leafy &eggies
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Escherichia coli (O157:H7)
%847G<7 strains are identified by their inability to break
down sorbitol
Belongs to the enterohemorrhagic group
Cattle are the major reser&oir
=ound in their intestinal tracts
#o>in producer
,higa and Aero to>ins
%ccurs as both a foodborne and waterborne pathogen
"ajor risk group is childrenG hemolytic uremic
syndrome
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E. coli Diagnosis
5actose fermenter with -2
Citrate utili@ation is negati&e.
+rea utili@ation is negati&e.
A3 negati&e.
"0 positi&e
Indole positi&e
"annitol fermentation positi&e
%847 can not utili@e sorbitol
,orbitol "acConkey agar plates
Colonies of %847 remain colorless
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Case study: E. coli O157
ue to broken pump in 8HH4
Aillage of =ife, ,cotland.
94F population at risk
=arm usually used well water
ue to broken pump, they decided to use ri&er water.
3ump with pressure greater than town water pressure.
2I# problems
#own was di&ided into / @ones
Ione 8 had 8;;; C=+ while Ione / @ero per 8;; ml.
Causati&e agentsG E. coli and Compylobacter
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