Vibrionaceae

Campylobacter
Helicobacter

1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

Vibrio cholerae
Morphology :
- coma-shaped rod

- aerob
- actively motile : single
flagellum polar

- pili

1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

 Colony

: convec, smooth and round.

Grow well at 37C on many kind media (eg.
TCBS= thiosulfate-citerate-bile-sucrose media,
coloni : yellow)

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Yulia Tanti Narwati (Departemen Mikrobiologi)

 Positive

oxidase : differentiates them from

enteric Gram-negative bacteria.
sucrose (+), mannose (+) dan arabinosa (-)
Most Vibrios : halotolerant (NaCl often
stimulates their growth) grows at a very high pH
(8.5-9.5) and rapidly killed by acid.

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Yulia Tanti Narwati (Departemen Mikrobiologi)

Antigenic structure and classification :

Flagellar H antigen
Lipopolysaccharides : serologic specifity
139 O antigen groups :
- Strain O1 & O139 : cause classic cholera
- non O1 & non O139 : causing cholera like disease
Strain O1 : - serotype inaba & Ogawa
- biotype : classic & El Tor (hemolysin + &
resistant polymyxin B)
V. cholerae O139 V. cholerae O1 biotype El Tor
V. cholerae O139 makes polysaccharides capsule, V
cholerae O1 does not

1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

V. cholerae enterotoxin
V.

cholerae and related Vibrios produces heat

labile enterotoxin
Enterotoxin : subunit A & B.
Gangliosida (GM1) : receptor mucosal subunit
B (promotes entry subunit A into the cell).
Activation subunit A increase intracellular cAMP
resulting hypersecretion of water and
electrolites .
Increase sodium-dependent chloride secretion
Absorption natrium and chloride are inhibited
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Yulia Tanti Narwati (Departemen Mikrobiologi)

PATHOGENESIS
Vibrio cholerae Ingestion
Adheres to and colonizes
Small-intestinal mucosa
Produces toxin
Cholera toxin acts on mucosal cells
Ekstensive fluid & ion loss from tissues
Leading to hypotention,
Electrolyte imbalance, and death
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Yulia Tanti Narwati (Departemen Mikrobiologi)

 Diarhea

20-30L/day resulting dehydration,

shock, acidosis and death
A person with normal gastric acidity may have
to ingest 1010 or more cells to become infected
when the vehicle is water
When vehicle is food : 102 104 cells (buffering
capacyti of food)
Any medication that decrease stomach acidity
makes person more susceptible to infection with
V. chlolerae (sensitive to acid).
Cholera : non invasive infection
1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

CLINICAL FINDING

Mortality rate without treatment : 25-50 %.

Incubation periode 1-4 day
Symptoms : nausea, vomiiting and profuse diarrhea with
abdominal craps.
Feces : ricewater stool, containing mucous, epithelial cell
and large numbers of Vibrios.
Treatment : water and electrolyte replacement.

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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Diagnostic Laboratory Test

Spesimen : for culture consist of mucus flecks from
stool
Smears : dark-field or phase contrast microscopy
may show the rapidly motile vibrios
Culuture : growth rapidly in peptone agar, blood
agar, TCBS agar. For enrichment a few drops of
stool can be incubated for 6-8 hours in taurocholatepeptone.
Specifid test : slide agglutination tests using anti-O
group 1 antisera and biochemical reactions patterns

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V. parahaemolyticus
Halofilic
Acute

gastroenteritis (eat raw

contaminated seafood )
12-24 hours after incubation
pariode : nausea, vomiting,
abdomen crap, fever and diarrhea
V. parahaemolyticus : oxsidase
(+) on blood agar
On TCBS : green colony
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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CAMPYLOBACTERIACEAE
a.

Campylobacter jejuni & Campylibacter coli

Causing enteritis, sometimes systemic infection

. Campylobacter jejuni & Campylibacter coli Clinically
cannot be differentiated
. Gram negative, coma/S shape, motile (single polar flagel),
do not form spore
. Oxsidase (+), catalase (+), nitrate reduction (+), H2S (+)
.

. Optimum

temeperature 36-37C
. Culture on 42C (inhibit others feces bacteria)
. LPS (lipopolisaccharida) with endotoxin activity.
1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

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Campylobacter jejuni

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 Transmition

fecal-oral, food or contact with

infected animal or animal product
Campylobacter jejuni sensitive to gastric acid
Infection occurs by oral route if we ingest 10 4
cells.
Multipication of bacteria occurs in intestine, then
invade ephitelial cell and causing inflamation
Feces containg : red and white blood cells
Clinical symptom : abdomen cramp, diarrhea
with blood, headache and fever.
Treatment :water and electrolyte replacement.
Specimen : stool
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d.Helycobacter pylori

Spiral rod, Gram negative, microaerofilic, multiple flagel polar

Oxsidase (+), catalase (+)
Optimum on pH 6-7, sensitive to acid (die on the pH 12/lumen gastric)
Found deep in the mucous layer near the ephitelial suface
(pH 7)
Produce protease/mucinase : reduce viscosity the gastric
mucous
Produce urease (strong) : buffering of acid by producing
ammonia
In human volunteers, ingestion H pylori result in development
of gastritis and hypochlorydia

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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Diagnostic Laboratory Test

Specimens : Gastric biopsy can be used for
histologic examination or minced in saline for culture
Culture : Grows in 3-6 days incubated 37C
Skirrows medium with vancomicin, polymixin B and
trimethoprim, chocolate medium or others selective
media with antibiotics. To prevent contaminations
with other mucosal bacteria

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Yulia Tanti Narwati (Departemen Mikrobiologi)

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STAPHYLOCOCCUS
NEISSERIAE
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Cocci
Gram
Positive
Staphylococcus

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Negative

Streptococcus

Yulia Tanti Narwati (Departemen Mikrobiologi)

Neiserriae

19

Gram-positive Cocci

Staphylococcus

Streptococcus

Grapelike cluster
- Chain and pair
- Catalase +
- Catalase .

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STAPHYLOCOCCUS

CHARAKTERISTIC :
Cells : spherical
Arrangement : irregular cluster (grapelike)
Gram +
non motile
Lack of spores and flagel
May be encapsulated
aerob/ microaerofilic
Optimum temperature 370C
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Coloni : roud, smooth, convec dan shinny

Catalase + (differentiated them from streptococcus)
Ferment sugar (slow) : producing acid, no gas
Produce pigment (white to yellow) on room temperature
(20-25C).
- S. aureus : gold
- S. citreus : yellow
- S. albus : white
Staphylococcus divided into 2 major group : aureus and
non-aureus.
Coagulase : + aureus
- non aureus

1/20/16

Yulia Tanti Narwati (Departemen Mikrobiologi)

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Important pathogen of Staphylococcus :

1. S. aureus
2. S. epidermidis, S. capitis dan S. hominis
(flora normal)
3. S. sapropyticus

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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Staphylococcus
aureus
Virulent factors :
1.
Capsular polysaccharides : promote the adherence to host cells
2.
Pentidoglycan and teichoic acid : adherence to mucosal surface
3.
Protein A : interfering opsonizations and ingestion by polymorphonuclear
cells
4.
Catalase : differentiated them from Streptococcus
2H2O2
2H2O
+
O2
5.
Coagulase : convert fibrinogen to fibrin which coat bacteria with fibrin
prevent opsonizations.
6.
Hyaluronidase : dygest connective tissue of the host
7.
Staphylokinase : dygest blood clot (beku
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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8.
9.
10.

11.
12.
13.
14.

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Lipase : dygest oils, allowing bacteria to more easily

colonize the skin.
Penicillinase : inactivates penicillin
Hemolysin (,,) : lyse red blood cells
-hemoysis : incomplete lysis of erythrocytes with the
formation of green pigment
-hemolysis : complete disruption of erythrocytes with
release of hemoglobin.
-hemolysis : non hemolysis
Leukocidin : lyse neutrophyl dan macrophages
Enterotoxin : induse nausea, vomiting and diarrhea
Exfoliative toxins (A, B) : desquamation of the skin
Toxic shock syndrome toxin (TSST) : induce fever,
vomiting, rash and organ damage
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1/20/16

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Others Staphylococcal
S. Epidermidis : normal habitat skin and mucous
membranes
S. Homini : skin areas rich in apocrine glands (kel.
Keringat)
S. Capitis : scalp, face and external ear
Infections
barrier

1/20/16

bacteria enter breaks in the protective skin

Yulia Tanti Narwati (Departemen Mikrobiologi)

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The scope of clinical Staphylococcal

disease
Localized

Cutaneous infections : exp. Superficial

inflamation on hair follicle (folliculitis)
Systemic infections : spreading from local
infections to other site via bloodstream (exp.
Osteomyelitis)
Toxigenic Staphylococcal disease : disorders
due to the toxin production (exp. Toxin S. aureus
cause food intoxication, scalded skin syndrome,
etc.)
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Resistance mechanism of Staphylococcal to antimicriboal

agents :
1.
2.
3.
4.
5.
6.

1/20/16

-Lactamase production : under plasmid control resistant to many

penicillins.
Resistance to nafcillin : lack or inaccesibility of certain penicillin
binding proteins (PBPs) in the organisms.
VISA (vancomycin intermediate S. Aureus) : resistance associated
with to increased cell wall synthesis and alterations in cell wall
VRSA (vancomycin resistant-S aureus) : gene mec A and van A.
Plasmid mediated resistance to tetracyclin, erythromycins,
aminoglycosides etc
Tolerance : inhibited by a drug (antimicrobial agents) but not killed
by it, exp. Lack of activation of autolytic anzymes in the cell wall.

Yulia Tanti Narwati (Departemen Mikrobiologi)

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Identification of Staphylococcal in Clinical Samples

1.
2.
3.
4.
5.
6.

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Specimens : pus, tissue exudates, sputum, urine and blood.

Culture : sheep or rabbit blood agar or selective media
(mannitol salt agar)
Gram stained : irregular cluster of Gram positive cocci
Catalase production : differentiated Staphylococci from
Streptococci
Coagulase test : to differenetiated S aureus(+) from non
aureus (-)
Others : novobiocin resistant (S. saprophyticus),
fermentation mannose (S. epidermidis), lack of urease
production (S. capitis), lack of anaerobic growth (S. hominis)

Yulia Tanti Narwati (Departemen Mikrobiologi)

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NEISSERIA

1/20/16

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NEISSERIAE
.
.
.
.
.
.
.
.
.
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Characteristics :
Gram negative
Cell : bean-shape and paired (diplococcus)
Non-motile
Capsule : pathogen Neisseria, pili
Koloni : konveks, shinny, mukoid
Aerobic or microerophilic
Oxsidase +
Ferment carbohydrates producing acid, no gas
Pathogen intracellular
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Gonoccoci dan Meningoccoci have 70 % DNA homolog,

differentiated with laboratory diagnostic and specific
characteristics :

Meningoccoci has polysacahrides capsul

Gonoccoci has plasmid; Meningoccoci rare
Meningoccoci caused upper respiratory tract infections
and meningitis; Gonoccoci causing genitourinary tract
infection

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1/20/16

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Neisseria gonorhoeae (gonococci)

Antigenic Structure :
Pilin : attachment to host cell, resistance to phagocytosis.
Por : occurs in trimers to form pore in the surface through
which nutrient enter the cell
Opa : adhesion cell within colony and
Rmp (reduction modifiable protein) : associated with Por to
form pore on cell surface
Lopooligosaccharide (LOS) : avoid immune recognition (
glicosphyngolipid on human membrane cell).
Others protein

1/20/16

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1/20/16

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Genetic and Antigenic Heterogenity :

Gonococci have evolved mechanism for frequently
switching from one antigenics form (pilin, Opa or
lipoolygosaccharide/LOS) to another antigenic form of
the same molecule.
Example Switching mechanism of Pilin :
Gonococci has multiple genes that code pilin but only
one gene is inserted into expression site, and can
remove all or part of this pilin gene and replace it with all
or part of another pilin gene.
It allows gonoccoci to express many antigenically
diffenrent pilin molecule over times.
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Pathogenesis :
Gonococcus attack mucous membrane or genitourinary
tract, eye, rectum and throat
Acute supuration (penanahan akut)
Tissue invation
Chronic inflammation and fibrosis
In males : urethritis with yellow creamy pus & painful
urination
In female : primary infection endocervix --- salpingitis
(radang sal. telur), fibrosis
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Yulia Tanti Narwati (Departemen Mikrobiologi)

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Diagnostic Laboratory Test

Spesimen

s: pus & secretions (urethra, cervix,

rectum, conjungtiva), throat swab --- culture in
selective meduim (eg. Thayer martin medium)
Smears : Gram stain = diplococcus (bean-shape) ,
Gram negative
Systemic infection : blood culture
Serologi : ELISA, radioimmunoassay

1/20/16

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Neisseria meningitidis
(meningococcus)
Antigenic structure :
.
.
.
.

Capsule polisaccharide (serogroups) : important

group (human diseses) A,B,C, y dan W-135
Protein outer membrane Por ( 20 serotype)
Opa
LPS : toxic
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Pathogenesis
Portal of entry : nasopharynx
Attach to epithelial cell (pili)
Enter the blood stream (bacteremia)
Spread: arthritis, meningitis etc
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Laboratory Diagnose :

Blood specimens : culture on medium

without sulfonate
Spinal liquid :
- culture : chocolate agar
- smear : Gram
- Chemical reaction
Nasopharyngeal swab : carrier
survey

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1/20/16

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VIRUS
1.
2.
3.
4.
5.
6.

1/20/16

ORTHOMYXOVIRIDAE
PARAMYXOVIRIDAE
RUBELLA
ADENOVIRIDAE
VIRUS RABIES (RHABDOVIRIDAE)
SLOW VIRUS INFECTION & PRION
DISEASES
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