Vibrio, Aeromonas & Plesiomonas

Содержание

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Similarities to Enterobacteriaceae Gram-negative Facultative anaerobes Fermentative bacilli Differences from Enterobacteriaceae

Similarities to Enterobacteriaceae
Gram-negative
Facultative anaerobes
Fermentative bacilli
Differences from Enterobacteriaceae
Polar flagella
Oxidase

positive
Formerly classified together as Vibrionaceae
Primarily found in water sources
Cause gastrointestinal disease
Shown not closely related by molecular methods

General Characteristics of Vibrio, Aeromonas and Plesiomonas

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Comma-shaped (vibrioid) bacilli V. cholerae, V. parahaemolyticus, V. vulnificus are most

Comma-shaped (vibrioid) bacilli
V. cholerae, V. parahaemolyticus, V. vulnificus are most significant

human pathogens
Broad temperature & pH range for growth on media
18-37°C
pH 7.0 - 9.0 (useful for enrichment)
Grow on variety of simple media including:
MacConkey’s agar
TCBS (Thiosulfate Citrate Bile salts Sucrose) agar
V. cholerae grow without salt
Most other vibrios are halophilic

Morphology & Physiology of Vibrio

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Vibrio spp. (Family Vibrionaceae) Associated with Human Disease

Vibrio spp. (Family Vibrionaceae) Associated with Human Disease

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Vibrio spp. (including V. cholerae) grow in estuarine and marine environments

Vibrio spp. (including V. cholerae) grow in estuarine and marine environments

worldwide
All Vibrio spp. can survive and replicate in contaminated waters with increased salinity and at temperatures of 10-30oC
Pathogenic Vibrio spp. appear to form symbiotic (?) associations with chitinous shellfish which serve as an important and only recently recognized reservoir
Asymptomatically infected humans also serve as an important reservoir in regions where cholera is endemic

Epidemiology of Vibrio spp.

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Taxonomy of Vibrio cholerae >200 serogroups based on somatic O-antigen O1

Taxonomy of Vibrio cholerae

>200 serogroups based on somatic O-antigen
O1 and O139

serogroups are responsible for classic epidemic cholera
O1 serogroup subdivided into
Two biotypes: El Tor and classical (or cholerae)
Three serotypes: ogawa, inaba, hikojima
Some O1 strains do not produce cholera enterotoxin (atypical or nontoxigenic O1 V. cholerae)
Other strains are identical to O1 strains but do not agglutinate in O1 antiserum (non-cholera (NCV) or non-agglutinating(NAG) vibrios) (non-O1 V.cholerae)
Several phage types
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Epidemiology of Vibrio cholerae Cholera recognized for more than two millennia

Epidemiology of Vibrio cholerae

Cholera recognized for more than two millennia with

sporadic disease and epidemics
Endemic in regions of Southern and Southeastern Asia; origin of pandemic cholera outbreaks
Generally in communities with poor sanitation
Seven pandemics (possible beginning of 8th) since 1817 attributable to increased world travel
Cholera spread by contaminated water and food
Human carriers and environmental reservoirs
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Recent Cholera Pandemics 7th pandemic: V. cholerae O1 biotype El Tor

Recent Cholera Pandemics

7th pandemic:
V. cholerae O1 biotype El Tor
Began in Asia

in 1961
Spread to other continents in 1970s and 1980s
Spread to Peru in 1991 and then to most of South & Central America and to U.S. & Canada
By 1995 in the Americas, >106 cases; 104 dead
8th pandemic (??)
V. cholerae O139 Bengal is first non-O1 strain capable of causing epidemic cholera
Began in India in 1992 and spread to Asia, Europe and U.S.
Disease in humans previously infected with O1 strain, thus no cross-protective immunity
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Pathogenesis of V.cholerae Incubation period: 2-3 days High infectious dose: >108

Pathogenesis of V.cholerae

Incubation period: 2-3 days
High infectious dose: >108 CFU
103

-105 CFU with achlorhydria or hypochlorhydria (lack of or reduced stomach acid)
Abrupt onset of vomiting and life-threatening watery diarrhea (15-20 liters/day)
As more fluid is lost, feces-streaked stool changes to rice-water stools:
Colorless
Odorless
No protein
Speckled with mucus
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Pathogenesis of V.cholerae (cont.) Cholera toxin leads to profuse loss of

Pathogenesis of V.cholerae (cont.)

Cholera toxin leads to profuse loss of fluids

and electrolytes (sodium, potassium, bicarbonate)
Hypokalemia (low levels of K in blood)
Cardiac arrhythmia and renal failure
Cholera toxin blocks uptake of sodium & chloride from lumen of small intestine
Death attributable to:
Hypovolemic shock (due to abnormally low volume of circulating fluid (plasma) in the body)
Metabolic acidosis (pH shifts toward acid side due to loss of bicarbonate buffering capacity)
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Treatment & Prevention of V. cholerae Untreated: 60% fatality Treated: Rehydration

Treatment & Prevention of V. cholerae

Untreated: 60% fatality
Treated: <1% fatality
Rehydration &

supportive therapy
Oral
Sodium chloride (3.5 g/L)
Potassium chloride (1.5 g/L)
Rice flour (30-80g/L)
Trisodium citrate (2.9 g/L)
Intravenous (IV)
Doxycycline or tetracycline (Tet resistance may be developing) of secondary value
Water purification, sanitation & sewage treatment
Vaccines
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Virulence Factors Associated with Vibrio cholerae O1 and O139

Virulence Factors Associated with Vibrio cholerae O1 and O139

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Two Broad Classes of Bacterial Exotoxins Intracellular Targets: A-B dimeric (two

Two Broad Classes of Bacterial Exotoxins

Intracellular Targets: A-B dimeric (two domain)

exotoxins: (prototype is diphtheria toxin of Corynebacterium diphtheriae):
Bipartite structure: Binding domain (B) associated with absorption to target cell surface and transfer of active component (A) across cell membrane; once internalized, domain (A) enzymatically disrupts cell function
Receptor-mediated endocytosis (host cell uptake and internalization of exotoxin)
ADP-ribosylation of intracellular target host molecule
Cellular Targets: Cytolytic exotoxins (usually degradative enzymes) or cytolysins: hemolysis, tissue necrosis, may be lethal when administered intravenously
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Cholera Toxin (A2-5B)(Vibrio cholerae) Chromosomally-encoded; Lysogenic phage conversion; Highly conserved genetic

Cholera Toxin (A2-5B)(Vibrio cholerae)

Chromosomally-encoded; Lysogenic phage conversion; Highly conserved genetic sequence
Structurally

& functionally similar to ETEC LT
B-subunit binds to GM1 ganglioside receptors in small intestine
Reduction of disulfide bond in A-subunit activates A1 fragment that ADP-ribosylates guanosine triphosphate (GTP)-binding protein (Gs) by transferring ADP-ribose from nicotinamide adenine dinucleotide (NAD)
ADP-ribosylated GTP-binding protein activates adenyl cyclase leading to an increased cyclic AMP (cAMP) level and hypersecretion of fluids and electrolytes
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Mechanism of Action of Cholera Toxin 1 4 3 2 NOTE:

Mechanism of Action of Cholera Toxin

1

4

3

2

NOTE: In step #4, uptake of

Na+ and Cl- from the lumen is also blocked.
HCO3- = bicarbonate which provides buffering capacity.
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Mechanism of Action of Cholera Toxin

Mechanism of Action of Cholera Toxin

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Summary of Vibrio parahaemolyticus Infections

Summary of Vibrio parahaemolyticus Infections

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Summary of Vibrio vulnificus Infections

Summary of Vibrio vulnificus Infections

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Virulence Factors Associated with Non-cholerae Vibrios (Kanagawa positive)

Virulence Factors Associated with Non-cholerae Vibrios

(Kanagawa positive)

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Laboratory Identification of Vibrios Transport medium - Cary-Blair semi-solid agar Enrichment

Laboratory Identification of Vibrios

Transport medium - Cary-Blair semi-solid agar
Enrichment medium -

alkaline peptone broth
Vibrios survive and replicate at high pH
Other organisms are killed or do not multiply
Selective/differential culture medium - TCBS agar
V. cholerae grow as yellow colonies
Biochemical and serological tests
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Characteristics and Epidemiology of Aeromonas (Family Aeromonadaceae) Gram-negative facultatively anaerobic bacillus

Characteristics and Epidemiology of Aeromonas (Family Aeromonadaceae)

Gram-negative facultatively anaerobic bacillus resembling

members of the Enterobacteriaceae
Motile species have single polar flagellum (nonmotile species apparently not associated with human disease)
16 phenospecies: Most significant human pathogens A. hydrophila, A. caviae, A. veronii biovar sobria
Ubiquitous in fresh and brackish water
Acquired by ingestion of or exposure to contaminated water or food
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Associated with gastrointestinal disease Chronic diarrhea in adults Self-limited acute, severe

Associated with gastrointestinal disease
Chronic diarrhea in adults
Self-limited acute, severe disease

in children resembling shigellosis with blood and leukocytes in the stool
3% carriage rate
Wound infections
Opportunistic systemic disease in immunocompromised
Putative virulence factors include: endotoxin; hemolysins; eneterotoxin; proteases; siderophores; adhesins

Clinical Syndromes of Aeromonas

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Afimbriated Aeromonas hydrophila Nonadherent Afimbriated Bacterial Cells and Buccal Cells

Afimbriated Aeromonas hydrophila

Nonadherent Afimbriated Bacterial Cells and Buccal Cells

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Adherent Fimbriated Bacterial Cells and Buccal Cells Fimbriated Aeromonas hydrophila

Adherent Fimbriated Bacterial Cells and Buccal Cells

Fimbriated Aeromonas hydrophila

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Characteristics of Plesiomonas Formerly Plesiomonadaceae Closely related to Proteus & now

Characteristics of Plesiomonas

Formerly Plesiomonadaceae
Closely related to Proteus & now classified as

Enterobacteriaceae despite differences:
Oxidase positive
Multiple polar flagella (lophotrichous)
Single species: Plesiomonas shigelloides
Isolated from aquatic environment (fresh or estuarine)
Acquired by ingestion of or exposure to contaminated water or seafood or by exposure to amphibians or reptiles
Self-limited gastroenteritis: secretory, colitis or chronic forms
Variety of uncommon extra-intestinal infections
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Characteristics of Aeromonas and Plesiomonas Gastroenteritis

Characteristics of Aeromonas and Plesiomonas Gastroenteritis

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REVIEW

REVIEW

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Vibrio spp. (Family Vibrionaceae) Associated with Human Disease REVIEW

Vibrio spp. (Family Vibrionaceae) Associated with Human Disease

REVIEW

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Vibrio spp. (including V. cholerae) grow in estuarine and marine environments

Vibrio spp. (including V. cholerae) grow in estuarine and marine environments

worldwide
All Vibrio spp. can survive and replicate in contaminated waters with increased salinity and at temperatures of 10-30oC
Pathogenic Vibrio spp. appear to form symbiotic (?) associations with chitinous shellfish which serve as an important and only recently recognized reservoir
Asymptomatically infected humans also serve as an important reservoir in regions where cholera is endemic

Epidemiology of Vibrio spp.

REVIEW

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Taxonomy of Vibrio cholerae >200 serogroups based on somatic O-antigen O1

Taxonomy of Vibrio cholerae

>200 serogroups based on somatic O-antigen
O1 and O139

serogroups are responsible for classic epidemic cholera
O1 serogroup subdivided into
Two biotypes: El Tor and classical (or cholerae)
Three serotypes: ogawa, inaba, hikojima
Some O1 strains do not produce cholera enterotoxin (atypical or nontoxigenic O1 V. cholerae)
Other strains are identical to O1 strains but do not agglutinate in O1 antiserum (non-cholera (NCV) or non-agglutinating(NAG) vibrios) (non-O1 V.cholerae)
Several phage types

REVIEW

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Epidemiology of Vibrio cholerae Cholera recognized for more than two millennia

Epidemiology of Vibrio cholerae

Cholera recognized for more than two millennia with

sporadic disease and epidemics
Endemic in regions of Southern and Southeastern Asia; origin of pandemic cholera outbreaks
Generally in communities with poor sanitation
Seven pandemics (possible beginning of 8th) since 1817 attributable to increased world travel
Cholera spread by contaminated water and food
Human carriers and environmental reservoirs

REVIEW

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Summary of Vibrio cholerae Infections REVIEW

Summary of Vibrio cholerae Infections

REVIEW

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Summary of Vibrio cholerae Infections (cont.) REVIEW

Summary of Vibrio cholerae Infections (cont.)

REVIEW

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Pathogenesis of V.cholerae (cont.) Cholera toxin leads to profuse loss of

Pathogenesis of V.cholerae (cont.)

Cholera toxin leads to profuse loss of fluids

and electrolytes (sodium, potassium, bicarbonate)
Hypokalemia (low levels of K in blood)
Cardiac arrhythmia and renal failure
Cholera toxin blocks uptake of sodium & chloride from lumen of small intestine
Death attributable to:
Hypovolemic shock (due to abnormally low volume of circulating fluid (plasma) in the body)
Metabolic acidosis (pH shifts toward acid side due to loss of bicarbonate buffering capacity)

REVIEW

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Virulence Factors Associated with Vibrio cholerae O1 and O139 REVIEW

Virulence Factors Associated with Vibrio cholerae O1 and O139

REVIEW

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Mechanism of Action of Cholera Toxin REVIEW

Mechanism of Action of Cholera Toxin

REVIEW

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Summary of Vibrio parahaemolyticus Infections REVIEW

Summary of Vibrio parahaemolyticus Infections

REVIEW

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Summary of Vibrio vulnificus Infections REVIEW

Summary of Vibrio vulnificus Infections

REVIEW

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Virulence Factors Associated with Non-cholerae Vibrios (Kanagawa positive) REVIEW

Virulence Factors Associated with Non-cholerae Vibrios

(Kanagawa positive)

REVIEW

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Characteristics and Epidemiology of Aeromonas (Family Aeromonadaceae) Gram-negative facultatively anaerobic bacillus

Characteristics and Epidemiology of Aeromonas (Family Aeromonadaceae)

Gram-negative facultatively anaerobic bacillus resembling

members of the Enterobacteriaceae
Motile species have single polar flagellum (nonmotile species apparently not associated with human disease)
16 phenospecies: Most significant human pathogens A. hydrophila, A. caviae, A. veronii biovar sobria
Ubiquitous in fresh and brackish water
Acquired by ingestion of or exposure to contaminated water or food

REVIEW

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Associated with gastrointestinal disease Chronic diarrhea in adults Self-limited acute, severe

Associated with gastrointestinal disease
Chronic diarrhea in adults
Self-limited acute, severe disease

in children resembling shigellosis with blood and leukocytes in the stool
3% carriage rate
Wound infections
Opportunistic systemic disease in immunocompromised
Putative virulence factors include: endotoxin; hemolysins; eneterotoxin; proteases; siderophores; adhesins

Clinical Syndromes of Aeromonas

REVIEW

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Characteristics of Plesiomonas Formerly Plesiomonadaceae Closely related to Proteus & now

Characteristics of Plesiomonas

Formerly Plesiomonadaceae
Closely related to Proteus & now classified as

Enterobacteriaceae despite differences:
Oxidase positive
Multiple polar flagella (lophotrichous)
Single species: Plesiomonas shigelloides
Isolated from aquatic environment (fresh or estuarine)
Acquired by ingestion of or exposure to contaminated water or seafood or by exposure to amphibians or reptiles
Self-limited gastroenteritis: secretory, colitis or chronic forms
Variety of uncommon extra-intestinal infections

REVIEW

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Characteristics of Aeromonas and Plesiomonas Gastroenteritis REVIEW

Characteristics of Aeromonas and Plesiomonas Gastroenteritis

REVIEW

- Предыдущая
Капитализм XVIII века. Промышленный переворот в Англии
Следующая -
Чесменское сражение (1770 г)

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