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Vibrio cholerae

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Gram negative curved bacilli<br />

• Presented by:<br />

• Zeena makkie &<br />

Zainab khalid.


Gram negative curved bacilli<br />

• There are certain M.O that share this type of<br />

morphology which is sometimes described as<br />

coma-shaped<br />

• The following M.O are gram negative curved<br />

bacilli:<br />

1. <strong>Vibrio</strong>.<br />

2. Aeromonas.<br />

3. Plesiomonas.<br />

4. Campylobacter.<br />

5. Helicobacter.


General charectarestics:<br />

• Gram negative curved bacilli.<br />

• Motile by a single polar flagellum.<br />

• Live in fresh water &sea water.<br />

• It can cause diarrhoea in human.


Family: vibrinaceae<br />

genus :vibrio<br />

Genus vibrio is classified 10 important<br />

species:<br />

1.<strong>Vibrio</strong> <strong>cholerae</strong>:it can cause epedic<br />

&pandemic cholera.<br />

2.Non cholera vibrios:it can cause<br />

ear,wound,soft tissue infection&extra<br />

intestinal infections


• The most important species are:<br />

V.mimicus, V .vulnificus, V .hollisae, V<br />

.fluvialis,V.damesla,V. frunissi,V.<br />

alginolyticus,V. metschnikovii.<br />

3. V.parahaemolyticus:Causes<br />

gastroenteritis,&extrintestinal infections.


• John Snow (1813-<br />

1858):<br />

• Water borne<br />

transmission of<br />

Cholera (1855)<br />

Causative Agent<br />

Discovery


• Filippo Pacini (1812-<br />

1883)<br />

– 1854: Cholera reaches<br />

Florence, Italy. Pacini<br />

discovers causative agent<br />

– Publishes “Microscopical<br />

Observations and<br />

Pathological Deductions on<br />

Cholera”<br />

– 1965: Bacterium named<br />

<strong>Vibrio</strong> <strong>cholerae</strong> Pacini 1854<br />

Discovery


• Robert Koch (1843-<br />

1910)<br />

• 1884: Rediscovers<br />

<strong>Vibrio</strong> <strong>cholerae</strong><br />

Discovery


<strong>Vibrio</strong> <strong>cholerae</strong><br />

• Have 2 imp antigens;H(shared)&O spesific which<br />

is LPS.<br />

• There are at least 139 O-antigen groups.<br />

• Only of O group 1(o1)&139(o139) cause classical<br />

cholera disease.<br />

• While non O1-O139 can cause cholera like<br />

disease<br />

• Both o1-o139 of 2 bio type:<br />

1. Classical .<br />

2. El-Tor.


Both bio types can be sub grouped into<br />

3 biotypes:


Differentiation between classical<br />

and EL-TOr biotypes of V.cholera<br />

tests<br />

Voges-proskauer<br />

Chicken RBC<br />

agglutination<br />

Polymyxin-B<br />

sensitivity (50 U)<br />

Group IV choleraphage<br />

sensitivity<br />

Bet-haemolysis (on<br />

blood agar)<br />

classical<br />

_<br />

_<br />

+<br />

+<br />

_<br />

EL-Tor<br />

+<br />

+<br />

_<br />

_<br />

+


<strong>Vibrio</strong> cholrae(O-1&O139)<br />

• These m.o are highly aerobic.<br />

• Very actevly motile (described as<br />

darting(shooting) motility.<br />

• The best way to detect motility is by dark<br />

feiled microscopy or contrast microscopy.<br />

• After prolonged culture these m.o become<br />

straight .<br />

• Can tolerate temp. of range 18-37.


Biochemical characteristics of<br />

V. <strong>cholerae</strong>:<br />

• They ferment glucose,maltose&succarose.<br />

with acid production only.<br />

• Oxidase +ve &catalase +ve.<br />

• Give ve cholera red reaction on nitrate<br />

pepton media by reducing nitrate to nitrite.<br />

• Indol test +ve on tryptophan media when<br />

the lator 2 test are combined red coulor<br />

also appear due to nitroso-indol when<br />

H2SO4 is added.


• TSI is A/A.<br />

• The optemal ph of growth is 7 but they can<br />

tolerate up to 8,5-9.<br />

• They are sensitive to acidic PH less than 6<br />

so they are quite suseptable to gastric<br />

juice.<br />

• V.<strong>cholerae</strong> o-139 is like El-Tor but it<br />

differs by being capsulated.


Culture of V. <strong>cholerae</strong><br />

1. Alkaline peptone water media:<br />

PH of this media is 8.5-9 .<br />

Used for primary cultivation from clinical<br />

specimens.<br />

Growth on it can be detected as a surface<br />

pellicle within 8 h.<br />

Sub culture on solid media .


2. Thiosulfate Citerate Bile salt<br />

Sucrose agar (TCBS)<br />

• TCBS is the medium of choice for the isolation of V.<br />

<strong>cholerae</strong>.<br />

• easy to prepare, requires no autoclaving .<br />

• it has a relatively short shelf life once prepared (3 to 5<br />

days) unless plates are carefully protected against<br />

drying.<br />

• The non –inoculated m.o is olive green.<br />

• bromo thymol blue is the indicator.<br />

• V.<strong>cholerae</strong> is sucrose – fermenter.<br />

• Asid production drop the ph & change colour to yellow.


Overnight colonies of V. <strong>cholerae</strong> on TCBS agar are<br />

large (2-4 mm) and yellow because of the fermentation<br />

of sucrose. They are characteristically round, smooth,<br />

glistening, and slightly flattened.


3- Tullerite Taurochelate Gelatine<br />

Agar(TTGA)<br />

TTGA is a selective and differential agar specific for the<br />

isolation of V. <strong>cholerae</strong> .<br />

has a relatively long shelf life after preparation.<br />

overnight colonies of V. <strong>cholerae</strong> on TTGA tend to be<br />

smaller (1 to 2 mm) than those from the TCBS agar.<br />

Potassium tellurite, which is added to the medium to<br />

increase selectivity .<br />

Overnight growth of V. <strong>cholerae</strong> on TTGA agar appears<br />

as small opaque colonies with slightly dark centers<br />

opaque zone around colonies which resembles a halo,<br />

which is due to the production of the enzyme gelatinase,<br />

can be intensified by brief (15- to 30-minute) refrigeration<br />

of the plate


TTGA


4. Meat extract agar.<br />

• The colonies appear translucent green to<br />

red pronzy in colour.<br />

• On old culture the colonies appearopaque<br />

&rough


5. Taurocholate pepton broth<br />

• This media can be used for primary<br />

cultivation .<br />

• Sub cultured on other medias can be<br />

done.


6. MacConkey s agar.<br />

• They are non – lactose fermenters.<br />

• Overnight colonies of V. <strong>cholerae</strong> on MAC<br />

tend to be small to moderately sized (1 to<br />

3 mm) and usually appear as lactosenegative<br />

.


MacConkey agar


Blood agar.<br />

• El-tor growth show beta haemolysis


Practical procedure of cultevation<br />

of V. <strong>cholerae</strong><br />

1. direct stool examenation:<br />

• motility: dark field microscopy.<br />

• Microscopical<br />

examination:mucous,epith.,cells& large<br />

numbers of m.o,but no pus cells are<br />

seen.<br />

• Fluresent antibody staining


• 2 ml of faeses + 20 ml APW ph 8-8.5 are<br />

incubated for 5 h.<br />

• At the same time the TCBS is heavily<br />

inoculated & left overnight.<br />

3. From the TCBS,APW,an another APW<br />

are inoculated & left 5 h.


Furtheer identification of V.<br />

1. string test:<br />

<strong>cholerae</strong>:<br />

• a drop of 0.5% Na-deoxycholate is mixed<br />

with a colony after 60 seconds with aloop<br />

there will be a thread of tenacious like<br />

nature it is +ve test for V.<strong>cholerae</strong>.<br />

2. Poly valent antisera(anti O1,anti O139):<br />

agglutination test with specific<br />

antisera&emulsified colonies is carried<br />

out to .


String test


3. Biochemical test :<br />

• including cholera red reaction.<br />

4. Serotyping by specific antisera against<br />

A,B antigenic factors to determine<br />

Ogawa,Inaba&Hikojima.


FACTORS OF PATHOGENISITY<br />

1. Adherance &motility:<br />

the actively motile m.o can adher to the<br />

the intestinal wall(pathogenic)& visaversa<br />

for the non motile(non pathogenic).<br />

V.<strong>cholerae</strong> dose not usually reach to the<br />

blood stream.


• 2. Enterotoxine :<br />

it has amolecular wt.of 84ooo daltons.<br />

it is composed of 6 light chains of 8000<br />

each,&one heavy chain of 28000 daltons<br />

which has 2 portions:<br />

A-toxic portion(A1):98% protein,1%lipid<br />

1%CHO<br />

B-stabilizer portion(A2)


Cholera toxine


• The A1portion increase the intracellular<br />

cAMPof the intestinal epithelium.<br />

• The cAMP prevents reabsorption of Na<br />

ion, excretion of NaHCO3,Cl&K ions.<br />

• This lead to accumulation of water in large<br />

quantities(>20 liters/day),acidosis<br />

,hypokalemia& death.


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