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VIBRIO

Morphology
Aeromonas & vibrio
- Facultative anaerob
- Rod, curve
- Sucrose, mannose-fermenting
- Non arabinose-fermenting
- Positive oxidase
- Polar flagella (most)
- Bisa hidup di 14-40oC (WIDE RANGE)
- Bisa hidup dengan banyak NaCl
- pH 6,5 – 9,0; susceptible to acid

Classification

1. V. cholerae:

Serogroup O1 (serotype: Inaba, Ogawa, Hikojima), O139

Biotype:

- El Tor (produce hemolysin  + at Voges Proskauer test)


- Clasical

1817  7 times pandemic

2. V. parahaemolyticus
3. V. vulnificus
V. vulnificus & non O1 have polysaccharide capsule  help dissemination

Virulence factors

Toxin co-regulated pilus (TCP)  in Vibrio pathogenicity island 1

LPS

Pathogenicity
TCP (by VPI 1) place of attachment of lysogenic bacteriophage  Vibrio engulfed by
bacteriophage (CTX-omega)  ace gene (acessory cholerae enterotoxin gene),zot gene (zonula
occludens toxin gene), cep (chemotaxis protein genes) [in O1 and O139]

Cholerae have Complex A-B toxin (like E.coli). Cara kerja toxin: mengubah ATP menjadi CAMP
menyebabkan waterry diarrhea (1,5 ltr). TCP membuat Vibrio dapat menempel di mucosse cell
layer. TCP dikode oleh TCP gene. ACE menyebabkan sekresi fluid, ZOT menyebabkan lusion of
tap junction. Vibrio parahaemolyticus memiliki adhesin and thermostabile direct hemolisin
(Kanagawa hemolysin)>> cause hemolisis. Kanagawa also increasing calcium intraceluler
sehingga meningkatkan sekresi cl.

Strain yang dapat memproduksi beta hemolysin menyebabkan necrosis.

Vibrio vulnificus mempunyai fx virulens: menghancurkan lysin dan memproduksi alkaline bile
product ketika masuk ke lambung. Dapat menghindari imun respons dengan memicu apotoksik
makrofag dan polisakarida (antifagosit). Punyai surface protein yang akan menempel di host
cells dan melepaskan cytolotic toxin.

Epidemiology: (3-9 milion case per year) (outbreak when a dissaster)

Estuarine & marine enviroment >> water, chitinous selfish (oyster, calms, mussels).

Asymptomatic but continously shedding.

7th pandemic caused by serogroup O1 & biotype El Tor.

V. cholera O139 in Bengal(the only serogroup outside O1 yang bikin pandemic) will produce
same toxin with O1.

Cholera transmitted by water & food not person to person 10 8 (hypochlorhydria 103-5). Must
cooking over 40*C.

Transmission: stool < 24 hours (very infectious)

V. parahaemolyticus penyebab gastroenteritis in Japan, Southeast Asia, and US.

V. vulnificus >> rare isolated, most fatal, cause vibrio septichemia


Clinical diease: V. cholerae O1 >> asymptomatic, self-limited. Incubation period: 2-3 days after
ingest or < 12 hours (abrupt onset of vomiting and diarrhea), fever is rare, rice water stool
(colorless, dolorless, proteinless) >>> dehydration

V. cholerae O139 like V.cholerae O1

V. cholerae non-O1 menyebabkan septicemia and small diarrhea in


immunocompromised/hematologic malignant

V. parahaemolyticus >> incubation period 5-72 jam (rata-rata 24 jam), explosive watery
diarrhea

V. vulnificus >> 90% mortality. Caused septicemia after shellfish ingestion, wound infection with
contaminated sea water. Gejala: Fever, chills, vomit, diarrhea, abdominal cramp. Characteristic
of wound: swelling, erythema, pain, vesica >> tubula >> necrosis

Diagnosis:

Micoscopic examination : Small size (0.5-1.5-3 mikrometer), curve, find in stool (onset
cholerae), gram stained

Immuno assay: detect cholera toxin O1/O139/lipopolisacharides

Cultue: media carry-blair and in refrigerator (can’t in buffered-glycerol saline), Mac Conkey,
TCBS agar, enrichment broth that contain alkaline pepton broth (ph 8,6)

Treatment:

Rehydration

Azythromycin single dose

Resistant with tetracyclin and floroquinolon

V. parahaemolyticus is self limited

V. vulnificus >> minocycline or doxycycline + ceftriazone/cefotaxime

Vaccines: high risk to travelling or care of illness patients

AEROMONAS
Aeromonas hydrophila, Aeromonas caviae, Aeromonas veronii biovar sobria

Cause diarrhea (dysentric diarrhea, blood, and leukocytes), wound infection, and opportunistic
sistemic in immunocompromised patient.

Transmission: Fecal-oral (contaminated food)

Unussual Aeromonas infection by medicinal leeches

Fx virulence: endotoxin, hemolysin, heat labile, and heat stabile enterotoxin (cara kerja tidak
diketahui)

Treatment: resistent with penicilin, cephalosporin, and eritromycin. Floroquinolon