Sarang S. Desai. V / 05 / 0170 ‘A’ batch With help BVC Suresh sir of Dr.


Yersinia entericolitica
It is a Gram-negative, nonlactose fermenting, urease positive rod.

Fluorescence techniques to demonstrate organism.

Y. enterocolitica on Blood Agar Plate

• Anthropozoonosis
• Y enterocolitica , Y pseudotuberculosis • Man, buffalo, cat, goat, deer, hare, mink, pig, rabbit, racoon, rat, wild rodents. • IP - less than 10 days • Fatality rate – less than 1% [ but not for immunocompramised & old persons ] Transmission • Ingestion of water, food, milk, ice cream. [ which are contaminated by intestinal carriers ] • Tranaplacental

Syndrome • Acute terminal ileitis • Acute mesenteric lymphadenitis • Ulcerative lesions • Abdominal tenderness, anorexia, vomiting, erythema nodosum i.e. skin eruption leading to painful red swelling, enteritis with diarrhoea • Toxemia [ Toxins liberated are Y-ST ] • Septicemia with icterus & hepatomegaly [ in immunocompramised cases & elders where fatality is 50 % ] • Conjunctivitis -- middle aged --- corneal inflammation, pharyngeal --Sjogren’s females inflammation, enlargement of glands, syndrome dry throat. Appenditis with fever Pain

Within 2-3 Post-infection

• Pulmonary abscess • Arthritis – refuted by some scientists • Variation in symptoms with strain, dose ingested, host genetic factors, age & health of host. Bottone 1977, Larson 1979 • Organism shows diverse variation Failure to report human Yersiniosis.

• Molecular mimicry In Thyroid Diseases – Y. enterocolitica has TSH binding sites
Autoimmune disease.

• Serovar 03 – Arthritis erythema – Scandinavia • Serovar 08 – Soft tissue infection, conjunctivitis, Osteomyelitis – N. America.

Diagnosis • Isolating pathogens by cold enrichment from faeces • Blood culturing • ELISA • Strain typing [ biovars 1 to 5 ; Many serovars ; Environmental bioserovar – biovar 1] • Radiological examination with Barium. Prevention & Control • Prevent faecal contamination of food & drinking water. • Use pasteurized milk. • In a nutshell – sanitary disposal of faeces, hygienic food handling, kitchen hygiene. • MASS EDUCATION

On ultrasound -Symmetrical mural thickening of caecum & ileum.

Liver of a marmoset diagnosed with yersiniosis indicating multifocal hepatic necrosis.

Marmoset diagnosed with yersiniosis. Lymph node: multifocal necrosis (arrows) with central large lobulated colonies of coccobacilli (arrowheads). Hemotoxylin-eosin stain (HE). Bar = 100 µm.

Liver: area of necrosis (arrow) with intralesional large lobulated colonies of coccobacilli (arrowheads). HE. Bar = 50 µm.

Spleen: area of necrosis (arrow) with central large lobulated colonies of coccobacilli (arrowheads) and marked lymphoid depletion. HE. Bar = 100 µm.


Figure 1

Figure 2

Figure 1: Annual incidence of cattle brucellosis and yersiniosis, Auvergne, France, 19891997

Figure 2: Yersinia enterocolitica O:9 infections in humans, Auvergne, France, 19901998..

• Helicobacter pylori is a gram negative, microaerophilic that inhabits various areas of the stomach and duodenum. • It contains a hydrogenase which can be used to obtain energy by oxidizing molecular H2 that is produced by intestinal bacteria • It is capable of forming biofilms. • Campylobacter pyloridis then C. pylori then Helicobacter pylori

Scanning electron micrograph of H. pylori

Closer view

Helicobacter species on the gastric mucosa of a spotted hyena (Crocuta crocuta) SEM,magnification x2000

Endoscopic image [ From the human patient ]

Epidemiological distribution of H. pylori

•Prevalence of H. pylori infection correlates best socio-economic status rather than race. • In the United States, probability of being infected is greater for older persons (>50 years = >50%), minorities (African Americans 40-50%) and immigrants from developing countries (Latino > 60%, Eastern Europeans > 50%). •The infection is less common in Caucasians ( < 40 years = 20%).
The mountain range in Caucasia between the Black Sea and the Caspian Sea that forms part of the traditional border between Europe and Asia

Western Countries • H.pylori affects about 20% of persons below the age of 40 years, and 50% of those above the age of 60 years. • H.pylori is uncommon in children. • Low socio-economic H.pylori infection. • Immigration Western countries.

Developing Countries • In developing countries most adults are infected. • It is evident from careful surveys that the majority of persons in this world are infected with H.pylori.

Occurrence of HP in USA

p.a. : per annum

Transmission •The route of transmission unknown, although individuals become infected in childhood. •H. pylori's helix shape is thought to have evolved to penetrate the mucoid lining of the stomach. Diagnosis • H.pylori can be cultured from the stools in most infected persons (using special techniques). • This gives evidence that spread by faeco-oral route with infected persons is possible. • PCR can detect H.pylori in dental plaque from 30% of persons with the gastric infection. Treatment •Treatment with of bismuth salts, metronidazole, and either ampicillin or tetracycline. •Antimicromial therapy with clarithromycin, a nitroimidazole (metronidazole or tinidazole), and amoxycillin.

"Helicobacter Foundation"
• • The "Helicobacter Foundation" Prof. Barry J. Marshall in early 1994. The latest information about Helicobacter pylori , its diagnosis, treatment and clinical perspectives. .

“Famous people with Helicobacters”
• • • • George Bush; (At one time in the 60's had a duodenal ulcer) Lots of men in the CIA have HP because they have lived overseas, particularly Latin America. Central Intelligence Agency Pope John Paul II; (Had gastric bleeding in the 1980's. Most Poles have HP). Alfred Nobel

H. Pylori in the section of the stomach

H. pylori colonized on the surface of regenerative epithelium (image from Warthin-Starry's silver stain)

α proteobacteria
P. abikonensis, P. aminovorans, P. azotocolligans, P. carboxydohydrogena, P. carboxidovorans, P. compransoris, P. diminuta, P. echinoides, P. extorquens, P. lindneri, P. mesophilica, P. paucimobilis, P. radiora, P. rhodos, P. riboflavina, P. rosea, P. vesicularis.

β proteobacteria
P. acidovorans, P. alliicola, P. antimicrobica, P. avenae, P. butanovorae, P. caryophylli, P. cattleyae, P. cepacia, P. cocovenenans, P. delafieldii, P. facilis, P. flava, P. gladioli, P. glathei, P. glumae, P. graminis, P. huttiensis, P. indigofera, P. lanceolata, P. lemoignei, P. mallei, P. mephitica, P. mixta, P. palleronii, P. phenazinium, P. pickettii, P. plantarii, P. pseudoflava, P. pseudomallei, P. pyrrocinia, P. rubrilineans, P. rubrisubalbicans, P. saccharophila, P. solanacearum, P. spinosa, P. syzygii, P. taeniospiralis, P. terrigena, P. testosteroni.

γ-β proteobacteria
P. beteli, P. boreopolis, P. cissicola, P. geniculata, P. hibiscicola, P. maltophilia, P. pictorum.


γ proteobacteria
P. beijerinckii, P. diminuta, P. doudoroffii, P. elongata, P. flectens, P. halodurans, P. halophila, P. iners, P. marina, P. nautica, P. nigrifaciens, P. pavonacea, P. piscicida, P. stanieri.

δ proteobacteria
P. formicans...

Ps. Aeroginosa
at high magnification

• Rod shaped • Gram-negative • One or more polar flagella motility

• Aerobic although some species have been found to be facultative anaerobes (e.g. P. aeruginosa) • Non–spore forming • Positive catalase test • Slime production also contributes to surface-colonising biofilms which are difficult to remove from food preparation surfaces. • Growth of Pseudomonads on spoiling foods can generate a "fruity" odor.

Ps. aeroginosa on trypic soy

The soluble blue pigment pyocyanin is produced by many, but not all, strains of Pseudomonas aeruginosa

…………….Pseudomonas • Bacteria of potential health concern. • Widespread in environment. Soil & Water • Grows at low nutrition situation. • Resistant to many antibiotics. • Nosocomical infection • Faulty plumbing • THUS • Tap water limit the use of tap water in hospitals. eye infection IV route & wounds ……………N. F. Lightfoot

• No effect if injested

Gram stain - Pseudomonas aeruginosa

Pseudomonas aeruginosa colonies on agar

Pseudomonas aeruginosa SEM

Pseudomonas aeruginosa SEM - CDC

Epidemiology • Australia – South East Asia – Myanmar – Shrilanka • Thailand – rice farmers -- soil

Worldwide distribution of Ps.

IN INDIA Assam, Kerala, Maharashtra, Orrisa, TN, Tripura, WB – rice producing states

Distribution of Ps. In India & Shrilanka

Transmission • Cuts, lesions that are exposed to contaminated soil & water • Dust inhalation • Mosquitoes & flies – aedes aegypti & xenopsyla chenopis • Venereal ????

Symptoms • Liver abscess, puss, septicaemic cases • In Australia – Acquired pneumonia • Disease Pulmonary Septicaemic Extrapulmonary / Subclinical

Diagnosis • Clinico-pathological symptoms • Isolation & identification • Lab animal inoculation • CFT, IH • PCR Prevention & Control • Clothing, gumboots • Avoiding barefoot walk in low lying areas • Protect skin lesions • Prophylactic antibiotic treatment • Immunization – Heat killed fromalinised vaccine – For high risk group only


• Ubiquitous organism • Breaking down of A. A. chains Protein degradation

• Simple striated muscles is the target site • Main putrefying organism • Pigments are the real putrefying agents • Localised organism & not systemic pathogen • Consumer acceptibility ZERO

References • Wikipedia • The Helicobacter Foundation • CDC • Todar's Textbook of Bacteriology • Zoonoses-Pal • Zoonoses-Martin High • Food Born Pathogens-Varman