Microbial

Diseases of the
GastroIntestinal
Tract
Salmonellosis
 Salmonellosis
• Salmonellosis is an infection
with bacteria called Salmonella.
• Most persons infected with
Salmonella develop diarrhea,
fever, and abdominal cramps 12
to 72 hours after infection.
• The illness usually lasts 4 to 7 days, and most persons
recover without treatment.
• The elderly, infants, and those with impaired immune
systems are more likely to have a severe illness.
 Diagnosis
• Many different kinds of
illnesses can cause diarrhea,
fever, or abdominal cramps.
• Determining that Salmonella
is the cause of the illness
depends on laboratory tests
that identify Salmonella in the
stool of an infected person.
 Mode of
Transmission
• Salmonella live in the intestinal tracts of
humans and other animals, including birds.
• Salmonella are usually transmitted to
humans by eating foods contaminated with
animal feces.

• Salmonella may also be found in the feces of some pets,

especially those with diarrhea, and people can become
infected if they do not wash their hands after contact
with pets or pet feces.
• Reptiles, such as turtles, lizards, and snakes, are
particularly likely to harbor Salmonella.
 Signs and
Symptoms
• The bacterium induces responses in the animal that it is infecting, and
this is what typically causes the symptoms, rather than any direct toxin
produced.
• Symptoms are usually gastrointestinal, including nausea, vomiting,
abdominal cramps and bloody diarrhea with mucus. Headache, fatigue
and rose spots are also possible.

• These symptoms can be severe, especially

in young children and the elderly.
Symptoms last generally up to a week,
and can appear 12 to 72 hours after
bacterium ingestion.
 Prevention
• Cook poultry, ground beef, and eggs thoroughly. Do not eat or drink
foods containing raw eggs, or raw (unpasteurized) milk.
• If you are served undercooked meat, poultry or eggs in a restaurant, don't
hesitate to send it back to the kitchen for further cooking.
• Wash hands, kitchen work surfaces, and utensils with soap and water
immediately after they have been in contact with raw meat or poultry.
• Wash hands with soap after handling reptiles, birds, or baby chicks, and
after contact with pet feces.
• Mother's milk is the safest food for young infants. Breastfeeding prevents
salmonellosis and many other health problems.
 Treatment
• Salmonella infections usually resolve in 5-7 days and often do not
require treatment other than oral fluids.
• Persons with severe diarrhea may require rehydration with intravenous
fluids.
• Antibiotics, such as ampicillin, trimethoprim-sulfamethoxazole, or
ciprofloxacin, are not usually necessary
unless the infection spreads from the intestines.
• Some Salmonella bacteria have become
resistant to antibiotics, largely as a result
of the use of antibiotics to promote the
growth of food animals.
Shigellosis
 Shigellosis
• Shigellosis is an acute bacterial infection of
the lining of the intestines
• Shigellosis is an intestinal infection
caused by Shigella bacteria(S.
dysenteriae, S. boydii, S. sonnei , and S.
flexneri). The bacteria produce toxins
that can attack the lining of the large
intestine, causing swelling, ulcers on the
intestinal wall, and bloody diarrhea.
 Diagnosis
• Gram-stain

• culture of stool
 Mode of
Transmission
• fecal-oral route

• ingestion of contaminated
material after a bowel
movement
Signs and
Symptoms
• Acute (sudden) abdominal
pain or cramping
• Acute (suden) fever
• Blood, mucus, or pus in stool
• Crampy rectal pain (tenesmus)
• Nausea and vomiting
• Watery diarrhea
 Prevention
• Proper handling, storage, and
preparation of food, in addition to good
cleanliness.
• Hand washing is the most effective
preventive measure.
• Avoid contaminated food
and water.
 Treatment
• Usually not necessary, but antibiotics
can shorten the illness.
. • Antibiotics include
sulfamethoxazole and
trimethoprim (Bactrim),
ampicillin, ciprofloxacin
(Cipro), or azithromycin.
 Viral
Gastroenteritis
 Viral
Gastroenteritis
• Viral gastroenteritis is a
general expression for viral
infection of the intestine. A
major cause is the rotavirus,
a virus transmitted by the
fecal-oral route and capable
of causing severe diarrhea
 Diagnosis
• Specific diagnosis of infection with rotavirus A is made by
identification of the virus in the patient's stool by enzyme
immunoassay. There are several licensed test kits on the market which
are sensitive, specific and detect all serotypes of rotavirus A.

• Other methods, electron

microscopy and polyacrylamide
gel electrophoresis, are used in
research laboratories. Reverse
transcription-polymerase chain
reaction (RT-PCR) can detect and
identify all species and serotypes
of human rotavirus.
 Mode of
Transmission
• Rotavirus is transmitted by the
fecal-oral route,
• Via contact with contaminated
hands, surfaces and objects
• Possibly by the respiratory
route
• Rotavirus A from the feces of
an infected child
 Signs and
• Vomiting,
Symptoms
• Watery diarrhoea
• Low-grade fever.
• Dehydration
• Once a child is infected by the virus,
there is an incubation period of about two days before
symptoms appear
• Infection in newborn children, although common, is often
associated with mild or asymptomatic disease.
• The most severe symptoms tend to occur in children six
months to two years of age, the elderly, and those with
compromised or absent immune system functions.
Prevention
• Improved sanitation
• Use of oral rehydrating
medicines
• Vaccination
 Treatment
• If untreated, children can die from the resulting severe
dehydration. Depending on the severity of diarrhea,
treatment consists of oral rehydration with plain water,
water plus salts, or water plus salts and sugar.
• Some infections are serious enough to warrant
hospitalization where fluids are given by intravenous drip
or nasogastric tube, and the child's electrolytes and blood
sugar are monitored.
• Treatment of acute rotavirus infection
is nonspecific and involves management
of symptoms and, most importantly,
maintenance of hydration.
Typhoid Fever
Typhoid Fever
• Typhoid fever is caused by
the Gram-negative, aerobic rod
Salmonella typhi
• The incubation period of
typhoid fever usually lasts one
to three weeks.
• The bacteria collect in the
small intestine, from which
they enter the bloodstream
 Diagnosis
• Blood test
• Bone marrow test
• Stool cultures test
• Widal test (demonstration of
salmonella antibodies against
antigens O-somaticand H-
flagellar).
 Mode of
Transmission
• The bacillus is transmitted
by milk, water, or solid
food contaminated by feces
of typhoid victims or of
carriers, that is, healthy
persons who harbor
typhoid bacilli without
presenting symptoms
 Signs and
(104 °F),
Symptoms
• Sustained fever as high as 40 °C • Bloody nose (epistaxis)
• Profuse sweating, • Abdominal pain
• Less commonly a rash of flat, • Diarrhea
rose-colored spots may appear • Hepatosplenomegaly
• Fever
Bradycardia,
• Intestinal hemorrhage
•
• Malaise, • Peyer's patches
• Headache • Encephalitis
• Cough • Dehydration
• Severe cases lead to
death
 Prevention
• There are two vaccines currently
recommended by the World
Health Organization:
• Ty21a vaccine (sold as Vivotif
Berna)
• Typhoid polysaccharide vaccine
(sold as Typhim Vi and
• Sanitation and Typherix).
hygiene
• Careful food
preparation
• Washing of hands
 Treatment
• Fluoroquinolone (ciprofloxacin)
• Cefixime
• Ampicillin
• Chloramphenicol
Cholera
 Cholera
• Cholera, severe infectious disease
endemic in India and some other
tropical countries and occasionally
spreading to temperate climates.
• The causative agent of cholera is the
bacterium Vibrio cholerae, which
was discovered in 1883 by the
German physician and bacteriologist
Robert Koch
Diagnosis
• Cholera can be confirmed
only by the isolation of
the causative organism
from the diarrheic stools
of infected individuals.
 Mode of
Transmission
• Cholera is transmitted from person to person through ingestion of
water contaminated with the V. cholerae, usually from feces or other
effluent.
• The source of the contamination is typically other cholera patients
when their untreated diarrhea discharge is allowed to get into
waterways or into groundwater or drinking water supplies.

• Any infected water and any foods

washed in the water, as well as
shellfish living in the affected
waterway, can cause an infection.
• Cholera is rarely spread directly from
person to person.
 Signs and
S ymptoms
• Watery diarrhea
• Vomiting
• Rice-water stools
• Muscle cramps
• Dehydration
• Sunken eyes
• Reduced urine
• Muscle weakness
 Prevention
• Cholera vaccination
• Drink only water that you have boiled, or that you have treated with
chlorine or iodine. Other safe beverages include tea and coffee made
with boiled water, and carbonated, bottled beverages with no ice.
• Make sure that all vegetables are cooked, and avoid salads.

• Eat only foods that have been

thoroughly cooked and are still hot, or
fruit that you have peeled yourself.
• Avoid undercooked or raw fish or
shellfish
Treatment
• Bed rest
• Tetracycline
• Sulphonamides
• Fluid replacement
• Electrolytes
• Salt solutions
• Intravenous fluids
• Isolation and anti-
transmission protocols
Gastric Ulcers
Disease
 Gastric Ulcers
Disease
• an erosion in the stomach wall caused by gastric
acid, digestive enzymes, or other factors that may
include bacterial infection
• In recent years, gastric ulcers have been related to
the Gram-negative rod Helicobacter pylori. This
organism survives in the lining of the
stomach by producing enzymes to
convert urea to ammonia,
thereby raising the pH.
 Diagnosis
• Urea breath test
• Direct culture from an EGD biopsy specimen
• Direct detection of urease activity in a biopsy specimen by
rapid urease test
• Measurement of antibody levels in blood
• Stool antigen test
• Histological examination and staining of an
EGD biopsy.
• Upper gastrointestinal (GI) X-ray
 Mode of
Transmission
• feces
• saliva
• dental plaque of some
infected people
• Hygienic environment
 Signs and
• Symptoms
•
Recurrent abdominal pain Breathlessness
• Abdominal pain after food • Abdominal pain
• Abdominal pain at night • Lack of sleep
• Blood in vomit • May be relieved by
• Nausea antacids or milk
• Anorexia • Worsened
• Black stools
on eating
• Fatigue
Prevention
• Stop using NSAIDs. You can talk
with your doctor about alternatives
• Do not smoke.
• Do not drink alcohol.
• kimchi contains a bacterium strain
"showing strong antagonistic
activity against H. pylori."
• Avoidance of NSAID medications
(aspirin, ibuprofen (Nurofen,
Brufen etc)
 Treatment
• Symptomatic relief: antacid preparations
• Anti-acid medications: "Proton-Pump" inhibitors (eg omeprazole,
lansoprazole), H2 antagonists (eg ranitidine, cimetidine)
• Eradication of Helicobacter pylori infection: oral antibiotics, proton pump
inhibitor
• Surgical partial gastrectomy
• If the ulcer bleeds, endoscopy can control bleeding in most cases

• Surgery may be recommended for

persons who do not respond to
medicines or endoscopy. Surgical
procedures for gastric ulcers include;
• Vagotomy
• Partial gastrectomy
Staphylococcal
Food Poisoning
Staphylococcal
Food Poisoning
• is a type of food poisoning caused
by infection with the
Staphylococcus aureus (S. aureus)
bacterium.
• The bacteria multiply in foods and
produce a toxin even at
refrigerator temperatures.
• The toxins may be present in
dangerous amounts in foods that
have no signs of spoilage, such as
a bad smell.
 Diagnosis
• Staph food poisoning is diagnosed based on a medical
history and a physical exam

• A stool culture and blood

tests may be done if your
symptoms are severe or to
rule out other causes
 Mode of
Transmission
• Ingestion of contaminated food that has not been kept hot
enough [140F or above] or cold enough [40F or below] such
as:
• Meats
• Poultry and egg products
• Salads such as egg, tuna, chicken, potato, and macaroni
• Bakery products such as cream-filled pastries, cream pies,
and chocolate eclairs
• Sandwich fillings
• Milk and dairy products
 Signs and
•
Symptoms
Symptoms of staph food poisoning include:
• nausea
• vomiting
• retching
• stomach cramping
• diarrhea
• In more severe cases:
• dehydration
• headache
• muscle cramping
• changes in blood pressure and pulse rate may occur.
 Prevention
• Shop safely. Bag raw meat, poultry, or fish separately from
other food items.
• Prepare foods safely. Wash your hands before and after
handling food. Wash fresh fruits and vegetables by rinsing
them well with running water
• Store foods safely. Cook, refrigerate, or
freeze meat, poultry, eggs, fish, and
ready-to-eat foods within 2 hours.
Make sure your refrigerator is set at
40F or colder.
• Cook foods safely. Reheat leftovers to
at least 165F. Do not eat undercooked
foods.
• Serve foods safely.
 Treatment
• Treat staph food poisoning by managing any complications
until it passes.
• Treatment really just involves staying hydrated by take
frequent sips of a rehydration drink (such as Lytren,
Pedialyte, or Rehydralyte)
• controlling your fever (if any) and waiting things out.
• The infection usually will resolve without
the need for medication.
• Try to stick to your normal diet as much as
possible
• avoid foods that are high in fat and sugar.
Also avoid spicy foods, alcohol, and coffee
for 2 days after all symptoms have
disappeared.
Campylobacteri
osis
 Campylobacteri
osis
• Caused by Campylobacter
jejuni (Gram-negative
bacteria)
• Diarrhea caused by eating rare
chicken or unpasteurized milk
• Sites of tissue injury include
the jejunum, the ileum, and
the colon
 Diagnosis
• Gram stain of stool with high
specificity and a sensitivity

• Stool culture (presence

of fecal leukocytes)
 Mode of
Transmission
• Fecal-oral
• Person-to-person sexual contact
• Ingestion of contaminated food (generally unpasteurized
(raw) milk and undercooked or poorly handled poultry)

• Waterborne (contaminated
drinking water)
• Contact with contaminated
poultry, livestock, or household
pets, especially puppies
 Signs and
Symptoms
• Diarrhea (sometimes bloody)
• Cramping
• Abdominal pain
• Fever
• Sometimes nausea and vomiting
• Symptoms begin 2 to 5 days after exposure
and last about 7 to 10 days.
 Prevention
• Pasteurization of milk and chlorination of drinking water
• Treatment with antibiotics can reduce fecal excretion
• Infected health care workers should not provide direct patient care

• Separate cutting boards should be

used for foods of animal origin and
other foods. After preparing raw
food of animal origin, all cutting
boards and countertops should be
carefully cleaned with soap and hot
water.
 Treatment
• Usually no treatment is needed

• But some antibiotics

(erythromiycin or
fluoroquinolone) may
improve recovery
time.
 GUERRA, JUENELLE
a.k.a.

Viral Gastroenteritis

Microbiology
HULIGANGA, JEMILEE
a.k.a.

Shigellosis

and
LEGION, ARIANE CLARISE
a.k.a.

Salmonellosis
Parasitology
MAGTIBAY, JULIUS
a.k.a.

Typhoid Fever
MARTINEZ, DARYL
a.k.a.

Cholera
MENDOZA, SCHELMA