Pathogenic Microorganisms

Dr. Linroy Christian

Salmonellosis
Etiologic agent Salmonella
Common species; Salmonella enteritidis and Salmonella typhimurium Gram negative, rod-shaped bacterium Facultative anaerobe motile Poultry and poultry products and faecally contaminated food and water Pets, in particular reptiles, carry Salmonella Faecal-oral route through ingestion of undercooked, contaminated food

Source

Mode of transmission

Salmonellosis
Morbidity
Salmonella are often the most isolated pathogen from faeces in many countries. The US generally reports 40,000 cases per year of Salmonellosis

Mortality
If left untreated, Salmonellosis can result in death. In the US over 600 persons die each year. The immunocompromised, children and the elderly are most likely to get and succumb to Salmonellosis

Salmonellosis
Symptoms develop within 12-72 hours and usually last between 4 to 7 days Symptoms may include:
Diarrhoea Fever Abdominal cramps

Symptoms are generally self-limiting, but may require antibiotic treatment Infection may also spread to the bloodstream and other body sites and may lead to death if antibiotic treatment is not received

Salmonellosis
Persons with diarrhoea eventually recover, but may be carriers for several weeks Some individuals may develop Reiters Syndrome:
Joint pain Irritation of the eyes Painful urination

Reiters syndrome may lead to chronic arthritis

Salmonellosis
Treatment
Rehydration or IV fluids Antibiotics are not generally necessary

If the infection has spread from the intestines, antibiotics may be used such as ampicillin, gentamicin or ciprofloxacin Some salmonella are resistant to antibiotics due to use of antibiotics in animal feed

Salmonellosis
Prevention
Cook food thoroughly and avoid food and drink made with raw eggs and raw unpasteurised milk Avoid undercooked meat and poultry Wash hands and clean kitchen and work surfaces thoroughly Wash hands after handling pets, especially reptiles and birds Avoid cross contamination of cooked food with potentially contaminated raw food

Tuberculosis
Etiologic agent
Mycobacterium tuberculosis Rod-shaped, acid fast bacterium aerobic

Mode of transmission
Transmitted from person to person via droplet nuclei when an infected person coughs, sneezes or talks The inhaled bacterium subsequently infects the lungs

Tuberculosis
Morbidity
In 2005 there were in excess of 14 million cases world wide

Mortality
In 2005, greater than 1.5 million people died world wide

Tuberculosis
TB infection may be latent or infected individuals may develop TB disease Latent TB
The bacterium is in the body without infection or symptoms and the infected individual is incapable of spreading the disease

TB disease

Individuals are infected with bacteria that are actively multiplying Symptoms develop and disease may be spread from person to person

Tuberculosis
symptoms include weakness, weight loss, fever, loss of appetite and night sweats Infection of the lungs include coughing for more than 3 weeks, chest pain and coughing blood Infection may spread to other parts of the body If exposed to an infected individual for prolonged periods then it is advisable that a diagnostic test be done to determine if infection occurred
Tuberculin (Mantoux) test QuntiFERON TB-Gold

Tuberculosis
Treatment
Latent Isoniazid for 9 months is the preferred treatment TB disease Isoniazid, rifampin, ethambutol and pyrazinamide daily for 8 weeks followed by daily isoniazid and rifampin for 18 weeks Regime should be closely adhered to Monitoring for drug resistance should be done BCG vaccine Not approved for use in many countries with the exception of the US Vaccine generally 60-80% effective

Tuberculosis
Protection of health care workers
Appropriate hospital policy
Assignment of responsibility Standard procedures Vaccination Screening System evaluation

Environmental control Respiratory protection

Hepatitis
5 types are classified as Hepatitis viruses
A, B, C, D and E

3 are transmitted through blood and bodily fluids

B, C and D

All cause infections of the liver of varying degrees of severity

Hepatitis A
Transmitted from person to person via faecally contaminated food Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, diarrhoea and fever Symptoms may persist for months Lifelong immunity develops following recovery Vaccine available Good hygienic practices are important for prevention

Hepatitis B
Transmitted from person to person via blood and body fluids Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting and joint pain Long-term infection may develop and may lead to cirrhosis of the liver, liver cancer, liver failure and death Vaccine available Drugs such a lamivudine used to treat chronic disease Special precautions required for health care workers

Hepatitis C
Transmission via blood from person to person Majority of individuals show no signs or symptoms Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea and dark urine Infections is generally chronic in nature and may include chronic liver infection, liver disease and cirrhosis No vaccine available Interferon and ribavirin are approved for treatment

Hepatitis D
Transmitted from person to person via blood and body fluids Can develop as a co-infection with Hep. B Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain and dark urine Hep. B vaccine can be given to prevent coinfection Chronic infection may be treated with interferon Liver transplant may be necessary

Hepatitis E
Transmitted via ingestion of faecally contaminated food and drink No chronic infection Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting and dark urine Prevention through proper hygiene