Campylobacter,

Helicobacter
and
Legionella

Campylobacter
Discovered in 1970 - 13 species
C. jejuni & C. coli - important cause of

diarrhoea
slender curved or spiral rods - Gram -ve
microaerophilic - 5% O2, temp. 420 C
Pathogenesis:
organism is ingested, invades the intestines
1 2 3 4 5
IP 3D
fever
abdominal pain
bloody
diarrhoea

organism in faeces

21

Campylobacter
Lab diagnosis:
Direct microscopy - rapidly motile bacteria
Culture: selective media- 5% O2, 10% CO2, 420 C
Treatment: erythromycin, ciprofloxacin
Epidemiology:
common in western countries & young adults
Source of infection
animals e.g. birds - contaminate surface
water
poultry e.g chicken - undercooking & cross
contamination of raw vegetables & salads
Control:
Boiling - water & milk
control infection in poultry
hygenic food preparation

Genus- Helicobacter

H. pylori - discovered in 1983

Gram -ve spiral, microaerophilic rods

produce urease
colonise the gastric mucosa
implicated in the aetiology of peptic ulcer
& type B gastritis

site of infection - antrum

abdominal pain, nausea & flatulence
Lab diagnosis:

Biopsy - endoscopic - urease test &

culture
Urea breath test
Serology : antibodies (IgA) to H. pylori
Treatment: colloidal bismuth, amoxycillin
+
metronidazole

Legionella
1976- outbreak of 182 cases in Philadelphia at
an Americal Legion convention
Gram -ve rods - coccobacilli
natural habitat - water
36 species L. pneumophila & 14 species - human
infections

2 clinical forms
Legionnaires disease - pneumonia
IP 2-10 d, high fever, respiratory distress, cough
confusion, focal neurological signs
Nosocomial or community accquired

Pontiac fever - brief febrile illness

Legionella
Pathogenesis - How does man get infected with
Legionella?

inhalation of fine water droplets containing

organisms- aerosols
water in cooling towers of refrigeration & air
conditioning systems
hot water systems in hotels/hospitals
warm water in nebulizers & O2 line humidifiers
showers, whirl pool baths

Infection

pneumonic consolidation with little sputum

mild

fatal pneumonia

no chronic infections or carrier states

severe in debilitated, elderly, IC, surgery

Legionella
Lab diagnosis
Specimens - Broncho alveolar lavage
microscopy, culture & detect antigens

serology to detect antibodies ELISA/FAT

Treatment -erythromycin, ciprofloxacin
Control: case identification & notification

Heat water > 600 C before distribution

without stagnation & cooling.
Cold water < 200 C
chlorination