Kliebsiella , Salmonella Lecture Notes

Kliebsiella

• Normal inhabitants of intestine and respiratory tract

• Saprophytes in soil and water

• Some caus e disease in man

• Morphology

• Gram negative ,nonmotile capsulated bacilli

• Culture

• Lactose fermenters on MacConkeys agar

• K.pneumoniae causes lobar pneumonia,urinary tract infection

• K.rhinoscleaomatis-rhinoscleroma

• K.ozaenae –arophic rhinitis

• K.oxytoca-hospital acquired infection

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Salmonella

• Most important are Salmonella typhi,

• Paratyphi A,B and C.

• Morphology

• Gram negative ,motile non capsulated bacilli

• Cultural characters

• On MacConkeys pale non-lactose fermenting colonies

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• Diseases

• Enterocolitis(food poisoning)

• Enteric fever-caused by S.typhi,Paratyphi A and B.

•Mode of transmission

• Oral route by ingestion of contaminated food or drinks,raw vegetables,fruits,raw shell fish ,milk products

• Multiplies in Peyers patches

• Passes through lymphatics to blood stream-bacteraemia( persists one week)

• Disseminates to kidney(excreted in urine)

• liver(excreted in bile-

• reaches intestine.

Salmonella clinical picture

• Incubation period 2 weeks

• Fever

• Malaise

• Headache

• Delirium

• Tender abdomen

• Constipation with spleen enlargement

• Rose spots on abdomen

• Complications

• intestinal haemorrhage and perforation are reduced due to proper use of antibiotics

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Rose spots on abdomen

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Gram negative bacilli

• Salmonella carriers

• After recovery some individuals continue to harbour salmonella in their tissues as carriers

• In gall bladder excrete in stools

• Carried in the Urinary tract

• Should not work as food handlers

• Diagnosis of enteric fever

• Isolation from blood by blood culture 1st week

• 2nd week

• Isolation from stools and urine

Laboratory diagnosis of Salmonella

• Serological diagnosis

• Widal test

• Antibodies to salmonella appear in serum of patient during 2nd week of illness

• Raech maximum titre in 4 weeks.

• Tube agglutination test

• The end titre is highest dilution of serum which gives agglutination

• Diagnosis of carriers

• Isolation of organism from stool

• Urinary carriers

• Repeated examination of carriers

Prophylaxis

• Sanitary measures to prevent contamination of food and water by the organism

• Carriers not to work as food handlers

• Vaccines

• 1TAB vaccine in 2 doses subcutaneously interval of I month

• 2Oral typhoid vaccine

• C-Vi capsular plysacchride given intramuscularly.

• 3Treatment

• chloroamphenicol,ampicillin,and trimethoprim-sulfamethoxazole.ceftriaxone

Salmonella enterocolitis Food poisoning

• Common pathogens of animals and poultry

• Mode of transmission

• Improperly cooked meat of infected animals,eggs of infected birds

• Food contaminated with rat

• Excreta

• Disease-nausea,vomiting,abdominal discomfort,diarrhoea and slight fever

• Organism multiplies in intestine (infection and not due to toxin (12-48 hrs incubation period to allow multiplication. isolate from stools.

• Recovery within 1 week -self limited antibiotics only for neonates

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