Diagnostic microbiology lecture: 17 CHLAMYDIA Abed ElKader Elottol MSc . Microbiology 2010 - PowerPoint PPT Presentation

Diagnostic microbiology lecture: 17 CHLAMYDIA Abed ElKader Elottol MSc . Microbiology 2010. General

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Diagnostic microbiologylecture: 17CHLAMYDIA

Abed ElKaderElottolMSc. Microbiology

2010

Abed ElKaderElOttol

General Characteristics

• Obligate intracellular bacteria.

• Have ribosomes like bacteria.

• Are metabolically deficient.

Morphology

• Small rounded organism.

• Multiply by binary fission.

• Cell wall consists of inner & outer membranes but differ from that of Gram negative bacteria by absence of peptidoglycan.

Abed ElKader ElOttol

Important Species

  • C. psittaci
  • C. pneumoniae
  • C. trachomatis
  • Cultural Characters Grow in:
  • Yolk sac of chicken embryo
  • Tissue culture (McCoy cells)
  • PATHOGENESIS
  • • Infect epithelial cells of mucous membranes & lungs
  • Virulence is due to:
  • • Resistance to phagocytic killing by lysosomal enzymes
  • • Heat-labile toxin
  • • Competition with host cell for nutrients
  • • Host’s immune response may account for inflammation & tissue destruction.

Abed ElKader ElOttol

Abed ElKader ElOttol

CHLAMYDIA PSITTACI

  • A zoonotic respiratory disease.
  • Natural habitat : birds
  • Transmitted through inhalation of :
  • Respiratory secretions & dust from faeces of infected birds
  • Common in poultry workers
  • Disease : Pneumonia (Psittacosis)
  • Diagnosis
  • Isolation of organism from sputum by tissue culture
  • Complement fixation test to detect specific Abs
  • Treatment
  • Tetracycline in adults
  • Erythromycin in babies

Abed ElKader ElOttol

CHLAMYDIA PNEUMONIAE

Also known as TWAR

(TW – Taiwan & AR – acute respiratory)

Cause atypical pneumonia like Mycoplasmapneumoniae

Treatment

Tetracycline in adults

Erythromycin in babies

Abed ElKader ElOttol

CHLAMYDIA TRACHOAMATIS

15 serotypes (A-L)

Transmission: Through close personal contact like:

• Sexual

• Passage through birth canal

• Finger to eye or fomite to eye (Trachoma)

DISEASES

1. Trachoma

• Caused by serotypes A, B, Ba & C

• One of the leading causes of blindness in developing countries with dry & hot weather

• Chronic conjunctivitis : leads to scarring of eye lids and cornea

Abed ElKader ElOttol

2. Genital Tract Infections (Serotypes D-K)

• Non-gonococcalurethritis in men

• A common cause of non-gonococcalurethritis

• Mucopurrulent urethral discharge

• May progress to epidydmitis & orchitis (testes inflamation)

• Cervicitis & Vaginitis

• Mucopurrulent vaginal discharge

• Pelvic Inflammatory Disease (PID)

• May lead to secondary infertility

Abed ElKader ElOttol

3. Neonatal Infections (Caused by serotypes D-K)

• Acquired from mother’s birth canal

• Inclusion Conjunctivitis

• Profuse mucopurrulent discharge 7-12 days after birth

• Pneumonia.

4. LymphogranulomaVenereum (LGV)

• Caused by serotypes L1, L2 & L3

• A STD with lesions on genitalia & LNs (buboes)

5. Reiter’s Disease

An autoimmune disease caused by Abs formed against C. trachomatis which cross react with antigens on cells of urethra & joints(arthritis, redness of the eyes, and urinary tract signs).

Abed ElKader ElOttol

LAB DIAGNOSIS

  • • Specimens from urethra, conjunctiva, sputum & cervix.
  • • Microscopy.
  • • Chlamydial “cytoplasmic inclusions” are detected by:
  • • Giemsa staining
  • • Fluorescent Ab staining
  • • PCR
  • • Cell Culture
  • • Sero-diagnosis
  • TREATMENT
  • Tetracycline in adults
  • Erythromycin or Azithromycin in babies

Abed ElKader ElOttol

Calymmatobacteriumgranulomatous

GRANULOMA INGUINALE

Abed ElKader ElOttol

The disease is commonly known as donovanosis

  • Small, painless nodules appear after about 10–40 days of the contact with the bacteria. Later the nodules burst, creating open, fleshy سميك, oozingرشح lesions.
  • General characteristics
  • Capsulated short Gram-negative rod
  • A STD with higher incidence in homosexuals
  • Clinical Features
  • Initially papules appear on external genitalia which ulcerate and extend widely – ulcer formation
  • Base of ulcer is “BEEFY”; spreads by contact so is known as “KISSING ulcers”
  • Lymph Nodes may enlarge
  • Treatment : Tetracycline

Abed ElKader ElOttol

MYCOPLASMA

Abed ElKader ElOttol

GENERAL CHARACTERISTICS

  • The smallest free-living organism (0.3 μ diameter).
  • Have no cell wall.
  • Insensitive to penicillins & cephalosporins.
  • Poorly stained by Gram-staining.
  • Cytoplasmic membrane contains cholesterol.
  • Slow growth on specialized artificial culture media (a week).
  • Typical “fried-egg” appearance of colonies by a plate microscope

Abed ElKader ElOttol

Formulae

Difco™ PPLO Agar

Approximate Formula* Per Liter

Beef Heart, Infusion from 50 g ................................... 6.0 g

Peptone ................................................................... 10.0 g

Sodium Chloride ........................................................ 5.0 g

Agar ......................................................................... 14.0 g

Abed ElKader ElOttol

MYCOPLASMA PNEUMONIAE

MAIN DISEASE

• Primary atypical pneumonia

• Common in late summer and early autumn

PATHOGENESIS & EPIDEMIOLOGY

• Droplet infection.

• Organism adhere to respiratory epithelium.

• Inhibit ciliarymotion.

• Damage epithelium.

• Common in chidren & young adults

• Increased incidence in winter

Abed ElKader ElOttol

CLINICAL FEATURES

  • Sore throat, fever & headache.
  • Cough with small amount of whitish non-purulent sputum.
  • Some extrapulmonarysymptoms.
  • Opacities on chest X-Rays.
  • IMMUNITY
  • Incomplete: second episode can occur.

Abed ElKader ElOttol

UREAPLASMA URELYTICUM

Abed ElKader ElOttol

Differentiated from mycoplasma due to urease enzyme production Like mycoplasma produce “fried egg” colonies on specialized medium.

  • Diseases
  • • Non-gonococcal, non-chlamydial urethritis in men.
  • • Post-partum fever in women.
  • • Transmitted by sexual contact.
  • MYCOPLASMA & UREPLASMA
  • LAB DIAGNOSIS
  • Culture : “Fried egg” colonies on specialized medium
  • Cold Agglutinin detection A titer of 1:128 or higher – indicates recent infection
  • TREATMENT
  • Tetracycline OR Spectinomycin

Abed ElKader ElOttol

RICKETTSIA & COXIELLA

Abed ElKader ElOttol

Rickettsiae
  • A genus of small, rod-shaped, round to pleomorphic microorganisms .
  • gram-negative
  • cultivable only in living tissues.
  • Transmitted by liceقمل and ticksقراد, they cause disease in humans and domestic animals but are also found in the cytoplasm of tissue cells of lice, fleas, ticks and mitesسوس , which may act as reservoirs and vectors

Transmission

    • Biological
      • Examples
        • Ticks
        • Sucking lice
      • Live inside arthropods for months
    • Mechanical
      • Examples
        • Instruments
        • Blood transfusions
      • Live short time outside of host

Pathogenesis

    • Insect vectors for human transmission: arthropods such as fleas, ticks, mites عث, or lice
    • Rodents, humans, or arthropods: all can serve as reservoirs
    • Multiply in salivary glands of ticks & gut of lice/fleas
    • Site of Bite = Eschar (encrustedمتقشرulcer) → necrotic tissue:

Site of bite = point at which Rickettsia enters the body becomes blackened

  • Following bite, organisms taken into body by “phagocytosis process
  • Organisms multiply in both nucleus & cytoplasm of host cell.

Typhus Group

    • Louse borne (epidemic) Typhus.
    • Etiological agent = Rickettsiaprowazekii
    • Transmission: person-to-person by infected human body louse that excretes organisms in feces
      • Introduction of pathogen form lice facilitated by scratching the louse bites
    • high fever, chills, rash possible
    • Duration of Disease: ~2 weeks; more severe in ederly
    • Complications: CNS dysfunction and myocarditis

Rock Mountain Spotted Fever

  • Etiological agent = Rickettsiaricketsii
  • Reservoir = rodents (mice, rats)
  • Vector = Tick Bite
  • Rickettsiain saliva of tick, transfer to humans after bite Human infection
    • High fever & malaise, then rash – initially, but becomes petechial or hemorrhagic
    • Rash starts on extremities, then rapid spread to entire body.
    • Untreated cases – vascular disturbances with myocardial or renal failure possible
Coxiella
  • Etiological agent = Coxiellaburnetti
  • Q fever
  • Reservoir = cattle, sheep, rodents, ticks
  • Vector = contaminated aerosol
  • C. burnettienters the body via mucous membranes, abrasions & GIT via consumption of milk for infected animals
    • Zoonosisbecouseanimal direclty transmits the organism to humans
    • high fever, cough, pneumonia, hepatitis – all self-limiting usually; rarely – endocarditis (scarring of hrt. valves) and scarring of liver
    • complicated by hepatitis, myocarditis, or encephalitis

Growth characteristics

• Grow only in eukaryotic cell like

• Tissue cultures OR embryonated eggs

Abed ElKader ElOttol

RICKETTSIA & COXIELLA : LAB DIAGNOSIS

• Serology

• PCR

• Tissue culture

• Weil-Felix Reaction

• Antigens of several species of Rickettsiae cross-react with cell wall O antigen of Proteus OX-2, OX-19, OX-K.

• These Proteus antigens can be used in lab to detect presence of specific antibodies against certain Rickettsia in patients serum.

• Reaction negative in Q fever

TREATMENT

• Tetracycline

• Chloramphenicol

Abed ElKader ElOttol

End of Lecture

Abed ElKaderElOttol

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