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Practical taxonomy

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Miscellanous bacteria Mycoplasma, Ureaplasma, Chlamydia Ricketsiaceae Spirochetales - Spirochetes, Leptospira, Borrelia Mycobacterium Nocardia , Actinomycetes, – PowerPoint PPT presentation

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Title: Practical taxonomy


1
Practical taxonomy
Miscellanous bacteria
Mycoplasma, Ureaplasma, Chlamydia Ricketsiaceae Sp
irochetales - Spirochetes, Leptospira,
Borrelia Mycobacterium Nocardia , Actinomycetes,
2
GenusBacillus - Gsporeforming bacilli, aerobic
and facultatively anaerobic
  • Bacillus anthracis,Bacillus
    cereus,Other Bacillus sp.
  • Bacillus cereus - 2 enterotoxins
    -
    heat stable - emetic form - contaminated rice -
    heat resistant spores survive initial cooking
    that kills vegetative cells, germinate, multiply
    and toxin is not destroyed by reheting

    - heat labile - diarrheal form
    - adenylcyclase-cAMP system stimulation in
    intestinal cells - fluid accumulation
    -contaminated meat and vegetable - toxin is
    produced in situ, longer incubaion
  • Panophthalmitis - traumatic eye infection (soil,
    penetrating object), complete loss, massive
    destruction

    - toxins - necrotic - heat labile
    enterotoxin
    - cereolysin - hemolysin

    -
    phospholipase C - lecithinase
  • Ubiquitous, isolation witout symptoms
    contamination
  • Other Bacillus - immunosupressed patients - shunt
    and catheter inf.

3
Bacillus antracis
4
Bacillus anthracis
  • Spore and capsule (protein) not seen in clinical
    specimens
  • Antrax toxin - 3 antigenically distinct
    components -protective Ag, lethal factor, edema
    factor - not active separately,
  • Pathogenesis capsule - antiphagocytic, Ab are
    not protective, toxins are active in cooperation
    of protective lethal or edema f.
  • Cultivation - on nonselective media, rapidly
    growing adherent colonies, no hemolysis, Non
    motility,liquifaction of agar

    Microscopy caput medusae
    serpentine like chains,

5
Bacillus anthracis
  • Human diseases - cutaneous - inoculation -
    painless papule, ulcer, necrosis


    - respiratory -
    inhalation - rapid progresive diffuse pulmonary
    involvement - respiratory failure - 95 mortality

    -
    gastrointestinal - ingestion - rare - mesenteric
    adenopathy, hemorrhage, ascites, 90 mortality
  • Therapy - PNC (TTC, CMP)., control of animal
    antrax, vaccination.

6
Bacillus antracis
7
Non sporeforming G bacilli - heterogenous group
  • Corynebacterium - coryneforms, diphtheroids- C.
    diphteriae (diphtheria), C. jeikeium
    (oportunistic). C. urealyticum(urinary tranct
    inf.), C. pseudodiphthericum (endocarditis), C.
    ulcerans (pharyngitis)
  • Arcanobacterium haemolyticum - pharyngitis
  • Actinomyces - granulomatous ulcerative inf.
  • Rhodococcus - suppurative pneumonia,
    opportunistic
  • Listeria - meningitis, septicemia, granulomatosis
    infantiseptica
  • Erysipelothrix - erysipeloid, septicemia,
    endocarditis
  • Gardnerella - bacterial vaginosis

8
Corynebacterium
  • Pleoimorphia, Grods, forming short chains, china
    letters, or letter Y,V - forms
  • Metachromatic granuls resulting colour differs
    from the colour of the used one
  • Special cell wall structure mesodiaminopimelic
    acid, arabinogalactan, mycolic acid with short
    chains taxonomic neighbour to mycobacteria
  • C. diphtheriae preventabil disease diphthteria
  • asymptomatic carriage in pharynx droplet
    transmission
  • C. jeikeium - JK - oportunistic patogen in
    immunocompromised - hematological disorders
  • Others - transmitted from annimals

9
Corynebacterium- patogenesis and immunity
  • Diphtheric exotoxin - tox gen can be transmitted
    to bacteria (C. diftérie, C. ulcerans,
    C.pseudotuberculosis via bacteriophage
    lysogenic conversion
  • A-B protein B phragment binding on the cell
    surface enable enter of A phragment to the cell.
    A phragment is enzymatically active - blocking
    synthesis of proteins prolngation of peptid
    chain on ribosomes
  • Skin test detection of neutralising antibodies
    in vivo - i.d. application of diphtheric toxin

10
  • Phospholipase D - dermonecrotic toxin enable
    spread by increasing vascular permeability .
    ulcerans, C. pseudodiphthericum
  • Urease - C. urealyticum alkalinisation of urine
    and urine calculi forming
  • ATB resistence selection of resistent strains -
    C. urealyticum, C. jeikeium resistent to
    commonly used ATB in UT infection

11
Diphtheria
  • Clinical presentation depends on state of
    immunity and place of infection - asymptomatic
    colonisation, mild respiratory infection,
    fulminant diphtheria
  • Difphtheria URT infectionwith low grade fever,
    toxin induce local damage adherent pseudomembrane
    on tonsils, pharynx, nose and general symptoms of
    intoxication. Myocarditis.
  • Skin diphtheria transmission via skin contact
    from infected persons, colonisation and enter via
    small injurie - papules and chronic ulcers with
    membrane and general signs of intoxication, less
    sever,

12
Diphtheria
13
Laboratory diagnosis
  • Microscopy detection of metachromatic granules
    methylen blue staining not important
  • Cultivation on common media (blood agar),
    special media Loffler
    medium,
    - tellurit agar gray
    brown colonies
  • 3 types of colonies - gravis (big, irregular,
    gray), mitis (small, convex,round, black),
    intermedius (small, plate, gray) connected with
    importance and virulence not considered more
  • Biochemical identification
  • Detection of toxigenicity - Eleks test -
    immunodiffusion, - antitoxic test on annimal
    model.,

14
Arcanobacterium
  • A.haemolyticum - colonise human, responsible for
    pharyngitis (/- scarlet fever-like rash),
    cutaneusinf., endocarditis, meningitis - in older
    patients
  • Missdiagnosed as Str. pyogenens, grows slowly,
    weak hemolysis
  • 2 toxins - hemolysin and phospholipase D
  • enzymes neuraminidase

15
Erysipelotrix
  • E. rusiopathiae G non spore forming facultative
    anaerobic bacillus, worldwide distribution in
    animals
  • Cultivation in reduced oxygen athmosphere, small
    grayish, alfa hemolytic colonies, 2-3 days,
    sample from deep tissue or deep aspirates.
  • Erysipeloid - occupational disease (butchers,
    meat processors) after subcutaneous innoculatio
    -localised skin infection

    -generalised
    cutaneous forme

    -septicaemia - associated with endocarditis
    (undamaged heart valve - aortic)
  • Therapy PNC, ERY,CLI (sulfonamids, vancomycin,
    aminoglycosides - resistent)

16
Listeria
  • 7 species, most important L. monocytogenes
    facultatively anaerobe neonporeforming G rod
  • meningoencephalitis, bacteraemia, endocarditis
  • New borne, older gravid women, immunocompromised
    patients (after transplantation
  • Frequently transfer via milk and row milk
    products, row vegetable
  • Able to grow in wide range of pH a and low
    temperature 22C , faible beta hemolysis, motile
    in liquid media

17
Clinical syndroms
  • Newborne listeriosis - infection in utero -
    granulomatosis infantiseptica, devasting disease,
    diseminated abscesses and granulomes multiorgan
    involvement

    - late listeriosis - 2-3 weaks after delivery -
    meningitis, septicaemia
  • Meningitis of adults in immunocompromised,after
    transplantation
  • Bacteraemia, Endocarditis
  • Dg. Microckopy of CSF usually negat.- few
    bacteria, Cultivation and indentification
  • Therapy - penicillin /- combination with
    aminoglycosids

18
Rhodococcus
  • G, obligate aerobic, red-pigmented, acid fast,
    mycolic acid. Veterinary pathogen. Present in
    soil
  • Intracellular - surviving in macrophages
  • Granulomatous inflammation with abscess formation
    (lung,lymph nodes, menings, pericardium, skin) -
    immnosupressed
  • Cultivation - nonselected media, aerobically,
    pigmented colonies after 4 and more days
  • Therapy prolonged - multiple ATB able to
    penetrate into macrophages

19
Gardnerella
  • Morphologically resembles gram negative bacilli,
    has cell wall structure of gram , nonmotile, not
    capsule
  • part of normal vaginal flora
  • present in bacterial vaginosis together with
    obligate anaerobes - Mobiluncus,
    Peptostreptococcus,absence of Lactobacillus.
    Present in postpartum bacteremia, endometritis,
    vaginal abscesses
  • Lab. dg. - simple isolation is not prooving,
    importance of microscopic examination - clue
    cells - epitelial cells covered with G variable
    bacilli (Gardnerella) and G- small curved bacilli
    (Mobiluncus), absence of G bacilli
    (Lactobacilli)
  • Therapy ampicilin, metronidasol

20
Actinomyces
  • G filamentous rods, 5-10CO2,
  • Actinomyces israeli, A. meyeri, A. naeslundii,
    A.odontolyticus
  • chronical disease with abscess, tissue
    destruction and sulphur granules in tissue (mass
    of mycelia surrounded by protein, polysaccharide
    and bacteria)
  • cervicofacial forme(endogenous, after tooth
    extraction) - abdominal,( starting in appendix
    and diverticules) -pelvic forme (from
    IntraUterinDevices)
  • hematogenous disemination
  • Lab. Dg. - pus with sulphur granuls - Ziehl
    Neelsen - microscopy, cultivation - agar with
    heart brain infusion - 10 days, colony shape -
    mollar tooth

21
Nocardia
  • Gstrictly aerobe rods. Similar to quickly
    growing mycobacteria, saprophytes in environment.
    Acid fast., Mycolic acid
  • Nocardia asteroides, N. brasiliensis, N. madurae
  • pneumonia - with confluent abscess formation,
    exogenous inhalation
  • skin infection - Actinomyces brasilinensis -
    localised celulitis, purulent sinuses with
    chronical granulomatous inflamation - mycetoms
  • Madurmycosis - chronical granulomatous infection
    of bone and soft tissue, deformations, (Sudam,
    Northern Africa, East India)
  • diseminated - CNS - brain abscesses, in
    immunocompromised
  • Lab. Dg. - microscopy - modified Ziehl Neelsen,
    Gram , cultivation - standard media -2-30 days,
    colonies adherent to agar, cream, orange rose
    color, chalky consistence
  • Therapy surgeryATB 3 months sulphonamids,
    amikacin, imipenem, broad spectrum to be
    effective if fungal ethiology

22
Anaerobic bacteriae
  • Gcocci
    polymicrobial
  • G-cocci
    endogenouse
  • G-rod
    mixture
  • Grod nonspores forming fac.patogenic

  • sporeforming patogens,

  • clinical units

23
Gcocci anaerobic
  • Peptostreptococcus, -Peptococcus,- Sarcina (fac.
    anaerobic) -
    Coprococcus, - Ruminococcus
    -
    colonisation of the skin and mucouse membrane
    GIT, UGT, -
    oportunistic patogens in connection with foreign
    bodies cultivation require special grow
    conditions, slowly growing


    Clinical symptoms - pleuropneumonia
    following aspiration, sinusitis, brain absces
    spreading from oropharynx or lung,

    - intraabdominal infection and sepsis
    spreading from colon,
    - pelvic infections (endometritis, absces,
    puerperal sepsis, bacterial vaginosis)


    - infection of soft tissue (celulitis),
    endocarditis, osteomyelitis
  • Laboratory diagnosis colonising bacteria or
    ethiological agent, sampling and transport under
    anaerobic conditions, prolonged cultivation on
    enriched media
  • Th - PNC, cefalosporins, imipenem, CMP -
    polymicrobial ethiology.

24
G-cocci
  • anaerobic
  • Veillonella, Megasphera present in oropharynx,
    low virulence, in cultivation usually part of
    polymicrobial mixture

25
G-rod anaerobic
  • Bacteroides fragilis

    obligatory anaerobic rod, not sporeforming,

    - most important part of
    fysiological flora in oropharynx, UGT, GIT.
  • Clinical symptomes - pleuropneumonia,
    intraabdominal abscess, genital infections.
  • Endogenous and polymicrobial infections,
    absceses after break down of physiological
    barieres.
  • Lab.dg. strictly anaerobic sampling, transport
    and cultivation
    stimulation of the growth by 20 cholic
    acid.

  • Th surgery intervention ATB, - B.producesa
    betalactamase, Metronidasol
  • B(G). stearothermophilus- spores used for testing
    efficiency of sterilisation devices
  • Prevotella, Porphyromonas, Fusobacterium,
    Leptotricha, Wolinella colonisation of
    orofarynx, GIT, UGT, part of physiological flora,
    pathogenic after the breakdown of natural
    barieresr e.g.. Surgical intervention
  • They produce histolytical enzymes,
  • absceses and polymicrobial infection (CNS,
    UGT,intraabdominal)
  • Production of betalaktamase resistente to
    PNC.
  • Lab. dg. Anaerobic sampling and transport,
    prolonged cultivation

26
Grods aerobic
  • Spores forming

    - Bacillaceae - Bacillus cereus,
    B. antracis - flagella, facultative anaerobes or
    strict aerobes. Production of toxins.
  • Nonsporesforming

    - Listeria
    monocytogenes - motile, aerobic, surviving 22C
    and broad interval of pH, infecting annimals

    -
    Corynebacteriaceae -aerobic nonmotile slightly
    curved, forming picture of alphabet letters,
    irregularly stainable Containing metachromatic
    granules, production of toxin -
    lysogenic conversion - toxigenicita of strains
    - Eleks test.

    Corynebacterium diphtheriae, C.
    pseudodiphtericum,

    Erysipelotrix rusiopathiae - facult. anaerobic,
    transmission from annimals, grey colonies, alfa
    hemolysis,


    Nocardiaceae Nocardia asteroides
    contain lipid in the cell wall modified Ziehl
    Neelsen staining, nonmotil, filamentous form in
    microscopy, prolonged cultivation

27
Grods anaerobic nonsporesforming
  • - Actinomycetaceae Actionomyces israeli,
    A.naeslundii
  • Clinical signs cerebral, cerevicofacial,
    abdominal, thoracal actinomycosis,
  • chronical pyogenic infection with absceses.

  • Lab.dg. Sampling from the depth of sinus or
    abscess containing sulphur granules, typical
    colonies looking like tooth molar, requiring,
    long cultivation.
  • Th surgery ATB prolonged PNC

    -Propionibacteriaceae
    Propionibacterium acnes
  • colonisation of skin, external ear, conjunctiva,
    orofarynx, female external genital tract.
  • Clinical symptomes Acne and opportunistic
    infections in patients with foreign bodies.
  • Lab. dg. On common media, prolonged cultivation

    - Mobiluncus
    ---gram variable, structue of G, curved, growth
    reqirements, colonisation of fem.external genital
    in case of dysmicrobia - vaginosis


    -Bifidobacteriaceae, Eubacteriaceae,-
    Lactobacillaceae . part of physiological flora

28
Anaerobic Gram sporesforming rodsClostridium
sp.
  • strictly anaerobic, spores typically localised in
    the cell enlarging the body, proteolytical
    ensymes, production of toxins,
  • C. tetaní tetanus traumatic
  • - newborne
  • C. botulinum - botulizmus newborne
  • -
    wound
  • - food
    borne
  • C. septicum - nontraumatic myonecrosis, patients
    immunocompromised - Ca of colon

    - breakdown of the integrity of colon, spread of
    clostridia in tissues, hyperacute course
  • C. difficile - pseudomembranouse colitis
    connected with broad spectrum ATB therapy,


    produces 2 toxins, part of FF,
    exposition to ATB taht eliminate colon bacterial
    flora overgrowth of C. difficile and its spores

29
Anaerobic gram spores forming rodsClostridia
of anaerobic traumatoses
  • Clostridia - 100 species, some of them can be
    aerotolerantné

    - C. histolyticum can looks like gram
    negatívne, spores not constantly detectable.
    Commonly present in soil, water, GIT of annimal
    and human.
  • C. perfringens - Bacteraemia, myonecrosis gas
    gangrene, infection of soft tissue, necrotising
    enteritis

30
Clostridium tetani
  • Motile rod, spores forming, spores enlarging
    cell,squash rocket, transiently gram negative.
    Very sensitive to oxygen, metabolically very
    active.
  • Produces 2 toxins - Termolabil neurotoxin-
    tetanospasmin released from lysing cells. AB
    toxin - blocking neurotransmitters in CNS on na
    inhibation synapsesh nonregulation of
    excitation synaptic activity - spastic paraysis,
    convulsions.
    -
    tetanolysin
  • Present in soil and GIT of annimal. Vegetative
    formes are very sensitive on oxygen. Spores are
    surviving years
  • Generalised tetanus, - localised tetanus, -
    nexborne tetanus, - tetanus of drug abusers
  • Therapy - PNC, antitoxin, - toxin bound on
    synapses is not neutralisable and ATB are active
    agains viable cells (not toxin) Symptomatic
  • Vaccination

31
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32
Clostridium botulinum
  • Heterogennous group, nutritionnaly requiring
    spores forming rods. 4 groups I
    - IV based on proteolytical aktivity a type of
    toxin.
  • Producing 7 antigenically different botulotoxines
    A,B,C alfa, D, E, F, G - A,B,E most frequent. AB
    toxin , termolabil toxin - 20minutes/80C
  • Blocking transmission on nervemuscular platelet
    on synapses of periferic nerves.
  • Food borne, wound botulisme, infant botulisme
  • Blurred vision, dilatation of pupils, dry tongue,
    constipation, bilateral muscular weakness
    complete restoration after months or years
  • Wound botulisme very rare

  • Infant botulisme - 1976 - in vivo production of
    neurotoxin in colon colonising clostridia (age of
    6mnth - 1 y) progresive paralysis, respiration
    failure - mortality 1 - frequently cause of SIDS
  • Dg. - clinical, detection of clostridium or toxin

  • Th. lavage of stomach antitoxin,

  • PNC, destruction of spores and
    prevention of spores germination

33
Clostridium botulinum
34
Clostridium perfringens
  • Colonisation or sever disease, spores are seen
    scarecely, hemolysis, metabolic aktivity.
  • Production of letal toxins (alfa, beta, epsilon,
    iota, termolabil enterotoxin) with sever life
    threating biological activity, ensymes. Types
    A-E A in environment, B-E in colon,
    A gas
    gangrene and intoxication, C necrotizing
    enteritis
  • Microscopy - Grods without leu in clinical
    samples Th
    surgery in traumatoses, high doses of PNC,
    antitoxin, hyperbaric room for oxygen therapy

35
Clostridium perfringens
  • Bacteraemia usually not significant, transient
    from skin contaminant.
  • Gas gangrene life threating, histotoxic
    clostridia, after injury, devitalised tissue
    gas production. (C. septicum, histolyticum,
    novyi)

  • Celulitis, fasciitis after colonisation of the
    wound, oftently not important or rapidly
    progressing destruction of tissue (C. septicum)

  • Necrotizing enteritis small intestine, typ C,
    50 letality
    Food borne intoxication short
    incubation time, spasmes, watery diarrhoe
    ingestion of contaminated food, toxin -
    termolabil protein
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