“parvobacteria” (small, gram negative cocco bacilli) need blood or blood products for...
TRANSCRIPT
![Page 1: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/1.jpg)
““ParvobacteriaParvobacteria””(Small, Gram negative cocco bacilli)Need blood or blood products for growth.
Include the genera:HaemophilusBordetellaBrucellaPateurellaFrancisellaActinobacillusGardnerella
![Page 2: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/2.jpg)
Haemophilus speciesHaemophilus species Gram negative coccobacilliGram negative coccobacilli With pleomorphism- different shapes in Clinical With pleomorphism- different shapes in Clinical
specimens e. g. C.S.Fspecimens e. g. C.S.F
Habitat:Habitat: Usually found in upper respiratory tract of man.Usually found in upper respiratory tract of man. CultureCulture All species need blood or blood products for growthAll species need blood or blood products for growth Haemophilus influenzae can grow on:Haemophilus influenzae can grow on:
e.g. (A) Chocolate agar it contains both x and v factors e.g. (A) Chocolate agar it contains both x and v factors
![Page 3: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/3.jpg)
Haemophilus InfluenzaeHaemophilus Influenzae (Cont.) (Cont.)(B)(B) Blood agarBlood agar with growth of with growth of
Staphylococcus aureusStaphylococcus aureus – a phenomenon called – a phenomenon called satellitismsatellitism
Large colonies of H. influenzae near Staphylococcuscolonies
Colonies of Staphylo-coccus aureus producingV factor
Small colonies of H. influenzae away from colonies of Staph. aureus
Blood Agar Plate
Providing X Factor
![Page 4: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/4.jpg)
44BAP culture showing Haemophilus influenzae satelliting
around Staphylococcus aureus, Picture from CDC.
This is responsible for the phenomenon of “Satellitism” in which Hemophilus influenzae forms colonies in the vicinity of Staphylococcal colonies.
![Page 5: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/5.jpg)
c)c) On nutrient agar with:On nutrient agar with:
X Factor = Haematinand / or
V Factor = DI or TRI Nucleotide According to need for X, V OR XV Factors
Haemophilus species can be divided into:
Factor Required SpeciesX and V H. influenzae, H. aegyptius
H. haemolyticus
X H. ducreyiV H. parainfluenzae,
parahaemolyticus
![Page 6: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/6.jpg)
Pathogenecity of Pathogenecity of Haemophilus speciesHaemophilus species (Diseases (Diseases))
SpeciesSpecies DiseaseDisease
H. influenzae capsulated Meningitis, arthritis, osteomyelitis, (mainly type a, b) cellulitis, epiglottitis, bacteremia
H. influenzae non- Exacerbations of chronic bronchitis,capsulated sinusitis, otitis media, others.
H. aegyptius ConjunctivitisH. ducreyi Chancroid (Sexually Transmitted)
H. parainfluenzae Commensals of the upperH. Haemolytic Respiratory tract; rarelyH. Parahaemolyticus Cause disease in
immunocompromised patients
![Page 7: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/7.jpg)
Haemophilus influenzaeHaemophilus influenzae
The most important pathogenic species:
1. Gram – negative coccobacilli
2. Growth on chocolate agar
3. Shows smooth drop like colonies on chocolate agar
4. Needs X and V factors for growth on nutrient agar
5. Shows satellalism near Staphyloccocus aureus colonies
6. Shows pleomorphism from clinical specimens eg csf7. Divided into Capsulated and Non-capsulated strains.
![Page 8: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/8.jpg)
Capsulated StrainsCapsulated Strains
a) Capsule is made of Polysaccharides
b) It is antigenic
c) It increases the pathogenecity of strains
d) Prevents phagocytosis
e) Capsulated strains are divided into 6Serotypes a b c d e f
f) Most pathogenic is type b.
![Page 9: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/9.jpg)
H.influenzaeH.influenzae invasive Infections (mainly by type invasive Infections (mainly by type BB))
Include:Include:a) Meningitisa) Meningitisb) Epilottitisb) Epilottitisc) Cellulitisc) Cellulitisd) Arthritisd) Arthritise) Osteomyelitise) Osteomyelitis
Usually accompanied with bacteriaemia Usually caused by type b The major virulence factor is the polysaccharide capsule Affects children between 3 months to 3 years. Infection under two(2) months is rare because of presence of
maternal IgG antibodies.
![Page 10: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/10.jpg)
Laboratory DiagnosisLaboratory Diagnosis
Specimens depends on the type of diseases
a. CSF – in meningitis
b. Blood –meningitis and bacteriaemia and all types of invasive disease.
c. Sputum – in pneumonia
d. Swab – in cellulitis
e. Synovial fluid – in arthritis Direct smear shows pus cell + pleomorphic gram –ve
coccobacilli CSF Culture, on chocolate agar CSF detection for presence of antigens by agglutination
![Page 11: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/11.jpg)
Epidemiology of Invasive Epidemiology of Invasive H. influenzaeH. influenzae InfectionInfection
More common in winter after viral infection. More common in crowded families with poor status. Family members can infect each other. Mortality is 5% In meningitis neurological lesions - 10-15 % Production of conjugate vaccine (Hib) reduced the
morbidity and mortality.
![Page 12: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/12.jpg)
ImmunizationImmunization Early preparations consists of purified type b
polysaccharide vaccines. But found not to be effective in children ↓ 18 months old.
Now conjugated vaccine which consist of polysaccharide combined with a carrier molecule, (which could be tetanus toxoid, non toxic diphtheria toxin or N. meningitidis components). This vaccine is protctive for children younger than 2 years.
![Page 13: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/13.jpg)
TreatmentTreatment
a) Ampicillin (amoxycillin) if not β lactamase Producer if β lactamase producer it destroy ampicillin and amoxycillin so use.
b) Chloramphenicol
c) Ceftriaxone,Cefuroxime
d) Chemoprophylaxis: Contacts of patient with H. influenzae type b infection can be given Rifampicin for 4 days as prophylaxis.
![Page 14: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/14.jpg)
H = Haemophilus
I = Influenzae
B = Pittman type b
Composition Polysaccharide + Carrier protein to increase antigenecity
Carrier Protein 1) Toxoid of diphtheria2) Toxoid non-toxogenic diphtheria3) Toxoid of Tetanus4) Outer Membrane protein of N. Meningitidis.
Hib VaccineHib Vaccine
![Page 15: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/15.jpg)
HibHib (Contact)(Contact)
Total doses = 3 - 4 dosesStarting at = 2/12 ageRoute = IntramuscularEffective after = 2/52Not effective in = 1. HIV, antibodies deficiency
2. Asplenia, anatomical3. Functional asplenia4. Sickle cell disease5. Bone marrow transplant6. Therapy for malignancy
![Page 16: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/16.jpg)
Non capsulatedNon capsulated strains morphology is similar strains morphology is similar to capsulated strains.to capsulated strains.
They cause:They cause:a)a) Otitis media:Otitis media: presenting with pain and presenting with pain and
discharge of pus from the ear.discharge of pus from the ear.
b)b) Sinusitis:Sinusitis: presenting with headache and presenting with headache and postnasal discharge with low grade fever.postnasal discharge with low grade fever.
c)c) ExacerbationExacerbation of chronic bronchitis in elderly, of chronic bronchitis in elderly, smoking people presenting with cough and smoking people presenting with cough and large amount of sputum.large amount of sputum.
![Page 17: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/17.jpg)
( Cont. Non capsulated strains)
a) Pneumonia: mainly affecting both lungs called Bronchopneumonia.
b) Bronchiectasis: collection of pus in dilated bronchi presenting with cough, chest pain, fever, and production of large amount of sputum
![Page 18: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/18.jpg)
Bordetella pertussis Bordetella pertussis And And Bordetella parapertussisBordetella parapertussis
B. pB. pertussis – causes WHOOPING COUGH
B. parapertussis – causes a MILDER FORM OF WHOOPING COUGH.
Live mainly in the human respiratory tract. Morphology: short, gram – negative coccobacilli.
![Page 19: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/19.jpg)
MEDIAa. Bordet Gengue medium
b. Charcoal blood agar
BORDET – GENGUE CONTAINS:
a. 30 % blood
b. Penicillin
c. Glycerol
d. Penicillin WHY? To supress normal flora
COLONIES look like mercury drops
![Page 20: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/20.jpg)
ANTIGENIC STRUCTURE: Sharing 3 antigens 1, 2, 3 organism can carry
TYPETYPE 1, 2 antigens1, 2 antigens
TYPETYPE 1, 2, 3 antigens1, 2, 3 antigens
TYPETYPE 1, 3 antigens1, 3 antigens
![Page 21: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/21.jpg)
PATHOGENECITYPATHOGENECITY – – Strict human pathogenStrict human pathogen
Causes Causes WHOOPING COUGHWHOOPING COUGH Due to Due to PRODUCTION OF ENDOTOXINPRODUCTION OF ENDOTOXIN which affect the respiratory mucosa.which affect the respiratory mucosa.
![Page 22: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/22.jpg)
PathogenesisPathogenesis Non invasive disease Does not cause bacteremia Human are the only natural host Incubation period 1-2 weeks Initial stage colonization of ciliated epithelium of the
bronchi and trachea. Production of cytotoxin which paralysis the cilia - so
cough as the only protective mechanism Production of pertussis toxin (PT)
Lymphocytosis Can also predispose to secondary bronchopneumonia.
![Page 23: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/23.jpg)
Clinical FeaturesClinical Features
a) Affect preschool children
b) Severe in under 1 year of age
c) An acute Tracheobronchitis
Divided into 3 stages
a) Catarrhal stage 2 / 52
- Fever
- Rhinorrhoea, sneezing
- Anorexia
- Malaise
![Page 24: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/24.jpg)
(Cont. 3 STAGES)(Cont. 3 STAGES)
b) Paroxysmal cough 2 / 52
-Violent cough followed by inspiratory (whoop)
- Vomiting
- Convulsions
c) Convalences stage 4 / 52
-Leucocytosis (Lymphocytosis) can mimic lymphocytic leukemia.
![Page 25: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/25.jpg)
DiagnosisDiagnosis
a) Clinical
b) Pernasal swab
c) Cough plate
d) Swab by Immunofluorescence (Rapid Method)
![Page 26: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/26.jpg)
TreatmentTreatment
a) Erythromycin
b) Effective on early stage
c) Not effective in later stage WHY??
![Page 27: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/27.jpg)
VaccinationVaccination
1. Whole killed bacterium vaccine2. Give Intramuscularly as part of the Triple
Vaccine DPTD = DIPTHERIAP = PERTUSSIST = TETANUS
3. Safe but there are some cases of CNS involvement.
![Page 28: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/28.jpg)
4. A cellular vaccine formed of
a) PT = Pertussis toxin
b) FHA = Filamentous haemagglutinin
is supposed to be more save.
![Page 29: “Parvobacteria” (Small, Gram negative cocco bacilli) Need blood or blood products for growth. Include the genera: Haemophilus Bordetella](https://reader033.vdocuments.site/reader033/viewer/2022061419/56649e995503460f94b9c41e/html5/thumbnails/29.jpg)
Complications Of Whooping (Cough)Complications Of Whooping (Cough)
A) Bronchopneumonia - due to pyogenic cocci
B) Bronchiatiasis
C) Sub conjunctival haemorrgae