proteus & providencia spp. - mymensingh medical … file/proteus spp by akram.pdf · proteus &...

Proteus & Proteus &

Providencia spp.Providencia spp.Providencia spp.Providencia spp.

Professor Md. Akram HossainProfessor Md. Akram Hossain

12/28/201312/28/2013 11Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, ProteusProteus

Review QuestionsReview Questions

Both Proteus & Salmonella are motile & NLF, How can Both Proteus & Salmonella are motile & NLF, How can you differentiate?you differentiate?

Both Proteus & Shigella are NLF, How can you Both Proteus & Shigella are NLF, How can you differentiate?differentiate?

What is swarming growth? Why it occurs?What is swarming growth? Why it occurs? What is swarming growth? Why it occurs?What is swarming growth? Why it occurs? What is the peculiarity of UTI caused by Proteus?What is the peculiarity of UTI caused by Proteus? Between Esch coli & Proteus as CA, which is one is Between Esch coli & Proteus as CA, which is one is

most common and which one is most dangerous?most common and which one is most dangerous? Why Proteus UTI is dangerous?Why Proteus UTI is dangerous?


IntroductionIntroduction

HauserHauser firstfirst isolatedisolated inin 18851885..

ProteusProteus speciesspecies areare mainlymainly soilsoil inhabitants,inhabitants, ProteusProteus speciesspecies areare mainlymainly soilsoil inhabitants,inhabitants,particularlyparticularly commoncommon inin decomposingdecomposingorganicorganic mattermatter..


TaxonomyTaxonomy

1.1. Proteus mirabilisProteus mirabilis

2.2. Proteus vulgarisProteus vulgaris

3.3. MorganellaMorganella3.3. MorganellaMorganella

4.4. RetgerellaRetgerella

5.5. ProvidenciaProvidencia


Salient propertiesSalient properties

ProteusProteus hashas twotwo interestinginterestingandand notablenotable features,features,

First,First, thethe cellscells areare highlyhighly motilemotileandand oftenoften swarmswarm acrossacross thethesurfacesurface ofof agaragar platesplates ((FigureFigureAA))..AA))..

TheThe otherother notablenotable featurefeature ofofbothboth ProteusProteus andand ProvidentiaProvidentiaisis thethe abilityability toto degradedegrade ureaurea totoammonia,ammonia, byby productionproduction ofof thethe

enzymeenzyme ureaseurease..


ProteusProteus SerologySerology

ProteusProteus can be typed by Flagellar H & can be typed by Flagellar H & Somatic O antigensSomatic O antigens

O antigen has similarity with OX19, OXK O antigen has similarity with OX19, OXK

and OX2 strains of Rickettssia prowazeki and OX2 strains of Rickettssia prowazeki and OX2 strains of Rickettssia prowazeki and OX2 strains of Rickettssia prowazeki

(causing typhus fever)(causing typhus fever)

Weil and Felix in 1916 discovered weilWeil and Felix in 1916 discovered weil--

Felix testFelix test

Heterophile antibodiesHeterophile antibodies


Morphology & cultural Morphology & cultural

characters characters

Highly motile with peritrichous flagellaHighly motile with peritrichous flagella

GNB 1GNB 1--3umx0.4 um3umx0.4 um

LactoseNon Fermenter . LactoseNon Fermenter . form pale colonies with form pale colonies with swarming growthswarming growth


Virulence factorsVirulence factors

1.1. Endotoxin like other GNB.Endotoxin like other GNB.

2.2. FlagellaFlagella-- Flagella are thick, long and no. Flagella are thick, long and no. is more unit length.is more unit length.is more unit length.is more unit length.

3.3. Urease productionUrease production


Summary of EndotoxinSummary of Endotoxin

LPS

LPS-LBP

CD14

TLR4

Circulation

Details of endotoxin

TLR4

TNF

Fever tissue damage IL6 IL8 IL1 PAF

Toxic shock

Macrophages


Structure of a GramStructure of a Gram--Negative Cell Negative Cell

WallWall


Clinical infectionsClinical infections

1.1. Urinary tract infection (UTI)Urinary tract infection (UTI)-- causes more causes more damages & forms calculidamages & forms calculi

2.2. Nosocomial infectionsNosocomial infections2.2. Nosocomial infectionsNosocomial infections

3.3. Other infectionsOther infections

SepticemiaSepticemia

Wound infectionsWound infections


UTI by Proteus spp.UTI by Proteus spp.

TheThe vigorouslyvigorously motilemotile ProteusProteus entersenters urinaryurinarytracttract fromfrom intestineintestine.. ItIt hashas enzymeenzyme ureaseureasewhichwhich cleavescleaves ureaurea toto NHNH33 && COCO22,, thusthus raisesraisesurinaryurinary pHpH andand encouragesencourages formationformation ofof stonesstones(calculi)(calculi) calledcalled strulitestrulite composedcomposed ofofmagnesiummagnesium ammoniumammonium hydroxidehydroxide..magnesiummagnesium ammoniumammonium hydroxidehydroxide..

StonesStones ofof urinaryurinary tracttract obstructobstruct urineurine flow,flow,damagedamage urinaryurinary epitheliumepithelium andand servsservs asas nidusnidusforfor recurrentrecurrent infectioninfection byby trappingtrapping bacteriabacteriawithinwithin thethe stonestone.. BecauseBecause alkalinealkaline urineurine alsoalsofavoursfavours thethe growthgrowth thethe organismorganism andand moremoreextensiveextensive renalrenal damage,damage, treatmenttreatment involvesinvolveskeepingkeeping thethe urineurine atat aa lowlow pHpH..12/28/201312/28/2013 1212Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain,

ProteusProteus

UTI by ProteusUTI by Proteus

AlkalineAlkaline pHpH

FoulFoul smellingsmellingFoulFoul smellingsmelling


Other important causes of Other important causes of

UTIUTI

1.1. Esch coliEsch coli2.2. KlebsiellaKlebsiella3.3. ProteusProteus4.4. ProvidenciaProvidencia5.5. CitrobacterCitrobacter5.5. CitrobacterCitrobacter6.6. AcinatobacterAcinatobacter7.7. PseudomonasPseudomonas8.8. Staph saprophyticus & S. aureusStaph saprophyticus & S. aureus9.9. Streptococcus Gr. D & Streptococcus Streptococcus Gr. D & Streptococcus

pyogenespyogenes


Antimicrobial sensitivityAntimicrobial sensitivity

UTI UTI fluoroquinolonesfluoroquinolones-- (ciporofloxacin, (ciporofloxacin, levofloxacin, Gatifloxacin)levofloxacin, Gatifloxacin)

Sepsis Sepsis 33rdrd generation cephalosporingeneration cephalosporin Sepsis Sepsis 33rdrd generation cephalosporingeneration cephalosporin


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