gram-negativecocci gram-negative...
TRANSCRIPT
![Page 1: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/1.jpg)
Gram-negative Cocci Gram-negative bacilli
Miklos Fuzi
![Page 2: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/2.jpg)
Neisseria
![Page 3: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/3.jpg)
Pyogen ic Cocci GRAM -
Aerobic: Oxidase +Neisseria N. gonorrhoeae
N. meningitidisothers (N. sicca, N. subflava, N. flavescens and apathogenic spp.)
Moraxella M. catarrhalis
Anaerobic: Veillonella spp.
Veillonellae vietsciences.free.fr
![Page 4: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/4.jpg)
N. gonorrhoeae and N. meningitidis
Morpholog yGram-negativeDiplococci
www.waterscan.co.yu/images
![Page 5: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/5.jpg)
path.upmc.edu
Gram-negative Diplococci
![Page 6: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/6.jpg)
N. gonorrhoeae and N. meningitidis
Oxidase +
path.upmc.edu
Culture:Special demandsNutrient rich medium(Chocolate agar and5-10% CO2)
Resistance:Sensitive bacteria:Dry, Heat, Disinfectants, Antibiotics
![Page 7: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/7.jpg)
http://www.mfi.ku.dk/ppaulev/chapter33/images/33-3.jpg
![Page 8: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/8.jpg)
Antigens and Virulence factors:Pili/Fimbriae (Antigenic variations!)IgA-Proteases!outer membrane proteins (OMP)
(Antigenic variations!)LOS (Mimicry!- sialiation in serum prevents
immune response)Cell-wall Peptidoglycan (Toxic)Inhibits apoptosis in macrophages (prevention
of immune response)
N. gonorrhoeae = Gonococcus
![Page 9: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/9.jpg)
N. gonorrhoeae = Gonococcus
![Page 10: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/10.jpg)
N. gonorrhoeae = Gonococcuste
xtbo
okof
bact
erio
logy
.net
Pili
![Page 11: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/11.jpg)
neisseria.org/images/ng-lym2.jpg
Gonococcus-Lymphocyte Interaction
N. gonorrhoeae = Gonococcus
![Page 12: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/12.jpg)
N. gonorrhoeae = Gonococcus
Source of infectionSick humans
Transmission- Direct (sexual) Contact
Clinical findingsGonorrhea = TripperOphthalmoblenorrhea neonatorum
NO IMMUNITY!(Antigenic variations!)
![Page 13: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/13.jpg)
Medmicro
Pathogenesis
![Page 14: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/14.jpg)
Gonorrhea – acute Urethritis
www.stdservices.on.net ww
w.b
olto
nlgb
.co.
uk
![Page 15: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/15.jpg)
Gonorrhea – acute Urethritis
![Page 16: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/16.jpg)
www.boltonlgb.co.uk
Gonorrhea – acute Cervicitis
![Page 17: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/17.jpg)
Gonorrhea – acute Cervicitis
![Page 18: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/18.jpg)
Gonorrhea – acute ConjuctivitisBlenorrhea neonatorum
www.mc3.edu
www.slackbooks.com
Corneal ulcers due to gonococcus are very destructive and have a tendency to perforate the cornea.
![Page 19: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/19.jpg)
Gonorrhea – Chronic and disseminated Form
Endometritis, Salpingitis, Prostatitispurulent Arthritis, Vasculitis
Important! anorectal GO and Pharyngitis(„alternative Genitals”)
![Page 20: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/20.jpg)
Fig. 8.33 Gonococcal arthritis. Dactylitis secondary to gonococcal bacteriaemia. By courtesy of Dr. S.E. Thompson
Fig. 8.33 Gonococcal septic arthritis. Arthritis due to N. gonorrhoeae in a 24-year-old woman, showing marked erythema and swelling of the right ankle and leg. By courtesy of Dr. T.F. Sellers Jr.
![Page 21: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/21.jpg)
Gonorrhea – Diagnosis – acute Disease
MicroscopicDirect detection – phagocytosed diplococciGram stainingMethylenblue staining, Direct Immunofluorescent (DIF)
www2.mf.uni-lj.si,www.uni-ulm.de,
pathmicro.med.sc.edu
![Page 22: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/22.jpg)
GO – Gram staining – presumptive Diagnosis only!
![Page 23: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/23.jpg)
GO – Gram staining – only presumptive Diagnosis!
www.med.uni-giessen.de
![Page 24: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/24.jpg)
Gonorrhea – Diagnosis
Culture :„bedside” Thayer-Martin medium and chocolate agar, 5% CO2
Identification: ox+, glu+, mal-
Antigen detection (direct):Latex-agglutination
Detection of bact. DNA: PCR
www2.mf.uni-lj.si,www.uni-ulm.de,
pathmicro.med.sc.edu
![Page 25: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/25.jpg)
Therapy:3. Generation Cephalosporin (Ceftriaxone) or Spectinomycin (Aminoglycoside)
Prophylaxis:GO- Exposition (safe sex)- Source of infection: find and treat! - Early Diagnosis and treatment
Ophthalmia neonatorum : Application of 1% silver-nitrate in conjunctival sack
NO VACCINE! (Antigenic variants!)
Gonorrhea
www.tiscali.co.uk
![Page 26: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/26.jpg)
N. meningitidis = Meningococcus
scanning EM
text
book
ofba
cter
iolo
gy.n
et
![Page 27: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/27.jpg)
N. meningitidis = Meningococcus
Antigens and Virulence factors:Capsule – Polysaccharide, antiphagocytic
Multiple serotypes (A, B, C, W135, Y!)Capsule change
Pili/FimbriaeIgA-Proteases!Outer Membrane Protein s (OMP)LOS (Mimicry, sialisation: Serum resistant,
very toxic)
![Page 28: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/28.jpg)
![Page 29: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/29.jpg)
zdsys.chgb.org.cn
Meningococcus
![Page 30: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/30.jpg)
Source of infectionhuman – carriers (sick, healthy)
Transmission, Portal of entry- Direct, drop-infection- Nose, throat
Clinical findingPharyngitisMeningitis cerebrospinalis epidemicaSepsis = Waterhouse-Friderichsen Syndrome
N. meningitidis = Meningococcus
![Page 31: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/31.jpg)
Fig. 10.56 Acute meningococcaemia. Note the variabl e size of the lesions and their peripheral distribution. Some of the lesions are obviously purpuric, others macular or papular.
![Page 32: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/32.jpg)
Fig. 10.60 Acute meningococcaemia. Petechia on bulb ar conjunctiva.
![Page 33: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/33.jpg)
Fig. 10.62 Acute meningococcaemia. Gangrene of the extremities following a near-fatal illness with hypotension.
![Page 34: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/34.jpg)
Fig. 10.63 Acute meningococcaemia. Gangrene of both legs in a black man with acute meningococcal infection. Bilateral below knee amputations were later required.
![Page 35: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/35.jpg)
The characteristic skin rash of meningococcal septi caemia, caused by Neisseria meningitidis . (Courtesy of Wellcome Trust Photographic Library) srs.dl.ac.uk
![Page 36: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/36.jpg)
Waterhouse- Friderichsen Syndrome: schwere nekrotisierende Hautläsionen bei Meningokokkensepsis mit Verbrauchskoagulopathie (R. E. Rieger, Univ.-Kinderklinik Marburg).
© U
rban
& F
isch
er 2
003
–R
oche
Lex
ikon
Med
izin
, 5.
Auf
l.
www.gesundheit.de
![Page 37: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/37.jpg)
The patient with Waterhouse-Friderichsen syndrome h as sepsis with DIC and marked purpura. medlib.med.utah.edu
![Page 38: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/38.jpg)
Purulent meningitis with hemorrhage in the frontal lobe (gross findings).
path
y.fu
jita-
hu.a
c.jp
![Page 39: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/39.jpg)
Acute hemorrhage in bilateral adrenals caused acute adrenal insufficiency (Waterhouse-Friderichsen syndrome).
pathy.fujita-hu.ac.jp
![Page 40: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/40.jpg)
Meningitis Diagnosis
Samples, specimen:Liquor (cerebrospinal fluid) ! – Lumbar punctionBloodcarriers: throat
![Page 41: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/41.jpg)
DetectionMicroscopic examination(Liquor, blood culture)CultureLiquor, Blood, ThroatDirect detection of antigen(Liquor) – Latex-agglutinationDirect detection of bact. DNAReal-time PCR from blood, CSF
Meningitis Diagnosis
![Page 42: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/42.jpg)
Culture: Bloodagar, Chocolate agar
Identification:glu+, mal+
MIC (E-test)
DiagnosisN. meningitidis
![Page 43: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/43.jpg)
Meningococcus meningitis
Therapy:Penicillin and/orCeftriaxone; cefotaximeNO Beta-lactamase production
Prophylaxis:Active ImmunisationVaccine for:- Risk groups- Traveler(Meningitis belt!)
Chemoprophylaxis:Ciprofloxacin; rifampicin(Contacts)
![Page 44: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/44.jpg)
Meningitis belt
![Page 45: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/45.jpg)
Neisseria meningitidis - B
Europe!
NO VACCINE!
Rifampicin only
www.versapharm.com
![Page 46: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/46.jpg)
Haemophilus
![Page 47: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/47.jpg)
GRAM-NEGATIVE COCCOBACILLI
Genus SpeciesHaemophilus H. influenzae
H. parainfluenzaeH. aegyptius H. ducreyi
Bordetella B. pertussis B. parapertussis
P: Pathogen
![Page 48: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/48.jpg)
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
Morphology:Gram - Coccobacillus, ca. 1 µm
Cultivation:Growth factors !(chocolate, X= Haem, V= NAD, Satellite-phenomenon; Satellitism
www.waterscan.co.yu/images
![Page 49: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/49.jpg)
phil.cdc.gov Blood agar plate culture showing Haemophilus influe nzae satelliting around Staphylococcus aureus.
![Page 50: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/50.jpg)
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
Antigens and Virulence factors:Capsule – Polysaccharide
Types: a, b, c, d, e, f (HiB!)
IgA-Protease!Surface antigens:
Outer Membrane Proteine (OMP)LPS
![Page 51: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/51.jpg)
Haemophilus influenzae Type b (Hib)
www.soundmedicine.iu.edu
![Page 52: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/52.jpg)
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
Clinical findings:Meningitis , Sepsis
Cellulitis
Upper respiratory tract:Epiglottitis !, Nasopharyngitis, Sinusitis, Otitis media
Lower respiratory tract:Bronchitis, Pneumonia,
![Page 53: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/53.jpg)
An infant with severe vasculitis with disseminated intravascular coagulation (DIC) with gangrene of the hand secondary to Haemophilus influenzae type b septicemia - prior to the availability of the Hib vaccine. -Image provided by: Visual Red Book on CD-ROM--(2000 Red Book: 25th Edition, Report of the Committee on Infectious Diseases)
www.ecbt.org
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
Sepsis
![Page 54: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/54.jpg)
Periorbital cellulitis. © Neal Halsy, MD www.cispimmunize.org
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
![Page 55: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/55.jpg)
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzae
Clinical findings:Meningitis , Sepsis
Cellulitis
Upper respiratory tract:Epiglottitis! , Nasopharyngitis, Sinusitis, Otitis media
Lower respiratory tract:Bronchitis, Pneumonia,
![Page 56: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/56.jpg)
HiB-epiglottitis
![Page 57: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/57.jpg)
![Page 58: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/58.jpg)
![Page 59: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/59.jpg)
Haemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeHaemophilus influenzaeDiagnosis:Samples, specimen
�LIQUOR! (CSF)� Site of infection (Nose, throat, Sputum etc.)
Detection:Microscopic, Culture, Capsule Ag detection (Latex-agglutination)Real-time PCR from blood, CSF
Therapy:1. Ampicillin + III. gen. Cephalosporins2. Ampicillin + Aminoglycosides
Prophylaxis:Active Immunisation - HiB Conjugate-Vaccine
(Polysaccharide + Protein)
![Page 60: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/60.jpg)
Lipopolysaccharid Extract - Vaccine
ibs-isb.nrc-cnrc.gc.ca
www.kmhk.kmu.edu.tw
![Page 61: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/61.jpg)
Haemophilus ducreyiHaemophilus ducreyiHaemophilus ducreyiHaemophilus ducreyi
Causing: Ulcus molle = Chancroid == soft Chancre
Haemophilus aegyptiusHaemophilus aegyptiusHaemophilus aegyptiusHaemophilus aegyptius
Causing: Brasilian Purpuric Fever
Haemophilus parainfluenzaeHaemophilus parainfluenzaeHaemophilus parainfluenzaeHaemophilus parainfluenzae
Pharyngitis, Endocarditis, Conjunctivitis
![Page 62: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/62.jpg)
Ulcus molle
![Page 63: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/63.jpg)
Ulcus molle
![Page 64: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/64.jpg)
medinfo.ufl.edu
![Page 65: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/65.jpg)
www.smu.eduChancroid in female
![Page 66: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/66.jpg)
Bordetella
![Page 67: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/67.jpg)
Bordetella pertussis
Morpholog y:Gram-negative Coccobacillus, ca. 1 µm
www.waterscan.co.yu/images
![Page 68: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/68.jpg)
Bordetella pertussis
Culture:Special MediumBordet – Gengou
www.szu.cznobelprize.org
![Page 69: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/69.jpg)
Antigens and Virulence factors:CapsuleFimbriae, filamentous HaemagglutininOuter Membrane Proteine (OMP)LPSPertactin
Extracellular Toxins:Pertussis ToxinAdenylate-cyclase ToxinTracheal cytotoxinDermatonecrotic Toxin
Bordetella pertussis
![Page 70: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/70.jpg)
FIGURE 31-2 Virulence factors of B pertussis .
Medmicro
![Page 71: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/71.jpg)
Pertussis toxin
www.med.sc.edu:85
![Page 72: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/72.jpg)
Pathogenesis, Infection:Source: sick – in prodromal and catarrhal Stadium
Portal of entry: Respiratory tract
Transmission: drop-infection → sensitive! 55°C; 30’
Bordetella pertussis
![Page 73: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/73.jpg)
FIGURE 31-1 Pathogenesis of whooping cough.
Medmicro
![Page 74: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/74.jpg)
www.my-pharm.ac.jp
![Page 75: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/75.jpg)
FIGURE 31-3 Binding of pertussis toxin to cell memb ranes.
Medmicro
![Page 76: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/76.jpg)
FIGURE 31-4 Synergy between pertussis toxin and the filamentous hemagglutinin in binding to ciliated respiratory epithelial cells.
Medmicro
![Page 77: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/77.jpg)
Bordetella pertussis
Clinical finding:Whooping caugh / Pertussis(Peribronchial inflammation, Intersticiale Pneumonia)
4-Phases:Prodromal, Catarrhal, Paroxysmal, Convalescent
Colonization of tracheal epithelial cells by B. pertussis web.umr.edu/~microbio
![Page 78: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/78.jpg)
www.gesundes-kind.de,www.vaccineinformation.org
Pertussis –paroxysmal Phase
![Page 79: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/79.jpg)
www.thecrookstoncollection.com aapredbook.aappublications.org
www.med.sc.edu
Pertussis - Diagnosis
Lymphocytosis
![Page 80: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/80.jpg)
Bordetella pertussis
Diagnosis
Cultivation:Bordet – GengouDirect caugh!Charcoal MediumSerology:IgM, IgA, IgG Detection of DNAPCR
medinfo.ufl.edu
![Page 81: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/81.jpg)
Bordetella pertussis
Therapy:Macrolides
Prophylaxis:Active Immunisation – acellular Vaccine DaPT
ToxoidFH/PilusPertactin
DPT = DiPerTe – killed B. pertussis
![Page 82: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/82.jpg)
![Page 83: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/83.jpg)
Pertussis in the USA – 2012 (CDC)
< 1 year 4516 1-6 years 7312 7-10 years 8349 11-19 12484 20+ years 8890 Unknown 329 Total 41880
![Page 84: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/84.jpg)
Brucella
![Page 85: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/85.jpg)
BrucellaeBrucellaeBrucellaeBrucellae
Morpholog y:Gram-negative coccobacilli
Cultivation :Agar – nutrient rich(Serum, Glycerine)Atmosphere: CO2Incubation: days-weeks
![Page 86: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/86.jpg)
Description: Brucella spp. Colony Characteristics: - A. Fastidious, usuall y not visible at 24h. - B. Grows slowly on most standard l aboratory media (e.g. sheep blood, chocolate and trypticase soy agars). Pinpoin t, smooth, entire translucent, non-hemolytic at 48h
staf
f.vbi
.vt.e
du/p
athp
ort/p
athi
nfo_
imag
es/B
ru...
![Page 87: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/87.jpg)
BrucellaeBrucellaeBrucellaeBrucellae
Pathogenesis, Infection, Clinical findings
B. melitensis Goat Maltese feverB. abortus Cattle Morbus BangB. suis Pig Swine Brucellosis
Anthropozoonosis All is Brucellosis„Febris undulans” RES!(undulating fever: „wavelike”)
- from sick animals (meat, milk)- through direct contact or contaminated food- invasion through skin lesions or conjunctiva or GI tract
mucosa
![Page 88: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/88.jpg)
Brucella – source of infection
Medmicro
![Page 89: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/89.jpg)
Brucella –
portals of entry
Figure 28-1 Portals of entry for Brucella species.
Medm
icro
![Page 90: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/90.jpg)
Brucella – spreading
Medmicro
![Page 91: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/91.jpg)
Figure. Acute unilateral scrotal swelling in a 27-year-old man with brucellosis.
www.medscape.com/.../art-iim441224.fig.jpg
![Page 92: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/92.jpg)
Fig.13.36 Brucellosis. Arthritis of the left knee. This was accompanied by fever, malaise, generalized myalgia and depression.Fig. 13.37 Orchitis – B. abortus
![Page 93: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/93.jpg)
DiagnosisCulture: min. 5 daysSerologyAntibody detection
Tube-agglutination (Wright)IgM ChromatographyELISA
Direct detection of DNA : PCRTherapy:Doxycyclin, Rifampicin, Streptomycin
Prophylaxis:Avoid expositionTreatment or annihilation of sick animals
WHO – Bioterror Category B!!!
Brucella IgM
www.kit.nl
BrucellosisBrucellosisBrucellosisBrucellosis
![Page 94: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/94.jpg)
Francisella
![Page 95: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/95.jpg)
Francisella tularensisFrancisella tularensisFrancisella tularensisFrancisella tularensis
Morphology:Gram-negative rods
Survives in wet and cold environment.
Cultivation is prohibited!Only in special LaboratoriesWHO – Bioterror category A!!!
Pathogenesis, Infection- From sick animals- through direct contact or inhalation or per os or via ectoparasites
NO HUMAN-TO-HUMAN TRANSMISSION
![Page 96: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/96.jpg)
Francisella tularensisFrancisella tularensisFrancisella tularensisFrancisella tularensis
Clinical findings:TULAREMIALymphnodes, small granulomas+ ulceration+ necrosisAssociated with diverse symptomscutano-, oculo-, tonsilloglandular, (visible!)thoracal, abdominal - (invisible!) formsGeneralisation – Granulomatous lesions!
Diagnosis: SerologyDetection of DNA: PCRTherapy:Streptomycin, Doxycyclin,Ciprofloxacin
![Page 97: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/97.jpg)
A reported case of exposure of a patient to a wild rabbit, which subsequently died, suggested that tularemia was the likely etiology
staff.vbi.vt.edu/.../Ftularensis
![Page 98: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/98.jpg)
Description: Cervical Lymphadenitis in a Patient With Pharyngeal Tularemia ; Patient has marked swelling and fluctuant suppurati on of several anterior cervical nodes. Infection was acquired by ingestion of contaminated food or water. Source: World Health Organization
staff.vbi.vt.edu/.../Ftularensis
![Page 99: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/99.jpg)
Description: Chest Radiograph of a Patient With Pulmonary Tularemia
Description: These Francisella tularensis colonies show characteristic opalescence on cysteine heart agar with sheep blood (cultured at 37 C for 72 hours). Note: On cysteine heart agar, F tularensis colonies are characteristically opalescent and do not discolor the medium
staff.vbi.vt.edu/.../Ftularensis
![Page 100: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/100.jpg)
Yersinia
![Page 101: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/101.jpg)
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis Genus: Enterobacteriaceae!
Morphology: Gram-negative rods – bipolar staining
www.lonlygunmen.deGiemsa staining www.mja.com.au
![Page 102: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/102.jpg)
![Page 103: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/103.jpg)
www.idph.state.il.us, www2.cnrs.fr, ww.knowledgenews.net,
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
NO CULTURE! FORBIDDEN!Only in special LaboratoriesWHO – Bioterrorcategory A!!!
![Page 104: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/104.jpg)
Plague: 14th century
![Page 105: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/105.jpg)
Plague in medieval Europe
![Page 106: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/106.jpg)
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
VIRULENCE FACTORS
Capsule – Protein!V Antigen (Protein) AntiphagocyticW Antigen = Endotoxin
Extracellular Substances- Plasminogen – Activator – Protein (Pla)
spreading, fibrinolytic-Toxin (kills mice)
![Page 107: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/107.jpg)
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
Pathogenesis, Infection:Source of infection:Rats (and other rodents)→ Elimination of Rats!!!
Transmission:direct contact,Rat-flea-bites
Penetration: skin
![Page 108: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/108.jpg)
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
Figure 29-4 Pathogenesis of Y. pestis in plague patients.
Medmicro
![Page 109: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/109.jpg)
Clinical findings :1)Bubon ic plague(swollen lymph nodes)
2) Septic form → haemorrhagic inflammation
3) Pulmonary form = Pneumonia ← direct aerogen transmission from human to human (airborne infection → primary pulmonary plague)!
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
![Page 110: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/110.jpg)
Fig. 13.55 Plague. Enlarged tender inguinal lymphnodes in a Vietnamese child with bubonic plague.Fig. 13.56 Advanced stage of inguinal lymphadenitis in bubonoc plague. The nodes have undergone suppuration and the lesion has drained spontaneously.By courtesy of Dr. J.R. Cantey
Bubonic form
![Page 111: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/111.jpg)
Necrosis of finger tips of septicemic plague.
www.imcworldwide.org
Cutaneous Hemorrhages in Plague. Source www.cdc.gov
Septic form
![Page 112: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/112.jpg)
www.imcworldwide.orgPulmonary plague
![Page 113: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/113.jpg)
Yersinia pestisYersinia pestisYersinia pestisYersinia pestis
DiagnosisClinical pictureDirect detection – microscopic (bipolar!)Real-time PCRSerology – tube-agglutination, IF
Therapy:Doxycyclin, Streptomycin
![Page 114: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/114.jpg)
Biological Weapons – Bioterrorism
Biological Weapon: Microbe, ToxinAim:• to kill individuals and/or whole population • economic damage
Biological war (military conflicts)Bioterrorisms (ideology!)Biological crime (personal)
![Page 115: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/115.jpg)
Categories: A, B, CMost dangerous: AB. anthracis, C. botulinum, F. tularensis, Y. pestis
Easy to cultureEasy to spread/transmit – airborneHigh rate of mortalityTherapy? (too late)High number of cases
Biological Weapons – Bioterrorism
![Page 116: Gram-negativeCocci Gram-negative bacillisemmelweis.hu/mikrobiologia/files/2014/05/FGM_2013-2014-1-08_.pdf · Gram-negative bacilli MiklosFuzi. Neisseria. Pyogenic Cocci GRAM - Aerobic:Oxidase](https://reader030.vdocuments.net/reader030/viewer/2022012912/5b93ad0b09d3f22b0a8bc0d5/html5/thumbnails/116.jpg)
THE ENDKorfu, 2006