proteus & providencia spp. - mymensingh medical … file/proteus spp by akram.pdf · proteus &...
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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
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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?
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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..
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TaxonomyTaxonomy
1.1. Proteus mirabilisProteus mirabilis
2.2. Proteus vulgarisProteus vulgaris
3.3. MorganellaMorganella3.3. MorganellaMorganella
4.4. RetgerellaRetgerella
5.5. ProvidenciaProvidencia
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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..
12/28/201312/28/2013 55Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, ProteusProteus
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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
12/28/201312/28/2013 66Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, ProteusProteus
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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
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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
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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
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Structure of a GramStructure of a Gram--Negative Cell Negative Cell
WallWall
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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
12/28/201312/28/2013 1111Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, ProteusProteus
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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
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UTI by ProteusUTI by Proteus
AlkalineAlkaline pHpH
FoulFoul smellingsmellingFoulFoul smellingsmelling
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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
12/28/201312/28/2013 1414Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, ProteusProteus
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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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