20 chlamydia&spirochaetales - كلية الطب · 2 Chlamydia *Chlamydia has characters between...
Transcript of 20 chlamydia&spirochaetales - كلية الطب · 2 Chlamydia *Chlamydia has characters between...
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Chlamydia *Chlamydia has characters between the bacteria and virus .
* We do not care about it very much because a few and old diseases of this
a contagious bacterial infection of : ex: Trachomasome still until now type ,
. the eye
(like volume :similar to virusThis genus has properties and characteristics *
we can't culture it in it has membrane filters ,and , it has very small size,
also it , tissue cultureal media which we use to bacteria we use to it tradition
from machineries is obligate intracellular so it use the ATP and metabolism
the host cell )
contain DNA & RNA in : (similar to bacteria characteristics and another*
)t virus contain either RNA or DNA the same time bu
•Chlamydia is a genus of pathogenic bacteria that are obligate
some types of : ( and birds) human(intracellular parasites of mammals
. ) Psittacosisspecies caused Chlamydia psittaci Parrotsbirds like
Psittacosis يشع سئي ظة االشخاص انز ك ػهى اذظال يثاشش ,: داء انثثغاء
مو تمها نهشخض Chlamydia ـــــيغ طائش انثثغاء ف ارا كا انطائش حم ان
contains one medically important –order chlamydiales –• Classification
chlamydia –genus
r_ales mean orde
• Chlamydia infections are the most common bacterial Sexually
in humans (Lymphogranuloma venereum diseases) transmitted diseases
.)trachoma( and are the leading cause of Infectious blindness worldwide
ndness. if the trachoma isn't treatment it will lead to bli
• Reported rates 3 times higher in females than in males.
susceptible to Chlamydia than males3 time more sFemale*
so its need ( DNA and RNA, and ribosomes, lack ATP contain•
ays, non biosynthetic pathwlack , ) cells host the for metabolic machineries
e most important motile. Multiply in the cytoplasm of the host cell. Th
., species that we will take about this lecture are ..
) responsible for trachoma( C. Trachomatis
) Psittacosis with associated( C. psittaci
with pneunoma ) ( associated C. pneumoniae
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Slide 3 min 7:00
Transmission •Transmission is sexual or vertical (from the mother to fetus)
• Highly transmissible
• Incubation period 7-21 days (3 weeks )
• Significant asymptomatic reservoir انسردع ا انؼائم exists in the
population
(no symptoms appear on patient so he/she become method to transfer the
disease)
• Re-infection is common why ? because the variation in antigenic structure
, consist of more than one stereotype so one infectious does not give full
immunity , can be affected with other antigenic form )
• Perinatal (فرشج حل انالدج) transmission results in neonatal conjunctivitis
in 30%-50% of exposed babies .
*This bacteria is different from other type of bacteria which we mentioned
before , it has life cycle .
* it has two phases :
1_ Elementary body (EB): the infectious one by which it inter to host cell ,
not reproductive phase .
2_Reticulate body (RB):metabolic active and replication happen.
* once it inter the host cell its converted from (EB) to (RB), and when it get
out of host cell it back to (EB)
Slide 4 min 11:00
Have a complex developmental cycle The infectious form is called an Elementary Body (EB) which is
circular in form and is taken into the cell by induced phagocytosis.
Phagocytosis : when the material has a molecular weight ( ضى خهي)
Pinocytosis : when the material is liquid (cellular drink ششب خهي)
Exocytosis : ( طشح خهي)
Inside the phagocytic vesicle replication takes place.يا تررأشش تؼه انضى انخهي
Fusion In lysosome and phagocytic vesicle then the lysosomal enzyme
released
Over the next 6-8 hours, the EB reorganizes into the noninfectious, but
metabolically active Reticulate Body (RB) which is larger and less dense
than the EB.
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For 18-24 hours the RB synthesized new materials and divides by
binary division to form Inclusion Bodies that reorganize and condense
into EBs.
Inclusion body :vesicle contain RB is indicate the Chlamydia infection
Inside inclusion body (RB) converted to (EB) , and then Exocytosis happen
to it
(EB*انشكم انزي ذخشج ت انشكم انزي دخهد ت انــ )
Between 48-72 hours (three days), the cell lyses and releases the EB
which begin the cycle again.
Slide 5 min 13:16
If we want to differentiate between (EB) and (RB) :
• Elementary body – 0.25 - 0.3 um diameter
– electron-dense nucleoid
– Released from ruptured infected cells. Human to human
– & bird to human.
• Reticulate Body – Intracytoplasmic form 0.5 - 1.0 um
– Replication and growth. ( Inclusion body ) طس ذكاششي
– without a dense center.
*EB which inter the cell (engulfment) ….>divided by binary fission ….>
make inclusion body (green)…..> some in the yellow still EB …>Exocytosis
Chlamydia inclusion bodies
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* this slide consist of inclusion body this circle above contain large amount
of RB
slide 8 min 15:15
Chlamydiaceae Family _aceae : family
Three species will be considers :
Species (genus) Disease
C. Trachomatis (many serotypes)
ع يظهantigen انؼذذ ي حذدخ
ػ طشك
^antigen-antibody reaction^
Trachoma, NGU, PID, neonatal conjunctivitis,
inclusion conjunctivitis,
Infant pneumonia, LGV
C. Pneumoniae (TWAR) Taiwan acute respiratory agent
Pharyngitis, bronchitis, pneumonia
C. psittaci
(many serotypes) Psittacosis(influenza-like illness)
* many serotype mean different type of antigen that diagnosis by
antibody/antigenic reactions
*biotype : diagnosis by biochemical reactions .
*LGV (Lymphogranuloma venereum ) :
Venereum : mean sexually transmitted
( .genitaliaػضاء انرالهح )حذز ذضخى تانؼمذ انهفاح ف يطمح اال
* c.pneumoniae : one antigenic form (serotype) ….> TWAR make
respiratory tract infection in upper and lower
* psittacosis also does not give long lasting immunity , transmitted by bird .
Slide 9 min 19:04
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Clinical significance 1. Chlamydia trachomatis
Caused many diseses:
1)Genital tract infection– is sexually transmitted and frequently found
concomitantly(يغ تؼغ)with N. gonorrhoea (In males symptoms include
urethritis,dysuria and sometimes progresses to epididymitis(انراب انثشتخ);
In females symptoms include mucopurulent cervical inflammation
(there is discharge)which can progress to salpingitis(انرظاق ف لاخ انشحى)
and PID) , and also may lead to infertility (انؼمى)
2)Inclusion conjunctivitis (انراب يهرحح انؼ انض) – from inclusion body
which contain RB second phase , occurs in both newborns and adults and
a genital tract infection is the source of the infection. In new born mostly get it from mother by genital tract while delivery
(vertical).
In adult auto infection , if she had a disease in genital tract or other cases of
chlamydia in the hand or nails , and if she /her put her/his hand in her/his
eyes .
It is self-limited conjunctivitis which heals with no scarring. Newborns
are infected during the birth process, with a mucopurulent discharge. In
adults causes an acute follicular conjunctivitis with little discharge
(autoinoculation).
3)Trachoma, greatest cause of blindness in underdeveloped countries.
(Transmission is by direct contact and in poor, less developed countries,
children may be infected in the first three months of life (because they
have incomplete immune system ).
انرشاخيا : انراب يهحح انؼ يشع لذى , كا تائ ي انطمس نالػاد ف انؼشاق
جف ظف( ي انرشاخيا حس كاا prophylacticسرخذي يهح انه كــ لائ ) كاا
حرى خشج انذو انؼ ت
4)Lymphogranuloma venereum(مرض اللمف الحبب الجىس) is a venereal
disease(or sexual transmitted disease ) that occurs in poor, tropical areas.
painless lesion occurs at the site of entry with symptoms of regional
suppurative lymphadenopathy (buboes)
Buboes ذمح انؼمذ انهفاح انحاطح تانـ :genitalia
Slide 10 min 25:00
Chlamydia psittaci
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Mainly it’s a normal flora in birds ,some people love to feed the Parrot by
his/her mouth so if the parrot infected with Chlamydia it can be transmitted
to human respiratory system
– naturally infects avian species causing mild to severe
illness.
– In man causes psittacosis (ornithosis) and is acquired by
contact with an infected animal.
– Infection can range from subclinical to fatal pneumonia.
* its depend on the immunity of the person or the dose which he
take from Chlamydia
– Most commonly causes an Atypical (انالرجح)pneumonia
with fever, chills, dry cough, headache, sore throat, nausea,
and vomiting.
* Mycoplasma pneumonia is the cause of atypical pneumonia
Chlamydia pneumoniae
- This bacterium was first recognized as a respiratory pathogen,
after isolation from pharyngitis case.
- Pneumonia or Bronchitis, gradual onset of cough with little or no
fever. Less common presentations are Pharyngitis, Laryngitis,
and Sinusitis
* give long lasting immunity because its
have only one serotype (TWAR) = only one antigen
slide 11 min 28:15
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* Proctitis: / انراب انسرمى * inguinal : االستح…> in genitalia
Slide 12 min 29:8
Pathogenesis (some of it virulence factor ) - Chlamydiae have a hemagglutinin that may facilitate attachment to
cells to the host as pili .
- An endotoxin-like toxin has been described.
Laboratory Diagnosis
• Culture
Not traditional culture for bacteria its tissue culture because obligate
intracellular
• Non-culture tests
– Nucleic Acid Amplification Tests polymeraze reaction but
now it byBCR
– Non-Nucleic Acid Amplification Tests including Direct
fluorescent antibody (DFA), Enzyme immunoassay (EIA),
and Nucleic acid hybridization (NA probe)
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probe كم ال حري ػهى genetic constituent probe which one strand
اد انساش انخاط تانثكرشا ؼها ؼم فظم نه
hybridization ارا طاس
supp codeing
يؼاا ايالة نهكاليذا ايا ارا ياطاس فزا ؼ اا يش كاليذا
– Serology antibody antigen reactions
* most classification was by serology
Slide 13 min 30:51
Prevention • Nature of the infection
– Chlamydia is commonly asymptomatic in men and
women.
– In women, there is an increased risk of upper
reproductive tract damage with re-infection.
Transmission issues
– Abstain from sexual intercourse)LGV) until partners
are treated and for 7 days after a single dose of
azithromycin antibiotic .
**************************************** THE END
NEW SLIDES
Slide 1 min 32:00 We talked about rod , spherical and now spiral
Spirochaetales Treponema, Borrelia, Leptospira
All spirals (Treponema, Borrelia, Leptospira)are helical and they
differentiate from each other in this coil , the turn(coil) cloud be large or
small, the distant between helical and helical can be long or short , may be
coil then straight then coil and so on …. And this method we use to separate
between different type of spirals .
Slide 2 min 33
Taxonomy Order: Spirochaetales
Family: Spirochaetaceae
Genus: Treponema
Borrelia
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Other family within the same order Other family within the same order
Family: Leptospiraceae
Genus: Leptospira
Gram-negative spirochetes
• Spirochete from Greek for “coiled hair”
Extremely thin and can be very long
Motile by periplasmic flagella (axial fibrils or endoflagella)
Outer sheath encloses axial fibrils
• Axial fibrils originate from insertion pores at
both poles of cell
* It is not stain with gram stain because its very transparent so we use silver
nitrate stain
* some bacteria has axial fibrils ط يشكزيل or endoflagella : contain flagella
between outer membrane and peptidoglycan layer .
* spiral bacteria not like rod or spherical its move very fast and change it
shape so its harder to diagnose it .
* student asked why its gram negative bacteria while we can not stain it by
gram stain ? D.A: because the structure of it is identical to all gram negative
bacteria cell wall
slide 4 min 47:50
Periplasmic Flagella Diagram
Slide 5 min 39:10
Spirochaetales Associated Human Diseases
Note :we will not talk about Leptospira
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Genus Species Disease
Treponema pallidum ssp. pallidum
pallidum ssp. endemicum
pallidum ssp. pertenue
carateum
Syphilis
Bejel
Yaws
Pinta
Borrelia Burgdorferi
recurrentis
Many species
Lyme disease (borreliosis)
Epidemic relapsing fever
Endemic relapsing fever
Leptospira Interrogans Leptospirosis
(Weil’s Disease)
* syphilis : sexual transmitted dieses
*we will focus on recurrentis from borrelia which cause relapsing fever
its go and back because its more than one serotype (انحى انشاجؼح)
* relapsing fever has two type
- epidemic (تائ) & endemic (يسرط).
Slide 6 &7 min 40:20
We will srart with
Treponema pallidum ssp. Pallidum which responsible for syphilis= انزشي .
Its sexual transmitted disease and can stay with the patient for long period
(20_30_40 years)
* could be asymptomatic in first phases
* has many phases primary , secondary , and tertiary .
*its easy to treat it in earlier phases .
*transmit by mucous membrane of genital.
Venereal Treponemal Disease - T. pallidum are slender spirals with spiral coils spaced at a distance of
1 μm from one another between coil and another 1 μm .
- Pathogenic T pallidum has never been cultured on artificial media, in
fertile eggs, or in tissue culture. طؼث
- Nonpathogenic treponemes (Reiter strain) can be cultured
anaerobically in vitro.
- T pallidum is a microaerophilic (need oxygen less than what found
in atmosphere ) organism; it survives best in 3–5% oxygen.
- Cause Syphilis
Primarily sexually transmitted disease تشكم سئس
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May be transmitted congenitally (from mother to fetus)called
congenital syphilis can lead to abortion(إجاع) or early born or may
cause born of baby with mental problems .
Darkfield Microscopy of Treponema pallidum
* the shape of it have very tiny zigzag (coil ) very close to each other .
*we use dark field microscope because its already transparent .
General Characteristics of
Treponema pallidum
Too thin to be seen with light microscopy in specimens stained with
Gram stain or Giemsa stain
• Motile spirochetes can be seen with darkfield micoscopy
الا شفاف
• Staining with anti-treponemal antibodies labeled with
fluorescent dyes
Intracellular pathogen
Cannot be grown in cell-free cultures in vitro
• Koch’s Postulates have not been met
( حث اوها ال تىمى ف المختبر أما كىخ فقد قال kochأي اوها ال تىطبق على فرضة)الزم و وىمه ف المحتبر مه االوسان او الحىان ووعسله اوىا وأخذ العامل الممرض
طلع وفسه
Do not survive well outside of host
sorry in advance for any mistake you will found *-*
good luck :) :)