Actinomyces. lecture slides
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Transcript of Actinomyces. lecture slides
Actinomycetes
Prof M.I.N. MateeDepartment of Microbiology and
ImmunologySchool of Medicine
MUCHS
Tuesday, November 8, 2005
General propertiesGram positive branching filamentsSlow growers
Resemble Corynebacteria, mycobacteria and fungiInclude:
Actinomyces – anaerobe, normal floraNorcadia – aerobe, saprophyte – PARTIALLY ACID FASTStreptomyces- aerobe, saprophyte
Actinomyces
• Strict anaerobe
• Gram positive
• Non-motile
• Non-proteolytic
• Catalase negative
Motility
From left to right:+ – +
Actinomyces
C diptheriae: Gram stain
CytoplasmCytoplasm
Lipoteichoic acid Peptidoglycan-teichoic acid
Cytoplasmic membrane
GRAM POSITIVE CELL GRAM POSITIVE CELL ENVELOPEENVELOPE
Degradative enzyme
ACTINOMYCESAnaerobic, filamentous, gram positive
bacillus – Exhibit true branching
• “Mykes” – Greek for “fungus”
• Thought by early microbiologist to be fungi because of:– Morphology– Disease they cause
Actinomycosis
• Chronic suppurative disease
• Spread by direct extension - sinuses
• A israelii
• A bovis – lumpy jaw in cattles
ACTINOMYCOSISForm indurated masses with fibrous walls
and central loculations with pus– Pus contains "Sulfur Granules"
• Gritty, yellow white• Average diameter - 2mm• Composed of “mycelial” mass
Chronic infection
– Form burrowing sinus tracts to skin or mucus membranes
• Discharge purulent material
Actinomycosis - sulfur granule
III. Epidemiology
-part of normal mouth and gut flora
-cervicofacial infection from tooth extraction or poor oral hygiene
-thoracic infection from aspiration
-abdominal infection from perforated gut or ruptured appendix
-foot infection from bacteria in soil
-infection mainly in immunocompromised patients
-not a communicable disease
Pulmonary Actinomycosis
• 15% of cases• Aspiration of organism
from the oropaharynx• Slowly progressive
process involving lung and pleura– May be mistaken for
malignancy
• Chest pain, fever, wgt loss and hemoptysis
Laboratory diagnosis
• Specimens – pus, sputum, tissue biopsy
• Microscopic examination – sulphur granules
• Culture – thioglycolate medium and BHI
• Incubation: anaerobic for 2 weeks
• Gas liquid chromtography (GLC) of metabolic by-products
Anaerobic jar
Figure 6.5
IV. Control
-surgical drainage of abscess,
-parenteral penicillin for a few weeks, followed by oral for 6-12 months (very long term treatment)-cephalosporins, erythromycin, clindamycin if pt allergic to pen
-prophylactic penicillin if pt has recurring infection, esp. before oral surgery
Nocardia asteroides
I. Organism
-also actinomycete morphology
-produces shorter mycolic acids, hence partially acid fast
-aerobe, with both aerial and subsurface mycelia
Norcadiosis
Nocardiosis – is a localized or disseminated disease occurring after inhalation of organisms.
Pulmonary infections resemble tuberculosis
may disseminate, with a predilection for the brain and meninges.
It is usually a disease of compromised hosts
II. Clinical(nocardiosis)
-usually presents as lobar pneumonia in alcoholics or immunocompromised patients
-abscess formation in lung lobe
(nocardiosis)-usually presents as lobar pneumonia in alcoholics or
immunocompromised patients
-abscess formation in lung lobe
-may spread to brain and CNS and cause meningitis or brain abscess
II. Clinical(nocardiosis)
-usually presents as lobar pneumonia in alcoholics or immunocompromised patients
-abscess formation in lung lobe
-may spread to brain and CNS and cause meningitis or brain abscess
-can also on the foot from soil-based infections
III. Epidemiology-soil bacterium
-opportunistic pathogen
-lung infection from aspiration, dissemination to CNS, kidneys
Laboratory diagnosis
• Specimens – sputum, pus, spinal fluid, biopsy
• Microscopy – coccoid, bacillary, tangled mass
• Culture – on most ordinary media
• Tissue section – methenamine-silver stain
IV. Treatment
Mycetoma – aminoglycosidesNocardiosis – sulfonamides or sxt
–Surgical debridement
–Underlying cause
• Actinomycetes such as Streptomyces have a world-wide distribution in soils.
• They are important in aerobic decomposition of organic compounds and have an important role in biodegradation and the carbon cycle.
• Actinomycetes are the main producers of antibiotics in industrial settings, being the source of most tetracyclines, macrolides (e.g. erythromycin), and aminoglycosides (e.g. streptomycin, gentamicin, etc.).
•Thank you for listening