Презентация на тему Bordetella, Francisella & Brucella

Bordetella, Francisella & Brucella General Overview of       Bordetella, Francisella & BrucellaExtremely small Aerobic nonfermentersGram-negative Human Disease & Associated Pathogens Bordetella pertussis Man is only natural host; obligate parasites of manDisease is highly communicable (highly infectious)Person-to-person spread via Incidence & Severity of Pertussis Cases in USA Incidence of Pertussis in USA Age Distribution & Severity of Pertussis Cases Changes in Age Distribution for Pertussis CasesBlue = 1988Orange = 1998 Clinical Progression of PertussisMost infectious, but generally not yet diagnosedInflammation of respiratory mucosal memb.,or death Fimbriae not primarily involved in adherence; Exotoxin & hemagglutinin mediate attachment specifically to ciliated epithelium of Virulence Factors Associated with Bordetella pertussis Laboratory Culture, Prevention & Treatment of BordetellaInactivated whole bacterial cells and toxoid are prepared in formalin Differential Characteristics of Bordetella Species Francisella tularensis Francisella tularensis Infections Francisella tularensis Infections (cont.) Clinical Presentation of TularemiaNOTE: Also Gastrointestinal & Pneumonic forms of disease Rabbits, ticks & muskrats are main reservoirs in USTwo biochemical varietiesF. tularensis bv. tularensis (a.k.a., Jellison Biochemical Variants (Biovar) of Francisella tularensis Antiphagocytic capsule Thin lipid capsule present in pathogenic strainsFacultative intracellular parasite that can survive in macrophages NonmotileFastidious and slow-growingRequires cysteine-supplemented specialized media wiRequires prolonged growth Disease prevention:Avoidance of reservoirs and vectorsProtective clothing Antibody Response to  Francisella tularensis Infections Brucella spp. Brucella Infections Brucella Infections (cont.) Animals are natural reservoirCattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes500,000 human cases per year Incidence of Brucellosis in USA Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, Human Brucellosis & Associated SpeciesSevere Brucellosis in HumansReportable diseaseHuman brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoirDisease associated with contact with Acute disease often develops with initial nonspecific symptoms of malaise, chills, fatigue, weakness, myalgias (muscles), weight Plate agglutination test (a.k.a., Brucella ring test) diagnosing Brucella Drop of serum mixed with drop of In 1934, the U.S. Department of Agriculture (USDA) established the National Brucellosis Eradication Effort which is REVIEWBordetella, Francisella & Brucella General Overview of       Bordetella, Francisella & BrucellaExtremely small Aerobic nonfermentersGram-negative Human Disease & Associated PathogensREVIEW Review of     Bordetella pertussis Bordetella pertussis InfectionsREVIEW Bordetella pertussis Infections (cont.)REVIEW Man is only natural host; obligate parasites of manDisease is highly communicable (highly infectious)Person-to-person spread via Changes in Age Distribution for Pertussis CasesBlue = 1988Orange = 1998REVIEW Clinical Progression of PertussisMost infectious, but generally not yet diagnosedInflammation of respiratory mucosal memb.,or deathREVIEW Virulence Factors Associated with Bordetella pertussisREVIEW Review of   Francisella tularensis Francisella tularensis InfectionsREVIEW Francisella tularensis Infections (cont.)REVIEW Clinical Presentation of TularemiaNOTE: Also Gastrointestinal & Pneumonic forms of diseaseREVIEW Rabbits, ticks & muskrats are main reservoirs in USTwo biochemical varietiesF. tularensis bv. tularensis (a.k.a., Jellison Biochemical Variants (Biovar) of Francisella tularensis REVIEW Review of      Brucella spp. Brucella InfectionsREVIEW Brucella Infections (cont.)REVIEW Animals are natural reservoirCattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes500,000 human cases per year Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, Human Brucellosis & Associated SpeciesSevereREVIEW Brucellosis in HumansReportable diseaseHuman brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoirDisease associated with contact with

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Bordetella, Francisella & Brucella



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& BrucellaExtremely small Aerobic nonfermentersGram-negative coccobacilliTrue pathogens: isolation always associated with disease; i.e., always

General Overview of Bordetella, Francisella & Brucella

Extremely small
Aerobic nonfermenters
Gram-negative coccobacilli
True pathogens: isolation always associated with disease; i.e., always clinically significant
NOTE: Previously studied nonfermenters were all opportunistic pathogens


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Human Disease & Associated Pathogens


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Bordetella pertussis


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communicable (highly infectious)Person-to-person spread via inhalation of infectious aerosolsIncidence in U.S.A. significantly reduced with required

Man is only natural host; obligate parasites of man
Disease is highly communicable (highly infectious)
Person-to-person spread via inhalation of infectious aerosols
Incidence in U.S.A. significantly reduced with required DPT vaccine; Incidence increasing as some local school boards stop requirement
Children under one year at highest risk, but prevalence increasing in older children and adults

Epidemiology of Bordetella pertussis Infection


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Incidence & Severity of Pertussis Cases in USA


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Incidence of Pertussis in USA


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Age Distribution & Severity of Pertussis Cases


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Changes in Age Distribution for Pertussis Cases

Blue = 1988
Orange = 1998


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respiratory mucosal memb.,or death

Clinical Progression of Pertussis

Most infectious, but generally not yet diagnosed

Inflammation of respiratory mucosal memb.

,

or death


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specifically to ciliated epithelium of bronchial treeCells multiply among cilia of epithelial cells and produce

Fimbriae not primarily involved in adherence; Exotoxin & hemagglutinin mediate attachment specifically to ciliated epithelium of bronchial tree
Cells multiply among cilia of epithelial cells and produce filamentous hemaglutinin and classic A-B exotoxin and other toxins leading to localized tissue damage and systemic toxicity
Pertussis toxin, adenylate cyclase toxin, tracheal cytotoxin, dermonecrotic toxin, filamentous hemagglutinin, LPS (lipid A & lipid X)
Classical A-B exotoxin has three distinct activities
Histamine sensitizing factor
Lymphocytosis promoting factor
Islet activating protein

Virulence Factors Associated with Bordetella pertussis


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Virulence Factors Associated with Bordetella pertussis


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toxoid are prepared in formalin for inclusion in DPT vaccineSubunit (acellular) vaccine also availableTreatment with

Laboratory Culture, Prevention & Treatment of Bordetella

Inactivated whole bacterial cells and toxoid are prepared in formalin for inclusion in DPT vaccine
Subunit (acellular) vaccine also available
Treatment with erythromycin, suction, oxygen
Treatment does not eliminate symptoms

Nonmotile
Fastidious and slow-growing
Requires nicotinamide and charcoal, starch, blood, or albumin to absorb toxic substances
Requires prolonged growth
Isolated on modified Bordet-Gengou agar


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Differential Characteristics of Bordetella Species


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Francisella tularensis


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Francisella tularensis Infections


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Francisella tularensis Infections (cont.)


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Clinical Presentation of Tularemia

NOTE: Also Gastrointestinal & Pneumonic forms of disease


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tularensis bv. tularensis (a.k.a., Jellison Type A) F. tularensis bv. palaearctica (a.k.a., Jellison Type A)

Rabbits, ticks & muskrats are main reservoirs in US
Two biochemical varieties
F. tularensis bv. tularensis (a.k.a., Jellison Type A)
F. tularensis bv. palaearctica (a.k.a., Jellison Type A)

Jellison Type A strains are the major biovar associated with severe disease in North America
Most commonly, transmission by tick vectors from rabbit reservoirs or direct contact with rabbits

Epidemiology of F. tularensis Infection


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Biochemical Variants (Biovar) of Francisella tularensis


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that can survive in macrophages of the reticuloendothelial systemVirulence Factors of

Antiphagocytic capsule
Thin lipid capsule present in pathogenic strains

Facultative intracellular parasite that can survive in macrophages of the reticuloendothelial system

Virulence Factors of Fransicella tularensis


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of reservoirs and vectorsProtective clothing and glovesLaboratory personnel should be made aware of potential for

Nonmotile
Fastidious and slow-growing
Requires cysteine-supplemented specialized media wi
Requires prolonged growth

Disease prevention:
Avoidance of reservoirs and vectors
Protective clothing and gloves
Laboratory personnel should be made aware of potential for Fransicella in clinical specimens

Laboratory Culture, Prevention & Treatment of F. tularensis


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Antibody Response to Francisella tularensis Infections


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Brucella spp.


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Brucella Infections


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Brucella Infections (cont.)


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coyotes500,000 human cases per year worldwideLess than 100 annual cases in the U.S. due to

Animals are natural reservoir
Cattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes
500,000 human cases per year worldwide
Less than 100 annual cases in the U.S. due to successful control of the disease in livestock and the animal reservoir
Transmission via i) ingestion of contaminated milk or cheese, or ii) direct contact with infected animals or animal products
Because it can be transmitted to humans, brucellosis is one of the most regulated diseases of cattle in the U.S.

Epidemiology of Brucellosis


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Incidence of Brucellosis in USA


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to glucose) like breast, uterus, placenta and epididymis (tube that connects a pair of ducts

Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, placenta and epididymis (tube that connects a pair of ducts that conduct spermatozoa during ejaculation)
Asymptomatic carriage, sterility or abortions
Transmitted between animals in aborted tissues

Brucellosis in Animals


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Human Brucellosis & Associated Species



Severe




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Bang & Sir David Bruce who discovered BrucellaFacultative intracellular pathogens of mononuclear-phagocyte system (formerly reticuloendothelial

Brucellosis in Humans


Reportable disease
Human brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce who discovered Brucella
Facultative intracellular pathogens of mononuclear-phagocyte system (formerly reticuloendothelial system which is involved in immune defense against microbial infection and removal of worn-out blood cells)
Bacteria are phagocytosed by macrophage or polymorphonuclear leukocyte
Survive intracellularly by inhibiting killing
Carried to spleen, liver, bone marrow, lymph nodes, kidneys
Form granulomas (mass of granulation tissue produced in response to chronic infections, inflammation, or foreign bodies) and cause destructive tissue damage


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reservoirDisease associated with contact with infected cattle, cattle products, or dogs is a milder form

Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoir
Disease associated with contact with infected cattle, cattle products, or dogs is a milder form
Disease associated with contact with goats and sheep is acute and severe with complications common
Disease associated with contact with swine is chronic & suppurative with destructive lesions and localization in cells of the reticuloendothelial system (RES)
Occupational hazard of laboratory personnel, veterinarians, farm workers, and meat handlers at risk through direct contact or inhalation
Protective clothing for abattoir workers, avoidance of unpasteurized dairy products
Highest numbers of cases reported in CA and TX

Brucellosis in Humans (cont.)


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fatigue, weakness, myalgias (muscles), weight loss, arthralgias (joint), and nonproductive coughMild disease with rare suppurative

Acute disease often develops with initial nonspecific symptoms of malaise, chills, fatigue, weakness, myalgias (muscles), weight loss, arthralgias (joint), and nonproductive cough
Mild disease with rare suppurative complications
Chronic disease and recurrence are common because it can survive in phagocytic cells and multiply to high concentrations
May also take the form of destructive lesions

Clinical Presentation of Human Brucellosis


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serum mixed with drop of Brucella antigenClumping indicates infectionIf the mixture remains clear, the result

Plate agglutination test (a.k.a., Brucella ring test) diagnosing Brucella
Drop of serum mixed with drop of Brucella antigen
Clumping indicates infection
If the mixture remains clear, the result is negative.
Treated with combination of tetracycline and doxycycline
For infants, tetracycline is toxic, so children are treated with trimethoprim-sulfamethoxazole.

Diagnosis & Treatment of Human Brucellosis


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Brucellosis Eradication Effort which is managed by Animal, Plant, and Health Inspection Service (APHIS)APHIS certifies

In 1934, the U.S. Department of Agriculture (USDA) established the National Brucellosis Eradication Effort which is managed by Animal, Plant, and Health Inspection Service (APHIS)
APHIS certifies states as brucellosis-free, classes A, B, or C of which all states are currently classified A
Serology & confirmatory bacterial culture to identify infected animals
Positive animals/herds are destroyed
Vaccination is available but is not a 100% effective and is costly to cattle ranchers

Control & Prevention of Brucellosis


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REVIEW
Bordetella, Francisella & Brucella


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& BrucellaExtremely small Aerobic nonfermentersGram-negative coccobacilliTrue pathogens: isolation always associated with disease; i.e., always

General Overview of Bordetella, Francisella & Brucella

Extremely small
Aerobic nonfermenters
Gram-negative coccobacilli
True pathogens: isolation always associated with disease; i.e., always clinically significant
NOTE: Previously studied nonfermenters were all opportunistic pathogens

REVIEW


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Human Disease & Associated Pathogens

REVIEW


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Review of Bordetella pertussis


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Bordetella pertussis Infections

REVIEW


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Bordetella pertussis Infections (cont.)

REVIEW


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communicable (highly infectious)Person-to-person spread via inhalation of infectious aerosolsIncidence in U.S.A. significantly reduced with required

Man is only natural host; obligate parasites of man
Disease is highly communicable (highly infectious)
Person-to-person spread via inhalation of infectious aerosols
Incidence in U.S.A. significantly reduced with required DPT vaccine; Incidence increasing as some local school boards stop requirement
Children under one year at highest risk, but prevalence increasing in older children and adults

Epidemiology of Bordetella pertussis Infection

REVIEW


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Changes in Age Distribution for Pertussis Cases

Blue = 1988
Orange = 1998

REVIEW


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respiratory mucosal memb.,or deathREVIEW

Clinical Progression of Pertussis

Most infectious, but generally not yet diagnosed

Inflammation of respiratory mucosal memb.

,

or death

REVIEW


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Virulence Factors Associated with Bordetella pertussis

REVIEW


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Review of Francisella tularensis


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Francisella tularensis Infections

REVIEW


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Francisella tularensis Infections (cont.)

REVIEW


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Clinical Presentation of Tularemia

NOTE: Also Gastrointestinal & Pneumonic forms of disease

REVIEW


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tularensis bv. tularensis (a.k.a., Jellison Type A) F. tularensis bv. palaearctica (a.k.a., Jellison Type A)

Rabbits, ticks & muskrats are main reservoirs in US
Two biochemical varieties
F. tularensis bv. tularensis (a.k.a., Jellison Type A)
F. tularensis bv. palaearctica (a.k.a., Jellison Type A)

Jellison Type A strains are the major biovar associated with severe disease in North America
Most commonly, transmission by tick vectors from rabbit reservoirs or direct contact with rabbits

Epidemiology of F. tularensis Infection

REVIEW


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Biochemical Variants (Biovar) of Francisella tularensis

REVIEW


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Review of Brucella spp.


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Brucella Infections

REVIEW


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Brucella Infections (cont.)

REVIEW


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coyotes500,000 human cases per year worldwideLess than 100 annual cases in the U.S. due to

Animals are natural reservoir
Cattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes
500,000 human cases per year worldwide
Less than 100 annual cases in the U.S. due to successful control of the disease in livestock and the animal reservoir
Transmission via i) ingestion of contaminated milk or cheese, or ii) direct contact with infected animals or animal products
Because it can be transmitted to humans, brucellosis is one of the most regulated diseases of cattle in the U.S.

Epidemiology of Brucellosis

REVIEW


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to glucose) like breast, uterus, placenta and epididymis (tube that connects a pair of ducts

Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, placenta and epididymis (tube that connects a pair of ducts that conduct spermatozoa during ejaculation)
Asymptomatic carriage, sterility or abortions
Transmitted between animals in aborted tissues

Brucellosis in Animals

REVIEW


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Human Brucellosis & Associated Species



Severe



REVIEW


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Bang & Sir David Bruce who discovered BrucellaFacultative intracellular pathogens of mononuclear-phagocyte system (formerly reticuloendothelial

Brucellosis in Humans


Reportable disease
Human brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce who discovered Brucella
Facultative intracellular pathogens of mononuclear-phagocyte system (formerly reticuloendothelial system which is involved in immune defense against microbial infection and removal of worn-out blood cells)
Bacteria are phagocytosed by macrophage or polymorphonuclear leukocyte
Survive intracellularly by inhibiting killing
Carried to spleen, liver, bone marrow, lymph nodes, kidneys
Form granulomas (mass of granulation tissue produced in response to chronic infections, inflammation, or foreign bodies) and cause destructive tissue damage

REVIEW


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reservoirDisease associated with contact with infected cattle, cattle products, or dogs is a milder form

Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoir
Disease associated with contact with infected cattle, cattle products, or dogs is a milder form
Disease associated with contact with goats and sheep is acute and severe with complications common
Disease associated with contact with swine is chronic & suppurative with destructive lesions and localization in cells of the reticuloendothelial system (RES)
Occupational hazard of laboratory personnel, veterinarians, farm workers, and meat handlers at risk through direct contact or inhalation
Protective clothing for abattoir workers, avoidance of unpasteurized dairy products
Highest numbers of cases reported in CA and TX

Brucellosis in Humans (cont.)

REVIEW


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