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Microbes and diseases: what to study-1 • 1. Causative microbe: name, morphology (shape, size, Gram stain, etc.), physiology (aerobe, anaerobe, etc) and some info on classification (what's it related to?) • 2. Pathogenesis and clinical disease: what disease does it cause (signs and symptoms) and how does it do it (capsule, toxins..)? • 3. Transmission and epidemiology: how do you get the disease? 1 Microbes and diseases: what to study-2 • 4. Diagnosis: How does the lab usually identify the causative agent? • 5. Treatment: antibiotics prescribed (or not- no cell wall, no penicillin) or other treatment (oral rehydration therapy for cholera). • 6. Prevention and control (stop the spread; condoms, kill urban rats..) 2 Pathogenic Bacteria • Gram positive rods and cocci – Pyogenic cocci: Staph and Strep – Gram positive rods: Bacillus to Actinomycetes • Gram negative cocci and bacilli – Gram negative cocci: Neisseria – The Enteric bacteria – Aerobic & Anaerobic Gram negative bacteria • Miscellaneous pathogens – Mycoplasmas to Helicobacter; Gram -, but odd 3 Staphylococcus: G+ coccus 4 • S. aureus and S. epidermidis. – S. aureus much worse, S. epi an opportunist. – Sturdy, salt tolerant, fac anaerobes; clusters – S. epidermidis common on skin, S. aureus less. • Diseases of S. aureus – Food poisoning, skin diseases (impetigo, folliculitis, furuncles & carbuncles, scalded skin syndrome), systemic diseases (TSS, bacteremia, heart, lung, and bone infections) – Diseases spread by fomites and direct contact. Characteristics of S. aureus infections 5 tray.dermatology.uiowa.edu/ DIB/SSSS-002.htm www.omv.lu.se/.../ rorelse/popup/01d1x.htm S. aureus virulence factors & Rx 6 • Coagulase, triggers blood clotting. • Capsules, hyaluronidase, staphylokinase, betalactamases (destroy penicillins) • Toxins: various, including TSS toxin, exfoliatin, and enterotoxins (heat stable) • 95% resistant to penicillin, but now many resistant to methicillin, and now vancomycin, leaving ______?? Streptococci: G+ cocci • Genera: Streptococcus and Enterococcus • Aerotolerant anaerobes, catalase negative – Grow in chains, pairs – Strep: Lancefield groups, viridans, S. pneumoniae • Group A strep: S. pyogenes – Pharyngitis, scarlet fever, pyoderma, erysipelas, TSS, necrotizing fasciitis – Sequelae: rheumatic fever and glomerulonephritis • Group B strep: S. agalactiae – Infects newborns during birth, various illnesses 7 Characteristics of Streptococcal infections http://euclid.dne.wvfibernet.net/~jvg/Bio208/resp_pix/scarlet-fever.jpg http://textbookofbacteriology.net/vvpath.jpeg 8 Virulence factors, etc. • S. pyogenes (“pus-producing”) – M protein and capsule: avoids phagocytosis – Streptokinase, streptolysins for escape & attack – Pyrogenic erythrotoxins (SPEs) 3 different types • Cause scarlet fever: fever, rash – Beta hemolytic on blood agar • Viridans group: greenish alpha hemolysis – Common in throat, mouth, but can be opportunists – S. mutans associated w/ dental caries 9 Viridans and pneumoniae 10 faculty.mc3.edu/ jearl/ML/ml-11.htm www.ulb.ac.be/sciences/ biodic/ImBacterie2.html S. pneumoniae 11 • Gram + coccus in pairs, alpha hemolytic • Pneumonia, sinusitis, otitis media, meningitis • Major virulence factor is a capsule – Other unrelated bacteria also have capsules, cause meningitis – Also, get phagocytized by “non-professionals”, spread • Carried in URT by 75% of population – Disease greatest in children and elderly Enterococcus 12 • Formerly part of Group D Strep • Grow under conditions (e.g. high salt) that Strep do not tolerate. • E. faecium, E. faecalis found in GI tract • Opportunists – Cause of nosocomial, wound infections • Resistant to most antibiotics – Plasmids transfer resistance to others Bacillus: G+ rods-1 • Bacillus species very common and numerous – Present in soil, most non-pathogenic – All form endospores when nutrient limited • Bacillus cereus: cause of GI distress – Emetic and diarrheal toxins; bad rice http://biochem.ultraevil.com/bio/Images/bioloskoorozje/anth rax/BacillusAnthrax.jpg 13 Bacillus: G+ rods-2 • Bacillus anthracis: cause of anthrax – Anti-phagocytic capsule of glutamic acid – 3 protein toxin that is lethal – Zoonotic: primarily disease of livestock – Ingestion, inhalation, and cutaneous forms • Black eschar characteristic of cutaneous form – Not hemolytic; antibiotics, vaccine effective 14 Clostridium: G+ rods 15 • Strict anaerobes! Endospore formers. Toxigenic – Common in soil, sewage animal GI tracts – Produce neurotoxins, enterotoxins, histolytic toxins • Four important species: C. perfringens, C. botulinum, C. tetani, and C. difficile. • C. perfringens – Food poisoning: cramps and diarrhea – From injury: myonecrosis to gas gangrene • Fermentation in tissues, killing of tissues and spread of cells into anaerobic areas. • Oxygen treatment, debridement, amputation More clostridia 16 • C. difficile: normal GI microbiota – Cause of pseudomembranous colitis, resulting from overgrowth following broad spectrum anitbiotics • Damage to GI wall can lead to serious illness – Nosocomial infection, easily transmitted • C.botulinum: cause of botulism – Usually acquired by ingestion: intoxication • Food borne, infant (no honey), wound – Produces neurotoxin, inhibits acetylcholine release • Flaccid paralysis; Botox: deadly poison / beauty – Mouse bioassay; administer antitoxin Opposing muscle groups 17 When biceps contracts, triceps relaxes. When triceps contracts, biceps relaxes. Excitatory neurons send signal to contract, inhibitory neurons send signal to NOT contract. http://upload.wikimedia.org/wikipedia/sv/thumb/d/dd/185px-Muscles_biceps_triceps.jpg Function of nerves 18 http://upload.wikimedia.org/wikipedia/fr/thu mb/e/e4/200px-Synapse.png http://www.people.virginia.edu/~dp5m/phys_304/figures/motor_unit.jpg More clostridia-2 • C. tetani: cause of tetanus – Growth in anaerobic wounds, makes tetanus toxin – Toxin prevents action of inhibitory neurons • Opposing muscle pairs both contract • Spastic paralysis, leading to death. – Recommendation is booster shot every 10 years • Toxoid vaccine, with diphtheria toxin • No natural immunity: you die first. 19 Listeria: Gram + rod • L. monocytogenes, non-spore forming coccobacillus – Common in many environments • Portal of entry is food or drink –Esp. meat, dairy products. Check for recalls. –Is psychrotrophic. – Escapes into cytoplasm during phagocytosis • Lives intracellularly, moves cell to cell – Severe infections in: pregnant women/fetuses, newborns, elderly, immunocompromised 20 Corynebacterium: G+ rod • Found on humans, animals, plants – Normal microbiota and opportunists • C. diphtheriae: cause of disease diphtheria – Colonizes the throat, inflammation, fever, and pseudomembrane, release of toxin • Pseudomembrane can block throat – Toxin inhibits protein synthesis, kills cells locally • Toxin diffuses, kills heart and nerve cells – Antitoxin, antibiotic treatment – Vaccination (DPT); humans are only host. 21 Mycobacterium: G+ rods • Many non-pathogenic species, most disease: M. tuberculosis and M. leprae – M. avium-intracellulare: environmental source of lung disease (like TB) in AIDS patients – Mycolic acids as part of complex cell wall • Protects against dessication • Protects against destruction by phagocytes • Requires acid-fast staining – Generally grow very slowly (chronic illnesses) – Can grow intracellularly 22 M. tuberculosis 23 • Causes disease tuberculosis, mostly lung dis. • Cord factor: cell wall factor that connects cells, resists phagocytosis, toxic to host cells • Disease: cells enter lungs, infect macrophages – Cell mediated immunity fights back, walls off infection; forms tubercle (caseous necrosis occurs) – Disease remains controlled, cured, or returns • Disseminated TB: spreads thru body • Worldwide problem; lowered immunity=risk – Skin test, chest x-ray, drug treatment, vaccine? M. leprae • Cause of Hansen’s disease, aka leprosy • Slow growing, likes it cool; armadillos as model • Grows in peripheral nerve and skin cells – Numbness is characteristic of disease • Tuberculoid vs. lepromatous leprosy – Mild, severe, respectively, depending on cell mediated immune response. – Numbness vs tissue destruction • Spread mostly by direct contact • Treatable with antibiotics, but long term 24 Other Gram positive rods • Propionibacterium – Ferments, produces propionic acid and CO2 – makes Swiss cheese – P. acnes: causes inflammation of sebaceous glands: acne. Bacterial growth stimulated by excessive oil production. • Diphtheroids – Bacteria resembling Corynebacterium diphtheriae as normal microbiota on skin. 25 Other G+ -2 • Partially to totally filamentous bacteria – Nocardia asteroides • Causes skin and lung disease • Filamentous cells with pus, draining • Acid fast – Actinomycetes • Large group of filamentous bacteria • Mostly environmental, source of geosmin, antibiotics • Some species do cause infections –abscesses 26