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Jumpstart 3/22/2010 Create a Venn diagram comparing and contrasting Staphylococcus aureus and Streptococcus pyogenes. Corynebacterium and Mycobacterium Corynebacterium • The basics: – Gram positive rods in clumps or short chains – Non-spore forming – High guanine-cytosine content – Some species are commonly found on the skin, respiratory tract, GI tract, and urogentital tract • Can cause opportunistic infections – Some are commonly associated with disease Corynebacterium diptheriae • Toxins – Exotoxin secreted by bacteria causes the effects observed • Diptheria toxin and A-B exotoxin – Damages the heart, kidneys, and nervous system Diphtheria • C. diphtheria causes a disease called diphtheria (shocking, I know) • Found worldwide – Higher incidences in poor, crowded urban areas – Last big outbreak was in Soviet union in 1994 where it caused 1746 deaths. • Transmitted by respiratory droplets or by touching a person who has it. • Humans are the only known reservoir Diphtheria • Uncommon in the US, because immunization is required for school children (DPT vaccine) – 200000 cases in 1921 vs. 5 cases since 1980 • Different forms of diphtheria – Respiratory – Cutaneous Respiratory Diphtheria • 2-6 day incubation period. • Organisms multiply in pharynx, damaging those cells – Sore throat, malaise, low-grade fever – Thick exudate is produced that is tough to dislodge without causing the underlying tissue to bleed • Infection lasts about 1 week, the thick exudate breaks up and is expectorated Respiratory Diphtheria • Bull neck Cutaneous diphtheria • Acquired through skin contact with an infected person • Has to enter body through a break in the skin • Papule develops first, can turn into a nonhealing ulcer. Systemic signs can occur due to exotoxin effects. Cutaneous diphtheria Diagnosis and Treatment • Must be clinically diagnosed because lab tests could take at least a week • Treatment is early administration of antitoxin. Once toxin enters the cells of the body, death is certain. Treatment • Penicillin or erythromycin is used to kill C. diptheriae and stop it from producing toxin. • Bed rest, isolation • If you are going to be around infected people, booster within 5 yrs is required. Diphtheria Guided Reading 1. Summarize the outbreak of diphtheria in Nome, Alaska in 1925. 2. What factors caused the first recorded epidemic of diphtheria? 3. When were routine immunizations for diphtheria introduced? What has happened since then? 4. Why might there be a “reemergence” of diphtheria? 5. Pretend that you are a Red Cross worker in the 1920s. On a half sheet of white paper, create an ad that explains diphtheria and the importance of routine vaccination of children. Jumpstart 3/26/2010 • What is the causative agent of diphtheria? • List signs, symptoms, and treatment for the disease. • How can diphtheria be prevented (name 3 ways). Mycobacterium • The basics: – Non-motile – Non-spore forming – Aerobic rods – Do not Gram stain...do you remember why? • Cell wall is waxy….have to use an “acid-fast” stain Importance of that cell wall in mycobacteria • Because their cell wall is so complex, – They have slow growth – They are resistant to detergents – They are resistant to a lot of antibiotics • The one mycobacterium we are going to talk about is Mycobacterium tuberculosis Mycobacterium tuberculosis • Intracellular pathogen capable of causing lifelong infections. • A lot about this bacterium and how it causes disease is still unknown. M. tuberculosis…what we do know: • Enters the respiratory tract and passes through the alveoli where is phagocytized by macrophages. • Lysosomes are unable to break it down, so it just exists inside of the macrophage (called a phagosome) and now has access to nutrients for replication. • These bacteria can then kill cells and tissues, forming granulomas. (these become dormant and encapsulated and can later break off and spread). Epidemiology • Humans are the only natural reservoir – Primates and other animals can become infected in the laboratory, but not naturally • Spread by close person-to-person contact through inhalation of respiratory droplets • In 2002, it was estimated by the WHO that a third of the world’s population was infected by M. tuberculosis • In the U.S., incidence is lower than in most places… about 15000 cases per year are reported (more than half being foreignborn) Tuberculosis • Can involve any organ, but most common place you see it is in the lungs. • The likelihood that exposure to the pathogen will lead to active disease is only about 10-15 %. • Malaise, coughs, weight loss, night sweats • Sputum will be bloody and purulent • Tissue destruction can occur Diagnosis • Diagnosis is in 3 parts: – Positive Skin test reactivity – Radiographic evidence of pulmonary disease – Laboratory detection of Mycobacteria Treatment • Antibiotic treatment: Streptomycin • Unfortunately, M. tuberculosis is showing resistance • Usually a combination of several antibiotics taken over a long period of time Case Study page 309 • Complete questions 1, 2, 3, and 5 (skip question 4. Jumpstart 3/29 1. What does the microbe M. tuberculosis do to the human body in an active infection? 2. Describe how you would positively diagnose a patient you suspect might have TB? TB Reading 1. What is the causative agent of TB? 2. How is TB transmitted? 3. Describe the course of infection of tuberculosis (be specific) 4. Describe the impact of industrialization on TB. 5. Describe the WHOs strategy for ridding the world of TB.