1 miscellaneous bacterial agents of disease. 2 spirochetes gram negative human pathogens treponema...
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Miscellaneous Bacterial Agents of Disease
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Spirochetes
Gram negative human pathogens
• Treponema
• Leptospira
• Borrella
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Treponema
• Thin, regular, coiled cells
• Live in the oral cavity, intestinal tract, & perigenital regions of humans & animals
• Pathogenic species are strict parasites
• Require live cells for cultivation
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Treponema pallidum• Humans are the natural host• Extremely fastidious & sensitive• Causes syphilis• Infectious dose is 57 organisms• Primary syphilis – chancre appears• Secondary syphilis – skin lesions; infectious• Tertiary syphilis – neural + cardiovascular
symptoms• Treatment: penicillin G
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Borrella
• Large spirochetes, 3-10 coils
• Borrelioses transmitted by arthropod vector
• B. hermsii - relapsing fever
• B. burgdorferi - Lyme disease
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B. hermsii - Relapsing Fever• Mammalian reservoirs –squirrels,
chipmunks, wild rodents• Tick-borne• After 2-15-day incubation, patients have high
fever, shaking, chills, headache, & fatigue• Progression to nausea, vomiting, muscle
aches, abdominal pain; extensive damage to liver, spleen, heart, kidneys, & cranial nerves
• Parasite changes & immune system tries to control it- recurrent relapses
• Treat with tetracycline
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B. burgdorferi - Lyme disease
• Transmitted by Ixodes ticks• Complex 2-year cycle involving mice & deer• Nonfatal, slowly progressive syndrome that mimics
neuromuscular & rheumatoid conditions• 70% get bull’s eye rash• Fever, headache, stiff neck, & dizziness• If untreated can progress to cardiac & neurological
symptoms, polyarthritis• Tetracycline and amoxicillin are effective• Vaccine for dogs• Use insect repellant containing DEET or equivalent
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Vibrio cholera
• Comma-shaped, possess unique O & H antigens• One of the top 7 causes of morbidity and mortality• Ingested with food or water• Infectious dose 108 cells• Infects surface of small intestine, non-invasive• Cholera toxin causes electrolyte & water loss
through secretory diarrhea• Resulting dehydration leads to muscle,
circulatory, & neurological symptoms• Treatment: oral rehydration, tetracycline
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Vibrio cholera
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Alterations in Intestinal Function Caused by Cholera Toxin
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Helicobacter pylori• Curved cells discovered in 1979 in
stomach biopsy specimens • Causes 90% of stomach & duodenal
ulcers• People with type O blood have a 1.5-2X
higher rate of ulcers• Produces large amounts of urease• Discoverers Robin Warren and Barry
Marshall received Nobel Prize
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Rickettsia• Obligate intracellular parasites• Gram-negative cell wall• Among the smallest bacteria• Non-motile pleomorphic rods or coccobacilli• Ticks, fleas & lice are involved in their life
cycle • Bacteria enter vascular endothelial cells &
cause necrosis of the lining – vasculitis, vascular leakage & thrombosis
• Treat with tetracycline & chloramphenicol
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4 Types of Rickettsioses1. Epidemic typhus – R. prowazekii carried by lice;
starts with a high fever, chills, headache, rash; Brill-Zinsser is a chronic, recurrent form
2. Endemic typhus – R. typhi, harbored by mice & rats; occurs sporadically in areas of high flea infestation; milder symptoms
3. Rocky Mountain spotted fever – R. rickettsii zoonosis carried by dog & wood ticks; most cases on eastern seaboard; distinct spotted rash; may damage heart & CNS
4. Ehrlichia genus contains 2 species of rickettsias; tickborne bacteria cause human monocytic & granulocytic ehrlichiosis
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Chlamydia
• Obligate intracellular parasites• Small, gram-negative cell wall• Alternate between 2 stages– elementary body – small metabolically
inactive, extracellular, infectious form– reticulate body – grows within host cell
vacuoles
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Chlamydia
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Chlamydia trachomatisTrachoma – attacks the mucous membranes of the eyes,
genitourinary tract & lungs– ocular trachoma – severe infection, deforms eyelid
& cornea, may cause blindness– inclusion conjunctivitis – occurs as babies pass
through birth canal; prevented by prophylaxis– STI – urethritis, cervicitis, salpingitis (PID),
infertility, scarring– Treat with tetracyclines
• Lymphogranuloma venereum – disfiguring disease of the external genitalia & pelvic lymphatics
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Mycoplasma• Naturally lack cell walls, highly pleomorphic• Require special lipids from host membranes• Treat with tetracycline, erthyromycin• M. pneumoniae – primary atypical
pneumonia; pathogen slowly spreads over interior respiratory surfaces, causing fever, chest pain & sore throat
• M. hominis & Ureplasma urealyticum – weak sexually transmitted pathogens
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Bacteria in Dental Disease• Oral cavity is a complex, dynamic
ecosystem, containing 400 species • Dental caries – slow progressive
infection of irregular areas of enamel surface
1. Begins with colonization by slime-forming species of Streptococcus & cross adherence with Actinomyces
2. Thick, adherent material forms (plaque) that harbors masses of bacteria which produce acid that dissolves enamel
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3. If plaque is allowed to stay, secondary invaders appear – Lactobacillus, Bacteroides, Fusobacterium, Porphyromonas, Treponema
4. Effect of acid on enamel can lead to eventual exposure of tooth pulp
Dental Caries - Continued
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Peridontal Disease
• Soft tissue disease• Occurs when plaque becomes calcified
into calculus above and below the gingiva• Gingiva is irritated, causing inflammation
– gingivitis • Pockets between tooth & gingiva are
invaded by bacteria (spirochetes & gram-negative bacilli)
• Tooth socket may be involved (peridontitis)
• Tooth may be lost
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Plaque and Calculus