Coxiella burnetii - PowerPoint PPT Presentation

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Coxiella burnetii

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Title: Coxiella burnetii


1
Coxiella burnetii

By
R.Teja sri
2
Introduction
  • Coxiella burnetti is the causative agent of
    Q-fever
  • Obligate intracellular, gram negative bacterium
  • Distributed globally
  • Found in many species of animals

3
Morphology-
  • obligate intracellular pathogen .
  • gram negative .
  • Pleomorphic .
  • size rods- 0.2 0.4 x 0.4 1.0 mc
  • spheres - 0.3 0.4 mc
  • filterable .
  • better stained with GIMINEZ and other
    rickettsiael stains .

4
C. burnetii
i
en.wkipedia.org
5
Culture
  • Grows well in yolk sac of chick embryos and in
    various cell cultures .

6
Ag structure
  • shows phase variation .
  • phase I ,II .
  • phase I - autoagglutinable
  • more immunogenic
  • activity due to periodate sensitive
    trichloracetic acid-soluble surface carbohydrate
    .
  • Phase II - more suitable for CFT .
  • both phase I ,II elicit good Ab response .

7
Resistance
  • Resistant to physical and chemical agents
  • In pasteurization flash method is effective
  • Can survive in dust and aerosols
  • Inactivated by 2 formaldehyde
  • 5 H2O2
  • 1 Lysol .

8
Contd.
  • Resistant to heat, drying and disinfectants
  • Air samples test positive for 2 weeks
  • Soil samples test positive for 150 days
  • Spore formation

9
PATHOGENESIS
10
History
  • Q stands for Query or Queensland
  • Origin of disease unknown
  • First reported cases were in Queensland,
    Australia

11
  • Differentiating features
  • 1. Having smaller size
  • 2. Resistance to heat and drying
  • 3. Major route of transmission is-
  • inhalation/ingestion

12
Primary Reservoir
Goats
Cattle
Sheep
All eukaryotes can be infected
13
Bacteria is excreted in
of infected animals
14
Release Into Environment-
  • During birthing the organisms are shed in high
    numbers in amniotic fluids and the placenta
  • 109 bacteria per gram of placenta

15
Transmission
  • Most common route is inhalation of aerosols
  • Contaminated dust, manure,
    birthing products
  • Tick bites (rare)
  • Human to human also very rare

gsbs.utmb.edu
16
Contd..
  • Whos at risk?
  • Farmers, veterinarians, researchers, abattoir
    (slaughterhouse) workers etc.
  • People who breed animals
  • Immunocompromised

17
Acute or Chronic Q fever
gsbs.utmb.edu
Bacteria spread through blood
18
Symptoms
  • Acute Q fever
  • Self-limiting, flu-like disease
  • Fever, nausea, headaches, vomiting,
    chest/abdominal pain
  • Pneumonia granulomatous hepatitis

19
  • Chronic Q fever (gt 6 months)
  • Endocarditis meningoencephalitis
  • Pre-existing disease

20
Host interaction
  • Entry via inhalation
  • Alveolar macrophages encounter bacteria
  • C. burnetii phagocytosed

R Heinzen, NIAID
21
Host interaction
  • Replication within phagolysosme
  • Low pH needed for metabolism
  • No cellular damage unless lyses occurs
  • Can invade deeper tissue and cause complications

22
Phagocytosis
  • Binding/entry into macrophages via
  • Integrin Associated Protein (IAP)
  • Leukocyte Response Integrin (LRI)

bacteria
macrophage
23
Binding Entry
24
LAB DIAGNOSISHard to diagnose because
  • Asymptomatic in most cases
  • Looks like other disease (Flu or cold)
  • Serology continues to be best method
  • PCR, ELISA and other methods
  • WEIL FELIX test is negative .

25
Contd..
  • Bio safety level 3 (BSL-3) facility
  • Very infectious (one organism causes infection)
  • Listed by the CDC as a potential bioterrorism
    agent.
  • Isolated in cell cultures or embryonated eggs

26
Treatment
  • Once infected, humans can have life-long immunity
  • Acute Q fever treated with

  • doxycycline,

  • chloramphenicol,

  • erythromycin or

  • fluoroquinolones
  • Chronic Q fever treated with
  • More than one antibiotic
  • tetracycline and cotrimoxazole for 2 years

27
  • Vaccines -
  • prepared from formalin killed whole cells
  • attenuated strains
  • trichloroacetic acid
    extracts

28
Prophylaxis-
  • Pasteurization and sterilization of milk and
    other dairy products
  • Disinfect utensils, machines used in farm areas
    for birthing
  • Regular testing of animals and those who work
    closely with them
  • Protective Personal Equipment

29
  • BARTONELLA

30
INTRODUCTION
  • Family Bartonellaceae contain two genera
  • Bartonella
  • Grahamella
  • Grahamella does not infect humans

31
  • Bartonella contain 3 species

  • B.bacilliformis
  • B.quintana
  • B.henselae

32
BARTONELLA BACILLEFORMIS
  • Carrions disease
  • Causes OROYA fever

33
  • MORPHOLOGY
  • Gram negative
  • Pleomorphic
  • strict aerobe
  • motile, small bacillu0.3-0.5x0.2-0.5mc
  • found inside erytrocyte infected persons
  • Opt. temp 25-28 c

34
  • CULTURE
  • Grow in semisolid nutrient agar with
  • 10 rabbit serum
  • 0.5Hb
  • Growth is slow takes about 10 days

35
PATHOGENISIS-
  • Causes OROYA fever
  • Transmitted by SAND flies
  • INCUBATION PERIOD
  • 3 weeks to 3 months

36
CLINICAL FEATURES-
  • Fever
  • Headache
  • Chills
  • Severe anemia
  • Several weeks after recovery pt. develop
  • nodular lesions on the body
  • Secondarily infect produce ulcers
  • VERUGA PERUANA


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39
Lab diagnosis-
  • Demonstrated in blood smear by GIEMSA stain
  • Seen in cytoplasm and adhere to cell surface
  • Grown on NA agar contain rabbit serum,
  • Hb
  • Guinea pig inoculation leads to
  • VERUGA PERUANA

40
TRETMENT-
  • Susceptible to penicillin
  • streptomycin
  • Tetracycline
  • Chloramphenicol

41
PREVENTION
  • Insecticides such as DDT should be used
  • to eliminate sand flies

42
BARTONELLA QUINTANA
43
  • MORPHOLOGY-
  • small gram negative bacillus
  • 0.3-0.5 mc to1.0-1.7 mc
  • Does not posses flagella
  • show twitching movments by fimbriae

44
  • CULTURE-
  • Grows on rabbit /sheep blood agar
  • opt. temp -35 c in 5 CO2
  • colonies appear after 14 days primary

  • inoculation

45
PATHOGENESIS-
  • Formerly called Rochalimaea quintana
  • Causes TRENCH fever
  • also called FIVE DAY fever

46
  • Transmission by body louse
  • vertical transmission does not occur in lice
  • Lice after acquiring infection remain infectious
    through out life

47
CLINICAL FEATURES-
  • Mild symptoms
  • leads to chronic rickttesiaemia
  • Relapse have been observed even after 20
    years primary disease

48
Lab diagnosis-
  • Detected in the gut of infected lice
  • Isolate from pt. blood by cultur
    sheep blood agar
  • Weil-felix test negative
  • PCR- detect organism in tissues

49
  • BARTONELLA HENSELAE

50
  • MORPHOLOGY-
  • Gram negative
  • Slightly curved
  • Show twitching movments

51
  • CULTURE-
  • Grows on chocolate agar
  • columbia agar with 5sheep
    blood
  • tryptic-soy agar
  • opt.temp-35-37 c in 5 CO2


52
  • COLONY MORPHOLOGY-
  • white, dry, cauliflower like and
  • embedded in the agar

53
PATHOGENESIS-
  • Causes CAT-SCRATCH disease
  • Occur by contact with scratch / bite of
  • an
    infected cat

54
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55
CLINICAL FEATURES-
  • Regional lymphadenopathy
  • Fever
  • Endocarditis
  • In AIDS pt. leads to
  • bacillary angiomatosis


56
Lab diagnosis-
  • lymph node biopsy stained with
  • WARTIN-STARRY SILVER IMPREGNATION
    clusters of bacillus
  • Grow on chocolate agar/ columbia agar

57
TREATMENT-
  • Self limiting
  • No specific treatment required

58
THANK YOU
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