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
• 
  

37
(No Transcript)
38
(No Transcript)
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
(No Transcript)
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