16 - Airborne bacterial diseases Flashcards
Upper respiratory tract
- Anaerobes outnumber aerobes 10:1
- May include pathogens in low numbers
- Contains normal flora
How does normal flora exclude pathogens
- Occupy the same site
- Secreting bactericidal chemicals that kill pathogens
Lower respiratory tract
Maybe sterile (trachea and lungs)
Physical defences of the respiratory tract
- nasal hair
- mucous layer
- ciliary action
Chemical defences of the respiratory tract
Lysozyme (saliva, tears)
Immunological defences of the respiratory tract
- Alveolar macrophages (lungs)
- Secretory IgA (saliva, tears)
Mechanical defences of the respiratory tract
Cough, sneeze
Pathogen that causes Diphtheria
Corynebacterium diphtheriae
Pathogen that causes Legionnaires’ disease
Legionella pneumophila
Pathogen that causes Streptococcal diseases
Streptococcus pyogenes
Pathogen that causes Pertussis (whooping cough)
Bordetella pertussis
Pathogen that causes Tuberculosis
Mycobacterium tuberculosis
Pathogens that cause Meningitis
- Neisseria meningitidis
- Haemophilus influenzae
Pathogens that cause Bacterial pneumonias
- Streptococcus pneumoniae
- Haemophilus influenzae
- Legionella sp
Clinical symptoms of Diphtheria
- Pharyngitis (sore throat), fever
- Swelling of neck, formation of membrane which
occludes the airway and results in asphyxiation - Diphtheria toxin may cause cardiac arrest
Diphtheria transmission
Affects unvaccinated people living in crowded conditions via respiratory secretions
Diphtheria treatment and control
- Vaccine containing diphtheria toxoid (inactivated toxin)
- Antibiotics such as penicillin, erythromycin
Diagnostic characteristics of diphtheria
- Gram-positive rod containing polyphosphate granules
- Snapping cell division results in cells in palisades (or “Chinese letters”)
- Fastidious, difficult to grow in the lab
Virulence determinants of diphtheria
Diphtheria toxin DT
Characteristics of diphtheria toxin
- Secreted as a polypeptide, chains A and B linked by
a disulphide bond - B contains receptor domain, binds to host cell receptor
- Toxin taken into cell into endocytic vacuole
- Vacuole acidifies, B cell transmembrane domain
allows A chain to enter cytosol - A (active enzyme) blocks protein synthesis in host
cell cytosol - Causes death of host cell
Transmission of Legionnaires’ disease (legionellosis)
- Found in soil, water, AC systems, showers, spas
- Live within amoebae, protozoa, and macrophages
- Optimum temp 35ºC
- Spread via aerosols from environment
Diagnostic characteristics of Legionnaires’ disease (legionellosis)
Gram negative rods
Clinical symptoms of Legionnaires’ disease (legionellosis)
- High fever, cough, headache, bronchopneumonia
- Death in 5 to 30% of cases
Diagnosis of Legionnaires’ disease (legionellosis)
- Doesn’t grow on blood agar, special media required
- Serology can be used to detect a rise in antibodies on blood, or legionella antigens in urine
Treatment and control of Legionnaires’ disease (legionellosis)
- Antibiotics such as macrolides
- Prevention depends on identifying and eliminating environmental source
Pathogenesis of Legionnaires’ disease (legionellosis)
- Bacteria reside inside alveolar macrophages
- Tissue destruction via a protease toxin
Diseases caused by Streptococcus pyogenes
- Strep throat
- Scarlet fever
Clinical symptoms of Streptococcus pyogenes
- Pharyngitis, tonsillitis, otitis
- Fever
Which group is Streptococcus pyogenes
Group A streptococci
Streptococcus pyogenes sequelae (poststreptococcal diseases)
- Rheumatoid arthritis
- Rheumatic fever (damage to heart valves)
- Gangrene
- Glomerulonephritis (kidney damage)
Treatment of Streptococcus pyogenes
Antibiotics (penicillin)
Diagnostic characteristics of Streptococcus pyogenes
- Gram-positive coccus (chains or diplococci)
- Beta-haemolytic on blood agar
- Antigen detection from throat swabs
Virulence factors of Streptococcus pyogenes
- Erythrogenic toxin genes carried in a phage genome
- Polysaccharide capsule and M protein inhibit phagocytosis
- M protein and other proteins mediate bacterial attachment to host cells
Exotoxins of Streptococcus pyogenes
- streptolysin (a haemolysin)
- streptokinase (dissolves blood clots)
Clinical symptoms of Pertussis (whooping cough)
- Similar to common cold
- Mild cough developing into severe whoop/gasp
- Death due to apnea (breathing interruption)
- Mainly a childhood disease
Transmission of Pertussis
- Respiratory droplets
- Infections peak in Winter
Treatment and control of Pertussis
- Vaccine: acellular subunit vaccines (components of pathogen e.g. pertussis
toxin), combined with diphtheria and tetanus - Antibiotics
Diagnosis of Pertussis
- Gram negative coccobacillus
- Fastidious, difficult to culture
- Diagnosis by culture, and PCR for gene encoding
pertactin (an outer membrane protein)
Virulence determinants of Pertussis
- Filamentous haemagglutinin (FHA) adhesin mediates
adhesion to respiratory epithelium - Cytotoxin stops cilia from beating
- Pertussis toxin
Effects of Pertussis toxin
- Leads to increase in cyclic AMP (cAMP) which impairs function of immune effector cells
- Contributes to mucus production
- In conjunction with other toxins causes whooping type cough
Clinical symptoms of TB
- Weight loss, coughing up bloody sputum
- Fatigue, fever, death
Treatment and control of TB
- BCG vaccine (live attenuated Mycobacterium bovis)
- Antibiotics (limited due to multidrug resistant TB)
Epidemiology of TB
- One of the top microbial killers of people world-wide
- 1/3 of world’s population infected
- In developed countries, most common in homeless, prisons, alcoholics, elderly
Diagnostic characteristics of TB
- Gram positive rod, cell wall has high lipid content
(mycolic acid) - Extremely slow growth (6-10 weeks on agar plates)
- detection of mycobacterium antigens and mycolic acid directly from sputum
Virulence determinants of TB
- Cell wall lipids are toxic to host cells and create hydrophobic barrier, protective against host defences
- Survives within macrophages
Meningitis
Inflammation of brain or spinal cord meninges
Clinical symptoms of Meningitis
- Initial respiratory illness
- Stiff neck
- Onset of coma
- Sequelae: blindness, deafness, gangrene
- Meningococcemia (systemic infection)
Treatment and control of Meningitis
- Antibiotics: immediate treatment is essential
- Vaccines: effective against multiple serotypes
Diagnostic characteristics of Meningitis
Gram negative diplococci
Transmission of Meningitis
- Respiratory secretions from carriers
- 5-15% humans carry meningococcus in nasopharynx
- Close contact, prisons, student residential halls, bars
- Young adults susceptible, as well as children and aged
Diagnosis of Meningitis
- Culture organism from cerebral spinal fluid (CSF),
blood or throat - PCR, serology
Virulence factors of Meningitis
- Attachment and invasion of epithelial cells of the nasopharynx: Type IV pili are required
- Establishment of bacteraemia in the bloodstream: capsule protects against
phagocytosis - Crossing the meninges: Type IV pili are required
Bacterial pneumonias
Lung inflammation, cough, chest pain, fever, difficulty breathing
Streptococcus pneumoniae
- Gram positive diplococcus
- Main cause of bacterial pneumonia and a leading cause of infectious disease deaths in developed countries
- Alpha-haemolytic on blood agar
Haemophilus influenzae
- Gram negative rods/coccobacilli
- Also causes meningitis
- Controlled by Hib vaccine