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BACTERIOLOGY - 2 > 29 – Coxiella, Borrelia and Bartonella > Flashcards

29 – Coxiella, Borrelia and Bartonella Flashcards

1
Q

Coxiella microbiological characteristics

A
  • Obligate intracellular parasites
  • Doesn’t stain using Gram-stain
  • Worldwide distribution EXCEPT New Zealand
  • Not culturable using standard techniques
  • Biocontainment level 3
  • *requires specialized conditions in vitro (inoculation of embryonated eggs)
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2
Q

Borrelia microbiological characteristics

A
  • Large spirochetes
  • Small linear chromosome
  • Biocontainment level 2
  • On both continents (Europe and USA) for over 100 years
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3
Q

Bartonella microbiological characteristics

A
  • Small Gram-negative coccobacilli
  • Biocontainment level 2
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4
Q

Coxiella natural host or habitat

A
  • Obligate parasite: host associated
  • Infects wide variety of species
  • Shed in milk, urine, feces, amniotic fluids at parturition
  • Can survive in environment up to 150 days
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5
Q

Borrelia natural host or habitat

A
  • Obligate parasites: host associated
  • Associated with reservoir hosts and arthropod vectors
    o Highly adapted to their specific arthropod vector
  • Transmission via tick bites=most likely by nymphs
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6
Q

Bartonella natural host or habitat

A
  • Facultative intracellular parasite
    o Erythrocyte and endothelial cell pathogens
  • Have principle animal reservoir
  • Spread through vectors
  • *Generally mild disease in reservoir host, pathology when incidental host infected
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7
Q

Coxiella burnetiid virulence factors

A
  • Little known
  • LPS: phase variation (antigenic variation that masques it from the immune system)
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8
Q

Borrelia burgdorferi virulence factors

A
  • Outer surface proteins: attachment in tick host, allows organism to persist in gut between meals
  • Surface lipoproteins: stimulate inflammation
  • Porin-like proteins: adhesion
  • Flagella; motility
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9
Q

Bartonella spp. virulence factors

A
  • Type 4 secretion systems
  • Bartonella effector proteins (BEPS): secreted into host cells and modulate physiology in favour of bacteria
    o Induction of phagocytosis by host cells
    o Prevention of apoptosis
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10
Q

Coxiella burnetii is a generalist parasite of eukaryotic cells and is found in

A
  • Arthropods
  • Reptiles
  • Birds
  • Mammals
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11
Q

What is Coxiella burnetii the agent of?

A
  • Q fever
    o Short ‘query’ fever
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12
Q

When Coxiella burnetii is present, there are high concentrations in placenta and fetal tissues

A
  • Animals frequently eat these after birth
  • Passes through GIT
  • Excreted in feces
  • Can be aerosolized as dust
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13
Q

Aerosol transmission of Coxiella burnetii is very important

A
  • Very low infectious dose
    1. Enters lungs
    1. Replicates in pulmonary macrophages
    1. Disseminates throughout the body
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14
Q

Interesting life cycle of Coxiella burnetti (?)

A
  1. Small cell variant ‘eaten’ by macrophage
  2. Vacuoles acidifies, stimulating development of large cell variants
  3. By 2 days parasitophorous vacuole contains lots of replicated large CV
  4. By day 6, small CV reappear
  5. By 12 days, host cell lyses and small CV released
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15
Q

Coxiella burnetii in domestic animals are mild or non-apparent: clinical sings relate to sites of localization (ruminants)

A
  • Reproductive and mammary tract: abortions and shedding in milk
    o Sporadic abortions: sheep, goats, cattle, cats
    o Placentitis
    o fetal pathology: many
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16
Q

Fetal pathology with Coxiella burnetii (ruminants)

A
  • hepatitis
  • myocarditis
  • interstitial pneumonia
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17
Q

How do you control Coxiella burnetii? (ruminants)

A
  • Segregation of parturient ruminants
  • Careful disposal of tissues
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18
Q

Vaccination for Coxiella burnetii (ruminants)

A
  • Inactivated vaccines available
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19
Q

Coxiella burnetii in dogs and cats

A
  • Most common sublclinical
  • Affected dogs=SPLENOMEGALY most common
  • Cats=abortions
    o Has been associated with human outbreaks
    o See fever, lethargy, anorexia 2 days following experimental infection
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20
Q

What does Coxiella burnetii in humans cause?

A
  • Q-fever
  • Incubation period: 3 weeks
  • 50% infected=asymptomatic
  • Acute febrile illness (flu like)
  • Case fatality <2% of hospitalized patients
  • *NOT notifiable in Canada
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21
Q

What are some serious complications that can occur with Coxiella burnetii in humans?

A
  • Pneumonia
  • Granulomatous hepatitis
  • Myocarditis
  • Abortion
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22
Q

There was large, multiyear outbreaks of Coxiella burnetii in humans in the Netherlands

A
  • 2005: dairy goats
  • 2007: human infections spiking
    o Living downwind with important
  • Clusters of infections associated with psychiatric patients who had contact with lambs as part of therapy
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23
Q

How was Coxiella burnetii in humans in the Netherlands brought under control?

A
  • Vaccination
  • Manure management
    o Removal
    o Pasteurization
    o NOT spreading on fields
  • Bulk tank milk surveillance
  • Massive culling
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24
Q

Coxiella burnetii in humans is often acquired as occupational disease

A
  • Farmers
  • Abattoir workers
  • Vets
  • Lab workers
  • *FOODBORNE: unpasteurized products
  • *rarely associated with cats
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25
Q

How do you treat Coxiella burnetii in humans?

A
  • Doxycycline
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26
Q

How do you prevent Coxiella burnetii in humans?

A
  • Vaccine for high risk workers
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27
Q

Who are the only competent vectors of Borrelia burgdorferi, Lyme Disease?

A
  • TICKS: North America
    o I. scapularis
    o I. pacificus
  • *ticks infected by biting reservoir host
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28
Q

Transmission of Borrelia burgdorferi, Lyme disease: ‘timeline’

A
  • Not instantaneous
    o Can take up to 24hrs for transmission to occur
  • Co-infection with other vector borne diseases is common
29
Q

Where Is LYME mostly in North America?

A
  • In the east
  • Technically broad rang
  • I. pacificus likes to feed on lizards=Borrelia don’t amplify as efficiently
30
Q

What is the most common sign of Borrelia burgdorferi in dogs?

A
  • NOTHING
    o Not usually cause of disease
31
Q

What may be seen in affected dogs with Borrelia burgdorferi?

A
  • Intermittent recurrent lameness: polyarthritis is best documented
  • Fever
  • Anorexia
  • Lymphadenopathy
  • Swollen joints
  • *fatal renal failure: immune complex deposition in kidney
32
Q

Clinical disease of Borrelia burgdorferi does NOT often manifest in cats

A
  • Seroconversion occurs, but cats seem somewhat RESISTANT
  • If infected=similar signs as dogs
33
Q

What is the treatment of Borrelia burgdorferi in dogs and cats?

A
  • Early treatment is important
  • Doxycycline, amoxicillin, azithromycin recommended
34
Q

How do you control Borrelia burgdorferi in dogs and cats?

A
  • Acaricides
  • Removing ticks promptly
  • Vaccination
    o Variety of product available
35
Q

Borrelia burgdorferi, Lyme disease in humans

A
  • Does cause serious illness
  • Symptoms 3-30 days post infection
  • Chronic signs occurring days to months later
36
Q

Symptoms of Borrelia burgdorferi, Lyme disease in humans 3-30 days post infection

A
  • Fever, chills, swollen lymph nodes
  • Characteristic erythema migrans rash (TARGET)
37
Q

Chronic signs of Borrelia burgdorferi, Lyme disease in huamns

A
  • Severe headache
  • Arthritis
  • Facial palsy
  • Pain
  • Heart palpitations
  • Dizziness
  • Inflammation of brain
  • Nerve pain
38
Q

Canada distribution: Lyme disease

A
  • Parts of BC, MB, S. ON, QB, Nova Scotia
  • *locally acquired disease not reported in SK or AB
  • Over time: appears to be increase
  • **highest frequency in ON (related to size of population
  • **highest incidence in Nova Scotia
39
Q

Clinical significance of B. afzelli

A
  • Cause of Lyme in Europe
40
Q

Clinical significance of B. mayoni

A
  • Novel one causing Lyme disease
41
Q

Clinical significance of B. lonstari

A
  • Vectored by Amblyoma americanum
  • Associated with southern tick rash illness in people, birds and deer
42
Q

Clinical significance of B. theileri

A
  • Vectored by Rhipicephalus spp.
  • Cause of bovine borreliosis (+sheep and goats)
43
Q

Bartonella henselase in cats

A
  • Clinical signs rare
  • 30-40% of clinically healthy shelter cats are carriers
  • Lack of evidence for clearance of Bartonella from treated cats
44
Q

Bartonella henselase in EXPERIMENTALLY infected cats, signs:

A
  • Transient fever
  • Papules/abscesses at site of inoculation
  • Lymphadenopathy
  • Myalgia
45
Q

Bartonella spp. in dogs

A
  • Many implicated
  • Endocarditis: B. vinsonii + more
  • Hepatitis: B. henselae
  • *flea and tick prevention is important
  • If clinical signs: treat with LONG DURATION ANTIMICROBIALS
    o Enrofloxacin
    o Doxycycline
    o Amoxicillin
    o Rifampin
46
Q

Bartonella henselae, cat scratch disease (CSD) in humans

A
  • Important zoonoses: people infected following cat scratches
  • Symptoms develop 1-3 weeks post exposure
  • Can see bacillary angiomatosis
    o Angiogenesis and lesions on skin
47
Q

What are the symptoms 1-3 weeks post exposure of Bartonella henselae, cat scratch disease (CSD) in humans

A
  • Fever
  • Papule or pustule at site of scratch
  • Enlarged, painful lymph nodes
48
Q

What does Bartonella quintana cause in humans?

A
  • Trench fever: name from soldiers in WWI
    o Bacteremia
    o Localized tissue infections
    o Endocarditis
49
Q

Where is Bartonella quintana in humans reemerging?

A
  • People affected by extreme poverty in developing countries AND homeless (developed countries)
50
Q

Bartonella quintana in humans

A
  • Vectored by human body louse
  • Humans only confirmed reservoir
  • Also reported in cats
51
Q

What does Bartonella baciliformis cause in humans?

A
  • Carrion’s disease
    o Hemolytic anemia
    o Localized tissue infection
    o Angiomatosis
  • *biphastic disease
52
Q

Carrion’s disease from Bartonella baciliformis in humans is a biphasic disease

A
  • First phase: erythrocyte infection, anemia and transient immunosuppression
  • Second phase: nodular dermal eruptions occur as a result of vascular proliferation
53
Q

What is Bartonella baciliformis transmitted by?

A
  • Sandflies in Andes Mountains (W. South America)
54
Q

Coxiella: sample collection and handling

A
  • Blood
  • Serum
  • Placental tissues
55
Q

Borrelia: sample collection and handling

A
  • Blood
  • Biopsies of cutaneous lesions
56
Q

Bartonella: sample collection and handling

A
  • Blood
  • Tissues collected on necropsy
    o Vegetations in cases of endocarditis
57
Q

Coxiella burnetii: Lab ID

A
  • Culture only done in specialized laboratories
  • PCR: detect organism in early stage
  • Immunohistochemistry of biopsy specimens
  • Serology: acute and convalescent
    o Cross reactions with many species
58
Q

Bartonella spp: Lab ID

A
  • can be cultured
  • PCR
  • Serology: most common
    o Beware of cross-reactive Abs
59
Q

Borrelia: Lab ID

A
  • Serology
  • Antigen capture ELISA
  • Fluorescent Ab
  • PCR
60
Q

Borrelia: Lab ID with serology

A
  • Interpretation difficult, many seropositive are not clinically affected
  • Validation challenging b/c of lack of culture positive GOLD standard cases
61
Q

Coxiella burnetti: zoonotic/interspecies transmission

A
  • Capable of causing lab acquired infections
    o Fatal infections are reported
  • Potential BIOLOGICAL WEAPONE
    o Aerosolized organism with aim of debilitating large population
62
Q

Borrelia burgdorferi: zoonotic/interspecies transmission

A
  • NOT acquired directly from infected animals
    o All about vectors
63
Q

Bartonella spp: zoonotic/interspecies transmission

A
  • avoid cat scratches/bites (protective behaviours #1!)
  • flea and tick control important
  • testing and decolonization therapy NOT recommended for healthy cats
64
Q

Treatment options

A
  • SUCEPTIBILITY TESTING IMPOSSIBLE
65
Q

C. burnetii treatment

A
  • Doxycycline
66
Q

Borrelia treatment

A
  • Doxycycline, beta-lactams
  • Depends on species
67
Q

Baronella spp. treatment for animals

A
  • Enrofloxavin
  • Doxycycline
68
Q

Baronella spp. treatment for humans

A
  • Azithromycin
  • Doxycycline
  • Aminoglycosides

BACTERIOLOGY - 2 (21 decks)

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