Bacillus Anthracis Flashcards

1
Q

Bacillus Anthracis

Overview

A
  • G+
  • Rod
  • Aerobic & Facultative anaerobic
  • Non-motile
  • Form endospores
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2
Q

B.anthracis
Encounter

A
  • Main encounter is through Animal products contaminated w/ endospores.
  • Soil bacteriumm
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3
Q

B.anthracis
Entry

A
  • Inoculation into break in skin
  • Inhalation
  • Ingestion (rare)
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4
Q

B.anthracis
Spread

A
  • Point sources
  • NO person to person spread
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5
Q

B.anthracis
Damage

A
  • Mediated by toxin
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6
Q

B.anthracis
Diagnosis

A
  • Gram stain
  • Colony morphology of clinical specimen culture
  • Capsule presence
  • Serological tests
  • PCR
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7
Q

B.anthracis
Treatment and Prevention

A
  • Combination therapy with Ciprofloxacin or Doxycyclin and a second antibiotic
  • Prevention via vaccination of Livestock
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8
Q

Endospore

A
  • Dormant, non-reproductive structure, allows bacterial survival in harsh environmental conditions.
  • 1 spore/cell
  • Highly resistant to temperature, chemical disinfectants, dessication, radiation, lysozyme.
  • Protoplast carries the material for future vegetative cell
  • Cortex provides heat and radiation resistance
  • Spore wall provides protection from chemicals & enzymes
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9
Q

B.anthracis
Pathogenesis

A
  • The ID50 of B. anthracis not known.
  • Rely on primate data
  • LD50 determined to be about 8,000-10,000 spores or .08-.5 micrograms
  • Inhalation of about 1,000 spores (.01g) can cause inhalation anthrax
  • 100,000 times deadlier than the deadliest chemical warfare agent
  • If treatment begins 48 hrs after symptoms, mortality still ~95%
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10
Q

Virulence Factors (Strutural)
Capsule

A
  • Glycocalyx
  • Sticky, gelatinous polymer external to cell wall
  • Made up of poly D-glutamic acid
  • Non-toxic on its own
  • Only encapsulated B. anthracis virulent
  • Prevents opsonization and phagocytosis &
  • Inhibits complement activation
  • Genes required for capsule synthesis located on pX02, a 95 kbp plasmid.
  • capBCADE operon encodes capsule biosynthesis genes
  • regulated by gene product of acpA and acpB
  • capsule production is abolished ΔacpA ΔacpB double mutant.
    • regulation
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11
Q

Virulence Factor
Toxins

A
  • 3 Separate toxins:
  • Protective antigen (PA)
  • Edema factor (EF)
  • Lethal factor (LF)
  • Make up 50% of proteins in the organism
  • Individually all are non toxic.
  • Work by AB model:
  • Protective Antigen forms a pore. (B)
  • Lethal Factor and Edema Factor have toxin activity
  • PA+LF —> lethal activity
  • EF+PA —> edema
  • EF+LF —> inactive
  • PA+LF+EF —> edema & necrosis; lethal
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12
Q

Virulence Factor:
Toxin - Protective Antigen (PA, PA83, 83kDa, pag)

A
  • Binds to receptor: either tumor endothelium marker-8 (TEM8) or capillary morphogenesis protein 2 (CMG2)
  • AKA: Anthrax Receptor 1 and 2 .
  • Cell surface furin cleaves PA83 to PA63 and PA20
  • PA63 can multimerize into heptamers.
  • Multimers can interact w/ either EF of LF.
  • Endocytosis brings PA heptamer complexed w/ EF or LF into the cell.
  • The low pH of the endosome causes a confirmation change in PA, allowing pore formation.
  • EF or LF enter the cytoplasm
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13
Q

Virulence Fator:
Toxin - Edema Factor (ED, 89 kDa, cya)

A
  • EF is a Ca2+ and calmodulin dependent adenylate cyclase
  • Increases the level of cAMP in the cell up to 1000x.
  • This upset osmotic balance of the cell causing rapid efflux of electrolytes and water.
  • Efflux of fluid leads to edema (swelling) of affected tissues and tissue destruction.
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14
Q

Virulence Factor:
Toxin - Lethal Factor (LF, 87 kDa, lef gene)

A
  • Affects only macrophages
  • LF is a Zn2+-dependent metalloprotease that snips off the N-terminus of mitogen-activated protein kinase kinases (MAPKK).
  • Interferes w? cell signaling pathways, preventing normal macrophage function, and eventually leads to apoptosis of the macrophage.
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15
Q

Toxin Regulation

A
  • all three on plasmid px01
  • large plasmid
  • all three genes + regulated by AtxA
  • AtxA is located on same plasmid
  • ΔatxA mutants do not express any of the three toxins
  • also + regluates acpA&B (capsule formation)
  • transmible plasmid
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16
Q

Summary of Pathogenosis

A
  • toxemia: presence of toxin in blood
  • cut & inh result can result in spread of bacteria via lymph system
  • death —> septic shock or pulmonary edema
17
Q

Cutaneous Anthrax

A
  • 95% infections occur when bacteria enters cut via contam. animal products
  • or by insects that fed on infected hosts
  • spore germination —> toxin production –> red bump—-> vesicle —–> painless black ulcer (1-3 cm diameter)
  • most common form
  • incubation period: usually immediate (up to 1 day)
  • arms, face, hands
  • fatality w/out TX: 20%
    w/ TX: 1%
18
Q

Inhalation Anthrax

A
  • Spores need to be less than 5 microns to reach the alveolus.
  • Macrophages phagocytose and destroy some of the spores.
  • Surviving spores are transported to lymph nodes.
  • Germination of spores leads to vegetative cell growth and toxemia.
  • At least 2,500 spores have to be inhaled to cause an infection.
  • Disease immediately follows germination.
  • Bacterial toxins released during replication result in mediastinal widening due to edema in the lymph nodes.
19
Q

Inhalation Anthrax

A
  • Initia S/Sx (non-specific): fever, non-productive cough, myalgia, malaise.
  • Death results 2-3 days after the onset of symptoms.
  • Natural infection is extremely rare
  • Incubation period:
  • 1–7 days, Possibly ranging up to 42 days (depending on how many spores were inhaled)
  • Fatality: w/out TX 97%
  • w/ TX 75%
20
Q

Inhalation Anthrax
DX

A
  • Culture of lesion, blood, or g-stain
  • CT
  • Chest x-ray
21
Q

Inhalation Anthrax
TX

A
  • Before 2001, 1st line was penicillin G
  • Stopped for fear of selecting genetically resistant strains
  • 60 day course of antibiotics —> Cipro or Doxycycline
  • For inhalational, need another antimicrobial agent
  • Clindamycin, rifampin, or chloramphenicol