L32 Chlamydia, Mycoplasma, Legionella Flashcards
What are the major shared features of Chlamydia, Mycoplasma, and Legionella?
- Do not Gram stain well
- Difficult to culture
- Frequently cause respiratory tract infection (upper respiratory tract, atypical community-acquired pneumonia)
Chlamydia, Mycoplasma, and Legionella do not stain well with Gram stain. Why?
Chlamydia and Legionella are intracellular bacteria. Mycoplasma has no cell wall.
Bacteria in the family Chlamydiaceae are ___ bacteria with a unique life cycle. Why do they need a host?
Obligate intracellular; they need the host cell for energy, as they do not produce ATP.
How are bacteria in the family Chalmydiaceae cultured?
Only within live cells, which is difficult
Describe the life cycle of Chlamydiaceae.
- Elementary bodies (small, infectious, non-replicative) attach to a specific host cell receptor.
- The elementary bodies are endocytosed into a phagosome.
- Within the cell, elementary bodies reorganize into large reticulate bodies (non-infections, replicative) within the phagosome.
- Reticulate bodies multiply via binary fission within the host cell. The phagosome enlarges into an inclusion.
- The reticulate bodies condense back into elementary bodies, which lyse the cell and are released. The cycle restarts
What is the difference between elementary bodies and reticulate bodies?
- Elementary body: infectious, non-replicative
2. Reticulate: non-infectious, replicative
Describe the structure of bacteria in the Chlamydiaceae family.
- Rigid cell membrane without peptidoglycan but high lipid content (confers rigidity)
- Inclusion bodies stain purple/blue with Giemsa
- Cell wall contains PBPs, but penicillin is not effective
What are the 3 clinically relevant species of Chlamydiaceae?
- C. trachomatis
- Chalmydophila psittaci
- Chlamydophila pneumoniae
Describe the structure of Mycoplasma.
- Smallest free living bacteria
- No cell wall; has single triple layered cell membrane (sterols)
- Requires cholesterol for growht
- Beta-lactams are ineffective
- Culture is difficult; use Eaton agar; fried egg appearance
Describe the pathogenesis of Mycoplasma in the respiratory tract.
Attach to cilia of the bronchial epithelium and stimulate a huge inflammatory response (cytokine storm)
Describe the pathogenesis of Mycoplasma in the UG tract.
Binds oligosaccharide receptors on mucosal epithelium using P1 adhesion; stimulates a huge inflammatory response (cytokine storm)
What are the 4 important types of Mycoplasma?
- Mycoplasma pneumoniae
- Mycoplasma hominis
- Mycoplasma genitalium
- Ureaplasma urealyticum
What are 3 Mycoplasma that can colonize the UG tract?
M. hominis, M. genitalium, U. urealyticum
Which Mycoplasma causes UG tract infection more commonly in women? In men?
Women: M. hominis
Men: M. genitalium
Describe the pathogenesis of Chlamydia trachomatis.
Major outer membrane proteins (MOMP) facilitate infection of non-ciliated epithelial cells on mucous membranes. This causes minute abrasions, followed by a robust inflammatory response (no long-term immunity).
Discuss the epidemiology of Chlamydia trachomatis.
- Most common STI in the U.S>
- > 1.3 million infections/year; rates are increasing
- Ocular trachoma endemic in Arica/Asia/South America
How is Chlamydia trachomatis transmitted?
Direct contact across mucosal surfaces (anogenital, oropharyngeal)
What are the major clinical manifestations of infection with Chlamydia trachomatis?
- UG tract infections
- Eye disease: ocular trachoma and adult inclusion conjunctivitis
- Lymphogranuloma venereum
- Congenital infection: infant inclusion conjunctivitis (most common cause of neonatal conjunctivitis) and pneumonitis
Which of the clinical manifestations of infection with Chlamydia trachomatis are most common?
UG tract infections
UG tract infections with Chlamydia trachomatis are seen in which populations? Discuss the transmission rate.
Sexually active young adults and teens; 25% of men are asymptomatic. 80% of women are asymptomatic. High transmission rate
What types of UG infections are caused by Chlamydia trachomatis in men?
Urethritis, epididymitis, prostatitis, proctocolitis
What types of UG infections are caused by Chlamydia trachomatis in women?
Cervicitis, PID, proctocolitis
What is ocular trachoma and in what populations is it common?
Chronic inflammatory granulomatous eye disease; follicular conjunctivitis causes eyelids to curl, scars the cornea, ends in blindness; common in poor rural areas and in children
How are congenital infections of Chlamydia trachomatis transmitted? Discuss the manifestations and their symptoms.
Via infected birth canal
- Infant inclusion conjunctivitis (eyelid swelling, mucopurulent discharge)
- Pneumonitis (rhinitis, staccato cough)
Describe LGV. Discuss the incubation period and its prevalence in the world.
Suppurative multiocular inguinal lymph nodes (buboes) enlarge and form a draining fistula. Fever, chills, myalgia, headache, proctococlitis, primary lesions - painless papule or ulcer
Incubation: 1-4 weeks
Sporadic in US, prevalent elsewhere
How is Chlamydia trachomatis diagnosed?
- Culture of epithelial tissue
- Ag detection - MOMP (direct immunofluorescence stain, ELISA)
- NAAT (preferred)
- Serology