Test 2- Burkholderia Flashcards

1
Q

Genus Burkholderia

A

Gram negative

Aerobic

Rods

Catalase positive

  • Taxonomically not yet very clear
  • Many new description of species
  • Mostly environmental bacteria:

• Pathogenic species:

• B. mallei: glanders

  • B. pseudomallei: melioidosis
  • B. cepacia (humans, frequently in cystic fibrosis patients)

• Plant pathogens

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2
Q

B. mallei: glanders

general

A

• BSL3 agent

  • Has been used in WW I
  • Primarily Equine pathogen

————-Also infects felines, dogs, humans,…

When diagnosed: has to be declared

————- Now mainly in Asia and South America

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3
Q

B. mallei: glanders

• Symptoms

A

• Nodules and ulcers, pyogranulomatous

  • Orchitis
  • Skin respiratory tract
  • Great variability in severity
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4
Q

Virulence factors for B. Malleli

A

Virulence factors; non specific

  • Capsule
  • LPS
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5
Q

B. mallei: glanders

Transmission

A

• Ingestion: feed, water

  • Inhalation
  • wounds
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6
Q

B. mallei: glanders Pathogenesis

A
  • Chronic
  • Debilitating

Entry– Pharynx, skin

Spread- via lymphatic and blood

Nodular lesions in lymph nodes, lung, liver, spleen, nose and skin

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7
Q

B. mallei: glanders Pathology

A

Suppurative lesions

  1. Nodular:
    neutrophils, fibrin, red blood cells
  2. Granulomatous:
    Central: necrotic granulomatous

Surrounded by

epithelial cells, giant cells
lymphocytes embedded in granulation tissue- CAN MAKE TX HARD

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8
Q

B. mallei: glanders Symptoms

• Acute infection

A

• Fever

  • Nasal discharge
  • Lymphadenitis (head & neck)

• Frequently fatal (2 weeks)

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9
Q

B. mallei: glanders Symptoms

Chronic

A

• You should not see this (declaration at acute phase)

  • Fever & respiratory problems
  • Skin abscesses (cranial lymph nodes)
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10
Q

Is B. mallei zoonotic?

A

YES!

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11
Q
A

B. mallei: glanders

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12
Q

B. mallei: glanders Diagnosis

A

• Isolation and identification

• Serology: Care for false positives

• Difficult

• Few laboratories do it

• Cross reactions (false positive)

—–Environmental group of bacteria

• CFT, ELISA, HAI

Horses CFT is official test, but creates sometimes false positives

• Intradermo test (mallein test)

  • Type IV hypersensitivity
  • Cellular
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13
Q

B. Mallei Prevention:

A
  • No vaccination available
  • Screening and culling of positive animals
  • After outbreak: bedding, feed should be disinfected (burned)

• Avoid contact with horses from endemic areas

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14
Q

Treatment of B. mallei

A

• Outbreak should be notified to competent authorities

• Culling of positive animals

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15
Q

Burkholderia pseudomallei, Melioidosis

A

• Melioidosis
• pyogranulomatous infections • Reportable disease

• Real saprophyte- JUST IN NATURE NOT CONTAGIOUS
• In water rich environments
• Frequently infections after flooding’s, heavy rain fall • Swampy terrain
• Rice paddies

  • Melioidosis
  • pyogranulomatous infections • Reportable disease
  • Real saprophyte
  • In water rich environments
  • Frequently infections after flooding’s, heavy rain fall
  • Swampy terrain
  • Rice paddies

• Endosymbiont of environmental amoeba

• Wide host range: large dissemination possibilities

  • Mammalians
  • Mainlysheep&goat
  • Rodents: reservoir in endemic regions (Tropical and subtropical)

• Avian (rather rare)
• Reservoir in Amoeba

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16
Q

Burkholderia pseudomallei, Melioidosis

• Transmission

A

• Ingestion

  • Wound infection
  • Airborne
  • Arthropod bites (wound infection like)
17
Q

Burkholderia pseudomallei, Melioidosis

• Virulence factors

A

• Adhesins-flagella

  • Capsule
  • T3SS and T4SS- Needle that injects factor proteins into the cell

• Not all is known

18
Q

Burkholderia pseudomallei, Melioidosis

• Human infection

A
  • Highly variable disease symptoms
  • Subclinical (asymptomatic) to acute and fatal (sepsis)

• Pneumonia

19
Q

Burkholderia pseudomallei, Melioidosis

species

A

Dogs
• Febrile diseases with localizing suppurative foci
• Very important in military dogs during war in Vietnam

Equine
• Mimics glanders: pseudoglanders- this is what makes it reportable- because it’s so similar to B. Mallei

Cattle
• Acute to chronic
• lungs, joints and uterus

Sheep

• Arthritis and lymphadenitis

Goat

• Loss of condition, respiratory and central nervous system disturbances, arthritis, and mastitis

Swine

• Loss of condition, respiratory and central nervous system disturbances, arthritis, mastitis, abortion and diarrhea

  • more backyard swine
20
Q

Burkholderia pseudomallei, Melioidosis Diagnosis

A
  • BSL3
  • Samples

-Purulent content

Cultivation

-Blood agar or McConkey

Serology: Care for false positives
• CFT, ELISA, HAI
• Horses CFT is official test, but creates sometimes false positives

  • Intradermo test (mallein test) • Type IV hypersensitivity
  • Cellular

• PCR

21
Q

Burkholderia pseudomallei, Melioidosis

Treatment and control

A

Prevention
• No vaccination
• Difficulty: water & soil contact is common

Therapy

  • Outbreak should be notified to competent authorities
  • Drainage of abscesses

• Antimicrobials (susceptibility profile!)
-Fluoroquinolones, tetracyclines, anti-pseudomonas β-lactams

22
Q

Burkholderia mallei and pseudomallei differentiation

A
  • Isolation and identification
  • Blood or glycerol agar, glycerol-potatoe, chocolate agar and MacConkey agar
  • B.pseudomalleigrowsfasterthanB.mallei<48h
  • B.pseudomalleigrowson2%NaCl
  • B.pseudomalleioxidizeslactose,norB.malleiorP.aeruginosado
  • B.pseudomalleiandP.aeruginosacangrowat42°C.B.malleican’t • B.pseudomalleiismotile,B.malleiisnon-motile
  • Use of Selective media aids in mixed infections • Ashdown’s selective medium for B. pseudomallei
  • PCR