Unit 1; Chlamydia, Ricketsia, Spirochetes Flashcards by Sarah King

What Chlamydia species can cause human infections?

C. trachomatis, C. psittaci, C. pneumoniae

C. pneumoniae is least pathogenic due to lack of plasmid

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What Chlamydia species can cause infections in animals?

C. abortus, C. pecorum

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How is Chlamydia similar to viruses?

Chlamydia requires host resources for their metabolism

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because chlamydia is gram-negative, the LPS has little __________ activity.

endotoxic

????

small amount of peptidoglycan?

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Chlamydia:

Major outer membrane protein (MOMP)-very diverse, but very conserved in _____________.

C. pneumoniae

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Plasmid DNA is present in what species of chlamydia? but not in which one?

C. trachomatis and C. psittaci,

not in C. pneumoniae

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Glycogen-containing inclusions only in C.__________

trachomatis

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Susceptibility to sulfonamides: C.__________

trachomatis

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What are the two components of chlamydia life cycle?

Intracellular: reticulate body (RB)-replicative

Extracellular: elementary body (EB)-infective

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What is the most common sexually transmitted bacteria in the US?

Chlamydia Trachomatis

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What is the most common sexually transmitted bacteria in the US?

Chlamydia Trachomatis

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What is the most common sexually transmitted bacteria in the US?

Chlamydia Trachomatis

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C. Trachomatis:

_____ serovars (outer membrane proteins) based on MOMP antigenic differences

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What complications can C. Trachomatis cause?

PID, ectopic pregnancy and infertility
GTI in females ages of 15 and 24 yr

Lymphogranuloma venereum (LGV): acute and chronic (e.g. rectal fistulas, rectal stricture etc.)

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How common is Ocular trachoma?
Blindness?

84 million worldwide

7 to 9 million worldwide

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Prevalent areas of chlamydia?

Africa, Asia, Central and South America

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What is the major transmitsion for C. Trachomatis?

direct contact (human to human)

Vertical transmission: neonatal pneumonia or inclusion conjunctivitis

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In US: C. Trachomatis causes ____% NGU

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What are the oculogenital infections caused by chlamydia?

acute inclusion conjunctivitis in adults and newborns, GTI (urethritis, cervicitis, bartholinitis, salpingitis, proctitis, epididymitis and acute urethral syndrome in females, NGU

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Is chlamydia always easily recognized?

no, Many asymptomatic and not easily recognized

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What are the usual symptoms of chlamydia?

unusual discharge and pain, symptoms similar to gonorrhea

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How is chlamydia diagnosed in the lab?

Preferred for screening: endocervix sample.

Others: Urogenital swab and fresh urine sample.
*Bacteria is labile, so keep sample cold and transport ASAP.

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plasmid DNA is responsible for causing ________.

disease

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Whare are the basic steps of chlamydia life-cycle?

specific host cell receptor binding
endocytosed into cell
EB recognized into large reticular body
multiplication by binary fission —-> produces an inclusion
condensation into EB forms

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What can chlamydia sometimes be mistaken for by doctors?

benign tumors

What is a major way the immune system can stop the spread of chlamydia?

stop the production of the receptor needed for chlamydia to be taken into the cell.

Why are cultures not usually done for chlamydia?

because it is intracellular. But if done, must use cell lines.

Why are cultures done for chlamydia only 70-90% sensitive?

some cells in the culture may not have the receptor needed to become infected.

What is the transport media used for chlamydia?

2SP, 0.2M sucrose-phosphate transport medium with antibiotics (prevents other bacteria from contaminating it)

What culture media is sometimes used for chlamydia but less frequently?

McCoy, HeLa and monkey kidney

48-72 hr culture, stained with fluorescent labeled monoclonal antibody

cell lines

Chlamydia cultures are _____% specificity and _____% sensitivity.

100, 70-90 this method is preferred for legal implications

What are the three direct detection methods for chlamydia?

1. Inclusion bodies: round, vacuolar (by DFA staining) 2. Antigen detection: EIA 3. NA hybridization: Digene hybrid capture II assay (uses RNA probe to detect DNA in a sample)

chlamydia inclusions can be stained by use of _________.

iodine -100% specificity with the presence of inclusion bodies

C. Psittaci is ______________ resistant.

Sulfonamide

type of chlamydia that is more common in birds and domestic animals

C. Psittaci

What are the symptoms of C. Psittaci?

Birds: diarrhea or no symptoms Bird to human: aerosols, IP: 5-15 days Pnumonia, severe headache, mental status changes, hepatospenomegaly

Should use BSL___ for C. Psittaci.

How is C. Psittaci diagnosed?

almost always by serology IgM titer: 1:32 or greater for diagnosis PCR: rRNA sequences followed by RFLP

What are the symptoms of C. pneumoniae?

Pnumonia, brochitis, pharyngitis, sinusitis and flulike illness May be the causative agent of atherosclerosis.

C. peneumoniae is more common in... how is it spread?

More common in human, no birds or animals Person to person: aerosolized droplets

How can C. pneumonia be diagnosed?

Direct methods: NAAT (RCR and real-time PCR) Cultivation: oropharynx swab, cold in TM, culture in McCoy cell lines- multiple blind passages Use monoclonal antibody to detect organism Serodiagnosis: CFT, 4 fold rise in IgG or IgM

Drugs for C. trachomatis?

Tetracyclines, azithromycin, doxycycline, erythromycin,fluoroquinolones and other macrolide antibiotics -similar for C. trachomatis?

What is the drug of choice for treating C. psittaci?

Tetracycline

-Obligate intracellular and fastidious organism -Can survive briefly outside of host -Small (1-2 micron), pleomorphic and gram –ve -Human: accidental host in most cases -Multiply intracellularly, but not intracellular development -Damage endothelial cells, cause cell injury and death

Rickettsia

What are the three groups of Rickettsia based on arthropod mode of transmission?

1. spotted fever group, 2. the typhus group, 3. the scrub typhus group

What is the vector for R. conorii, R. rickettsia, and R. parkeri?

Tick

causes Indian or kenya tick typhus, & Mediterranean or Israeli spotted fevers

R. conorii

cause Rocky Mountains spotted fever

R. rickettsia

causes mild illness with no reported fatalities

R. parkeri

Lice is the vector for...

R. prowazekii: epidemic typhus and Brill-Zinsser diseases

Fleas are the vector for...

R. typhi: Murine typhus

How is Rickettsia diagnosed? And specimen

common PCR or RFLP, others: EIA, IFA and DFA (useful for R. rickettsii, Ab produced 2 wks after infections in others) Specimen: biopsy from the rash (preferred)

Three bacteria that... -cannot survive outside the host cell -very little is known

-Ehrlichia sp. -Anaplasmam phagocytophilium, -Neorickettsia sennetsu

E. chaffeensis infects ___________. What is the vector?

monocytes ticks

A. phagocytophilium infects...

bone marrow, primarily neutrophils.

A. phagocytophilium causes... What is the vector?

Anaplasmosis (fever, chills, headache, muscle ache. Vector: ticks (black legged)

What symptoms does Neorickettsia sennetsu cause? Vector?

Sennetsu fever: in SE asia, high fever, muscle aches vector unknown (maybe raw fish??)

How are these bacteria diagnosed in the lab? -Ehrlichia sp. -Anaplasmam phagocytophilium, -Neorickettsia sennetsu

-Giemsa stain of WBC (because parasite present in monocytes) -Serodiagnosis: EIA, IFA, DFA -PCR

What is Q fever and what is the causative agent?

an acute systemic infection of the lungs Coxiella burnettii

Can Coxiella burnettii survive outside the host cells?

yes, but can only be grown in lung cells

Is Coxiella burnettii resistant?

More resistant to various chemical and physical agents

What are the two Coxiella burnettii antigenic states in life cycle?

1. Large-cell varient form: highly infectious 2. small-cell variant form: spore like, not infectious, can survive extracellular, seen in cultured cell lines

Coxiella is mostly found in...

domestic animals (cattle, sheep, and goats)

What is the difference between Q-fever and Coxiellosis?

Q-fever- acute Coxiellosis- chronic

How prevalent is Q-fever?

endemic worldwide except in New Zealand

What are the symptoms associated with Coxiella infections?

*No rash developed (because the infection is in the lungs) -Atypical pneumonia, granulomatous hepatitis, endocarditis, neurological manifestations, osteomyelitis *only causes internal infections

How is Coxiella diagnosed?

-Diagnosis: must use BSL3 -Culture: 6-14 days at 370C in *CO2 environment – direct IFA -NAAT, PCR, serology tests: EIA, IFA

What drug is used for both acute and chronic Q fever?

Tetracycline

How does chronic coxiellosis usually manifest?

1 to 20 years later as endocarditis -Others: chronic hepatitis, osteomyelitis, septic arthritis, lung diseases

Coxiella infections can occur even with treatment, and mortality can be as high as _____%.

characteristics of Bartonella

intracellular, fastidious, facultative anaerobic, zoonotic.

causes similar symptoms to Rickettsia, associated with trench fever What is the vector?

Bartonella quintana lice

Is bacteria causes acute hemolytic bacteremia (Oroya fever), chronic vasoproliferative diseases, mortality 40-90%

Bartnonella bacilliformis

Bacteria associated with cat scratch disease?

Bartonella henselae

How is Bartonella diagnosed? What is the treatment?

Diagnosis: Culture, PCR, serology Treatment: Similar to C. trachomatis

What bacteria is associated with Whipple's disease?

Tropheryma whippelii

What is Whipple's diseases?

(arthralgia, diarrhea, weight loss, lymphadenopathy, hyperpigmentation)- in middle-aged men Leads to malabsorption

How is Tropheryma whippelii diagnosed?

-Can not culture -Diagnosis: NAAT, PCR and other techniques

What is the treatment for Tropheryma whippelii?

Trimethoprim/sulfamethoxazole Macrolides Aminoglycosides Tetracycline Penicillin