20 chlamydia&spirochaetales - كلية الطب .2 Chlamydia *Chlamydia has characters between the

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Text of 20 chlamydia&spirochaetales - كلية الطب .2 Chlamydia *Chlamydia has characters between the

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    made by :Hala Nsour

    corrected by: tyma'a al-zabn

    date : 22_11_2016

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    Chlamydia *Chlamydia has characters between the bacteria and virus .

    * We do not care about it very much because a few and old diseases of this

    a contagious bacterial infection of : ex: Trachomasome still until now type , . the eye

    (like volume :similar to virusThis genus has properties and characteristics *

    we can't culture it in it has membrane filters ,and , it has very small size,

    also it , tissue cultureal media which we use to bacteria we use to it tradition

    from machineries is obligate intracellular so it use the ATP and metabolism

    the host cell )

    contain DNA & RNA in : (similar to bacteria characteristics and another*

    )t virus contain either RNA or DNA the same time bu

    Chlamydia is a genus of pathogenic bacteria that are obligate

    some types of : ( and birds) human(intracellular parasites of mammals

    . ) Psittacosisspecies caused Chlamydia psittaci Parrotsbirds like

    Psittacosis ,:


    contains one medically important order chlamydiales Classification

    chlamydia genus

    r_ales mean orde

    Chlamydia infections are the most common bacterial Sexually

    in humans (Lymphogranuloma venereum diseases) transmitted diseases

    .)trachoma( and are the leading cause of Infectious blindness worldwide

    ndness. if the trachoma isn't treatment it will lead to bli

    Reported rates 3 times higher in females than in males.

    susceptible to Chlamydia than males3 time more sFemale*

    so its need ( DNA and RNA, and ribosomes, lack ATP contain

    ays, non biosynthetic pathwlack , ) cells host the for metabolic machineries

    e most important motile. Multiply in the cytoplasm of the host cell. Th

    ., species that we will take about this lecture are ..

    ) responsible for trachoma( C. Trachomatis

    ) Psittacosis with associated( C. psittaci

    with pneunoma ) ( associated C. pneumoniae

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    Slide 3 min 7:00

    Transmission Transmission is sexual or vertical (from the mother to fetus)

    Highly transmissible

    Incubation period 7-21 days (3 weeks )

    Significant asymptomatic reservoir exists in the


    (no symptoms appear on patient so he/she become method to transfer the


    Re-infection is common why ? because the variation in antigenic structure

    , consist of more than one stereotype so one infectious does not give full

    immunity , can be affected with other antigenic form )

    Perinatal ( ) transmission results in neonatal conjunctivitis

    in 30%-50% of exposed babies .

    *This bacteria is different from other type of bacteria which we mentioned

    before , it has life cycle .

    * it has two phases :

    1_ Elementary body (EB): the infectious one by which it inter to host cell ,

    not reproductive phase .

    2_Reticulate body (RB):metabolic active and replication happen.

    * once it inter the host cell its converted from (EB) to (RB), and when it get

    out of host cell it back to (EB)

    Slide 4 min 11:00

    Have a complex developmental cycle The infectious form is called an Elementary Body (EB) which is

    circular in form and is taken into the cell by induced phagocytosis.

    Phagocytosis : when the material has a molecular weight ( )

    Pinocytosis : when the material is liquid (cellular drink )

    Exocytosis : ( )

    Inside the phagocytic vesicle replication takes place.

    Fusion In lysosome and phagocytic vesicle then the lysosomal enzyme


    Over the next 6-8 hours, the EB reorganizes into the noninfectious, but

    metabolically active Reticulate Body (RB) which is larger and less dense

    than the EB.

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    For 18-24 hours the RB synthesized new materials and divides by

    binary division to form Inclusion Bodies that reorganize and condense

    into EBs.

    Inclusion body :vesicle contain RB is indicate the Chlamydia infection

    Inside inclusion body (RB) converted to (EB) , and then Exocytosis happen

    to it

    (EB* )

    Between 48-72 hours (three days), the cell lyses and releases the EB

    which begin the cycle again.

    Slide 5 min 13:16

    If we want to differentiate between (EB) and (RB) :

    Elementary body 0.25 - 0.3 um diameter electron-dense nucleoid Released from ruptured infected cells. Human to human & bird to human.

    Reticulate Body Intracytoplasmic form 0.5 - 1.0 um Replication and growth. ( Inclusion body ) without a dense center.

    *EB which inter the cell (engulfment) .>divided by binary fission .>

    make inclusion body (green)..> some in the yellow still EB >Exocytosis

    Chlamydia inclusion bodies

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    * this slide consist of inclusion body this circle above contain large amount

    of RB

    slide 8 min 15:15

    Chlamydiaceae Family _aceae : family

    Three species will be considers :

    Species (genus) Disease

    C. Trachomatis (many serotypes)


    ^antigen-antibody reaction^

    Trachoma, NGU, PID, neonatal conjunctivitis,

    inclusion conjunctivitis,

    Infant pneumonia, LGV

    C. Pneumoniae (TWAR) Taiwan acute respiratory agent

    Pharyngitis, bronchitis, pneumonia

    C. psittaci

    (many serotypes) Psittacosis(influenza-like illness)

    * many serotype mean different type of antigen that diagnosis by

    antibody/antigenic reactions

    *biotype : diagnosis by biochemical reactions .

    *LGV (Lymphogranuloma venereum ) :

    Venereum : mean sexually transmitted

    ( .genitalia )

    * c.pneumoniae : one antigenic form (serotype) .> TWAR make

    respiratory tract infection in upper and lower

    * psittacosis also does not give long lasting immunity , transmitted by bird .

    Slide 9 min 19:04

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    Clinical significance 1. Chlamydia trachomatis Caused many diseses:

    1)Genital tract infection is sexually transmitted and frequently found

    concomitantly( )with N. gonorrhoea (In males symptoms include

    urethritis,dysuria and sometimes progresses to epididymitis( );

    In females symptoms include mucopurulent cervical inflammation

    (there is discharge)which can progress to salpingitis( )

    and PID) , and also may lead to infertility ()

    2)Inclusion conjunctivitis ( ) from inclusion body

    which contain RB second phase , occurs in both newborns and adults and

    a genital tract infection is the source of the infection. In new born mostly get it from mother by genital tract while delivery


    In adult auto infection , if she had a disease in genital tract or other cases of

    chlamydia in the hand or nails , and if she /her put her/his hand in her/his

    eyes .

    It is self-limited conjunctivitis which heals with no scarring. Newborns

    are infected during the birth process, with a mucopurulent discharge. In

    adults causes an acute follicular conjunctivitis with little discharge


    3)Trachoma, greatest cause of blindness in underdeveloped countries.

    (Transmission is by direct contact and in poor, less developed countries,

    children may be infected in the first three months of life (because they

    have incomplete immune system ).

    : ,

    ( prophylactic )

    4)Lymphogranuloma venereum( ) is a venereal

    disease(or sexual transmitted disease ) that occurs in poor, tropical areas.

    painless lesion occurs at the site of entry with symptoms of regional

    suppurative lymphadenopathy (buboes)

    Buboes :genitalia

    Slide 10 min 25:00

    Chlamydia psittaci

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    Mainly its a normal flora in birds ,some people love to feed the Parrot by

    his/her mouth so if the parrot infected with Chlamydia it can be transmitted

    to human respiratory system

    naturally infects avian species causing mild to severe illness.

    In man causes psittacosis (ornithosis) and is acquired by contact with an infected animal.

    Infection can range from subclinical to fatal pneumonia. * its depend on the immunity of the person or the dose which he

    take from Chlamydia

    Most commonly causes an Atypical ()pneumonia

    with fever, chills, dry cough, headache, sore throat, nausea,

    and vomiting.

    * Mycoplasma pneumonia is the cause of atypical pneumonia

    Chlamydia pneumoniae

    - This bacterium was first recognized as a respiratory pathogen, after isolation from pharyngitis case.

    - Pneumonia or Bronchitis, gradual onset of cough with little or no fever. Less common presentations are Pharyngitis, Laryngitis,

    and Sinusitis

    * give long lasting immunity because its

    have only one serotype (TWAR) = only one antigen

    slide 11 min 28:15

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    * Proctitis: / * inguinal : > in genitalia

    Slide 12 min 29:8

    Pathogenesis (some of it virulence factor ) - Chlamydiae have a hemagglutinin that may facilitate attachment to

    cells to the host as pili .

    - An endotoxin-like toxin has been described.

    Laboratory Diagnosis

    Culture Not traditional culture for bacteria its tissue culture because obligate


    Non-culture tests


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