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chlamydia&spirochaetales

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 يشع سئي ظة االشخاص انز ك ػهى اذظال يثاشش ,: داء انثثغاء

مو تمها نهشخض Chlamydia ـــــيغ طائش انثثغاء ف ارا كا انطائش حم ان

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 انسردع ا انؼائم exists in the

population

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

disease)

• 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 (فرشج حل انالدج) 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 ( ضى خهي)

Pinocytosis : when the material is liquid (cellular drink ششب خهي)

Exocytosis : ( طشح خهي)

Inside the phagocytic vesicle replication takes place.يا تررأشش تؼه انضى انخهي

Fusion In lysosome and phagocytic vesicle then the lysosomal enzyme

released

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*انشكم انزي ذخشج ت انشكم انزي دخهد ت انــ )

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 ) طس ذكاششي

– 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)

ع يظهantigen انؼذذ ي حذدخ

ػ طشك

^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

( .genitaliaػضاء انرالهح )حذز ذضخى تانؼمذ انهفاح ف يطمح اال

* 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(يغ تؼغ)with N. gonorrhoea (In males symptoms include

urethritis,dysuria and sometimes progresses to epididymitis(انراب انثشتخ);

In females symptoms include mucopurulent cervical inflammation

(there is discharge)which can progress to salpingitis(انرظاق ف لاخ انشحى)

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

2)Inclusion conjunctivitis (انراب يهرحح انؼ انض) – 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

(vertical).

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

(autoinoculation).

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 ).

انرشاخيا : انراب يهحح انؼ يشع لذى , كا تائ ي انطمس نالػاد ف انؼشاق

جف ظف( ي انرشاخيا حس كاا prophylacticسرخذي يهح انه كــ لائ ) كاا

حرى خشج انذو انؼ ت

4)Lymphogranuloma venereum(مرض اللمف الحبب الجىس) 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 ذمح انؼمذ انهفاح انحاطح تانـ :genitalia

Slide 10 min 25:00

Chlamydia psittaci

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Mainly it’s 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 (انالرجح)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: / انراب انسرمى * inguinal : االستح…> 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

intracellular

• Non-culture tests

– Nucleic Acid Amplification Tests polymeraze reaction but

now it byBCR

– Non-Nucleic Acid Amplification Tests including Direct

fluorescent antibody (DFA), Enzyme immunoassay (EIA),

and Nucleic acid hybridization (NA probe)

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probe كم ال حري ػهى genetic constituent probe which one strand

اد انساش انخاط تانثكرشا ؼها ؼم فظم نه

hybridization ارا طاس

supp codeing

يؼاا ايالة نهكاليذا ايا ارا ياطاس فزا ؼ اا يش كاليذا

– Serology antibody antigen reactions

* most classification was by serology

Slide 13 min 30:51

Prevention • Nature of the infection

– Chlamydia is commonly asymptomatic in men and

women.

– In women, there is an increased risk of upper

reproductive tract damage with re-infection.

Transmission issues

– Abstain from sexual intercourse)LGV) until partners

are treated and for 7 days after a single dose of

azithromycin antibiotic .

**************************************** THE END

NEW SLIDES

Slide 1 min 32:00 We talked about rod , spherical and now spiral

Spirochaetales Treponema, Borrelia, Leptospira

All spirals (Treponema, Borrelia, Leptospira)are helical and they

differentiate from each other in this coil , the turn(coil) cloud be large or

small, the distant between helical and helical can be long or short , may be

coil then straight then coil and so on …. And this method we use to separate

between different type of spirals .

Slide 2 min 33

Taxonomy Order: Spirochaetales

Family: Spirochaetaceae

Genus: Treponema

Borrelia

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Other family within the same order Other family within the same order

Family: Leptospiraceae

Genus: Leptospira

Gram-negative spirochetes

• Spirochete from Greek for “coiled hair”

Extremely thin and can be very long

Motile by periplasmic flagella (axial fibrils or endoflagella)

Outer sheath encloses axial fibrils

• Axial fibrils originate from insertion pores at

both poles of cell

* It is not stain with gram stain because its very transparent so we use silver

nitrate stain

* some bacteria has axial fibrils ط يشكزيل or endoflagella : contain flagella

between outer membrane and peptidoglycan layer .

* spiral bacteria not like rod or spherical its move very fast and change it

shape so its harder to diagnose it .

* student asked why its gram negative bacteria while we can not stain it by

gram stain ? D.A: because the structure of it is identical to all gram negative

bacteria cell wall

slide 4 min 47:50

Periplasmic Flagella Diagram

Slide 5 min 39:10

Spirochaetales Associated Human Diseases

Note :we will not talk about Leptospira

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Genus Species Disease

Treponema pallidum ssp. pallidum

pallidum ssp. endemicum

pallidum ssp. pertenue

carateum

Syphilis

Bejel

Yaws

Pinta

Borrelia Burgdorferi

recurrentis

Many species

Lyme disease (borreliosis)

Epidemic relapsing fever

Endemic relapsing fever

Leptospira Interrogans Leptospirosis

(Weil’s Disease)

* syphilis : sexual transmitted dieses

*we will focus on recurrentis from borrelia which cause relapsing fever

its go and back because its more than one serotype (انحى انشاجؼح)

* relapsing fever has two type

- epidemic (تائ) & endemic (يسرط).

Slide 6 &7 min 40:20

We will srart with

Treponema pallidum ssp. Pallidum which responsible for syphilis= انزشي .

Its sexual transmitted disease and can stay with the patient for long period

(20_30_40 years)

* could be asymptomatic in first phases

* has many phases primary , secondary , and tertiary .

*its easy to treat it in earlier phases .

*transmit by mucous membrane of genital.

Venereal Treponemal Disease - T. pallidum are slender spirals with spiral coils spaced at a distance of

1 μm from one another between coil and another 1 μm .

- Pathogenic T pallidum has never been cultured on artificial media, in

fertile eggs, or in tissue culture. طؼث

- Nonpathogenic treponemes (Reiter strain) can be cultured

anaerobically in vitro.

- T pallidum is a microaerophilic (need oxygen less than what found

in atmosphere ) organism; it survives best in 3–5% oxygen.

- Cause Syphilis

Primarily sexually transmitted disease تشكم سئس

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May be transmitted congenitally (from mother to fetus)called

congenital syphilis can lead to abortion(إجاع) or early born or may

cause born of baby with mental problems .

Darkfield Microscopy of Treponema pallidum

* the shape of it have very tiny zigzag (coil ) very close to each other .

*we use dark field microscope because its already transparent .

General Characteristics of

Treponema pallidum

Too thin to be seen with light microscopy in specimens stained with

Gram stain or Giemsa stain

• Motile spirochetes can be seen with darkfield micoscopy

الا شفاف

• Staining with anti-treponemal antibodies labeled with

fluorescent dyes

Intracellular pathogen

Cannot be grown in cell-free cultures in vitro

• Koch’s Postulates have not been met

( حث اوها ال تىمى ف المختبر أما كىخ فقد قال kochأي اوها ال تىطبق على فرضة)الزم و وىمه ف المحتبر مه االوسان او الحىان ووعسله اوىا وأخذ العامل الممرض

طلع وفسه

Do not survive well outside of host

sorry in advance for any mistake you will found *-*

good luck :) :)