23
Bordatella Dr. R. Someshwaran, MD., Assistant professor, Dept. of Microbiology, KFMS&R 06/21/22 1

Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Embed Size (px)

Citation preview

Page 1: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Bordatella

Dr. R. Someshwaran, MD., Assistant professor, Dept. of Microbiology, KFMS&R

05/02/23 1

Page 2: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

General characteristics

• Obligate aerobe• Gram negative cocco bacilli• Catalase positive• Oxidase positive• Indole negative• Sugars negative

05/02/23 2

Page 3: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Bordetella species of clinical importance

B. pertussis

B. parapertussis

B. bronchosepticus

B. avium

05/02/23 3

Page 4: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

1. What is the organism and what are its physiologic characteristics?

2. What are the pathogenic factors of this organism?3. Why is there a preponderance of lymphocytes?4. What is the epidemiology of and prophylaxis for the

disease?

Q: A 2-year-old male is presented to you with a 10-day history of persistent cough. The long cough spells are followed by a deep breath. The cough often leads to choking, vomiting, gasping and cyanosis. His pulse rate is 190 (n: 100-160) and respiratory rate is 72 (n: 10-20). Chest x-ray is normal. WBC counts are16,000/cm2 with 70% lymphocytes.

05/02/23 4

Page 5: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Bordetella pertussis

Causative agent of whooping cough

Gram negative cocobacillus

Requires special media to grow

05/02/23 5

Page 6: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Bordetella pertussis

Gram negative coccobacilli

Small, transparent hemolytic colonies on BG medium

Oxidase+,Urease-; (B. parapertussis: oxidase-, urease+; B. brochosepticus: +/+)

05/02/23 6

Page 7: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: epidemiology

pertussis is a disease mainly of children

05/02/23 7

Page 8: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: course of disease

05/02/23 8

Page 9: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: virulence factors

Pertussis toxin (pertussigen)*Adenylate cyclase toxinTracheal toxinDermonecrotic toxinFilamentous haemagglutinin*Lipopolysaccharide

05/02/23 9

Page 10: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussigen:(an AB-toxin, oligopeptide)

Increases histamine and LPS sensitivityIncreases IgE levelsT-cell lymphocytosisImpairs phagocyte functionsADP-ribosylates the Gi protein (results in increased cAMP)

05/02/23 10

Page 11: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussigen:Structure

05/02/23 11

Page 12: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussigen: dysregulation of adenylate cyclase

Pertussistoxin

cAMPATPCholera toxin

05/02/23 12

Page 13: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: adenylate cyclase toxin

Activated by calmodulin

Catalyses ATP to cAMP conversion

Ac tox

Ac tox

Calm

cAMP

H2O

05/02/23 13

Page 14: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussistracheal Toxin

A peptidoglycan-like molecule

Binds to ciliary epithelial cells

Inhibits ciliary movement

Kills ciliary ciliary epithelial cells

Causes pertussis

05/02/23 14

Page 15: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis:dermonecrotic toxin

Strong vasoconstrictor

Causes ischemia

Synergizes with tracheal toxin

to causes tracheal necrosis

05/02/23 15

Page 16: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis:filamentous haemagglutinin

Causes binding of bacteria to

ciliated epithelial cells

05/02/23 16

Page 17: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

B. pertussis:interactions with pneumocyte

05/02/23 17

Page 18: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

B. pertussis: lipopolysaccharide

Activates inflammatory

cytokines

Activates complement

In larger quantities, causes

shock and cardiac arrest05/02/23 18

Page 19: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: diagnosis

Based on symptoms

Culture on Bordet-Gengou (potato-

glycerol-blood agar) medium

05/02/23 19

Page 20: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Laboratory Diagnosis

Specimens Post / per nasal swab (no cotton swab) / cough plate

Microscopy Gram negative coccobacilli

Culture Bordet – Gengou Medium mercury drop pearl appearance colonies

Antibiotic Erythromycin / Co-trimoxazole

Identification Microscopy & slide agglutination

Fluorescent antibody stain

05/02/23 20

Page 21: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Pertussis: treatment

Erythromycin is the drug of choice

Vaccine is extremely effective

05/02/23 21

Page 22: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Immunization

D P T VACCINE

Diphtheria Pertussis Tetanus

3 doses

Intervals of 4 - 6 wks

4th dose year after

School entryPrimary Booster

1st Pertussis vaccine- whole cell Acellular vaccine now used

Combination vaccines

05/02/23 22

Page 23: Bordetella PERTUSIS - WHOOPING COUGH - THEORY MICROBIOLOGY

Thank you

05/02/23 23