MICROBIOLOGY PPT LECTURE NOTES | Karya Tulis Ilmiah

(1)

SPIROCHETES

Treponema, Borrelia

and

Leptospira

(2)

Spirochetes

•

Gram negative

•

Long, thin, helical, motile

•

axial filaments

–

locomotion

(3)

Spirochete



spirochaetaceae leptospiraceae

cristispira

leptonema

serpulina

leptospira

spirochaeta

treponema

borrelia

(4)

Treponema

T.pallidum T.carateum

subsp.pallidum

subsp.endemicum

subsp.pertenue

(5)

Histology:

Treponema pallidum

- testis infected rabbit

(6)

Treponema pallidum

•

transmission

–

genital/genital

–

in utero

or during birth



0.1-0.2

x 6-15um; 8-14

small, regular spirals;

actively motile

(7)

syphilis

 After initial infection, a primary chancre (an area of After initial infection, a primary chancre (an area of

ulceration/inflammation) is seen in genital areas or

elsewhere within 10-60 days. The organism, meantime,

has penetrated and systemically spread.

 The patient has flu-like symptoms with secondary lesions The patient has flu-like symptoms with secondary lesions

particularly affecting the skin . These occur 2-10 weeks

later.

 The final stage (if untreated) is tertiary syphilis (several The final stage (if untreated) is tertiary syphilis (several

years later). In primary and secondary syphilis organisms

are often present in large numbers. However, as the

disease progresses immunity controls bacterial replication

and fewer organisms are seen. It is extremely difficult to

detect spirochetes in tertiary syphilis. The systemic

lesions of skin, central nervous system and elsewhere are

suggestive of a delayed hypersensitivity reaction.

(8)

Syphilis Syphilis



 chronicchronic



 slowly progressiveslowly progressive

Primary stage

•

• 10 to 60 days 10 to 60 days

•

• primary lesion -primary lesion - chancre chancre

•

• area of area of

ulceration/ inflammation ulceration/ inflammation

•

• many organismsmany organisms

•

• rich in rich in TPTP

•

• a predominance of a predominance of

lymphocytes and plasma cells lymphocytes and plasma cells

•

• hard chancre硬硬硬hard chancre

•

• infectious highlyinfectious highly

•

• heal spontaneouslyheal spontaneously

Secondary stage



 Secondary (2Secondary (2--10 10 weeks

weeks after primary after primary stage

stage))

•

• systemic spread systemic spread

•

• flu-flu-like symptomslike symptoms

•

• skin, particularlyskin, particularly

•

• many organismsmany organisms



 rich in rich in TPTP



 red red maculopapularmaculopapular rash anywhere on the rash anywhere on the body

body



 infectious highlyinfectious highly



 subside spontaneouslysubside spontaneously

Tertiary stage



 Tertiary Tertiary

•

• several years laterseveral years later

•

• rarerare

•

• skin, skin,

•

• central nervous system central nervous system

•

• delayed hypersensitivity delayed hypersensitivity

•

• few organismsfew organisms

•

• control by immune control by immune response

response



 3-3-5 years after infection5 years after infection 

 few few TPTP 

 granulomatousgranulomatouslesions in lesions in

skin,bone, and liver skin,bone, and liver



 degenerative changes in degenerative changes in

the central nervous the central nervous



 cardiovascular lesionscardiovascular lesions

3w

(9)

Congenital syphilis



Interstitial keratitis 硬硬硬

Interstitial keratitis



Hutchinson’s teeth



Saddlenosema

硬硬硬

硬



Periostitis 硬硬硬

Periostitis



A variety of central nervous system

anomalies

(10)

Microbiological diagnosis

•

not culturable

•

dark field microscopy

–

actively motile

organisms

–

brightly lit against

dark backdrop

–

light shines at an

angle

–

reflected from thin

organisms

•

conventional light

microscopy

–

light shines through

–

NOT visualized

(11)



Autoimminty:

cardiolipin/self antigen



no vaccine



antibiotics

(e.g. penicillin)

–

effective



Other treponemal diseases



bejel

地地地地地

(12)

Borrelia burgdorferi

and Lyme disease

Ixodes scapularis, tick vector for Lyme disease. Also known as Ixodes dammini. CDC

Lyme

LymeDisease Disease erythematous

erythematousrashrash

Lyme

Lyme disease disease -- symptomssymptoms

•

• bacteremia bacteremia

–

– acuteacute

•

• arthritisarthritis

•

• cardiaccardiac

•

• neurologicneurologic

–

– chronic chronic

*

* weeks, months laterweeks, months later

• acuteacute

–

–responds to antibioticresponds to antibiotic

–

–antibodies not detectableantibodies not detectable

•

• late diagnosislate diagnosis

–

–not curablenot curable

–

(13)

(14)

Lyme Disease

-

etiology

•

reactive arthritis similar to

–

Reiter's syndrome

–

rheumatic fever

(15)

B . Recurrentis and Relapsing fever

•

immune response develops disease

relapses

•

new antigens expressed

•

no immunity : disease reappears

•

transmission

–

tick-

B. hermsii

*

rodent host

(16)

Diagnosis

•

serum antibodies to

B. burgdorferi

.

•

laboratory strains

–

grow extremely slowly

–

tissue culture media

(17)

Therapy

•

early antibiotic therapy

–

curable

*

penicillin

*

tetracycline

•

late antibiotic administration

(18)

Leptospirosis

(19)

•

symptoms

–

flu-like

–

severe systemic disease

*

kidney

*

brain

*

eye

Leptospirosis

(20)

Morphology



0.1-0.2 x 6-

0.1-0.2 x

6-20um; fine

20um; fine

coiling, one or

both ends are

usually

hooked; deep

brown color

stained with

silver

impregnation

stain (Fontana

stain),

(21)

•

infected urine

–

rodents

–

farm animals

•

water

•

through broken skin.

Transmission

(22)

Epidemiology

worldwide zoonosis

animal hosts:

rats,mice,wild

rodents,dogs,swine,and

cattle

(23)

Epidemiology

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$

paddy planting area

(24)

17/9/7

Pathogenicity

Multiply in kidney and

liver.

Shed in the urine for

life long of animal.

(25)

Laboratory Diagnosis

•

serology