MICROBIOLOGY PPT LECTURE NOTES | Karya Tulis Ilmiah
SPIROCHETES
Treponema, Borrelia and
Leptospira
Spirochetes
• Gram negative
• Long, thin, helical, motile
• axial filaments
– locomotion
– between peptidoglycan layer/outer membrane
* runs parallel
Spirochete
spirochaetaceae
cristispira
serpulina
spirochaeta
treponema
borrelia
leptospiraceae
leptonema
leptospira
Treponema
T.pallidum
subsp.pallidum
subsp.endemicum
subsp.pertenue
T.carateum
Histology: Treponema pallidum
- testis infected rabbit
Treponema pallidum
0.1-0.2 x 6-15um; 8-14
small, regular spirals;
actively motile.
• transmission
– genital/genital
– in utero or during birth
syphilis
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
particularly affecting the skin . These occur 2-10 weeks
later.
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.
Primary stage
Syphilis
chronic
slowly progressive
• 10 to 60 days
• primary lesion - chancre
• area of
ulceration/ inflammation
• many organisms
• rich in TP
• a predominance of
lymphocytes and plasma cells
• hard chancre硬
chancre 硬 硬
• infectious highly
• heal spontaneously
Secondary stage
Secondary (2(2- 10
weeks after primary
stage)
stage)
•
•
•
•
Tertiary stage
•
•
•
•
•
•
•
systemic spread
fluflu- like symptoms
skin, particularly
many organisms
rich in TP
red maculopapular
rash anywhere on the
body
infectious highly
subside spontaneously
Tertiary
several years later
rare
skin,
central nervous system
delayed hypersensitivity
few organisms
control by immune
response
3- 5 years after infection
few TP
granulomatous lesions in
skin,bone, and liver
degenerative changes in
the central nervous
cardiovascular lesions
3w
2y
Congenital syphilis
Interstitial keratitis 硬硬硬
Hutchinson’s teeth
Saddlenosema 硬硬硬
Periostitis 硬硬硬
A variety of central nervous system
anomalies
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
screening method
antibodies to
cardiolipin
specific diagnosis
antibodies to
treponemal antigen
fluorescence microscopy
antibody staining
PCR
Autoimminty: cardiolipin/self antigen
no vaccine
antibiotics (e.g. penicillin)
– effective
Other treponemal diseases
bejel 地地地地地
yaws 地地
pinta 地地地
Borrelia burgdorferi and Lyme disease
Ixodes scapularis, tick vector for Lyme disease.
Also known as Ixodes dammini. CDC
Lyme disease - symptoms
• acute
– responds to antibiotic
–antibodies not detectable
• late diagnosis
– not curable
– antibodies detectable
Lyme Disease
erythematous rash
• bacteremia
– acute
• arthritis
• cardiac
• neurologic
– chronic
* weeks, months later
Lyme Disease
- etiology
• reactive arthritis similar to
– Reiter's syndrome
– rheumatic fever
• resembles rheumatoid arthritis.
B . Recurrentis and Relapsing fever
• immune response develops disease
relapses
• new antigens expressed
• no immunity : disease reappears
• transmission
–tick-B. hermsii
* rodent host
– lice-B. recurrentis
* human host
Diagnosis
• serum antibodies to B. burgdorferi.
burgdorferi
• laboratory strains
– grow extremely slowly
– tissue culture media
–patient body fluids/tissue sample
Therapy
•
•
early antibiotic therapy
– curable
* penicillin
* tetracycline
late antibiotic administration
– ineffective
Leptospirosis
Leptospirosis
• symptoms
–flu-like
–severe systemic disease
* kidney
* brain
* eye
0.1-0.2 x 620um; fine
coiling, one or
both ends are
usually
hooked; deep
brown color
stained with
silver
impregnation
stain (Fontana
stain), Gramnegative.
Morphology
Transmission
•
infected urine
– rodents
– farm animals
•
•
water
through broken skin.
Epidemiology
worldwide zoonosis
animal hosts:
rats,mice,wild
rodents,dogs,swine,and
cattle
Human is accidental
Epidemiology
中中中中中中中中中
硬硬硬硬
%
%
硬硬硬硬硬硬硬硬
硬硬硬
%
硬硬硬硬硬硬
硬硬硬
硬硬硬
硬硬硬
硬硬硬
硬硬硬硬硬
$E
$paddy planting area
Leptospirosis area
%
硬硬硬硬硬硬硬
$
硬硬硬
%
$
E%
%
硬硬硬
硬硬硬
硬硬硬
%
硬硬硬
%
硬硬硬
%硬硬硬
E
E
%
硬硬硬
$
$
硬硬硬
硬硬硬
%
E
%E
E
%
$
$ 硬硬硬
%E$
硬硬硬
硬硬硬
E
%
硬硬硬
E
%E $ $%
$ 硬硬硬
E$
%
硬硬硬
硬硬硬
$ 硬硬硬硬硬硬硬
硬硬硬
E
%
%E
%E $ %E $
$
%
$E
硬硬硬
Pathogenicity
Multiply in kidney and
liver.
Shed in the urine for
life long of animal.
Damage to the capillary
endothelium is the main
cause
17/9/7
Laboratory Diagnosis
•
•
serology
most readily culturable of spirochetes
– culture still extremely difficult
Treponema, Borrelia and
Leptospira
Spirochetes
• Gram negative
• Long, thin, helical, motile
• axial filaments
– locomotion
– between peptidoglycan layer/outer membrane
* runs parallel
Spirochete
spirochaetaceae
cristispira
serpulina
spirochaeta
treponema
borrelia
leptospiraceae
leptonema
leptospira
Treponema
T.pallidum
subsp.pallidum
subsp.endemicum
subsp.pertenue
T.carateum
Histology: Treponema pallidum
- testis infected rabbit
Treponema pallidum
0.1-0.2 x 6-15um; 8-14
small, regular spirals;
actively motile.
• transmission
– genital/genital
– in utero or during birth
syphilis
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
particularly affecting the skin . These occur 2-10 weeks
later.
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.
Primary stage
Syphilis
chronic
slowly progressive
• 10 to 60 days
• primary lesion - chancre
• area of
ulceration/ inflammation
• many organisms
• rich in TP
• a predominance of
lymphocytes and plasma cells
• hard chancre硬
chancre 硬 硬
• infectious highly
• heal spontaneously
Secondary stage
Secondary (2(2- 10
weeks after primary
stage)
stage)
•
•
•
•
Tertiary stage
•
•
•
•
•
•
•
systemic spread
fluflu- like symptoms
skin, particularly
many organisms
rich in TP
red maculopapular
rash anywhere on the
body
infectious highly
subside spontaneously
Tertiary
several years later
rare
skin,
central nervous system
delayed hypersensitivity
few organisms
control by immune
response
3- 5 years after infection
few TP
granulomatous lesions in
skin,bone, and liver
degenerative changes in
the central nervous
cardiovascular lesions
3w
2y
Congenital syphilis
Interstitial keratitis 硬硬硬
Hutchinson’s teeth
Saddlenosema 硬硬硬
Periostitis 硬硬硬
A variety of central nervous system
anomalies
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
screening method
antibodies to
cardiolipin
specific diagnosis
antibodies to
treponemal antigen
fluorescence microscopy
antibody staining
PCR
Autoimminty: cardiolipin/self antigen
no vaccine
antibiotics (e.g. penicillin)
– effective
Other treponemal diseases
bejel 地地地地地
yaws 地地
pinta 地地地
Borrelia burgdorferi and Lyme disease
Ixodes scapularis, tick vector for Lyme disease.
Also known as Ixodes dammini. CDC
Lyme disease - symptoms
• acute
– responds to antibiotic
–antibodies not detectable
• late diagnosis
– not curable
– antibodies detectable
Lyme Disease
erythematous rash
• bacteremia
– acute
• arthritis
• cardiac
• neurologic
– chronic
* weeks, months later
Lyme Disease
- etiology
• reactive arthritis similar to
– Reiter's syndrome
– rheumatic fever
• resembles rheumatoid arthritis.
B . Recurrentis and Relapsing fever
• immune response develops disease
relapses
• new antigens expressed
• no immunity : disease reappears
• transmission
–tick-B. hermsii
* rodent host
– lice-B. recurrentis
* human host
Diagnosis
• serum antibodies to B. burgdorferi.
burgdorferi
• laboratory strains
– grow extremely slowly
– tissue culture media
–patient body fluids/tissue sample
Therapy
•
•
early antibiotic therapy
– curable
* penicillin
* tetracycline
late antibiotic administration
– ineffective
Leptospirosis
Leptospirosis
• symptoms
–flu-like
–severe systemic disease
* kidney
* brain
* eye
0.1-0.2 x 620um; fine
coiling, one or
both ends are
usually
hooked; deep
brown color
stained with
silver
impregnation
stain (Fontana
stain), Gramnegative.
Morphology
Transmission
•
infected urine
– rodents
– farm animals
•
•
water
through broken skin.
Epidemiology
worldwide zoonosis
animal hosts:
rats,mice,wild
rodents,dogs,swine,and
cattle
Human is accidental
Epidemiology
中中中中中中中中中
硬硬硬硬
%
%
硬硬硬硬硬硬硬硬
硬硬硬
%
硬硬硬硬硬硬
硬硬硬
硬硬硬
硬硬硬
硬硬硬
硬硬硬硬硬
$E
$paddy planting area
Leptospirosis area
%
硬硬硬硬硬硬硬
$
硬硬硬
%
$
E%
%
硬硬硬
硬硬硬
硬硬硬
%
硬硬硬
%
硬硬硬
%硬硬硬
E
E
%
硬硬硬
$
$
硬硬硬
硬硬硬
%
E
%E
E
%
$
$ 硬硬硬
%E$
硬硬硬
硬硬硬
E
%
硬硬硬
E
%E $ $%
$ 硬硬硬
E$
%
硬硬硬
硬硬硬
$ 硬硬硬硬硬硬硬
硬硬硬
E
%
%E
%E $ %E $
$
%
$E
硬硬硬
Pathogenicity
Multiply in kidney and
liver.
Shed in the urine for
life long of animal.
Damage to the capillary
endothelium is the main
cause
17/9/7
Laboratory Diagnosis
•
•
serology
most readily culturable of spirochetes
– culture still extremely difficult