Atypical Bacteria chlamydia+ mycoplasma.ppt

Atypical Bacteria chlamydia and mycoplasma.ppt

1. Chlamydiae
Diseases:Diseases:
Psittacosis Psittacosis
Trachoma Trachoma
Lymphogranuloma venereum ‘LGV’ Lymphogranuloma venereum ‘LGV’

2. Species & Diseases

1. 1. ChlamydiaChlamydia psittacipsittaci: causes : causes
psittacosis. It has one immunotype.psittacosis. It has one immunotype.
2. 2. ChlamydiaChlamydia trachomatistrachomatis: causes : causes
eye , respiratory and genital tract eye , respiratory and genital tract
infections. Has 15 immunotypes.infections. Has 15 immunotypes.

3. 3. ChlamydiaChlamydia pneumoniaepneumoniae: causes : causes
atypical pneumonia. Has one type.atypical pneumonia. Has one type.

3. Important properties
Chlamydiae are obligate Chlamydiae are obligate
intracellular bacteria.intracellular bacteria.
They have a distinct replicative They have a distinct replicative
cycle:cycle:

1. The elementary body is 1. The elementary body is
sporelike inert form, that enters sporelike inert form, that enters
the cell and form,the cell and form,

4. 
2. The metabolically active, 2. The metabolically active,
reticulate body.reticulate body.

That divides by binary fission to That divides by binary fission to
form many elementary bodies. form many elementary bodies.
(intracytoplasmic inclusion (intracytoplasmic inclusion
bodies).bodies).

Which are released from the cell.Which are released from the cell.

5. Chlamydia

6. Intracytoplasmic inclusion bodies

7. Transmission

1. Chlamydia psittaci: by inhalation 1. Chlamydia psittaci: by inhalation
of the organism in dry bird feces.of the organism in dry bird feces.

2. Chlamydia trachomatis: by close 2. Chlamydia trachomatis: by close
personal contact eg, sexually, during personal contact eg, sexually, during
birth, or finger-to-eye contact.birth, or finger-to-eye contact.

3. Chlamydia pneumoniae: aerosol 3. Chlamydia pneumoniae: aerosol
from a patient. from a patient.

8. Pathogenesis
Chlamydiae infect the Chlamydiae infect the
epithelial cells of epithelial cells of
mucous membranes and mucous membranes and
the lung.the lung.
 Deep invasion is rare.Deep invasion is rare.

9. Clinical findings

PsittacosisPsittacosis : :

Fever and pneumonia.Fever and pneumonia.

May be asymptomatic.May be asymptomatic.

It is not infectious.It is not infectious.

10. 
C. pneumoniae:C. pneumoniae:

Causes bronchitis Causes bronchitis
and pneumonia in and pneumonia in
young adults.young adults.

11. Chlamydia trachomatis
Exists in more than 15 Exists in more than 15
immunotype: A- L.immunotype: A- L.
1. 1. TypesTypes A, B, and C: cause A, B, and C: cause
trachoma, a chronic conjunctivits trachoma, a chronic conjunctivits
, that may lead to blindness ., that may lead to blindness .

It is transmitted by fingers, flies It is transmitted by fingers, flies
and fomites.and fomites.

12. Inclusion conjunctivitis. See
follicles.

13. Trchoma . New vessel formation.

14. 
2. Types D-K: cause genital 2. Types D-K: cause genital
tract infections.tract infections.

In men: In men:

Nongonococcal urethritis.Nongonococcal urethritis.

Epididymitis.Epididymitis.

Prostatitis.orProstatitis.or

Proctitis.Proctitis.

15. Chlamydial urethritis. Non
purulent discharge.

16. 
In In womenwomen::

Cervicitis.Cervicitis.

Salpingitis, andSalpingitis, and

Pelvic inflammatory disease Pelvic inflammatory disease
PID.PID.

Infertility and ectopic Infertility and ectopic
pregnancy.pregnancy.

17. 
In newborns to infected In newborns to infected
mothers:mothers:

Neonatal inclusion Neonatal inclusion
conjunctivitis: 7-12 days after conjunctivitis: 7-12 days after
birth.birth.

Pneumonitis: 2-12 weeks after Pneumonitis: 2-12 weeks after
delivery.delivery.

18. Chlamydial ophthalmia
neonatorum.

19. Reiter’s syndrome

Is an autoimmune disease caused Is an autoimmune disease caused

by antibodies against chlamydial by antibodies against chlamydial
antigens , antigens ,

cross-reacting with body tissuescross-reacting with body tissues

Leading to urethritis, arthritis Leading to urethritis, arthritis
and uveitis.and uveitis.

20. Lymphogranuloma
venereum
Is a sexually transmitted Is a sexually transmitted
disease caused by L1-L2 &L3 disease caused by L1-L2 &L3
immunotypes of immunotypes of
C.trachomatis.C.trachomatis.

With lesions on genitalia and With lesions on genitalia and
in lymph nodes.in lymph nodes.

21. Painful, enlarged buboes in LGV

22. Inguinal adenitis . LGV.

23. LGV. Inguinal Lymph nodes matted
together, and sinus present.

24. Laboratory diagnosis

Cytoplasmic inclusions (dividimg Cytoplasmic inclusions (dividimg
reticulate body) can be seen with Giemsa reticulate body) can be seen with Giemsa
stain or immunofluorescence.stain or immunofluorescence.

Fluorescent antibody stain or DNA probe Fluorescent antibody stain or DNA probe
for tissue exudates.for tissue exudates.
Chlamydial antigens in exudates or urine Chlamydial antigens in exudates or urine
can be detected by ELISA.can be detected by ELISA.
PCR test for urine.PCR test for urine.

25. Urethral discharge shows
intracytoplasmic inclusion body

26. Intracytoplasmic inclusion bodies
in epithelial cell from infant’s
eye

27. Direct immunofluorescence of the
elementary bodies. Bright green dots

28. ELISA. Colour change +ve test, left

29. Treatment

The treatment of choice for The treatment of choice for
C.trachomatis is azithromycin.C.trachomatis is azithromycin.

The treatment of choice for The treatment of choice for
C.psittaci , C.pneumoniae and C.psittaci , C.pneumoniae and
lymphogranuloma venereum lymphogranuloma venereum
is doxycycline.is doxycycline.

31. Mycoplasmas
Disease: atypical pneumoniaDisease: atypical pneumonia

32. Important properties

Mycoplasmas are the smallest free Mycoplasmas are the smallest free
living organisms.living organisms.

They are wall-less, so they stain They are wall-less, so they stain
poorly with Gram stain and poorly with Gram stain and
penicillins are ineffective in their penicillins are ineffective in their
treatment.treatment.

When grown on special media they When grown on special media they
produce ‘fried-egg’ colonies in more produce ‘fried-egg’ colonies in more
than one week.than one week.

33. Clinical findings

mycoplasma pneumoniae is the mycoplasma pneumoniae is the
most frequent cause of atypical most frequent cause of atypical
pneumonia in young adults.pneumonia in young adults.

Sore throat and small amount Sore throat and small amount
sputum is produced.sputum is produced.

It resolves in 10-14 days.It resolves in 10-14 days.

34. 
Mycoplasma infections Mycoplasma infections
induce autoantibodies (cold induce autoantibodies (cold
agglitinins)agglitinins)

Against RBCs, brain, lung Against RBCs, brain, lung
and liver.and liver.

35. Laboratory diagnosis

By serology:By serology:

A cold-agglutinin (IgM) titer of A cold-agglutinin (IgM) titer of
1:128 or higher indicates recent 1:128 or higher indicates recent
infection.infection.

Complement fixation test: a 4-Complement fixation test: a 4-
fold rise in specific antibody titer fold rise in specific antibody titer
comfirms the diagnosis.comfirms the diagnosis.

36. Treatment

Erythromycin Erythromycin
or or
Tetracycline .Tetracycline .

37. Other Mycoplasmas

Mycoplasma hominis: causes Mycoplasma hominis: causes
pelvic inflammatory disease.pelvic inflammatory disease.

Ureaplasma urealyticum: causes Ureaplasma urealyticum: causes
nongonococcal urethritis. nongonococcal urethritis.
(It produces urease)(It produces urease)