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Listeria and Erysipelothrix

Listeria and Erysipelothrix. Ali Somily MD. Classification. Genus listeria Soil , water, and vegetation Many species? L.ivanovia ( animal) L.innocua ( food) L.monocytogen Pathogenic to human. Microbiology. Specimen Blood CSF Amniotic fluid Non sterile site Vagina

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Listeria and Erysipelothrix

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  1. ListeriaandErysipelothrix Ali SomilyMD

  2. Classification • Genus listeria • Soil , water, and vegetation • Many species? • L.ivanovia ( animal) • L.innocua ( food) • L.monocytogen • Pathogenic to human

  3. Microbiology • Specimen • Blood • CSF • Amniotic fluid • Non sterile site • Vagina • Stool spp not swab • 1-5% carrier • Media • BAP • CHO • Temp • Cold enrichment for several days

  4. Microbiology • Smear • Aerobic non spore forming short G+ve B or coccobacilli • Rounded end , singly or short chain • In CSF might mimic • Enterococcus • S.pneumoniae • Corynebacterium • Haemophilus • Culture • Catalase +ve • H2S –ve

  5. Listeria monocytogenes

  6. Clinical syndromes • Epidemiology • Summer month • Epidemic& sporadic • Dairy product & meat • Predisposing factors • Newborn • Elderly • Pregnancy • Cell mediated Abn. • AIDS • Lymphoma • Transplant • Diseases • Septcemia • CNS (meningitis, encephalitis) • AmnionitisPreg. Termination

  7. Life Cycle

  8. Treatment • Ampicillin not cefotaxime

  9. Erysipelothrixs rhusiopathiae • Genus Erysipelothrixs • Two spp • E. rhusiopathiae (only pathogen) • E.tonsillarum

  10. Microbiology • Smear • Gram positive nonspore forming short baccilli, • Rounded end singly or short chain • Slender and long filaments

  11. Microbiology • All -ve • Catalase • Oxidase • H2S +ve

  12. E. rhusiopathiae • Carried by animal (fish, Swine) • Cutaneous infection Erysipeloid • Skin abrasion, injury bite from infected animal. • Hand of veterinarians butchers and fish handlers • Generalized rare • I’C (bacteremia and endocarditis)

  13. Erysipeloid

  14. Corynebacterium

  15. Coryneform • Aerobic non spore forming gram positive bacilli • Coryne= clubcoynebacterium • >40 spp devided into 3 groups • Group I human and animal • Group II plant • Group III nonpathogenic • C.dipthteriae • Archanobacterium • Gardnerella

  16. Microbiology • Smear • Vary from coccoid to rod .Clubbed stain unevenly Arrange in V-shape Chinese letter .Rod in parallel or palisade formation • C.diphtheria • Nasopharyngeal swab • BAP • Selective media • Tellurite medium( black colonies) • Tinsdale • Cystine –tellurite BAP • Sensitive to K tellurite may not grow • Loeffler’ s media not as primary mediametachromatic granules

  17. Identification • Catalase +VE • APICoryne • RapID CB plus • Toxigenicity • Elek test reference lab • Antisera on strep under special media • Neg and pos control in addition to the patientsample • Incubate 37d • 45o line of precipitation • Reincubate 72 hr if negative

  18. C. diphtheriae

  19. VARIENT OF C.DIPHTHERIA: • GRAVIS • MITIS • INTERMEDIUS

  20. COLONIAL MORPHOLOGY

  21. TINSDAL MEDIA

  22. TINSDAL MEDIA

  23. (i) C. diphtheriae biotype gravis colonies on a Tinsdale agar plate

  24. Recovery of Miscellaneous Pathogens From Throat Cultures • Pseudomembrane of the pharynx • Occasionally of the skin. • Toxigenic strains of Corynebacterium. • To confirm a clinical diagnosis of diphtheria, the strain isolated diphtheriae. • The disease is characterized must be shown to produce toxin.

  25. Clinical infections • Respiratory and cutaneous • Uncommon in North America and Western Europe. • Humans are the only natural hosts for C. diphtheriae. • Carried in the upper respiratory tract • Spread by droplet infection or hand-tomouth contact. • IP 2 to 5 days. • Low-grade fever, malaise, and a mild sore throat. • Tonsils or pharynx.

  26. Rapidly multiply on the epithelial cells and trigger an inflammatory reaction. • The infecting toxigenic strain of C. diphtheriae produces toxin locally • Tissue necrosis and exudate formation. • Cell necrosis and exudate forms a very tough gray to white pseudomembrane, which attaches to the tissues. • Spread downward into the larynx and trachea. • Suffocation if the membrane spreads

  27. Blocks the air passage or if it is dislodged • The toxin also is absorbed and produces a variety of systemic effects. • Kidneys, heart, and nervous system • Death often is a result of cardiac failure. • Another effect of the toxin is a demyelinating peripheral neuritis paralysis following the acute illness • Mortality of 5-10%, highest in very young and old. • Erythromycin is the drug used for penicillin-sensitive individuals.

  28. Antitoxin • Produced in horses. • Hypersensitivity to horse serum precludes its administration. • 10% allergic reaction to the horse serum. • Antibiotics have no effect on toxin • Eliminate the focus of infection as well as prevent the spread of the organism. • The drug of choice is penicillin.

  29. Nonrespiratory sites • Cutaneous • Systemically, but systemic complications are less common than from upper respiratory infections.

  30. The routine immunization • Diphtheria, pertussis, tetanus, polio : • 2,4,6,18 months, 4 yrs • Routine immunization since 1950's - one or two cases a year, classic diptheria rare • Since 1990, thousands of cases in former Soviet Union (mortality 3-23%)

  31. Diptheria-vaccine • Toxoid; cell-free detoxified diphtheria toxin protects against the systemic effects of toxin but not against local infection/colonization

  32. Diphtheria toxin/Zoonotic • C.ulceran • Bovine mastitis • C.pseudotuberculosis • Animal(sheep) LNs

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