송혜영 ( 자료조사 및 정리 ) 유가영 ( 자료조사 및 정리 ) 유정희 (ppt 수정, 발표 ) 이근재 ( 자료조사 및 정리 ) 이선주 (ppt 제작, Quiz)

1 PART 2

1 free-living bacteria in soil, seawater, fresh water a single polar flagellum oxidase & catalase (+) no ferment carbohydrate → oxidation metabolism produce pseudomycins against fungi

1 PART common inhabitant Ubiquitous pathogen Resistance in soaps, dyes, disinfectants, drugs and drying Opportunistic (weakened host defenses) Virulent factors exotoxins, phagocytosis- resistant slime layer, hemolysin, LPS

1 PART nosocomial pseudomonas infection : severe burns, neoplastic desease, cystic fibrosis complications: pneumonia, urinary tract infection, abscess, otitis, corneal disease pseudomonas septicemia -> endocarditis, meningitis, bronchopneumonia blue pus : grapelike odor, noticeable color in tissue, pus, other exudate multidrug resistance :cephalosporins, aminoglycosides, carbenicillin, polymixin. quinolones, monobactams

1 PART Genera : Burkholderia, Acinetobacter, Stenotrophomonas Similar to pseudomonads - Living in soil, water, and related environments - Oxidase (+) - Opportunistic infection - Culture in blood agar and MacConkey agar

1 PART Isolated from moist environment Toxic substance biodegradation Resistance in antimicrobic drugs Co-infection with Pseudomonas → severe respiratory compromise Opportunistic infection

1 PART Resides in soil and water of tropical climate melioidoses : Prevalent in Southeast Asia, Africa, India, Middle East symptoms - wound infection – skin nodules along with symtoms of fever and muscle aches - lung infection - bronchitis, pneumonia Chronic infection : septicemia, endotoxic shock, abscesses in liver, brain.

1 PART soil and water resistant to environment nosocomial & community- acquired infections high-profile pathogen multidrug-resistant(MDR) strains (combination of carbapenem, colistin, polymyxin B, ampicillin) control : isolation procedure, environmental disinfection

1 PART Living in water, soil associated with plant root Contaminant Formation of biofilm Most drug-resistant bacteria Effective in cephalosporin, Tetracycline, fluoroquinolone, newer penicillin

1 PART Coccobacilli Spore Brucella abortus (cattle), Brucella suis (pig), Brucella melitensis (sheep)

1 PART Synonyms → Undulant fever → Malta fever → Bang’s disease Animal brucellosis : cause abortion Human brucellosis : cause sever febrile illness but not abortion

1 PART Human infection

1 PART diagnosis - patient’s history - serological test ( Agglutination titer test ) - blood cultures - Newer genetic test Treatment : Combination of tetracycline and rifampin or streptomycin

1 PART Coccobacilli Similar to Yersinia pestis Zoonotic disease Endemic to the northern hemisphere, not in the tropics In wild rabbits → Rabbit fever

1 PART Rabbits, rodents, bloodsucking arthropod vecters, wild animal, some domestic animals not communicated from human to human Infective dose of 10~50 organisms → the most infectious of all bacteria

1 PART Depending upon the portal entry : Headache, fever, chills, malaise, Ulcerative skin lesion, Swollen lymph glands, Sore throat, Intestinal disruption, systemic symptom, pulmonary involvement

1 PART gentamicin, tetracycline → intracellular persistence of F. tularensis leads to relapses Live attenuated vaccine, protective glove, mask, eyewear

1 PART non-motile, encapsulated coccobacillus Urease, nitrate reductase, citrate (-) Responsible for pertussis (whooping cough) : communicable childhood affliction (birth to 4 years), acute respiratory syndrome →severe, life-threatening complications in babies Direct contact with droplets, inhalation of infection aerosols

1 PART ① receptors : recognize ciliated respiratory epithelial cells ② toxin : destroy and dislodge ciliated cells → the loss of the ciliary mechanism → build up of mucus and blockage of the airways

1 PART ① catarrhal stage : nasal drainage, congestion, sneezing, occasional coughing ② paroxysmal stage recurrent, persistent coughing, 10 to 20 abrupt, hacking cough → the need for oxygen → stimulates a deep inspiration → draws air swiftly through the narrowed larynx → ‘whoop’

1 PART Treatment : Erythromycin, azithromycin, clarithromycin Prevention - Vaccine DPT (diphtheria, tetanus, pertussis) - Acellular vaccine (aP, contains toxoid) with DT vaccine

1 PART motile rods, cocci to filaments, non-capsule Catalase( + ), oxidase (+) Fastidious nutrient requirements → charcoal yeast extract (BCYE) media or cell culture Ability to survive and persist in natural habitats

1 PART Living intracellularly in free-living ameba Distributed in aqueous abitats : Tap water, cooling towers, spas, pond, fresh water etc. Can be carried for long distances Not communicable from person to person Nosocomial infections : in elderly patients hospitalized with diabetes, malignant disease, transplants, alcoholism, lung disease

1 PART Legionnaires’disease, Pontiac fever → Fever(41 ℃ ), cough, diarrhea, abdominal pain Legionnaires’disease : Lung consolidation, impaired respiration & organ (fatality rate : 3~30%) Prevalent in males over 50 years of age Diagnosis : Fluorescent antibody staining, Cultivation on charcoal yeast extract (CYE) agar, DNA probes, Symptom & patient’s history Treatment : Erythromycin with rifampin

2 PART Healthy and sick farm animals, fish, fruits & vegetables, drinking water → invade the small intestinal mucosa → lymphatics → intracellularly in phagocytes → inflammantion of the ileum & mesenteric lymph nodes → severe abdominal pain (mimics appendicitis) More benign than Y.enterocolitica Lymph node inflammation

2 PART Gram-negative rods Bipolar staining, Capsules Facultative anaerobes Non Spore, Non flagella Zoonotic disease

2 PART Capsular and envelope proteins → protect against phagocytosis → foster intracellular growth Coagulase : clots blood - obstructing blood vessels in human → necrosis - clogging the esophagus in fleas Endotoxin & murine toxin

2 PART Plague bacillus : naturally in many animal hosts Endemically : Africa, South America, the Mideast, Asia, the former USSR, India Attributed to increased populations of rats, flea vectors No human to human transmission since 1924 Humans can develop plague - Sylvatic cycle : Through contact with wild animals - Urban cycle : Domestic or semi-domestic animals, or infected humans

2 PART The plague bacillus multiplies in the bite → necrosis & swelling of the local lymph nodes (bubo) Localized to the lungs Highly contagious through sputum, aerosols Disseminated intravascular coagulation, subcutaneous hemorrhage, necrosis, gangrene. Visible darkening of the skin, “black death.”

2 PART Diagnosis : The patient’s history, Culture of bubo aspirate Treatment : Streptomycin, Tetracycline, Chloramphenicol Prevention - Killed vaccine : effective only for a few month - Attenuated vaccine : short effect and has a side effect

2 PART Oxidase (+) Nonenteric Pathogens Gram-negative rods Normal flora in animals Facultative anaerobes Optimal temperature : 33 ~ 37 ℃ Motility (-) Bipolar staining Grow well on blood or chocolate agar, but not MacConkey agar Virulent factor : endotoxin (LPS), capsule Most common in human disease : Pasteurella multocida

2 PART Normal flora in animals Zoonotic infection Opportunistic infection Poultry & wild fowl : cholera-like outbreaks Cattle : outbreaks of hemorrhagic septicemia or pneumonia “shipping fever” Cats & dogs : nasopharynx, tonsils

2 PART Animal bites or scratches → local abscess → immunocompromised patients : septicemic complication (Central nerve system, heart) Treatment : Penicillin, Tetracycline, Cepahlosporin

2 PART Tiny, gram-negative pleomorphic rods Fastidious & sensitive to dry, temperature, disinfectants Not grow on blood agar, require for Blood factor - factor X: necessary component of cytochromes, catalase, peroxidase - factor V: important coenzyme Chocolate agar, Filed medium

2 PART Nonvirulent species : normal colonist of the upper respiratory tract or vagina Virulent species - H. influenzae - H. aegyptius ( conjunctivitis ) - H. ducreyi ( chancroid ) - H. parainfluenzae ( childhood miningitis ), - H. aphrophilus

2 PART Isolated from patients with ‘flu’, but the causative agent → influenza virus Acute bacterial meningitis : By the ‘b’ serotype, children ( 3 months ~ 5 years )

2 PART Haemophilus meningitis → Not associated with epidemics, but sporadic cases or cluster in daycare & family settings → Very similar symptom to meningococcal meningitis Haemophilus infections → Transmitted by close contact, nose & throat discharges → Healthy adult carriers : reservoirs of the bacillus → Untreated cases : fatality rate is 90%

2 PART Epiglottitis → In older children & young adults → Immediate intubation or tracheostomy Otitis media, Sinusitis, Pneumonia, Bronchitis Treatment - chloramphenicol + ampicillin - rifampin prophylaxis combination with DTaP Prevention - vaccination - subunit vaccine ( Hib ) → based on type ‘b’ polysaccharide

2 PART Diseases : acute communicable ‘conjunctivitis’ (pinkeye) In children, by contaminated fingers & shared personal items, gnats & flies Treatment : antibiotic eyedrops

2 PART Diseases : chancroid ( soft chancre ) - STD In the tropics & subtropics, mostly males direct contact with infected lesions unclean personal habits. Treatment : cotrimoxazole

2 PART Normal oral & nasopharyngeal flora Diseases : infective endocarditis in adults (underlying congenital or rheumatic heart disease) Periodontal disease, oral injury

1 QUIZ ① Resistance in soaps, dyes, disinfectants, drugs and drying ② Ubiquitous pathogen ③ Virulent factors ④ endotoxins ⑤ Opportunistic 1. Which is NOT characteristic of the pseudomonas aeruginosa?

2 QUIZ ① Facultative anaerobes ② Grow well on MacConkey agar, but not blood or chocolate agar ③ Non-motility ④ Oxidase (+) Nonenteric Pathogens ⑤ Bipolar staining

3 QUIZ 3. What is the meaning of following information? necessary component of cytochromes, catalase, peroxidase in haemophilus

4 QUIZ 4. Which following is not true about Brucellosis? ① It is also called Undulant fever, Malta fever, Bang’s disease ② It is caused by Brucella ③ Human Brucellosis cause abortion ④ Its treatment is combination of tetracycline and rifampin or streptomycin ⑤ Human Bucellosis cause sever febrile illness

5 QUIZ ① Disseminated intravascular coagulation, subcutaneous hemorrhage, necrosis, gangrene. ② Visible darkening of the skin, “black death.” ③ necrosis & swelling of the local lymph nodes ④ Highly contagious through sputum, aerosols

6 QUIZ 6. Which of following is not true about Bordetella pertussis ? ① destroy and dislodge ciliated cells ② encapsulated coccobacillus ③ Responsible for pertussis ④ recognize ciliated respiratory epithelial cells ⑤ Indirect contact with droplets, inhalation of infection aerosols

Foundations in Microbiology / McGrow-hill Education / Kathleen Park Talaro / 7 th edition / 2008 진단미생물학 / 현문사 / 김양호 외 5 명 / 2002 최신진단미생물학 / 서흥출판사 / 정윤섭 외 6 명 / 제 4 판 / 2009 병원미생물학 / 고려의학 / 권필승 외 4 명 / 제 3 판 / 2011