LeptOspIrOsIs

Leptospira Introduction Cell Biology Transmission Risk of transmission Pathogenesis Resistance Disease - Diagnosis - sign and symptom - clinical presentation - Treatment Prevention Leptospira

Introduction leptospirosis has emerged as a health threat in new settings due the influence of globalization and climate Endemic in tropical and subtropical regions . with an estimated 873,000 infections and 48,000 deaths annually

Features of leptospira Thin Helically coiled Motile spirochetes usually 6–20 μm in length . The hooked ends of this bacterium give its distinctive question-mark shape. Dark field microscope; in korthof’s media.

Transmission

Risk of Transmission

Uterus in pregnant animal pathogenesis penetration fever Localized in lung liver jaundice kidney brain Uterus in pregnant animal abortion

Resistance Biofilms make liptospira more resistant to environmental conditions , with the result that, more chances to survive and infect humans .

Requirement of biofilms : 1- extensive reprogramming of transcription patterns along the three replicons of L. biflexa and involves many regulatory networks like c-di-GMP signaling, anti-anti-sigma factors. 2-canonical two-component systems that control basal functions, like DNA metabolism and replication 3-more specific functions like cell motility or lipid and sugar metabolisms

EtBr as an indicator to resistance mechanisms . L. biflexa shows to possess a mechanical barrier, the outer membrane (OM). hydrophilic agents, including EtBr and some antibiotics, cannot diffuse into the periplasm. even though EtBr may enter via porins, leptospira can prevent diffusion , by multidrug efflux pumps spanning both the outer and the inner membranes inner-membrane single-drug transporters can contribute to the efflux of EtBr back to the periplasm

Conclusion Overexpression of proteins involved in the process of drug efflux or mutational gain of function in the genes encoding these proteins contribute to antibiotic resistance in a number of bacterial species .

Leptospirosis a kind of zoonotic infectious Leptospirosis: a contagious disease endemic in tropical and subtropical regions affecting both animals and humans and spread by infection with a bacterial pathogen called Leptospira. Early diagnosis for the bacteria is very important because the treatment is very effective in early stages. Severity of the disease could be mild and self limiting to life threatening condition. Nosogenic age: young and middle age,children.

S $ S Three symptoms: fever, myalgia, fatigue; Three signs: conjunctival suffusion muscle tenderness enlargement of lymph nodes

Treatment Most cases of leptospirosis are self-limited in the absence of antimicrobial therapy, although a proportion of patients do develop severe complications with significant morbidity and mortality and need antimicrobial therapy . For inpatient : (SEVERE) Penicillin G, ampicillin, amoxicillin, ceftriaxone or cefotaxime and all are administered parentally. For outpatient : (MILD) Doxycycline or azithromycin are enough

PREVENTION

Vaccines The first demonstration has been provided in 1916 that immunisation with killed leptospires protects against experimental infection. Since then, whole Leptospira-based vaccines have been routinely administered to livestock and domestic animals and used for immunization of human populations . Whole Leptospira-based vaccines are associated with high rates of advers reactions and confer only short-term serovar-specific immunity . Furthermore whole-Leptospira vaccines are not universally effective in preventing carriage, which limits their use as a transmission blocking intervention.

The availability of multiple genome sequences provides an opportunity to apply high throughput strategies for identifying novel vaccine candidates. The ultimate goal for vaccine development will be to identify a candidate which protects against the spectrum of Leptospira agents. Until epidemiologically-validated immune correlates are identified, discovery of vaccine candidates will likely continue to rely on the search for new virulence factors and outer membrane proteins.

MaisALReem AL-Housani Hadeel AL-Zoubi MaisALReem AL-Housani Alaa Abu Romman Sara Tablieh Ola Rahamneh