1. Gram-positive Non-Spore-Forming Bacilli
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김철우 자료조사, 발표

2. Toxoid 란? 우리말로 ‘독소’ 사전적 : 독성을 상실하고 면역원성을 유지하고 있는 단백질독소.
쉽게 말해 인체에 유해하지 않을 정도로 약한 독

3. 저희 조가 발표할 세균은 그람 양성균으로써 아포를 생성하지 않는 regular type의 세균인 리스테리아와 에리시펠로쓰릭스와 irregular 세균 중 항산성 염색이 되지 않는 세균인 corynebacterium과 프로피오니박테리움입니다.

4. <Contents>
1. Gram-Positive Regular Shape Non-Spore-Forming Bacilli
Listeria
Erysipelothrix
2. Gram-Positive irregular Shape Non-Spore-Forming Bacilli
Corynebacterium
Propionibacterium

5. Gram-positive Regular Shape Non-Spore-Forming Bacilli
Lactobacillus
Listeria
Caryophanon
Kurthia
Erysipelothrix
Bronchothrix
Renibacterium
종류에는 락토바실러스와 리스테리아 에리시펠로쓰릭스 컬시아 칼요패논 브론쇼쓰릭스 레니박테리움등이 있는데 그 중 병원성을 띄는 리스테리아와 에리시펠로쓰릭스에 대해 알아보도록 하겠습니다.

6. Listeria monocytogenes
리스테리아는 작은 간균으로 주위에 생긴 섬모로 운동을 하며, 인체의 유산을 일으키는 병원균입니다.

7. Listeria monocytogenes
Range in morphology from coccobacilli to long filaments in palisades formation
Tumbling motility with 1~4 flagella
No capsules
No spore
유산 일으키는 대표적인 균

8. Listeria monocytogenes
β-hemolytic
Resistant to heat, cold, salt PH extremes, bile
Intracellular parasitism
Listeriolysin같은 독소를 생성하여 세포막 손상

9. Epidemilogy and pathology of Listeriosis
Primary reservoir : soil and water
Secondary source of infection : Animals, plants, food
Ingesting contaminated dairy products, poultry, meat
Aged cheese – Listeria readily survive through long storage, grow during refrigeration

10. Epidemilogy and pathology of Listeriosis
Immunocompetent individual – nonspecific symptoms
Immunocompromised patients, fetuses, neonates – affects the brain and meninges
-> septicemia
Intrauterine infections – premature abortion, fetal death
Neonatal infections – damage to the nerveus system

11. Diagnosis and Control of Listeriosis
Cold enrichment : 4℃, periodically plated onto media,
4weeks
Catalase (+)
CAMP (+), ★우산모양★
Rapid diagnostic kit : ELISA
Immunofluorescence DNA analysis

12. Diagnosis and Control of Listeriosis
Antibiotic theraphy – as soon as suspected
Ampicillin, trimethoprim-sulfamethoxazole
Erythromycin
Pasteurization (low temperature) : Not effective

13. Erysipelothrix rhusiopathiae

14. Erysipelothrix rhusiopathiae
Gram (+)
Catalase (-)
Rod shaped
Endotoxin X
Non spore and capsule
Mobility X

15. Erysipelothrix rhusiopathiae
Primary reservoir : tonsils of healthy pigs
Commonly isolated from sheep, chickens, fish
Persist long periods in sewage, seawater, soil, food
Epidemics of swine erysipelas(돼지단독균)

16. Erysipelothrix rhusiopathiae
Human infection : Erysipeloid
- Handle animals, carcasses,
meats (slaughterhouse
workers, butchers)
Common portal of entry – scratch, abrasion on the hand or arm

17. Erysipelothrix rhusiopathiae
Rare case of complication : Septicemia
Endocarditis
Drug : penicillin, erythromycin

18. Gram-Positive Irregular Shape Non-Spore-Forming Bacilli
Corynebacterium, Mycobacterium, Nocardia , Propionibacterium
Catalase(+)
Pleomorphic and to stain unevenly
Unique type of peptidoglycan
Mycolic acids
Clinical significance

19. Corynebacterium Motility x Spore x Stain → Metachromatic granule
C.xerosis, C.striatum, C.diphtheriae

20. Corynebacterium diphtheriae
Most human disease associated with C. diphtheriae
Morphology
1. Pleomorphic variants
2. Metachromatic granule
3. Straight or somewhat curved rod, tapers at the ends
4. Club, filamentous and swollen shapes
Pleomorphic : 형태학적 다양함
Palisade : 울타리
granule : 과립

21. Epidemiology of Diphtheria
Significant cause of mortality but rate have steadily declined
Most cases occur in non-immunized children living in crowded, unsanitary situations
Still, many populations harbor a reservoir of healthy carriers

22. Pathology of Diphtheria
Contact with droplets from human carriers or active infections
Local infection (Cutaneous diphtheria)
Toxin production & Toxemia
Primary infection site : upper respiratory tract
Cutaneous diphtheria starts from virulence factors that assist in its attachment and growth -> deep, erosive ulcers
Not invasive but usually remain localized at portal of entry
Erosive ulcer : 부식성 궤양
혈액 내에 침입하지 않고도 독소로 인해 전신증상을 나타낼 수 있다.

23. Diphtherotoxin and Toxemia
- C. diphtheriae 가 감염부위에서 생성하는 매우 강력한 외독소
- Consisted of : Fragment A & B
1. Fragment A : interacts metabolically with factors in the
cytoplasm and stops protein synthesis.
2. Fragment B : Binds to target cells in
heart and nerve system
쉽게 말해 B가 target cell에 부착하면 A가
분리되고 cytoplasm으로 들어가서 독작용
Cardinal : 가장 중요한

24. Diphtherotoxin and Toxemia
Local infection
Inflammatory reaction, swelling neck and fever
Systemic infection
-Pseudomembrane
Greenish-gray film, solidification of fluid in pharynx
-Toxemia (독혈증)
Toxin absorbed from throat carried by blood
to heart and nerves
-> Asphyxiation, Heart damage, Muscle weakness
Pseudomembrane – 단단하게 붙어있어 떼려고 하면 출혈, 기도에 생겨 질식 유발
Myocarditis and abnormal EKG patterns : 심근염과 부정맥
Asphyxiation : 질식

25. Diagnostic Methods for Corynebacterium
Positive Schick test
- Diphtheriae 변성 독소를 주입하여 반응 여부 검사
빨갛게 변함(+) : 백신 접종 필요
반응 없음(-) : 굳이 백신 접종할 필요가 없음
- 백신의 이차적인 부작용 결과를 최소화
디프테리아 변성독소(Toxoid)를 주입하여 체내에서 이 독소에 반응할 수 있는 능력이 있는지를 살핌.
빨갛게 변함(+) : 백신 접종이 필요함
아무 반응 없음(-) : 굳이 백신 접종을 할 필요가 없음.
디프테리아 변성독소에 양성반응을 보인 경우에만 항독소를 주입하는 백신을 접종하게 되었기에 백신의 이차적인 부작용 결과를 최소화 할 수 있게 되었다.

26. Treatment and Prevention of diphtheria
- DAT (Diphtheria Anti-Toxin) : 말 혈청에 대한 allergy test필요
- Penicillin + erythromycin
Prevention
- DPT : Vaccination with toxoid
- DTaP : DPT의 부작용을 최소한 한 Vaccine.
- D : Diphtheria
T : Tetanus by Clostridium tetani (파상풍)
P : Pertussis by Bordetella pertussis (백일해)
DAT : 말의 혈청이용, 말의 혈청에 대한 allergy test를 먼저 진행해야함.
DTaP : D,T는 Toxoid, aP는 bacterial protein 성분.
항원 : Toxoid – 독작용 x 항원작용 o
Bacterial protein 성분 포함

27. The Genus Propionibacterium
Different by aerotolerant or anaerobic, nontoxigenic
Propionibacterium acnes
- Glands of human skin
Genetic and hormonal factors
Resemble Corynebacterium in morphology and arrangement
P. acnes : 여드름 (화농성) 유발

28. Q&A

29. Quiz

30. Which of the following is not C.diphtheriae’s morphological type?
Curve rods
Filamentous
Club shape
Lancet shaped
Palisades arrangement

31. Which is not used for treatment & prevention of C.diphtheriae?
DTaP
DAT
Penicillin
Erythromycin
None of these

32. The action of the diphtherotoxin can’t cause
Pseudomembrane
Myocarditis
Muscle weakness
Endocarditis

33. An infection peculiar to swine causes _______ when transmitted to humans.
Anthrax
Diphtheria
Tuberculosis
Erysipeloid

34. Reference 최신 진단미생물학, 정윤섭외6명, 제4개정판, Pg189~206
FOUNDATIONS IN MICROBIOLOGY, Talaro Chess, McGRAW-HILL INTERMATIONAL EDITION, 2012, 8판, Pg581~584