1. 2007274002 류정희 ( 자료조사,PPT 제작, 발표 ) 2008274004 임창하 ( 자료조사,PPT 제작, 발표 ) 2008274036 고원정 ( 자료조사,PPT 제작, 발표 )

3. Helical form Motility - periplasmic space periplasmic flagella =endoflagellum=axial flagella →flexing →rotation & crawling motion Gram-negative Free-living saprobes or commensals of animals endoflagellum Periplasmic space endoflagellum Outer membrane Cell body

4. http://www.youtube.com/watch?v=O0y7 X5acK8Mhttp://www.youtube.com/watch?v=O0y7 X5acK8M

6. phylumfamilyGenus Spirochete s Spirochaetacea e Borrelia Brevinema Cristispiraeta Spirochaeta Spironema Treponema Brachyspiracea e Brachyspira Leptospiraceae Leptospira leptonema

7. Schematic designation of spirochetes based on general morphology. (From Baron EJ, Finegold SM. Bailey and Scott’s diagnostic microbiology. St. Louis: Mosby, 1990, with permission.)

8. Thin, regular, coiled cells Strictly anaerobic & microaerophilic Perigenital regions of humans, Oral cavity, intestinal tract, Strict parasites : complex growth requirements Treponematoses

9. Diseases caused by Genus Treponema Syphilis –Treponema pallidum ss. Pallidum Nonsyphilis –Bejel: Treponema pallidum ss. endemicum –Yaws: Treponema pallidum ss. pertenue –Pinta: Treponema carateum

10. Treponema pallidum : The Spirochete of Syphilis 1. Epidemiology and virulence factors Host - Human Extremely fastidious - not survive for long outside the host - Destroyed heat, drying, disinfectants, soap, high oxygen tension, pH changes

11. The risk of infection from an infected sexual partner: 12~30% Uncommon mode - the fetus in utero, medical accident Coinfection with other STDs - gonorrhea, chlamydia, herpes simplex, AIDS

12.  Direct contact with Mucous membranes or abraded skin  Hooked tip to the epithelium  Multiplies and penetrates the capillaries.  Slow generation time(but progressive disease)

13. Outer membrane proteins : virulence facter  No toxins, not directly kill cells Formed phagocytes and antitreponemal antibodies.  but, cell-mediated immune responses are unable to contain it  Form granulomas and block blood circulation.  organs damaged

14. Primary Syphilis - Hard chancre internal and external Genitalia lips, oral cavity, nipples, finger, rectum - Painless; - heals spontaneously, but the spirochete into the circulation.

15. Treponema pallidum : The Spirochete of Syphilis 3. Clinical Manifestations Secondary Syphilis fever, headache, sore throat  Lymphadenopathy, Peculiar red or brown rash on all skin surfaces  Disappears spontaneously

16. Latency - Early and late latency / spirochete is not detected Tertiary Syphilis - Cardiovascular syphilis/Gumma/neurosyphilis

17. Treponema pallidum : The Spirochete of Syphilis 3. Clinical Manifestations

18. Congenital syphilis - spontaneous miscarriage or stillbirth - nasal discharge, skin eruption and loss, bone deformation, nervous system abnormalities Huntchinson’s teeth

19. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis * Overlapping symptoms of concurrent, sexually transmitted infections(gonorrhea, chlamydiosis) can further complicate diagnosis Direct detect method Serological Test for Syphilis(STS) - Non-treponemal test - Treponemal test

20. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis dark-field microscopy of a suspected lesion direct immunofluorescence staining DNA PCR Direct detect method

21. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis Serologic Test for Syphilis ; STS RPR (Rapid Plasma Reagin) VDRL(Veneral Disease Research Laboratory) - based on Wasserman test - anti-cardiolipin antibodies screening test for syphilis

22. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis MHA-TP ( T. pallidum micro-hemagglutination assay), TPHA - treponemal antigen coated red blood cells + patient’s serum → agglutination TPI ( T. pallidum immobilization) test - live syphilis spirochetes + test serum → observed microscopically for loss of motility

23. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis FTA-ABS (Fluorescent Treponemal Antibody Absorbance) test - test serum is absorbed with treponemal cells → reacted with antihuman globulin labeled with fluorescent dyes → the fluorescent on the outside of these cells with fluorescent microscope

24. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis Direct detect method Dark-field microscopy Direct immunofluorescence staining DNA PCR DNA hybridization Serological Test for Syphilis Nontre ponem al Test Rapid Plasma Reagin(RPR) VDRL Trepon emal Test MHA-TP, TPHA FTA-ABS TPI(T. pallidum immobilization)test

25. Treponema pallidum : The Spirochete of Syphilis 4. Clinical and Laboratory Diagnosis

26. Treponema pallidum : The Spirochete of Syphilis 5. Treatment and Prevention Treatment - Penicillin G with benzathine or procaine - Tetracycline & erythromycin : if penicillin allergy Prevention - Barrier effect of a condom

27. Rarely transmitted sexually or congenitally Bejel, Yaws, Pinta Local invasion to skin mucous membrane → subcutaneous tissues, bones, joints Penicillin, erythromycin, tetracycline

28. Nonvenereal childhood syphilis T. pallidum endemicum : Reservoir of Nomadic people In arid areas Chronic, inflammatory childhood disease, small, moist patches

29. Bouba, frambesia tropica, patek T. pallidum pertenue Endemic to warm, humid, tropical regions Symptom - Large, abscessed papule ‘mother yaw’ on leg or lower trunk → moist nodular tumors → mutilating ulcerations of the face, extremities

30. Chronic skin infection(mal del pinto, carate) T. carateum Tropical forest, valley regions : Central & South America Symptom - scaly papule (reminiscent of leprosy)→ pigmented secondary macules → blanched tertiary lesions

31. Q &A

32. reference Clinical Laboratory Medicine2nd Edition / 2002 년 / williams&wikins  최신진단미생물학 / 서흥출판사 / 정윤섭외 6 명 / 제 4 판 /p368-371  Microbiology/Higher Education/Kathleen Park Talaro / 제 7 판 /p621-628