2. Pasteurellaceae

3.  Haemophilus influenzae  Haemophilus ducreyi  Oppurtunists: Haemophilus parainfluenzae Haemophilus spp.  Pasteurella multocida  Actinobacillus actinomycetemcomitans Human Pathogens

4. Pasteurellaceae General Overview  Taxonomic Confusion in Family Pasteurellaceae  Three Genera: Haemophilus: Most Common in Human Disease Actinobacillus Pasteurella  Haemophilus  Common Characteristics of Family Small (0.2 x 0.3-2.0 mm) Gram-negative Nonmotile bacilli Aerobic or facultatively anaerobic Fastidious growth requirements

5. Pasteurellaceae Differential Characteristics X factor = hemin (hematin) V factor = (NAD or NADP) nicotinamide adenine dinucleotide

7. Haemophilus

8. Haemophilus General Overview  Gram-negative bacilli liking blood (as per genus name)  Obligate Parasites of Man and Animals  Major pathogens for which humans are natural hosts Haemophilus influenzae Acute pyogenic, normally invasive infections Chronic infections with H. influenzae as 2 o pathogen Haemophilus ducreyi True pathogen (i.e., not found in healthy individuals) STD; Soft chancre (chancroid )

9. Haemophilus Diseases

10. Haemophilus Infections PRP = polyribitol phosphate (see others in text)

11. Haemophilus Infections (cont.) NOTE: Polysaccharide PRP is weakly immunogenic Pediatric immunity not mature for processing polysaccharide antigens until ~18 months Conjugated Vaccine: PRP conjugated to protein carrier induces protective immunity (carriers may include: diphtheria toxoid, tetanus toxoid or meningococcal OMP)

12. Haemophilus influenzae Incidence NOTE: Dramatic decrease in children <5 years; remains constant in older children (per 100,000)

13. Haemophilus influenzae Diseases

14. Haemophilus ducreyi Incidence

16. Actinobacillus

17. Actinobacillus General Overview  Slow-growing; Small; Gram-negative Bacilli  Facultatively Anaerobic  Require CO 2 for growth on chocolate or blood agar  Three Species of Actinobacillus Associated with Human Disease  Actinobacillus actinomycetemcomitans is: Most serious pathogen of genus Hyperadherent in vitro and on damaged heart valves Commonly isolated with Actinomyces -comitans is Latin for “accompanying” Normal oropharyngeal flora in 20% of healthy people

18. Actinobacillus Diseases HumanJuvenile & adultSubacute

20. Pasteurella

21. Pasteurella General Overview  Small; Gram-negative; Fermentative Pleomorphic Coccobacilli  Facultatively Anaerobic Therefore infects sutured bites or scratches  Pasteurella multocida: Most common human pathogen Domestic pets serve as major reservoir Commensals in upper respiratory tract of dogs,cats,etc. Human infection often related to animal bites or scratches or shared food (and you wondered why that lady was buying so much cat food --- it’s cheaper! )

22. Pasteurella DIseases Three Forms of Disease  Localized cellulitis and lymphadenitis following animal bite or scratch  In patients with underlying lung dysfunction, worsening of chronic pulmonary disease from aspiration of organisms colonizing patient’s oropharynx  Systemic infection in immunocompromised Liver disease patients at highest risk

23. Pasteurella Diseases (cont.) Animal scratch or

25. REVIEW of Pasteurellaceae

26. Pasteurellaceae Differential Characteristics X factor = hemin (hematin) V factor = (NAD or NADP) nicotinamide adenine dinucleotide REVIEW

27. Review of Haemophilus

28. Haemophilus General Overview  Gram-negative bacilli liking blood (as per genus name)  Obligate Parasites of Man and Animals  Major pathogens for which humans are natural hosts Haemophilus influenzae Acute pyogenic, normally invasive infections Chronic infections with H. influenzae as 2 o pathogen Haemophilus ducreyi True pathogen (i.e., not found in healthy individuals) STD; Soft chancre (chancroid ) REVIEW

29. Haemophilus Diseases REVIEW

30. Haemophilus Infections PRP = polyribitol phosphate (see others in text) REVIEW

31. Haemophilus Infections (cont.) NOTE: Polysaccharide PRP is weakly immunogenic Pediatric immunity not mature for processing polysaccharide antigens until ~18 months Conjugated Vaccine: PRP conjugated to protein carrier induces protective immunity (carriers may include: diphtheria toxoid, tetanus toxoid or meningococcal OMP) REVIEW

32. Haemophilus influenzae Incidence (per 100,000) NOTE: Dramatic decrease in children <5 years following use of PRP conjugated vaccine; Disease rate remains constant in older children REVIEW

33. Haemophilus ducreyi Incidence REVIEW

34. Review of Actinobacillus

35. Actinobacillus General Overview  Slow-growing; Small; Gram-negative Bacilli  Facultatively Anaerobic  Require CO 2 for growth on chocolate or blood agar  Three Species of Actinobacillus Associated with Human Disease  Actinobacillus actinomycetemcomitans is: Most serious pathogen of genus Hyperadherent in vitro and on damaged heart valves Commonly isolated with Actinomyces -comitans is Latin for “accompanying” Normal oropharyngeal flora in 20% of healthy people REVIEW

36. Actinobacillus Diseases HumanJuvenile & adultSubacute REVIEW

37. Review of Pasteurella

38. Pasteurella General Overview  Small; Gram-negative; Fermentative Pleomorphic Coccobacilli  Facultatively Anaerobic Therefore infects sutured bites or scratches  Pasteurella multocida: Most common human pathogen Domestic pets serve as major reservoir Commensals in upper respiratory tract of dogs,cats,etc. Human infection often related to animal bites or scratches or shared food (and you wondered why that lady was buying so much cat food --- it’s cheaper! ) REVIEW

39. Pasteurella DIseases Three Forms of Disease  Localized cellulitis and lymphadenitis following animal bite or scratch  In patients with underlying lung dysfunction, worsening of chronic pulmonary disease from aspiration of organisms colonizing patient’s oropharynx  Systemic infection in immunocompromised Liver disease patients at highest risk REVIEW

40. Pasteurella Diseases (cont.) Animal scratch or REVIEW