1. Coxiella burnetii By
R.Teja sri

2. Introduction Coxiella burnetti is the causative agent of ‘Q-fever’
Obligate intracellular, gram negative bacterium
Distributed globally
Found in many species of animals

3. Morphology:- gram negative . Pleomorphic .
obligate intracellular pathogen .
gram negative .
Pleomorphic .
size : rods:- 0.2 – 0.4 x 0.4 – 1.0 mc
spheres :- 0.3 – 0.4 mc
filterable .
better stained with GIMINEZ and other rickettsiael stains .

4. C. burnetii i
en.wkipedia.org

5. Culture
Grows well in yolk sac of chick embryos and in various cell cultures .

6. Ag structure shows phase variation . phase – I ,II .
phase – I :- autoagglutinable
more immunogenic
activity due to periodate sensitive trichloracetic acid-soluble surface carbohydrate .
Phase – II :- more suitable for CFT .
both phase I ,II elicit good Ab response .

7. Resistance Resistant to physical and chemical agents
In pasteurization flash method is effective
Can survive in dust and aerosols
Inactivated by 2% formaldehyde
5% H2O2
1% Lysol .

8. Contd…. Resistant to heat, drying and disinfectants
Air samples test positive for 2+ weeks
Soil samples test positive for 150+ days
Spore formation

9. PATHOGENESIS

10. History Q stands for Query or Queensland Origin of disease unknown
First reported cases were in Queensland, Australia

11. Differentiating features :
1. Having smaller size
2. Resistance to heat and drying
3. Major route of transmission is-
inhalation/ingestion

12. * All eukaryotes can be infected
Primary Reservoir
Goats
Cattle
Sheep
* All eukaryotes can be infected

13. Bacteria is excreted in:
Feces
Urine
Milk
of infected animals

14. Release Into Environment:-
During birthing the organisms are shed in high numbers in amniotic fluids and the placenta
109 bacteria per gram of placenta
Do not touch!

15. Transmission Most common route is inhalation of aerosols
Contaminated dust, manure, birthing products
Tick bites (rare)
Human to human also very rare
gsbs.utmb.edu

16. Contd…..
Who’s at risk?
Farmers, veterinarians, researchers, abattoir (slaughterhouse) workers etc.
People who breed animals
Immunocompromised

17. Acute or Chronic Q fever
gsbs.utmb.edu
*Bacteria spread through blood

18. Symptoms Acute Q fever Self-limiting, flu-like disease
Fever, nausea, headaches, vomiting, chest/abdominal pain
Pneumonia & granulomatous hepatitis

19. Chronic Q fever (> 6 months)
Endocarditis & meningoencephalitis
Pre-existing disease

20. Host interaction Entry via inhalation
Alveolar macrophages encounter bacteria
C. burnetii phagocytosed
Macrophage
C. burnetii
R Heinzen, NIAID

21. Host interaction Replication within phagolysosme
Low pH needed for metabolism
No cellular damage unless lyses occurs
Can invade deeper tissue and cause complications

22. Phagocytosis Binding/entry into macrophages via:
Integrin Associated Protein (IAP)
Leukocyte Response Integrin (LRI)
bacteria
macrophage

23. Binding & Entry Phagocytosis Phagocytic vesicle
Phago-lysosome fusion: bacteria survive and multiplies
Lysis of phago-lysosome and macrophage

24. LAB DIAGNOSIS Hard to diagnose because:
Asymptomatic in most cases
Looks like other disease (Flu or cold)
Serology continues to be best method
PCR, ELISA and other methods
WEIL – FELIX test is negative .

25. Contd….. Bio safety level 3 (BSL-3) facility
Very infectious (one organism causes infection)
Listed by the CDC as a potential bioterrorism agent.
Isolated in cell cultures or embryonated eggs

26. Treatment Once infected, humans can have life-long immunity
Acute Q fever treated with:
doxycycline,
chloramphenicol,
erythromycin or
fluoroquinolones
Chronic Q fever treated with:
More than one antibiotic
tetracycline and cotrimoxazole for 2 years

27. prepared from formalin killed whole cells attenuated strains
Vaccines :-
prepared from formalin killed whole cells
attenuated strains
trichloroacetic acid extracts

28. Prophylaxis:-
Pasteurization and sterilization of milk and other dairy products
Disinfect utensils, machines used in farm areas for birthing
Regular testing of animals and those who work closely with them
Protective Personal Equipment

29. BARTONELLA

30. INTRODUCTION Family Bartonellaceae contain two genera Bartonella
Grahamella
Grahamella does not infect humans

31. Bartonella contain 3 species:
B.bacilliformis
B.quintana
B.henselae

32. BARTONELLA BACILLEFORMIS
Carrions disease
Causes OROYA fever

33. MORPHOLOGY:
Gram negative
Pleomorphic
strict aerobe
motile, small bacillu x mc
found inside erytrocyte infected persons
Opt. temp c

34. CULTURE;
Grow in semisolid nutrient agar with
10% rabbit serum
0.5%Hb
Growth is slow takes about 10 days

35. PATHOGENISIS:- Causes OROYA fever Transmitted by SAND flies
INCUBATION PERIOD;
3 weeks to 3 months

36. CLINICAL FEATURES:- Fever Headache Chills Severe anemia
Several weeks after recovery pt. develop
nodular lesions on the body
Secondarily infect produce ulcers –
VERUGA PERUANA

39. Lab diagnosis:- Demonstrated in blood smear by GIEMSA stain
Seen in cytoplasm and adhere to cell surface
Grown on NA agar contain rabbit serum, Hb
Guinea pig inoculation leads to
VERUGA PERUANA

40. TRETMENT:- Susceptible to penicillin streptomycin Tetracycline
Chloramphenicol

41. PREVENTION Insecticides such as DDT should be used
to eliminate sand flies

42. BARTONELLA QUINTANA

43. MORPHOLOGY:-
small gram negative bacillus
mc to mc
Does not posses flagella
show twitching movments by fimbriae

44. CULTURE:-
Grows on rabbit /sheep blood agar
opt. temp -35 c in 5% CO2
colonies appear after 14 days primary
inoculation

45. PATHOGENESIS:-
Formerly called Rochalimaea quintana Causes TRENCH fever also called FIVE DAY fever

46. Transmission; by body louse
vertical transmission does not occur in lice
Lice after acquiring infection remain infectious through out life

47. CLINICAL FEATURES:- Mild symptoms leads to chronic rickttesiaemia
Relapse have been observed even after 20 years primary disease

48. Lab diagnosis:- Detected in the gut of infected lice
Isolate from pt. blood by cultur sheep blood agar
Weil-felix test negative
PCR- detect organism in tissues

49. BARTONELLA HENSELAE

50. MORPHOLOGY:-
Gram negative
Slightly curved
Show twitching movments

51. CULTURE:-
Grows on chocolate agar
columbia agar with 5%sheep blood
tryptic-soy agar
opt.temp c in 5% CO2

52. embedded in the agar COLONY MORPHOLOGY:-
white, dry, cauliflower like and
embedded in the agar

53. PATHOGENESIS:- Causes CAT-SCRATCH disease
Occur by contact with scratch / bite of
an infected cat

54. Cat contact Resolution in weeks to months Dissemination in immuno-
(scratch, bite,
? cat flea bite)
1 - 3 weeks
Dissemination
in immuno-
compromised
hosts

55. CLINICAL FEATURES:- Regional lymphadenopathy Fever Endocarditis
In AIDS pt. leads to;
bacillary angiomatosis

56. Lab diagnosis:- lymph node biopsy – stained with
WARTIN-STARRY SILVER IMPREGNATION –clusters of bacillus
Grow on chocolate agar/ columbia agar

57. TREATMENT:-
Self limiting
No specific treatment required

58. THANK YOU