Other G- bacteria Neisseria form oxidase and catalase, G- cocci in pairs N. gonorrhae Microscopy: G- cocci in pairs and in leukocytes (intracell. parasite) Cultivation: CHA/Thayer-Martin, 48 h, higher tension of CO2 Biochemistry: rend only glucosis Pathogenicity: always gonorrhea (uretritis, cervicitis, faryngitis), complication: infertility, peritonitis, new born babies - keratoconjunctivitis. Vector: sexual contact Factors of pathogenicity: IgA protease, fimbrias Detection: microscopy and cultivation on CHA – growth as drop of dew, oxidase + Therapy: penicillin, fluoroquinolons, azithromycin, complications: cefotaxim. New born babies: Septonex drops, prevention safe sex nego2 N. meningitidis •Microscopy: G- cocci in pairs •Cultivation: CHA, BA s growth factors •Biochemistry: rend glucosis and maltosis •Pathogenicity: not always the pathogen – sometimes is person only vector, in other cases - faryngitis, sepsis (in young adults) starting as fever with skin spots ends as DIC (first coagulation, later bleeding). Cofactors: immunity, smoking, stress. Transport via droplets! •Factors of virulence: IgA protease, systems binding transferin with Fe, capsular antigens (neisserias are divided to serol. groups A, B, C, W135, Y, Z – antigens are used for vaccine preparation), catalase, oxidase etc. •Diagnostic: cerebrospinal fluid – rapid diagnostic is needed, agglutination+PCR •Cultivation on BA with vancomycin and colistin, which circle out normal flora, biochemistry •Therapy and prevention: vaccination (only against A and C antigen, B antigen is missing!), infusion, plasma, heparin, activators of fibrinolysis, penicillin, ceftriaxon, chloramphenicol Branhamella (Moraxella) catarrhalis ‼ •Microscopy and biochemistry: G-cocci, oxidase, catalase, hydrolysis of indoxylacetate (INAC) •Pathogenicity: bronchitis, conjunctivitis, sinusitis •Therapy: ampicillin, cotrimoxazol, macrolides, cefalosporins • •Oral neisseria (N. subflava, N. sicca aj.) • •Cultivation and biochemistry: less sensitive than previous neisseria, rend various sugars •Pathogenicity: compound of normal flora, in immunocompromised endocarditis •Diagnostic: less used, Neisseria test •Therapy: PNC G- difficult cultivable aerobe rods •Bordetella pertussis, parpertussis, bronchiseptica • •Pathogenicity: pertusis: catarrhal stadium – cold with fever •1 week later: paroxysmal stadium – dyspnoea, cyanotic, crowing child. Last stadium: reconvalescence, also may stay cough •Factors of pathogenicity: pertussis toxin, tracheal toxin... •Diagnostic: direct-microscopy less used, cultivation on B-G soil eradication of other bacteria due to penicillin, agglutination with spec. antiserum, PCR •Indirect: ELISA, aglutinace •Therapy: erytromycin •Prevention: vaccination with cellular or acellular vaccine (less side effects) Pathogen urease oxidase Pathogenicity BA McConkey Bordet-Gengou medium B. pertussis - + pertusis (whooping cough) - - 3-5 days, little pearle colonies B. parapertussis + - pertusis - mild form + +/- 1-3 days, higher colonies, haemolysis B. bronchiseptica + + Disease similar like pertusis + + + Intracellular parasites •Francisella tularensis • •Cultivation: difficult, needs cystein/medium with egg yolk (McCoy soil), chicken yolk vac, ČHA •Pathogenicity+pathogenesis: various forms: •Ulceroglandular - passes through the skin – swelling of lymphatic nodes and local ulcus •Orofaryngeal/gastrointestinal – after diggestion of contaminated food – in GIT form bleeding ulcerations, tyfoid – gastrointestinal form ending as sepsis •Oculoglandular – contaminate hands in contact with conjunctiva – conjunctivitis •Pulmonary – inhalation of the dust •Epidemiology: contact with infected hlodavci (hare, tick, rabbits). Autumn - skinning of bucks/foxes after chase •Diagnosis: direct - Giemsa stain/immunofluorescence, cultivation on spec. medias with cystein, indirect: ELISA, agglutination •Therapy: streptomycin, fluoroquinolons BD06152_ Legionella pneumophila • •Cultition: difficult, BCYE medium (with active carbon), 7 days – grey colonies with fluorescence under the UV light •Pathogenicity: •Legionary disease – fever, caugh, headache, chestpain, hard pneumonias •Pontiac fever - 2-5 days lasting light disease with fever and muscle pain •Epidemiology: entrance via inhalation – aerosol, also present in water or climatization units (air-condition) •Detetction: direct – Gramm staining - bad, silver staining, cultivation on BCYE, antigen detection in urine via ELISA method (many serotypes) - specific only for specific serotype •Indirect - indirect immunofluorescence, ELISA •Therapy: erytromycin, tetracyclin in hard form, pontiac fever stops without therapy pk2007-3-kratochvil Brucella abortus, suis, melitensis, canis •Cultivation: special media with serum, chicken embryas •Pathogenicity: Bang disease (Maltese fever) •enter via skin, various forms: hepatolienal, cardial, orchitis…. •Epidemiology: contact with animals, inhalation, consummation, prevention: veterinary control •Detection: direct – cultivation, indirect - KFR, ELISA, agglutination to proof of incomplete antibodies •Therapy: doxycyklin PE02661_ Bů