Anaerobic G+rods to filaments • Rod Actinomyces (A. israelii, A. naeslundii) • •Microscopy: G + rods to filaments •Biochemistry: glucosis fermentation •Cultivation: anaerobic, 5-7 day growth •Pathogenity: common in the mouth, vagina, endogenous origin •Forms: cervikofacial (neck fistule) inoculation by face trauma for ex. ski stick •abdominal – looks like cancer •thoracic – atypic pneumonia •pelvic – occurs in woman fitted with plastic intra-uterine contraceptive devices •Typical for actinomycosis, „pus“ contain characteristic agglomerate of microbes •Dg.: direct – microscopy and cultivation •Treatment: PNC (doxycyklin, linkomycin) • •Disease like this is also caused by Bifidobacterium, Propionibacterium (cause also acne) • • • nes18783_2713 Aerobic G+rods to filaments Nocardia (N. asteroides, N. brasiliensis) •Microscopy: G + rods to filaments, often disintegrate •Cultivation: aerobic actinomycets, velvet white to yellowish colonies, aerobic growth on most nonselective media, (2-3 days, to 14 days) •Pathogenicity: conditional patogens, lead to pulmonary infection, brain absces, skin form looks like actinomycosis (usually in tropical areas, comes from soil) •Dg.: microscopy and scultivation •Treatment: cotrimoxazol, drenage, tetracyklin • 27 Nocardia asteroides M. tuberculosis •Microscopy: don’t use Gramm stain •Ziehl-Neelsenem stain of sputum (heated carbol fuchsin - acid diluted in ethanol, a blue/green counterstain ) - pink rods in ZN stain, blue background, called acid-fast bacilli •Fluorescent stain •Cultivation: solid soil (Löwenstein-Jensen) growth 3-6 weeks, yellow, cauliflower colonies, liquid media (Šula) forms semolina like sediment •Pathogenesis: grow intracellulary (inside macrophages) and slowly, damage of a tissue is caused by reaction of macroorganism (late immune response no. IV) •Pathogenicity: cause tuberculosis (TBC) •Primary TBC – lung disease, basilary meningitis, scrofulous lymphadenitis of neck nodes •Postprimary TBC - reactivation when the individual ages or immune status changes, lung disease •TBC signs: caugh, blood caughing, temperature, weight loose • M. tuberculosis II. •Treatment: multidrug therapy, initial phase (2 months) - HRZS, HRZE – large numbers are killed, continuation phase (6-8 months) – remainders are killed (HR, HE) •Epidemiology: transmitted by aerosols from an infected individual •Prevention: vaccination in new-born babies, before next vaccination diagnostic test Mantoux is needed, after 48-72 hours induration occurs, vaccination is made only in tuberculin negative person •Dg.: microscopy, cultivation (L-J, Ogawa – solid media; Šula, Banič – liquid media) – 1,3,6 and 9 weeks. Demonstration on guinea-pig, detection of metabolic products or PCR • •*H – INH, R – rifampicin, Z – pyrazinamid, S – streptomycin, E - etambutol M. tuberculosis TBC1 03 1312_mycoba „cauliflower“ colonies Ziehl-Neelsenem stain red rods on blue background Mycobacteria other than tuberculosis •M. bovis (BCG) - serves as vaccination strain • •M. leprae •Will not grow in culture, only on mice, infection of peripheral nerves •tuberculoid – anesthetic plaques on skin •lepromatous – leads to loss of digits on fingers, face damage, blindness • •Atypic mycobacteria - are found in water + in soil, cause skin infection, TBC like disease – lung infections, resistant to many antituberculotics – multidrug therapy is needed • C:\Documents and Settings\muprac\Dokumenty\Černohorská\Prezentace 01-06\super obrazky\spina2.jpg 01 leprosy