Chlamydia *Chlamydia has characters between the bacteria and virus. * We do not care about it very much because a few and old diseases of this

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1 #20 chlamydia&spirochaetales made by :Hala Nsour corrected by: tyma'a al-zabn date : 22_11_2016 1

2 Chlamydia *Chlamydia has characters between the bacteria and virus. * We do not care about it very much because a few and old diseases of this type, some still until now ex: Trachoma : a contagious bacterial infection of the eye. * This genus has properties and characteristics similar to virus: (like volume, it has very small size, it has membrane filters,and we can't culture it in traditional media which we use to bacteria we use to it tissue culture, also it is obligate intracellular so it use the ATP and metabolism machineries from the host cell ) * and another characteristics similar to bacteria : ( contain DNA & RNA in the same time but virus contain either RNA or DNA ) Chlamydia is a genus of pathogenic bacteria that are obligate intracellular parasites of mammals (human) and birds : (some types of birds like Parrots Chlamydia psittaci species caused Psittacosis ). : Psittacosis داء انثثغاء, يشع سئ ي ظ ة االشخاص انز ك ػهى اذظال يثاشش يغ طائش انثثغاء ف ارا كا انطائش ح م ان Chlamydia م و ت مه ا نهشخض Classification order chlamydiales contains one medically important genus chlamydia _ales mean order Chlamydia infections are the most common bacterial Sexually transmitted diseases (Lymphogranuloma venereum diseases) in humans and are the leading cause of Infectious blindness worldwide (trachoma). if the trachoma isn't treatment it will lead to blindness. Reported rates 3 times higher in females than in males. * Females 3 time more susceptible to Chlamydia than males contain DNA and RNA, and ribosomes, lack ATP (so its need metabolic machineries for the host cells ), lack biosynthetic pathways, non motile. Multiply in the cytoplasm of the host cell. The most important species that we will take about this lecture are..., C. Trachomatis (responsible for trachoma ) C. psittaci (associated with Psittacosis) C. pneumoniae ( associated with pneunoma ) 2

3 Slide 3 min 7:00 Transmission Transmission is sexual or vertical (from the mother to fetus) Highly transmissible Incubation period 7-21 days (3 weeks ) Significant asymptomatic انؼائم ا ان سر دعreservoir exists in the population (no symptoms appear on patient so he/she become method to transfer the disease) Re-infection is common why? because the variation in antigenic structure, consist of more than one stereotype so one infectious does not give full immunity, can be affected with other antigenic form ) Perinatal ح ل ان الدج) (فرشج transmission results in neonatal conjunctivitis in 30%-50% of exposed babies. *This bacteria is different from other type of bacteria which we mentioned before, it has life cycle. * it has two phases : 1_ Elementary body (EB): the infectious one by which it inter to host cell, not reproductive phase. 2_Reticulate body (RB):metabolic active and replication happen. * once it inter the host cell its converted from (EB) to (RB), and when it get out of host cell it back to (EB) Slide 4 min 11:00 Have a complex developmental cycle The infectious form is called an Elementary Body (EB) which is circular in form and is taken into the cell by induced phagocytosis. ( ضى خه ي ( weight Phagocytosis : when the material has a molecular (ششب خه ي Pinocytosis : when the material is liquid (cellular drink (طشح خه ي ( : Exocytosis يا تررأشش تؼ ه ان ضى انخه ي. place Inside the phagocytic vesicle replication takes Fusion In lysosome and phagocytic vesicle then the lysosomal enzyme released Over the next 6-8 hours, the EB reorganizes into the noninfectious, but metabolically active Reticulate Body (RB) which is larger and less dense than the EB. 3

4 For hours the RB synthesized new materials and divides by binary division to form Inclusion Bodies that reorganize and condense into EBs. Inclusion body :vesicle contain RB is indicate the Chlamydia infection Inside inclusion body (RB) converted to (EB), and then Exocytosis happen to it *انشكم انزي ذخشج ت انشكم انزي دخهد ت ان )EB( Between hours (three days), the cell lyses and releases the EB which begin the cycle again. Slide 5 min 13:16 If we want to differentiate between (EB) and (RB) : Elementary body um diameter electron-dense nucleoid Released from ruptured infected cells. Human to human & bird to human. Reticulate Body Intracytoplasmic form um ط س ذكاششي ) body Replication and growth. ( Inclusion without a dense center. *EB which inter the cell (engulfment).>divided by binary fission.> make inclusion body (green)..> some in the yellow still EB >Exocytosis Chlamydia inclusion bodies 4

5 * this slide consist of inclusion body this circle above contain large amount of RB slide 8 min 15:15 Chlamydiaceae Family _aceae : family Three species will be considers : Species (genus) C. Trachomatis (many serotypes) ع يظه حذدخ انؼذ ذ يantigen ػ طش ك ^antigen-antibody reaction^ C. Pneumoniae (TWAR) Taiwan acute respiratory agent Disease Trachoma, NGU, PID, neonatal conjunctivitis, inclusion conjunctivitis, Infant pneumonia, LGV Pharyngitis, bronchitis, pneumonia C. psittaci (many serotypes) Psittacosis(influenza-like illness) * many serotype mean different type of antigen that diagnosis by antibody/antigenic reactions *biotype : diagnosis by biochemical reactions. *LGV (Lymphogranuloma venereum ) : Venereum : mean sexually transmitted حذز ذضخى تانؼمذ انه فا ح ف ي طمح االػضاء انر اله ح )genitalia(. * c.pneumoniae : one antigenic form (serotype).> TWAR make respiratory tract infection in upper and lower * psittacosis also does not give long lasting immunity, transmitted by bird. Slide 9 min 19:04 5

6 Clinical significance 1. Chlamydia trachomatis Caused many diseses: 1)Genital tract infection is sexually transmitted and frequently found تؼغ) concomitantly with (يغ N. gonorrhoea (In males symptoms include ;(انر اب انثشتخ) epididymitis urethritis,dysuria and sometimes progresses to In females symptoms include mucopurulent cervical inflammation (انرظاق ف ل اخ انشحى) salpingitis (there is discharge)which can progress to (انؼمى) and PID), and also may lead to infertility 2)Inclusion conjunctivitis يهرح ح انؼ انض ) (انر اب from inclusion body which contain RB second phase, occurs in both newborns and adults and a genital tract infection is the source of the infection. In new born mostly get it from mother by genital tract while delivery (vertical). In adult auto infection, if she had a disease in genital tract or other cases of chlamydia in the hand or nails, and if she /her put her/his hand in her/his eyes. It is self-limited conjunctivitis which heals with no scarring. Newborns are infected during the birth process, with a mucopurulent discharge. In adults causes an acute follicular conjunctivitis with little discharge (autoinoculation). 3)Trachoma, greatest cause of blindness in underdeveloped countries. (Transmission is by direct contact and in poor, less developed countries, children may be infected in the first three months of life (because they have incomplete immune system ). انرشاخ يا : انر اب يهح ح انؼ يشع لذ ى, كا تائ ي انطم س نالػ اد ف انؼشاق كا ا سرخذي يهح انه ك لائ )prophylactic( ي انرشاخ يا ح س كا ا ظف جف انؼ ت حرى خشج انذو 4)Lymphogranuloma الل مف الحب ب الجىس ) venereum (مرض is a venereal disease(or sexual transmitted disease ) that occurs in poor, tropical areas. painless lesion occurs at the site of entry with symptoms of regional suppurative lymphadenopathy (buboes) genitalia ذم ح انؼمذ انه فا ح ان حاطح تان :Buboes Slide 10 min 25:00 Chlamydia psittaci 6

7 Mainly it s a normal flora in birds,some people love to feed the Parrot by his/her mouth so if the parrot infected with Chlamydia it can be transmitted to human respiratory system naturally infects avian species causing mild to severe illness. In man causes psittacosis (ornithosis) and is acquired by contact with an infected animal. Infection can range from subclinical to fatal pneumonia. * its depend on the immunity of the person or the dose which he take from Chlamydia Most commonly causes an Atypical pneumonia (انال رج ح) with fever, chills, dry cough, headache, sore throat, nausea, and vomiting. * Mycoplasma pneumonia is the cause of atypical pneumonia Chlamydia pneumoniae - This bacterium was first recognized as a respiratory pathogen, after isolation from pharyngitis case. - Pneumonia or Bronchitis, gradual onset of cough with little or no fever. Less common presentations are Pharyngitis, Laryngitis, and Sinusitis * give long lasting immunity because its have only one serotype (TWAR) = only one antigen slide 11 min 28:15 7

8 * Proctitis: انر اب ان سرم ى / * inguinal : < االست ح in genitalia Slide 12 min 29:8 Pathogenesis (some of it virulence factor ) - Chlamydiae have a hemagglutinin that may facilitate attachment to cells to the host as pili. - An endotoxin-like toxin has been described. Laboratory Diagnosis Culture Not traditional culture for bacteria its tissue culture because obligate intracellular Non-culture tests Nucleic Acid Amplification Tests polymeraze reaction but now it bybcr Non-Nucleic Acid Amplification Tests including Direct fluorescent antibody (DFA), Enzyme immunoassay (EIA), and Nucleic acid hybridization (NA probe) 8

9 9 probe حر ي ػهى كم ال genetic constituent probe which one strand ؼ م فظم نه اد ان ساش انخاط تانثكر ش ا ؼ ه ا hybridization ارا طاس supp codeing يؼ ا ا ا ي الة نهكالي ذا ايا ارا ياطاس ف زا ؼ ا ا يش كالي ذ ا Serology antibody antigen reactions * most classification was by serology Slide 13 min 30:51 Prevention Nature of the infection Chlamydia is commonly asymptomatic in men and women. In women, there is an increased risk of upper reproductive tract damage with re-infection. Transmission issues Abstain from sexual intercourse)lgv) until partners are treated and for 7 days after a single dose of azithromycin antibiotic. **************************************** THE END NEW SLIDES Slide 1 min 32:00 We talked about rod, spherical and now spiral Spirochaetales Treponema, Borrelia, Leptospira All spirals (Treponema, Borrelia, Leptospira)are helical and they differentiate from each other in this coil, the turn(coil) cloud be large or small, the distant between helical and helical can be long or short, may be coil then straight then coil and so on. And this method we use to separate between different type of spirals. Slide 2 min 33 Taxonomy Order: Spirochaetales Family: Spirochaetaceae Genus: Treponema Borrelia

10 Other family within the same order Other family within the same order Family: Leptospiraceae Genus: Leptospira Gram-negative spirochetes Spirochete from Greek for coiled hair Extremely thin and can be very long Motile by periplasmic flagella (axial fibrils or endoflagella) Outer sheath encloses axial fibrils Axial fibrils originate from insertion pores at both poles of cell * It is not stain with gram stain because its very transparent so we use silver nitrate stain * some bacteria has axial ل ط يشكزيfibrils or endoflagella : contain flagella between outer membrane and peptidoglycan layer. * spiral bacteria not like rod or spherical its move very fast and change it shape so its harder to diagnose it. * student asked why its gram negative bacteria while we can not stain it by gram stain? D.A: because the structure of it is identical to all gram negative bacteria cell wall slide 4 min 47:50 Periplasmic Flagella Diagram 10 Slide 5 min 39:10 Spirochaetales Associated Human Diseases Note :we will not talk about Leptospira

11 Genus Species Disease Treponema Borrelia pallidum ssp. pallidum pallidum ssp. endemicum pallidum ssp. pertenue carateum Burgdorferi recurrentis Syphilis Bejel Yaws Pinta Lyme disease (borreliosis) Epidemic relapsing fever Endemic relapsing fever Many species Leptospira Interrogans Leptospirosis (Weil s Disease) * syphilis : sexual transmitted dieses *we will focus on recurrentis from borrelia which cause relapsing fever its go and back because its more than one serotype (انح ى انشاجؼح) * relapsing fever has two type.(يسر ط ) & endemic ( تائ ) - epidemic Slide 6 &7 min 40:20 We will srart with. انز شي syphilis= Treponema pallidum ssp. Pallidum which responsible for Its sexual transmitted disease and can stay with the patient for long period (20_30_40 years) * could be asymptomatic in first phases * has many phases primary, secondary, and tertiary. *its easy to treat it in earlier phases. *transmit by mucous membrane of genital. Venereal Treponemal Disease - T. pallidum are slender spirals with spiral coils spaced at a distance of 1 μm from one another between coil and another 1 μm. - Pathogenic T pallidum has never been cultured on artificial media, in طؼث culture. fertile eggs, or in tissue - Nonpathogenic treponemes (Reiter strain) can be cultured anaerobically in vitro. - T pallidum is a microaerophilic (need oxygen less than what found in atmosphere ) organism; it survives best in 3 5% oxygen. - Cause Syphilis تشكم سئ سdisease Primarily sexually transmitted 11

12 May be transmitted congenitally (from mother to fetus)called congenital syphilis can lead to (إج اع) abortion or early born or may cause born of baby with mental problems. Darkfield Microscopy of Treponema pallidum * the shape of it have very tiny zigzag (coil ) very close to each other. *we use dark field microscope because its already transparent. General Characteristics of Treponema pallidum Too thin to be seen with light microscopy in specimens stained with Gram stain or Giemsa stain Motile spirochetes can be seen with darkfield micoscopy ال ا شفاف Staining with anti-treponemal antibodies labeled with fluorescent dyes Intracellular pathogen Cannot be grown in cell-free cultures in vitro Koch s Postulates have not been met أي اوها ال تىطبق على فرض ة) koch ( ح ث اوها ال تىمى ف المختبر أما كىخ فقد قال اوىا وأخذ العامل الممرض مه االوسان او الح ىان ووعسله و وىم ه ف المحتبر الزم طلع وفسه Do not survive well outside of host sorry in advance for any mistake you will found *-* good luck :) :) 12

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