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Corynebacterium Erysipelothrix & Listeria. Pathogenic Anaerobic Gram-Positive Bacilli. Corynebacteria (Genus Corynebacterium ). Ø Aerobic or facultatively anaerobic

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Presentation Transcript
slide2

Corynebacterium

Erysipelothrix

& Listeria

slide4

Corynebacteria (Genus Corynebacterium)

ØAerobic or facultatively anaerobic

ØSmall, pleomorphic (club-shaped), gram-positive bacilli that appear in short chains (“V” or “Y” configurations) or in clumps resembling “Chinese letters”

ØCells contain metachromatic granules (visualize with methylene blue stain)

ØLipid-rich cell wall contains meso-diaminopimelic acid, arabino-galactan polymers, and short-chain mycolic acids

ØLysogenic bacteriophage encodes for potent exotoxin in virulent strains

slide5

Mycobacterium

Nocardia

Corynebacterium

Distinguishing Features of CMN Group

slide6

Pathogenic Corynebacterial Species

  • Corynebacterium diphtheriae
  • Corynebacterium jeikeium
  • Corynebacterium urealyticum
slide7

Corynebacterium urealyticum

    • ØUrinary tract infections (UTI’s); rare but important
    • ØUrease hydrolyzes urea; release of NH4+, increase in pH, alkaline urine, renal stones
slide8

Corynebacterium jeikeium

    • ØOpportunistic infections in immunocompromised (e.g., patients with blood disorders, bone marrow transplants, intravenous catheters)
    • ØMultiple antibiotic resistance common (MDR)
    • ØCarriage on skin of up to 40% of hospitalized patients (e.g., marrow t-plants)
slide9

Percentage of Individuals Colonized

Corynebacterium jeikeium Carriers

slide10

Corynebacterium diphtheriae

    • ØRespiratorydiphtheria (pseudomembrane on pharynx) and cutaneous diphtheria
    • ØPrototype A-B exotoxin acts systemically
      • Toxoid in DPT and TD vaccines
    • ØDiphtheria toxin encoded by tox gene introduced by lysogenic bacteriophage (prophage)
    • ØSelective media: cysteine-tellurite; serum tellurite; Loeffler’s
    • ØGravis, intermedius, and mitis colonial morphology
slide18

Mechanism of Action of Diphtheria Toxin: Inhibition of Protein Synthesis

slide19

Catalytic Region

A Subunit

B Subunit

Translocation Region

Receptor-Binding Region

Molecular Structure of Diphtheria Toxin

slide21

Immune Status to C. diphtheriae and Sensitivity to Diphtheria Toxoid

TOXIN

TOXOID

Diagnostic Schick Skin Test

slide24

Listeria monocytogenes

  • Gram-positive beta-hemolytic bacillus
  • Multiply at refrigerator temperatures (4oC)
  • Tumbling motility at room temperature
  • CAMP Test positive (like Group B Streptococcus)
slide25

Where do we find Listeria?

  • Intestinal tract of mammals & birds (especially chickens)
  • Persists in soil
  • Soft cheeses & unwashed raw vegetables
  • Raw or undercooked food of animal origin
    • Luncheon meats
    • Hot dogs
  • Large scale food recalls have become common
slide27

Natural Reservoirs

Common Routes for Human Exposure

Population at Greatest Risk

Epidemiology of Listeria Infections

slide28

Listeriosis

  • Neonates, elderly & immunocompromised
  • Granulomatosis infantiseptica
    • Transmitted to fetus transplacentally
    • Early septicemic form: 1-5 days post-partum
    • Delayed meningitic form: 10-20 days following birth
  • Intracellular pathogen
    • Cell-mediated and humoralimmunity develop
    • Only cell-mediated immunity is protective
slide30

Intracellular Survival & Replication of Listeria

Phagocytosis

Macrophage

Listeriolysin O?

Macrophage

Intracellular Replication

Actin Filaments

slide32

Erysipelothrix rhusopathiae

  • Gram-positive non-motile bacillus; forms filaments
  • Occupational disease of meat and fish handlers, hunters, veterinarians
    • Preventable withprotective gloves & clothing
  • Erysipeloid in humans; erysipelas in swine & turkeys
    • Organisms enter through break in skin
    • Nonsuppurative, self-limiting skin lesions with erythema and eruption
    • Peripheral spread may lead to generalized infection, septicemia and/or endocarditis
    • Organisms can be isolated from skin biopsy
slide36

Corynebacterium diphtheriae

    • ØRespiratorydiphtheria (pseudomembrane on pharynx) and cutaneous diphtheria
    • ØPrototype A-B exotoxin acts systemically
      • Toxoid in DPT and TD vaccines
    • ØDiphtheria toxin encoded by tox gene introduced by lysogenic bacteriophage (prophage)
    • ØSelective media: cysteine-tellurite; serum tellurite; Loeffler’s
    • ØGravis, intermedius, and mitis colonial morphology

REVIEW

slide39

Mechanism of Action of Diphtheria Toxin: Inhibition of Protein Synthesis

REVIEW

slide40

Corynebacterium jeikeium

    • ØOpportunistic infections in immunocompromised (e.g., patients with blood disorders, bone marrow transplants, intravenous catheters)
    • ØMultiple antibiotic resistance common (MDR)
    • ØCarriage on skin of up to 40% of hospitalized patients (e.g., marrow t-plants)

REVIEW

slide41

Corynebacterium urealyticum

    • ØUrinary tract infections (UTI’s); rare but important
    • ØUrease hydrolyzes urea; release of NH4+, increase in pH, alkaline urine, renal stones

REVIEW

slide42

Listeria monocytogenes

  • Gram-positive beta-hemolytic bacillus
  • Multiply at refrigerator temperatures (4oC)
  • Tumbling motility at room temperature
  • CAMP Test positive (like Group B Streptococcus)

REVIEW

slide43

Natural Reservoirs

Common Routes for Human Exposure

Population at Greatest Risk

Epidemiology of Listeria Infections

REVIEW

slide44

Listeriosis

  • Neonates, elderly & immunocompromised
  • Granulomatosis infantiseptica
    • Transmitted to fetus transplacentally
    • Early septicemic form: 1-5 days post-partum
    • Delayed meningitic form: 10-20 days following birth
  • Intracellular pathogen
    • Cell-mediated and humoralimmunity develop
    • Only cell-mediated immunity is protective

REVIEW

slide45

Intracellular Survival & Replication of Listeria

Phagocytosis

Macrophage

Listeriolysin O?

Macrophage

Intracellular Replication

Actin Filaments

REVIEW

slide46

Erysipelothrix rhusopathiae

  • Gram-positive non-motile bacillus; forms filaments
  • Occupational disease of meat and fish handlers, hunters, veterinarians
    • Preventable withprotective gloves & clothing
  • Erysipeloid in humans; erysipelas in swine & turkeys
    • Organisms enter through break in skin
    • Nonsuppurative, self-limiting skin lesions with erythema and eruption
    • Peripheral spread may lead to generalized infection, septicemia and/or endocarditis
    • Organisms can be isolated from skin biopsy

REVIEW