Q-Fever (Coxiella burnetii)
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Transcript Q-Fever (Coxiella burnetii)
By
R.Teja sri
Introduction
Coxiella
burnetti is the causative agent of
‘Q-fever’
Obligate
intracellular, gram negative
bacterium
Distributed
Found
globally
in many species of animals
Morphology: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 .
C. burnetii
i
en.wkipedia.org
Culture
Grows
well in yolk sac of chick embryos
and in various cell cultures .
Ag structure
shows phase variation .
phase – I ,II .
phase – I :- autoagglutinable
more immunogenic
activity due to periodate sensitive trichloracetic
acid-soluble surface carbohydrate .
o Phase – II :- more suitable for CFT .
o both phase I ,II elicit good Ab response .
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 .
Contd….
Resistant to heat, drying and disinfectants
Air samples test positive for 2+ weeks
Soil samples test positive for 150+ days
Spore formation
PATHOGENESIS
History
Q
stands for Query or Queensland
Origin
of disease unknown
First reported cases were in
Queensland, Australia
Differentiating
features :
1. Having smaller size
2. Resistance to heat and drying
3. Major route of transmission isinhalation/ingestion
Primary Reservoir
Goats
Cattle
Sheep
* All eukaryotes can be infected
Bacteria is excreted in:
Feces
Urine
Milk
of infected animals
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!
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
Contd…..
Who’s
at risk?
Farmers,
veterinarians, researchers,
abattoir (slaughterhouse) workers etc.
People
who breed animals
Immunocompromised
Acute or Chronic Q fever
gsbs.utmb.edu
*Bacteria spread through blood
Symptoms
Acute Q fever
Self-limiting, flu-like disease
Fever, nausea, headaches, vomiting, chest/abdominal
pain
Pneumonia & granulomatous hepatitis
Chronic
Q fever (> 6 months)
Endocarditis & meningoencephalitis
Pre-existing disease
Host interaction
Entry
via inhalation
Alveolar macrophages encounter bacteria
C. burnetii phagocytosed
Macrophage
C. burnetii
R Heinzen, NIAID
Host interaction
Replication
Low
within phagolysosme
pH needed for metabolism
No
cellular damage unless lyses
occurs
Can
invade deeper tissue and cause
complications
Phagocytosis
Binding/entry
into macrophages via:
Integrin Associated Protein (IAP)
Leukocyte Response Integrin (LRI)
macrophage
bacteria
Binding & Entry
Phagocytosis
Phagocytic vesicle
Lysis of phagolysosome and
macrophage
Phago-lysosome
fusion: bacteria
survive and
multiplies
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 .
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
Treatment
Once infected, humans can have life-long
immunity
Acute Q fever treated with:
doxycycline,
chloramphenicol,
erythromycin or
fluoroquinolones
Chronic Q fever treated with:
Vaccines : prepared from formalin killed whole
cells
attenuated strains
trichloroacetic acid extracts
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
BARTONELLA
INTRODUCTION
Family Bartonellaceae contain two genera
Bartonella
Grahamella
Grahamella does not infect humans
Bartonella contain 3 species:
B.bacilliformis
B.quintana
B.henselae
BARTONELLA BACILLEFORMIS
Carrions disease
Causes OROYA fever
MORPHOLOGY:
Gram negative
Pleomorphic
strict aerobe
motile, small bacillu0.3-0.5x0.2-0.5mc
found inside erytrocyte infected persons
Opt. temp 25-28 c
CULTURE;
Grow in semisolid nutrient agar with
10% rabbit serum
0.5%Hb
Growth is slow takes about 10 days
PATHOGENISIS:
Causes OROYA fever
Transmitted by SAND flies
INCUBATION PERIOD;
3 weeks to 3 months
CLINICAL FEATURES:
Fever
Headache
Chills
Severe anemia
Several weeks after recovery pt. develop
nodular lesions on the body
Secondarily infect produce ulcers –
VERUGA PERUANA
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
TRETMENT:
Susceptible to penicillin
streptomycin
Tetracycline
Chloramphenicol
PREVENTION
Insecticides such as DDT should be used
to eliminate sand flies
BARTONELLA QUINTANA
MORPHOLOGY:small gram negative bacillus
0.3-0.5 mc to1.0-1.7 mc
Does not posses flagella
show twitching movments by fimbriae
CULTURE: Grows on rabbit /sheep blood agar
opt. temp -35 c in 5% CO2
colonies appear after 14 days primary
inoculation
PATHOGENESIS:Formerly called Rochalimaea quintana
Causes TRENCH fever
also called FIVE DAY fever
Transmission; by body louse
vertical transmission does not occur in lice
Lice after acquiring infection remain
infectious through out life
CLINICAL FEATURES:
Mild symptoms
leads to chronic rickttesiaemia
Relapse have been observed even after 20
years primary disease
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
BARTONELLA
HENSELAE
MORPHOLOGY:Gram negative
Slightly curved
Show twitching movments
CULTURE:Grows on chocolate agar
columbia agar with 5%sheep blood
tryptic-soy agar
opt.temp-35-37 c in 5% CO2
COLONY MORPHOLOGY:-
white, dry, cauliflower like and
embedded in the agar
PATHOGENESIS:
Causes CAT-SCRATCH disease
Occur by contact with scratch / bite of
an infected cat
Resolution
in weeks to
months
1 - 3 weeks
Cat contact
(scratch, bite,
? cat flea bite)
Dissemination
in immunocompromised
hosts
CLINICAL FEATURES:
Regional lymphadenopathy
Fever
Endocarditis
In AIDS pt. leads to;
bacillary angiomatosis
Lab diagnosis:
lymph node biopsy – stained with
WARTIN-STARRY SILVER
IMPREGNATION –clusters of bacillus
Grow on chocolate agar/ columbia agar
TREATMENT:
Self limiting
No specific treatment required