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Haemophilusinfluenzae

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H. influenza & Bordetella

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Haemophilusinfluenzae

  1. 1. HaemophilusHaemophilus && BordetellaBordetella A. L. Samer FaisalA. L. Samer Faisal
  2. 2. Haemophilus influenzaeHaemophilus influenzae  Gram negative Rods.Gram negative Rods.  Range from coccobacillary to long filamentousRange from coccobacillary to long filamentous forms.forms.  Non – motileNon – motile  AerobicAerobic  Fastidious organismsFastidious organisms
  3. 3. Haemophilus influenzaeHaemophilus influenzae  Humans are the only natural hostsHumans are the only natural hosts  Transmission:Transmission: respiratory droplet spreadrespiratory droplet spread  Peak Prevalence of Meningitis:Peak Prevalence of Meningitis: 6 – 126 – 12 monthsmonths  The incidence of Hib fell by 95% in populationsThe incidence of Hib fell by 95% in populations with high rates of vaccinationwith high rates of vaccination
  4. 4. Haemophilus influenzaeHaemophilus influenzae Two main typesTwo main types::  II The uncapsulated (untypable) strainsThe uncapsulated (untypable) strains  IIII The encapsulated strainsThe encapsulated strains
  5. 5. CapsuleCapsule  Polysaccharide in naturePolysaccharide in nature  Six types : a, b, c, d, e and fSix types : a, b, c, d, e and f  Type b is associated with most severe form ofType b is associated with most severe form of diseasedisease  Hib capsule is Polyribitol Phosphate (PRP)Hib capsule is Polyribitol Phosphate (PRP)
  6. 6. Haemophilus influenzaeHaemophilus influenzae UnencapsulatedUnencapsulated Responsible for localizedResponsible for localized infections i.e.infections i.e.  Otitis mediaOtitis media  ConjuctivitisConjuctivitis  BronchitisBronchitis  SinusitisSinusitis CapsulatedCapsulated Responsible for InvasiveResponsible for Invasive disease i.e.disease i.e.  MeningitisMeningitis  SepticaemiaSepticaemia  EpiglottitisEpiglottitis  PneumoniaPneumonia  Septic arthritisSeptic arthritis  CellulitisCellulitis
  7. 7. LABORATORY DIAGNOSISLABORATORY DIAGNOSIS  Clinical SpecimensClinical Specimens  Blood, sputum, CSF, Joint fluidBlood, sputum, CSF, Joint fluid  MicroscopyMicroscopy  Gram StainGram Stain  Flourescent antibody stainFlourescent antibody stain  CultureCulture  Chocolate Agar (Factor V & X)Chocolate Agar (Factor V & X)  SerologySerology  Latex agglutination, Counter immunoelectrophoresisLatex agglutination, Counter immunoelectrophoresis  PCRPCR
  8. 8. Growth requirements in VitroGrowth requirements in Vitro  FactorFactor VV HeminHemin  FactorFactor XX NADNAD  Chocolate agar provide both these factorsChocolate agar provide both these factors  Growth is enhanced in 5% CoGrowth is enhanced in 5% Co22
  9. 9. TREATMENTTREATMENT  Meningitis – CeftriaxoneMeningitis – Ceftriaxone  Otitis media & Sinusistis – Amoxycillin-Otitis media & Sinusistis – Amoxycillin- clavulanate & Co-trimoxazoleclavulanate & Co-trimoxazole PREVENTIONPREVENTION  Vaccine against hemophilus type-b (Hib)Vaccine against hemophilus type-b (Hib)  Age 2-15 monthsAge 2-15 months  Conjugate vaccineConjugate vaccine  RifampicinRifampicin
  10. 10. Haemophilus ducreyiHaemophilus ducreyi  Causes a sexually transmitted infection calledCauses a sexually transmitted infection called ChancroidChancroid  Requires only Factor X for growthRequires only Factor X for growth
  11. 11. Bordetella pertussisBordetella pertussis  Small CoccobacillarySmall Coccobacillary  Gram negative rodGram negative rod  CapsulatedCapsulated  Causes Pertussis (Whooping Cough) – a highlyCauses Pertussis (Whooping Cough) – a highly infectious disease in its early phaseinfectious disease in its early phase
  12. 12. Bordetella pertussisBordetella pertussis  Pathogen only for humansPathogen only for humans  Transmitted by airborne dropletsTransmitted by airborne droplets  Highly contagiousHighly contagious  Worldwide distributionWorldwide distribution  Primarily infants & young childrenPrimarily infants & young children
  13. 13. • Typical Organisms The organisms are minute, gram-negative coccobacilli resembling H influenzae. A capsule is present. • Culture  Primary isolation of B pertussis requires enriched media.  Bordet-Gengou medium (potato-blood-glycerol agar) that contains penicillin G, 0.5 μg/mL, can be used.  A charcoal-containing medium supplemented with horse blood, cephalexin, and amphotericin B (Regan-Lowe) is preferable because of the longer shelf life.  The plates are incubated at 35–37°C for 3–7 days aerobically in a moist environment.  The small, faintly staining gram negative rods are identified by immunofluorescence staining.  B pertussis is non-motile.
  14. 14. • Growth Characteristics  The organism is a strict aerobe.  it is oxidase and catalase positive.  but nitrate, citrate, and urea negative, the results of which are useful for differentiating among the other species of bordetellae.  It does not require X and V factors on subculture.
  15. 15. CLINICAL FEATURESCLINICAL FEATURES  Acute tracheobronchitis in childrenAcute tracheobronchitis in children  Mild upper respiratory tract symptomsMild upper respiratory tract symptoms  Severe paroxysmal cough (1 to 4 weeks)Severe paroxysmal cough (1 to 4 weeks)  Death due to pneumoniaDeath due to pneumonia  In AdultsIn Adults  Paroxysmal cough lasting weeks (100 day cough)Paroxysmal cough lasting weeks (100 day cough)  Whoop is absentWhoop is absent
  16. 16. Laboratory DiagnosisLaboratory Diagnosis  Clinical SpecimensClinical Specimens  Nasopharyngeal swabNasopharyngeal swab  MicroscopyMicroscopy  Gram negative rodsGram negative rods  Flourescent antibody stainingFlourescent antibody staining  CultureCulture  Bordet gengou medium (20-30% blood)Bordet gengou medium (20-30% blood)  SerologySerology  Agglutination with specific antiseraAgglutination with specific antisera  PCRPCR
  17. 17. TREATMENTTREATMENT  AntibioticAntibiotic  ErythromycinErythromycin  Supportive CareSupportive Care  Oxygen TherapyOxygen Therapy  Suction of mucusSuction of mucus
  18. 18. PREVENTIONPREVENTION  VaccinesVaccines  Acellular pertussis vaccineAcellular pertussis vaccine  BoostrixBoostrix  AdacelAdacel  Killed VaccineKilled Vaccine  Higher side effects (encephalopathy)Higher side effects (encephalopathy)  AntibioticsAntibiotics  ErythromycinErythromycin  Un-immunized & exposedUn-immunized & exposed  Immunized & < 4 yrs.Immunized & < 4 yrs.
  19. 19. QUESTIONS...???QUESTIONS...???

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