Spirochaetes treponema, borrelia & leptospira
•
49 likes•8,371 views
Spirochaetes are spiral shaped, motile bacteria found in the order Spirochaetales. Treponema pallidum causes syphilis in humans through direct contact with skin lesions. It has a long latent period and can cause cardiovascular or neurological complications if left untreated. Leptospira and Borrelia species can also infect humans through contact with infected animals or ticks, causing diseases like leptospirosis and Lyme disease respectively. These spirochetes are diagnosed through microscopy, culture and serological tests.
Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (8)
Similar to Spirochaetes treponema, borrelia & leptospira
Similar to Spirochaetes treponema, borrelia & leptospira (20)
More from Dr. Kanwal Deep Singh Lyall
More from Dr. Kanwal Deep Singh Lyall (20)
Recently uploaded
Recently uploaded (20)
Spirochaetes treponema, borrelia & leptospira
- 1. Spirochaetes Dr. Kanwal Deep Singh Lyall M.D. Microbiology
- 2. Spirochaetales Spirochaetaceae Leptospiraceae Spirochaeta Christispira Treponema Borrelia Leptospira Leptonema Anaerobic, fac. Anaerobic, Microaerophillic NOT HOOKED Obligate aerobes HOOKED Order Family Genus Treponema, Borrelia & Leptospira are pathogenic to humans See C-x ray for T B
- 3. Spirochaetes • Spira = coil + chaite = hair • 5 – 500 µm, Largest are Borrelia • Cell wall like GNB • Endo flagella b/w outer membrane & peptidoglycan (periplasmic space) attached subterminally at poles • Provide spiral shape & motility • Motility = flexion & extension, corkscrew like rotation backward, forward and translatory – side to side
- 4. Treponema pallidum • Trepo = turn, nema = thread, pallidum = pale staining • Thin (10x 0.1-0.2µm) delicate with tapering ends with ≈10 regular spirals • 2° spirals appear during motility • Delicate – dies @ 0-4 C x 3 days, hence blood is refrigerated • Heat therapy
- 5. Culture • Don’t grow on artificial medium • Reiter’s – T. phagedenis • Noguchi’s – T. refrigenis • Nichol’s – Virulent T. pallidum – serial s/c in rabbit testis
- 6. Antigenic structure Outer membrane (rich in lipids) Endoflagella Peptidoglycan Trilaminar cell membrane
- 7. • Leads to production of 3 types of antibodies • Group specific antigen: common amongst pathogenic & non-path treponemes antibodies detected using Reiter’s treponemes • Species sp. Ag: polysaccharide , T.P. is used • Non-specific Ag: reagin antibodies – Cardiolipin Ag – hapten (diphosphatidyl glycerol)
- 8. Pathogenesis • Natural infections in humans only • STD – incubation period 9 to 90 days • Entry through minute abrasions- skin , mucosa • 1° stage: papule – ulcer – hard chancre (painless, indurated, circumscribed) covered with thick exudate rich in treponemes– LAP (swollen, non-tender, rubbery) • Heals with 10-40 days without Rx
- 9. • Asymptomatic period of 2-6 months • 2° stage: widespread multiplication & dissimination thorough blood • Most infectious stage , 4 – 5 years • Rash on skin & mucosa – coalesce in intriginous region – perianal region – condymolata • May present with retinitis, periostitis, arthritis
- 10. • Latent : dormant for many years without symptoms , but serology is positive • 3° stage: few spirochaetes –Cardio-vascular lesions (aneurysms) –Ch. Granulomata (gummata) –Meningiovascular manifestations –Neurological – Tabes dorsalis, GPI
- 11. • Congenital syphilis: 1° or 2° infection in mother • Non-veneral – HCWs or blood transfusion • Extra-genital or no chancre
- 12. Hutchinson's teeth: widely spaced, pegged teeth Snuffles Frontal bossing Saddle nose Keratitis
- 13. Specimens Collected 1. Serous fluid from Chancre/ 1° skin lesion • Collection 2. Blood for serological tests 3. CSF for serological tests
- 14. Diagnostic Methods Used In Syphilis Demonstration of Treponemes Serological tests 1. DGM 2. DFA-TP 3. Silver impregnation methods Non - Treponemal tests Treponemal CFT VDRL RPR, ART TRUST USR Reiter strain Nichol’s strain RPCF Live Treponemes •TPI Killed Treponemes •TPA •TPIA •FTA-ABS Extract of Treponemes •TPHA •EIA
- 15. 10 – 90 days 6 weeks to 6 months 10 – 30 years after primary Primary Chancre Secondary Eruptions Tertiary Disease DGM + RPR +/- VRDL +/- RPR + VRDL + TPHA + FTA-ABS+ RPR +/- VRDL +/- TPHA + FTA-ABS+ Syphilis stages & possible results Stage VDRL / RPR FTA – ABS TPHA 1° 70 – 80 85 – 100 65 – 85 2° 100 100 100 3° 60 – 70 95 – 100 95 – 100
- 17. Treatment • Premunition / infection immunity 1. Early syphilis - 1°, 2 °, latent infection of ≤2 yrs • Inj. Benzathine Benzyl Penicillin I/M • Or tab . Doxycycline 100mg BD orally x 15 days 2. Late syphilis - >2yrs • Inj. Benzathine Pen 24 LU I/M x once wkly x 3 wks • * Jarish – Herxhemer Reaction • Prophylaxis : barrier contraceptives, screening of high risk patients
- 18. Non – Venereal Treponemotoses • Yaws: T. Pallidum ss. Pertenue • Pinta: T. Pallidum ss. Carateum • Endemic syphilis: T. Pallidum ss endemicium
- 19. Yaws: T. Pallidum ss. Pertenue • Orissa / AP /MP • Morphologically & Ag similar to TP • Extra genital papule – ulcer – infection by direct contact • 2°,3° manifestations +nt , no CNS, CVS involv. • Diagnosis s/a Syphillis
- 20. Pinta: T. Pallidum ss. Carateum • Central & South America • m/c in 10 – 15 yrs of age • Non-ulcerating extra-genital papule • Hyper or hypo-pigmented lesion
- 21. Oral treponemes • T. denticola, T. pectinovorum, T. socranskii , T. vincentii , T. lecithinolyticum, T. maltophilum, T. medium , T. parvum , T. putidum and T. amylovorum - cultivated from the oral cavity, • 70% of Treponema phylotypes –uncultivatable • T. denticola – periodontitis by penetration & immune evasion, cytotoxic to epithelial cells
- 22. Spirochaetales Spirochaetaceae Leptospiraceae Spirochaeta Christispira Treponema Borrelia Leptospira Leptonema Anaerobic, fac. Anaerobic, Microaerophillic NOT HOOKED Obligate aerobes HOOKED Order Family Genus Treponema, Borrelia & Leptospira are pathogenic to humans See C-x ray for T B
- 23. Borrelia
- 24. • Larger than other spirichaetes • 8-30 µm x 0.2-0.5 µm • Irregular, wide coils (5-8) • Motile, Gram negative, pointed ends • Commensal in mouth or genitals
- 25. Medically important borreliae • B. recurrentis – relapsing fever • B. vicentti – Vincent’s angina • B. burgdoferi – Lyme disease
- 26. Relapsing fever Epidemick B. recurrentis Louse borne (pediculus humanus corporis) Endemic Tick borne B. Duttoni B. Parkeri B. Turicatae B. Hermssi Tick Entick No difference in morphology
- 27. Culture • Microaerophillic @ 28-30° C in Noguchi’s medium , CAM, rat or mouse • Stain – Wright , Giemsa stain • Relapse: because it undergoes Ag variations – each variation – each relapse – when antibodies against all Ag variation – recovery
- 28. Pathogenesis • Tick / louse bite – transmission – IP 2-10 days • Sudden fever lasting 3-5 days (abundant borreliae in blood) • Afebrile (4-10 days) – Borreliae not demonstrated in blood • 3-10 cycles – recovery
- 29. Lab diagnosis Direct microscopy DGM, Geimsa or Leishman staining White mouse Animal inoculation Patient’s blood is inoculated Intra- peritoneally After 2 days blood from tail vein shows spirochetes Culture & Serology Difficult & impractical
- 30. Treatment & prophylaxis • CPC, P , ERY • Control of vectors
- 31. B. vincentii • Gram negative, Motile, 5-20 µm • Easily stained with carbol fuchsin or methyl violet • Normally flora of mouth, potential pathogen • Causes ulcerative gingivitis along with Leptotrichia buccalis ( Fusobacterium fusiforme) – k/a fusospirochetosis • Culture – Noguchi’s medium , anaerobically • Treatment – Penicillin, Metronidazole
- 32. B. burgdorferi (Lyme’s disease) • 1st observed in 1975, Lyme, USA • 4-30 µm x 0.2 µm, Gram negative • Microaerophillic x Kelley’s (BSK) medium x 33- 37°C X > 2 wks • Rodents, deer etc. reservoir • Vector – Ixodid ticks – regurgitation of gut contents during bitting
- 33. Pathogenesis • IP x 3-30 days • Erythema migrans (small red macule or papule) at the biting site – Bull’s eye appearance • After few wks – dissemination – headache, fever, myalgia & LAP • Persistent infection: months – years – Ch. Arthritis, polyneuropathy, encephalopathy
- 34. Lab. Diagnosis • Culture – skin, CSF, blood – too slow • Serology – ELISA, IF • May give a positive FTA-ABS test but VRDL negative • Treatment: TET, P, ERY
- 35. Spirochaetales Spirochaetaceae Leptospiraceae Spirochaeta Christispira Treponema Borrelia Leptospira Leptonema Anaerobic, fac. Anaerobic, Microaerophillic NOT HOOKED Obligate aerobes HOOKED Order Family Genus Treponema, Borrelia & Leptospira are pathogenic to humans See C-x ray for T B
- 36. Leptospira
- 37. • Lepto – fine or thin + spira – coil • Actively motile, delicate, closely wound coils, Characteristic HOOKED ends • Don’t stain readily, can be seen under DGM • Zoonotic disease – leptospirosis
- 38. Leptospira Human pathogens L. Interrogans L. Biflexa Saprophytic, non-pathogenic, surface waters 20 serogroups – Ictero-haemorrhagiae, Canicola, Australis, Hebdomadis, Andaman Etc. Each serogroup has serovars , ≈ 200 serovars Serogroup Ictero-haemorrhagiae has serovar Copenhegan,, Smith, Budapest, Ictero-haemorrhagica
- 39. • Stain poorly, Fluorescence tech., silver impreg., DGM, Phase contrast, e-Ms • Motility – rapidly rotate along long axis with sharp bending & flexion • Culture: aerobic & microaerophillic, media rich in rabbit serum, Korthof’s, Stuart’s, Fletcher’s • Semi-synthetic media – EMJH (Ellinghousen, McCullogh, Johnson, Harris x 6-14 days • Generation time: 12-16 hrs in media & 4-8 hrs in animals • CAM
- 40. Resistance • Survival depends on t, pH & Pollution • Die @ 60 C x 10 secs • Live in polluted river waters upto 30 days • 12-14 hrs in sewage water • 3 mins in chlorinated water
- 42. Leptospira shed in urine of carrier animals Direct or indirect contact with humans Enter through skin abraisions, cut or mucus membranes IP – 6-8 days, febrile illness (Septicemic phase) least 3-7 days Disappear from blood & enter various organs – liver, kidney, meninges (aseptic meningitis), M/C kidney, shed in urine Severe form is k/a WEIL’S disease – fever, conjunctivitis, albuminuria, H’ages. M/C caused by L. icterohaemorhagiae, f/b Canicola & hebdomadis
- 43. Lab diagnosis Direct microscopy (DGM) Blood – 1st wk Urine – 2nd – 6th wk Intra-peritoneal – G.Pig Animal inoculation Peritoneal fluid – DGM x 3rd day heart blood culture Culture on Mod. Korthof’s, Fletcher’s, EMJH 28-32 C x aerobically – DGM x every 3rd day till 6 wks Serology
- 44. Serology • Most useful test • Antibodies appear @ end of 1st wk & ↑ till 4th • Screening tests: genus specific, using L. Biflexa Patoc 1 strain – CFT , IF, ELISA, lysis of sensistized RBCs – detect IgM & IgG • Serotype specific: to detect infecting serovar – Micro-agglutionation test (MAT): formalin killed sus. Of refference starins + serial dil. Of serum – Macro-agglutination test-formalised or live culture sus. Are used – CROSS REACTIONS ARE COMMON
- 45. Treatment & Prophylaxis • P, TET, ERY • Rodent control • Disinfection of water reservoirs • Protective clothing
- 46. x