The University of Jordan The University of Jordan Faculty of Medicine Faculty of Medicine

Gram-negative coccobacilli Gram-negative coccobacilli and cocciand cocci

Prof. Dr. Asem Shehabi and Dr. Suzan Matar

11--Haemophilus GroupHaemophilus Group Gram-negative cocco/large- thin bacilli.. Micro-Gram-negative cocco/large- thin bacilli.. Micro-

aerophilic.. Requires growth factors ( aerophilic.. Requires growth factors ( V- X-V- X-factorsfactors)..Red blood cells, Grow around hemolytic)..Red blood cells, Grow around hemolytic StaphylococcusStaphylococcus, Rapid autolysis outside body , Rapid autolysis outside body

Normal FloraNormal Flora.. Human Upper Respt. Tract.. Many .. Human Upper Respt. Tract.. Many species Haemophilus.. opportunistic pathogens species Haemophilus.. opportunistic pathogens Virulence factors.. Endotoxin & Capsule.. localized-Virulence factors.. Endotoxin & Capsule.. localized-invasive infections invasive infections

H. influnzae type bH. influnzae type b: Most common pathogenic : Most common pathogenic species.. capsulated .. Causing Localized and species.. capsulated .. Causing Localized and Invasive Infect.. Sore Throat, Otitis Media, Sinusitis, Invasive Infect.. Sore Throat, Otitis Media, Sinusitis, Conjunctivitis, Brochopneumonia, Septicemia & Conjunctivitis, Brochopneumonia, Septicemia & Meningitis.. Children 6 Months-5 Years.. Antibiotics. Meningitis.. Children 6 Months-5 Years.. Antibiotics.

Lab DiagnosisLab Diagnosis: : Blood, CSF & Others Culture.. Blood, CSF & Others Culture.. Chocolate & blood agar included X & V Factors.. Chocolate & blood agar included X & V Factors.. Hib-Hib-Vaccine.Vaccine.. Infants > 2 months old.. Infants > 2 months old.

Haemophilus colonies growth Haemophilus colonies growth surrounding Stapholococcus coloniessurrounding Stapholococcus colonies

Bordetella pertussisBordetella pertussis Gram-negative coccbacilli.. Aerobic.. Highly human Gram-negative coccbacilli.. Aerobic.. Highly human

Communicable agentCommunicable agent.. Droplets Infection..close .. Droplets Infection..close contact.. Bacteria attach to lower respiratory tract contact.. Bacteria attach to lower respiratory tract mucosa., Incub. period 7-10 days..Destruction mucosa., Incub. period 7-10 days..Destruction tracheal ciliated cells by releasing tracheal ciliated cells by releasing Pertussis toxinPertussis toxin (cytotoxin) . (cytotoxin) . Pertussis Pertussis start by mild coughing, start by mild coughing, sneezing..intense cough (Whooping / paroxysmal sneezing..intense cough (Whooping / paroxysmal cough), vomiting, red eyes ..Infants & Children more cough), vomiting, red eyes ..Infants & Children more susceptible to infection than adults, high fatal in Adults susceptible to infection than adults, high fatal in Adults than in children. Antibiotics are useful in first stage. than in children. Antibiotics are useful in first stage. Prevention: Prevention: DTP vaccine within first 2 -4-6 Ms DTP vaccine within first 2 -4-6 Ms

DiagnosisDiagnosis: Clinical signs and Symptoms.. Less : Clinical signs and Symptoms.. Less Culture & Lab tests. Culture & Lab tests.

Neisseria & Moraxella GroupsNeisseria & Moraxella Groups Neisseria Neisseria spp., spp., Moraxella spp.: Moraxella spp.: Gram-negativeGram-negative

diplococci, Facultative anaerobes, Oxidase & diplococci, Facultative anaerobes, Oxidase & Catalase+ve, Highly susceptible to Low/High Tempt… Catalase+ve, Highly susceptible to Low/High Tempt… Dryness, Rapid Autolysis .. Room Tempt. Normal Dryness, Rapid Autolysis .. Room Tempt. Normal Flora Respiratory Tract.. Rare Non-pathogens (N. Flora Respiratory Tract.. Rare Non-pathogens (N. sicca, N. flava, M. Mucosa).. Common Pathogens.. sicca, N. flava, M. Mucosa).. Common Pathogens.. N. N. gonorrhea, N. meningitiditesgonorrhea, N. meningitidites. .

1-1-N.gonorrheaN.gonorrhea:: Pili, IgA-Protease, LPS, Colonization Pili, IgA-Protease, LPS, Colonization Mucosa.. Invasion..Inflammation.. Genitourinary Tract, Mucosa.. Invasion..Inflammation.. Genitourinary Tract, Rectum, Throat, Sexually Transmitted Diseases.. Rectum, Throat, Sexually Transmitted Diseases.. Acute/Subacute/Asymptomatic Infections.. Acute/Subacute/Asymptomatic Infections.. Uretral/Vaginal Discharge, Urethritis, Cervicitis, Uretral/Vaginal Discharge, Urethritis, Cervicitis, Salpengitis.. Common Reinfection.. Salpengitis.. Common Reinfection..

Neisseria Gramstain-Intracellular Neisseria Gramstain-Intracellular Presence in Urethral DischargePresence in Urethral Discharge

Follow/2Follow/2 Lab diagnosisLab diagnosis: Direct Gram-stain.. Intracellular G-ve : Direct Gram-stain.. Intracellular G-ve

diplococci in WBCs (pus cells).. Rapid Culture in diplococci in WBCs (pus cells).. Rapid Culture in Blood/chocolate Agar.. Antibiotics, No Vaccine.Blood/chocolate Agar.. Antibiotics, No Vaccine.

2- N. meningitidites2- N. meningitidites: : Capsular Polysaccharides, LPS, Capsular Polysaccharides, LPS, IgA-Protease, Serotypes A,B,C, Invasive, Exogenous IgA-Protease, Serotypes A,B,C, Invasive, Exogenous Infect. Respt.Tract.. Sore Throat.. Septicemia.. Infect. Respt.Tract.. Sore Throat.. Septicemia.. Meningitis.. Acute disease with high Mortality without Meningitis.. Acute disease with high Mortality without treatment. Children (6-Months-5 years) more treatment. Children (6-Months-5 years) more susceptible than adults. Epidemic outbreaks.susceptible than adults. Epidemic outbreaks.

Protective Vaccine is available. Protective Vaccine is available. 3- 3- M. catarrhalisM. catarrhalis:: Part of normal Respiratory tract.. Part of normal Respiratory tract..

Opportunistic pathogen.. Pneumonia.. Rarely Opportunistic pathogen.. Pneumonia.. Rarely Septicemia.. Compromised Lung/heavy smokers.Septicemia.. Compromised Lung/heavy smokers.

Lab DiagnosisLab Diagnosis: Direct-Gram-stain, Culture Blood/ : Direct-Gram-stain, Culture Blood/ chocolate Agar, Biochemical tests, Antibiotics,chocolate Agar, Biochemical tests, Antibiotics,