Pseudomonas, Non Fermenters - Bacteriology - Lecture Slides, Slides for Bacteriology. B R Ambedkar National Institute of Technology

Bacteriology

Description: Pseudomonas, Non Fermenters, Pseudomonas Aeruginosa, Opportunistic Infections, Oxidase Positive, Antibiotic Resistance, Greenish Pus, Human Infections, Pigment Production. Are the key points of Bacteriology.
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Pseudomonas & Other Non-fermenters

Pseudomonas &

Other Non-fermenters

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KEY WORDS Pseudomonas aeruginosa Pigments

Pyocyanin Fluorescein

Toxin A Opportunistic Infections Greenish Pus Non-fermenter Oxidase positive Motile Hospital infection Antibiotic resistance

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Pseudomonas

Obligate Aerobe, mostly saprophytic Gram-negative non-sporing rods Motile Majority of human infections

P. aeruginosa

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Pigment production

Greenish yellow pigment

No pigment

Pseudomonas aeruginosa Burkholderia mallei

Burkholderia pseudomallei

Medically important species of Pseudomonas

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Common in the environment

waterair soil

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Burns and wounds destruction of blood vessels phagocyte access limited

Cancer cytotoxic drugs

*destroy the immune system Cystic fibrosis

altered respiratory epithelium pneumonia

.

P. aeruginosa and compromised host

Cystic fibrosis (CF) is a hereditary disease that affects mainly the lungs and digestive system, causing progressive disability, and, for some, early death. Formerly known as cystic fibrosis of the pancreas, this entity has increasingly been labeled simply cystic fibrosis.[1] Average life expectancy is around 37 years, although improvements in treatments mean a baby born today could expect to live longer.[2]

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IdentificationPigments

Pyocyanin (blue-green) Fluorescein (green-yellow, fluorescent) Best produced in King’s A & B Media

Biochemical reactions – Non fermenter Oxidase positive Cultures have fruity smell (Grape like)

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Toxin A - ADP ribosylates EF2 functions as NADase

similar to diphtheria toxin

Slime layer is anti-phagocytic

Pathogenesis

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Virulence factors of P. aeruginosa • Lipopolysaccharide: endotoxin, pyrogen • Capsule: anti-phagocytosis, inhibits complement fnc. • Proteases: damage host proteins such as complement

and IgA • Hemolysins • Exotoxin A: a diptheria-like toxin - toxic for

macrophages • Pyocyanin: impairs ciliary activity • Fimbriae: adherence factor • Other non-pilus adhesins • Others like elastases………..

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Transmission Endogenous infection Contact spread

Virulence Toxin and Extracellular products

Protease , Pyocyanin, Cytotoxin (leukocidin) Endotoxin, Haemolysin, Exotoxin A & Exotoxin S

Pathogenesis

Mucoid strains in Cystic fibrosis due to alginate

Source Endogenous (skin of axilla, perineum or GIT)

Exogenous Respirators, bed pans, lotions, ointments, eye drops, stock of distilled water, disinfectants (QAC)

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Community Suppurative Otitis

Hospital

Eye Keratitis and Endophthalmitis

Ear Otitis externa and Otitis media

Skin Burns infection, wound sepsis

UTI Cystitis (catheterized)

RTI Pneumonia (ventilation / tracheostomy)

GIT Infantile diarrhea

CNS Meningitis brain abscess (iatrogenic)

Diseases (Pathogenicity)

Nosocomial infection

Ecthyma gangrenosum

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Lab Diagnosis Specimens Wound discharge, sputum, urine, blood

Microscopy Gram negative bacilli

MAC NLF, blue green with distinct feathered edges

NA Green diffusible pigment

Cetrimide agar Selective media

Identification tests Oxidase + TSI: K- / K- (non fermenter)

AST Ceftazidime, ticarcillin, piperacillin, ciprofloxacin, amikacin, gentamicin, Polymyxin B

Bacteriophage typing Hospital outbreak investigation

Aeroginocine (Pyocine) typing

11 Indicator strains

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Antipseudomonad beta lactam

Combination therapy in impaired defense mechanism

Strict attention to asepsis

Treatment of underlying disease (correction of granulocytopenia)

Treatment & Control

Aminoglycosides

Fluoroquinolones

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8:10 PM Atul: are you there me: Hi Atul: hi 8:11 PM me: That day I came on line in d evening but by that time u

were off! How's life? Atul: did i tell you about isolation of burkholderia pseudomallei at

dharwad me: Saw my mail? 8:12 PM Atul: yha me: No. Just now I am preparing my power point on

that very topic. May be I can use ur story to make lecture interesting! 8:13 PM Atul: please send me as many full text articles you can on this

topic.\ sure i will send you the case report. when do you want it 8:14 PM me: Certainly. Can u send me a brief summary. May be

tomorrow a real brief one.. but incl all essentials. Atul: sending it now 8:15 PM me: Wonderful. The students will like it and I will mention the

co-incidence that my friend was talking of exactly the same organism!! Telepathy?

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Burkholderia pseudomalai septicaemia – a case report • A 35 old male working as daily labourer presented to the

Medicine OPD on 19th September 2007 at 1 pm with complaint of fever for 8 days and reduced urine output for about one month. He was known diabetic and was on regular insulin therapy of which precise duration could not be known. He belonged to the costal town Karwar of Karnataka, India.

• On examination the patient was emaciated and dehydrated. His blood pressure was 70 mm / 50 mm of Hg and pulse rate was 120 per minute. CVS examination revealed S1 S2. On auscultation he showed bilateral basal crepitations. There was a vertical scar on the abdomen and the patient gave history of splenectomy 10 years ago of which reason was not identified. Liver was palpable one finger below costal margin and he had mild ascitis. Samples were sent for investigation including blood culture and he was put on Metrogyl (Dose) and Monocef 1 gm i/v.

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No pigment, non motile

Whitmore’s bacillus

No pigment, motile

Cause Melioidosis (glanders like disease)

Burkholderia mallei

Cause Glanders in horses, donkeys and mules

Rarely cause human disease (suppurative lesions)

Burkholderia pseudo mallei

Acute septicemia (typhoid like disease)

Multiple abscess formation

Transmitted via rats either by rat fleas or food contaminated with excreta

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CLINICAL SYNDROMES Opportunistic Infections

 Respiratory tract  Urinary tract  Wounds  Septicemia

EPIDEMIOLOGY  Niches Include:

• Natural environments • Moist surfaces in hospitals (e.g., respiratory therapy

equipment) • Dry surfaces (e.g., human skin); rare for gram-negative bacilli • Occasionally normal flora in oropharynx

TREATMENT, PREVENTION & CONTROL  Antibiotic Resistance Common  Empirical Treatment for Acute Infections: β-lactam +

Aminoglycoside  Specific Therapy According to Antibiotic Susceptibility

Acinetobacter baumanii (calcoaceticus)

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GENERAL OVERVIEW  Formerly classified as Neisseria & more recently Branhamella

CLINICAL SYNDROMES  In Elderly Patients with Chronic Pulmonary Disease • Bronchitis • Bronchopneumonia

 In Previously Healthy People • Sinusitis • Otitis

TREATMENT, PREVENTION, AND CONTROL  Most strains produce β-lactamase; Penicillin Resistant

Moraxella catarrhalis

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KEY WORDS Pseudomonas aeruginosa Pigments

Pyocyanin Fluorescein

Toxin A Opportunistic Infections Greenish Pus Non-fermenter Oxidase positive Motile Hospital infection Antibiotic resistance

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