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Kingdom: Bacteria Phylum: Proteobacteria Class: Beta Proteobacteria Order: Burkholderiales Family: Alcaligenaceae Genus: Bordetella Species: B.

pertussis

Bordetella pertussis
Dr.Aravind

Bordetella pertussis
Dr.Aravind

Causes Whooping Cough (Pertussis)

Very Small, Gram-negative, Aerobic Coccobacillus


Oxidase (+), Catalase (-), Urease (-)

Requires Special Media (Nicotinamide, Charcoal, Salts Etc).


Bordet-gengou Media- 3-7 Days Growth, Small, transparent, Mercury

Droplet appearance, and hemolytic


Strictly Human Pathogen
Dr.Aravind

Virulent Factors
Adhesion:
Filamentous Haemagglutinin - Binds To Sulfatides Of Ciliated Cells. Pertussis toxin (B unit) Fimbreae Peractin

Exotoxins:
Invasive Adenylate cyclase toxin
Activated By Calmodulin Catalyses ATP To cAMP conversion Reduce Phagocytic Activity
Dr.Aravind

Pertussis toxin A&B toxin (S1,S2,S3, 2 S4 and S5)


A Unit - S1 (lethal Action)
ADP-ribosylates The Gi Protein ( signal transduction) Inhibits Chemotaxis, Phagocytosis, The Oxidative Burst. Lymphocytosis And Alteration Of Hormonal Activities (Increased Insulin Hypoglycemia, increased Histamine - In Increased Capillary Permeability, Hypotension And Shock)

B Unit Binding
S2 Attaches To Lactosylceramide receptors Of Ciliated Cells S3 Attaches Glycoplipids receptors On Phagocytes S4 & S5 Unknown Receptors

Dr.Aravind

Tracheal Cytotoxin:
Cytotoxin Is A Peptidoglycan Fragment Binds To Ciliary Epithelial Cells Inhibits Ciliary Movement Kills Ciliary Epithelial Cells IL 1 Fever

Lipopolysaccharide:
Endotoxin In larger quantities, causes shock and cardiac arrest
Dr.Aravind

Epidemiology
Nasopharyngeal region Transmitted by droplet nuclei <1 year age group Now, no incidence because of vaccination Seen in adults (act as carriers)

Dr.Aravind

Pathogenesis
FHA, and Pertussis toxin

Tracheal toxin damage cilia

Pertussis toxin and Adenylate cyclase toxin destructs cells and signal transduction

Blood vessel

Dr.Aravind

Clinical features

Dr.Aravind

Stage

Length

Clinical Features

Stage 1: Catarrhal Usually 7-10 days; range of 4-21 Coryza Low-grade fever Mild, occasional cough (which gradually becomes more severe) Usually lasts 1-6 weeks, but may Paroxysms of numerous, rapid coughs due to difficulty Stage 2: persist for up to 10 weeks expelling thick mucus from the tracheobronchial tree. Paroxysmal Long aspiratory effort accompanied by a high-pitched "whoop" at the end of the paroxysms Cyanosis Vomiting and exhaustion Paroxysmal attacks: Occur frequently at night, with an average of 15 attacks per 24 hours. Increase in frequency during the first 1-2 weeks, remain at the same frequency for 2-3 weeks, and then gradually decrease. Usually 7-10 days; range of 4-21 Characterized by:Gradual recovery Stage 3: Less persistent, paroxysmal coughs that disappear in 2-3 Convalescent weeks Paroxysms often recur with subsequent respiratory infections Dr.Aravind for many months after the onset of pertussis.

Paroxysmal Stage

Catarrhal Stage

Dr.Aravind

Complications
In children: Pneumonia, seizures, encephalopathy 1% will die

In adults: Weight loss, Urinary incontinence, Syncope & Rib fractures from severe coughing

Dr.Aravind

Diagnosis
Specimens - Post / per nasal swab (no cotton swab) / cough plate
Culture Bordet Gengou Medium mercury drop pearl appearance

colonies (Regon lowe)


Staining Grams negative coccobacilli

Fluorescent antibody stain


PCR
Dr.Aravind

Treatment
Erythromycin Is The Drug Of Choice

Prevention
Vaccine Is Extremely Effective DTP Vaccine

Dr.Aravind

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