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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