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Corynebacterium

Corynebacterium
Aerobic
Gram-positive
Coryneform group:
-Corynebacterium+related group
-irregularly shaped

Corynebacterium

Small rod
Club-shaped
Mycolic acid in cell wall
Gram stain: short chains with V or Y
configurations
Chinese letters
Methylene blue: Metachromatic
granules

Corynebacterium

Colonize skin, respiratory tract,


gastrointestinal tract, urogenital tract
Opportunistic pathogen
C. diphtheria : the most famous

Less common Coryneform


bacilli

Archanobacterium
Brevbacterium
Oerskovia
Turicella

Corynebacterium diphtheriae

Facultative anaerobe
Most strains grow well on lipid-free media
Metachromatic granules with methylene blue:
not spesific For C. diphteriae
The organism do not have to enter blood
stream to produce the systemic signs. The
exotoxin is responsible for the symptoms.

Corynebacterium diphteriae

Respiratory diphteriae
Cutaneous diphteriae

Culture

Tellurite agar: gray to black colonies


Lffler media: better microscobic
morphology
Gravis, intermidius and mitis: coloni
morphology. For epidemiological
classification.

Exotoxin

Tox gene
By a beta-phage (lysogenic phage)
A-B exotoxin
Inhibits protein synthesis by inactivating
elongation factor 2 (EF-2)

Toxigenicity testing
In vitro immunodiffusion assay: Elek
test
In vivo quinea pig neutralization assay
PCR test for detecting toxin gene
**nontoxigenic strains should not be
ignored because they have been
associated with significant disease

Corynebacterium Treatment

Antitoxin
Penicillin
Toxoid

Other Corynebacterium

C. jeikeium(group JK):opportunistic
pathogen in immunocompromised
patients: hematologic disorders or
intravascular catheters.
Resistant to many antibiotics

Anaerobic Gram-positive bacilli

No spore
Actinomyces
Propionibacterium
Mobiluncus
Lactobacillus

Actinomyces

Not acid-fast( in contrast to the


morphologically similar Nocardia)
Filamentous forms and hypae
A. israelii, A. meyeri(strict anaerobe)
Colonize the upper respiratory tract,
gastrointestinal tract, female genital
tract

Actinomyces

Normal mucosal barriers should be


disrupted by trauma,surgery or
infection
Actinomycosis
Macroscopic colonies: sulfur granules :
masses of filamentous organisms bound
by calcium phosphate

Actinomyces

Cervicofacial
Thoracic
Abdominal
Pelvic

Aerobic actinomycetes

Nocardia
Rhodococcus

Nocardia

1.
2.
3.
4.

Have mycolic acid in cell wall, filamentous


Stain irregular with gram-stain
Partially acid-fast, cord factor, catalase and
sd
Four genera:
Nocardia
Rhodococcus
Tsukamurella
Gordona

Nocardia

N. asteroides
Bronchopulmonary disease in
immunocompromised patient
Secondary CNS infections
Selective media

Rhodococcus

Red-pigmented rod like to coccus


Mucoid colonies
R. Equi
Invasive pulmonary disease
Difficult to treat

Gordona and Tsukamurella

Opportunistic pathogens

Mycetoma

Fungi (eumycotic mycetoma)


Bacteria (actinomycotic mycetoma)
Actinomadura, Nocardiopsis,
Streptomycetes, Nocardia
3 weeks slow growing
Surgical debridement-antibiotic therapy

Tropheryma whipplii
Whipple disease arthralgia, diarrhea,
weight loss

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