Bacillus

Dr. Nan Nwe Win

 Bacillus species

• large aerobic
• Spore-forming gram positive bacilli
• occur in chains
• Can survive for many years ( due to spores)
Most are saprophytes.

Medically important Bacillus species are

• Bacillus anthracis - Anthrax

• Bacillus cereus - Food poisoning
 Other Bacillus species

• Bacillus megatarium - Largest bacteria

• Bacillus polymyxa - Produce Polymyxin
• Bacillus stereotermophilus - biological indicator to
test efficiency of autoclave
• Bacillus globigi - test efficiency of
ethylene oxide
• Bacillus thurigiensis - used as pesticide
• Bacillus anthracis used as a biological
weapon of mass destruction

• They form spores which can survive for

many years transmitted by inhalation and
cause fatal pulmonary anthrax
 ETIOLOGY OF ANTHRAX
Causal agent - Bacillus anthracis

Morphology
• Large gram positive, spore bearing bacilli
• Square end, arranged in long chains
• Capsule present
• Spore - central, oval, non-bulging
Gram positive bacilli with central spores

free Bacilli
Spore

Endospore Spore
Growth Characteristics
• Aerobes
• Blood agar - haemolysis is uncommon
• Gelatin stabs - liquifies gelatin
(Inverted fir tree appearance)
Reaction to chemical and physical agents
• Spores - resistant to environmental changes,
dry heat and chemical disinfectants

• Animal products contaminated with anthrax

spores can be sterilized only by autoclaving
Virulence Factors
• Capsule
- Poly-D-glutamic acid
- under control of plasmid
- antiphagocytic
• Production of anthrax toxin
- protective antigen (PA)
- oedema factor (OF)
- lethal factor (LF)
 PATHOGENESIS
Causal agent - Bacillus anthracis

Primarily a disease of sheep, goats, cattle, horses &

other herbivores (Zoonosis)
Infective form - spores
 MOT
For man
1)Direct contact : entry of spores through
injured skin or mucous membrane

2)Inhalation of spores

3)Ingestion of infected meat (usually in

animals)
• For animals - by ingestion
 Clinical Types

• Direct contact Cutaneous anthrax

• Inhalation Pulmonary anthrax

• Ingestion Intestinal anthrax

• At the site of entry spores germinate
into vegetative form
• result in production of 3 exotoxins (PA, LF, EF)

• PA - protective Ag binds to specific cell receptors

• following proteolytic activation
• it forms a membrane channel entry of EF
and LF into the cell

• LF, EF - result in formation of gelatinous edema

and congestion
• spread via lymphatic vessel to blood stream
 Cutaneous anthrax
(Hide-porter’s disease)
Clinical features
1. Cutaneous anthrax (Hide-porter’s disease)

• I.P: 1 - 7 days
• papule
• vesicles
• malignant pustule
• ulcer - central black eschar
• After entry of spores or an organism- a pruritic
papule develop resemble insect bite)
• Change into a small ring of vesicles - coalesce and
a necrotic ulcer develop

• Typical lesions - painless ulcer with contract black

eschar and local marked oedema
• is called malignant pustules(Hide-porter's disease)

• If untreated - 20% bacteremia > Sepsis > systemic

infection - meningitis and death
2. Pulmonary anthrax
• Inhalation anthrax / Industry anthrax
- Wool-sorter’s disease
• Animal products

Autoclaving
Wool-sorter’s disease
• Pulmonary anthrax (Wool-sorter’s disease)
- I.P:- as long as 6 weeks

• Start with non specific respiratory symptoms

resemble influenza – cough

• Substernal pain is prominent, associated with

hemorrhagic necrosis and edema of the
mediastinum , hemorrhagic pleural effusion,
septic shock and death
• Occur in wool industry called Woolsorter's
diseases
• Usually fatal form (85 - 90% mortality )

• Haematogenous spread to
- GI tract - bowel ulceration ,
- to meninges - hemorrhagic meningitis
3. Intestinal anthrax
- abdominal pain
- vomiting
- bloody diarrhoea
MOT
- Ingestion
- Haematogenous spread
 Occupational Risks
Anthrax is a zoonotic disease which usually affects
• agricultural workers,
• animal handlers,
• veterinarians and
• industrial laborers working with animal products
(bone meal, hides and wool)
DIAGNOSTIC LABORATORY TESTS
A. Specimens
- fluid or pus from the lesion
- blood
- sputum

B. Stained smears
- Gram stain - large gram positive rods in
chains
- Immunofluoresence staining of dried smears
C. Culture
- blood agar - no haemolysis, gray colonies
- semisolid medium - non-motile

D. Serology
- Detection of Ab to protective Ag by ELISA
TREATMENT
- Ciprofloxacin for treatment

- Prophylaxis with ciprofloxacin or doxycycline

in potential exposure to B. anthracis as biologic
warfare
 PREVENTION & CONTROL
General Measure
1. Disposal of animal carcasses
- burning
- deep burial in lime pits
2. Decontamination of animal products
- autoclaving
3. Protective clothing & gloves for handling
potentially infective materials
Specific Measure
4. Active immunisation of
domestic animals
5. Immunisation of persons
with high occupational risk