B.

PERTUSSIS
BORDETELLA SPECIES OF CLINICAL IMPORTANCE

-B. pertussis

-B. parapertussis

-B. bronchoseptica

-B. avium

MORPHOLOGY

-Gram negative(-)

-It is a small, ovoid coccobacillus ( 0.5 µm).

-It is nonmotile and non sporing.

-Encapsulated.

-Aerobic

-Highly fastidious
VIRULENCE FACTORS

Structural components(adhesion)

--filamentous hemagglutinin
adheres to the cilia of Respiratory epithelia and to RBC
-Agglutinogens
species specific surface agglutionogens with capsule K antigens,14 agglutinin factors
are identified(1-6 is only B Pertussis)
they help the bacteria to attach to the epithelium
-Pertactin
-fimbriae

Toxins
1. pertussis toxin
- It plays an important role in the pathogenesis of whooping cough
-histamin sensitivity
-lymphocytosis promotion
-stimulation of insulin secretion
-hexamer protein composed of six subunits with an A-B structure (the A portion is the
enzymatically active site and the rest B subunits bind the toxin to cell surface receptor )
-increases cAMP (ADP-ribosylates the Gi protein)

2 adenylate cyclase toxin

-It acts by catalysing the production of cAMP by various types of cell
-Inhibits phagocyte function
3.trachael cytotoxins
-induces ciliary damage,paralyzes cilia
4.dermonecrotic toxin
5 .heat-labile toxin.
TRANSMISSION
-transmission occurs via respiratory droplets
-very contagious
PATHOGENICITY

1.CATARRHAL STAGE:
-It lasts 2 weeks
-flu-like symptoms(nasal congestion,cough,low grade fever)
-very contagious
-important the antibiotic treatment in this phase
2.PAROXYSMAL STAGE
(1-6 weeks)
-whooping cough
-the violent force of paroxysm can lead to vomiting,collapsed lungs,broken ribs
In infants gasping,cyanosis,apnea,decresed O2 levels
3.CONVALESCENCE STAGE
(3 months)
-slow cough
-lymphocytosis
-encephalitis

LABORATORY DIAGNOSIS
Specimens
nasopharingeal swab,nasal swab,cough droplets

processing
1.Microscopy: Gram negative coccobacilli small,round pearl appearance of colonies
grows at 35 to 37 degrees

2.Culture: smear on Bordet – Gengou Agar+ penicillin and nicotinamide

3.Test for identification

-Direct Immunoflourescence assay
-PCR
-serologic test(ELISA)
TREATMENT
Macrolides(erithromycicin,Azithromycin and clarithromycin )

PREVENTION
Acellular vaccine containing pertussis toxicoid ans 4 purified proteins
-usually is given as a part of DTAP(Diphteria,Tetanus,Acellular Pertussis)

B.Parapertussis
-less severe
-larger colonies
-grows in blood agar and macConkey agar
-some virulance factors except pertussis toxin