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BACTERIAL INFECTION ON

UPPER RESPIRATION
TRACT

eri dian
Mikrobiologi FK Yarsi

Haemophilus

Characteristics of
Haemophilus
Small, pleomorphic gram-negative coccobacilli, non
motile
Growth in culture on chocolate agar & requires
exogenous hemin (oxidized ferroprotoporphyrin) (X
factor) and/or nicotinamide adenine dinucleotide
(NAD) (V factor)

Haemophilus: Natural
Habitats
Normal inhabitant of the upper respiratory,
gastrointestinal, and genital tracts of humans except
Haemophilus ducreyi (not normal microbial flora)

Haemophilus species of
clinical importance
1. H. influenzae
-type

b is an important human pathogen

2. H. ducreyi
-sexually

transmitted pathogen
(chancroid)
3. Other Haemophilus are normal flora

- H. parainfluenzae

- H. aphrophilus
- H. aegyptius

Haemophilus: Modes of
Infection
Encapsulated strains of Haemophilus
influenzae associated with invasive
infection caused by person-to-person
spread of H. influenzae due to
inhalation of infectious respiratory
droplets
Type b H. influenzae was most
commonly associated with disease prior
to conjugate vaccine but prevalence has
declined with advent of vaccination

Haemophilus: Types of
Infectious Disease
Encapsulated (types a-f) strains of H.
influenzae produce invasive infection
(pneumonia, meningitis, epiglottitis, and
bacteremia)
Unencapsulated (non-typeable) strains of
H. influenzae cause otitis media in
children, and lower respiratory tract
infections (acute tracheobronchitis,
pneumonia) in children and adults

Haemophilus influenzae

Differentiation of
Species
Hemolysis

Growt
h
X Facto V
r

Haemophilus influenzae

Aerobic/facultativ anaerob gram-negative bacteria


Polysaccharide capsule
Six different serotypes (a-f) of polysaccharide capsule
95% of invasive disease caused
by type b

Haemophilus influenzae type b


Clinical Features*

*prevaccination era

Haemophilus influenzae type


b
Epidemiology
Reservoir
Human
Asymptomatic carriers
Transmission

Respiratory droplets

Haemophilus influenzae type b


Pathogenesis
Organism colonizes nasopharynx
In some persons organism invades bloodstream and
cause infection at distant site
Antecedent upper respiratory tract infection may be a
contributing factor

Pathogenic Mechanisms
H. influenzae
Antiphagocytic polysaccharide capsule is the
major pathogenesis factor
Lipopolysaccharide lipid A component from the
cell wall (major role in non capsule strains)
All virulent strains produce neuraminidase and
an IgA protease
No exotoxins

Pathogenesis Host Factors


Hib conjugate vaccine (Poliribitol phosphate ( PRP)
capsule)
The Hib conjugate vaccine does not protect against
nontypeable strains
Persons at risk for invasive H influenzae disease

Asplenia
Immunocompromised

Basis for the H.influenzae


type B vaccine
The polysaccharide capsule of H.influenzae
type B is and represent its major virulence
antiphagocitic Factor. The capsule contain
ribose,ribitol,and phosphate,known
collectively as polyribitol phosphate (PRP).
Phagocytosis and complement-mediated
activity are stimulated in the presence of
antibodies directed at the H.influenzae type B
capsule.
H.influenzae type B vaccine contain PRP
antigens conjugated to specific protein
carriers.

Haemophilus influenzae requires X and V factors for growth. In


this culture haemophilus has only grown around the paper disc
that has been impregnated with X and V factors. There is no
bacterial growth around the discs that only contain either X or V

Public Health AspectsH. influenzae


Typing based on capsule polysaccharide a f
Polyribose-ribitol phosphate (PRP) capsule (type b)
Nonencapsulated (nontypeable) organisms are
part of normal flora of the respiratory tract
95% of invasive disease caused by type b

Moraxella spp

Moraxella spp
M. atlantae, M. bovis, M. canis, M. caprae. M.
catarrhalis, M. equi, M. lacunata, M. lincolnii, M.
nonliquefaciens, M. oblonga, M. osloensis, M.
pluranimalium. Moraxella phenylpyruvica

Characteristics of Moraxella
CHARACTERISTICS:
The genus Moraxella is a member of the family
Moraxellaceae;
coccobacillary gram negative rods that are usually
in short chains or pairs .
Species that are rod shaped range from 1.0-1.5 x
1.5-2.5 m in size and species that are cocci
shaped are 0.6-1.0 m in diameter(2). Most
species are aerobic, and oxidase and catalase
positive

PATHOGENICITY/
TOXICITY
Moraxella species are normally present in the
oropharynx, mucous membranes, skin, and genital
tract,.
The organisms are commensals of mucosal surfaces
and sometimes give rise to opportunistic infection
Moraxella catarrhalis usually resides in respiratory
tract, but can gain access to the lower respiratory
tract in patients with chronic chest disease or
compromised host defenses, thus causing
tracheobronchitis and pneumonia.
Moraxella lacunata is one of the causes of
blepharoconjunctivitis in human
Moraxella bovis is the cause of Infectious bovine
keratoconjunctivitis

Other Moraxella species can cause conjunctivitis


and keratitis (Moraxella lacunata), meningitis, and
arthritis (Moraxella oloensis), endocarditis
(Moraxella lacunata), osteomyelitis (Moraxella
oloensis), upper and lower respiratory tract
infections (Moraxella nonliquefaciens) and
otolaryngologic infections (Moraxella lacunata).
Several species are found in the natural human
flora; however, their pathogenicity, if any, has not
been established

Selected Biochemical Reactions for


Identification of Neisseria and
Moraxella catarrhalis1
Glu

Mal
+

Lac

Suc
DNa
BE

N. gon

N. men
+
+

N. lac
+
+
+

M. cat

+
+
1Glu=glucose, Mal=maltose, Lac=lactose,
Suc=sucrose, DNa=DNase, BE=butyrate
esterase (indoxyl butyrate substrate), N.
gon=N. gonorrhoeae, N. men=N.
meningitidis, N. lac=N. lactamica, M.
cat=Moraxella catarrhalis

Fusobacterium species
Fusobacterium is a genus of anaerobic, Gram-negative
bacteria,rod-shaped bacilli with pointed ends.
Strains of Fusobacterium cause several human diseases,
including periodontal diseases, Lemierre's syndrome,
and topical skin ulcers.
Although older sources state that Fusobacterium is part
of the normal flora of the human oropharynx, the
current consensus is that Fusobacterium should always
be treated as a pathogen. [2] In 2011, researchers
discovered that this bacterium flourishes in colon cancer
cells, and is often also associated with ulcerative colitis,
although researchers have not determined if the
organism actually causes these diseases or if it simply
flourishes in the environment these diseases create