1. Jumpstart 4/9 Get a book from the cart (hint ch. 30 and 31) Answer the following questions: 1.What bacteria causes gonorrhea? 2.What bacteria causes bubonic plague?

2. Neisseria and Enterobacteraceae Medical Microbiology Spring 2010

3. Neisseriaceae Family of bacteria with 4 genera, 2 are strictly pathogenic and the other 2 are normal flora—we are only going to look at 1 of them Gram negative cocci, typically arranged in pairs (diplococcus)

5. Characteristics of Neisseria Gram negative diplococcus Do not form spores Most are catalase positive too (makes it easy for laboratory detection) Have pili that extend from the membrane –Allow attachment to hosts –Exchange of genetic material

6. Neisseria cont. Pathogenic species need iron to grow and compete with their human hosts for iron. The type that we will focus on is Neisseria gonorrhoeae

7. Virulence Factors Pilin- attachment Por protein- keeps them from being destroyed by the immune system easily Opa protein- firm attachment Rmp protein- protects surface antigens from being destroyed 3 proteins for acquiring iron LOS (lipooligosaccharide) endotoxin An enzyme to destroy penicillin

8. Neisseria gonorrhoeae Causes the disease gonorrhea –Occurs only in humans –2 nd only to chlamydia as the 2 nd most commonly reported bacterial STD in the US –About 300,000 cases per year are reported –Highest incidence is in the age group 15-24 –Transmitted primarily by sexual contact

9. Only about half of infected women experience symptoms (other half are asymptomatic). Men almost always experience symptoms. Chance of acquiring the infection if sexual contact with an infected person: –If female, 50% –If male, 20%

10. Gonorrhea Signs and symptoms –Depends on the gender and location of the infection

11. Gonorrhea in males Mostly restricted to the urethra –Purulent urethral discharge –Dysuria (painful urination) Swelling of epididymis, prostate may occur

12. Gonorrhea in females Primarily restricted to the cervix Not able to infect the vagina Signs and symptoms –Vaginal discharge –Dysuria –Abdominal pain –PID –Ovarian abcesses

14. Diagnosis Swab infected area and do a gram stain Oxidase/catalase postitive

15. Treatment Penicillin was the drug of choice for years –You already know why not so much anymore (think about its virulence factors) –Also makes them resistant to erythromycin, tetracycline, aminoglycosides –In Asia and Pacific islands, we also see resistance to Cipro Now, drug of choice is Azithromycin (Z- pac) or doxycycline

16. Enterobacteriaceae You have 10 minutes to read and take notes on the structure and physiology of enterobacteriaceae

17. Group Time I sneakily wrote a number on your paper while you were taking notes. Get with your group. #1’s: E. coli #2’s Salmonella #3’s: Shigella #4’s:Yersinia (my fav) #5’s: Klebsiella #6’s: Treatment, Prevention, and Control

18. Jumpstart 4/13 How can gonorrhea be treated? Name 3 ways that Enterobacteriaceae is different from Neisseria.

19. E.coli Escherichia coli Capable of causing sepsis, UTIs, meningitis, gastroenteritis 2 major virulence factors –Adhesins: allow it to stick cells and not be flushed away –Exotoxins

20. E. Coli Large numbers of E. coli are found in the GI tract Major cause of UTIs (80% of UTIs are caused by E.coli Common cause of gastroenteritis in developing countries

21. Gastroenteritis (E. coli) EPEC (enteropathogenic): –Small intestine, causes infant diarrhea; watery, nonbloody ETEC (Enterotoxigenic): –Small intestine, “traveler’s diarrhea” and infant diarrhea; cramps, nausea, low-grade fever

22. Gastroenteritis, cont EHEC (Enterohemorrhagic) –Large intestine; bloody diarrhea, no fever EIEC (Enteroinvasive) –Large intestine; watery diarrhea, may progress to dysentery with bloody stool EAEC (Enteroaggregative) –Small intestine, infant/traveler’s, persistent

23. Salmonella Ingested and travel to the stomach where they can survive the harsh conditions Colonizes nearly all animals Most infections result from infected foods (fecal/oral) Most notorious species is Salmonella typhii

24. Salmonella, cont. Gastroenteritis Septicemia Enteric fever (typhoid) –Malaise, fever, headache, gastrointestinal problems

25. Shigella Common cause of dysentery (S. dysenteriae) –Exotoxin called Shiga toxin that disrupts protein synthesis and damages endothelial cells Causes shigellosis –Abdominal cramps, diarrhea, fever, bloody stools

26. Yersinia Read the information provided and answer the following questions: 1.Between 1347 and 1351, how many people died from bubonic plague? 2.What is the main source of Y. pestis? 3.Describe how a bite from this organism may lead to the plague. 4.Describe several impacts of the Black Plague. 5.Should we be concerned with the plague returning? Why or why not? 6.Create a mini-timeline on your notebook paper to represent the history of the plague.

27. Klebsiella Prominent capsule Can cause pneumonia

28. Treatment Some infections do not require antibiotic treatment, just treat symptomatically. –E. coli and Salmonella infections can be prolonged by antibiotic use For other infections, streptomycin