1. Pasteurellaceae D

2.  Haemophilus influenzae  Haemophilus ducreyi  Oppurtunists: Haemophilus parainfluenzae Haemophilus spp.  Pasteurella multocida  Actinobacillus actinomycetemcomitans Human Pathogens

3. Pasteurellaceae General Overview  Taxonomic Confusion in Family Pasteurellaceae  Three Genera: Haemophilus: Most Common in Human Disease Actinobacillus Pasteurella  Haemophilus  Common Characteristics of Family  Small (0.2 x 0.3-2.0 mm) Gram-negative Nonmotile bacilli  Aerobic or facultatively anaerobic  Fastidious growth requirements

4. Pasteurellaceae Differential Characteristics X factor = hemin (hematin) V factor = (NAD or NADP) nicotinamide adenine dinucleotide

5. Haemophilus

6. Haemophilus General Overview  Gram-negative bacilli liking blood (as per genus name)  Obligate Parasites of Man and Animals  Major pathogens for which humans are natural hosts Haemophilus influenzae  Acute pyogenic, normally invasive infections  Chronic infections with H. influenzae as 2 o pathogen Haemophilus ducreyi  True pathogen (i.e., not found in healthy individuals)  STD; Soft chancre (chancroid )

7. Haemophilus Diseases

8. Haemophilus Infections PRP = polyribitol phosphate (see others in text)

9. Haemophilus Infections (cont.) NOTE:  Polysaccharide PRP is weakly immunogenic  Pediatric immunity not mature for processing polysaccharide antigens until ~18 months  Conjugated Vaccine: PRP conjugated to protein carrier induces protective immunity (carriers may include: diphtheria toxoid, tetanus toxoid or meningococcal OMP)

10. Haemophilus influenzae Incidence NOTE: Dramatic decrease in children <5 years; remains constant in older children (per 100,000)

11. Haemophilus influenzae Diseases

12. Haemophilus ducreyi Incidence

13. Actinobacillus

14. Actinobacillus General Overview  Slow-growing; Small; Gram-negative Bacilli  Facultatively Anaerobic  Require CO 2 for growth on chocolate or blood agar  Three Species of Actinobacillus Associated with Human Disease  Actinobacillus actinomycetemcomitans is:  Most serious pathogen of genus  Hyperadherent in vitro and on damaged heart valves  Commonly isolated with Actinomyces -comitans is Latin for “accompanying”  Normal oropharyngeal flora in 20% of healthy people

15. Actinobacillus Diseases HumanJuvenile & adultSubacute

16. Pasteurella

17. Pasteurella General Overview  Small; Gram-negative; Fermentative Pleomorphic Coccobacilli  Facultatively Anaerobic  Therefore infects sutured bites or scratches  Pasteurella multocida:  Most common human pathogen  Domestic pets serve as major reservoir  Commensals in upper respiratory tract of dogs,cats,etc.  Human infection often related to animal bites or scratches or shared food (and you wondered why that lady was buying so much cat food --- it’s cheaper! )

18. Pasteurella DIseases Three Forms of Disease  Localized cellulitis and lymphadenitis following animal bite or scratch  In patients with underlying lung dysfunction, worsening of chronic pulmonary disease from aspiration of organisms colonizing patient’s oropharynx  Systemic infection in immunocompromised  Liver disease patients at highest risk

19. Pasteurella Diseases (cont.) Animal scratch or

20. REVIEW of Pasteurellaceae

21. Pasteurellaceae Differential Characteristics X factor = hemin (hematin) V factor = (NAD or NADP) nicotinamide adenine dinucleotide REVIEW

22. Review of Haemophilus

23. Haemophilus General Overview  Gram-negative bacilli liking blood (as per genus name)  Obligate Parasites of Man and Animals  Major pathogens for which humans are natural hosts Haemophilus influenzae  Acute pyogenic, normally invasive infections  Chronic infections with H. influenzae as 2 o pathogen Haemophilus ducreyi  True pathogen (i.e., not found in healthy individuals)  STD; Soft chancre (chancroid ) REVIEW

24. Haemophilus Diseases REVIEW

25. Haemophilus Infections PRP = polyribitol phosphate (see others in text) REVIEW

26. Haemophilus Infections (cont.) NOTE:  Polysaccharide PRP is weakly immunogenic  Pediatric immunity not mature for processing polysaccharide antigens until ~18 months  Conjugated Vaccine: PRP conjugated to protein carrier induces protective immunity (carriers may include: diphtheria toxoid, tetanus toxoid or meningococcal OMP) REVIEW

27. Haemophilus influenzae Incidence (per 100,000) NOTE: Dramatic decrease in children <5 years following use of PRP conjugated vaccine; Disease rate remains constant in older children REVIEW

28. Haemophilus ducreyi Incidence REVIEW

29. Review of Actinobacillus

30. Actinobacillus General Overview  Slow-growing; Small; Gram-negative Bacilli  Facultatively Anaerobic  Require CO 2 for growth on chocolate or blood agar  Three Species of Actinobacillus Associated with Human Disease  Actinobacillus actinomycetemcomitans is:  Most serious pathogen of genus  Hyperadherent in vitro and on damaged heart valves  Commonly isolated with Actinomyces -comitans is Latin for “accompanying”  Normal oropharyngeal flora in 20% of healthy people REVIEW

31. Actinobacillus Diseases HumanJuvenile & adultSubacute REVIEW

32. Review of Pasteurella

33. Pasteurella General Overview  Small; Gram-negative; Fermentative Pleomorphic Coccobacilli  Facultatively Anaerobic  Therefore infects sutured bites or scratches  Pasteurella multocida:  Most common human pathogen  Domestic pets serve as major reservoir  Commensals in upper respiratory tract of dogs,cats,etc.  Human infection often related to animal bites or scratches or shared food (and you wondered why that lady was buying so much cat food --- it’s cheaper! ) REVIEW

34. Pasteurella DIseases Three Forms of Disease  Localized cellulitis and lymphadenitis following animal bite or scratch  In patients with underlying lung dysfunction, worsening of chronic pulmonary disease from aspiration of organisms colonizing patient’s oropharynx  Systemic infection in immunocompromised  Liver disease patients at highest risk REVIEW

35. Pasteurella Diseases (cont.) Animal scratch or REVIEW