By Ms. Kostiuk from Microbiology department

1. Diphtheria Tuberculosis

2. Diphtheria is acute human infectious disease caused by toxigenic Corynebacterium diphtheriae, transmitted by airborne droplets, manifesting in local fibrinous inflammation of mucous membrane of nasopharynx and trachea, and common intoxication, cardiovascular, nervous, urogenital system injury

5. Morphology of С. diphtheriae Methylene blue stain Neisser’s stain Metachromatically stained volutin inclusions

7. Biochemical activity of C.diphtheriae + Nitrate reduc-tion Gelatin hydrosysis Catalase - - + - + + Urease Maltose Sucrose Glucose

9. Differentiation criterions for C.diphtheriae biotypes Less strains are toxigenic More strains are toxigenic Toxigenicity Yes No Hemolysis No Yes Fermentation of starch No Yes Fermentation of glycogen Diffuse turbidity Surface pellicle and granular deposit Growth in broth S colonies R colonies Growth on solid media Mitis Gravis Feature

10. С. diphtheriae biotypes cultural properties Gravis forms large colonies R-form (rough surface, with uneven edge) Mitis forms small colonies S-form (smooth surface, with flat edge)

13. The clinical appearance in diphtheria infection Inflammation of the pharynx and tonsils marked by a pleudomembrane and swelling over the entire area.

14. Toxigenisity of C.diphtheria The toxigenisity of C.diphtheria is connected with bacteriophage. The DNA that codes for diphtheria toxin is part of the genetic material of a temperate bacteriophage. During the lysogenic phase of viral growth, the DNA if this virus integrates into the bacterial chromosome and the toxin is synthesized. C.Diphtheria cells that are not lysogenized by this phage do not produce exotoxin and are nonpathogenic.

17. Immunoprecipitation test for diphtheria toxin 1 2 3 4 5

18. Biologic test for toxin detection

21. The incidence and fatality rates for diphtheria in the USA

25. M.Tuberculosis in sputum Red acid-fast bacilli against acid-susceptible blue cells. M.Tuberculosis bacilli are frequently localized intracellularly Ziehl-Neelsen stained specimen

28. Cord formation in infected tissue Red-stained M.tuberculosis and blue macrophages

30. Tubercle formation Primary tubercolosis. The bacilli in lung are phagocytosed by macrophages and multiply intracellulary. After 2 weeks, delayed hypersensitivity to the TB develop. Macrophages fuse together to form large multinucleated cells. Lymphocytes and macrophages then wall off the infected area from the surrounding tissue. The localized collection of inflamatory cells is called a granuloma (tubercle). In most cases, growth of the TB is halted by granuloma formation. Serondary reactivation tuberculosis. Live bacilli can remain dormant and become reactivated weeks, months, or years later. They multiplies, spreads into the bronchial tube and upper respiratory tract.

34. A fluorescent acid-fast stain of M.tuberculosis from sputum

38. Cultural properties of mycobacteria M. tuberculosis M. kansasii (photochromogenic) M. gordonae (scotochromogenic)

39. Agent of leprosy Mycobacterium leprae is agent of leprosy. M.leprae has not been grown in the laboratory media or in cell culture. It can be cultivated in the mouse footpad on in the armadillo. The bacilli replicates intracellularly, typically within skin hystiocytes, endothelial cells, and nerve cells. Red acid-fast bacilli Ziehl-Neelsen stain

40. Leprosy The incubation period averages several years (due to very slow multiplication of bacilli) There are 2 distinct forms of leprosy – tuberculiod and lepromatous When lepromatous form deformation of hands, nose, lips, chin. Leprosy is a chronic, progressive disease of the skin and nerves