Section Six BACTERIA BACTERIAL RESPIRATORY INFECTIONS
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Section Six BACTERIA BACTERIAL RESPIRATORY INFECTIONS The upper respiratory tract may become susceptible to bacterial infection as a result of health conditions such as allergies and viral infections, as well as the effects of smoking and airborne environmental pollutants. BACTERIAL RESPIRATORY INFECTIONS Streptococcus pneumoniae, Haemophilus influenzae and Klebsiella pneumoniae are the most common bacterial pathogens in upper and lower respiratory tract infections. BACTERIAL RESPIRATORY INFECTIONS Bacterial pathogens adhere to mucous membranes and colonization ensues. In an otherwise healthy individual the host immune system responds to the invading bacteria resulting in edema and swelling. BACTERIAL RESPIRATORY INFECTIONS If antimicrobial treatment does not eradicate the invading organisms and successfully interrupt the progress of the infection, the patient may develop recurrent or chronic disease. BACTERIAL RESPIRATORY INFECTIONS S. pneumoniae and other pathogens once susceptible to Penicillin and other antibiotics are now becoming resistant. Bacterial resistance has developed and disseminated because of the widespread use of antibiotics. BACTERIAL RESPIRATORY INFECTIONS Major mechanisms of bacterial resistance to antimicrobials in upper respiratory tract infections include membrane impermeability, alteration of the target inside bacterial cells and active pumping out of antibiotic (efflux). 1) Test for Bacterial respiratory infections Using Blood Agar Procedure 1- Suspend 28 grams of nutrient agar in 1000 ml purified/distilled water. 2- Heat to boiling to dissolve the medium completely. 3- Sterilize by autoclaving at 1.5 atm (121°C) for 15 minutes. 4- Cool to 45-50°C. 5- Add 5% sterile defibrinated blood (warmed to room temperature) and mix gently but well (avoid Air bubbles). 5- Plating using pour plate method (add 0.1 ml of sample and then pour the medium and mix gently. 6- Invert the agar plates and put them in the incubator at 37°C for 24-48 hrs. 7- After incubation period, examine the plates and write your observation. Observation 1- Alpha hemolysis: Partial lysis of the RBC to produce a greenish-grey or brownish discoloration around the colony. α hemolysis is due to the reduction of RBC hemoglobin to methemoglobin in the medium surrounding the colony. Example: Streptococcus pneumoniae. Observation clearing of blood 2- Beta Hemolysis: Complete lysis of red blood cells causing a clearing of blood from the medium under and surrounding the colonies. Example: Streptococcus pyogenes. Observation 3- Gamma or non-hemolysis: No hemolysis of RBC. No change of the medium under and surrounding the colonies. Example: Klebsiella pneumoniae. Comment Blood agar is an enriched, bacterial growth medium. Fastidious organisms, such as Streptococci spp., do not grow well on ordinary growth media. Blood agar is a type of growth medium (Nutrient agar enriched with 5% sheep blood) that encourages the growth of bacteria, such as Streptococci, that otherwise wouldn’t grow. Blood contains inhibitors for certain bacteria such as Neisseria and Haemophilus genera and the blood agar must be heated to inactivate these inhibitors and to release essential growth factors (e.g., V factor). Heating of blood agar converts it into chocolate agar (heated blood turns a chocolate color) and supports the growth of these bacteria. Comment Certain bacterial species produce extracellular enzymes that lyse red blood cells in the blood agar (hemolysis). These hemolysins (extotoxin) radially diffuses outwards from the colony (or colonies) causing complete or partial destruction of the red cells (RBC) in the medium and complete denaturation of hemoglobin within the cells to colorless products. There are different types of hemolysis which produced in sheep blood agar by Streptococci namely; alpha hemolysis, beta hemolysis and gamma hemolysis. Practice (10) Organism Colony color Type of hemolysis Greenish-grey or brownish Streptococcus pneumoniae Alpha hemolysis discoloration around the colony Complete lysis of red blood cells Streptococcus pyogenes Beta hemolysis causing a clearing of blood Complete lysis of red blood cells Staphylococcus aureus Beta hemolysis causing a clearing of blood Haemophilus influenzae Can not grow on this medium Negative No hemolysis of RBC. No change Klebsiella pneumoniae Gamma hemolysis of the medium 2) Antibiotic sensitivity test Procedure 1- Suspend 28 grams of nutrient agar in 1000 ml purified/distilled water. 2- Heat to boiling to dissolve the medium completely. 3- Sterilize by autoclaving at 1.5 atm (121°C) for 15 minutes. 4- Cool to 45-50°C. 5- The bacterial strains are added to the melted agar medium and mix gently but well and then pour the inoculated medium into sterile Petri dishes. Then, Leave the plates to solidify. 6- Cut circular holes into the agar by a corkborer. 2) Antibiotic sensitivity test Procedure 7- Add the solutions of the antibiotics into the holes separately. 8- Incubate at 37°C for 24-48 hrs. 9- After incubation period, examine the plates and write your observation. Observation After overnight incubation, Zones of inhibition (ZOI) are formed. The diameter of each zone should be measured and recorded in mm. Comment Antibiotics are types of antimicrobial substances produced by some microorganisms that kill or slow down the growth of bacteria. They include a range of powerful drugs and are used to treat diseases caused by bacteria. Antibiotics cannot treat viral infections, such as cold, flu, and most coughs. Antibiotics are powerful medicines that fight certain infections and can save lives when used properly. They either stop bacteria from reproducing or destroy them. Before bacteria can multiply and cause symptoms, the immune system can typically kill them. Comment White blood cells (WBCs) attack harmful bacteria and, even if symptoms do occur, the immune system can usually cope and fight off the infection. Sometimes, however, the number of harmful bacteria is excessive, and the immune system cannot fight them all. Antibiotics are useful in this case. The first antibiotic was penicillin which mainly produced by Penicillium notatum and P. chrysogenum. Comment Mode of action of antibiotics: 1- Penicillin: it prevents the formation of cell wall in susceptible bacteria. 2- Bacitracin is a peptide antibiotic and produced by Bacillus licheniformis. Its antimicrobial spectrum is against Gram-positive bacteria. It inhibits bacterial cell wall synthesis by inhibiting dephosphorylation of lipid pyrophosphate. 3- Streptomycin: it produced by Streptomyces griseus. Protein synthesis in a culture is inhibited at about the time that the vial count begins to decrease. Later, DNA and RNA synthesis and respiration are inhibited, and the cell membrane is damaged. 4- Erythromycin is an antibiotic produced by growth of certain strains of Streptomyces erythreus. It acts by inhibiting elongation at the transpeptidation step, specifically aminoacyl translocation from the A-site to P-site by binding to the 50s subunit of the bacterial 70s rRNA complex. This product acts against both Gram-negative and Gram- positive bacteria. Comment 5- Actinomycin D which produced by Streptomyces sp. inhibits the proliferation of cells by forming a stable complex with double-stranded DNA, inhibiting DNA-primed RNA synthesis and causing single-stranded breaks in DNA. It has been shown to be an inhibitor of the minus-strand transfer step in reverse transcriptase. 6- Chloramphenicol is isolated from Streptomyces venezuelae. It blocks the formation of peptide bonds on bacterial ribosomes and therefore inhibits protein synthesis. 7- Cyclosporin A is produced by Tolypocladium inflatum. It inhibits the T-cell receptor signal transduction pathway via the formation of cyclosporin A-cyclophilin complex that inhibits calcineurin (protein phosphatase 2B). Thank you .