MORPHOLOGY, CLINICAL MANIFESTATION, LABORATORY DIAGNOSIS, PROPHYLAXIS

1. BORDETELLA
DR. RAJESH KUMAR R
S

2. SPECIES
 Bordetella pertussis
 Bordetella parapertussis
 Bordetella bronchiseptica
 Bordetella avium

3. A Tribute to Bordet - Gengou
3

4. BORDETELLA PERTUSSIS
 Gram negative small, ovoid coccobacillus
 Non motile and non sporing
 Capsulated
 Thumb print appearence

5. CULTURAL CHARACTERISTICS
 Obligate aerobe
 35 - 36º C
 BORDET GENGOU GLYCERINE POTATO BLOOD AGAR
 REGAN LOWE MEDIA
 Charcoal blood agar
 Bisected pearls or mercury drops appearence
 Aluminium paint appearence

6. BIOCHEMICAL REACTIONS
 Biochemically inactive
 Reduce nitrates
 Oxidase positive
 Catalase +
 Indole +
 Citrate +
 Urease +

7. VIRULENCE FACTORS
 Agglutinogens
 Pertussis toxin
 Filamentous haemagglutinin
 Pertactin
 Adenylate cyclase
 Heat labile toxin
 Tracheal cytotoxin
 Lipopolysaccharide

8. AGGLUTINOGENS
 Associated with fimbriae
 Factors 1, 2 and 3
 Factor specific antibodies are present in the sera of convalescent and
immunised persons.
 Helps bacteria to attach to respiratory epithelial cells
 Serotyping

9. PERTUSSIS TOXIN
 Present only in B. pertussis
 Lymphocytosis producing factor (LPF)
 Histamine sensitising factor (HSF)
 Islet Activating Protein (IAP)
 Toxoided
 PT toxoid is the major component of acellular pertussis vaccine

10. FILAMENTOUS HEMAGGLUTININ
 Adheres to the cilia of respiratory epithelium and erythrocytes
 Present on bacterial surface and easily shed
 Promotes secondary infection by Haemophilus influenzae and S.
pneumoniae.
 Piracy of adhesins
 Antibodies to FHA are protective

11. PATHOGENICITY
 Whooping cough or Pertussis
 Incubation period is 1 – 2 weeks
 3 stages – Catarrhal, Paroxysmal and Convalescent
 During the paroxysm, the patient experiences violent spasms of
continuous coughing, followed by in rush of air into the almost empty
lungs, with a characteristic whoop

12. Violent Paroxysms of cough

13. COMPLICATIONS
 Subconjunctival haemorrhage, subcutaneous emphysema
 Bronchopneumonia and Lung collapse
 Neurlogical complications like epilepsy, paralysis, retardation, blindness or
deafness

14. LABORATORY DIAGNOSIS
 Per nasal swab or Nasopharyngeal swab
 Post nasal swab or Per Oral Swab
 Cough plate method
 Transported in casamino acid solution or Modified Stuart’s medium or
Mischulow’s charcoal agar
 Dacron or Calcium alginate swab

15. LABORATORY DIAGNOSIS
 Microscopy in respiratory secretions using fluorescent antibody technique
 Bordet Gengou Glycerine Potato Blood Agar
 Regan Lowe medium with cephalosporins
 Incubated at high humidity ( 35 - 36° C) for 48 – 72 hours
 Identification confirmed by slide agglutination or direct
immunofluorescence using specific antisera.

16. LABORATORY DIAGNOSIS
 PCR
 Serology by agglutination, gel precipitation or complement fixation tests
 Marked leucocytosis (20,000 to 30,000/cu.mm) with relative lymphocytosis
(60-80%)

17. TREATMENT
 Antimicrobial therapy is beneficial only if initiated within the first ten days of
the disease.
 Erythromycin – drug of choice
 Chloramphenicol and cotrimoxazole

18. PROPHYLAXIS
 Isolation is not practicable
 Whole cell killed vaccine
 Acellular vaccine

19. WHOLE CELL KILLED VACCINE
 Smooth phase I strain
 0.2% Merthiolate
 Alum absorbed vaccine
 Plain vaccine
 DPT VACCINE
 3 doses at 4 – 6 weeks interval
 Post vaccinial encephalopathy
 Not advisable after 7 years of age

20. ACELLULAR VACCINE
 Pertussis toxin
 Filamentous haemagglutinin
 Agglutinogen 1, 2, 3
 Pertactin
 Protection rate of 90%

21. THANK YOU