SPIROCHETES AND OTHER SPIRAL-SHAPED
TREPONEMA SPP.
ORGANISMS
Introduction
Treponema
Family
Borrelia
Leptospira Spirochaetaceae
Disease in this family have been known to
exist since ancient times (1975)
Multiply within a living host having no
natural reservoir in inanimate environment
TREPONEMA pathogenic for humans are
transmitted from person-person through
direct contact , either sexual/otherwise
BORELLIA pass through an arthropod
vector
LEPTOSPIRA contacted accidentally by
humans who comes in contact with
contaminated water by animal urine or who
is bitten by an infected animal
MORPHOLOGY
Long, slender, helically curved, gram (-)
bacilli with axial fibrils and sheath
(Fibrils/axial filaments) flagella-like
organelles that wrap around the bacterial
cell wall. Enclosed within the outer sheath
and facilitates motility.
Attached within the cell wall by platelike
structures called INSERTION DISK
Bacterial movement appears corkscrew-like
winding
Differentiation within genera :
1. Number of axial filaments
2. Number of insertion disk present
3. Biochemical and metabolic features
Genera based on morphology :
1. TREPONEMA : slender with tight coils
2. BORRELIA : thicker and fewer and
looser coils
3. LEPTOSPIRA : resembles Borrelia for
their hooked ends
TAXONOMIC CONSIDERATION
TREPONEMA causative agent of
syphilis, pinta, yaws and bejel
BORRELIA agents of relapsing fever
and lyme disease, stains are more
readily and more easily visualized
LEPTOSPIRA agents of leptospirosis ,
contains diaminopimetic acid in their
cell wall instead of ornithine , cultivated
more easily in vitro than other genera
A. Laboratory Diagnosis of Syphilis
Have to attach to the host cell
membranes, penetrate, and multiple to
cause disease
Inflammatory response of the host
mediate the pathology
Cultivation of this organism is still not
possible for most clinical laboratories so
diagnosis rest on serologic methods and
clinical acumen
Primary lesion (chancre)
Secondary lesion (condyloma lata)
Causative agent :
Trepanoma palladium : biotype
palladium
Examination for the presence of motile
spirochetes under darkfield illumination
1. Depends greatly on technical
expertise and number of organisms
in the lesion
2. Highly specific when performed on
genital lesion
Long, slender, tightly coiled, moving
very slow and may bend on the middle
Best examined under OIO darkfield lens
to substantiate the morphology
Should be cared with extreme caution
as positive lesion may be teeming with
viable spirochetes that are highly
infectious
B. Other Treponemas
Spp. that caused human diseases :
1. T. pallidum pertunue (yaws)
2. T. pallidum endemicus (bejel)
3. T. carateum pinta
Usually found in the tropics/subtropics
area and usually spread by human
contact
Poor personal hygiene plays a role in
transmission
Serologic test and microscopic test for
manifestation of disease
Normal inhabitants of the oral cavity
and human genital tract
1. T. vincentii
2. T. denticola
3. T. refringens
4. T. macrodentium
5. T. oralis
Cultivable anaerobically on artificial
media
Causes oral infections
 BORRELIA SPP.
A. Relapsing Fever
Caused by more than 15 spp. of Borellia
Transmitted to humans by the bite of a
louse or a tick
B. recurrentis carried by louse (lice)
Transmitted via tick bites:
1. B. hermsii
2. B. turicatae
3. B. parkeri
4. B. bergmanni
Organism can be cultured in
nutritionally rich media under
microaerobic conditions but the
procedure are cumbersome
Clinical lab. rely on direct obdervation
of organism in peripheral blood of
patients for diagnosis
Found in 70% of cases when blood
specimen from febrile patients re
examined
B. Lyme Disease
Tick-borne disease discovered as a
cause of pseudojuvenile rheumatoid
arthritis, epidemic among boys in Lyme,
Connecticut in mid-1970
Characterized by 3 stages :
1. 1st erythema migrans (red annular
skin lesion at site of tick bite)
2. 2nd arthritis and other
neurological disorders
3. 3rd chronic arthritis
Caused by B. burgdorferi
Recovered from blood, CSF, skin lesion
of patients and rarely from joint fluid
Several genera of ticks act as vector
including Ixodes spp.
All stages of ticks can harbor the
spirochete and can transmit disease
Ticks require lengthy period of
attachment before they transmit
disease
Insect repellant best preventive
strategies
Periphery of erythema migrans blood,
CSF best specimen for cultures
Silver stain tissue section
Giemsa stain CSF section
Serologic diagnosis best routine test
available for clinical lab
Leptospirosis
Includes free-living and parasitic forms
Leptospira interrogans pathogenic
spp. , includes more than 180 different
serologically defined types designated
as serovars
Leptospira biflexa saprophytic
leptospires
Saprophytes differentiated by
pathogens by their ability to grow on
10oC and lower/at least 5oC lower than
growth temperature of pathogenic
leptospirosis
Too small to be seen in wet preparation
made of fresh blood and they do not
cause motion of erythrocytes and
Borrelia do
Culture is the most reliable diagnosis
from blood/CSF
Fletchers/Ellinghausen, McCullough,
Johnson, Harris (EMJH) media few
drops of heparinized/sodium-oxalate-
anticoagulated blood
Urine should be inoculated after
collection
1 or 2 drops of undiluted urine
1:10 dilution of urine are added to 5mL
medium
1:1, 1:10, 1:100 liver and kidney may
aseptically macerated and inoculate for
urine cultures
All cultures must be incubated at room
temp / 30oC in the dark for up to 6
weeks
Examined weekly for observation of
growth under darkfield illumination
Corkscrew-like motility
Serologic diagnosis best performed
using bacterial antigens containing
many serotypes in each pool
Macroscopic agglutination
Indirect hemagglutination
ELISA test
IgM antibody