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Click to edit Master subtitle ITS CDSR Department Of Microbiology, style Department Of

ACTINOMYCETES

INTRODUCTION

Domain: Bacteria Phylum: Actinobacteria Class: Actinobacteria Order: Actinomycetales Family: Actinomycetaceae Genus: Actinomyces Gram positive, filamentous bacteria intermediate in properties between true bacteria and fungi Form mycelial network of branching filaments like fungi

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Family Actinomycetes contains three medically important genera:

Actinomyces : (Causes Actinomycosis) A. bovis A. bowdenii A. canis A. Cardiffensis A. Catuli A. coleocanis A. dentalis A. denticolens A. europaeus A. funkei A. georgiae A. gerencseriae A. graevenitzii A. hongkongensis A. hordeovulneris A. howellii A. humiferus A. hyovaginalis A. israelii A. marimammalium A. meyeri A. naeslundii A. nasicola A. neuii A. odontolyticus A. oricola A. radicidentis A. radingae A. slackii A. streptomycini A. suimastitidis A. suis A. turicensis A. urogenitalis A. vaccimaxillae A. viscosus 1. Nocardia: (Causes Nocardiosis) 4/22/12 Department Of 33 2. Actinomadura: (Causes Red grain mycetoma of the
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MORPHOLOGY
Non motile Non sporing In tissue, Appear in pus as granules Clubs- Gram negative, acid fast, host origin. Filaments- Gram positive, non acid fast

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Fig 1.

Fig 1. Actinomyces microscopic view)

Fig 2. Actinomyces (Electron

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CULTURE

Grows best under anaerobic or microaerophilic conditions. Optimum temp 37 degrees celsius under 5-10% CO2. Culture media: Brain heart infusion agar : Blood agar : Thioglycollate broth Growth seen after 2-3 days, except, A.israelii: 7-14 days. Solid media: Spidery colonies formed get heaped up. Liquid media: Small fluffy balls below the surface of medium. Sun ray appearance
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PATHOGENESIS

Causes disease known as Actinomycosis. Occurs rarely in humans but rather frequently in cattleas a disease calledlumpy jaw. This name refers to the large abcessesthat grow on the head and neck of the infected animal. It can also affect swine, horses, and dogs, and less often wild animals and sheep. A chronic granulomatous disease characterised by multiple abscesses, tissue destruction, fibrosis and formation of multiple sinuses. Causative specie in man: A. israelli
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It has four clinical forms:

Cervicofacial: Commonest, occurs in cheek and submaxillary regions. Thoracic: Lungs Abdominal: Ileocaecal region Pelvic: Associated with use of intrauterine devices

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Macroscopically, painless indurated swelling with multiple discharging sinuses Pus contains yellow colored sulphur granules May also present as mycetoma

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ACTINOMYCES AND NOCARDIA

ACTINOMYCES
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NOCARDIA
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Anaerobic and Non acid fast Causative specie: A.israeli (humans) Recovery is possible Natural habitat of is mouth, intestine and vagina A. bovis extremely sensitive to penicillin Early stages may be treated with broad spectrum antibiotics Clinical forms: Abdominal, Thoracic, Pelvic, Cervico facial Endogenous infection Culture: Solid media- Spidery colonies

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Aerobic and Acid fast Causative specie: N.Asteroides (humans) Usually fatal Natural habitat is soil N. Asteroides resistant to any treatment Targeted approach required, Sulfadiazine MUST be included in drug regimen Clinical forms: Cutaneous infection, Systemic nocardiasis Exogenous infection Culture: Solid media- Dry wrinkled colonies

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LESIONS OF ACTINOMYCOSIS AND NOCARDIOSIS

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Actinomycosis

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DENTAL ASPECTS

A. naeslundii, A. meyeri, A. odontolyticum are associated with formations of dental plaque Can also cause gingivitis and periodontitis

A. israelii may occur as commensals in mouth of normal individuals mainly around the teeth Infection is mostly endogenous and may result from trauma. Eg: Dental extraction

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EPIDEMIOLOGY

Non contagious disease Mostly endogenous infection Frequently seen in rural areas 70% are cervicofacial and 20% abdominal.

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LABORATORY DIAGNOSIS
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SPECIMENS
Pus from lesion or sinuses Discharge from fistula Sputum in pulmonary disease Tissue or biopsy

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2. MICROSCOPY

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Gram stain shows dense network of thin Gram positive filaments, surrounded by a peripheral radiating Gram negative clubs Acid fast staining shows central part as non acid fast surrounded by acid fast clubs. In tissue sections, sulphur granules and mycelia are detected by using fluorescein-conjugated specific antisera

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3. BIOPSY

Haematoxylin-eosin stained section shows mycelial mass surrounded by pus cells and chronic inflammatory cells.

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TREATMENT

Surgical removal of affected tissue along with penicillin or tetracycline therapy is effective

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