概念

ボルデテラ属
グラム陰性桿菌(グラム陰性球桿菌)
好気性
百日咳の原因菌
伝染性が強い
不顕感染はまれ

毒素

百日咳毒素：リンパ球増加、低血糖、気管上皮への付着　←　リンパ球増多症
アデニルシクラーゼ毒素：白血球走化能の抑制
気管細胞毒素
皮膚壊死毒素
線維素性血球凝集素
リポポリサッカライド

感染症

百日咳

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/27 16:38:07」(JST)

wiki en

[Wiki en表示]

Bordetella pertussis is a Gram-negative, aerobic coccobacillus capsulate of the genus Bordetella, and the causative agent of pertussis or whooping cough. Unlike B. bronchiseptica, B. pertussis is nonmotile. Its virulence factors include pertussis toxin, filamentous hæmagglutinin, pertactin, fimbria, and tracheal cytotoxin.

There does not appear to be a zoonotic reservoir for B. pertussis—humans are its only host.

The bacterium is spread by airborne droplets; its incubation period is seven to 14 days.

Pertussis[edit]

Pertussis (or whooping cough) is an infection of the respiratory system characterized by a “whooping” sound when the person breathes in. In the US, it killed between 10,000 and 20,000 people per year before a vaccine was available. Vaccination has transformed this; between 1985 and 1988, fewer than 100 children died from pertussis. Worldwide in 2000, according to the WHO, around 39 million people were infected annually and about 297,000 died. A graph is available showing the dramatic effect of introducing vaccination in England.^[1] Bordetella pertussis infects its host by colonizing lung epithelial cells. The bacterium contains a surface protein, filamentous haemagglutinin adhesin, which binds to the sulfatides found on cilia of epithelial cells. Once anchored, the bacterium produces tracheal cytotoxin, which stops the cilia from beating. This prevents the cilia from clearing debris from the lungs, so the body responds by sending the host into a coughing fit. These coughs expel some bacteria into the air, which are free to infect other hosts.

B. pertussis has the ability to inhibit the function of the host's immune system. The toxin, known as pertussis toxin (or PTx), inhibits G protein coupling that regulates an adenylate cyclase-mediated conversion of ATP to cyclic AMP. The end result is phagocytes convert too much ATP to cyclic AMP, which can cause disturbances in cellular signaling mechanisms, and prevent phagocytes from correctly responding to an infection. PTx, formerly known as lymphocytosis-promoting factor, causes a decrease in the entry of lymphocytes into lymph nodes, which can lead to a condition known as lymphocytosis, with a complete lymphocyte count over of 4000/μL in adults or over 8000/μL in children.

The infection occurs mostly in children under the age of one when they are unimmunized, or children with faded immunity, normally around the ages 11 through 18. The signs and symptoms are similar to a common cold: runny nose, sneezing, mild cough, and low-grade fever. The patient becomes most contagious during the catarrhal stage of infection, normally two weeks after the coughing begins. It may become airborne when the person coughs, sneezes, or laughs. Pertussis vaccine is part of the diphtheria, tetanus, and acellular pertussis (DTaP) immunization. The paroxysmal cough precedes a crowing inspiratory sound characteristic of pertussis. After a spell, the patient might make a “whooping” sound when breathing in, or may vomit. Adults have milder symptoms, such as prolonged coughing without the “whoop”. Infants less than six months also may not have the typical whoop. A coughing spell may last a minute or more, producing cyanosis, apnoea and seizures. However, when not in a coughing fit, the patient does not experience trouble breathing. This is because B. pertussis inhibits the immune response, so very little mucus is generated in the lungs. A prolonged cough may be irritating and sometimes a disabling cough may go undiagnosed in adults for many months.

Diagnosis[edit]

A nasopharyngeal or an oropharynx swab is sent to the bacteriology laboratory for Gram stain (Gram negative, coccobacilli, diplococci arrangement), growth on Bordet-Gengou agar or BCYE plate with added cephalosporin to select for the organism, which shows mercury-drop-like colonies.

Several diagnostic tests are available, especially ELISA kits. These are designed to detect FHA and/or PT antibodies of the following classes: IgG, IgA, IgM. Some kits use a combination of antigens which will lead to a higher sensitivity, but might also make the interpretation of the results harder since one cannot know which antibody has been detected. There is also a new rapid molecular test, real-time PCR, based on the so-called FilmArray technology . This test takes about one hour and detects about 15–17 viruses and bacteria, including B. pertussis.

The organism is oxidase positive, but urease, nitrate reductase, and citrate negative. It is also nonmotile.

References[edit]

^ "HPA - Whooping Cough (Pertussis)". Retrieved 2009-04-12.

lil ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.
Kenneth Todar, PhD. (2008). "''Bordetella pertussis and Whooping Cough". Online Textbook of Bacteriology. Retrieved December 11, 2009.

External links[edit]

Pertussis Information from the World Health Organisation
Bordetella chapter in Baron's Medical Microbiology (online text at the NCBI bookshelf).
Bordetella pertussis in ARUP Consult—The Physician's Guide to Laboratory Test Selection and Interpretation
Pertussis United Kingdom Health Protection Agency.

UpToDate Contents

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1. 思春期および成人における百日咳菌感染症の治療および予防 treatment and prevention of bordetella pertussis infection in adolescents and adults
2. 幼児および小児における百日咳菌感染症の治療および予防 treatment and prevention of bordetella pertussis infection in infants and children
3. 思春期および成人における百日咳菌感染症の臨床症状および診断 clinical manifestations and diagnosis of bordetella pertussis infections in adolescents and adults
4. 幼児および小児における百日咳菌感染症の臨床的特徴および診断 clinical features and diagnosis of bordetella pertussis infection in infants and children
5. 百日咳菌感染症の微生物学、疫学、および病因 microbiology epidemiology and pathogenesis of bordetella pertussis infection

English Journal

Characterization of Bordetella holmesii isolates from patients with pertussis-like illness in the Netherlands.

Mooi FR, Bruisten S, Linde I, Reubsaet F, Heuvelman K, van der Lee S, J King A.SourceNational Institute of Public Health and the Environment (RIVM), Centre for Infectious Diseases Control (CIb), Laboratory for Infectious Diseases and Perinatal Screening (LIS), Bilthoven, The Netherlands.
FEMS immunology and medical microbiology.FEMS Immunol Med Microbiol.2012 Mar;64(2):289-91. doi: 10.1111/j.1574-695X.2011.00911.x. Epub 2011 Dec 14.
Bordetella holmesii is a recently described human pathogen mainly isolated from blood. However, in the US and Canada, B. holmesii has also been cultured from the nasopharynx of patients with pertussis-like symptoms. To the best of our knowledge, respiratory isolates from Europe have not been charac
PMID 22098551

Prevalence of Bordetella pertussis and Bordetella parapertussis infections in Tunisian hospitalized infants: results of a 4-year prospective study.

Zouari A, Smaoui H, Brun D, Njamkepo E, Sghaier S, Zouari E, Félix R, Menif K, Ben Jaballah N, Guiso N, Kechrid A.SourceMicrobiology Laboratory, Children's Hospital of Tunis, Tunis, Tunisia.
Diagnostic microbiology and infectious disease.Diagn Microbiol Infect Dis.2012 Feb 6. [Epub ahead of print]
The prevalence of pertussis in Tunisia remains undetermined essentially because of the unavailability of a basic laboratory diagnostic service. Specific diagnostic tools were applied for the first time in a Tunisian prospective study in order to get a first estimation of the prevalence of Bordetella
PMID 22313629

A structural motif is the recognition site for a new family of bacterial protein O-glycosyltransferases.

Charbonneau ME, Côté JP, Haurat MF, Reiz B, Crépin S, Berthiaume F, Dozois CM, Feldman MF, Mourez M.SourceCanada Research Chair on Bacterial Animal Diseases, Université de Montréal, Faculté de Médecine Vétérinaire, St-Hyacinthe, 3200 Sicotte, St-Hyacinthe, Québec, J2S 7C6, Canada Department of Biological Sciences Mass Spectrometry Facility, Department of Chemistry, University of Alberta, Edmonton, Alberta, T6G 2E9, Canada INRS-Institut Armand-Frappier, 531 Boul. des Prairies, Laval, Québec, H7V 1B7, Canada.
Molecular microbiology.Mol Microbiol.2012 Feb 5. doi: 10.1111/j.1365-2958.2012.07973.x. [Epub ahead of print]
The Escherichia coli Adhesin Involved in Diffuse Adherence (AIDA-I) is a multifunctional protein that belongs to the family of monomeric autotransporters. This adhesin can be glycosylated by the AIDA-associated heptosyltransferase (Aah). Glycosylation appears to be restricted to the extracellular do
PMID 22304382

Japanese Journal

コンベンショナルPCRを用いたBordetella属菌の一斉スクリーニング法

秋山由美,齋藤悦子,榎本美貴 [他]
感染症学雑誌 = The journal of Japanese the Association for Infectious Diseases 87(6), 721-725, 2013-11
NAID 40019903532

小児・成人の百日咳の治療 (特集外来診療における正しい抗菌薬の使用)

尾内一信,田中孝明
日本医師会雑誌 141(5), 1004-1006, 2012-08
NAID 40019362501

Bactericidal activity of topical antiseptics and their gargles against Bordetella pertussis

SUZUKI Takahisa,KATAOKA Hiroshi,IDA Takashi,KAMACHI Kazunari,MIKUNIYA Takeshi
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 18(2), 272-275, 2012-04-01
NAID 10030545840

香川県におけるLAMP法による百日咳遺伝子検出状況

宮本孝子,有塚真弓,関和美 [他]
香川県環境保健研究センター所報 11, 82-85, 2012
NAID 40019570761

Related Pictures

★リンクテーブル★

リンク元	「エリスロマイシン」「ボルデテラ属」

「エリスロマイシン」

Bordetella pertussis
Scientific classification
Kingdom:	Bacteria
Phylum:	Proteobacteria
Class:	Beta Proteobacteria
Order:	Burkholderiales
Family:	Alcaligenaceae
Genus:	Bordetella
Species:	B. pertussis
Binomial name
	Bordetella pertussis; (Bergey et al. 1923); Moreno-López 1952

　　[★]

英: erythromycin, EM
商: アイロタイシン、エリスロシン、エコリシン、エリコリ、E-Mycin, Ery-Tab, Ery-C, Ilosone, Eryc, Ilotycin
関: 抗菌薬

first aid step1 2006 p.141,143,144,144-145,165,166,169,170,173,178,208

分類

抗菌薬

マクロライド系抗菌薬

14員環マクロライド

特徴

ペニシリン過敏症の患者に対する第一選択となる
P450の阻害作用を持つので他の薬剤との相互作用に注意が必要。
耐性菌が多い。MRSAは100%、肺炎球菌は50%が耐性を持つ (SMB.157)

構造

作用機序

50Sに結合し、リボソームの動きを妨げることで、A siteのpeptidyl-tRNAをP siteに移動するのを妨げる？
inhibit protein synthesis by blocking translocation

抗菌スペクトル

IRE.166

グラム陽性球菌、細胞内寄生菌(マイコプラズマ・ニューモニエ、クラミジア・トラコマティス、クラミドフィラ・ニューモニエ)、スピロヘータ(Borrelia burddorferi)、グラム陰性菌(Bordetella pertussis、Bartonella henselae、Bartonella quintana、Haemophilus ducreyi)

動態