- 日
- オリエンティア・ツツガムシ
- 同
- Rickettsia tsutsugamushi、恙虫病リケッチア
- 関
- ツツガムシ病 scrub typhus
PrepTutorEJDIC
- 『東洋』(the East)
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/27 15:36:52」(JST)
[Wiki en表示]
| Orientia |
|
| Orientia tsutsugamushi |
| Scientific classification |
| Kingdom: |
Bacteria |
| Phylum: |
Proteobacteria |
| Class: |
Alpha Proteobacteria |
| Order: |
Rickettsiales |
| Family: |
Rickettsiaceae |
| Genus: |
Orientia |
| Species: |
O. tsutsugamushi |
| Binomial name |
Orientia tsutsugamushi
(Hayashi 1920) Tamura et al. 1995 |
Orientia tsutsugamushi (from Japanese tsutsuga "illness" and mushi "insect") is the causative organism of scrub typhus,[1] and the natural vector and reservoir is probably trombiculid mites (genus Leptotrombidium).[2][3] The organism is an obligate intracellular pathogen, which needs to infect eukaryotic cells in order to multiply. The envelope is similar to that of Gram negative bacteria, but it is not easily stained with Gram stain and the Gimenez stain is preferred. There are a large number of serotypes described: these include Karp (which accounts for approximately 50% of all infection)[3], Gilliam (25%)[3], Kato (less than 10%)[3], and Kawasaki,[4] but there exists enormous variability, with eight serotypes being reported in a single field in Malaysia,[5] and many more serotypes continue to be reported.[6][7][8] Genetic methods have revealed even greater complexity than had been previously described (for example, Gilliam is further divided into Gilliam and JG types). Infection with one serotype does not confer immunity to other serotypes (no cross immunity). Repeated infection in the same individual is therefore possible, and this complicates vaccine design.
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Contents
- 1 Microbiology
- 2 Antimicrobial therapy
- 3 Vaccine
- 4 References
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Microbiology
The bacterium was initially categorised in the genus Rickettsia,[1] but is now classed in a separate genus, Orientia, in which it is the only species.[9]
It is 0.5µm wide and 1.2 to 3.0µm long, and is an obligatory intracellular organism that can only be cultured in cell monolayers. The organism is highly virulent and should only be handled in a laboratory with biosafety level 3 facilities.[10]
Antimicrobial therapy
For more details on this topic, see Scrub typhus.
O. tsutsugamushi is sensitive in vitro to doxycycline, rifampicin and azithromycin. It is innately resistant to all β-lactam antibiotics (for example, penicillin) because it lacks a peptidoglycan cell wall.[11] Aminoglycosides (for example, gentamicin) are also ineffective in human infection because the organism is intracellular, and aminoglycosides do not penetrate intracellularly.
Vaccine
There are currently no licensed scrub typhus vaccines available. It is now known that there is enormous antigenic variation in Orientia tsutsugamushi strains,and immunity to one strain does not confer immunity to another. Any scrub typhus vaccine should give protection to all the strains present locally, in order to give an acceptable level of protection. A vaccine developed for one locality may not be protective in another locality, because of antigenic variation. This complexity continues to hamper efforts to produce a viable vaccine.
References
- ^ a b Watt G, Parola P (October 2003). "Scrub typhus and tropical rickettsioses". Curr Opin Infect Dis 16 (5): 429–36. doi:10.1097/00001432-200310000-00009. PMID 14501995. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0951-7375&volume=16&issue=5&spage=429.
- ^ Traub R, Wisseman CL Jr (1974). "The ecology of chigger-borne rickettsiosis (scrub typhus)". J Med Entomol 11 (3): 237–303. PMID 4212400.
- ^ a b c d Kelly DJ, Fuerst PA, Ching W-M, Richards AL (2009). "Scrub typhus: The geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi". Clin Infect Dis 48 (s3): S203–30. doi:10.1086/596576. PMID 19220144.
- ^ Yamamoto S, Kawabata N, Tamura A, et al. (1986). "Immunological properties of Rickettsia tsutsugamushi, Kawasaki strain, isolated from a patient in Kyushu". Microbiol Immunol 30 (7): 611–20. PMID 3095612.
- ^ Shirai A, Tanskul PL, Andre, RG, et al. (1981). "Rickettsia tsutsugamushi strains found in chiggers collected in Thailand". Southeast Asian J Trop Med Public Health 12 (1): 1–6. PMID 6789455.
- ^ Kang JS, Chang WH (1999). "Antigenic relationship among the eight prototype and new serotype strains of Orientia tsutsugamushi revealed by monoclonal antibodies". Microbiol Immunol 43 (3): 229–34. PMID 10338191.
- ^ Bakshi D, Singhal P, Mahajan SK, Subramaniam P, Tuteja U, Batra HV (2007). "Development of a real-time PCR assay for the diagnosis of scrub typhus cases in India and evidence of the prevalence of new genotype of O. tsutsugamushi". Acta Trop 104 (1): 63–71. doi:10.1016/j.actatropica.2007.07.013. PMID 17870041.
- ^ Parola P, Blacksell SD, Phetsouvanh R, et al. (2008). "Genotyping of Orientia tsutsugamushi from Humans with Scrub Typhus, Laos". Emerg Infect Dis 14 (9): 1483–1485. doi:10.3201/eid1409.071259. PMC 2603112. PMID 18760027. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2603112.
- ^ Tamura A, Ohashi N, Urakami H, Miyamura S (1995). "Classification of Rickettsia tsutsugamushi in a new genus, Orientia gen. nov., as Orientia tsutsugamushi comb. nov". Int J Syst Bacteriol 45 (3): 589–591. doi:10.1099/00207713-45-3-589. PMID 8590688.
- ^ Centers for Disease Control and Prevention (1999). "Section VII-E: Rickettsial Agents". Biosafety in Microbiological and Biomedical Laboratories (BMBL) (4th ed.). Washington DC: U.S. Government Printing Office. pp. 149–53. http://www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4s7e.htm. Retrieved 13 Mar 2009.
- ^ Amano K, Tamura A, Ohashi N, Urakami H, Kaya S, Fukushi K (1987). "Deficiency of peptidoglycan and lipopolysaccharide components in Rickettsia tsutsugamushi". Infect Immun 55 (9): 2290–2292. PMC 260693. PMID 3114150. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=260693.
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Infectious diseases · Bacterial diseases: Proteobacterial G− (primarily A00–A79, 001–041, 080–109)
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| α |
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Rickettsiales
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Rickettsiaceae/
(Rickettsioses)
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Typhus
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Rickettsia typhi (Murine typhus) · Rickettsia prowazekii (Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus)
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Spotted
fever
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Tick-borne
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Rickettsia rickettsii (Rocky Mountain spotted fever) · Rickettsia conorii (Boutonneuse fever) · Rickettsia japonica (Japanese spotted fever) · Rickettsia sibirica (North Asian tick typhus) · Rickettsia australis (Queensland tick typhus) · Rickettsia honei (Flinders Island spotted fever) · Rickettsia africae (African tick bite fever) · Rickettsia parkeri (American tick bite fever) · Rickettsia aeschlimannii (Rickettsia aeschlimannii infection)
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Mite-borne
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Rickettsia akari (Rickettsialpox) · Orientia tsutsugamushi (Scrub typhus)
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Flea-borne
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Rickettsia felis (Flea-borne spotted fever)
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Anaplasmataceae
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Ehrlichiosis: Anaplasma phagocytophilum (Human granulocytic anaplasmosis, Anaplasmosis) · Ehrlichia chaffeensis (Human monocytic ehrlichiosis) · Ehrlichia ewingii (Ehrlichiosis ewingii infection)
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Rhizobiales
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Brucellaceae
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Brucella abortus (Brucellosis)
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Bartonellaceae
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Bartonellosis: Bartonella henselae (Cat scratch disease) · Bartonella quintana (Trench fever) · either henselae or quintana (Bacillary angiomatosis) · Bartonella bacilliformis (Carrion's disease, Verruga peruana)
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| β |
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Neisseriales
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M+ Neisseria meningitidis/meningococcus (Meningococcal disease, Waterhouse-Friderichsen syndrome, Meningococcal septicaemia)
M- Neisseria gonorrhoeae/gonococcus (Gonorrhea)
ungrouped: Eikenella corrodens/Kingella kingae (HACEK) · Chromobacterium violaceum (Chromobacteriosis infection)
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Burkholderiales
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Burkholderia pseudomallei (Melioidosis) · Burkholderia mallei (Glanders) · Burkholderia cepacia complex · Bordetella pertussis/Bordetella parapertussis (Pertussis)
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| γ |
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Enterobacteriales
(OX-)
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Lac+
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Klebsiella pneumoniae (Rhinoscleroma, Klebsiella pneumonia) · Klebsiella granulomatis (Granuloma inguinale) · Klebsiella oxytoca
Escherichia coli: Enterotoxigenic · Enteroinvasive · Enterohemorrhagic · O157:H7 · O104:H4 (Hemolytic-uremic syndrome)
Enterobacter aerogenes/Enterobacter cloacae
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Slow/weak
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Serratia marcescens (Serratia infection) · Citrobacter koseri/Citrobacter freundii
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Lac-
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H2S+
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Salmonella enterica (Typhoid fever, Paratyphoid fever, Salmonellosis)
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H2S-
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Shigella dysenteriae/sonnei/flexneri/boydii (Shigellosis, Bacillary dysentery) · Proteus mirabilis/Proteus vulgaris · Yersinia pestis (Plague/Bubonic plague) · Yersinia enterocolitica · Yersinia pseudotuberculosis
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Pasteurellales
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Haemophilus: H. influenzae (Haemophilus meningitis, Brazilian purpuric fever) · H. ducreyi (Chancroid) H. parainfluenzae (HACEK)
Pasteurella multocida (Pasteurellosis) · Actinobacillus (Actinobacillosis)
Aggregatibacter actinomycetemcomitans (HACEK)
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Legionellales
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Legionella pneumophila/Legionella longbeachae (Legionellosis) · Coxiella burnetii (Q fever)
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Thiotrichales
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Francisella tularensis (Tularemia)
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Vibrionales
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Vibrio cholerae (Cholera) · Vibrio vulnificus · Vibrio parahaemolyticus · Vibrio alginolyticus · Plesiomonas shigelloides
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Pseudomonadales
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Pseudomonas aeruginosa (Pseudomonas infection) · Moraxella catarrhalis · Acinetobacter baumannii
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Xanthomonadales
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Stenotrophomonas maltophilia
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Cardiobacteriales
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Cardiobacterium hominis (HACEK)
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Aeromonadales
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Aeromonas hydrophila/Aeromonas veronii (Aeromonas infection)
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| ε |
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Campylobacterales
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Campylobacter jejuni (Campylobacteriosis, Guillain-Barré syndrome) · Helicobacter pylori (Peptic ulcer, MALT lymphoma) · Helicobacter cinaedi (Helicobacter cellulitis)
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gr+f/gr+a(t)/gr-p(c)/gr-o
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UpToDate Contents
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English Journal
- Involvement of lipid rafts in the budding-like exit of Orientia tsutsugamushi.
- Kim MJ, Kim MK, Kang JS.SourceDepartment of Microbiology, Inha University School of Medicine, Jungsuk B/D, 3rd Street, Shinheung-Dong, Choong-Gu, Incheon 400-712, Republic of Korea.
- Microbial pathogenesis.Microb Pathog.2013 Oct;63C:37-43. doi: 10.1016/j.micpath.2013.06.002. Epub 2013 Jun 18.
- Orientia tsutsugamushi is an intracellular parasite that causes scrub typhus. After entering the cytoplasm by induced phagocytosis, O. tsutsugamushi escapes from the primary phagosome into the host cytosol, where it replicates slowly. Subsequently, it is released from the host cells by a process re
- PMID 23791848
- Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome.
- Varghese GM, Janardhanan J, Trowbridge P, Peter JV, Prakash JA, Sathyendra S, Thomas K, David TS, Kavitha ML, Abraham OC, Mathai D.SourceMedicine Unit I and Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India. Electronic address: georgemvarghese@hotmail.com.
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases.Int J Infect Dis.2013 Jul 25. pii: S1201-9712(13)00215-4. doi: 10.1016/j.ijid.2013.05.017. [Epub ahead of print]
- OBJECTIVES: This study sought to document the clinical and laboratory manifestations, genetic variability, and outcomes of scrub typhus, an often severe infection caused by Orientia tsutsugamushi, in South India.METHODS: Patients admitted to a large teaching hospital with IgM ELISA-confirmed scrub t
- PMID 23891643
- Rickettsioses in the central hills of Sri Lanka: serological evidence of increasing burden of spotted fever group.
- Kularatne SA, Rajapakse RP, Wickramasinghe WM, Nanayakkara DM, Budagoda SS, Weerakoon KG, Edirisinghe JS, Premaratna R.SourceDepartment of Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases.Int J Infect Dis.2013 Jul 16. pii: S1201-9712(13)00210-5. doi: 10.1016/j.ijid.2013.05.014. [Epub ahead of print]
- OBJECTIVES: To study the epidemiology, clinical features, and changing pattern of rickettsial infections on the western slopes of the hilly Central Province of Sri Lanka over 6 years.METHODS: All patients with rickettsial infections who presented to the Teaching Hospital, Peradeniya were studied pro
- PMID 23871280
Japanese Journal
- 田原 研司,川端 寛樹,安藤 秀二 [他],新井 智,板垣 朝夫,渡邉 治雄
- 日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 65(7), 535-541, 2012-07-20
- NAID 10030801012
- Prokaryotic expression and immunogenicity of 56-kDa protein of Orientia tsutsugamushi strain Karp
- Wang Yuan-Yuan,Chen Qiang,Yu Qiang [他]
- Microbiology and immunology 56(7), 423-430, 2012-07-00
- NAID 40019336412
Related Links
- Orientia tsutsugamushi オリエンティア・ツツガムシ グラム陰性の小さな球桿菌，細胞内のみで増殖する． ダニの刺咬によって伝播され，発疹チフスに似た臨床症状を呈する恙虫病の病原体である． 系統 抗菌薬 感受性 標準菌株 標準菌の ...
- Orientia tsutsugamushi (from Japanese tsutsuga "illness" and mushi "insect") is the causative organism of scrub typhus, and the natural vector and reservoir is probably trombiculid mites (genus Leptotrombidium). The organism is an ...
- Orientia tsutsugamushi [ôr′e·enshe′ə tso o tso o gəmo o ′she] Etymology: L, oriens, east; Jpn, tsutsuga, illness + mushi, tick a species of organisms, formerly known as Rickettsia tsutsugamushi, that causes scrub typhus. It is ...
Related Pictures
★リンクテーブル★
[★]
[正答]
※国試ナビ4※ ［104I019］←［国試_104］→［104I021］
[★]
- 関
- 細菌
[★]
- 英
- scrub typhus、tsutsugamushi fever、trombiculiasis、trombiculosis, tsutsugamushi disease
- 同
- 恙虫病、草原熱、(国試)つつが虫病、ツツガ虫病
- 関
- ツツガムシ、節足動物
[show details]
ツツガムシ病 : 約 147,000 件
ツツガ虫病 : 約 39,400 件
つつが虫病 : 約 36,500 件
つつがムシ病 : 約 147,000 件
つつがむし病 : 約 3,740 件
恙虫病 : 約 18,900 件
概念
疫学
- 世界ではアジアを中心として広く分布
- 北海道を除く全国で発生。毎年300-400例報告。
- 季節性
- 北陸、東北地方：春、秋
- 本州の関東以西、四国、九州：秋～冬
病原体
感染経路
潜伏期
症状
- 頭痛、発熱(弛張熱)、悪寒、戦慄
- 皮疹：麻疹、薬疹様の淡い不整形の紅斑が全身に広がる。手掌部紅斑はない
- リンパ節腫脹
- 所属リンパ節腫脹：ほぼ全例でみられる
- 全身リンパ節腫脹：半数例でみられる。
- (重症例)肺炎様症状、脳炎、播種性血管内凝固などをきたす。
三大徴候
刺咬部位
- 刺咬部位の写真
[show details]
検査
- 血小板低下
- 白血球：減少(好酸球が消失)
- AST、ALT：上昇
- LDH：上昇
- 尿検査：血尿、蛋白尿
- 免疫血清学的検査：抗ツツガムシ病リケッチア抗体の検出
- PCR法：末梢血よりリケッチアDNAの証明
鑑別疾患
- 日本紅斑熱：手掌部紅斑はツツガムシ病では見られないが、日本紅斑熱ではみられる。キノロン系薬は日本紅斑熱では有効であるが、ツツガムシ病では無効である。
- ウイルス性熱疾患(麻疹、風疹など)、薬疹
治療
- テトラサイクリン系薬
- ×ペニシリン系、セフェム系、アミドグリコシド系、キノロン系は無効。
参考
- 1. ツツガムシ病 - FORTH｜厚生労働省検疫所
- http://www.forth.go.jp/mhlw/animal/page_i/i04-12.html
- 2. ツツガムシ病 - 国立感染症研究所 感染症情報センター IDSC Infectious Disease Surveillance Center
- http://idsc.nih.go.jp/idwr/kansen/k02_g1/k02_13/k02_13.html
国試
[★]
- 英
- Arthropoda, arthropod, arthropods
- 関
- アルボウイルス
概念
- 参考1
節足動物（せっそくどうぶつ）とは、動物界最大の分類群で、昆虫類、甲殻類、クモ類、ムカデ類など、硬い殻（外骨格）と関節を持つグループ。陸・海・空・土中・寄生などあらゆる場所に進出し、現生種は約110万種と名前を持つ全動物種の85%以上を占める。ただし未記載の動物種もいまだ多く、最近の研究では海産の線形動物だけで1億種以上いると推定されている。
- 医学大辞典 医学書院
分類
- 参考1
節足動物による傷病
参考
[★]
Orientia tsutsugamushi、恙虫病リケッチア
[★]
ツツガムシ、恙虫
- 関
- chigger、red bug、trombiculid mite
