Chapter 44: Chlamydia and Rickettsia - Specimen:

a. Conjuctival, urethral, cervical/rectal scrapings

A. Chlamydia b. Endocervical and nasopharyngeal swabs
- Family Chlamydiaceae c. Lung biopsy samples
- Cannot produce ATP outside animal cell host
- In the past known as BEDSONIA (large viruses) 2. Chlamydophila pneumoniae
- Possess a gram (-) like call wall that have - Old name: TWAR
lipopolysaccharides (Taiwan 1965)
- Contain both DNA and RNA ribosomes - strain TWAR: TW – 183, AR – 39
- Important genera: - Pear – shaped with large periplasmic space and round EB
Chlamydia and Chlamydophila
 Clinical Infections
- MOT, incubation period unknown
- No known animal reservoir or vector
- Spread human to human
- Mild respiratory infections, Sinusitis
- Biphasic: Pharyngitis (flu-like), Pneumonia
- Risk factor for Guillain-Barre syndrome.
- 90% mild/asymptomatic

 Treatment
- Macrolides, Levoflaxacin and Tetracycline

1. Chlamydia trachomatis  Laboratory Diagnosis

- most common sexually transmitted bacterial pathogen - Tissue cell culture
- 2 biovars: Trachoma and LGV HeLa or Hep – 2 cell lines
- Ocular trachoma: cause blindness - Immunofluorescent stain
- Trachoma: Eye pain, blurred vision and photphobia - Molecular assays
- Micro-IF, ELISA
 Clinical Infections - Serodiagnosis

3. Chlamydophila psitacci
- Old name: Chlamydophila

 Clinical Infections
- Psittacosis or Ornithosis (parrot fever)
- Acquired from birds by inhalation of aerosols or fomites
- Pneumonia
- Incubation period: 1 – 2 weeks, characterized by chills,
fever and malaise.
- Organism is deposited in alveoli and ingested by alveolar
 Treatment macrophages leading to entry to lymph nodes and then
- Tetracycline: doxycycline dissemination to the RES (Reticulo endothelial system
- Erythromycin: azithromycin
- Fluoroquinolones  Treatment
- Macrolides and Tetracycline
 Laboratory Diagnosis
a) Cell Culture (Cell lines)  Laboratory Diagnosis
McCoy’s heteroploid murine cells - Immunofluorescent stain
HeLa 229 cells, L929 cells and BHK-21 cells - Molecular assays
Examined 48 – 72 hours - Serodiagnosis
b) Nonculture, nonamplied
DFA, EIA, OIA B. Rickettsia
c) Nonculture, amplified
DNA Probe, PCR, NAAT  General Characteristics
d) Serology - Family Rickettsiaceae
Cytological, cell culture, Ag/Ab detection and Nucleic acid - Genere: Rickettsia and Orienta
probes w/ amplification - Arthropod-borne, obligate intracellular pathogens
- Frei Test - intradermal skin test of LGV antigen - Triad symptoms of fever, headache and rash
- Infects birds, small mammals, rats, cattle, sheep, rodents
 Specimen collection and flying squirrels.
- Scrapping over swab:
Dacron / Rayon (Transport medium)

PandaMT13
 - Consist of three groups
1. Spotted Fever Group

C. Anaplasmataceae
- Genera: Erlichia and Anaplasma
- Can survive in cytoplasmic vacuoles, able to grow in
neutrophils, monocytes, platelets and erythrocytes
 Laboratory Diagnosis
- Immunohistology and PCR, NAAT, IFA (gold standard)
- Giemsa, Wright’s /Diff-Quik-stained peripheral or buffy
coat smears
- Embryonated eggs and tissue culture
- Punch biopsies of skin and eschars
2. Typhus Group - EDTA or ACD anticoagulated WB

 Weil-Felix rxn.
(P. vulgaris OX-19, OX-2 and P. mirabilis OX-K)

3. Scrub Typhus Group

Others:

PandaMT13