Bordetella pertussis

Last updated

Bordetella pertussis
Bordetella pertussis.jpg
Scientific classification Red Pencil Icon.png
Domain: Bacteria
Phylum: Proteobacteria
Class: Betaproteobacteria
Order: Burkholderiales
Family: Alcaligenaceae
Genus: Bordetella
Species:
B. pertussis
Binomial name
Bordetella pertussis
(Bergey et al. 1923) Moreno-López 1952

Bordetella pertussis is a Gram-negative, aerobic, pathogenic, encapsulated coccobacillus of the genus Bordetella , and the causative agent of pertussis or whooping cough. Unlike B. bronchiseptica , B. pertussis is not motile. Its virulence factors include pertussis toxin, filamentous hæmagglutinin, pertactin, fimbria, and tracheal cytotoxin.

Aerobic organism

An aerobic organism or aerobe is an organism that can survive and grow in an oxygenated environment. In contrast, an anaerobic organism (anaerobe) is any organism that does not require oxygen for growth. Some anaerobes react negatively or even die if oxygen is present.

Pathogenic bacteria

Pathogenic bacteria are bacteria that can cause disease. This article deals with human pathogenic bacteria. Although most bacteria are harmless or often beneficial, some are pathogenic, with the number of species estimated as fewer than a hundred that are seen to cause infectious diseases in humans. By contrast, several thousand species exist in the human digestive system.

Bacterial capsule

The bacterial capsule is a very large structure of many bacteria. It is a polysaccharide layer that lies outside the cell envelope, and is thus deemed part of the outer envelope of a bacterial cell. It is a well-organized layer, not easily washed off, and it can be the cause of various diseases.

Contents

The bacterium is spread by airborne droplets; its incubation period is 7–10 days on average (range 6–20 days). [1] [2] Humans are the only known reservoir for B. pertussis. [3] The complete B. pertussis genome of 4,086,186 base pairs was published in 2003. [4] Compared to its closest relative B. bronchiseptica, the genome size is greatly reduced. This is mainly due to the adaptation to one host species (human) and the loss of capability of survival outside of a host body. [5]

Genome entirety of an organisms hereditary information; genome of organism (encoded by the genomic DNA) is the (biological) information of heredity which is passed from one generation of organism to the next; is transcribed to produce various RNAs

In the fields of molecular biology and genetics, a genome is the genetic material of an organism. It consists of DNA. The genome includes both the genes and the noncoding DNA, as well as mitochondrial DNA and chloroplast DNA. The study of the genome is called genomics.

History

The first to describe this disease was french physician Guillaume de Baillou after the epidemic of 1578. The causative agent of pertussis was identified and isolated by Jules Bordet and Octave Gengou. [6]

Guillaume de Baillou French physician and founder of modern epidemiology

Guillaume de Baillou (1538–1616) was a French physician born in Paris.

Jules Bordet Belgian immunologist and microbiologist

Jules Jean Baptiste Vincent Bordet was a Belgian immunologist and microbiologist. The bacterial genus Bordetella is named after him. The Nobel Prize in Physiology or Medicine was awarded to him in 1919 for his discoveries relating to immunity.

Octave Gengou was a Belgian bacteriologist. He researched with Jules Bordet the Bordetella pertussis bacteria.

Taxonomy

The genus Bordetella contains nine species: B. pertussis, B. parapertussis, B. bronchiseptica, B. avium, B. hinzii, B. holmesii, B. trematum, B. ansorpii and B.petrii. The first three listed form a closely related phylogenetical group. [5]

B. parapertussis causes a disease similar to whooping cough in humans. B. bronchiseptica infects a range of mammal hosts, including humans, and causes a spectrum of respiratory disorders. [5]

Pertussis

Pertussis 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.[ citation needed ] 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. [7]

Respiratory system A biological system of specific organs and structures for gas exchange in animals and plants

The respiratory system is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies greatly, depending on the size of the organism, the environment in which it lives and its evolutionary history. In land animals the respiratory surface is internalized as linings of the lungs. Gas exchange in the lungs occurs in millions of small air sacs called alveoli in mammals and reptiles, but atria in birds. These microscopic air sacs have a very rich blood supply, thus bringing the air into close contact with the blood. These air sacs communicate with the external environment via a system of airways, or hollow tubes, of which the largest is the trachea, which branches in the middle of the chest into the two main bronchi. These enter the lungs where they branch into progressively narrower secondary and tertiary bronchi that branch into numerous smaller tubes, the bronchioles. In birds the bronchioles are termed parabronchi. It is the bronchioles, or parabronchi that generally open into the microscopic alveoli in mammals and atria in birds. Air has to be pumped from the environment into the alveoli or atria by the process of breathing which involves the muscles of respiration.

Vaccination administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop protection from a disease. Vaccines contain a microorganism in a weakened or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world.

B. 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. Other adhesins are fimbriae and petractin. [5] 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 of over 4000/μl in adults or over 8000/μl in children. Beside targeting lymphocytes, it limits neutrophil migration to the lungs. It also decreases the function of tissue-resident macrophages, that are responsible for some bacterial clearance. [8]

Another toxin important for inhibiting the immune response is the adenylate cyclate toxin. This toxin has an intrinsic adenylate cyclase activity, increasing intracellular cAMP almost immediately. Also, it is capable of forming pores in the membrane of the target cell. These pores are cation-specific. [5] [9] The resulting deregulation of cell signaling leads to blocking of phagocytosis and killing of bacteria by neutrophils. Also it inhibits maturation of dendritic cells and their migration to the lymph nodes. [8]

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. 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.

Prevention

Pertussis vaccine is widely used since the half of the 20th century. [10] [2] The first vaccines were whole-cell vaccines, composed of chemically inactivated bacteria. They are being replaced by acellular vaccines, composed of purified surface antigens, mainly fimbriae, filamentous haemaglutinin, pertactin and pertussis toxin. It is part of the diphtheria, tetanus, and acellular pertussis (DTaP) immunization. [2]

As a zoonotic disease

Uncertainties of B. pertussis and whooping cough as a zoonotic disease have existed since around 1910, [11] [12] but in the 1930s, the bacteria were found to have lost their virulent power when repeatedly spread on agar media. This explained the difficulties in reproducing results from different studies, as the preinoculating handling of the bacteria were not standardized among scientists. [13]

At least some primate species are highly sensitive to B. pertussis, and develop a clinical whooping cough in high incidence when exposed to low inoculation doses. [14] [15] Whether the bacteria spread naturally in wild animal populations has not been confirmed satisfactorily by laboratory diagnosis, but whooping cough has been found among wild gorillas. [16] Several zoos have learned to vaccinate their primates against whooping cough. [17]

Diagnosis

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. B. pertussis can also be detected by PCR, which is more sensitive than culture. The primers used for PCR usually target the transposable elements IS481 and IS1001. [18]

Several diagnostic tests are available, especially ELISA kits. These are designed to detect FHA and/or PT antibodies of IgG, IgA, or IgM. Some kits use a combination of antigens which lead to a higher sensitivity, but might also make the interpretation of the results harder, since one cannot know which antibody has been detected.

The organism is oxidase positive, but urease, nitrate reductase, and citrate negative. It is also not motile.

Treatment

Whooping cough is treated by macrolides, for example erythromycin. The therapy is most effective when started during the incubation period or the catarrhal period. When applied during the paroxysmal cough phase, the time of reconvalescence is not affected, only further transmission is prevented. [2]

Related Research Articles

Adenylyl cyclase enzyme

Adenylyl cyclase is an enzyme with key regulatory roles in essentially all cells. It is the most polyphyletic known enzyme: six distinct classes have been described, all catalyzing the same reaction but representing unrelated gene families with no known sequence or structural homology. The best known class of adenylyl cyclases is class III or AC-III. AC-III occurs widely in eukaryotes and has important roles in many human tissues.

Whooping cough human disease caused by the bacteria Bordetella pertussis

Whooping cough is a highly contagious bacterial disease. Initially, symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough. This is followed by weeks of severe coughing fits. Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in. The coughing may last for 10 or more weeks, hence the phrase "100-day cough". A person may cough so hard that they vomit, break ribs, or become very tired from the effort. Children less than one year old may have little or no cough and instead have periods where they do not breathe. The time between infection and the onset of symptoms is usually seven to ten days. Disease may occur in those who have been vaccinated, but symptoms are typically milder.

Exotoxin

An exotoxin is a toxin secreted by bacteria. An exotoxin can cause damage to the host by destroying cells or disrupting normal cellular metabolism. They are highly potent and can cause major damage to the host. Exotoxins may be secreted, or, similar to endotoxins, may be released during lysis of the cell. Gram negative pathogens may secrete outer membrane vesicles containing lipopolysaccharide endotoxin and some virulence proteins in the bounding membrane along with some other toxins as intra-vesicular contents, thus adding a previously unforeseen dimension to the well-known eukaryote process of membrane vesicle trafficking, which is quite active at the host-pathogen interface.

<i>Bordetella bronchiseptica</i> species of bacterium

Bordetella bronchiseptica is a small, Gram-negative, rod-shaped bacterium of the genus Bordetella. It can cause infectious bronchitis in dogs and other animals, but rarely infects humans. Closely related to B. pertussis—the obligate human pathogen that causes pertussis ; B. bronchiseptica can persist in the environment for extended periods.

<i>Bordetella</i> genus of bacteria

Bordetella is a genus of small, Gram-negative coccobacilli of the phylum Proteobacteria. Bordetella species, with the exception of B. petrii, are obligate aerobes, as well as highly fastidious, or difficult to culture. All species can infect humans. The first three species to be described ; are sometimes referred to as the 'classical species'. One of these is also motile.

Kennel cough upper respiratory infection affecting dogs

Kennel cough is an upper respiratory infection affecting dogs. There are multiple causative agents, the most common being the bacterium Bordetella bronchiseptica, followed by canine parainfluenza virus, and to a lesser extent canine coronavirus. It is highly contagious; however adult dogs may display immunity to reinfection even under constant exposure. Kennel cough is so named because the infection can spread quickly among dogs in the close quarters of a kennel or animal shelter.

Pertussis toxin

Pertussis toxin (PT) is a protein-based AB5-type exotoxin produced by the bacterium Bordetella pertussis, which causes whooping cough. PT is involved in the colonization of the respiratory tract and the establishment of infection. Research suggests PT may have a therapeutic role in treating a number of common human ailments, including hypertension, viral infection, and autoimmunity.

Cholera toxin protein

Cholera toxin is AB5 multimeric protein complex secreted by the bacterium Vibrio cholerae. CTX is responsible for the massive, watery diarrhea characteristic of cholera infection. It is a member of the Heat-labile enterotoxin family.

In medical terms, a booster dose is an extra administration of a vaccine after an earlier (prime) dose. After initial immunization, a booster injection or booster dose is a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protective levels, after memory against that antigen has declined through time. For example, tetanus shot boosters are often recommended every 10 years, after which memory cells specific against tetanus have lost their function or undergone apoptosis.

Bordetella parapertussis is a small Gram-negative bacterium of the genus Bordetella that is adapted to colonise the mammalian respiratory tract. Pertussis caused by B. parapertussis manifests with similar symptoms to B. pertussis-derived disease, but in general tends to be less severe. Immunity derived from B. pertussis does not protect against infection by B. parapertussis, however, because the O-antigen is found only on B. parapertussis. This antigen protects B. parapertussis against antibodies specific to B. pertussis, so the bacteria are free to colonize the host's lungs without being subject to attack by previous antibodies. These findings suggest B. parapertussis evolved in a host population that had already developed immunity to B. pertussis, where being able to evade B. pertussis immunity was an advantage.

The AB5 toxins are six-component protein complexes secreted by certain pathogenic bacteria known to cause human diseases such as cholera, dysentery, and hemolytic-uremic syndrome. One component is known as the A subunit, and the remaining five components are B subunits. All of these toxins share a similar structure and mechanism for entering targeted host cells. The B subunit is responsible for binding to receptors to open up a pathway for the A subunit to enter the cell. The A subunit is then able to use its catalytic machinery to take over the host cell's regular functions.

Bordet-Gengou agar is a type of agar plate optimized to isolate Bordetella, containing blood, potato extract, and glycerol, with an antibiotic such as cephalexin or penicillin and sometimes nicotinamide. The potato extract provided nitrogen and vitamins, and potato starch absorbed fatty acids present in nasal secretions or collection-swab cotton that inhibited growth; glycerol was a carbon source. Medical Microbiology, 4th edition states that Regan-Lowe medium has replaced Bordet-Gengou medium as the medium of choice for routine Bordetella pertussis incubation.

<i>Bacillus anthracis</i> species of bacteria, causes anthrax

Bacillus anthracis is the etiologic agent of anthrax—a common disease of livestock and, occasionally, of humans—and the only obligate pathogen within the genus Bacillus. B. anthracis is a Gram-positive, endospore-forming, rod-shaped bacterium, with a width of 1.0–1.2 µm and a length of 3–5 µm. It can be grown in an ordinary nutrient medium under aerobic or anaerobic conditions.

Pertussis vaccine

Pertussis vaccine is a vaccine that protects against whooping cough (pertussis). There are two main types: whole-cell vaccines and acellular vaccines. The whole-cell vaccine is about 78% effective while the acellular vaccine is 71–85% effective. The effectiveness of the vaccines appears to decrease by between 2 and 10% per year after vaccination with a more rapid decrease with the acellular vaccines. Vaccinating the mother during pregnancy may protect the baby. The vaccine is estimated to have saved over 500,000 lives in 2002.

The RTX toxin superfamily is a group of cytolysins and cytotoxins produced by bacteria. There are over 1000 known members with a variety of functions. The RTX family is defined by two common features: characteristic repeats in the toxin protein sequences, and extracellular secretion by the type I secretion systems (T1SS). The name RTX refers to the glycine and aspartate-rich repeats located at the C-terminus of the toxin proteins, which facilitate export by a dedicated T1SS encoded within the rtx operon.

cyaA

Bifunctional hemolysin/adenylate cyclase is a protein that in B. pertussis is encoded by the cyaA gene. This protein in turn is cleaved into a calmodulin-sensitive adenylate cyclase (cyaA–ACD) and hemolysin. Both are virulence factors facilitating respiratory tract colonization by B. pertussis. The cyaA–ACD binds to a M2 integrin cell surface receptor and inserts its N-terminal adenylyl cyclase domain into the cytosol. After binding to calmodulin, cyaA–ACD catalyzes the cyclization of AMP into cAMP. This catalysis raises the intracellular concentration of cAMP to toxic levels.

Tracheal cytotoxin

Tracheal cytotoxin (TCT) is a 921 dalton glycopeptide released by Bordetella pertussis and Neisseria gonorrhoeae.

References

  1. Heymann, David L. (ed): Pertussis; in Control of Communicable Diseases Manual. p. 457. American Public Health Association, Washington DC, 2008, ISBN   978-0-87553-189-2
  2. 1 2 3 4 Organization., Organisation mondiale de la santé. World Health (1998). Relevé épidémiologique hebdomadaire (Online) = Weekly epidemiological record. Organisation mondiale de la sante. OCLC   301147153.
  3. Pink Book 2015 , Ch. 16: Pertussis
  4. Parkhill J, et al. (2003). "Comparative analysis of the genome sequences of Bordetella pertussis, Bordetella parapertussis and Bordetella bronchiseptica". Nature Genetics. 35 (1): 32–40. doi:10.1038/ng1227. PMID   12910271.
  5. 1 2 3 4 5 Bordetella : molecular microbiology. Locht, Camille. Wymondham: Horizon Bioscience. 2007. ISBN   9781904933311. OCLC   159579443.
  6. Rosenberg, Eugene; DeLong, Edward F.; Lory, Stephen; Stackebrandt, Erko; Thompson, Fabiano, eds. (2013). The Prokaryotes. Berlin, Heidelberg: Springer Berlin Heidelberg. doi:10.1007/978-3-642-30144-5. ISBN   9783642301438.
  7. "Whooping Cough (Pertussis)". HPA. Retrieved 2009-04-12.
  8. 1 2 Carbonetti, Nicholas H (2007-06-01). "Immunomodulation in the pathogenesis of Bordetella pertussis infection and disease". Current Opinion in Pharmacology. Respiratory/Musculoskeletal. 7 (3): 272–278. doi:10.1016/j.coph.2006.12.004. ISSN   1471-4892. PMID   17418639.
  9. Sebo, Peter; Osicka, Radim; Masin, Jiri (2014-08-04). "Adenylate cyclase toxin-hemolysin relevance for pertussis vaccines". Expert Review of Vaccines. 13 (10): 1215–1227. doi:10.1586/14760584.2014.944900. ISSN   1476-0584.
  10. Sealey, Katie L.; Belcher, Thomas; Preston, Andrew (2016-06-01). "Bordetella pertussis epidemiology and evolution in the light of pertussis resurgence". Infection, Genetics and Evolution. 40: 136–143. doi:10.1016/j.meegid.2016.02.032. ISSN   1567-1348. PMID   26932577.
  11. Inaba, I. (1912). "Über den Bordet-Gengouschen Keuchhustenbacillus Übertragungsversuches des Keuchenhustens auf Tiere". Zeitschrift für Kinderheilkunde. 4 (1): 252–264. doi:10.1007/BF02088879.
  12. Bachamn, W.; Burghard, E. (1925). "Der Nachweis der Bordet–Gengouschen Bacillen und ihre ätiologische Bedeutung für den Keuchenhusten". Zeitschrift für Kinderheilkunde. 39 (5): 465–483. doi:10.1007/BF02225286.
  13. Shibley GS, Hoelscher H (1934). "Studies on whooping cough. I. Type-specific (S) and dissociation (R) forms of Hemophilus pertussis". Journal of Experimental Medicine. 60 (4): 403–18. doi:10.1084/jem.60.4.403. PMC   2132401 . PMID   19870311.
  14. Gustavsson OE, Röken BO, Serrander R (1990). "An epizootic of whooping cough among chimpanzees in a zoo". Folia Primatologica. 55 (1): 45–50. doi:10.1159/000156498. PMID   2394416.
  15. Warfel JM, Merkel TJ (2014). "The baboon model of pertussis: effective use and lessons for pertussis vaccines". Expert Review of Vaccines. 13 (10): 1241–52. doi:10.1586/14760584.2014.946016. PMID   25182980.
  16. Kingdon, Jonathan; Happold, David; Butynski, Thomas (2013). Primates. Mammals of Africa. 2. A&C Black. p. 51. ISBN   978-1-4081-8996-2.
  17. Loomis, M.R. (1985). "Immunoprofylaxis in infant great apes". In Graham, C.E.; Bowen, J.A. Clinical management of infant great apes: proceedings of a workshop on clinical management of infant great apes, held during the IXth Congress of the International Primatological Society. Monographs in Primatology. 5. Liss. pp. 107–112. ISBN   978-0845134047.
  18. Nieves DJ, Heininger U (2016). Bordetella pertussis. Microbiology Spectrum. 4. pp. 311–339. doi:10.1128/microbiolspec.EI10-0008-2015. ISBN   9781555819446. PMID   27337481.