hematogenouslytobones and joints tocause infections•Culture on chocolateagar or pepticdigestagar•Does not grow onblood-agar•Requires heminandNAD•Intrinsicallysensitiveto all antibiotics usedfor gram negativebacteria•80% have ampicillinresistance (TEM-1beta-lacamase)•Treat HIB with thirdgenerationcephalosporin•Has an invariantpolyribitolphosphate(PRP) capsule•Conjugated PRPvaccine preventsdiseaseNon-typeableH-flu (NTHi)•Gram negativecoccobacilli•Oral flora•Person-to-person•Localized, not invasive infections•Outer membrane proteins on thebacteria protect againstphagocytosisand complement•Invade sterile resipratoryepithelia(nasal sinuses, middle ear, bronchi)•Avoid immune response by varyingsugars and linkages in LOS andexcluding phospholipids from outermembrane•Pilibind sialicacid residues on cellsand mucin•Otitismedia•Sinusitis•Chronic bronchitis•Culture on chocolateagar or pepticdigestagar•Requires heminandNAD•Intrinsicallysensitiveto all antibiotics usedfor gram negativebacteria•80% have ampicillinresistance (TEM-1beta-lacamase)•No acquired immunitybecause there is toomuch antigenicvariation (e.g.variation oflipooligosaccharides(LOS) and OMP)a—Fastidious Bacteriaand mucin•LOS modified withphosphorylcholineto mimic hostPAF and invade cells•Type III/IV secretion systemsdeliver proteins into eukaryoticcells to disrupt host immuneresponses and cause cytoskeletalreorganization•Secretes many things: elastase, AP,LasAprotease, hemolysin,rhamnolipids, pyocyaninBordatellapertussis•Small gramnegative rod,faintly staining•Droplet spread;plentiful insecretions•100% attack rateof non-immunefamilies•Adherence: filamentoushemagglutinin, fimbriae, pertactin-OMP•Disease is toxin-mediated:PT(inhibits G-protein signaling), cya(anti-inflammatory and anti-phagocytic), tracheal cytotoxin(killsciliated epithelial cells), Lipid A(toxic)•Whooping cough(paroxysmal coughingleads to “whooping”sound due to smallairways)•URI or pneumonia inadults•Growth requiresmany nutrients and isslow –not doneroutinely•PCR•DFA•Serology•Infection but notvaccine stimulates IgAantibody production•PT and FIM•Antibiotics during thecatarrhal stage canprevent progression•Macrolidesortrimethoprimsulfareduce infectivity butdo not shorten illnessin the whooping stage•Prevent with acellularvaccine directedagainstpertussistoxin,filamentoushaemagglutinin,pertactin, and twoserotypes of fimbrialantigens oragglutinogens•3 doses of vaccine arerequired•Adults need booster
