ACTINOMYCETES

ACTINOMYCETES
 Actinomycetes are bacteria with a
fungal morphology; it means they are
transitional forms between bacteria
and fungi.
 Like fungi:
 Form mycelial network of branching
filaments.
 Like bacteria:
 Thin
 Possess cell walls containing
muramic acid
 Prokaryotic nuclei
 Therefore they are true bacteria,
bearing a superficial resemblance
to fungi.
 Gram +ve
 Non-motile
 Non-sporing
 Non-capsulated filaments.
 Breakup into:
 Bacillary elements
 Coccoid elements.
 FamilyActinomycetaceae
contain:
1. Actinomyces
2. Nocardia
3. Streptomyces
GENERAL PROPERTIES
 They grow well at 35-37o C and
assume the morphological
appearance of delicate branching
filamentous forms.
 Some species produce aerial
mycelia in culture.
 ACTINOMYCES
 The term actinomyces refers to
ray-like appearance of the
organism seen in the granules
obtained from pathogenic lesion.
 Soil saprophytes which are
potentially pathogenic.
 Others are commensals of mouth
and GIT of both men and animals.
 CLASSIFICATION

SPECIES HABITAT LESION

A.Israelii Oropharyngs and Human

A.eriksoni alimentary tract of actinomycosis
man

A.bovis Oropharynx of cattle Lumpy jaw in cattle

A.naeslundii Oropharynx of man Caries and dental

A.odontolyticus and animal plaque

A.viscosus Human oropharynx Caries and dental

plaque
MORPHOLOGY

 Gram +ve
 Non motile
 Non sporing
 Non acid fast
 Grow in mycelial form
 Breakup into coccal and bacillary
form
 Strict or facultative anaerobes
 In tissue of animal body the
organisms look different from
that of culture.
 Form microscopic colonies in
tissue

Appear in pus as granules

Granules crushed between

slides
 Consistof:
central filamentous Gram +ve
mycelium surrounded by
peripheral zone of swollen
radiating club shaped Gram-ve
structures presenting a sun ray
appearance.
 Clubs are Gram –ve but take acid fast
stain and are of host origin.
 Not part of the organism.
 Lipoidal materials of host tissue origin,
deposited around the bacterial
filaments as a part of defensive
attempt which are not formed in
artificial culture medium.
 Sulphur granules:
 White or yellowish
 Size varies between minute specks
to about 5 mm and found only in
PATHOGENESIS

 Strictparasite
 May occur as commensals in
mouths of normal individuals
mainly round the teeth, upper
respiratory tract and female
genital tract.
 Low virulence potential
 Produce disease only when
normal mucosal barriers are
disrupted by surgery, trauma or
 A.israelii infects both; man and
animal.
 Actinomycosis in human occurs in
4 main clinical forms:
1. Cervicofacial with
indurated lesion on the cheek
and submaxillary regions.
2. Thoracic with lesions in the
lung that may involve pleura
and pericardium and spread
outwards through the chest
3. Abdominal where the lesion is
usually around the cecum,
with the involvement of
neighbouring tissues and
abdominal walls.
Sometimes infection spreads
to the liver via portal vein.
4. Pelvic associated with use of
intrauterine devices.
LABORATORY DIAGNOSIS

 Microscopical examination
 Culture
 Biopsy
 NOCARDIA
 The genus nocardia was named
after NOCARD who first described
the bovine disease characterised
by pulmonary and cutaneous
lesions.
 Environmental or soil
saprophytes.
 Only a few are pathogenic to
human.
MORPHOLOGY

 Resemble actinomyces
morphologically but are aerobic.
 All species are Gram +ve and
form a mycelium that fragments
into rod shaped and coccoid
elements.
 Some are weakly acid fast when
decolourised with 1% sulphuric
acid.
 Acid fastness is due to presence
 Grow readily on ordinary media
forming dry, granular, wrinkled
colonies, which produce pigments
ranging from yellow to red.
 Frequently found in soil and
infection may be exogenous.
 Infection causes:
 Cutaneous lesions

 Subcutaneous in
 Systemic humans
MORPHOLOGY
 Cotrimoxazol given for several
months may be useful.
 Minocycline, Amikacin and
Cefotaxime are effective.
 STEPTOMYCES
 Gram +ve.
 Strict aerobes.
 Environmental organisms of soil.
 Infection is acquired through wound
contamination.
 S.somaliensis causes
mycetoma(“fungus tumour”).
 A significant number of these cases
involve the head and neck
producing so called “Madura Skull”.
 Mycetoma is characterised by
subcutaneous abscesses in the
lower extremities.
 The abscess tend to drain and
heal; but when it is left
untreated, infection may spread
into deeper tissues and invade
the bone.
 ACTINOMYCES NOCARDIA STREPTOMYCE

Staining Gram +ve Gram +ve S

Gram +ve
property (stain poorly)

Oxygen Strict or Strict aerobes Strict aerobes

requirement facultative
anaerobes

Epidemiology Part of normal Prevalent in Prevalent in

flora soil; soil and water
(oropharnx, occasionally
GIT) present in
sputum of
healthy
Clinical Produce individuals.
Cause Cause
disease abscesses subcutaneous subcutaneous
with yellow and infections with
granules pulmonary granules
infection (mycetoma)

Reproduction Non-spore Non-spore Spore former

former former
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