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| | #redirect[[Yersinia pestis infection causes]] |
| {{Taxobox
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| | color = lightgrey <!-- Please read [[WP:Taxobox_usage#Color]] before making any changes to the taxobox color. -->
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| | name = ''Yersinia pestis''
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| | image = Yersinia_pestis_fluorescent.jpeg
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| | image_width = 240px
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| | image_caption = ''Yersinia pestis'' under fluorescent staining, 2000x. cheese: CDC
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| | regnum = [[Bacterium|Eubacteria]]
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| | phylum = [[Proteobacteria]]
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| | classis = Gamma Proteobacteria
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| | ordo = [[Enterobacteriaceae|Enterobacteriales]]
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| | '''familia = [[Enterobacteriaceae]]
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| | genus = ''[[Yersinia]]'''''| species = '''''Y. pestis'''''
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| | binomial = ''Yersinia pestis''
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| | binomial_authority = (Lehmann & Neumann, 1896)<br>van Loghem 1944
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| }}
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| {{SI}}
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| {{CMG}}
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| {{SK}} Y. pestis
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| ==Overview==
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| '''''Yersinia pestis''''' is a [[Gram-negative]] [[facultative anaerobic]] bipolar-staining (giving it a safety pin appearance) [[bacillus]] [[bacterium]] belonging to the family [[Enterobacteriaceae]].<ref name=Baron>{{cite book | author = Collins FM | title = Pasteurella, Yersinia, and Francisella. ''In:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.1611 | id = ISBN 0-9631172-1-1 }}</ref> The [[pathogen|infectious agent]] of [[bubonic plague]], ''Y. pestis'' infection can also cause [[pneumonic plague|pneumonic]] and [[septicemic plague]].<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = pp. 484-8 | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385852-9-9 }}</ref> All three forms have been responsible for high mortality rates in [[epidemics]] throughout human history, including the [[Black Death]] that accounted for the death of approximately one-third of the [[Europe|European]] population in 1347 to 1353.
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| The [[genus]] ''Yersinia'' is Gram-negative, bipolar staining [[coccobacillus|coccobacilli]], and, similarly to other ''Enterobacteriaceae'', it has a [[fermentation (biochemistry)|fermentative]] [[metabolism]]. ''Y. pestis'' produces an [[antiphagocytic]] slime. The organism is [[motility|motile]] when isolated, but becomes nonmotile in the mammalian [[Host (biology)|host]].
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| ==Historical Perspective==
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| * ''Y. pestis'' was discovered in 1894 by Swiss/French [[physician]] and [[bacteriologist]] from the [[Pasteur Institute]], [[Alexandre Yersin]], during an [[epidemic]] of plague in Hong-Kong.<ref name=Bockemühl_1994>{{cite journal |author=Bockemühl J |title=[100 years after the discovery of the plague-causing agent--importance and veneration of Alexandre Yersin in Vietnam today] |journal=Immun Infekt |volume=22 |issue=2 |pages=72-5 |year=1994 |pmid = 7959865}}</ref>
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| * Yersin was a member of the [[Louis Pasteur|Pasteur]] school of thought. [[Shibasaburo Kitasato]], a German-trained Japanese bacteriologist who practiced [[Robert Koch|Koch's methodology]] was also engaged at the time in finding the causative agent of plague.<ref name=Ho>{cite journal |author=Howard-Jones N |title=Was Shibasaburo Kitasato the discoverer of the plague bacillus? | journal=Perspect Biol Med |volume=16 |issue=2 |pages=292-307 |year=1973 |pmid = 4570035}}</ref>
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| * However, it was Yersin who actually linked plague with ''Yersinia pestis''. Originally named ''Pasteurella pestis'', the organism was renamed in 1967.
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| * Three [[biovar]]s of ''Y. pestis'' are known, each thought to correspond to one of the [[Bubonic plague#Historical pandemics|historical pandemics of bubonic plague]].<ref name=Zhou_2004>{{cite journal |author=Zhou D, Tong Z, Song Y, Han Y, Pei D, Pang X, Zhai J, Li M, Cui B, Qi Z, Jin L, Dai R, Du Z, Wang J, Guo Z, Wang J, Huang P, Yang R |title=Genetics of metabolic variations between Yersinia pestis biovars and the proposal of a new biovar, microtus |journal=J Bacteriol |volume=186 |issue=15 |pages=5147-52 |year=2004 |url= http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8195371 | pmid = 15262951}}</ref>
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| * Biovar '''Antiqua''' is thought to correspond to the [[Plague of Justinian]]; it is not known whether this biovar also corresponds to [[Bubonic plague#History|earlier, smaller epidemics of bubonic plague]], or whether these were even truly bubonic plague.<ref name=Guiyoule_1994>{{cite journal |author=Guiyoule A, Grimont F, Iteman I, Grimont P, Lefèvre M, Carniel E |title=Plague pandemics investigated by ribotyping of Yersinia pestis strains |journal=J Clin Microbiol |volume=32 |issue=3 |pages=634-41 |year=1994 |id=PMID 8195371}}</ref>
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| * Biovar '''Medievalis''' is thought to correspond to the [[Black Death]].
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| * Biovar '''Orientalis''' is thought to correspond to the [[Third Pandemic]] and the majority of modern outbreaks of plague.
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| * The role of ''Y. pestis'' in the Black Death is debated among historians; some have suggested that the Black Death spread far too rapidly to be caused by ''Y. pestis''.
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| * DNA from ''Y. pestis'' is alleged to have been found in the teeth of an individual who supposedly died from the Black Death, however, and medieval corpses who died from other causes did not test positive for ''Y. pestis''.<ref>{{cite journal | author = Drancourt M, Aboudharam G, Signolidagger M, Dutourdagger O, Raoult D.| title = Detection of 400-year-old ''Yersinia pestis'' DNA in human dental pulp: An approach to the diagnosis of ancient septicemia | journal = PNAS | year = 1998| volume = 95 | issue = 21 | pages = 12637–12640 | url= http://www.pnas.org/cgi/content/abstract/95/21/12637} | pmid = 9770538 }}</ref><ref>{{cite journal | author = Drancourt M; Raoult D.| title = Molecular insights into the history of plague. | journal = Microbes Infect. | year = 2002 | volume = 4| issue = | pages = 105–9 | pmid = 11825781 }}</ref>
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| * This suggests that ''Y. pestis'' was, at the very least, a contributing factor in some (though possibly not all) of the European plagues. It's possible that the selective pressures induced by the plague might have changed how the pathogen manifests in humans, selecting against the individuals or populations which were the most susceptible.
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| ==Pathophysiology==
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| [[Image:Yersinia pestis.jpg|thumb|left|250px|A scanning electron micrograph depicting a mass of Yersinia pestis bacteria]]
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| * Pathogenicity of ''Y. pestis'' is in part due to two anti-phagocytic [[antigens]], named F1 (Fraction 1) and V, both important for [[virulence]].<ref name=Baron/> These antigens are produced by the bacterium at 37°C.
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| * Furthermore, ''Y. pestis'' survives and produces F1 and V antigens within [[blood]] cells such as [[monocyte]]s, but not in polymorphonuclear [[neutrophils]]. * Natural or induced [[immunity (medical)|immunity]] is achieved by the production of specific [[opsonin|opsonic]] [[antibody|antibodies]] against F1 and V antigens; antibodies against F1 and V induce [[phagocytosis]] by neutrophils.<ref>{{cite book | author = Salyers AA, Whitt DD | title = Bacterial Pathogenesis: A Molecular Approach | edition = 2nd ed. | publisher = ASM Press | year = 2002 | id = pp. 207-12}}</ref>
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| * A [[formalin]]-inactivated [[vaccine]] once was available for adults at high risk of contracting the plague until removal from the market by the [[FDA]]. It was of limited effectiveness and may cause severe [[inflammation]].
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| * Experiments with [[genetic engineering]] of a vaccine based on F1 and V antigens are underway and show promise; however, bacteria lacking antigen F1 are still virulent, and the V antigens are sufficiently variable, that vaccines composed of these antigens may not be fully protective<ref>{{cite journal | author = Welkos S ''et al.''.| title = Determination of the virulence of the pigmentation-deficient and pigmentation-/plasminogen activator-deficient strains of ''Yersinia pestis'' in non-human primate and mouse models of pneumonic plague | journal = Vaccine | year = 2002 | volume = 20 | issue = | pages = 2206–2214 | pmid = 12009274 }}</ref>.
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| ===Genetics===
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| * The complete [[genome|genomic]] sequence is available for two of the three sub-species of ''Y. pestis'': strain KIM (of biovar Medievalis)<ref>{{cite journal | author = Deng W ''et al.''.| title = Genome Sequence of ''Yersinia pestis KIM'' | journal = Journal of Bacteriology | year = 2002 | volume = 184 | issue = 16 | pages = 4601–4611 | url=http://jb.asm.org/cgi/content/full/184/16/4601 | pmid=12142430}}</ref>, and strain CO92 (of biovar Orientalis, obtained from a clinical isolate in the United States)<ref>{{cite journal | author = Parkhill J ''et al.''.| title = Genome sequence of ''Yersinia pestis'', the causative agent of plague | journal = Nature | year = 2001 | volume = 413 | issue = | pages = 523–527 | url=http://www.nature.com/cgi-taf/DynaPage.taf?file=/nature/journal/v413/n6855/abs/413523a0_fs.html | pmid = 11586360}}</ref>; as of 2006, the genomic sequence of a strain of biovar Antiqua has not yet been completed.
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| * The [[chromosome]] of strain KIM is 4,600,755 base pairs long; the chromosome of strain CO92 is 4,653,728 base pairs long. Like its cousins ''[[Yersinia pseudotuberculosis|Y. pseudotuberculosis]]'' and ''[[Yersinia enterocolitica|Y. enterocolitica]]'', ''Y. pestis'' is host to the [[plasmid]] pCD1.
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| * In addition, it also hosts two other plasmids, pPCP1 and pMT1 which are not carried by the other ''Yersinia'' species. Together, these plasmids, and a [[pathogenicity island]] called HPI, encode several proteins which cause the pathogenicity for which ''Y. pestis'' is famous.
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| * Among other things, these [[virulence]] factors are required for bacterial adhesion and injection of proteins into the host cell, invasion of bacteria into the host cell, and acquisition and binding of iron harvested from red blood cells.
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| * Y. pestis is thought to be descendant from ''Y. pseudotuberculosis'', differing only in the presence of specific virulence plasmids.
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| * A recent comprehensive and comparative [[proteomics]] analysis of ''Y. pestis'': strain KIM was recently performed <ref>{{cite journal | author = Hixson K ''et al.''.| title = Biomarker candidate identification in Yersinia pestis using organism-wide semiquantitative proteomics. | journal = Journal of Proteome Research | year = 2006 | volume = 5 | issue = 11 | pages = 3008-3017 | pmid = 16684765 }}</ref> , this analysis focused on the transition to a growth condition mimicking growth in host cells.
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| ===Susceptibility===
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| * The traditional first line treatment for ''Y. pestis'' has been [[streptomycin]],<ref>{{cite journal | author=Wagle PM. | title=Recent advances in the treatment of bubonic plague | journal=Indian J Med Sci | year=1948 | volume=2 | pages=489–94 }}</ref><ref>{{cite journal | author=Meyer KF. | title=Modern therapy of plague | journal=JAMA | year=1950 | volume=144 | pages=982–5 | pmid = 14774219}}</ref> [[chloramphenicol]], [[tetracycline]],<ref>{{cite journal | author=Kilonzo BS, Makundi RH, Mbise TJ. | title= A decade of plague epidemiology and control in the Western Usambara mountains, north-east Tanzania | journal=Acta Tropica | year=1992 | volume=50 | pages=323–9 | pmid = 1356303}}</ref> and [[fluoroquinolones]].
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| * There is also good evidence to support the use of [[doxycycline]] or [[gentamicin]].<ref>{{cite journal | author=Mwengee W, Butler T, Mgema S, ''et al.'' | title=Treatment of plague with gentamicin or doxycycline in a randomized clinical trial in Tanzania | journal=Clin Infect Dis | year=2006 | volume=42 | pages=614–21 | pmid = 16447105 }}</ref>
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| * It should be noted that strains resistant to one or two agents specified above have been isolated: treatment should be guided by antibiotic sensitivities where available.
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| ==Treatment==
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| ===Medical Therapy===
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| Antibiotic treatment alone is insufficient for some patients, who may also require circulatory, ventilatory, or renal support.
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| ==Gallery==
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| <gallery>
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| Image: Enterobacteria34.jpeg| Gram-negative Yersinia pestis bacteria, which was grown on a medium of sheep’s blood agar (SBA) 72hrs. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria31.png| Ulcerated skin lesion at a plague inoculation site caused by the Gram-negative bacterium, Yersinia pestis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria29.jpeg| Blood smear reveals presence of Gram-negative Yersinia pestis plague bacteria. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria22.jpeg| Gram-negative Yersinia pestis bacteria, which were cultured on a sheep blood agar (SBA) medium 120 hrs (20x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria21.jpeg| Gram-negative Yersinia pestis bacteria, which were cultured on a sheep blood agar (SBA) medium 120 hrs (20x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria20.jpeg| Gram-negative Yersinia pestis bacteria, which were cultured on a sheep blood agar (SBA) medium 24 hrs (10x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Enterobacteria19.jpeg| Gram-negative Yersinia pestis bacteria, which were cultured on a sheep blood agar (SBA) medium 72 hrs (10x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague16.jpeg| Hematoxylin-eosin stained (H&E) photomicrograph reveals histopathologic changes in a lymph node tissue sample in a case of fatal human plague. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague05.jpeg| Hematoxylin-eosin stained lung tissue sample revealed the histopathologic changes indicative of what was diagnosed as a case of fatal human plague from the country of Nepal (125x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague15.jpeg| Chest x-ray of a plague patient revealing bilateral infection, greater on the patient's left side, which was diagnosed as a case of pneumonic plague, caused by Yersinia pestis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague14.jpeg| Fingertips of patient’s right hand exhibited the signs of what is known as acral gangrene caused by the bacterium, Yersinia pestis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague12.jpeg| Patient acquired a plague infection through abrasions on his upper right leg. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| Image: Bubonic plague04.jpeg| Lung tissue sample revealed the histopathologic changes indicative of fatal human plague (125x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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| </SMALL>
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| Image: Bubonic plague01.jpeg| Purple-colored Yersinia pestis bacteria on the proventricular spines of a Xenopsylla cheopis flea. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL>
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| </gallery>
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| == External Links ==
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| * A list of variant strains and information on synonyms (and much more) is available through the [http://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?id=632 NCBI taxonomy browser].
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| ==References==
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| {{Reflist|2}}
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| [[Category:Disease]]
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| [[Category:Enterobacteria]]
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| [[Category:Bacterial diseases]]
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| [[br:Yersinia pestis]]
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| [[cs:Yersinia pestis]]
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| [[cy:Yersinia pestis]]
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| [[da:Yersinia pestis]]
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| [[de:Yersinia pestis]]
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| [[es:Yersinia pestis]]
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| [[fr:Yersinia pestis]]
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| [[it:Yersinia pestis]]
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| [[he:Yersinia pestis]]
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| [[la:Yersinia pestis]]
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| [[nl:Yersinia pestis]]
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| [[no:Yersinia pestis]]
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| [[pt:Yersinia pestis]]
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| [[ru:Yersinia pestis]]
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| [[simple:Yersinia pestis]]
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| [[sl:Yersinia pestis]]
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| [[sv:Yersinia pestis]]
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| [[vi:Yersinia pestis]]
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| [[tr:Yersinia pestis]]
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| [[uk:Yersinia pestis]]
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| [[zh:鼠疫桿菌]]
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