Gram Negative Bacillus

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    GRAM NEGATIVE BACILLI

     

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    Salmonella spp

      Gr –ve bacilli

       Non sporing , motile bacilli

      All exept S.typhi are non – capsulate bacilli

     

    Facultative anaerobes

    haracteristics

      Animal gut

      Human is the only natural host for S. typhi & S

     paratyphi

    Habitat

      Foodborne roote

     

    Faecal-oral route

    Transmission

      Endotoxin=cause fever , leukemia , hypotension

    &shock

      Capsule=antiphagocytosis

      Can survive within macrophages

    Pathogenesis

      Typhoid fever (Enteric fever)

    1.   bacteria rich small intestine and then enter

    lymphatics& blood streem

    2.  cause fever , malaria , headache ,

    constipation etc

    3. 

    spleen &liver become enlarged

      Enterocolitis (gastroenteritis or

    food poisoning )

      septicemia

    Diseases

      Oxidase – ve , non –lactose fermentation

      Produce acid &gas from glucose

      Grow well on macConnkey agar , DCA , .S.S

    agar

      Commercial kits available for full identification

    Laboratory

    Identification 

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    Shigella

      Gram –Ve bacillus

      Faculitatie anaerobic

     

    Most shigella pathogen is S.sonnei

       Non lactose fermentive .

       Non motile .

    haracteristics

      Endotoxin

      Capsule

      Antigenic phase variation .

    Pathogenesis

     

    Gastroenteritis (( shigellosis ))

      S.dysenteriae cause bacterial dysenteria

    Diseases

      Oxidase – Ve

      Isolation from specimens requires use of

    selective media .

    Laboratory

    Identification

     

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    Vibrio 

    -the second major group of gram-negative ,facultative anaerobic, fermentative rods. 

    - Were separated from Enterobacteriaceae on the basis of positive oxidase reaction

    and the presence of polar flagella.

     

    -the most important members of Vibrio spp are:1)Vibrio cholera.

    2)Vibrio parahaemolyticus.

    3)Vibrio vulnificus.

     

    -Vibrio species can grow on a variety of simple media within temp rate (14-40C).

     

    V.cholerae can grow in the absence of salts(most other species of vibrio that are

     pathogenic in human require salt [halophilic species]).

     

    -Vibrio tolerate a wide range of PH (e.g.PH of 6.5-9.0) but are susceptible to stomachacids. If gastric acid production is reduced or neutralized , patients are more

    susceptible to Vibrio infection.

     

    -most vibrio have asingle polar flagella (in contrast with peritrichous flagella in the

    family Enterobacteriaceae. 

    -vibrio have also various pili that are important for virulence.

     

    -epidemic strains of V.cholerae the etiologic agent of cholera 

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    Vibrio cholerae

      Small , curved (comma – shapped )

      Gr –ve bacilli

       Non sporing , motile bacilli , non capsulate

     bacilli

      Facultative anaerobes

      Were separated from Enterobacteriaceae on the

     basis of positive oxidase reaction and the

     presence of polar flagella.

    haracteristics

      Contaminated water (usually) or food

    (sometimes )

    Habitat

     

    Foodborne route

      Faecal – oral routeTransmission

      Choleragen enterotoxin = hypersecretion of

    electrolytes andwater.Pathogenesis

      Cholera

    1.   bacteria colonize the intestinal tract in

    very high numbers

    2.   bacteria attach to but do not invade the

    intestinal mucosa

    3.  intese vomiting & diarrhea

    4. 

    severe loss of water &electrolytes*gastroenteritis

    Diseases

      Oxidase +ve

      Commercial kits available for full identification

      Special selective media for vibrio thiusulfate

    citrate bile salts sucrose(TCBS).

      Do not require salts for growth. But can tolerate

    it.

    Laboratory

    Identification 

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      Vibrio cholerae are rarely seen in Gram-stained

    stool or wound specimens.

      By using darkfield microscope may able to detect

    the motile bacteria in stool specimen.

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    -members of the Enterobacteriaceae family are

    moderately in size, gram-negative rods .

     -they share a co

    mmon antigen (enterobacterial common antigen)

     

    -are either nonmotile or motile with peritrichous

    flagella

      -do not form spore.

     

    -all members can grow rabidly, facultative

    anaerobic) on variety of nonselctive

    media(e.g.blood agar) and selective

    (e.g.macConkey agar).

     -the Enterobacteriaceae have simple nutritional

    requirements, ferment glucose.

     

    -catalase +ve, oxidase –ve.

    -the absence of cytochrome oxidase activity is

    important characteristic , because it can bemeasured rabidly with simple test and is used to

    distinguish the Enterobacteriaceae from many other

    fermentative and nonfermentative gram-negative

    rods.

     

    -a few exceptions to these rules exits (e.g.

     plesiomonas shigelloides is oxidase +ve, klebsiella

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    granulomatis can not be cultured on traditional

    media.

     

    -the ability to ferment lactose has been used todifferentiate lactose-fermenting strains(e.g.

    Echerichia, klebsiella, enterobacter, citrobacter ,

    serratia spp) from strains that do not ferment

    lactose or do so slowly(e.g. proteus, salmonella,

    shiglla, yersinia spp).

      -resistance to bile salts in some selective media has

     been used to separate enteric pathogen(e.g.

    shigella, salmonella) from commensal organisms

    that are inhibited by bile salts(e.g. gram+ve and

    some gram-ve bacteria present in the

    gastrointestinal tract)

     -some Enterobacteriaaceae have prominent

    capsules (e.g. most klebsiella, some Enterobacter,

    Escherichia strains),

     

    -the heat-stable lipopolysaccharide(LPS) is the

    major cell wall antigen. 

    -most the Enterobaceriaceae are motile with the

    exception of the common isolates Klebsiella,

    shigella, yersinia.

     

    -the motile strains posses peritrichous flagella.

     

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    -there are other species of Enterobacteriaceae :

    1)Enterobacter 

    2)Citrobacter 

    3)Serratia4)Morganella

    -These species subdivide as lactose fermenter

    Enterobacteriaceae.

     

    -these species caused infections rarely in

    immunocompetent patients. 

    -they are more common causes of

    immunocompromised patients.

     

    -e.g. citrobacter koseri cause meningitis and brain

    abscesses in neonates.

     

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    Escherichia coli

      Gr –ve bacilli

       Non sporing , motile , non capsulated bacilli but

    some strains are capsulate

     

    Facultative anaerobes

    haracteristics

      Common normal flora of human intestinal tractabitat

      Foodborne route

      Faecal – oral route

      Endogenous spread

    Transmission

      Endotoxin = cause fever , leucopenia

      Capsule (in some strains ) = antiphagocytosis

      Enterotoxin = cause diarrhea

    Pathogenesis

      Urinary tract infection (UTI)

      Diarrhoeal disease

       Neonatal meningitis

      Septicemia

      Gastroenteritis.

    Diseases

      Oxidase –ve , lactose fermentive

      Grow well on macConkey agar , DCA , XLD

    agar

      Commercial kits available for full identification

    Laboratory

    Identification 

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    Proteus spp

      Gr –ve bacilli

       Non sporing highly motile , non capsulate bacilli

      Facultative anaerobes

     

    P.mirabilis is the most common species.

      Produce large quantitiesof urease.(this process

    raises the urine PH and facilitates the formation

    of renal stones , the increased alkalinity of the

    urine is also toxic.

    haracteristics

    Common normal flora of the human intestinal tractabitat

     

    Foodborne route

      Faecal – oral route

      Endogenous spread

    Transmission

    Endotoxin = cause fever , leucopenia

    Pathogenesis

      UTI

      SepticemiaDiseases

      Oxidase –ve , non lactose fermentive

      Grow well on macConkey agar , DCA , XLD

    agar

      Swarming colonies on solid media

      Commercial kits available for full identification

    Laboratory

    Identification 

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    Yersinia pestis

      Gr –ve bacilli (cocobacilli ) (facultative

    anaerobes)

      Have a tendency for bipolar staining (in

    which the endof the bacilli stain darker

    than the central part)

       Nonsporing , non motile bacilli . capsulate

     bacilli

      Some species (e.g.Y.enterocolitica) can

    grow at cold temp.

    haracteristics

      Animal reservoirs are rodents such as ratsHabitat

      Bacteria spreads between anmals by fleas

      Major outbreaks in humans result from

    exposure to infected rats

      The rat flea carries infection from rat to rat

    & from rat to human

      Bubonic plague is not transmitted from

     person to person

      Pneumonic plague spread from person

    to person by droplets (airborne route )

    Transmission

      Intracellular murine toxin = causing

    irreversible shock and death

      Capsule (f1) = antiphagocytosis

      The V/M antigen = specific protein act as

    antiphagocytosis & promote intracellular

    growth of the bacteria

    Pathogenesis

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    PLAGUE :

    1.  is normally azoonotic disease of rodents

    that exists in 2 kinds of epidemic centers

    2. 

     permanent but relatively resistant rat

     population (wild rat)

    3.  temporary but susceptible rat population

    (domestic rats )

    4.  epidemics of plague usually occur in

    crowded areas poor sanitation

       bubonic plague :

    1.  bacteria multiply at the entery

    site in the skin

    2.  bacteria spread via the

    lymphatics to lymph nodes

    3. 

    2 to 6 days after the flea bite

    occurs , lymph nodes become

    very tender , and enlarge to form

     buboes with haemorrhagic

    inflammation

    4.  death rate is about 75% in

    untread bubonic plague   pneumonic plague (black

    death) :

    1.  bacteria

    disseminates from

    lymph nodes by

    way of the

    Diseases

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     bloodstream to

    the spleen , liver ,l

    lungs

    2. 

     pneumonic plague

    can be transmitted

     by respri atory

    route but Iis

    3.  death tate is nearly

    100%in untreaed

     pneumonic plague

      stained smears should show bipolar

    staining

      organism can be grow from aspirtes of

    enlarged buboes , or from sputum in case

    of pneumonic plague

      colonies are grayish , mucoid & rough

    colonies may be noted

      the organism are not fastidious ; it can be

    rrown on routine media

     

    oxidase –ve .

    Laboratory

    Identification 

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    Pasteurella

      Garm –Ve bacillus

       Non spore forming

       Non motile

     

    Faculitative anaerobic

      Fermentative coccobacilli .

      Most common P.multocida and P.canis

    haracteristics

    abitat

    Transmission

    Pathogenesis

      Bite wound infection .

      Chronic pulmonary disesase

      Bacteremia

      Meningitis

    Diseases

     

    Grow well in blood and choclate agar . and

     poorly in macConkey agar .

      After over night incubation in blood agar

    large buttery colonies with musty odor cuase

     by product indole

    Laboratory

    Identification 

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    Klebsiella pneum oniae

      Gr –ve bacilli

       Non sporing , non motile , prominent capsulate

    that responsible for the mucoid.

     

    Facultative anaerobes

      Formerly called (Donovaina granulomatis)

    haracteristics

      Common normal flora of the human intestinal

    tract & oropharynxHabitat

      Foodborne route

      Faecal – oral route

      Endogenous spread

    Transmission

     

    Endotoxin = cause fever , leucopenia

      Capsule = antiphagocytosisPathogenesis

      UTI

       Neonatal meningitis

      Septicemia

      Pneumonia (Rare )

    Diseases

      Oxidase –ve , lactose fermentive

      Grow well on macConkey agar , DCA , XLD

    agar

      Large mucoid colonies

      Commercial kits available for full identification

    Laboratory

    Identification

     

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    Brucella spp

      Gr –ve small coccibacilli

       Non sporing ,non motile , non capsulated bacilli

      Intracellular pathogen

     

    Slow growth requirements

      Fastidious.

      Is member of the alpha –proteobacteria group

      Strictly aerobic

      Does not ferment carbohydrates.

      Four species:

    1)Brucella abortus 2)Brucella melitensis.

    3)Brucella suis 4)Brucella canis

    haracteristics

      Chronic infection in domestic animalsHabitat

      Contaminated milk or other unpasteurized dairy

     products

      Direct contact

    Transmission

     

    Invasion of the body by brucella results in

    lymphatic dissemination of the bacteria

      As regional lymph nodes become infected , the

     brucella are phagocytized , but they are capable

    of survive & intracellular multiplication inside

     phagocytic cells

      As phagocytic cells die , brucella , are released

    into the blood stream and intracellularly ,

    establish localized infection in bone marrow ,

    liver &spleen , and thus hide from host defence

    Pathogenesis

      Undulant fever (malta fever or brucellosis )

    1. 

     patients frequently present with PUO

    2.  chronic , debilitating febrile illness usually

    without any localizing signs

    3. 

    intracellularly , bacteria localize and cause

    Diseases

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  • 8/18/2019 Gram Negative Bacillus

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    granulomas lesions in the spleen , liver

     bone marrow & lymph nodes

    4.   patients presents with intermittent fever &

     profound weakness , chills , sweats ,

    headache , backache

    5.  two types of infection occur ; (acute

    infection ) or (chronic infection – lasting

    12 months )

      requiring complex growth media like :glucose

    serum or liver infusion broth or agar

      usuakky require 3-5 days incubation

       blood provides the best material for culture

      grow occasionally on MacConkey agar.

      Oxidase +ve

      Urease+ve

    Laboratory

    Identification

     

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  • 8/18/2019 Gram Negative Bacillus

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    Francisella tularensis

      Gr – Ve small bacilli (coccobacilli)

      Often showing bipolar staining

       Non motile , non sporing , capsulate , coccobacilli

     

    Strick aerobic

      Fastidious.

      Two species of Francisella spp:

    1)F.tularensis

    2)F.philomiragia

    *require cystein for growth.

    haracteristics

    Widely found in animal reservoirsHabitat

       biting arthropods

      direct contact with infected animal tissue

      ingestion of contamination food or water

     

    inhalation of aerosols

    Transmission

      F.tularensis is highly infection ; penrtration of the

    skin or mucous membranes or inhalation of 50

    organism can result in infection

      F.tularensis is an intracellular pathogen of

     phagocytosis cells

      Capsule= phagocytosis

    Pathogenesis

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      tularemia (sometimes called rabbit fever or

    glandular fever or tick fever or deer fly fever ):

    1-clinical presentation dependes on the route of

    infection2- a plague – like disease of rodents

    Diseases

       blood is taken for serological tests

      growth dose not occur in most ordinary

     bacteriological media but small colonies appear in

    1-3 day on glucose , blood agar incubated at 37 C

    under aerobic conditions

      culture on cystein-supplemented

    media(e.g.choclate agar, BCYE agar ) is specific.

      Culture on cystin blood agar.

      Culture on cystin glucose agar

      BCYT= buffered charcoal yeast extract.

    Laboratory

    Identification 

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  • 8/18/2019 Gram Negative Bacillus

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    emophilus

     

    -the family pasteurllaceae spp are1)Haemophilus

    2)Actinobacillus3)Pasteurella

     

    -the members of this family are:

    Small gram-negative*  Non-spore* Nonmotile*

    Aerobic or facultative anerobic rods* 

    -most members of this family have fastidious growthneeds, requiring enriched media for growth.

     the mostare Haemophilusmembers of the genus-

    commonly and significant human pathogen.

     

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    Haemophilus influenzae

      Gr –ve bacilli (coccobacilli)

       Non sporing , non moitile ,

      The surface of many(but not all) strains of

    H.influenzae is covered with polysaccharide

    capsule.

      Facultative anaerobes

      Haemophillic bacteria

      Pyogenic (pus –producing ) bacteria

      Plemorphic.

      Is the most species of Haemophilus that cause

    disease.

      The cell wall structure is typical of other gran-

    negative rods(lipopolysaccharide with endotoxin

    activity is present in thecell wall.

      Is fermentive.

    haracteristics

      Human upper respiratory tract as anormal flora

     but many also cause respiratory disease , usually

    as secondary invader

    Habitat

      Airborne routeTransmission

      Endotoxin = causing damage to the epithelial cell

    of the upper respiratory tract

      Capsule = antiphagocytosis

      IgAase = degrades IgA antibodies that is key host

    defense mechanism in mucous membrane

     

    H.influenzae type b is most virulent withRPR(polyribitol phosphate) in capsule

      Pili=adhere to host cells.

    Pathogenesis

      Cause severe infection in children ( acute

    meningitis )

      H.influenzae serotype was responsible for more

    than 95% of all Haemophilus infection.

     

    Serotypes C and F and noncapsulated

    Diseases

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    H.influenzae diseases.

      Cause chronic , less severe infection beyond age 6

    (,pneumonia,Otitis media , sinusitis , bronchitis )

    in older children and adult  This bacteria is the most common cause of

     bacterial meningitis in children from 5 months to

    5 years of age

      Mortality rate of untreated H. influenzaw

    meningitis may be up to 90%

      Act synergistically with viral infection ,

     predisposing to severe haemophilus infection , the

    incidwnce increase during influenza outbreaks

      Require enriched media such as blood or

    chocolate agar or(Levinthals agar)

       Need both od tow growth factor (factor V-X)

    1.  heat stable X factor = hemin or some

    other iron – containing prophrin

    2.  heat stable V factor = nicotinamide

    adenine nucleotide (NAD)

      grow poorly in the absence of oxygen & growth

    is enhancedin an atmosphere with add CO2

      on chocolate or blood agar : a streak of staph .

    aureus across the plate produce V factor and

    enlarges the size of adjacent colonies of H .

    inflluenzae = satellitism phenomena

      colonies are small , translucent , non hemolytic

      microscopy is sensitive test for detecting

    H.influenzae in(cerebrospinal fluidCSF .synovial

    fluid, and lower respirtory specimens.

    Laboratory

    Identification

     

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    Pseudomonas aeruginosa

      Gr –ve bacilli arranged in pairs.

       Non sporing , motile , capsulate (polysaccharide)

      Obligae aerobes

     

     Nonfermentative.

      The presence of cytochrome oxidase(detected in

    rabid,5minute test) in pseudomonas species is

    used to differentiate them from the

    Enterobacteriaceae

      Some pseudomonas produce diffusible pigments

    (e.g.pyocyanin

    [blue],fluorescein[yellow],pyorubin[raddish-

     brown]

      P.aeruginosa is the most common type.

    haracteristics

      Widley distributed in water , soil & moist areas

      Carriage as a part of normal gut flora in higher

     proporation of hospital inpatients

    Habitat

      Direct contact

     

    Endogenous spreadTransmission

      Exdotoxin = cause fever , leucopenia

      Exdotoxin A = inhibit protein synthesis

      Exdotoxin S = inhibit protein synthesis

      Protease & Elastase = destruction of tissue

      Capsule=inhibits antibiotics+suppresses

    neutrophil and lymphocyte activity.

     

    Pili=adhesin

    Pathogenesis

      UTI

      Septicemia

      Pneumonia

      Burn wounds & wound infection

      Ear and eye infection

    Diseases

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      Oxidase +ve , lactose fermentive

      Identified by colonial characteristics(e.g.

    hemolytic, green pigment, grape like odor)

     

    Grow well on macConkey agar , DCA , XLDagar

      Commercial kits available for full identification

    Laboratory

    Identification 

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    یق ف و ت ل ا ب

     

    cinetobacter spp

      Gr –ve bacilli (plump coccobacilli)

       Non sporing , non moitile , capsulated

    coccobacilli

     

    Strictly aerobic

      The genus can be subdivided into two groups:

    1)glucose oxidizing species(A.baumannii)

    2)glucose nonoxidizing species(A.lwoffii)

    haracteristics

    Survive in moist surfaces. Including respiratory therapy

    equipment .And survive on dry surface including human skin(the

    latter feature is unusual for gram-negative rods)

    Habitat

      Direct contact

      Indirect contact via invasive devicesTransmission

      It has ability to colonize on internal surfaces of

    the invasive devicesPathogenesis

    *pulmonary infection.

    *opportunistic pathogens that cause:

    Respiratory tract unfection and urinary tract infection and

    wound and septicemia.

    Diseases

      Oxidase –ve

      Grow well on simple mediaLaboratory

    Identification

     

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    Bacteriodes

      Gram –Ve bacillus .

      Obligate anaerobic .

      Most common species is b.fragilis .

     

    Polymorphic in size and shape .

     

    haracteristics

      Intraabdominal infection .

      Gynecologic .

      Skin and soft tissues infection .

      Bacteremia .

    Diseases

      Grow rapidly (( detected in 2 days )) .

      Stimulated growth in 20% bile .Laboratory

    Identification

     

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    یق ف و ت ل ا ب

    Bordetella pertussis

      Gr –Ve extremely smaal bacilli

       Non sporing , non motile bacilli

      Capsulate bacilli

     

    Obligate aerobes

    haracteristics

    Human respairatory tract

    Habitat

      airborne route

      direct contactTransmission

      tracheal cytotoxin = inhibits DNA synthesis in

    ciliated cells

      fimbrial antigen (pili ) = permit the adherence of

     bacteria to the ciliated epithelium of the

    respiratory tract

     

    endoxin = causing damage to the epithelial cells

    of the upper respiratory tract

       pertussis toxin

    Pathogenesis

      whooping cough (pertussis ) by Bordetella

     pertussis.

     

    Mild pertussis by Bordetella para pertissis.

      Respirtory disease in dogs by Bordetella

     bronchiseptica.

    Diseases

      slow growing & fastidious in its growth

    requirement

       bordet – gengous agar or blood – charcoal agar

      requires media supplemented with charcoal,

    starch, blood, or albumin.

    Laboratory

    Identification 

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     ال

     

    یق ف و ت ل ا ب

     

    Differential characteristics of Bordetell species

    B.bronchisepticaB.parapertussisB.pertussischaracteristics

    + - + oxidase

    + + - urease

    + - - motility

    + + - On sheep agar 

    + /+- - On macConkeyagar 

     

      requires 3-5 day incubation in moist atmosphere

      it dose not require X and V factors on culure

      oxidase amino acids.

     

     Not ferment carbohydrates.

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