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Pyogenic Cocci
bakteri berbentuk kokus dapat menyeragn semau jaringan/organ tubuh dan menyebabkan infeksi disertai dengan pernanahan Kokus Gram positif:
-Staphylococcus aureus
-Streptococcus pyogenes -Streptococcus pneumoniae Kokus Gram negatif:
-Neisseria gonorrhoeae
-Neisseria meningitidis
Staphylococcus sp.
S. aureus
- skin - nasal mucosa
S. epidermidis
- skin - Respiratory tract - GI tracts
S. saprophyticus
- urinary tract
Staphylococcus aureus
Morfologi :- kokus bergerombol - tidak berflagel - tidak berspora - Gram (+)
Kultur : T. opt 37C (15-40) pH opt 7,4 aerob, fakultatif anaerob Hemolytic zones
KLASIFIKASI
Staphylococcus aureus
Gram staining of a pus preparation: Grampositive cocci, some in grapelike clusters. Clinical diagnosis: furunculosis.
Blood agar is frequently used as a universal enrichment medium. Most human bacterial pathogens grow on it. Here is a pure culture of Staphylococcus aureus on blood agar: convex colonies with yellowish pigment and porcelain like surface, d:1-2 mm.
-toxin damages membranes, dermonecrosis Leukocidin Exfoliatin Enterotoxin Toxic shock syndrome toxin-1 (TSST-1)
purulent infections: furuncles, carbuncles, bullous impetigo, wound infections, sinusitis, otitis media, mastitis puerperalis, ostitis/osteomyelitis, sepsis illnesses: food poisoning (by enterotoxins), dermatitis exfoliativa/S4/ Ritter disease, pemphigus neonatorum, and bullous impetigo (by exfoliatins), toxic shock syndrome (by TSST-1)
Toxin-caused
S. saprophyticus
urinary tract infections in young women (1020%) occasional nonspecific urethritis in men
Staphylococcus
Katalase / Koagulase Mannitol /DNA ase
S. aureus
S. saprophyticus
S. endermidis
Coagulase Test utk membedakan Staphylococcus aureus dari spesies yang lain
Stafilokokus
catalase
H2O2
H20 + O2
KASUS KLINIK
KASUS KLINIK
Osteomielitis
Therapy
-lactamase resistant Penicillin Cephalosporin Vancomycin Topical Tetracycline for skin infection Abscess drainage The most important preventive measure in hospitals is washing the hands thoroughly before medical and nursing procedures
Streptococcus sp.
Gram-positive nonmotile catalase-negative Facultatively anaerobic cocci that occur in chains or pairs
KLASIFIKASI
further classification of (-hemolytic) Strep. based on carbohydrates in their cell walls Groups A-G normally infect people
alpha
beta
Pathogenic Streptococci
Streptococcus pyogenes
Morfologi : kokus berantai tidak berflagel tidak berspora aerob/fakultatif anaerob
Streptococcus pyogenes
Koloni Streptococcus
Culture on blood agar: small, whitish-gray colonies surrounded by large -hemolysis zones, 5-10% CO2 atmosphere provides optimum conditions for hemolysis
3.
4. 5.
Hemolisin: Streptolysin O, Streptolysin S Pyrogenic streptococcal exotoxins (PSE) A, B, C Streptokinase / Fibrinolisin DNase DNA depolimerisation Hyaluronidase
Invasive
infections
local: impetigo, erysipelas, cellulitis, pharyngitis, sinusitis, otitis media, tonsillitis general: sepsis, septic shock, necrotizing fasciitis
Sequelae
- Glomerulonephritis - Acute rheumatic fever
Therapy
The agents of choice are penicillin G or V. Alternatives are oral cephalosporins or macrolide antibiotics (erythromycin). In treatment of septic shock, a polyvalent immunoglobulin is used to inactivate the PSE.
mucoid (smooth, shiny) appearance (hence S form) without capsules produce colonies with a rough surface (R form)
Streptococcus pneumoniae
KULTUR
Streptococcus pneumoniae
Normal
flora of upper respiratory tract Pneumococcal infections usually arise from this normal flora (endogenous infections). Predispose factors: primary cardiopulmonary diseases, previous infections (e.g., influenza), extirpation of the spleen or complement system defects, malnutrition.
Clinical Features:
Lung:
lobar pneumonia, bronchopneumonia Bacteremia meningitis, endocarditis, septic arthritis Severe pneumococcal infections frequently involve sepsis
Therapy
Penicillin is still the antibiotic of choice. Macrolide antibiotics are an alternative to penicillins. Penicillin resistance is not due to penicillinase, but rather to modified penicillin-binding proteins (PBPs) to which penicillins have a lower level of affinity. Biochemically, penicillin resistance extends to cephalosporins as well. However, certain cephalosporins (e.g., ceftriaxone) can be used against penicillin-resistant pneumococci due to their higher levels of activity.