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Bacterial skin and soft tissue infection I (Staphylococcus aureus…

- - - - Folliculitis
      - Furuncle or boil
      - Carbuncles
      - Mastitis
      - Sinusitis
      - Impetigo
    - - Pneumonia
      - Osteomyelitis
      - Arthritis
      - Endocarditis
      - Myocarditis
      - Brain abscess
      - Meningitis
  - - - Inhibit opsonization and phagocytosis
    - - Adherence and complement
    - - Endotoxin
    - - Interact with Fc portion of IgG
      - Interfering opsonization
      - Coagglutination test
        
        Specific Ab detect Ag
    - - Barrier to antibiotics
      - Biofilm
    - - Free coagulase
        
        ตรวจ tube test
      - Bound coagulase
        
        ตรวจ slide test
      - Specific identification of S. aureus
    - - Facilitate the spread of bactiria by trapped fibrin
    - - สลาย tissue ช่วยเชื้อ spread
    - - Alpha toxin (alpha-hemolysin)
        
        Cytolytic pore-forming ทำให้ cell แตก
      - Beta toxin (beta-lysin)
        
        Sphingomyelinase
        
        Sphingomyelin —> phosphorylcholine + ceramide
        
        ทำให้ผิว cell บาง แต่ยังไม่แตก พร้อมที่จะแตก
        
        CAMP test
        
        Beta-lysin (produced by S. aureus) + CAMP factor (produced by group B strep)
        
        Cell แตก
        
        Arrow-head hemolysis
        
        Used for ident of group B strep agalactiae
      - Panton-valentine leukocidin (PVL)
        
        Associated CA-MRSA
        
        mecA gene
        
        PBP2a
      - Exfoliatin/Epidermolytic toxin
        
        Staphylococcal scalded skin syndrome
        
        ทำให้ epidermis หลุดออก
      - Toxic shock syndrome toxin (TSST)
        
        Toxic shock syndrome
        
        Associted with use tampons
      - Enterotoxins
        
        Heat stable toxins
        
        Major cause of food poisoning
  - - - Sterile container
        
        Pus, exudate
      - Amies or stuart transport
        
        For swab
        
        Room temp.
    - - Gram stain
        
        Gram +ve cocci in cluster and in pairs
    - - Blood agar
        
        Yellow colony with hemolysis
      - Mac conkey agar
        
        Inhibit gram +ve growth
        
        No growth
    - - Positive
    - - Positive
- - - - Pasteurella multocida
        
        พบในแมวมากกว่า
        
        Facultative anaerobic
        
        Gram -ve coccobacilli
      - Capnocytophaga canimorsus
        
        พบในสุนัขมากกว่า
        
        Fusiform gram -ve bacilli
        
        Capnophilic
        
        ชอบ CO2
  - - - Gram -ve rod, pleomorohic
      - Transmisson
        
        Fleas
      - Culture
        
        Slow growth
      - PCR
  - - - Anaerobes
      - Strep
      - Staph
        
        S. aureus
        
        S. epidermidis
      - Eikenella corrodens
        
        Gram -ve bacilli
  - - - Pleomorphic gram -ve rod
    - - Gram -ve spiral shaped
      - Sodoku
        
        Rat poison
- - - - Contact
        
        Infected animals
        
        Animal products
        
        Soil
        
        Spores can survive for decades in soil
      - Infection
        
        Inhalation of spores
        
        Through breaks in skin or mucous
        
        Ingestion
      - No person to person
    - - Capsule
        
        Inhibit phagocytosis
      - Anthrax toxin
        
        Edema toxin
        
        Increase cAMP
        
        Edema
        
        Inhibit neutrophil function
        
        Lethal toxin
        
        Stimulate macrophage
        
        TNF alpha and IL-1beta
        
        Shock, death
        
        Protective antigen
        
        Bing domain permit toxin entry into host cell
    - - Cutaneous anthrax
        
        Eschar
        
        Untreat
        
        Sepsis
      - Gastrointestinal and oropharyngeal anthrax
        
        High mortality
      - Inhalational anthrax
        
        Endospores enter blood stream
        
        Flu-like
        
        Respiratory failure
        
        Death within 3 days
      - Meningitis
    - - Fluorescent
        
        ย้อม capsule
      - India ink
        
        Capsule ใส
      - Blood agar
        
        Nonhemolytic
        
        Medusa head
        
        Tenacious colonies
        
        ยกขึ้น
        
        Sensitive to penicillin
    - - Heat destroy
        
        Autoclave at 121 องศา
        
        เชื้อน้อย 30 min
        
        เชื้อมาก 60 min