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ACID FAST BACILLI - Coggle Diagram
ACID FAST BACILLI
MYCOBACTERIUM
Karakteristik
rod-shaped, aerobic
resisten terhadap alkohol (acid-fast)
71 spesies, banyak di air dan tanah
Taxonomy
Ordo : Actinomycetales
Family : Mycobacteriaceae
Genus :
Mycobacterium
Spesies :
M.tuberculosis, M.bovis, M.leprae,
dl
Mycobacterium tuberculosis
Pendahuluan
causes tuberculosis, peningkatan tuberkulosis disebabkan oleh drug abuse, HIV-AIDS, malnutrisi, poor ekonomik, lingkungan kotor, polusi, over populated
Karakteristik
Thin straigt rods,
bisa coccoid / filamentous
tidak berspora, nonmotile, nocapsule
cell wall : large lipid fraction ABCD (mycolic acid, hydrophobic attribute), protein, Polysakarida
Kultur
Suhu 35-37 derajat C
inkubasi : 10-14 hari, rapid growers 7 hari
media : semisynthetic agar, Inspissated egg, Liquid.
Reaksi Physical and Chemical Agent
Physical effect : resisten to drying, saat kena matahari mati dalam 2 jam, dalam droplet bertahan hingga 8-10 hari..
Manfaat untuk antibiotik material karena lebih resisten ke agent kimiawi
Sensitif ke obat INH, pyrazinamide PAS.
Virulence Factor
Produce serpentine Cord, glycolipid, enzyme catalase, dan tidak hasilkan toxin
Patogenesis
Primary : Inhaled, Ingestion, Skin
Reactivation : menyebar (necrosis caseation), sering di paru paru, karakteristiknya chronic tissue lession, Formation of tubercules, Caseation, Fibrosis
Tuberculin Test
measures delayed type hypersensitivity to tuberculoprotein
standarnya PPD
Tipe tuberkulin : OT ( dari bovine strain di 5% glycerine) & PPD
Tuberculin Test by Mantoux Methods
pake OT/PPD, inject intracutaneusly
positif : ada induration, sudah pernah terinfeksi di masa lalu dan carrier, pernah di vaksin
negatif : no induration, gk pernah kontak sama mycobacterium, tidak imun (butuh vaksin)
Diagnosis & Identifikasi
Spesimen : Sputum
Biasanya terkontaminasi oleh bacilli lain --> homogenization & conncentration procedurs (KOH 3%, NaOH 4%, H2SO4 4%
Spesial stain: Ziehl Neelsen (Carbol-fuschin)
Baca hasil stain berdasarkan IUAT & WHO
membedakan human strain & other strain : Niacin Test (positif human) & Inoculation in trial animal ( hewan sakit -->human)
DNA Detection
PCR, radiology examination, microbiology examination ( direct smears, culture identification, drug resistance test), tuberculin test, clinical findings,
Treatment
Supportive, Tuberculostatics (First-Line drug & Second-Line drug) , Therapy 6-9 bulan
Preventive
imunisasi BCG vaksin --> bayi 0-1 bulan, Immunity 3-4 tahun, cross immunity dg leprae
Mycobacterium leprae
Karakteristik
ada di seluruh dunia sejak dulu
menyebabkan : Leprosy / Morbus Hanse's
Acid fast rod
tidak bisa tumbuh di artificial media (buatan), tumbuh di footpads of mice, armadillo, dan monyet.
Morphology
bentuk diametrical rods / curve rod
formation of bacilli : singly, grouping
(packet of Cigars)
non motile, tidak berspora
Staining
Gram positive, fast acid, less acid drpd M.tbc, seperti beads, morphological index
Antigen Struktur
Complex, occured a cross reaction, skin test (Lepromin test)
Lepromin Test
sebagai tes imun, untuk tau host immunity M.leprae, membantu diagnosis & prognosis, tau hasil treatment
cara membaca:
Early (fernandez, baca setelah 48 jam, positif bila ada erythema & induration)
Delayed (mitsuda, baca setelah 4-6 minggu, positif jika setelah 7-10 hari muncul papule yang akan jadi nodule, negatif kalau gk ada local reaction)
Hasil :
Lepromin positif (ada endurance, prognosis good)
Lepromin negatif (no endurance, prognosis jelek)
Patogenesis
intraseluler parasitic bakteri, di skin & schwan cell di nervous, inkubasi beberapa bulan hingga tahun.
Klasifikasi
Madrid (1954), Ridley-Joping (1962), WHO(base on bacterial load)
Diagnosis
Clinical findings
laboratory:
Spesimn --> kulit scraping, nasal scraping, sekresi jaringan)
Direct smear -- acid fast staining
Treatment
DDS, Rifampin, Clofazimin
Preventive
Case finding, isolasi pasien, imunisasi, contact therapy --> DDS