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Medical Bacteriology: Gram Positive, memicu pengaktifan T cells yang…

- - - - folliculitis
      - impetigo
      - furuncle
      - carbuncle
      - abses
      - surgical site infection
    - - nausea
      - vomitting
      - diare
    - - high fever
      - myalgia
      - skin rash
      - hipotensi
      - MODS
    - - bacteremia
      - endocarditis
      - pneumonia
      - osteomyelitis
  - - - spherical (bulat) bacteria
      - gram positif
      - bentuk seperti anggur
    - - aerobic
      - simple media, 37C
      - hasil fermentasi karbohidrat = asam laktat tanpa gas
      - memproduksi hemolisis
    - - polisakarida di luar, lalu ada peptidoglikan
      - asam teichoic
      - Protein A, bind to FC Portion of Ig G
      - Capsul, antifagosit
  - - - staphylococcaceae
    - - Staphylococcus
    - - aureus
      - epidermis
      - saprophyticus
    - - aureus = keemasan
      - albus = putih
      - citreus = kuning lemon
  - - - blood agar = ada hemolisis
      - mannitol salt agar = ada fermentasi manitol
  - - - resisten karena
        
        betha-lactamase production
        
        adanya gen mecA yang mengkode penicilin binding protein (PBP 2A)
- - - - s. pyogenes
      - s. bovis
      - s. pneumoniae
      - s. fecalis
      - s. salivarius
  - - - alpha partial = greenish zone
      - betha total = clear zone
        
        C carbohydrate (Lancefield) = Group A - V
      - gamma = no hemolisis
    - - facultative anaerob
      - strict anaerob
    - - pyogenes group
      - viridians goup
      - enterococci
      - lactic streptococci
  - - - gram +
      - pairs or chains
      - Spherical
    - - need enrich medium (ex. blood agar)
      - facultativ anaeron, better in mikrofilik (CO2 10%)
      - tidak ada katalase
    - - C karbohidrat = spesifik, faktor virulen terpenting, anti fagosit
      - M protein = >80 protein, patogenesis demam rheumatic
      - Protein T dan R
      - kapsul polisakarida
      - asam lipoteichoic
  - - - Cell Surfaces
        
        Epitel
        
        Protein F
        
        Protein M
        
        asam lipotheichoic
        
        fibronektin
        
        asam hyaluronat
      - Faktor Virulensi
        
        Surface Protein dan asam lipoteichoc = attachment
        
        Surface factor (hyaluronat) = inhibit fagosit
        
        Protein M = inhibit opsnonisasi oleh komplemen
        
        hemolisin - streptolysin O (inactive in the presence of o2), streptolysin S (ocygen stable) = merusak sel host
        
        Streptococcal pyrogenic exotoxin = superantigen -> rash, scarlet fever
        
        Streptokinase = digest fibrin, escape from blood clots
        
        hyaluronidase = spreading factor
        
        streptodornase (DNase) = spread staphylo
      - patogenesis and clinical finding
        
        local infection
        
        streptococcal sore throat
        
        impetigo and pyoderma
        
        invasion
        
        erysipelas
        
        Cellulitis
        
        necrotizing fascilitis
        
        puerperal fever and sepsis
        
        toxic shock syndrome and scarlet fever = death 30% of the case
        
        post disease
        
        acute glomerulonephitis -> infect skin
        
        rheumatic fever
      - how to identify