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Referensi
• Murray, Rosenthal, Levinson. MedicalMicrobiology 11th edition.
• Rosenthal & Tan, MedicalMicrobiology & !!unology
• Levinson, Medical Microbiology &!!unology
• "awet#, Melnick & adelberg, MedicalMicrobiology
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$akteriologi %linis
Coccus Bacil
Stahylococcus
$acillus
Stretococcus 'lostridiu!
(nterococcus Listeria
'orynebacteriu!
)ocardia
Coccus Bacil
)eisseria (nterobacteriaceas
Shigella, Sal!onella
*ibrio
'a!ylobacter,
+elicobacter+ae!ohilus
$ordetella
Legionella
Letosira
Mycobacterium
Tanpa dinding
Mycolas!e
'hla!ydia
Rickettsia
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ra! -
Rosenthal & Tan, Ra id Review Microbiolo &
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ra! ositive cocci
'atalase
ositif )egatif
StretococcusStahylococcus
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Staphylococcus aureus
• /isiologi dan struktur0 – 'occus gra! ositif, non!otil, tdk
bersora, !e!bentuk agregat. %oloni
berig!en kee!asan. – %atalase dan koagulase ositif
– Mannitol0 kuning
– /aktor virulensi0• struktural kasul, adherence, rotein 23
• To4in cytoto4in, e4foliative, TSST51,enteroto4in3
• en#i! coagulase, hyaluronidase,
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Staphylococcus aureus
• (ide!iologi dan !anifestasi klinis0 – 78598: oulasi S.aureus -3 di hidung
– %linis0• yogenic0 i!etigo, folliculitis, furuncles,
carbuncles, wound infections
• To4ic shock syndro!e
• /ood oisoning
• +2 MRS2
• *irtually every organ syste!
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Staphylococcus aureus
• ;iagnosis dan terai0 – Mikroskoi, kultur, u<i bioki!ia
– ;rainage dan incision untuk infeksi
yogenik
– MRS2 *anco!ycin
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Staphylococcus aureus
• Resistensi antibiotik ada S. aureussangat luas0 – =5Lacta!ase las!id3
– Mec2 gene chro!oso!e30 )afcillin,!ethicillin dan o4acillin
– *anco!ycin5resistant S. aureus *RS23 0van2
– las!id5!ediated resist to tetracycline,erythro!ycin, a!inoglycoside
– Tolerance
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Staphylococcus aureus
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Staphylococcus aureus
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Staphylococcus aureus
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.saprophyticus
• %oagulase negatif
• S. epidermidis >? novobiocin sensitif – /lora nor!al kulit
– nfeksi oortunistik !enyerang katuarti6sial, sendi rostetik, kateter
• S. saprophyticus >? novobiocin
resisten – Urinary tract infections
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StahylococciS. aureus S. eider!idis S sarohyticus
%atalase- %atalase - %atalase 5-
%oagulase - %oagulase 55 %oagulase 55
/er!entai !anitol Tidak fer!entasi Tidak fer!entasi
$ he!olytic )on5 he!olytic )on +e!olytic
ig!en e!as Tidak berig!en Tidak berig!en
neu!onia,@steo!ylitis, Seticarthritis, sesis,endocarsitis, abses
nfeksi oortunistiknfeksi nosoko!ialnf katu <antungterkait kateterisasi3
UT, terkaitkateterisasai
%eracunan !akananstah enteroto4in Sensitive novobiocin Resisten novobiocin
To4ic ShockSyndro!e TSS To4in3
MRS2A unakan*anco
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Stretococci
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S. pyogenes
• /isiologi dan struktur0 – 'occus gra! ositif, non!otil, tdk bersora.
$erbentuk rantai. %atalase negatif
– $acitracin sensitif – +e!olisis beta
• /aktor virulensi0 – 2ntifagositosis0 kasul, rotein M, '9a
etidase
– 2dherence0 /, M rotein
– To4in
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S. pyogenes
• (ide!iologi0 – enyebaran !elalui kontak dan
resiratory drolet
• !anifestasi klinis0 – Suuratif0
• /aringitis, scarlet fever, i!etigo,necroti#ing fasciitis
– )onsuuratif0• Rheu!atic fever
• 2cute glo!erulonehritis
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S. pyogenes
• ;iagnosis0 – Mikroskoi, kultur, deteksi antigen,
sensitivitas antibiotik, u<i bioki!ia
– Titer 2S@
• Terai0 – enicillin *
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S. pyogenes
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S. pyogenes
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Stretococci
S. yogenesru 23
S.2galactiaeru $
S.neu!oniae 5
*iridansstre
(nterococcusrou ;
$eta5
he!olytic
$ he!olytic 2lha
he!olytic
2lha
he!olytic
2lha,
$eta,ga!!a
$acitracin S $acitracin R @tochin S$ile soluble
@tochin R)on bilesol.
$ile andsalttolerant
M rotein,Stretokinase, Stretolysin@,Stretolysin S
*irulencefactor0'asule,g2rotease
S. !utansS. !itisS. bovis
S. faecalisS. faeciu!
Suurative0 Sesis & neu!onia (ndocarditi
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ra! ositive $acil
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$acillus
$. anthracis $. cereus
)on +e!olytic $eta he!olytic
)on5Motile Motile
Bba!boo treeC
BMedusa5headC, ground glassaearence
;iisolasi erta!a oD %ochA
To4in0 2, L/, (/ (nteroto4in0+eat labile > diarrheal for!+eat stable E e!etic for!
'utaneous anthra4 > escharnhalation anthra4 > wool sorterdisease anthra4
/ood oisoning > fried rice
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Bacillus anthracis
• hysiology and Structure0 – Sore5for!ing, non!otile, nonhe!olytic
gra!5ositive rod
– rotective antigen 23, ede!a factor(/3, and lethal factor L/3
– olyetide casule
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Bacillus anthracis
• ;isease and (ide!iology0 – ri!arily infects herbivores. +u!ans
infected through sore e4osure
– 'utaneous0 F9: of cases. black eschar – nhalation0 wool sorter disease.
Mediastinal ly!hadenoathy.
– astrointestinal
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Bacillus anthracis
• ;iagnosis and theray0 – us, blood, sutu!
– 'ulture0 not hemolytic, in contrast
with B. Cereus – (LS2
– Treat!ent0 'iroGo4acin, enicillin -
enta!ycinDstreto!ycin
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Bacillus cereus
• astroenteritis
• @cular infections
•
Severe ul!onary disease
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'lostridiu!C. tetani C. botulinum C. difcile C. perringens
Ter!inal sore >seerti raket
Sora <arang,;ouble #onehe!olysis,%asul
tetanosas!in
& tetanolysin
$otulinu!
to4in
(4oto4in 2 & $ 2lha to4in
lecithinase3!engha!bateleasan2$2 & glisin
!engha!bateleasanasetilkolin
deoli!erisasiaktin > cell death
!erusak!e!bran sel
Tetanus 0oisthotonos,risussardonicus,tris!us
$otulis! 522;5seudo!e!branous colitis
5as gangrene5/ood oisoningtie 235)ecroti#ingenterocolitistie '3
rev0
debride!ent,+T, vaksin
Treat!ent0
'hlora!,!etro
Treat!ent0 sto
antibiotik
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Clostridium tetani
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Clostridium botulinum
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Corynebacterium diphteriae
• /isiologi dan struktur0 – $atang, non sore for!ing, 'hinese letters
– Granula metakromatik (Neisser
–
H biotie0 gravis, !itis, inter!edius, belfanti – %ultur0 tellurite agar, blood agar, !oe"er#s
serum media, $ai media
• ;ihteria to4in > syste!ic to4ae!ia
• Resiratory dihteria & cutaneous dihteria• *accination, antito4in, enicillin atau
erythro!ycin
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Corynebacterium diphteriae
• (ide!iologi dan !anifestasi klinis0 – +anya !enyerang !anusia !elalui
drolet resiratori
– )yeri tenggorokan, fever,seudo!e!bran, bullneck
– rregular cardiac ryth! kerusakan otot
<antung3
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Corynebacterium diphteriae
• ;iagnosis dan terai0 – Segera obati
– Swab dari hidung, tenggorok s!ear
gra! - neisser3, kultur – (lek test u<i toksigenisitas
– Terai0 dihtheria antito4in - antibiotik
erythro!ycin3 – *aksin ;T
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Listeria monocytogenes
• /isiologi dan Struktur0 – ra! ositif, cocobacil, tumbling
motility
– Susunan alisading – ntraseluler fakultatif
– /aktor virulensi0 listeriolysin @,
internalin, 2ct2 rotein
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Listeria monocytogenes
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Listeria monocytogenes
• (ide!iologi dan !anifestasi klinis0 – %onsu!si !akanan
terkonta!inasisusu, ke<u, daging,
sayuran – )eonatus, wanita ha!il, geriatrik
– %linis0•
)eonatus0 granulo!atosis infantisetica• Ianita ha!il0 bactere!ia
• ;ewasa0 !eningitis
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Listeria monocytogenes
• ;iagnosis dan terai0 – ;arah atau 'S/. %ultur cold enrich!ent
ada agar darah. ;; dengan
Corynebacterium – Terai0 enicillin, a!icillin, genta!ycin
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Mycobacteria
• @bligat aerob, batang
• )on sore for!ing, wa4y enveloe
• $atang tahan asa!
• Mycobacterium tuberculosis: T$
• Mycobacterium leprae: lepra
•
Mycobacterium avium – intracellulareM. avium comple! " M#C$ danatypical mycobacteria: pathogenoportunisti%
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Mycobacterium tuberculosis
• J) stain sutu! atau sesi!en lainK? batang tahan asa! !ycosidesada hydrohobic layer3
• %ultur Lwenstein5"ensen !ediu! 5N!g
• ;isease0 T ul!onal &
ekstraul!onal• T40 sonia#id, Rifa!in, ira#ina!ude,
(tha!butol, Streto!ycin
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Mycobacterium leprae
• %ultur0 tidak bisa in vitro. nokulasiada ar!adillo, foot5ad !ice, kultur
<aringan.
• ;isease0 Lera D Morbus +ansen
• T40 Tuberculoid for!0 dasone -rifa!in N bulan. Lero!atous for!0
dasone - rifa!in - clofa#i!ine 7bulan
!epromatous Tuberculoid
Lesi kulit noduler Makular$T2 ??? OO
U<i lero!in 5 -!unitas ;e6siensi cell
!ediated
i!!unity
'ell !ediated
i!!unity nor!al
a!baran %linis /acies Leonina,
!adurosa,
Macula anesthesia
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ra! 5
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(nterobacteriaceae
/akultatif anaerob
%atalase -@ksidase >Reduksi nitrat2ntigen0 %, +, @
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(nterobacteriaceae
!actose %ermenter (Merah Non lactose ermenter (Takber&arna
(. coli Sal!onella
(T('
travellerPs diarrhea. )ofever((' infant diarrhea(2(' chronic infant diarrhea(+(' +e!orrhagic colitis,+e!olytic Ure!ic Syndro!e
(('sereny test
;e!a! enterik0 S. serovartyphiSesis0 S. serovar cholerasuisastroenteritis0 S. serovartyphimurium Tes widal
Shigella disenteri basiler
Shiga to4in > neuroto4ic ,cytoto4ic, enteroto4ic
Qersinia
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/a!ily &ibrionaceae: &ibrio sp.' #eromonas sp.' (lesiomonas sp.
• ra! negatif, batang !otil, curved
• @ksidase ositif, salt tolerant
• &. cholerae: Sread by consu!tionof conta!inated food or water
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V. cholera V. parahaemolyticus
%asul 5 -/aktor *irulensi 'T, ili, !ucinase 'ytoto4in, ili$ioche!ical @ksidase - @ksidase -/ 'T K? sti!ulasi s
rotein K? increasesc2M
%anagawa - K?
he!olisa darah!anusia dan kelinci
n6ltrasi le!ak dan
e!bengkakan
heatosit%linis Rice water diarrhea,
vo!it, dehidrasi
;iare berair, darah
-D5, kra! erut,
nausea, vo!iting,
de!a!, sakit keala
dehidrasi T'$S %oloni kuning %oloni hi<au biru
2ntibiotik Tetrasiklin Tetrasiklin,chlora! enikol
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Campylobacter )e)uni
• /a! Sirillaceae
• astroenteritis akut
• /aktor virulensi0 invasif
• T40 (ritro!isin, a!inoglikosida,tetrasiklin, chlora!enikol
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*elicobacter pylori
• /a!ili +elicobacteriaceae
• /aktor virulensi0 urease & !otilitas
• ;isease0 gastritis akut & kronis,etic ulcer, kanker gaster,! gastricM2LT ly!ho!a, (R;.
• T40 $is!uth, Metranida#ol, Tetrasiklin, 2!o4icillin,eritro!isin,chlora!enicol
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Bordetella pertussis
• ra! 5, kokobasil
• obligat aerob, kec. B. petrii
• )on !otil
• ertussis to4in K? c2M naik• +e!aglutinin
• $atuk re<an
• ;40 swab nasofaring, !edia $ordet5engou & Regan Lowe
• T40 (rythro!ycin
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Legionella pneumophila
• ra! 5, batang
• neu!onia legionnaires disease3 &ontiac fever
• /resh water, 2ir conditioner
• T40 * a#itro!isin, Guorouinolon,rifa!isin
*aemophilus sp
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*aemophilus sp.'pesies %aktor %aktor )
+. inGuen#a - -
+. ducreyi 5 -
*. in+uen,a
• -ram –
• ;isease0 !eningitis, neu!onia, baktere!ia,cellulitis, eiglotitis, erikarditis
• T40 a!icillin, chlora!henicol, tetracyclines,cefota4i!e, ceftria4one, co5a!o4iclav,
ciroGo4acin, a#ithro!ycin, & clarithro!ycin.*. ducreyi
•. ;isease0 Ulkus !olle, soft chancre K? nyeri, teitidak rata, !udah berdarah, dasar tidak bersih.
•. T40 Streto!ycin, 'hlortetracyclin, Sulfona!id
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eisseria sp
• eisseria gonorrhoeae
• eisseria meningitidis
• eisseria lactamica
• eisseria sicca
• eisseria sub+ava
• eisseria dentri/cans
• eisseria mucosa
• eisseria cinerea
• eisseria +avescens
• eisseria elongata
• Branhamella0Mora!ella catarrhalis
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eisseria gonorrhoeae
• Struktur – ;ilococcus gra! negatif. ntracellular
ada sel M). Seerti bi<i koi. Tidak
!otil. $erkasul ada isolat tubuh. ili-3
– Mikroaero6lik
– @ksidase -3
– Tes gula
– L@S liooligosaccharide3, RM, @a, or
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eisseria gonorrhoeae
– (ide!iologi• Trans!isi !elalui kontak seksual
– %linis0
• rostatitis, (idydi!itis• *aginitis, cervicitis, salhingitis, ; elvic
inGa!!atory disease3, ectoic regnancy
• ;isse!ination0 arthritis, der!atitis
• )eonatus0 ohthal!ia neonatoru!
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eisseria gonorrhoeae
– ;iagnosis• Mikroskoi, kultur, bioki!ia, serologi
• Sa!le0 urethral discharge
– Terai• 'ehalosorin gen
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eisseria gonorrhoeae
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eisseria meningitidis
– Struktur• ;ibedakan dari gonoccocus dengan tes gula.
ada !eningococcus glukosa -3 dan!altosa -3. ada gonococcus hanya
glukosa
• 'asule
• (ndoto4in
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eisseria meningitidis
– (ide!iologi• Trans!isi oleh sekret resiratori
• 2nak7 di bawah 9 tahun. @rang dewasa dgnkelainan siste! ko!le!en
– %linis• Meningitis
• Iaterhouse5/riderichsen
syndro!eD!eningococce!ia
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eisseria meningitidis
– ;iagnosis• ;arah, 'S/, sekret nasofaring !ikroskoi,
kultur
–
Terai• enicillin
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1reponema pallidum
– Struktur• Sirochete. Tidak daat diwarnai gra!.
;ilihat dengan dark 6eld. Motil
• Sulit dikultur.
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1reponema pallidum
• (ide!iologi – nfeksi ST; aling u!u! ketiga setelah
chla!ydia dan gonococcus
• %linis – ri!ary syhilis0 chancre ainless ulcer
– Secondary syhilis0 condylo!a lata
– Tertiary syhilis0 gu!!a. )euro and
cardiosyhilis – 'ongenital syhilis0 !ultiorgan. teeth &
bone
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1reponema pallidum
• ;iagnosis – Mikroskoi. %ultur 53
– ;eteksi antibodi• )ontreone!al test *;RL, RR• Treone!al test/T252$S, T52
• Terai
– enicillin
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Bacterial vaginosis
• Struktur – $atang leo!or6k 8.9 ! 1.957.93
!. ra! negatif > variable. 'lub for!s
> !etachro!atic granules > sering -3 – )on !otil
– %asul 53
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Bacterial vaginosis
• (ide!iologi – enital tract !anusia
– Urinary tract !anusia
• %linis – *aginosis0 +. /luor albus D Leukorea D
%eutihan
– Thin, gray, and ho!ogeneous – ;;0 gonococcus, tricho!onas, candida
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Bacterial vaginosis
• ;iagnosis – enital discharge !ikroskoi, kultur
• Terai – Metronida#ole
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Chlamydia sp
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Chlamydia sp
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2ic%ettsia sp
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2ic%ettsia sp