review uts mikro

8/16/2019 Review UTS Mikro

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Review UTS Mikro



Referensi

• Murray, Rosenthal, Levinson. MedicalMicrobiology 11th edition.

• Rosenthal & Tan, MedicalMicrobiology & !!unology

• Levinson, Medical Microbiology &!!unology

• "awet#, Melnick & adelberg, MedicalMicrobiology



$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



ra! -

Rosenthal & Tan, Ra id Review Microbiolo &



ra! ositive cocci

'atalase

ositif )egatif

StretococcusStahylococcus



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,




• (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!




• ;iagnosis dan terai0 – Mikroskoi, kultur, u<i bioki!ia

– ;rainage dan incision untuk infeksi

yogenik

– MRS2 *anco!ycin




• 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



.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



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



Stretococci



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



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



S. pyogenes

• ;iagnosis0 – Mikroskoi, kultur, deteksi antigen,

sensitivitas antibiotik, u<i bioki!ia

– Titer 2S@

• Terai0 – enicillin *



S. pyogenes



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



ra! ositive $acil



$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



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



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



Bacillus anthracis

• ;iagnosis and theray0 – us, blood, sutu!

– 'ulture0 not hemolytic, in contrast

with B. Cereus – (LS2

– Treat!ent0 'iroGo4acin, enicillin -

enta!ycinDstreto!ycin



Bacillus cereus

• astroenteritis

• @cular infections

•

Severe ul!onary disease



'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



Clostridium tetani



Clostridium botulinum



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




• (ide!iologi dan !anifestasi klinis0 – +anya !enyerang !anusia !elalui

drolet resiratori

– )yeri tenggorokan, fever,seudo!e!bran, bullneck

– rregular cardiac ryth! kerusakan otot

<antung3




• ;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



Listeria monocytogenes

• /isiologi dan Struktur0 – ra! ositif, cocobacil, tumbling

motility

– Susunan alisading – ntraseluler fakultatif

– /aktor virulensi0 listeriolysin @,

internalin, 2ct2 rotein




• (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




• ;iagnosis dan terai0 – ;arah atau 'S/. %ultur cold enrich!ent

ada agar darah. ;; dengan

Corynebacterium – Terai0 enicillin, a!icillin, genta!ycin



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%



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



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



ra! 5



(nterobacteriaceae

/akultatif anaerob

%atalase -@ksidase >Reduksi nitrat2ntigen0 %, +, @



(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



/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



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



Campylobacter )e)uni

• /a! Sirillaceae

• astroenteritis akut

• /aktor virulensi0 invasif

• T40 (ritro!isin, a!inoglikosida,tetrasiklin, chlora!enikol



*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



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



Legionella pneumophila

• ra! 5, batang

• neu!onia legionnaires disease3 &ontiac fever

• /resh water, 2ir conditioner

• T40 * a#itro!isin, Guorouinolon,rifa!isin

*aemophilus sp



*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



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



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




– (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!




– ;iagnosis• Mikroskoi, kultur, bioki!ia, serologi

• Sa!le0 urethral discharge

– Terai• 'ehalosorin gen



eisseria meningitidis

– Struktur• ;ibedakan dari gonoccocus dengan tes gula.

ada !eningococcus glukosa -3 dan!altosa -3. ada gonococcus hanya

glukosa

• 'asule

• (ndoto4in




– (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




– ;iagnosis• ;arah, 'S/, sekret nasofaring !ikroskoi,

kultur

–

Terai• enicillin



1reponema pallidum

– Struktur• Sirochete. Tidak daat diwarnai gra!.

;ilihat dengan dark 6eld. Motil

• Sulit dikultur.



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



1reponema pallidum

• ;iagnosis – Mikroskoi. %ultur 53

– ;eteksi antibodi• )ontreone!al test *;RL, RR• Treone!al test/T252$S, T52

• Terai

– enicillin



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



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



Bacterial vaginosis

• ;iagnosis – enital discharge !ikroskoi, kultur

• Terai – Metronida#ole



Chlamydia sp



2ic%ettsia sp

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