7/30/2019 Streptococci Aak

1/33

STREPTOCOCCI

7/30/2019 Streptococci Aak

2/33

Streptococci

facultative anaerobe

Gram-positive

chains or pairs

catalase negative

(staphylococci are catalase positive)

7/30/2019 Streptococci Aak

3/33

Streptococcusin chains

7/30/2019 Streptococci Aak

4/33

Streptococcu s pneumoniae(diplococcus). Fluorescent stain

7/30/2019 Streptococci Aak

5/33

StreptococciLancefield groups

*Satu atau lebih spesies per group*antigen permukaan

7/30/2019 Streptococci Aak

6/33

groupablestreptococci

A, B and D

most important C, G, F

rare

7/30/2019 Streptococci Aak

7/33

Non-groupable

S. pneumoniae

pneumonia

viridans streptococci

e.g. S. mutans* dental caries

7/30/2019 Streptococci Aak

8/33

hemolysis reaction - sheep blood

agar

(alpha)

partial hemolysis

green color

(beta)

complete clearing

A and B

(gamma)

no lysis

7/30/2019 Streptococci Aak

9/33

Hemolysis

Groups A an B

Group D or

S. pneumoniaeand viridans

7/30/2019 Streptococci Aak

10/33

hemolysis reaction + one characteristic

presumptive identification

7/30/2019 Streptococci Aak

11/33

Group A streptococcus(S.

pyogenes)

7/30/2019 Streptococci Aak

12/33

Group A streptococcal

menginfeksi semua umur

Insiden tertinggi pd usia 5-15thn

7/30/2019 Streptococci Aak

13/33

S. pyogenes -suppurat ive

non-invasive

pharyngitis

Infeksi kulit, impetigo

invasive bacteremia

toxic shock-like syndrome

"flesh eating" bacteriapyrogenic toxin

7/30/2019 Streptococci Aak

14/33

Pyrogenic toxin

superantigen

T cell mitogen

Mengaktifkan sistem imun

7/30/2019 Streptococci Aak

15/33

Scarlet fever

rash

erythrogenic toxin

7/30/2019 Streptococci Aak

16/33

non-suppurative

rheumatic fever inflammatory disease

life threatening

Sekuel kronik

demam

jantung

sendi rheumatic tidak sama dengan

rheumatoid arthritis

7/30/2019 Streptococci Aak

17/33

Rheumatic fever -etiology

M protein

cross-reacts heart myosin

autoimun

Antigen dinding sel

sedikit dicerna in v ivo

bertahan lama

7/30/2019 Streptococci Aak

18/33

Rheumatic fever

penicillin

- menyembuhkan pharyngitis

- Menurunkan resiko carditis

7/30/2019 Streptococci Aak

19/33

Acute glomerulonephritis

immune complex disease of kidney

7/30/2019 Streptococci Aak

20/33

Major pathogenesis factors

lipoteichoic acid/F protein

fimbriae

binds to epithelial cells

M protein

anti-phagocytic

7/30/2019 Streptococci Aak

21/33

M protein

major target

Imunitas alami

strain variation

antigenicity

re-infection

Terjadi dengan strain yg berbeda

7/30/2019 Streptococci Aak

22/33

Capsules

Anti-phagocytic

mucoid strains

7/30/2019 Streptococci Aak

23/33

Isolation and identification

hemolytic colonies

bacitracin menghambat

pertumbuhan

hemolytic colonies

group A antigen

7/30/2019 Streptococci Aak

24/33

hemolysis

hemolysin O

Sensitif oksigen

hemolysin SNon sensitive oksigen

7/30/2019 Streptococci Aak

25/33

Post-infectious diagnosis

(serology)

Antibodi thd streptolysin O

Penting! Bila menetap sekuel

kronik terjadi

7/30/2019 Streptococci Aak

26/33

M

T

R

Serotyping

7/30/2019 Streptococci Aak

27/33

Group B streptococcus

neonatal meningitis

septicemia

transmission vaginal flora

7/30/2019 Streptococci Aak

28/33

Group B streptococcus -

identification hemolysis

hippurate hydrolysis

CAMP reactionmeningkatkan hemolisis S. aureus

7/30/2019 Streptococci Aak

29/33

Group D streptococcus

Tumbuh pada bile esculin agar

precipitasi hitam

6.5% salin

Tumbuh

enterococci

Tidak tumbuh

non-enterococci

7/30/2019 Streptococci Aak

30/33

Enterococci

Hubungannya agak jauh dr streptococcilain

genus Enterococcus Flora usus

urinary tract infection Kontaminasi dr anus

opportunistic infections khususnya endocarditis

Paling sering E. (S.) faecalis

7/30/2019 Streptococci Aak

31/33

Enterococci

resisten thd banyak antibiotik

termasuk vancomycin

ujung D-ala diganti dengan D-lactat

7/30/2019 Streptococci Aak

32/33

Minute colony streptococciVarious groups (e.g. group A)

berbeda scr genetik

* koloni yg besar (e.g. S. pyogenes)

tdk ada demam rheuma

Koloni besar Koloni kecil

7/30/2019 Streptococci Aak

33/33

Viridans streptococci diverse species

oral

Karies gigi

hemolytic dan negatif thd tes lain

non-groupable.

termasuk S. mutans

endocarditis

cabut gigi