4 patogenesitas
TRANSCRIPT
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Bakteri sebagai Bakteri sebagai agen infeksiagen infeksi
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Definisi Definisi • Definisi-definisi
Adherence pelekatan(adhesion, attachment): proses dimana potongan bakteri melekat pada permukaan sel inang.
Infeksi adalah multifikasi agen yang bersifat infeksius di dalam tubuh.
Multifikasi bakteri—flora normal pada saluran gastrointestinal, kulit, umumnya bukan suatu infeksi.
Multifikasi bakteri patogenik (mis. Salmonella sp.), dalam tubuh, walaupun tidak menimbulkan gejala/simptom dianggap infeksi.
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Karier: orang atau hewan dengan infeksi tanpa gejala/simptom yang dapat ditularkan dengan mudah kepada orang/hewan lain.
Invasi: proses dimana bakteri, parasit hewan, fungi, virus masuk ke dalam sel inang atau jaringan dan menyebar dalam tubuh.
Non-patogen: mikroorganisame yang tidak menyebabkan penyakit (flora normal)
Patogen: mikroorganisame yang dapat menyebabkan penyakit.
Patogenesitas: kemampuan agen infeksius yang menyebabkan penyakit.
Toksigenesitas: kemampuan suatu organisme menghasilkan toksin yang mengkontribusi perkembangan penyakit.
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Virulensi: kemampuan secara kuantitatif suatu agen (mikroorganisme) yang menyebabkan penyakit. Agen yang virulen menyebabkan penyakit jika masuk ke dalam inang dalam jumlah kecil. Virulensi melibatkan invasi dan toksigenesitas.
Kolonisasi: bila suatu bakteri yang ada terus menerus di dalam tubuh dan tidak menyebabkan penyakit.
Contoh: resident microflora
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Faktor virulensi bakteri Faktor virulensi bakteri
• 1. Adherence• 2. Capsule• 3. Enzymes
– A. leukocidins– B. Hemolysins– C. Coagulase– D. Kinases– E. Hyaluronidase– F. Collagenase– G. Necrotizing Factor
• 4. toxin• 5. Ability to survive inside phagocytic cells
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1. Adherence – hampir semua patogen harus dapat melekat pada jaringan host
Patogen memiliki Binding Sites
adhesins
ligands
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Adhesins and ligands Adhesins and ligands umumnya berada pada pili umumnya berada pada pili
atau Fimbriaeatau Fimbriae
• Neisseria gonorrhoeae• ETEC
(Entertoxigenic E. coli)• Bordetello pertussis
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2. Capsules2. Capsules• Mencegah fagositosis• untuk menempel
– Streptococcus pneumoniae
– Klebsiella pneumoniae– Haemophilus influenzae– Bacillus anthracis– Streptococcus mutans– Yersinia pestis
K. pneumoniae
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3. Enzymes3. Enzymes
• Beberapa patogen menghasilkan enzim untuk meningkatkan patogenesitasnya– Leukosidin– Hemolisin– Koagulase– Kinase– Hyaluronidase– kolagenase
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A. LeukocidinsA. Leukocidins
• 1. merusak lekosit sehingga mencegah fagositosis
• 2. releases & ruptures lysosomes– lysosomes - contain powerful
hydrolytic enzymes which then cause more tissue damage
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B. Hemolysins – melisis eritrosit
Streptococci
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1. Alpha Hemolytic Streptococci
- secrete hemolysins that cause the incomplete lysis or RBC’s
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2. Beta Hemolytic Streptococci
- secrete hemolysins that cause the complete lysis of RBC’s
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C. Coagulase – C. Coagulase – menyebabkan menyebabkan pembekuan darahpembekuan darah
• Blood clots protect bacteria from phagocytosis from WBC’s and other host defenses
• Staphylococci - are often coagulase positive– abscesses
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D. Kinases - D. Kinases - enzim yang enzim yang melarutkan darah bekumelarutkan darah beku
• 1. Streptokinase - Streptococci• 2. Staphylokinase - Staphylococci
• Helps to spread bacteria - Bacteremia
• Streptokinase – digunakan untuk mencairkan/melarutkan sumbatan darah beku dalam jantung (Heart Attacks due to obstructed coronary blood vessels)
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E. HyaluronidaseE. Hyaluronidase• Breaks down Hyaluronic acid (found in
connective tissues)
• “Spreading Factor”
• mixed with a drug to help spread the drug thru a body tissue
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F. CollagenaseF. Collagenase• Breaks down collagen (found in many
connective tissues)
• Clostridium perfringens - Gas Gangrene– uses this to spread thru muscle tissue
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TOKSINTOKSIN
• Senyawa yang dihasilkan oleh (bakteri) yang bersifat toksik (beracun)
• Biasanya merupakan protein• Protein:
– antigenik tinggi, – BM besar, – struktur kompleks
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ToxinsToxins• toxins - primary factor -
pathogenicity• 220 known bacterial toxins
– 40% cause disease by damaging the Eukaryotic cell membrane
• Toxemia – Toxins yang masuk dan berada
dalam darah
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Toksin Toksin • Dibagi atas: eksotoksin dan endotoksin• Eksotoksin: toksin yang diekskresikan
keluar– Sitotoksin– Neurotoksin– enterotoksin
• Endotoksin: toksin yang merupakan bagian integral dari dinding sel bakteri gram negatif dan tidak diekskresikan keluar
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Perbedaan relatif eksotoksin & endotoksinPerbedaan relatif eksotoksin & endotoksin
-Sekret sel hidup, konsentrasi tinggi pada medum cair
-Dihasilkan oleh bakteri gram + & -
-Polipeptida, BM 104 – 9.105
-Labil, rusak pada suhu 60°C-Antigeniknya tinggi, menstimulasi pembentukan antibodi-Toksisitas tinggi, fatal bagi hewan dalam jumlah besar-Biasanya berikatan dengan reseptor spesifik di dalam sel-Tidak menunjukkan gejala demam
-Diubah menjadi antigenik, toksoid dengan formalin, asam, panas
-Bagian integral dinding sel bakteri gram -, dilepas seluruhnya pada bakteri yang mati -Dihasilkan oleh bakteri gram –
-Lipopolisakarida kompleks,
-Stabil-Immunogenik lemah
-Toksisitas sedang
-Tidak ada resetor spesifik
-Menunjukkan gejala demam, IL-1
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ENDOTOKSINENDOTOKSIN
• Merupakan lipopolisakarida yang berintegrasi dengan komponen membran luar bakteri gram negatif
• Dilepaskan hanya bila sel mengalami lisis
• Menimbulkan shock dan inflamasi
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ExotoxinsExotoxins• Mostly seen in Gram (+) Bacteria
• Umumnya gen yang mengkode eksotoksin berada plasmids or phages
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Response to ToxinsResponse to Toxins• Jika terekspos eksotoksin : tubuh akan
mengeluarkan antibodi untuk melawan toksin tersebut (antitoxins)
• Eksotoksin inaktif ( heat, formalin or phenol) tidak lagi menyebabkan penyakit, tetapi masih dapat menstimulasi produksi antitoksin– altered exotoxins - Toxoids
• Toxoids - diinjeksikan untuk menstimulasi produksi antitoksin dan menimbulkan imunitas
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Diseases caused by Diseases caused by NeurotoxinsNeurotoxins
• Botulism – Clostridium botulinum
• Gram (+), anaerobic, spore-forming rod, found in soil
– works at the neuromuscular junction– prevents impulse from nerve cell to
muscle cell– results in muscle paralysis
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Tetanus (Lock Jaw)Tetanus (Lock Jaw)• Clostridium tetani• Gram (+), spore-forming, anaerobic rod• neurotoxin acts on nerves, resulting in the
inhibition of muscle relaxation• tetanospasmin - “spasms” or “Lock Jaw”
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Diseases caused by Diseases caused by EnterotoxinsEnterotoxins
• Cholera– Vibrio cholerae– Gram (-) comma
shaped rods
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EHEC (Enterohemorrhagic E. EHEC (Enterohemorrhagic E. coli)coli)
• E. coli (0157:H7)• enterotoxin causes a hemolytic
inflammation of the intestines• results in bloody diarrhea
– Toxin• alters the 60S ribosomal subunit• inhibits Protein Synthesis• Results in cell death• lining of intestine is “shed”• Bloody Diarrhea (Dysentary)
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5. Ability to survive inside phagocytic cells5. Ability to survive inside phagocytic cells
• Mycobacterium tuberculose• Legionella pneumophila
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BAKTERIOLOGI KLINISBAKTERIOLOGI KLINIS
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• Staphylococcus sp• Streptococcus sp
Gram Positive CocciGram Positive Cocci
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StaphylococcusStaphylococcus• S. aureus, S. epidermidis, S. saprophyticus• S. aureus
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StreptococcusStreptococcus
• S. viridans– oral flora– infective endocarditis
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S. pyogenesS. pyogenes• Group A, beta hemolytic strep• pharyngitis, cellulitis• rheumatic fever
• fever• migrating polyarthritis • carditis• immunologic cross reactivity
• acute glomerulonephritis• edema, hypertension, hematuria• antigen-antibody complex
deposition
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S. pneumoniaeS. pneumoniae
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Gram Negative CocciGram Negative Cocci• Neisseria
– meningitidis– gonorrhea
• Moraxella catarrhalis
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Gram Positive BacilliGram Positive Bacilli
• Clostridium• Bacillus• Corynebacterium• Listeria• Actinomyces• Nocardia
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Clostridium tetaniClostridium tetani
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Clostridium botulinumClostridium botulinum• Descending weakness-->paralysis• diplopia, dysphagia-->respiratory failure
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Clostridium perfringensClostridium perfringens
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Corynebacterium Corynebacterium diphtheriaediphtheriae
• Fever, pharyngitis, cervical LAD• thick, gray, adherent membrane• sequelae-->airway obstruction,
myocarditis• colony morphology
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ActinomycesActinomyces
• Part of normal oral cavity flora• 50% of infections occur in face &
neck• forms abscesses with sulfur granules
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NocardiaNocardia
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Gram Negative BacilliGram Negative Bacilli• Facultative
Anaerobes– Respiratory
– Haemophilus– Bordetella– Legionella
– Zoonotic– Yersinia– Francisella– Pastuerella
– Enteric– Klebsiella– Serratia– Proteus– Enterobacter
• Strict Aerobes– Pseudomonas
• Anaerobes– Bacteroides
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Anaerobic BacteriaAnaerobic Bacteria
• Bacteroides• Fusobacterium• Peptostreptococc
us• Actinomyces• Prevotella
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EnterobacteriaceaeEnterobacteriaceae
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H. influenzaeH. influenzae
RespiratoryHaemophilusBordetellaLegionella
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LegionellaLegionella• Community and Nosocomial pneumonia• contaminated water sources
RespiratoryHaemophilusBordetellaLegionella
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B. pertussisB. pertussis
RespiratoryHaemophilusBordetellaLegionella
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PseudomonasPseudomonas
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Zoonotic Gram Negative RodsZoonotic Gram Negative Rods
• Yersinia– plague
• Franciscella– tularemia
• Pasturella– dog/cat bites
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SpirochetesSpirochetes• Treponema • Borrelia
• Leptospira
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Manifestations of SyphilisManifestations of Syphilis
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Leptospirosis Leptospirosis • Leptospirosis adalah penyakit
zoonosis yang menginfeksi manusia dan menunjukkan manifestasi klinik beragam dengan tingkat keparahan mulai dari akut – kronik dengan sindrom multiorgan hingga dapat berakibat fatal.
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LeptospiraLeptospira
• bakteri spiroketa gram negative• panjang 5 – 25 μm, diameter 0.1 μm
– 0.3 μm• Terdapat flagella periplasmic,
dengan struktur protein kompleks. • Lipopolisakarida Leptospira mirip
dengan bakteri gram negative lain tetapi memiliki aktivitas endotoksin lebih lemah.
Morfology Morfology
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LeptospiraLeptospira
• Secara tradisional , genus Leptospira L.interrogans---strain patogen L.biflexa ---strain safrofit
Klasifikasi Klasifikasi
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3 pola epidemiologi (Faine)• Leptospirosis pada daerah beriklim sedang
infeksi pada manusia terjadi karena kontak langsung dengan hewan terinfeksi. Kontrol dapat dilakukan melalui imunisasi hewan dan juga manusia .
• Leptospirosis pada daerah tropis basah infeksi menyeluruh dengan sumber penularan yang berasal dari lingkungan.
• Leptospirosis dengan sumber penularan hewan pengerat melalui lingkungan di perkotaan, terutama saat terjadi bencana alam seperti angin topan, banjir.
Epidemiologi Epidemiologi
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M. tuberculosisM. tuberculosis• Pulmonary disease (82%)• Extrapulmonary disease (18%)
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M. tbM. tb
• Kuman ini disebut juga basil dari koch.• Dapat menyebabkan penyakit tuberculosis
• Collins, Jates dan Granse (1982) membagi 5 varian Mycobacterium tuberculosis untuk tujuan epidemiologi:
- M. tuberculosis var. human (TBC manusia)- M. tuberculosis var. bovine (TBC lembu)- M. tuberculosis var. human Asian (TBC manusia Asian)- M. tuberculosis var. African I (M. africanum, Afrika
Barat)- M. tuberculosis var. African II (M. africanum, Afrika
Timur)
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HabitatHabitat• Hampir seluruh organ dapat
diserang oleh bakteri Mycobacterium tuberculosis seperti usus, tulang, dan juga kulit tetapi yang paling banyak diserang adalah paru-paru.
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• Mtb bersifat obligat aerob • Dalam es (keadaan dingin) bakteri ini
dapat bertahan selama bertahun-tahun, berada dalam keadaan dormant (tidak aktif).
• Di dalam jaringan Mtb hidup sebagai parasit intraseluler, yakni dalam sitoplasma makrofag.
• Makrofag yang tadinya memfagositasi, lebih disenangi Mtb sebagai tempat hidupnya karena mengandung banyak lipid.
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Daya tahanDaya tahan
• Suhu 60 – 650C → mati• Fenol 5% 24 jam → mati• Debu → hidup 8 – 10 hari• Sinar matahari 2 jam → mati• Dahak kering → hidup 20 – 30
jam
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M. lepraeM. leprae
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TugasMembuat daftar bakteri dan
penyakitnyaMis:Clostridium tetani tetanus