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Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
Altamash classification & staphylococci
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Altamash classification & staphylococci

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  • MRSA/Staph is often misdiagnosed as spider or insect bites . • MRSA/Staph spreads by infected skin to healthy skin contact as well as infected objects to healthy skin. It can enter healthy, clean, undamaged skin through such contact. • Washing your hands with soap and warm water can prevent the spread of MRSA/Staph. • MRSA/Staph lives on skin and survives on objects, such as towels and exercise equipment for 24 hours or longer. • If you think you may have MRSA/Staph, consult your doctor or healthcare provider. • For all skin infections, dispose of bandages properly and wash your hands frequently to avoid spreading germs to others.
  • Transcript

    • 1. SYSTEMIC BACTERIOLOGY
    • 2. CLASSIFICATION OF BACTERIA
    • 3. <ul><li>TAXONOMY </li></ul><ul><li>Includes </li></ul><ul><li>Classification </li></ul><ul><li>Identification </li></ul><ul><li>Nomenclature </li></ul>
    • 4. <ul><li>CLASSIFICATION </li></ul><ul><li> Is the arrangement of organisms into taxonomic groups on the basis of similarities or relationships (i.e. common properties). </li></ul><ul><li>IDENTIFICATION: </li></ul><ul><li> Is the practical use of a classification scheme to : Isolate & identify the causative agent of a disease. </li></ul><ul><li>NOMENCLATURE </li></ul><ul><li> Is naming of an organism by international rules according to its characteristics. Genera – Species – Sub species . </li></ul>
    • 5. CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA BACTERIA RIGID THICK-WALLED CELLS FLEXIBLE, THIN-WALLED CELLS WALL-LESS CELLS
    • 6. CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA RIGID THICK-WALLED CELLS FREE LIVING (EXTRACELLULAR ) NON FREE LIVING (OBLIGATE INTRACELLULAR PARASITES)
    • 7. FREE LIVING BACTERIA GRAM POSITIVE BACTERIA GRAM NEGATIVE BACTERIA ACID-FAST BACTERIA COCCI <ul><ul><li>RODS </li></ul></ul>SPOREFORMING NONSPOREFORMING COCCI RODS
    • 8. TETANUS CLOSTRIDIA (b)ANAEROBIC ANTHRAX BACILLUS (a) AEROBIC SPORE FORMING RODS (AEROBIC/ ANAEROBIC) RODS (SPORE FORMING RODS/ NON SPORE FORMING RODS) PNEUMONIA, PHARYNGITIS CELLULITIS STREPTOCOCCI ABSCESS SKIN & OTHER ORGANS STAPHYLOCOCCI COCCI DISEASE GENUS CHARACTERISTICS GRAM POSITIVE BACTERIA (COCCI/ RODS) CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA
    • 9. GONORRHEA MENINGITIS NEISSERIA COCCI GRAM NEGATIVE BACTERIA (COCCI/RODS) NOCARDIOSIS NOCARDIA ACTINOMYCOSIS ACTINOMYCES FILAMENTOUS MENINGITIS LISTERIA DIPHTHERIA CORYNEBACTERIUM NON FILAMENTOUS NON-SPORE FORMING RODS CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA
    • 10. BRUCELLOSIS BRUCELLA <ul><li>ZOONOTIC </li></ul><ul><li>ORGANISMS </li></ul>LEGIONELLA PNEUMONIA WHOOPING COUGH BORDETELLA MENINGITIS HAEMOPHILUS <ul><li>RESPIRATORY </li></ul><ul><li>ORGANISMS </li></ul>STRAIGHT RODS ( RESPIRATORY/ZOONOTIC/ENTERIC) DISEASE GENUS CHARACTERISTICS ANAEROBIC RODS AEROBIC RODS FACULTATIVE RODS (STRAIGHT/ CURVED) GRAM NEGATIVE RODS
    • 11. PNEUMONIA KLEBSIELLA ENTEROCOLITIS TYPHOID SALMONELLA UTI ENTEROBACTER UTI, DIARRHEA ESCHERICHIA <ul><li>ENTERIC & RELATED ORG. </li></ul>PLAGUE YERSINIA CELLULITIS PASTEURELLA TULAREMIA FRANCISELLA ZOONOTIC DISEASE GENUS CHARACTERISTIC
    • 12. TB, LEPROSY MYCOBACTERIUM ACID FAST BACTERIA PERITONITIS BACTEROIDES ANAEROBIC RODS UTI, PNEUMONIA PSEUDOMONAS AEROBIC RODS CHOLERA VIBRIO GASTRITIS, PEPTIC ULC HELICOBACTER ENTROCOLITIS CAMPYLOBACTER CURVED F. RODS DISEASE GENUS CHARACTERISTC
    • 13. CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA RIGID THICK-WALLED CELLS FREE LIVING (EXTRACELLULAR ) NON FREE LIVING (OBLIGATE INTRACELLULAR PARASITES)
    • 14. URETHRITIS, TRACHOMA, PSITTACOSIS CHLAMYDIA ROCKY MOUNTAIN SPOTTED FEVER RICKETSSIA DISEASE GENUS CHARACTERISTIC NON FREE LIVING (OBLIGATE INTRACELLULAR PARASITES)
    • 15. CLASSIFICATION OF MEDICALLY IMPORTANT BACTERIA BACTERIA RIGID THICK-WALLED CELLS FLEXIBLE, THIN-WALLED CELLS WALL-LESS CELLS
    • 16. LYME DISEASE BORRELIA LEPTOSPIROSIS LEPTOSPIRA SYPHILIS TREPONEMA DISEASE GENUS FLEXIBLE, THIN WALLED CELLS (SPIROCHETES )
    • 17. PNEUMONIA MYCOPLASMA DISEASE GENUS WALL-LESS BACTERIA
    • 18. Definitions <ul><li>Epidemiology </li></ul><ul><ul><li>The study of the transmission of disease </li></ul></ul><ul><li>Communicable Disease </li></ul><ul><ul><li>A disease that can be transmitted from one individual to another </li></ul></ul><ul><li>Contagious Disease </li></ul><ul><ul><li>A communicable disease that is easily spread from one individual to another </li></ul></ul><ul><li>Noncommunicable Disease </li></ul><ul><ul><li>A disease that is not transmitted from one individual to another </li></ul></ul>
    • 19. III. A. Definitions <ul><li>Epidemic Disease </li></ul><ul><ul><li>A disease condition present in a greater than usual percentage of a specific population </li></ul></ul><ul><li>Pandemic Disease </li></ul><ul><li>Endemic Disease </li></ul><ul><ul><li>A disease condition that is normally found in a certain percentage of a population </li></ul></ul><ul><ul><li>An epidemic affecting a large geographical area; often on a global scale </li></ul></ul>
    • 20. III. A. Definitions <ul><li>Reservoir of Infection </li></ul><ul><ul><li>The source of an infectious agent </li></ul></ul><ul><li>Carrier </li></ul><ul><ul><li>An individual who carries an infectious agent without manifesting symptoms, yet who can transmit the agent to another individual </li></ul></ul><ul><li>Fomites </li></ul><ul><ul><li>Any inanimate object capable of being an intermediate in the indirect transmission of an infectious agent </li></ul></ul>
    • 21. III. A. Definitions <ul><li>Animal Vectors </li></ul><ul><ul><li>An animal (nonhuman) that can transmit an infectious agent to humans </li></ul></ul><ul><ul><li>Two types: mechanical and biological </li></ul></ul><ul><ul><ul><li>Biological animal vectors: The infectious agent must incubate in the animal host as part of the agent’s developmental cycle; eg, the transmission of malaria by infected mosquitoes </li></ul></ul></ul><ul><ul><ul><li>Mechanical animal vectors: The infectious agent is physically transmitted by the animal vector, but the agent does not incubate or grow in the animal; eg, the transmission of bacteria sticking to the feet of flies </li></ul></ul></ul>
    • 22. GRAM POSITIVE COCCI <ul><li>GENUS </li></ul><ul><li>STAPHYLOCOCCI </li></ul><ul><li>STREPTOCOCCI </li></ul><ul><li>GENERAL PROPERTIES </li></ul><ul><li>NON MOTILE, NON SPORE-FORMING </li></ul><ul><li>STAPHYLOCOCCI: CATALASE POSITIVE </li></ul><ul><li>IN CLUSTER </li></ul><ul><li>STREPTOCOCCI : CATALASE NEGATIVE </li></ul><ul><li>IN CHAINS </li></ul>
    • 23. STAPHYLOCOCCI
    • 24. INTRODUCTION <ul><li>Staphyloccocci - derived from Greek “stapyle” (bunch of grapes) </li></ul><ul><li>Gram positive cocci arranged in clusters </li></ul><ul><li>Hardy organisms surviving many non physiologic conditions </li></ul><ul><li>Include a major human pathogen and skin commensals </li></ul>
    • 25.  
    • 26. Grouping for Clinical Purposes <ul><li>1. Coagulase positive Staphylococci </li></ul><ul><ul><li>Staphylococcus aureus </li></ul></ul><ul><li>2. Coagulase negative Staphylococci </li></ul><ul><ul><li>Staphylococcus epidermidis </li></ul></ul><ul><ul><li>Staphylococcus saprophyticus </li></ul></ul>
    • 27. A. Staphylococcus aureus <ul><li>Major human pathogen </li></ul><ul><li>Habitat - part of normal flora in some humans (nose , sometimes skin esp hospital staff and patients, vagina of 5% females) and animals </li></ul><ul><li>Source of organism - can be infected human host, carrier, fomite or environment </li></ul>
    • 28. DISEASES <ul><li>Due to direct effect of organism </li></ul><ul><ul><li>Local lesions of skin </li></ul></ul><ul><ul><li>Deep abscesses </li></ul></ul><ul><ul><li>Systemic infections </li></ul></ul><ul><li>Toxin mediated </li></ul><ul><ul><li>Food poisoning </li></ul></ul><ul><ul><li>toxic shock syndrome </li></ul></ul><ul><ul><li>Scalded skin syndrome </li></ul></ul>
    • 29. IMPORTANT PROPERTIES <ul><li>Gram positive cocci, arranged in clusters </li></ul><ul><li>Non spore forming, non motile </li></ul><ul><li>Catalase positive (breaks H2O2 into O2 & H2O) </li></ul><ul><li>S. aureus: Coagulase positive, Hemolytic, Ferments Mannitol. </li></ul><ul><li>Plasmid mediated Antibiotic resistance in S. aureus </li></ul><ul><li>Cell wall components of S. aureus </li></ul>
    • 30. Cell wall components & antigens of S.aureus <ul><li>Protein A (binds to Fc portion of Ig G at complement binding site) </li></ul><ul><li>Teichoic acid (adherence, antibody formation) </li></ul><ul><li>Microcapsule (11 serotypes) </li></ul><ul><li>Peptidoglycan has endotoxin-like properties. </li></ul>
    • 31. Factors predisposing to S. aureus infections <ul><li>Host factors </li></ul><ul><ul><li>Breach in skin </li></ul></ul><ul><ul><li>Chemotaxis defects </li></ul></ul><ul><ul><li>Opsonisation defects </li></ul></ul><ul><ul><li>Neutrophil functional defects </li></ul></ul><ul><ul><li>Diabetes mellitus </li></ul></ul><ul><ul><li>Presence of foreign bodies </li></ul></ul><ul><li>Pathogen Factors </li></ul><ul><ul><li>Catalase (counteracts host defences) </li></ul></ul><ul><ul><li>Coagulase </li></ul></ul><ul><ul><li>Hyaluronidase </li></ul></ul><ul><ul><li>Lipases (Imp. in disseminating infection) </li></ul></ul><ul><ul><li>B lactasamase(ass. With antibiotic resistance) </li></ul></ul>
    • 32. Factors predisposing to S. aureus infections <ul><li>Toxins produced by S. aureus </li></ul><ul><li>Enterotoxin </li></ul><ul><li>Toxic shock syndrome toxin (TSST is a super antigen) </li></ul><ul><li>Exfoliatin (epidermolytic) </li></ul><ul><li>Leucocidins </li></ul><ul><li>Alpha toxin (tissue necrosis) </li></ul><ul><li>Staphylokinase </li></ul>
    • 33. SKIN LESIONS (Pyogenic) <ul><li>Styes </li></ul><ul><li>Furuncles(infection of hair follicle) </li></ul><ul><li>Carbuncles (infection of several hair follicles) </li></ul><ul><li>Wound infections(progressive appearance of swelling and pain in a surgical wound after about 2 days from the surgery) </li></ul><ul><li>Impetigo(skin lesion with blisters that break and become covered with crusting exudate) </li></ul><ul><li>Cellulitis </li></ul>
    • 34. IMPETIGO
    • 35. SYMPTOMS OF STAPH INFECTIONS <ul><li>The symptoms of a staph infection depends on where the infection is. The staph bacteria can cause: </li></ul><ul><li>Boils – an abscess, bump, or swelling within the skin. Also called a furuncle. </li></ul>
    • 36. <ul><li>Cellulitis – a “flat” skin infection which can make the skin red, painful and warm but does not have pustules. </li></ul>
    • 37. <ul><li>Folliculitis – an infection of the hair follicles </li></ul>
    • 38. <ul><li>Impetigo – pustules (bulbous impetigo) or honey colored crusted lesions on the skin </li></ul>
    • 39.  
    • 40.  
    • 41. Staphylococcol Infection
    • 42. DEEP ABSCESSSES <ul><li>Can be single or multiple </li></ul><ul><li>Breast abscess can occur in 1-3% of nursing mothers in puerperium </li></ul><ul><li>Can produce mild to severe disease </li></ul><ul><li>Other sites - kidney, brain from septic foci in blood </li></ul>
    • 43. Systemic Infections <ul><li>1. With obvious focus </li></ul><ul><ul><li>Osteomyelitis, septic arthritis </li></ul></ul><ul><li>2. No obvious focus </li></ul><ul><ul><ul><li>heart (infective endocarditis) </li></ul></ul></ul><ul><ul><ul><li>Brain(brain abscesses) </li></ul></ul></ul><ul><li>3. Ass. With predisposing factors </li></ul><ul><ul><li>multiple abscesses, septicaemia (IV drug users) </li></ul></ul><ul><ul><li>Staphylococcal pneumonia (Post viral) </li></ul></ul>
    • 44. B. TOXIN MEDIATED DISEASES <ul><li>1. Staphylococcal food poisoning </li></ul><ul><ul><li>Due to production of entero toxins </li></ul></ul><ul><ul><li>Superantigen – IL-1 & 2 </li></ul></ul><ul><ul><li>heat stable entero toxin acts on gut </li></ul></ul><ul><ul><li>produces severe vomiting, non bloody diarrhea following a very short incubation period </li></ul></ul><ul><ul><li>Resolves on its own within about 24 hours </li></ul></ul>
    • 45. 2. Toxic shock syndrome <ul><li>High fever, diarrhoea, shock and erythematous skin rash which desquamate </li></ul><ul><li>Mediated via ‘toxic shock syndrome toxin’– super antigen </li></ul><ul><li>10% mortality rate </li></ul><ul><li>ass. With young women using tampones during menstruation & wound infection </li></ul>
    • 46.  
    • 47. 3. Scalded skin syndrome <ul><li>Disease of young children </li></ul><ul><li>Mediated through minor Staphylococcal infection by ‘epidermolytic toxin’ producing strains </li></ul><ul><li>Mild erythema and blistering of skin followed by shedding of sheets of epidermis </li></ul><ul><li>Children are otherwise healthy and most eventually recover </li></ul>
    • 48. S. aureus -- Kawasaki syndrome <ul><li>Unknown etiology </li></ul><ul><li>Vasculitis of medium & small sized arteries. </li></ul><ul><li>Strawberry tongue </li></ul>
    • 49. DIAGNOSIS <ul><li>1. In all pus forming lesions </li></ul><ul><ul><li>Gram stain and culture of pus </li></ul></ul><ul><li>2. In all systemic infections </li></ul><ul><ul><li>Blood culture </li></ul></ul><ul><li>3. In infections of other tissues </li></ul><ul><ul><li>Culture of relevant tissue or exudate </li></ul></ul>
    • 50. Diagnosis <ul><li>Gram Stain: Gram positive cocci in clusters </li></ul><ul><li>Yellowish colonies , b-hemolytic on Blood agar </li></ul><ul><li>Catalase and coagulase positive </li></ul><ul><li>Mannitol fermenter </li></ul>
    • 51. Antibiotic sensitivity pattern <ul><li>Very variable and not predictable </li></ul><ul><li>Very imp. In Pt. Management </li></ul><ul><li>Mechanisms </li></ul><ul><ul><li>1.B lactamase production - plasmid mediated </li></ul></ul><ul><ul><ul><li>Has made S. aureus resistant to penicillin group of antibiotics - 90% of S. aureus (Gp A) </li></ul></ul></ul><ul><ul><ul><li>B lactamase stable penicillins (cloxacillin, oxacillin, methicillin) used </li></ul></ul></ul><ul><ul><li>2. Alteration of penicillin binding proteins </li></ul></ul><ul><ul><ul><li>(Chromosomal mediated) </li></ul></ul></ul><ul><ul><ul><li>Vancomycin is the drug of choice </li></ul></ul></ul><ul><ul><ul><li>MRSA, NRSA, VISA </li></ul></ul></ul>
    • 52. <ul><li>Tested in lab using methicillin </li></ul><ul><li>Referred to as methicillin resistant S. aureus (MRSA) </li></ul><ul><li>Emerging problem in the world </li></ul><ul><li>In Sri Lanka prevalence varies from 20- 40% in hospitals </li></ul><ul><li>Drug of choice - vancomycin </li></ul><ul><li>In Japan emergence of VIRSA (vancomycin intermediate resistant S. aureus) </li></ul><ul><li>No effective antibiotics discovered -We might have to discover </li></ul>
    • 53. 2. Staphylococcus epidermidis <ul><li>Skin commensal </li></ul><ul><li>Has predilection for plastic material </li></ul><ul><li>Ass. With infection of IV lines, prosthetic heart valves, shunts </li></ul><ul><li>Causes urinary tract infection in cathetarised patients </li></ul><ul><li>Has variable ABS pattern , highly resistant </li></ul><ul><li>Treatment should be aided with ABST </li></ul><ul><li>Hospital acquired </li></ul><ul><li>Novobiocin sensitive </li></ul>
    • 54. 3. Stapylococcus saprophyticus <ul><li>Skin commensal </li></ul><ul><li>Imp. Cause of UTI in sexually active young women </li></ul><ul><li>Usually sensitive to wide range of antibiotics </li></ul>
    • 55. GRAM POSITIVE COCCI S. aureus  hemolytic mannitol yellow + - Staphylococcus (Clusters) Streptococcus (pairs & chains) Catalase BETA: Bacitracin S. pyogenes (group A) CAMP/ Hippurate S. agalactiae (group B) Hemolysis Coagulase S. epidermidis nonhemolytic (usually) mannitol white ALPHA: Optochin /Bile Solubility S. pneumoniae GAMMA: Bile Esculin 6.5% NaCl Group D* Enterococcus Bile Esculin 6.5% NaCl Group D* Non- Enterococcus (*can also be alpha hemolytic) Note: S. viridans is Is alpha hemolytic and negative for all the tests below below + + + + + + + - - Summary Figure (Identification Scheme)

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