This document summarizes information about Staphylococci and Streptococci bacteria. It discusses their microscopic morphology, cultivation characteristics, biochemical features, virulence factors, clinical presentations, and treatment. Key points include:
- Staphylococci are Gram-positive cocci that can be coagulase-positive like S. aureus or coagulase-negative like S. epidermidis. S. aureus is an important human pathogen able to cause both localized and invasive infections.
- Streptococci are Gram-positive cocci arranged in chains. Important species include S. pyogenes (Group A Strep) which causes pharyngitis and can lead to post-stre
Myself Dr. Manish Tiwari Tutor Department of microbiology at saraswati medical college and research center( unnao) making presentation is only for MBBS and MD students.
Gram reaction & characteristics:
Gram +ve cocci arrange in clusters (grape-like), non-motile.
Habitat:
Flora in the anterior nares (10-60% of population), nasopharynx, perineal area, skin & mucosa.
Virulence factor:
Protein A (binds Fc portion of IgG), coagulase (forms fibrin coat around organism) hemolysins, leukocidins (destroy RBCs and WBCs), hyaluronidase (breaks down connective tissue), staphylokinase (lyses formed clots), lipase (breaks down fat), Toxic shock syndrome toxin.
Disease:
Causes food poisoning (via enterotoxin), pneumonia, meningitis, osteomyelitis, septic arthritis bacteremia, endocarditis, wounds, abscesses, suppurative cutaneous infections, staphylococcal scalded skin syndrome, boils (carbuncles), furuncles, sinusitis, otitis media, folliculitis, impetigo, scalded skin syndrome (SSS), Tricuspid valve endocarditis (TVIE)> affects IV drug users.
Produces six types of enterotoxin and toxic shock syndrome toxin-1 (TSST-1)> TSS (fever, diarrhea, kidney failure, fever, headache). Ritter’s disease in newborn (severe form of scalded skin syndrome in neonates).
S. aureus is a leading cause of osteomyelitis in children and adults.
Myself Dr. Manish Tiwari Tutor Department of microbiology at saraswati medical college and research center( unnao) making presentation is only for MBBS and MD students.
Gram reaction & characteristics:
Gram +ve cocci arrange in clusters (grape-like), non-motile.
Habitat:
Flora in the anterior nares (10-60% of population), nasopharynx, perineal area, skin & mucosa.
Virulence factor:
Protein A (binds Fc portion of IgG), coagulase (forms fibrin coat around organism) hemolysins, leukocidins (destroy RBCs and WBCs), hyaluronidase (breaks down connective tissue), staphylokinase (lyses formed clots), lipase (breaks down fat), Toxic shock syndrome toxin.
Disease:
Causes food poisoning (via enterotoxin), pneumonia, meningitis, osteomyelitis, septic arthritis bacteremia, endocarditis, wounds, abscesses, suppurative cutaneous infections, staphylococcal scalded skin syndrome, boils (carbuncles), furuncles, sinusitis, otitis media, folliculitis, impetigo, scalded skin syndrome (SSS), Tricuspid valve endocarditis (TVIE)> affects IV drug users.
Produces six types of enterotoxin and toxic shock syndrome toxin-1 (TSST-1)> TSS (fever, diarrhea, kidney failure, fever, headache). Ritter’s disease in newborn (severe form of scalded skin syndrome in neonates).
S. aureus is a leading cause of osteomyelitis in children and adults.
Staphylococcus aureus,a bunch of grapes
commonly found on the skin or in the nose of even healthy individuals
cause skin infections but can cause pneumonia, heart valve infections, and bone infections.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Staphylococcus aureus,a bunch of grapes
commonly found on the skin or in the nose of even healthy individuals
cause skin infections but can cause pneumonia, heart valve infections, and bone infections.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. Gram-positiv cocci
Staphylococci and Streptococci
Katalase-reaction
negative positive
Micrococcaceae Family
Nitrofurantoin Susceptibility
Positiv (susceptible)
Staphylococcus genus
Negativ (Resistant)
Micrococcus genus
Streptococcus genus
Streptococcaceae Family
microscopic view
5. Staphylococcus aureus
2) Cultivation
• facultative anaerob
• In bouillon: homogenous
turbidity
• agar plate: 2-3 mm in
diameter, circular, golden
yellow colonies
• pigment in non diffusable, fat
soluble stains only the
colonies
• S. aureus AU referes to gold
• On blood agar: -haemolysis
• selective cultivation method:
7.5% NaCl
6. Staphylococcus aureus
3) Biochemical feature
catalase +
coagulase +
Exocoagulase (free coagulase):
• enzyme produced and released by the S. aureus,
• binds to serum factor immunoglobulin, this complex can convert
fibrinogen to fibrin
• detecting: coagulase tube test
Endocoagulase: „clumping factor” (bound coagulase):
• on the bacterial surface,
• direct convertion of fibrinogen to fibrin
• detecting: slide agglutination, latex-agglutination
9. polysaccharide capsule
slime layer (binds bacteria to catheters, grafts)
teicholic acid, lipoteicholic acid (mediates the attachment of
staphylococci to mucosal surfaces)
adhesive proteins (collagene-, laminin-binding protein)
clumping factor: endocoagulase mimikry by the fibrin layer
macrophages can not reach them
protein A (unique affinity for binding to the Fc fragment of
immunoglobulin, prevents antibody-mediated immune clearance
of S.aureus)
Staphylococcus aureus
4) Virulence factors on the bacterial cell surface
11. Staphylococcus aureus
• Toxic Shock Syndrome Toxin (TSST-1)septic state ,
high fever, multi organ failer
• Staphylococcus enterotoxin (SE) leads to diarrhoeae and
vomiting, toxico-infection
• exfoliative toxin split the intercellular bridges in the
stratum granulosum epidermis
4) Virulence factors: exotoxins
12. Staphylococcus aureus
Superantigens bind to T helper on the T cell receptor V β site leads to
proliferation of T cells and overproduction of cytokins: TNF- β, IFN- γ, IL-2.
The patients get into septic state : hypotension, shock, mulit-organ-failer
4) Virulence factors: Superantigen exotoxin
14. Clinial pictures
Purulent infections on the site of infection of the skin
folliculitis, furunculus, carbunculus, woundinfections ,
otitis media, mastoiditis, mastitis
Invasive Infections
pneumonia, bakteraemia, sepsis, meningitis, ostitis,
osteomyelitis, endocarditis
Toxin medaited infections
Gastroenteritis, TSS, Pemph. neonat, Scales Skin Syndrom
Source of infection : 5-10 % of population carry S. aures in the nose,
nasopharynx
Way of transmission by respitory droplets or direkt contact
23. • Osteomyelitis
• Mediastinitis
• Peritonitis
• Meningitis, Subduralempyema,
• Abscesse formation in all parenchymal organ
Deep purulent infections
24.
25.
26. Fig. 8.27 – Septic arthritis. Erythema and swelling of the left ankle joint
in a young girl with staphylococcal sepsis.
By courtesy of Mr. N.St.J.P. Dwyer
34. Therapy of Staphylococcus aures infections
Antibiotic treatment
β-lactam antibiotics with β-lactamase Inhibitors
eg.: amoxicillin + clavulanic acid
35. Therapy of Staphylococcus aures infections
Penicillin group of antibiotics (as all β-laktams)
Inhibit the peptidoglycan synthesis (cellwall synthesis)
Target molecula PBP (Pencillin Binding Protein) a transpeptidase, responsible
for the cellwall synthesis
β-lactam
antibiotics
Peptidoglycan of Cell wall : NAM: N-acetyl-muramin acid
: NAG: N-acetyl-glukosamin
NAM
NAG
NAM
NAG
NAM
PBP
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
beta-lactamase (penicillinase) production
36. Resistence to beta-lactams
Beta-lactamase production
(penicillinase production)
• Resistence only to
Penicillin group
• Penicillin-binding Proteine (PBP) – Struktur
modifing
• Resistance to all beta-lactame antibiotics:
– Penicillins
– Cephalosporins
– Karbapenems
– monobactams
– Beta-laktamase Inhibitors
MRSA: Methicillin Resistant S. aureus
Therefore the treatment:
amoxicillin + clavulanic acid
Penicillinase inhibitor
Penicillin
derivative
Antibiotic with different target
molecules :
Vancomycin
Linezolid
Mupirocin
Clindamycin
Daptomycin
Therefore the treatment is based on
antibiogramm:
37. MRSA = methicillin resistent S. aureus
Methicillin belongs Penicillin group of antibiotics (β-laktam)
Inhibtion of Peptidoglycan synthesis
Target molecula PBP (Pencillin Binding Protein)
Target molecule mutation PBP’2a modified target conferes
resistance to all β-lactam antibiotics
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
Uneffective
β-lactam
Antibiotics
Peptidoglycan of Cell wall
NAM
NAG
NAM
NAG
NAM
PBP’2a
39. VRSA = vancomycin resistent S. aureus
Vancomycin effective agent against MRSA
Inhibition of Cell wall synthesis
Targetmolecule is D-Alanin in Murein
Targer modification (D-Ala-lactate) leads to resistance VRSA
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
Ala-Glu-Lys-D-Ala-D-Ala
Vancomycin
Vancomycin
Vancomycin
Peptidoglycan of Cell wall
NAM
NAG
NAM
NAG
NAM
41. Coagulase-negativ Staphylococci
• Belong to the normalflora of the skin and
mucosalayers
• Fakultative Pathogens
S. epidermidis
S. hominis
S. hemolyticus
S. saprophyticus
42. Staphylococcus epidermidis
• Morphology: Gram-positve cocci in grape-like
clusters
• Cultivation: white pigment without hemolysis
• Biochemical features
– Katalase +
– Koagulase -
– Mannit -
43. Staphylococcus epidermidis
• Belongs to the normalflora of the skin
• On the intact skin causes no infection
• On plastic instruments biofilm formation
– exopolysaccharide
– Matrixproteins (Fibrin, Fibrinogen)
Attachment , colonisation
Bloodstream infection
44. Therapy: plastic devices should be removed
Therapy based on antibiogram
S. epidermidis resistance to beta-lactams:
MRSE : methicillin resistant S. epidermidis
Resistance to other group of antibiotics too:
vancmomycin, linezolid
Staphylococcus epidermidis
45. Staphylococcus saprophyticus
1) Microscopic morphology: Gram-positive cocci grape-like
clusters
2) Cultivation: no hemolysis on blood agar
3) Biochemical : coagulase negative, novobiocin resistent,
urease positive!
Clinical features: Belongs to the skin normalflora mainly on
the genitals cystitist („honeymoon cystitis”) in young
sexualle active women
S. saprophyticus can bind to the uroepithel and by the urease
activity NH3 will irritate the mucosalayer
46. Staphylococcus haemolyticus
Staphylococcus hominis
1) Microscopic morfology: Gram-positiv cocci grape-like
clusters
2) cultivation: white colonies weak or no hemolysis
3) Biochemical features : novobiocin susceptible
Belong to the normal flora of the skin :
Nosocomial pathogen biofilm production on catheter,
canuls, plastic devices, tubes of intubation
Mucus layer damages help the invasion to the bloodstream
bacteraemia and sepsis
48. Gram positive cocci : Streptococcus genus
Morphology: Gram positive cocci 1m in diameter
arranged in chains
Cultivation: demanding bacteria
blood agar media (-, -, - haemolysis)
1 mm in diameter roundish,
tiny needletip colonies
Biochemical feature: catalase negative
49. Classification of the Streptococcus genus
1. Haemolysis:
a) - haemolysis: Streptococcus pyogenes, S. agalactiae
b) -haemolysis: S. pneumoniae
c) non haemolytic: S. lactis, Enterococci
2.Lancefield grouping: according to the polysaccharide “C” in the cell
wall
serogroups: A, B, C, D, F, G human infections
“A” group: S. pyogenes
“B” group: S. agalactiae
“D” group: Enterococcus faecalis
50. Classification of the Streptococcus genus
3. “M” protein in the cell wall: serotypes
• S. pyogenes > 90 serotypes
• in certain diseases different serotypes are characteristic:
• e.g.: serotype 10 – scarlet fever;
• serotype 2, 4, 12, 49 – acut glomerulonephritis
• (nephritogen strains)
4. 16 S rRNA sequence coding DNA sequence:
• 6 clusters: anginosus, pyogen, mitis, salivarius, bovis, mutans
51. Streptococcus pyogenes
1) Microscopic morphology:
Gram positive cocci 1m in
diameter arranged in long
chains
• capsule is composed of
hyaluronic acid
52. Streptococcus pyogenes
2) Cultivation: demanding
bacteria (vitamin B)
blood agar media:
-haemolysis 1 mm,
circular, tiny needletip
colonies
S. pyogenes on blood agar
54. Streptococcus pyogenes
4) Virulance factors
I. On the cell surface: lipoteicholic acid, F-protein, capsule
II. Exotoxin: erythrogenic toxin – scarlet fever (capillar toxin)
Spe A, B, C, F – streptococcal pyrogenic exotoxin
III. Streptolysin S and O (haemolysin):
anti-streptolysin O titer – confirming rheumatic fever!
IV. Exoenzymes:
hyaluronidase (,,spreading factor”)
DNase
streptokinase (cleaves plasminogen to plasmin promoting fibronolysis
55. 5) Clinical pictures by
S. pyogenes
I. Purulent infections:
mediated by
S. pyogenes bacterium
II. Toxin mediated infections:
Scarlate fever,
TSST
III. Complications:
Post-streptococcal
diseases:
typ2 and typ 3
hypersensitive
reactions
61. Ignaz Semmelweis
Ignaz Semmelweis demonstrated that
childbed fever (puerperal fever),
caused by streptococcal infections,
was transmitted to patients by doctor’s
hands
Pioneer of antisepsis in
obstetrics
Women giving birth in hospitals
by medical students and
physicians were 4x more likely
to contract puerperal fever
compared to those by midwives
Handwashing with chlorin water
(leach powder)
Childbed fever (puerperal fever)
by S. pyogenes
63. Streptococcus pyogenes
5) Clinical pictures
II. Toxin mediated diseses
• Scarlet fever: mediated by
erythrogen toxin, which can
destroy the endothel cell of
capillaries – red rash
• Can not be formed into
toxoid! NO vaccination
• 2 days after the infection
exanthems on the skin and
throat
65. III. Poststreptococcal diseases
(complications of a S. pyogenes infection)
1.Rheumatic fever:
Typ 2 hypersensitive reaction: surface anigen of the heart muscle is
similar to the Str. pyogenes antigen(M-protein) antibodies bound to
the heart muscle
• inflammatory changes in the heart (pancarditis)
• endocarditis: damage of heart valves
2. Acute glomerulonephritis (GN): immuncomplex mediated
Immunkomplexes in joints: polyarthritis
Immunkomplexes in the glomerulus : nephritis
• Typ 3 hypersensitive reaction: immuncomplexes bind to the
glomerulus basalmembrane glomerulonephritis
• Hypertonia and oedema
3. Erythema nodosum:
• subcutan nodles, immuncomplex mediated
67. Immunity:
Antibacterial: you can have tonsillitis follicularis more than once
(several serotypes)
Antitoxical: you acquire scarlet fever only once
(erythrogenic toxin has the same structure in all the strains)
Treatment: penicillin (natural susceptible to penicillin),
• macrolid (if the patient has penicillin allergy)
• complications should be prevented.
68. 1) Microscopic morphology: Gram positive cocci 1m in diameter
arranged in chains
2) Cultivation: blood agar media: -haemolysis (narrow)
1 mm in diameter circular, tiny needletip colonies
diagnostic antibiotic: bacitracin (R)
CAMP +
3) Antigen structure: Lancfield group “B”
4) Pathogenicy: colonisation in the vagina
5) Clinical pictures: during pregnancy: abortion
during delivery the neonates can be infected: newborn pneumonia,
ARDS, meningitis, sepsis
(Screening of pregnant women after the 35th week of gestation!)
• Treatment and prevention: ampicillin
Streptococcus agalactiae
69. Enterococcus genus
1) Microscopic morphology: Gram
postive cocci (elongated) 1m in
diameter arranged in short chains
Antigen structure: Group D Lancfield
type
70. Enterococcus faecalis,
Enterococcus faecium
2) Cultivation: on blood agar
greyish colonies
• (sometimes green court
under the colony)
• selective culture media –
black colonies
(E67 culture media)
3) Biochemical feature:
esculin (polysaccharid)
hydrolysis
71. Enterococcus faecalis,
Enterococcus faecium
Clinical pictures:
enteric cocci : present in the intestine (normal flora)
facultative pathogen
inflammation of bile tract and urinary tract
nosocomial infection after surgery
Intestinal trauma /perforation sepsis, peritonitis
Treatment: natural resistance cephalosporin and sulfonamid!
Th.: synergistic combination: ampicillin + gentamycin
Th: vancomycin increased level of resistance to glycopeptid :
VRE: vancomycin resistant Enterococci
72. Streptococcus viridans group
(S. mutans, S. mitis, S. sanguis,
S. salivarius, S. milleri)
heterogenous collection of - haemolytic Streptococci
,,viridae” – Latin term for green
Member of the normal flora of the oral cavity.
• Cultivation on blood and chocolate agar: - haemolysis
• Separate from S. pneumoniae S: normal flora optochin R
• clinical picture: In oral cavity: colonisation on the teeth dental
plaque formation dental caries
• If Streptococcus viridans enter the circulation cause subacute
endocarditis
73. Peptostreptococci
Anaerobic Streptococci!
• Normal flora of the oral cavity, gastrointestinal tract.
• Polymicrobic, pyogenic infections, abscess formation in the
abdominal cavity, lung and brain or in the oral cavity
• Treatment: metronidazol, clindamycin
Abscess
75. Fig. 2.21 Pneumococcal pneumonia. Preparation of sputum showing
predominance of pneumococci mostly as lanceolate diplococci. Gram
stain. By courtesy of Dr. J.R. Cantey
Streptococcus pneumoniae
76. Streptococcus pneumoniae
2) Cultivation:
• blood and chocolate agar -
haemolysis
• autolysis: ageing colonies
are umbilicated
3) Biochemical features
optochin sensitivity (S)
separate from the viridans
group
4) Virulenc factor
Polysaccharide capsule
77. Streptococcus pneumoniae
• Can not be grouped with the
Lancefield technique!
• based on capsule – 91
serotypes
• ,,quellung”-reaction (German
,,swelling”): anticapsular
antibody plus pneumococci
greater refractiveness
around the bacteria by
microscope
Quellung reaction of
S. pneumoniae
78. Streptococcus pneumoniae
Clinical picture:
lobar pneumonia
sinusitis, otitis media
bacteriaemia, meningitis
ulcus serpens corneae (eye
infection)
Source of infection:
5-10% of population carry S.
pneumoniae in nose, throat
79. Streptococcus pneumoniae
Treatment: high penicillin resistance decreased affinity of the antibiotic to PBP
Therapy: macrolid, fluoroquinolones
Prevention: 13-valent polysaccharide vaccine (conjugated)
obligatory vaccine for new borns ( in Hungary since 2014 July)
recommended: 1. children (born before 2014 July)
2. adults above 65 years of age
3. adults with chronic disease
(COPD, heart failure)
4. patient after splenectomy
80. Vaccinations against bacterial
infections
1) BCG = against Mycobacterium tuberculosis (living attenuated bacterium)
2) aP = against Bordetella pertussis (acellulare Pertusis vaccination)
3) Diphtheria = against Corynebacterium diphtheriae (toxoid)
4) Tetanus = against Clostridium tetani (toxoid)
5) Hib = against Haemophilus influenzae b capsule antigen
6) Neisseria meningitidis capsule antigen
7) Streptococcus pneumoniae capsule anigen
8) Salmonella typhi killed bacteria (polysaccharide derivative)
9) Vibrio cholerae killed bacteria