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Streptococcus pneumoniae

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Streptococcus pneumoniae

  1. 1. YASHWANT KUMAR GROUP 8
  2. 2. INTRODUCTION THE PNEUMOCOCCUS IS AN ENCAPSULATED GRAM POSITIVE COCCUS. ELONGATED OR “LANCET-SHAPED”,ARRANGED IN PAIRS (DIPLOCOCCI) AND SHORT CHAINS. IT IS COVERED WITH POLYSACCHARIDE CAPSULE AND THEIR CELL WALL COMPONENT OF THE CELL IS TEICHOIC ACID AND PEPTIDOGLYCAN LAYER. ITS ALSO CONTAINS CRP,PHOSPHOCHOLINE AND AMIDASE.
  3. 3. VIRULENCE IT IS DETERMINED BY ABILITY TO COLONIZE OROPHARNX BY SURFACE PROTEIN ADHESIONS. SPREAD INTO NORMALLY STERILE TISSUES BY PNEUMOLYSIN,IGA PROTEASE. STIMULATE LOCAL INFLAMMATORY RESPONSE BY TEICHOIC ACID,PEPTIDOGLYCAN FRAGMENTS,AMIDASE,PNEUMOLYSIN HYDROGEN PER OXIDE ,LEADS TO TISSUE DAMAGE AND PHOSPHOCHOLINE ,PROTECTED FROM OPSONISATION AND PHAGOCYTOSIS. EVADE PHAGOCYTIC KILLING (POLYSACCHARIDE CAPSULE)
  4. 4. DISEASE PNENMONIA.(IN MOST OF THE CASES) SINUSITIS AND OTITIS MEDIA. MENINGITIS. BACTEREMIA. PERICARDITIS AND ENDOCARDITIS SEPSIS. OSTEOMYELETIS. PERITONITIS AND BRAIN ABSCESS.
  5. 5. MAIN SYMPTOMS OF INFECTION
  6. 6. CAUSES 1. Cerebral palsy 2. Chronic lung disease (COPD, bronchiectasis, cystic fibrosis) 3. Cigarette smoking 4. Difficulty swallowing (due to stroke, dementia, Parkinsons disease, or other neurological conditions) 5. Immune system problem ( Pneumonia in immuno-compromised host) 6. Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions) 7. Living in nursing facility 8. Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes mellitus 9. Recent surgery or trauma 10. Recent cold, laryngitis, or flu
  7. 7. EDIDERMIOLOGY MOST INFECTIONS ARE CAUSED BY ENDOGENOUS SPREAD FROM THE COLONIZED NASOPHARYNX OR OROPHARYNX TO DISTAL SITE(EG;LUNGS,SINUS,EARS,BLOOD,MENINGES) COLONIZATION IS HIGHEST IN CHILDREN . INDUVIDUALS WITH ANTECEDENT VIRAL RESPIRATORY TRACT DISEASE OR OTHER CONDITIONS THAT INTERFERE WITH BACTERIAL CLEARANCE FROM RESPIRATORY TRACT ARE INCREASED RISK FOR PULMONARY DISEASE. CHILDREN AND ELDERLY PEOPLE ARE AT GREATER RISK OF MENINGITIS. PEOPLE WITH HEMATOLOGIC DISORDER(EG;MALIGNANCY,SICKLE CELL DISEASE) OR FUNCTIONAL ASPLENIA ARE AT RISK FOR FULMINANT SEPSIS ORGANISM IS UBIQUITOUS ,DISEASE IS MORE COMMON IN COOL MONTHS. PERSON-TO-PERSON SPREAD THROUGH INFECTIOUS DROPLETS IS RARE.
  8. 8. Diagnosis : Physical Examination Lab testingPHYSICAL EXAMINATION : CHEST X-RAY CRACKLINGS VIA STETHOSCOPE INCREASED RESPIRATORY RATE(children) , COUGH, PERTUSIS.
  9. 9. LABORATORY DIAGNOSIS MICROSCOPY IS HIGHLY SENSITIVE,AS IS CULTURE, UNLESS THE PATIENT HAS BEEN TREATED WITH ANTIBIOTICS. ANTIGEN TEST FOR PNEUMOCOCCAL C POLYSACCHARIDE IS SENSITIVE WITH CSF (MENINGITIS) . NUCLEIC-ACID –BASED TESTS . CULTURE REQUIRES USE OGF ENRICHED-NUTRIENT MEDIA(EG;SHEEP BLOOD AGAR),ORGANISM HIGHLY SUSCEPTIBLE TO MANY ANTIBIOTICS, SO CULTURE CAN BE NEGATIVE IN PARTIALLY TREATED PATIENTS. ISOLATES IDENTIFIED BY CATALASE (NEGATIVE), SUSCEPTIBILTY TO OPTOCHIN,AND SOLUBILTY IN BILE.
  10. 10. TREATMENT PENICILLIN IS THE DRUG OF CHOICE FOR SUSCEPTIBLE STRAINS ,ALTHOUGH RESISTANCE IS INCREASINGLY COMMON. FLUOROQUINOLONE OR VANCOMYCIN COMBINED WITH CEFTRIAXONE IS USED IN PATIENTS ALLERGIC TO PENCILLIN OR PENCILLIN RESISTANCE STRAINS. IMMUNIZATION WITH 7-VALENT CONJUGATED VACCINE IS RECOMMENDED FOR CHILDRENS UNDER 2 YEARS, A 23-VALENT POLYSACCHARIDE VACCINE IS RECOMMENDED FOR ADULTS AT RISK FOR DISEASE. OTHER ANTIBIOTIC DRUGS USED ARE AMOXILLIN,TETRACYCLINES,ERYTHROMYCIN, AZITHOMYCIN,CLARITHROMYCIN.
  11. 11. Prevention andcontrol : 60 % pneumonia is bacterial origin Vaccination : Pneumonococcalvaccines Maintaining immuno competancy To be cautious about cold and flu’s No self medication
  12. 12. THANKYOUFOR LISTENTING

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