❗must know คำศัพท์
staphylococcus S. aureus ,S. epidermidis, S. saprophyticus สามตัวนี้เท่านั้นที่สามารถแยกได้จาก staph ตัวอื่นในห้องปฎิบัติการ
| name | morphology and characteristics | diagnosis lab | virulence factor | disease |
|---|---|---|---|---|
| S. aureus | golden yellow colony | |||
| non-motile อยู่ในรูป พวงองุ่น🍇 | ||||
| gram-positive cocci | ||||
| พบได้มากในโรงพยาบาล (nosocomial infection) |
| coagulase positive ใน staph 99%= S. aureus
-catalase test positive | 1.teichoic acid=endotoxin-like activity
2.protein A จับกับ antibody ทำให้ไม่ทำงาน
3.clumping factor , fibronectin-binding protein=colonization
4.extracellular enzymeเช่น coagulase, hyaluronidase , haemolysins
5.exotoxins=enterotoxin(SEs heat stable)
supra antigen cause toxic shock syndrome | ดื้อยา penicillin methicillin and vancomycin
-suppurative infection skin=pyoderma carbuncles, wound infection
pneumonia=เกิดโรคต่อจาก influenza
อื่น ๆ= arthritis, osteomyelitis
non suppurative =scaled skin syndrome ,toxic shock syndrome, food poisoning |
| S. epidermidis
S. saprophyticus | S. epidermidis white colony | coagulase negative | | |
streptococci
| name | morphology and characteristics | diagnosing test | virulence factor | disease |
|---|---|---|---|---|
| streptococcus | facultative ใช้O2 น้อย โตช้า | 1.antiphagocytosis=hyaluronic capsule (ลื่น) | ||
| M protein (ขนจับกินไม่ได้) | ||||
| 2.LTA เกาะ epithelium | ||||
| 3.toxin and enzyme= hemolysins(streptolysin O and S) , streptokinase, streptococcal pyrogenic exotoxin (SPEs, SETs)→toxic shock | ||||
| group A streptococci | ||||
| (streptococcus pyogenes) | largest colony | |||
| beta-hemolysis | ||||
| serotyping: M protein typing =115 serotype | anti-streptolysin O (ASO) titer, | |||
| Anti-DNase B | ||||
| Anti-hyaluronidase | ||||
| Anti-NADase | ||||
| Anti-streptokinase | ||||
| PYR test | ||||
| Bacitracin test | เหมือนช่อง streptococcus | invasive disease=erysipelas(dermis) , | ||
| cellulitis( subcutaneous tissue), necrotizing: down to deep fascia and muscles (die from toxic shock 14-17 day) | ||||
| local infection=acute pharyngotonsillitis ,streptococcal pyoderma | ||||
| systemic disease= scarlet fever(strawberry tongue), toxic shock syndrome | ||||
| poststreptococcal disease= rheumatic fever ,acute glomerulonephritis | ||||
| group B | ||||
| streptococci | ||||
| (streptococcus agalactiae) | normal flora in vagina | CAMP test positive: synergistic hemolysin of group B strep. and S. aureus | sialic acid capsule→ prevent complement activation | neonatal sepsis and meningitis |
| streptococcus pneumoniae | diplococci bullet shape | |||
| alpha hemolysis | ||||
| no lancefied AG | ||||
| capsular polysaccharide antigens:>80 serotypes | ||||
| optochin susceptibility test, | ||||
| Quellung test( capsule swelling test) bile solubility test | capsule | |||
| peptidoglycan fragment and choline teichoic acid →severe inflammatory response | ||||
| community-acquired pneumonia | ||||
| meningitis | ||||
| otitis media | ||||
| sinusitis สีน้ำตาล=พบบ่อยในเด็กเล็ก | ||||
| ดื้อยา penicillin ในไทย (40%) | ||||
| เริ่มพัฒนาดื้อยา cefotaxime | ||||
| Viridans streptococci | ||||
| (S. mitis ,S. mutans) คล้าย S. pneumoniae | alpha hemolysis | |||
| no lancefield antigen | optochin and bile solubility test | dental caries (ฟันผุ) | ||
| subacute bacteria endocarditis | ||||
| Enterococus spp.(group D streptococci) | ||||
| E. faecalis and E. faecium | salt tolerance (6.5% NaCl) | |||
| normal flora in colon intrinsic antibiotic resistance | salt tolerance test | |||
| bile esculin test | ||||
| PYR test | nosocomial infection (Vancomycin-resistant enterococi) |
| name | morphology and characteristics | diagnosing test | virulence factor | disease |
|---|---|---|---|---|
| Neisseria | ||||
| (N. gonorrhoeae, N. meningitidis ) | gram negative diplococci ,aerobic non-motile ,kidney shape | oxidase positive | ||
| catalase positive | ||||
| N. gonorrhoeae | gonorrhoeae(หนองใน) | |||
| purulent conjunctivitis (ตาอักเสบในเด็กแรกเกิด→ทา antibiotic ตาตอนเกิด) | ||||
| N. meningitidis | transient flora | |||
| crowed place | pus discharge, CSF, blood | |||
| 1.latex agglutination test CSF | ||||
| 2.บอกคนสัมผัสผู้ป่วยให้กิน antibiotic กันไว้ | polysaccharide capsule | |||
| pili (attachment) | ||||
| endotoxin | ||||
| IgA1 protease (cleaves secretory IgA) | meningococcal meningitis( เยื่อหุ้มสมองอักเสบ) | |||
| meningo-encephalitis(ไข้กาฬหลังแอ่น) | ||||
| disseminated infection | ||||
| Waterhouse–Friderichsen syndrome (WFS)=adrenal hemorrhage | ||||
| Moraxella catarrhalis | normal flora in upper respiratory tract | |||
| attack person who ภูมิคุ้มกันบกพร่อง, คนแก่ ,chronic lunge disease | sinusitis, otitis media, conjunctivitis |
