Gram positive cocci. Staphylococci and streptococci

Содержание

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RESPIRATORY INFECTIONS Respiratory infections are diseases that transmitted mainly by airborne

RESPIRATORY INFECTIONS

Respiratory infections are diseases that transmitted mainly by airborne way

and by dust. At the reception of a dentist, respiratory infections are one of the most frequently transmitted groups of infections, an aerosol formed during the operation of drills, turbines easily contaminate surrounding objects and enter the respiratory tract.
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MOST IMPORTANT PATHOGENS The most important pathogens of respiratory infections are

MOST IMPORTANT PATHOGENS

The most important pathogens of respiratory infections are pathogenic

cocci, which is an extensive group including gram+ and Gram- cocci that cause purulent inflammatory processes of different localization (also called pyogenic).
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COCCI A coccus (plural cocci) is any bacterium or archaeon that

COCCI

A coccus (plural cocci) is any bacterium or archaeon that has a spherical, ovoid, or generally round shape
Cocci

may occur as single cells or remain attached following cell division
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STAPHYLOCOCCAL INFECTION Staphylococcal infection is a collective concept that unites infectious

STAPHYLOCOCCAL INFECTION

Staphylococcal infection is a collective concept that unites infectious diseases

caused by staphylococci. It is characterized by purulent inflammation of any organs and systems with a tendency to progressive spreading, generalization and septic flow.
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STAPHYLOCOCCAL INFECTION Staphylococcus can take part in mixed purulent processes of

STAPHYLOCOCCAL INFECTION

Staphylococcus can take part in mixed purulent processes of the

maxillofacial area, stand out as a cop of microbial associations in abscesses, phlegmon, osteomyelitis and stomatitis. In dental hospitals and private clinics there is often a nosocomial staphylococcal infection after surgical interventions on the dentoalveolar system and the paranasal sinuses.
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STAPHYLOCOCCUS Staphylococcus is a genus of Gram-positive round bacteria that form

STAPHYLOCOCCUS

Staphylococcus is a genus of Gram-positive round bacteria that form in grape-like clusters
Aerobes or

facultative anaerobes
The Staphylococcus genus includes at least 40 species. Of these, nine have two subspecies, one has three subspecies, and one has four subspecies
Most are harmless and reside normally on the skin and mucous membranes of humans and other organisms
Staphylococci are ubiquitous microorganisms that cause various purulent-inflammatory processes in humans and animals (they are also called pyogenic)
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STAPHYLOCOCCUS Staphylococci belong to the department of Firmicutes, this family. Micrococaceae,

STAPHYLOCOCCUS

Staphylococci belong to the department of Firmicutes, this family. Micrococaceae, genus

Staphylococcus. The genus includes 27 species, among which there are pathogenic, conditionally pathogenic species and saprophytes. The main human lesions are caused by 3 species: S. aureus, S.epidermidis and S. saprophyticus.
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Staphylococcus aureus (Gram stain) http://www.meteoweb.eu/2016/03/il-diabete-aumenta-il-rischio-di-contrarre-gravi-infezioni-del-sangue/649580/

Staphylococcus aureus 
(Gram stain)
http://www.meteoweb.eu/2016/03/il-diabete-aumenta-il-rischio-di-contrarre-gravi-infezioni-del-sangue/649580/

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Staphylococcus epidermidis (Gram stain)

Staphylococcus epidermidis
(Gram stain)

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Staphylococcus saprophyticus (Gram stain)

Staphylococcus saprophyticus
(Gram stain)

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Staphylococci have a spherical shape (round cells are called cocci). In

Staphylococci have a spherical shape (round cells are called cocci). In

preparations from pure culture they are arranged in the form of disordered clusters resembling bunches of grapes. In smears from pus - singly, in pairs or in small groups. Do not have a dispute, flagella (immovable), can form a gentle capsule.

MORPHOLOGY

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Staphylococcus aureus (Gram stain) TINCTORIAL PROPERTIES Gram-positive

Staphylococcus aureus 
(Gram stain)

TINCTORIAL PROPERTIES

Gram-positive

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CULTURAL PROPERTIES OF S. AUREUS Facultative anaerobes Are not demanding for

CULTURAL PROPERTIES OF S. AUREUS

Facultative anaerobes
Are not demanding for nutrient media
On

dense media form colonies in S-form - round, with an even edge, painted in cream, yellow, orange
On liquid media give a uniform turbidity
They grow on saline media (5-10% NaCl)
Milk-salt and yolk-salt agar are elective media for staphylococci
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BIOCHEMICAL PROPERTIES Saccharolytic: ferment 5 carbohydrates of Hiss's medium to acid

BIOCHEMICAL PROPERTIES

Saccharolytic: ferment 5 carbohydrates of Hiss's medium to acid
Proteolytic: ferment

proteins with the formation of H2S, liquefy gelatin in the form of a funnel, for 4-5 days the funnel is filled with liquid
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STAPHYLOCOCCUS ANTIGENIC STRUSTURE Staphylococci have about 30 antigens: proteins, polysaccharides, teichoic

STAPHYLOCOCCUS ANTIGENIC STRUSTURE

Staphylococci have about 30 antigens: proteins, polysaccharides, teichoic acids;

many extracellular substances that form staphylococci have antigenic properties.
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FACTORS OF PATHOGENICITY Exotoxin (released outside, outside the cell), consisting of

FACTORS OF PATHOGENICITY

Exotoxin (released outside, outside the cell), consisting of several

fractions: hemolysin (destroys erythrocytes), leukocidin (destroys leukocytes), lethal toxin (kills rabbits), necrotoxin (causes skin necrosis in rabbit with intradermal administration), enterotoxin (causes food poisoning), exfoliatin (causes pemphigus in newborns - syndrome of "scalded skin")
Enzymes of aggression: hyaluronidase (destroys hyaluronic acid), plasmocoagulase (coagulates blood plasma), DNAse (destroys DNA), lecithovitellase (destroys lecithin), fibrinolysin (destroys fibrin clots)

W. E. Sause et al Antibody-Based Biologics and Their Promise to Combat Staphylococcus aureus Infections. Trends in Pharmacological Sciences. Volume 37, Issue 3, p231–241, March 2016

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RESISTANCE Staphylococci are resistant to external environment, but sensitive to des.

RESISTANCE

Staphylococci are resistant to external environment, but sensitive to des. solutions,

especially to diamond green, are often resistant to penicillin. form an enzyme penicillinase.
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EPIDEMIOLOGY OF STAPHYLOCOCCAL INFECTIONS Staphylococci are ubiquitous and are often found

EPIDEMIOLOGY OF STAPHYLOCOCCAL INFECTIONS

Staphylococci are ubiquitous and are often found in

normal human microflora (carriers). Staphylococcus aureus colonizes the nasal passages, abdominal cavity, axillary regions. Epidermal staphylococcus occupies the smooth skin, the surface of the mucous membranes. Saprophytic staphylococcus occupies the skin of the genitals, the mucous membrane of the urinary tract.
Most infections are endogenous and the infection is associated with the transfer of the pathogen from the places of colonization to the traumatized (damaged) surface.
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EPIDEMIOLOGY OF STAPHYLOCOCCAL INFECTIONS Staphylococcal infections are called plague of the

EPIDEMIOLOGY OF STAPHYLOCOCCAL INFECTIONS

Staphylococcal infections are called plague of the 20th

century, i.e. they are dangerous and very common, especially in maternity hospitals, in surgical departments.
1) source of infection - a sick person or a healthy carrier;
2) the transmission mechanism is mixed;
3) transmission ways: airborne, airborne, contact, food;
4) susceptibility of the population - susceptibility depends on the general condition and age; The most susceptible are newborns and infants.
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PATHOGENESIS AND CLINIC OF DISEASES Entrance gate - any organ and

PATHOGENESIS AND CLINIC OF DISEASES

Entrance gate - any organ and any

fabric; Staphylococci penetrate through damaged skin, mucous membranes of the mouth, respiratory tract, genitourinary system, etc.
Staphylococci reproduce at the site of penetration, form exotoxin and enzymes of aggression and cause the formation of local purulent-inflammatory foci. Propagating from these foci of staphylococci can enter the blood (sepsis), and with blood - into other organs (septicopyemia).
The incubation period is from several hours to 3 to 5 days.
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PATHOGENESIS AND CLINIC OF DISEASES Staphylococci cause more than 100 nosological

PATHOGENESIS AND CLINIC OF DISEASES

Staphylococci cause more than 100 nosological forms

of diseases. They affect the skin (furuncles, carbuncles), subcutaneous fat (abscesses, phlegmon), respiratory tract (tonsillitis, pneumonia, sinusitis), cause mastitis, purulent myositis and muscle abscesses, brain abnormalities after traumatic brain injuries, endocarditis, affect bones osteomyelitis, arthritis), affect the liver, kidneys, urinary tract (pyelonephritis, cystitis). Especially dangerous are the diseases when staphylococci enter the blood (sepsis) and affect internal organs (septicemia). Staphylococcal infections are accompanied by intoxication, fever, headache.
Diseases are acute, but may also be chronic.
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THE SYNDROME OF “SCALDED BABIES” The syndrome of "scalded babies" is

THE SYNDROME OF “SCALDED BABIES”

The syndrome of "scalded babies" is observed

in newborns. The disease begins violently, characterized by the formation of large foci of erythema on the skin with the formation of large blisters (as in thermal burns) and the exposure of wet eroded areas.
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THE TOXIC SHOCK SYNDROME The toxic shock syndrome was first recorded

THE TOXIC SHOCK SYNDROME

The toxic shock syndrome was first recorded in

1980 in women aged 15 to 25 years using tampons during menstruation. It is manifested by high fever (38.8° C and above), vomiting, diarrhea, rash, drop in blood pressure and development of shock, often leading to death.
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FOOD POISONING Food poisoning is manifested by vomiting, watery diarrhea within

FOOD POISONING

Food poisoning is manifested by vomiting, watery diarrhea within 2

to 6 hours after eating the infected foods, usually confectionery products with cream, canned food, meat and vegetable salads. Manifestations disappear or significantly weaken in 24 hours even without treatment.
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AN ALLERGY TO STAPHYLOCOCCAL TOXINS It is often develops an allergy

AN ALLERGY TO STAPHYLOCOCCAL TOXINS

It is often develops an allergy

to staphylococcal toxins, which leads to long, chronic illnesses.
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PYODERMA Pyoderma means any skin disease that is pyogenic (has pus)

PYODERMA

Pyoderma means any skin disease that is pyogenic (has pus)
Most common isolated organism was Staphylococcus aureus
Pyodermas are

a common cause of skin infection in children and are associated with many multidrug-resistant organisms
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WHITLOW A whitlow or felon is an infection of the tip

WHITLOW

A whitlow or felon is an infection of the tip of the finger
A whitlow results from penetration of

pyogenic microbes into the soft tissues of the palmar surface of the finger (as a rule, staphylococci, less often streptococci, sometimes a mixed pathogenic microflora is noted)
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ACUTE TONSILLITIS Acute tonsillitis (angina) is an infectious disease with local

ACUTE TONSILLITIS

Acute tonsillitis (angina) is an infectious disease with local manifestations

in the form of acute inflammation of the components of the lymphatic pharyngeal ring, most often the palatine tonsils caused by streptococci or staphylococci, less often by other microorganisms, viruses and fungi
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DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS Materials to be examined: pus, wounds liquor,

DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS

Materials to be examined: pus, wounds liquor, sputum,

blood, vomit, food
Bacterioscopic, bacteriological and biological methods are used
Serological reactions did not find application
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DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS Bacterioscopic method prepare a smear from pus,

DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS

Bacterioscopic method
prepare a smear from pus, Gram staining

and microscopy; in the smear are visible leukocytes, neutrophils, individual round cells of staphylococci and disordered clusters resembling a bunch of grapes (blood is not prepared from a blood smear)
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Gram stain of Staphylococcus aureus in pus

Gram stain of Staphylococcus aureus in pus

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DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS Bacteriological method Isolate a pure culture by

DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS

Bacteriological method
Isolate a pure culture by sowing the

material on nutrient media (more often on blood agar for detecting hemolysis) and then conducting its identification - study morphology (Gram stain), the presence of pathogenicity factors (plasmocoagulase, lecithovitelase) and biochemical properties (anaerobic cleavage of mannitol and glucose); the definition of an antibioticogram is mandatory; staphylococci are representatives of normal microflora, therefore, it is impossible to be limited by the isolation and identification of the pathogen, quantitative methods of analysis are needed-determination of the number of microbes in the sample
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DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS Bioprobe (food poisoning) infection of small suckling

DIAGNOSIS OF STAPHYLOCOCCAL INFECTIONS

Bioprobe (food poisoning)
infection of small suckling kittens, who

get vomiting and diarrhea in an hour and they die
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TREATMENT Apply broad-spectrum antibiotics, semisynthetic penicillins (methicillin, oxacillin), sulfonamide preparations It

TREATMENT

Apply broad-spectrum antibiotics, semisynthetic penicillins (methicillin, oxacillin), sulfonamide preparations
It is necessary

to determine the antibioticogram
In recent years, patients have been isolated from staphylococci, resistant to most chemotherapeutic drugs. In such cases, antitoxic anti-staphylococcal plasma or immunoglobulin obtained from the blood of donors immunized with staphylococcal anatoxin is used for treatment
When chronic forms of diseases are also introduced staphylococcal anatoxin, use autovaccine.