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Clinically Encountered Bacteria Suthan Srisangkaew, MD.

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Presentation on theme: "Clinically Encountered Bacteria Suthan Srisangkaew, MD."— Presentation transcript:

1 Clinically Encountered Bacteria Suthan Srisangkaew, MD.

2 Review: Classification Gram-positive Gram-negative Cocci -Chain -Cluster Bacilli -Spore forming -Non-spore forming -Branching -Non-branching Aerobic Anaerobic –Bacilli predominate

3 Aerobic Gram-positive Cocci In chain Streptococcus (Lancefield group) Enterococcus In cluster Staphylococcus (Coagulase) (Micrococcus, Leuconostoc)

4 Aerobic Gram-positive Bacilli Spore forming Bacillus Non-spore forming - Non-branching Corynebacterium Listeria Lactobacillus - Branching Nocardia

5 Aerobic Gram-negative Cocci Always in pair! Coffee bean shape Neisseria Moraxella

6 Aerobic Gram-negative bacilli LARGE GROUP…. Enterobacteriaceae –E. coli, Klebsiella, Enterobacter –Salmonella, Shigella –Yersinia –Proteus, Providencia, Serratia, Morganella Vibrionaceae –Vibrio, Aeromonas, Plesiomonas

7 Non-fermentative Pseudomonas Acinetobacter Burkholdderia Curve, Microaerophilic Campylobacter jejuni Helicobacter pyroli

8 Fastidious, Coccobacilli Haemophilus Bordetella Fastidious, Zoonosis Brucella Pasteurella

9 Anaerobic Gram-positive Bacilli Spore forming –Clostridium Non-spore forming Branching –Actinomyces Non-branching –Proprionibacterium –Bifidobacterium

10 Anaerobic Gram-negative bacilli Bacteroides Fusobacterium Prevotella

11 Special groups Mycobacterium Rickettsia Chlamydia Mycoplasma Spirochetes Treponema Leptospira

12 Systemic Orientation Skin, Wound, Soft tissue Bone, Joint Eye, Ear, Sinus Respiratory tract Gastrointestinal tract Urinary tract, Sexual transmitted infection Central nervous system Blood stream, Endocarditis

13 Skin infection Primary infection –S. aureus, group A strep., P. acne Blood-borne –Syphilis, rickettsia, virus –Bacterial toxin: gr. A strep, S. aureus Scarlet fever: gr. A strep Staphylococcal scalded skin syndrome: S. aureus

14 Scarlet fever

15 Staphylococcal scalded skin syndrome

16 Skin infection Folliculitis: S. aureus –Hair follicle Acne: P. acne –Sebaceous gland Impetigo: gr. A strep. –Superficial dermis Erysipelas: gr. A strep. –Deep dermis Cellulitis: S. aureus, gr. A strep., GNB, Clostridium –Subcutaneous connective tissue

17 Folliculitis

18 Impetigo

19 Erysipelas

20 Cellulitis

21 Wound Infection S. aureus: most common GNB: immunocompromized host Human bites: anaerobic bacteria : Bacteroides Dog, cat bites: Pasteurella multocida Burn wound, necrosis: P. aeruginosa Tetanus: Clostridium tetani Gas gangrene: Clostridium pefringen

22 Gas Gangrene

23 Bone & Joint Infection Osteomyelitis: S. aureus –Both blood-borne and direct trauma Gr. A strep, GNB, anaerobes Septic arthritis: –S. aureus –Neisseria gonorrhea (young adult)

24 Eye, Ear, Sinus Infection Conjuctivitis: S. aureus, Chlamydia trachomatis, N. gonorrhea Ear Otitis externa: P. aeruginosa Otitis media: S. pneumoniae, H. influenzae Sinus Acute sinusitis: S. pneumoniae, H. influenzae, Moraxella catarrhalis Chronic sinusitis: + anaerobes

25 Upper Respiratory Tract Infection Rhinitis: mostly virus Pharyngitis & Tonsillitis: –Exudate & hemorrhage: Bacteria Gr. A strep. (S. pyogenes) –Vesicle & ulcerative lesion: Virus –Psuedomembranous pharyngitis (Diphtheria) Corynebacterium diphtheria

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27 Middle Respiratory Tract Infection Epiglottitis –90% bacteria: H. influenzae, S. pneumoniae Laryngitis (Croup) –90% virus Bronchitis –80% virus –20% bacteria: H. influenzae, M. pneumoniae, C. pneumoniae, Bordetella pertussis

28 Lower Respiratory Tract Infection Acute pneumonia: days to hours –Children: 80% Virus –Adults: 80% Bacteria S. pneumoniae, S. aureus, H. influenzae M. pneumoniae, C. pneumoniae Enterobacteriaceae, P. aeruginosa Chronic pneumonia: weeks to months M. tuberculosis, Nocardia Fungus Lung abscess & Empyema S. aureus Anaerobes

29 Enteric Infection Watery diarrhea: proximal small intestine –Vibrio cholerae –Vibrio parahaemolyticus –Enterotoxigenic E. coli (ETEC) –Food poisoning S. aureus, B. cereus –Many viruses Dysentery: colon –Salmonella, Shigella –Campylobacter jejuni –Enteroinvasive E. coli (EIEC) –Plesiomonas spp. –Yersinia enterocolitica –C. difficile (ATB associated) –Entamoeba histolytica

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31 Food Poisoning No infection, Vomiting prodominate S. aureus 5-25% Bacillus cereus 1-2% (Fried rice) Clostridium botulinum –Neuromuscular paralysis Chemical 20-25% Recurrent Peptic Ulcer: Helicobacter pyroli

32 Foods and Germs Dairy –Campylobacter, Salmonella, Listeria, and Staphylococcus s pecies Eggs –Salmonella species Meats –C perfringens and Salmonella, Aeromonas, Campylobacter, and Staphyloc occus species Ground beef –Enterohemorrhagic E coli Poultry –Campylobacter species Pork –C perfringens and Y enterocolitica Seafood –Aeromonas, Plesiomonas, and Vibrio speci es and astrovirus Oysters –Plesiomonas and Vibrio speci es and calicivirus Vegetables –Aeromonas species and C perfringens Alfalfa sprouts –Enterohemorrhagic E coli and Salmonella species Fried rice –Bacillus species Custards, mayonnaise –Staphylococcus species

33 Urinary Tract Infection Cystitis: lower UTI Pyelonephritis: upper UTI, systemic symptoms 90-95% E. coli Other enterobacteriaceae K. pneumoniae, Enterobacter Staphylococcus saprophyticus (coag. Neg.) Candida

34 Sexual Transmitted Infection Neisseria gonorrhea –Urethritis, Cervicitis(phyryngitis, conjunctivitis) Chlamydia trachomatis –Non-gonococcal urethritis –Lymphogranuloma venerum Treponema pallidum –Syphilis (Chancre) Haemophilus ducreyi –Chancroid

35 Infection of fetus and newborn Transplacental: –Listeria monocytogenes –Treponema pallidum Perinatal: –Gr. B streptococci –E. coli –C. trachomatis –N. gonorrhea

36 Central Nervous System Infection Acute Meningitis –Newborn: Gr. B Strep., E. coli, Listeria monocytogenes, –Children: S. pneumo., H. influenzae, N. meningitidis, Salmonella –Adults: N. meningitidis, S. suis, S. pneumo., S. agalactiae Chronic Meningitis –Mycobacteria –Fungi

37 Bacteremia & Septicemia Bacteremia: occur normally Septicemia: bacteremia + clinical symptoms Most common from: –Urinary tract infection –Respiratory tract infection –Infection of skin and soft tissue

38 Endocarditis Native valve –Viridans streptococci30-50% –S. aureus15-40% –Other strep15-25% –Enterococci 5-18% –Coag. Neg. Staph. 4-30% –Gram-negative bacilli 2-13% Intravenous drug abuse –S. aureus Prosthetic valve –Coag. Neg. Staph.

39 Systemic Zoonosis Leptospirosis: Leptospira interrogans –Rats, Rodents Brucellosis: Brucella abortus –Goats, Sheeps Plaque: Yersinia pestis –Rats > Flea Anthrax: Bacillus antrasis –Cow, Horse > Spore

40 Thailand Endemic Leptospirosis –Dirty water contact Mellioidosis: Burkholderia pseudomallei –NE Thailand, soil contact Scrub typhus: Orientia tsutsugamushi –Chigger > bush contact, “Eschar” Murine typhus: Rickettsia typhi –Mouse > flea bites

41 Hospital Acquired Infection Pseudomonas aeruginosa Acinetobacter baumanii, A. lwoffii Sternotrophomonas maltophilia


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