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Anaerobes
Mengapa perlu belajar nonspore
forming anaerob bacteria?
apa
Ciri-ciri infeksi anaerob?
Disebabkan oleh mo endogen oportunistik, seringkali tidak menular
Terjadi pada imunokompromise host, dengan PO2 jaringan yang rendah
seringkali polimikroba
Membentuk abses atau jaringan nekrotik
Seringkali memerlukan antibiotik sepektrum luas
Tanda klinis infeksi anaerob
Keadaan klinis yang memungkinkan infeksi anerob al: infeksi paru dengan disertai aspirasi,
infeksi setelah operasi abdomen, sepsis post abortion
Discharge yang berbau busuk sekali
Jaringan nekrotik, gangrene, membentuk pseudomembran
Terbentuk gas pada jaringan atau discharge
Tanda infeksi tetapi kultur rutin (anaerob) negatif
Infeksi menyertai malignansi
Infeksi yang berhubungan dengan penggunaan aminoglikosid
Septic tromboplebitis
Bakteremik dengan jaundice
Infeksi karena gigitan atau tusukan
Perubahan warna eksudat menjadi hitam
Tampak granul sulfur pada discharge
Gas gangrene
Faktor virulensi?
Broad Classes of Virulence Factors
Associated with Gram-Neg. Anaerobes
Adhesins
Protection from:
Oxygen toxicity
Phagocytosis
Tissue Destruction
Anaerobic Gram-Neg. Virulence Factors
Anaerobic Gram-Negative Virulence
Factors (cont.)
Bagaimana menanganinya?
Non-Sporeforming
Anaerobes
Stains gram-variable or gram-negative,
but not a gram-negative cell wall
Non-Sporeforming
Anaerobes (cont.)
Most Common
Sites of Anaerobic
Infection
Anaerobic Gram-Positive
Non-Sporeforming
Bacterial Infections
Gram-Positive
Non-sporeforming
Anaerobes
(doxycycline)
Anaerobic Gram-Negative
Non-Sporeforming
Bacterial Infections
Anaerobic Gram-Negative Infections
Anaerobic Gram-Negative Infections (cont.)
Clinically Predominant Anaerobic Gram-Negatives
Epidemiology of
Bacteroides
Bacteroides Gram Stain
Bacteroides Virulence Factors
B fragilis
is a very important pathogen among the anaerobes that are part of the
normal microbiota (commensal in GIT)
Treatment of the animals with both gentamicin and clindamycin, a drug
effective against Bacteroides species, prevents both the initial sepsis and
the later devel
The capsular polysaccharides of Bacteroides are important virulence
factors.
have lipopolysaccharides (endotoxins) but lack the lipopolysaccharide
structures with endotoxic activity (including β-hydroxymyristic acid)
Specimen:Terutama pus
Microscopy:
Gram negative, non motile, non sporing, pleomorphic rod,
Culture:kanamycin or neomycin blood agar produce grey, non hemolitic,
glistening colonies
Treatment
The most active drugs for treatment of anaerobic infections are clindamycin
and metronidazole, although clindamycin resistance among the B fragilis
group has increased in the past decade.
Clindamycin is preferred for infections above the diaphragm.
The carbapenem antibiotics, ertapenem, imipenem, meropenem, and
doripenem, have good activity against many anaerobes, and resistance is
still uncommon.
Tigecycline, an agent that has FDA approval for the treatment of skin and
soft tissue and intra-abdominal infections, has good in vitro activity against
a variety of anaerobe species, including the B fragilis group