Streptococcus Pneumoniae Lp UTM

7/25/2019 Streptococcus Pneumoniae Lp UTM

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Streptococcus pneumoniae

Fac parte din flora normal a tractului respirator superior , frecventa portajului oro-

faringian fiind estimat la 30-70%.

Poate coloniza si mucoasa genito-urinar sau intestinul.

n raport cu localizarea infectie pneumococii pot cauza:

infectii acute ale tractului respirator inferior:

ronsit

!ronsita cronica - Procesul inflamator cronic determin leziuni ireversi!ile ale mucoasei "i

glandelor su!mucoase, precum "i ale aparatului mioelastic

Pneumonie

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infectii ale cavittilor conecte ale tractului respirator

sinusit

otit medie acut

mastoidit

alte infectii

peritonit

meningit

endocardit

conjunctivit etc.

$


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Diagnosticul de laborator in infectiile cuStreptococcus pneumoniae

Produse patologice

sputa,&', secretii etc

Recoltare produs patologic

PRODUS RECOLTREa!C"T#TTEb!TR"SPORT

O$SER%T##RESPECTA

PRECAUTIUNILE

UNIVERSALE

SPUTPeria&ul dintilor , clatireaenergica a gurii si gargara cuapa'

Tuseste si e(pectoreaza intr)un recipient steril *cu gatullarg cu capac care se inc+ideermetic!

a! - mlb! . / +

Se recolteaza sputa subdirecta indrumare aasistentei'

Se e(plica pacientuluidiferenta dintre ae(pectora si a scuipa'Sputa se recolteazadimineata cand pacientulface 00toaleta bronc+iilor1'

E(amenulmacroscopic: sputa ruginie, muco-purulenta

E(amenul microscopic direct(frotiu din produsului patologic *pp!

colora)ia *ram: coci lanceolati, dispusi +n diplo cu capetele ascutite spre eterior

si +nconjurati de o capsula proprie

coci dunt localizati intra si perileucocitar prezenta celulelor inflamatorii, care este

dovada ca s-a recoltat un produs patologic real sputa, nu saliva/, rare cellule

epiteliale

Sputum Gram stain from a patient with a pneumococcal pneumonia. Note the numerous

polymorphonuclear neutrophils and gram-positive, lancet-shaped diplococci. Courtesy of C. Sinave,

MD, personal collection

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&riterii de respingere a sputei

mai mult de $1 celule epiteliale pe campul microscopic

#nsamantarea pp

se insamanteaza in poligon desc2is fara o latura/ pe medii solide, in scopulo!tinerii coloniilor micro!iene izolate: &olum!ia sange

#ncubare la 374&, #5 $ ore, in prezenta 1% &6$

#dentificarea bacteriei

Caractere morfotinctoriale2 frotiu din cultur3 pur3: coci lanceolati, dispusi +n

diplo cu capetele ascutite spre eterior

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Caractere de cultur32 colonii 89, cu 2emoliza partiala viridans

;up #5-$ de ore coloniile mucoide vor prezenta +n centru o deprimare ceea ce confer

aspect crateriform coloniei, datorit fenomenului de autoliz.

Caractere bioc+imice:

4ermentarea inulinei

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Produce enzime autolitice fenomen indus si accelerat de !il, sruri !iliare,

acizi !iliari.

Testul bilolizeieste util +n diferentierea pneumococilor

de alti streptococi alfa-2emolitici care nu sunt lizati +n prezenta !ilei.

S.pneumoniaesunt sensi!ili la optoc2in etil-2idrocuprein/, sensi!ilitatea la aceast

su!stant fiind de asemenea util +n identificarea si +n diferentierea

pneumococului de alti streptococi viridans.

Testul de sensibilitate la optoc+in


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Reactia de umflare a capsulei

>ntigenul capsular poliza2aridic are si el specificitate de tip, +mprtind pneumococii +n

aproimativ ?0 de serotipuri capsulare diferite care pot fi identificate prin reactia de

umflare a capsulei cu seruri specifice anticapsulare polivalente si monovalente,

@eufeld/.

ntibiograma

9treptococcus pneumoniae prezenta o foarte mare sensi!ilitate la penicilin

pAn +n anul #?7.

Bulpinile rezistente la penicilin pot prezenta rezistent si la alte anti!iotice,

incluzAnd macrolide, rifampicina, cefalosporine, cloramfenicol,

sulfametoazoltrimetoprim, clindamicin, tetraciclin, etc.

>nti!iograma este astzi strict necesar +n infectiile pneumococice,

testarea sensi!ilittii fat de penicilin fiind realizat cu microcomprimate de

oacilin de # CgDml.

Eediul Euller inton cu 1% sange , inocul 0.1 EFarland, temp 31 &, incu!are #5 panala $ ore, 1 % &6$

>legerea discurilor pentru testarea sensi!ilitatii prin metoda difuzimetrica, interpretarea

rezultatelor conform Performance standards for antimicrobial susceptibility

testing;

&9G D$0#0 anterior numit @&&9/

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Kirby-Bauer sensitivity plate to test the effectiveness of various antibiotics on the bacterial culture.

Modul de desfasurare a lucrarii practice

studentii primesc manuscrisul cu etapele diagnosticului de laborator in

infectia cu Streptococcus pneumoniae.

1. Lp se desfasoara interactiv- se discuta pe marginea manuscrisului primit

anterior LP-ului

2. material demonstrativ-medii de cultura-Columbia-sange -colonii de

S. pneumoniae,studentii recunosc coloniile, recunosc hemoliza viridans

3. antibiograma S .pneumoniaestudentii masoara diametrele si noteaza in

caiet, interpretare conform CLSI/2010,.S. pneumoniae

4. Fiecare student prinde imaginea la microscop si examineaza frotiuri

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Bibliografie

Bacteriologie Medicala, Olga Dorobat, editura UTM, 2006

Clinical Microbiology Procedures Handbook, Henry D. Isenberg, editata

American Society for Microbiology,2004

Koneman's Color Atlas and Textbook of Diagnostic Microbiology,Washington

C Winn, Stephen D. Allen, Gail L. Woods, William M. Janda, Paul C.

Schreckenberger, editura Lippincott Williams & Wilkins, 2005

Manual of Clinical Microbiology , Patrick R. Murray,

Visit Amazon's Patrick R. Murray Page

search results

Learn about Author Central

Ellen Jo Baron, Michael A. Pfaller, Fred C. Tenover, Robert H. Yolken, editura

ASM, 2007

Performance Standards for Antimicrobial Susceptibility Testing.M 100, S19

CLSI /2010

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Streptococcus Pneumoniae Lp UTM

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