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Corynebacterium diphtheriae

Corynebacterium diphtheriae. Dr. Eko Budi Koendhori , dr.,M.Kes Bahan Kuliah FKM. Karakterisasi. Batang lurus atau sedikit bengkok , ramping, runcing kadang ujungnya membesar spt tongkat golf Ukuran 0,3 – 0,8 x 1,5 – 8,0 µm

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Corynebacterium diphtheriae

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  1. Corynebacteriumdiphtheriae Dr. Eko Budi Koendhori, dr.,M.Kes BahanKuliah FKM

  2. Karakterisasi • Batanglurusatausedikitbengkok, ramping, runcingkadangujungnyamembesarspttongkat golf • Ukuran 0,3 – 0,8 x 1,5 – 8,0 µm • Sel-seltersusuntunggalatauberpasangan, seringmembentukformasi V, L atau palisade (spthurufCina) • Gram pos, granulametakromatik pos  polimetafosfat • Non motil, sporaneg, BTA neg

  3. Fakultatifanaerob butuh media ygdiperkaya (serum/darah)  kolonikonveks, semi opaq, tepitdk rata • Katalase pos, mereduksinitratdantelurit • Kemoorganotrof : memfermentasiglukosadanmaltosamembentukasamtanpa gas • Obligatparasitpadamembranmukosaataukulitmamalia

  4. Patogenesis • C. diphtheriaebisaadadisalurannafas, luka, kulitorangygterinfeksiatau carrier • Toxin difteri : polipeptida, heat labile, BM 62.000, dosisletal 0,1 µg/kg • Toxin menghalangisintesa protein selshgmengalamikerusakan • Toxin diserapmukosadanselepitel rusak  fibrin, eritrositdanleukositberkumpulshgterbentukpseudomembranabu-abu, sering pd tonsil, faring ataularing, biladimanipulasiakanberdarah. • Terjadipembesarankelenjarlimfe regional.

  5. Bakteriterustumbuhdalammembranmemproduksi toxin menyebabkankerusakanlebihjauh, kerusakanparenkim, infiltrasilemak, nekrosisototjantung, hati, ginjaldankelenjar adrenal, kadangdisertaiperdarahanakut. • Difteripadalukaataukulitterjaditerutamadidaerahtropik, nampaklukaygsulitsembuhtpabsorbsi toxin hanyaringan, sistemikjarang. Toxin ygterbentukmemicuterbentuknyaantiboditerhadap toxin • C. diphtheriaeinfeksinyalokaltdkmasukkejaringanataukedarah

  6. Corynebacterium lain

  7. GejalaKlinis • Salurannafas: • nyeritenggorokdandemam, lemahdansesaknafaskrnobstruksiakibatpseudomembran • Segeralakukanintubasiatautrakheostomi matilemas • Ritmejantungtdkteratur  kerusakanmyocard • Gangguanmelihat, bicara, bengkak, sulitmenggerakkantangandan kaki

  8. DxLaboratoris • Terapispesifikharusdiberikantanpamenunggukonfirmasidx • Lakukan swab dihidung, tenggorokanataulesiditempat lain ygdicurigaisegerasebelumpemberianantibiotika • Swab dilakukandidasardarimembrandansegeraditanampada media transport sepertiAmies. • Segeralakukanpengecatanalkalinbirumetilinatau Gram

  9. Tanampada media lempeng agar darah, media Loefflerdantellurite plate • Dilanjutkan dg uji : • Elek test (kertas dg antitoxin) • Polymerase Chain Reaction  gen toxin (tox) • Enzyme-linked immunosorbent assay (Elisa) • Immunochromographic strip assay

  10. Terapi • Antibiotika : golpenisilinatauerytromisin membunuhbakteri • Antitoxin : harusdiberikansegera dg dosis 20.000 – 100.000 unit im/iv

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