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Family Enterobacteriaceae Manik Retno W., dr., MKes

Family Enterobacteriaceae Manik Retno W., dr., MKes. • Banyak di usus besar mns, hewan, serangga (normal flora), tanah & air (25 genus, 110 species) • Media diferensial : 1. MacConkey agar Gula : laktosa Indikator warna : neutral red

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Family Enterobacteriaceae Manik Retno W., dr., MKes

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  1. Family EnterobacteriaceaeManik Retno W., dr., MKes

  2. • Banyak di usus besar mns, hewan, serangga (normal flora), tanah & air (25 genus, 110 species) • Media diferensial : 1. MacConkey agar Gula : laktosa Indikator warna : neutral red - Kuman yg memfermentasi laktosa → koloni- nya berwarna merah - kuman yg tak fermentasi → tak berwarna

  3. 2. Eosin Methylene Blue agar (EMB) gula : laktosa & sukrosa indikator warna : Eosin & methylene blue E. coli : memfermentasi laktosa → koloninya metallic sheen

  4. LPS (Lipopolysaccharide) : suatu endotoksin - bagian dari dinding sel - menjadi toksin jika kuman hancur - menyebabkan demam pada inang

  5. Kuman yang memfermentasi laktosa • Escherichia • Klebsiella Merupakan flora normal usus : 1. Opportunistic pathogen (baru menimbulkan peny jika immun Px ↓) 2. Infeksi nosokomial : inf. yg terjadi di RS

  6. Penyebaran : 1.fecal – oral: † dg pemanasan, chlorinasi 2. Iatrogenik : karena tindakan medis

  7. E. coli • memproduksi colisins untuk mematikan kuman lain • Sering menyebabkan ISK Gejala : 1. sering kencing 2. dysuria (nyeri waktu kencing) 3. hematuria (darah +) 4. pyuria(sel darah putih) 5. Flank pain/nyeri punggung → ginjal • Melekat pd sel inang dg pili

  8. E. coli mempunyai sex pili penyalur materi genetik

  9. Enterotoxigenic E. coli (ETEC) • penyebab traveler’s diarrhea sumber : sayur mentah, air penduduk lokal kebal thd strain yg ada • kuman kolonisasi di usus halus, invasi (-)  enterotoxin Heat labile (LT):  cAMP Gx : watery diarrhea 20x/hr

  10. Lumen  Na+ aliran elektrolit normaldarah Na diserap dari lumen ke darah kolonisasi kuman, kuman memproduksi toxinheat labile toxin (LT)  cAMPaliran Na terhambatCl-  sehingga Cl ikut ke lumen NaCl menarik air ke lumenair terjadi diare kuman cAMP Na+ NaCl

  11. Klebsiella Kuman yg memproduksi urease : • Klebsiella • Proteus → memfermentasi laktosa Jika menginfeksi sal kencing → menghidrolisa urea → ammonia → pH jadi basa → presipitasi Ca & Mg → batu sal kencing

  12. 1% radang paru (pneumonia) disebabkan Klebsiella pneumoniae

  13. Klebsiella : - mempunyai kapsul (K antigen) → mencegah fagositosis a. K Ag tipe 1, 2 : inf saluran napas b. K Ag tipe 8,9,10,24 : inf saluran kencing - koloni mucoid

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