Mikroba Penyebab Infeksi Pada Organ Indera_2013

8/12/2019 Mikroba Penyebab Infeksi Pada Organ Indera_2013

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Department of Microbiology

FMUI-Jakarta, 2013


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Eye Nose and Upper Respiratory Tract

Ear Sinus


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Staphylococcus epidermidisand Lactobacillus spp. >>

Propionibacterium acnes

Staphylococcus aureus


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The eyelashes: prevent entry of foreign materialinto the eye

The lids blink 15 to 20 times per minute secretions of lacrimal glands and goblet cells wash away bacteria and foreign matter

Lysozyme and immunoglobulin A The delicate intraocular structures are envelope

in a touch: collagenous coat ( sclera, cornea)


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If the barriers are broken by penetrating

injury or ulcerationinfection may occur

Infection can also rich the eye via the

Bloodstream

Nervous system: HSV by movement alongtrigeminal nerve


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Conjunctivitis

Inflammation of the conjunctiva

KeratitisInflammation of the cornea

Endophthalmitis

Inflammation of the uveal tract or posteriorchamber; usually an intraocular infective cause

Orbital cellulitis

inflammation of the periocular tissue


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Blepharitis

Inflammation of the margins (edges) of the eye lids

Choroidoretinitis and uveitis

Inflamation of the retina and underlying choroid or the uvea. Lacrimal infection; canaliculitis

chronic inflammation of the lacrimal canals (eyelid swells andthick,mucopurulent discharge)

DacryocystisInfection of the lacrimal sac

Dacryo-adenitis

Acute infection of the lacrimal gland


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Neisseria gonorrhoeaeophthalmianeonatorum

Severe purulent conjunctivitis, occurs on the firstor second day of life

Corneal damage, blindness in later life


sticky eyes: 5-10 days after birth

Autogenous infection from nose or skin fingers


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Pseudomonas aureginosa

Opportunist cause, following trauma, present of

foreign body, operation on the eye, defectiveimmune response

Complication: invasion of the eye and blindness

Source: contaminated multi-dose containers of

eye drops, wet nail brushes, soap dishes


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Haemophilus influenzae Neisseria meningitidis

Streptococcus penumoniaeSevere purulent conjunctivitis

Treponema pallidum

Intertitisl keratitis (congenital syphillis syndromes)

blindness

Leptospira

Conjunctivitis as a part of Weils disease


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nonmotile coccoid bacteria, obligateintracellular parasites of eukaryotic cells

cause trachoma inclusion conjunctivitis (TRIC):

congenital infection ( follicular keratoconjunctivitis),

4-7 days after birth

Late life: mild-severe kerato-conjunctivitis, cornealdamage


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Surface molecules that bind specifically toreceptors on host cells

Transmission: contact (contaminated flies,fingers, towels), swimming pools

Trachoma: chronic repeated infections,prevalent when there is poor access of water,preventing regular washing of the hands andface


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Rubella Contracted during intra-uterine life and may

cause congenital eye lesion, incl. cataracts

Adenovirus Non-purulent conjunctivitis, often association

with pharyngitis Type 8epidemic keratoconjunctivitis,

associates with dust particles of factories orhospitals


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Herpes simplex Superficial corneal dendritic ulcersextend

corneal damage

Debilitated or immunosuppressed patients, steroids

Varicella zooster Conjunctivitis

Ophthalmic division of trigeminal nerve is frequentlyinvolved

Measles virus: via blood


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Fusarium, Candida, andAspergillus sp.

Very rare

Immunosupressed patient

Follow operations on the cornea inimmunologically normal patients


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Eyelid infection: Staphylococcus aureus

Orbital and inner eye infections Cellulitis of the skin around tge eyes

Spreading infection from adjacent sinuses

A mixed infection is often present

Choroidoretinitis Cytomegalovirus, AIDS, Rubella


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Swabs for bacterial or fungal culture: Direct smears and inoculation of plates

Stuarts transport medium

Conjunctival scrapings and cultures forchlamydia

Swabs for virus isolation

Serology


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Common species colonizing these areas include:

Streptococci, Staphylococci, Diphtheroids , Gram-negative cocci

Anaerobic bacteria

Some of the aerobic bacteria found in healthyindividuals are potentially pathogen e.g.:

S. aureus, S. pneumoniae, S. pyogenes, N meningitidis

MRSA=Methicillin Resistant Staphylococcus aureus

Candida


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Bacteria carried in the majority of people Streptococcus viridans, Neisseria spp.,

Diphtheroids

Anaerobic cocci, fusiforms, Prevotella spp.,Bacteroides

Respiratory bacterial pathogens that may be

carried asymptomatically S.pyogenes, S.pneumoniae

Haemophilus influenzae

Corynebacterium diphtheriae


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Organisms sometimes associated withtransient colonization secondary to antibiotic

therapy Coliforms Klebsiella spp., E.coli, etc.

Pseudomonas spp.

Candida albicans


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Nose

detection of MRSA carriers

Nasopharyngeal swabs diagnosis of Bordetella

pertussis

Nasopharyngeal swabs andwashings

diagnosis of viral disease


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Throat

detection ofstreptococcalpharyngitis


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Candida albicans penetrating the epithelium withits pseudomyceliacausing thrush

Prolonged administration of broad spectrumantibiotics

Immunity is impaired: HIV infection, malignancy,newborn, infants, and elderly

Diagnosis: Gram stain and culture of scraped

material

Treatment:Topical antifungal agents: nystatin, fluconazole


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Iritation in the outer ear and a scanty

discharge

Causes:

Bacterial: S.aureus, Proteus spp.,

Pseudomonas aeruginosa Fungal:Aspergillus niger, Candida albicans


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Acute diffuse otitis externa (swimmers ear)maceration (softening of tissue) of the ear

from swimming and/ or hot, humid weather(Pseudomonas aeruginosa)

Chronic otitis externaresults from the irritation of drainage frommiddle ear with chronic suppurative otitismedia and perforated eardrum


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Malignant otitis externa

necrotizing infection that spreads to

adjacent areas of soft tissue, cartilage andbone

Pseudomonas aeruginosa and anaerobic

bacteria Eldery diabetic patients


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Most common in infants and young children Causative agents:

Viruses >>

Bacteria:

Streptococcus pneumoniae

Haemophillus influenzae

Streptococcus pyogenes


Moraxella catarrhalis


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Anatomic and physiologic abnormalities

of the auditory tube predispose

individuals to develop otitis media

Infants and small children: auditory tube

is open more widely


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Auditory tube

Protecting the middle ear fromnasopharyngeal secretions

Draining secretions produced in the middleear into the nasopharynx

ventilating the middle ear so that airpressure is equilibrated with that in theexternal ear canal


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Chronic suppurative otitis media

No adequate treatment of OMA

Chronic discharge of pus through a perforation inthe ear drum, some obvious loss of hearingpresent

Causative agent = etiologies of OMA + Gram-negative bacilli (Proteus, Pseudomonas,Bacteroides)


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Mastoiditis: detected by tenderness orswelling behind the pinna

Meningitis

Otogenic brain abscess


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May follow a previous attack of otitis media butsometimes etiology is uncertain

Effusion present in the middle ear, serous ormucinous, fluctuating hearing loss

Drainage may required

Recurrent attacks

Cultured of fluid is often sterile


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Specimen collection for culture: Outer: swab

Inner: aspirate

Mastoid: taken on swabs during surgery

Specimens should be transported aerobically

and anaerobically Transport medium

Room temperature

Less than 2 hours


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Use moistened swab to remove any debris or crustfrom ear canal

Obtain sample by firmly rotating swab in outercanal

For otitis externa, vigorous swabbing is required surface swabbing may miss streptococcal cellulitis.


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Tympanocentesis should be reserved forcomplicated, recurrent, or chronic persistentotitis media. For intact eardrum, clean ear canal with

soap solution and collect fluid via syringe

aspiration. Submit in sterile container. For ruptured eardrum, collect fluid onflexible shaft swab via an auditoryspeculum. Transport time


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Sinuses: air-filled

cavities within thehead

The sinuses are

normally sterile


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develops during the course of a cold orinfluenzae illness and tend to be self-limitedlasting 1 to 3 weeks.

Symptoms: purulent nasal and postnasaldischarge, a feeling of pressure over the sinusareas of the face, cough, and nasal quality to thevoice.

Complication: local extension into the orbit,skull, meninges or brain, and development ofchronic sinusitis


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Most cases: bacterial secondary infection

5% - 10% of acute maxillary sinus infectionresult from a dental infection.

The primary problem associated with chronic

sinusitis are: inadequate drainage, impairedmucocilliary clearance, and mucosal damage


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Young adults:

Haemophilus influenzae,

Streptococcus pneumonia

Streptococcus pyogenes,

Moraxella cattarrhalis.

Children:

S. pneumoniae,

H. influenzae,

M. catarrhalis

Rhinovirus


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Otolaryngologist obtain the material frommaxillary sinus by puncture and aspiration orduring surgery

Transported in aerobic and anaerobic condition

Once received by the laboratory :

Gram-stained smears Aerobic and anaerobic cultures , identification

Susceptibility tests


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Mikroba Penyebab Infeksi Pada Organ Indera_2013

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