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  • Peptococcus Peptostreptococcus

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    Ion Popescu
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    This document summarizes various Gram-positive and Gram-negative bacteria. It lists Staphylococcus, Streptococcus, Enterococcus, Bacillus, Corynebacterium, Listeria, and others as Gram-positive aerobic cocci and bacilli. It also lists Clostridium, Actinomyces, Propionibacterium, and others as Gram-positive anaerobic bacilli. Gram-negative aerobic and anaerobic cocci and bacilli are also listed including Neisseria, Haemophilus, Pseudomonas, Acinetobacter, Bacteroides, and others. Common pathogenic and commensal microorganisms are distinguished.

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    curs 3.21 infectioase bals

    Original Title

    C3.2

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    This document summarizes various Gram-positive and Gram-negative bacteria. It lists Staphylococcus, Streptococcus, Enterococcus, Bacillus, Corynebacterium, Listeria, and others as Gram-positive aerobic cocci and bacilli. It also lists Clostridium, Actinomyces, Propionibacterium, and others as Gram-positive anaerobic bacilli. Gram-negative aerobic and anaerobic cocci and bacilli are also listed including Neisseria, Haemophilus, Pseudomonas, Acinetobacter, Bacteroides, and others. Common pathogenic and commensal microorganisms are distinguished.

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    © All Rights Reserved
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    22 views25 pages

    Peptococcus Peptostreptococcus

    Uploaded by

    Ion Popescu
    This document summarizes various Gram-positive and Gram-negative bacteria. It lists Staphylococcus, Streptococcus, Enterococcus, Bacillus, Corynebacterium, Listeria, and others as Gram-positive aerobic cocci and bacilli. It also lists Clostridium, Actinomyces, Propionibacterium, and others as Gram-positive anaerobic bacilli. Gram-negative aerobic and anaerobic cocci and bacilli are also listed including Neisseria, Haemophilus, Pseudomonas, Acinetobacter, Bacteroides, and others. Common pathogenic and commensal microorganisms are distinguished.

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    © All Rights Reserved
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    of 25

    Coci Gram pozitiv aerobi Coci Gram pozitiv anaerobi

    • Staphylococcus spp – Peptococcus


    – Stafilococ auriu (coagulazo pozitiv) – Peptostreptococcus
    – Stafilococ alb (coagulazo negativ)
    • Streptococcus spp
    – S.pyogenes (grup A beta hemolitic)
    – S.agalactiae (grup B)
    – S.bovis (grup D)
    – Streptococi “orali” (viridans)
    – S. pneumoniae
    • Enterococcus spp (faecalis, faecium, durans, avium)
    Bacili Gram pozitiv anaerobi
    Bacili Gram pozitiv aerobi • Actinomyces israelii
    • Bacillus (anthracis, cereus)
    • Corynebacterium diphteriae
    • Clostridium perfringens, tetani, botulinum, difficile
    • Erysipelothrix rhusiopathiae • Lactobacillus (facultativ anaerob)
    • Listeria monocytogenes • Propionibacterium acnes (facult anaerob)
    • Nocardia
    Coci Gram negativ aerobi Coci Gram negativ anaerobi
    Branhamella (Moraxella) catarrhalis • Veionella
    Neisseria meningitidis Bacili Gram negativ anaerobi
    • Bacteroides
    Neiserria gonorrhoeae • Prevotella
    • Fusobacterium
    Bacili Gram negativ aerobi
    Fermentativi Spirochaetaceae
    Enterobacteriaceae (E. Coli, Proteus, Salmonella, Shigella, Treponema, Borrelia, Leptospira
    Klebsiella, Enterobacter, Citrobacter, Serratia, Providencia,
    Morganella morganii, Yersinia, Aeromonas, Vibrio Mycobacteriaceae
    Fermentativi cu creștere dificilă (HACEK) Complexul tuberculosis (BK, bovis, africanum)
    Nefermentativi M.Leprae
    • Pseudomonas aeruginosa (piocianic) Micobacterii atipice (M.avium intracellulare, kansasii,
    • Burkolderia cepacia marinum, xenopi)
    • Stenotrophomonas maltophila Mycoplasmataceae
    • Acinetobacter spp M.pneumoniae, hominis, Ureaplasma urealyticum
    Alti BGN Chlamydiaceae
    Haemophillus influenzae, Brucella, Pasteurella, Bordetella C. pneumoniae, psittaci, trachomatis
    pertussis, Legionella, Campylobacter, Helicobacter, Rickettsiaceae
    Gardnerella vaginalis R.conorii, typhi, prowazekii, Coxiella burnetii,
    Ehrlichia, Bartonella henselae, quintana
    Microorganismele comensale vs patogene

    Saprofit: μorganism care se dezvoltă fără să


    determine manifestări patologice (uneori Patogen: μorganism capabil
    simbioză) să producă o boală
    Oportunist: agent infecţios ce devine patogen infecţioasă (BI)
    când imunitatea este alterată
    De unde vin microorganismele care cauzează
    infecţii?

    • Microorganismele care produc infecţii (sporadice, epidemice,


    endemice)
    – Endogene: comensale/saprofite
    – Exogene: aer, sol, apa, alimente, animale, oameni, vectori
    Cum se transmite un agent patogen de la o
    persoana la alta?

    Indirect Direct:
     Prin intermediul: apei, hranei,  Atingere, sărut, contact
    prod.biologice, organe, obiecte, sexual, picături Flugge
    instrumente chirurgicale  Muşcătură de animal,
     Prin vectori: mecanic, biologic contact cu solul
     Prin aer (particule 1-5μm, nu picaturi  Transplacentar
    Flugge)
    Ce determina caracterul “periculos” al unui
    microorganism?
    De unde vin microorganismele care cauzează
    infecţii?

    • Dupa locul în care sunt dobândite infecţiile:


    – Infecţii comunitare  germeni cu sensibilitatea la Ab de
    regula pastrata

    – Infectii asociate asistentei medicale  Gram-neg


    posibil MDR; +/-ESBL

    – Infecţii nozocomiale  Gram-neg MDR, germeni


    fermentativi (piocianic, acinetobacter)

    MDR=multi-drug resistant; ESBL=extended-spectrum beta-lactamase


    Bacterii implicate frecvent în
    infecţii comunitare

    • Respiratorii:
    Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus
    influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae
    • Intestinale: Salmonella, Shigella
    • Urinare: E.coli
    • Genitale: N. gonorrhoeae, Chlamydia trachomatis
    • Cutanate: Streptococcus pyogenes, Staphylococcus aureus
    Bacterii implicate în infecţiile nozocomiale
    Clostridium difficile
    • dintre cele mai frecvente IN la ora actuala: “diareea postantibiotic” =
    colita pseudomembranoasa

    Stafilococ-MR
    • Infectii mai frecvent nozocomiale, deci mai grave
    • Prognosticul - mai putin bun
    • Posibilitatile terapeutice (antibiotice) -considerabil reduse
    (antibiograma este indispensabila)
    Orice Stafilococ“de spital” este a priori MR pana la proba contrara!

    Enterococi
    • frecvent implicaţi în infecţii pelvine şi intra-abdominale
    • pot produce endocardite, infectii urinare inalte

    Bacili Gram-negativ
    • Fermentativi - Enterobacterii (E.coli, Klebsiella, Enterobacter,
    Serratia, Proteus, Citrobacter, mai rar Salmonella si Yersinia)
    • Nonfermentativi: Acinetobacter, Pseudomonas
    ESCAPE

    = bacteriile cu abilitate de a scapa (escape) efectului antimicrobienelor


    disponibile:

    E Enterococcus faecium

    S Staphylococcus aureus

    C Clostridium difficile

    A Acinetobacter baumannii

    P Pseudomonas aeruginosa
    K.pneumoniae, Enterobacter spp. si
    E Enterobacteriaceae: alte specii rezistente ca
    Escherichia coli si Proteus spp.

    Peterson LR. Clin Infect Dis. 2009;49:992


    Infecţia şi imunitatea antiinfecţioasă
    • Infecţia: multiplicarea unui μorganism la nivelul unei gazde (poate fi
    benefică)

    • Boală infecţioasă: rezultatul agresării organismului de către un


    agent patogen, care determină modificări:

    Anatomice  Manifestări clinice (BOALA)


    Funcţionale Biologice, umorale

    VIRULENŢA AGENT PATOGEN <=> CAPACITATE DE APĂRARE

    • Virulenţa: măsura cantitativă a patogenităţii (probabilitatea de a


    determina boala)

    • Patogenitatea: nr de persoane care dezvoltă boala clinic/nr de


    persoane infectate

    • Infectivitatea: nr de indivizi infectaţi/nr de indivizi susceptibili


    (expuşi)
    Durata până când o infecţie bacteriană devine
    manifestă
    Durata Boala Microorganism Mecanism

    Min/ore Toxinfectie S aureus Toxină alimentară

    Ore Fasceită Streptococcus Răspândirea


    necrozantă pyogenes bacteriilor

    Zile Antrax Bacillus anthracis Rezistenţă la macrofage

    Săptămâni Abces pulmonar Anaerobi orali Proces piogenic necrotizant


    Luni Endocardită bact. Streptococi β hemoliticiInfecţie sediu privilegiat

    Ani (persistenţă) Osteomielita S.aureus Infecţie piogenă de ţesut


    devitalizat +/-corp strain
    Ani (latenţă) Tuberculoza Mycobacterium Reactivarea unui focar tuberculosis latent în
    proces granulomatos
    Decade Oncogeneză Helicobacter pylori Persistenţa inflamaţiei
    selectează anomaliile celulare
    Microbiomul uman

    • Microbiom ~ Microbiota = ansamblul


    microorganismelor care populeaza cvasistabil un
    anumit areal

    • Microbiomul uman ~ ansamblul microbiotelor care


    populeaza diversele situsuri ale organismul uman:

    – Pielea
    – Tubul digestiv (cavitatea orala, intestinul subtire, colonul)
    – Vaginul
    – Caile respiratorii (fosele nazale)
    Tubul digestiv

    • Microbiota intestinala ajunge la 10^12 germeni/g materie fecala  10^14


    germeni in tubul digestiv  1.2 kg = organ bacterian

    • Suprafata tub digestiv ~ 400mp = cea mai mare suprafata expusa exteriorului 
    necesita cea mai puternica aparare: >60-80% din totalul LfT= la nivel intestinal!
    (majoritatea cu memorie, majoritatea CCR5)
    Microbiota intestinală
    increngaturi (phyla) predominante

    Firmicutes 35-65%
    Bacteroidetes 25-55%
    Actinobacteria 8-55%
    Proteobacteria 2%

    +/-Verrucomicrobia (0-5%)
    Kingdom Plylum Class Order Family Genus Species
    King Philip Came Over From Great Spain
    Firmicutes
     Lactobacillales  Lactobacillus spp
     Streptococcus spp, Enterococcus spp
     Clostridiales  Clostridium spp (cluster IV, XIV)
     SFB (segmented filamentous bacteria)
     Selenomonadales  Veillonella spp

    Bacteroidetes    Bacteroides spp (B fragilis 41% microbiote)


    Actinobacteria   Bifidobacterium spp
    Actinobacteria
    Proteobacteria
    Proteobacteria
    Enterobacteriales - Enterobacteriaceae
    Pseudomonadales  Pseudomonas spp
    Campylobacterales  Helicobacter spp

    Verrucomicrobia
    Veruccomicrobia
    Verrucomicrobiales  Akkermansia muciniphila
    Schirmer & al Cell 2016
    100

    Schirmer & al Cell 2016


    Schirmer & al Cell 2016
    Rolurile microbiotei intestinale

    • Sinteza vitamine grup B si K


    • Digestia polizaharidelor complexe de origine vegetala
    • Bariera pentru patogenii introdusi in organism

    • Diabet zaharat (SFB, Akk)


    • Patologie cardio-vasculara
    • Obezitate (Akkermansia muciniphila)
    • Imbatranire

    • Atractie sexuala (Klebs vs Ps)

    • Anxietate, depresii, alte tulburari de comportament


    (Bacteroides, Bifido, Lactobacillus ramnosis)

    • Imunitate (20 genuri - 41 spp) – in special produsii lor


    Dao &al Gut 2016; Naito &al J. Clin. Biochem. Nutr. 2018; Chen &al Front. Microbiol. 2018
    Conexiunea intestin-creier; film Caltech
    Organul imunitar
    • Microbiota - rol esential in dezv& antrenarea sistemului imun: soriceii germs-free hraniti
    cu hrana autoclavata& apa sterila dezvolta foarte putini foliculi limfatici intestinali si in
    organe limfatice la distanta – linii lfT si B sarac dezvoltate , aberante

    • Microbiota in sine (<) sau prin metaboliti (>>) poate varia pana la 10% rasp imun!!
    • Actioneaza in special pe TNF-A (Mo) si IFN-G (Lf)
    • Tunning al sistemului imun/comutare pe raspuns Th1, Th2, Th17 si Tregs:

    Lactobacillus,
    Clostridium cluster IV & XIV
    SFB (Candidatus savagella) Th0 Bacteroides fragilis
    ultima parte IS, primii 2-3 ani Bifidobacterium
    B
    de viata: ↑IgAs; preventie IL1
    2
    GF- TG
    IL4
    Akkermansia
    T IL6 F-
    DZI; ↑Th17 B
    ↑Tregs  ↑IL10

    Th1 Th17
    Th17 Treg
    Treg Th2

    Pro-inflammatory response Anti-inflammatory response

    IFN-G IL17 TGF-B IL4


    IL22 IL10 IL10
    Probiotice

    • Pro-bios = pentru viata (lunga)


    • ~100 ani, Elie Metchnikoff, parintele imunologiei (Nobel): microbii intestinali =
    cauza imbatranirii? Imbatranirea=autointoxicatie  bacteriile producatoare de
    acid lactic (din iaurt) suprima cresterea bacteriilor proteolitice, care provoaca
    “autointoxicarea”
    • Probiotice - Fuller (1989):“live microbial feed supplements that beneficially affect
    the host animal by improving its intestinal microbial balance.” bacteria such as
    lactic-acid bacteria and Escherichia coli strains (such as E. coli Nissle 1917), as
    well as yeast species including most prominently Saccharomyces boulardii

    • Prebiotice =“nondigestible food ingredients (lactulose, inulin, psyllium, and other


    oligosaccharides) that beneficially affect the host by selectively stimulating the
    growth and/or activity of one or a limited number of bacteria in the colon.”
    (onions, garlic, asparagus, leeks, artichoke, bananas, tomatoes, wheat, oats, soy
    beans, etc)

    • Synbiotics are a combination of a prebiotic and a probiotic, such as inulin and


    Lactobacillus rhamnosus GG or Bifidobacter longum.
    Verna&al Ther Adv Gastroenterol, 2010
    Verna&al Ther Adv Gastroenterol, 2010
    Ce mancam?

    • Probiotice
    – Iaurt: din lapte pasteurizat, NU UHT!!; drojdie
    – Comerciale: cand suntem sanatosi sau macar stabili!

    • Prebiotice & alte:


    – Polifenoli: struguri, (vin), ceai, mere, coacaze, merisor, midii
    – Isoflavone: soia
    – Acid clorogenic: cafea
    – Tryptophan (W): ou, cod, naut, susan, ciocolata, lactate
    – Acid palmitoleic: uleiuri vegetale, marine, nuci Macadamia

    • In calatorii:
    – Nu produse “stradale”!
    – Hrana: “Cook it, boil it, peel it or…forget it!”
    – Probiotice comerciale anterior testate
    – Apa imbuteliata – preferabil carbogazoasa (↑CO2)
    – Vaccinarea calatorului;
    – Trusa de calatorie: rifaximina, diosmectita, azitromicina

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