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Matrikulasi Profesi Apoteker
Matrikulasi Profesi Apoteker
apoteker STIFAR
19/8/2019
Patogen: Mikroorganisme yg mampu menyebabkan infeksi disebut
Patogenisitas : Kemampuan agen infeksi utk menimbulkan penyakit.
Virulensi : kemampuan kuantitatif agen infeksi untuk menimbulkan penyakit,
ukuran PATOGENISITAS suatu mikroba
Infeksi: pertumbuhan dan perbanyakan mikroba pada/dalam tubuh manusia
dengan/tanpa menimbulkan penyakit.
TWO BROAD QUALITIES OF PATHOGENIC BACTERIA UNDERLIE THE MEANS BY WHICH THEY CAUSE DISEASE:
• 1. INVASIVENESS IS THE ABILITY TO INVADE TISSUES.
IT ENCOMPASSES MECHANISMS FOR COLONIZATION (ADHERENCE AND INITIAL MULTIPLICATION), PRODUCTION OF
EXTRACELLULAR SUBSTANCES WHICH FACILITATE INVASION (INVASINS) AND ABILITY TO BYPASS OR OVERCOME HOST
DEFENSE MECHANISMS.
• 2. TOXIGENESIS IS THE ABILITY TO PRODUCE TOXINS.
• BACTERIA MAY PRODUCE TWO TYPES OF TOXINS CALLED EXOTOXINS AND ENDOTOXINS. EXOTOXINS ARE RELEASED
FROM BACTERIAL CELLS AND MAY ACT AT TISSUE SITES REMOVED FROM THE SITE OF BACTERIAL
GROWTH. ENDOTOXINS ARE CELL-ASSOCIATED SUBSTANCE. (IN A CLASSIC SENSE, THE TERM ENDOTOXINREFERS TO
THE LIPOPOLYSACCHARIDE COMPONENT OF THE OUTER MEMBRANE OF GRAM-NEGATIVE BACTERIA). HOWEVER,
ENDOTOXINS MAY BE RELEASED FROM GROWING BACTERIAL CELLS AND CELLS THAT ARE LYSED AS A RESULT OF
EFFECTIVE HOST DEFENSE (E.G. LYSOZYME) OR THE ACTIVITIES OF CERTAIN ANTIBIOTICS (E.G. PENICILLINS AND
CEPHALOSPORINS). HENCE, BACTERIAL TOXINS, BOTH SOLUBLE AND CELL-ASSOCIATED, MAY BE TRANSPORTED BY
BLOOD AND LYMPH AND CAUSE CYTOTOXIC EFFECTS AT TISSUE SITES REMOTE FROM THE ORIGINAL POINT OF
INVASION OR GROWTH. SOME BACTERIAL TOXINS MAY ALSO ACT AT THE SITE OF COLONIZATION AND PLAY A ROLE IN
INVASION.
MO patogen perlekatan molekul permukaan patogen ( adhesin/ ligan pada
permukaan reseptor komplementer pd sel inang
Adhesin berada pada glikokaliks/ fimbria
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fimbrae
flagella
adhesive slimes or capsules
cilia
Suckers/ pengisap
Hooks/kait
Barbs/duri/ kait
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CIRI-CIRI EKSOTOKSIN ENDOTOKSIN
DOSIS LETAL Dalam menit (toxisitas tinggi) Lebih lama (Toxisitas rendah
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Flora normal
• Mikroba yang secara alamiah menghuni tubuh manusia disebut flora normal,
atau mikrobiota
• Mo yg hidup dlm tubuh manusia dalam keadaan tertentu tidak
menyebabkan penyakit.
• Flora normal:
A. Mulut dan saluran nafas
B. Sal. Cerna
C. Sal genital dan urinari
D. kulit, hidung dan telinga
E. Darah dan jaringan
Habitat: lokasi/tempat tinggal spesifik suatu MO
MO yg tinggal di suatu lokasi dapat bersifat :
A. Transient sementara
B. Indigenous menetap dlm beberapa generasi, dan umumnya bertahan pd
kondisi lingkungan
Tahap- tahap pathogenesis bakteri
1. Bakteri masuk ke dalam tubuh
2. Adhesi-Kolonisasi
3. Invasi
4. Kehidupan intraseluler
5. Perusakan organ/jaringan
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Infeksi Lokal : microbes enters body & remains confined to
a specific tissue
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Mixed infection – several microbes grow simultaneously at the
infection site
Primary infection – initial infection
Secndar infection – another infection by a different microbe
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Respiratory,
saliva
Skin scales
Fecal exit
Urogenital
tract
Removal of
blood
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Primary habitat in the natural world from which a pathogen
originates
Living reservoirs may or may not have symptoms
◦ Asymptomatic carriers
◦ Passive carriers
◦ Vectors – live animal that transmits infectious disease
Nonliving reservoirs – soil, water
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Five Modes of Transmission
• Waterborne transmission
- drinking water or swimming (usually via ingestion)
- fecal-oral route
- fecal contamination of drinking water from municipal wastewater sources or
animal feedlots
• Foodborne transmission
– ingestion of infectious agents in food
– poor sanitation, hygiene (fecal-oral route)
– insufficiently cooked fish and shellfish
• Airborne Transmission
– inhalation of pathogens in aerosols
– aerosols created at wastewater treatment plants, land application of
sludge, showers
– legionellosis, fungal infections
• Vector-borne transmission
–transmission by the bite of an animal host
–malaria, sleeping sickness, yellow fever
Direct contact
Indirect contact
◦ Vehicle – inanimate material, food, water, biological products, fomites
◦ Airborne – droplet nuclei, aerosols
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* Horizontal: Mother to infant
Prenatal: across the placenta; HIV
Perinatal: at birth, STD like gonorrhea and
syphilis, even Chlamydia blindness
Diseases that are acquired during a hospital stay
Most commonly involve urinary tract, respiratory tract, &
surgical incisions
Most common organisms involved gram-negative intestinal
flora, E. coli, Pseudomonas, Staphylococcus
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Bakteri patogen pada sal cerna
Umumnya Bakteri famili enterobactericeae
Sal cerna, usus besar manusia( enterik) dan hewan, tanah, air,
Sebagian besar tidak menimbulkan penyakit
Bila terjadi perobahan pd hospes penyakit pd jar tubuh manusia
E. coli, Salmonella, shigella, Yersenia enteracolitica
Vibrio, H. pylori,Bacillus, campylocacter
E. coli
Gram (-). Kokobasil, flagel, simpai, tumbuh baik hampir di semua media
Dapat meragi laktosa. Mikroaerofilik
Memp. Struktur antigen O. H dan K
150 antigen O, 90 tipe antigen K dan 50 antigen H
Sifat fisik, antigen : 3 L. A. B
Faktor virulensi :
antigen permukaan
Enterotoksin
Hemolisin
Antigen permukaan
2 jenis fimbria E. coli: manosa sensitif (pili) dan manosa resisten(
colonization factor antigen, CFA I &II)
Kolonisasi : pelekatan bakteri pada sel hospes
CFA I, II melekatkan bakteri E. coli enteropatogenik pd sel epitel usus
Enterotoksin
LTtoksin (termolabil)
ST toksin ( termostabil)
MK toksin LT:
Merangsang enzim adenilat siklase( dlm sel epitel usus) sehingga
terjadi peningkatan permeabilitas sel usus, akumulasi cairan
didalm usus diare
Toksin ST
Asam amino
MK : mengaktifkan enzim guanilat siklase menghasilkan guanisin
monofosfat silik gangguan absorpsi klorida dan Na, menurunkan
motilitas usus.
Hemolisin perdarahan
Protein bersifat toksik terhadap sel jaringan
Patogenesis dan gejala penyakit
Kolonisasi E. coli terjadi :
Adanya bakteri dlm makanan, air, kontak pengasuh dengan bayi,
Melekat di usus, bertahan bbrp bulan- tahun
Perubahan populasi tjd setelah infeksi usus, penggunaan kemoterapi,
antibiotika yg dpt membunuh flora normal.
Bbrp galur menyebabkan infeksi sal cerna, kemih, otak, tergantung
serotipe E. coli,( adhesin, invasin, jenis toksin yang dihasilkan dll
E. coli : penyebab infeksi intestinal
a. E. coli Enteropatogenik (EPEC)
E. coli ini menyerang manusia khususnya pada bayi. EPEC melekatkan
diri pada sel mukosa kecil.. Pada usus halus, bakteri ini akan
membentuk koloni dan menyerang pili sehingga penyerapannya
terganggu. Akibatnya adalah adanya diare cair yang biasanya
sembuh sendiri tetapi dapat juga menjadi kronik. EPEC sedikit
fimbria, ST dan LT toksin, tetapi EPEC menggunakan adhesin yang
dikenal sebagai intimin untuk mengikat inang sel usus. Sel EPEC
invasive (jika memasuki sel inang) dan menyebabkan racun
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2065735/
SAMPAI JUMPA?!
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