Bacterial Infections of Respiratory Tract (RT)

Microbiological Aspects

dr. Hanina, M.Bmd

Fakultas Kedokteran dan Ilmu Kesehatan
Universitas Jambi
The Respiratory Tract (RT)
 The Respiratory Tract (RT)
The upper respiratory The lower respiratory
tract includes the: tract includes the:
• nose • bronchi
• nasal cavity • alveoli
• frontal sinuses • lungs
• maxillary sinus
• larynx
• trachea
Diseases of (RT)
 Bacterial Infection of (RT)
1. Community-acquired S.pneumoniae

H.influenzae

Other

Anaerobes
L.pneumophilia
M.pneumoniae C.pneumoniae
 Bacterial Infection of (RT)
2. Hospital-acquired
Ps. aeruginosa
 Bacterial Infection of (RT)
Pharyngitis
Groups A Streptococci
Group B Streptococci
Cory. diphtheriae
Cory. ulcerans
Mycoplasma pneumoniae
Arcanobacterium
Neisseria gonorrhoeae
 Groups A Streptococcus
Beta haemolyticus
S. pyogenes

Exoenzym Exotoxin
Hyaluronidase Streptolysin
Collagenase Erythrogenic toxin
streptokinase
 Group B Streptococcus
Encapsulated  inflamasi respon
Penyebab utama OMA, nasofaringitis,
rhinosinusitis
 Cory. diphtheriae
Flora normal
Patogen jika menghasilkan diphtheria toxin
 memblok sintesis protein sel host  sel
host mati  respon inflamasi 
pseudomembrane  obstruksi sal. nafas
 Bacterial Infection of (RT)
Sinusitis
1. Strep. pneumoniae
2. Haemophilus inftuenzae
3. Mixed anarobes
4. Staph. aureus
5. Moraxella catarrhalis
6. Group A Streptococcus
7. Pseudomonas aeruginosa
8. Other gram-negative
bacilli
 Bacterial Infection of (RT)
Epiglottitis
1. H. inftuenzae
2. Strep. pneumoniae
3. Staph. aureus
 Bacterial Infection of (RT)
Sinusitis
1. H. influenzae
2. Strep. pneumoniae
 Bacterial Infection of (RT)
Pneumonia
1. Community-acquired
2. Hospital-acquired
Community-acquired Penumonia
Pneumococcal pneumonia
H. Influenza
Mycoplasma pneumonia
Chlamidial pneumonia
 Pneumococcal pneumonia
Streptoccus alfa hemolyticus
S. Penumonia
Capsul polisakarida
Autolysin
Pneumolysin O
 Respon inflamasi : exudat kaya neutrophil dan RBC 
batuk produktif dan bloody sputum
Terapi : beta lactam, macrolide, quinolone
Vaccine : PCV13, PPSV23
 H. influenza
Encapsulated  meningitis
Non encapsulated  pneumonia
Gram -, coccobasil
D/ : culture chocolate agar
Th/ : beta lactam, macrolide, tetrasiklin
Vaccine influenza
 Mycoplasma pneumonia
Non flora normal  outbreak
Lingkungan padat
Dinding sel (-)  resisten beta lactam 
kultur media + penisilin
Punya organelle khusus berikatan dengan sel
silia
Self limiting disease, boleh kasih makrolide
 Chlamidial pneumonia
3 spesies :
C. pneumonia  most common
C. Psittaci  zoonosis burung peliharaan
C. Trachomatis  STD, pneumonia pada infant
Obligat intraseluler  tidak bisa dikultur
D/ : tes serologis, PCR
Th/: tetrasiklin, makrolide
 Hospital-acquired Penumonia
Klebsiella pneumonia
Pseudomonas pneumonia
 Klebsiella pneumonia
FR : usia tua, pre-existing lung condition,
immunocompromised
Capsul polisakarida  lung nekrosis  jelly
sputum
MDR
Ventilator
 Pseudomonas pneumonia
P. Auroginosa
Extremely antibiotic resistant
Exotoxin
FR : CF  (-) CFTR  akumulasi mucus di
paru
Related ventilator
 M. Tuberculosis
D/: ZN  BTA
MDR n XDR  genexpert
Mantoux tuberculin skin test
Strain  PCR dan sekuensing
BCG vaccine
 Pertussis
Bordetella pertussis, gram negatif, coccobasil
Adhesin, filamentous hemagglutinin
Pertussis toxin (PT), tracheal cytotoxin 
kerusakan sel epitel bersilia  akumulasi mucus di
paru
D/: kultur swab nasofaring  media Bordet
Gengou, PCR, ELISA
Vaccine DPT
 Bacterial Infection of (RT)
Lab. Diagnosis
Specimens
1. Sputum
2. Nasal swab
3. Nasopharyngeal swab
4. Throat swab
 Bacterial Infection of (RT)
Lab. Diagnosis
Microscopy
Gram stain
ZN stain
 Bacterial Infection of (RT)
Lab. Diagnosis
Culture
Blood agar
Chocolate agar
 Bacterial Infection of (RT)
Treatment
After performing
sensitivity test.
Thank you