Klinická mikrobiologie - Masaryk University

Klinick mikrobiologie Jana Jurnkov OKM FN Brno Septick stavy

Septick stavy Sepse X Bakterimie, virmie, fungmie Bakterimie, virmie, fungmie: ptomnost bakteri, vir nebo hub v krevnm obhu Sepse: tk onemocnn, reakce makroorganismu na ptomnost mikroorganism v krevnm obhu

Diagnostika sepse Klinick pznaky: zven i snen teploty, zven dechov frekvence, zrychlen tepu, zmatenost Hematologick pznaky: zven i snen potu leukocyt, snen potu trombocyt

Biochemick pznaky: hemokoagulan poruchy, metabolicko-respiran acidza, zven CRP Diagnostika sepse Bakteriologick diagnostika: pozitivn

hemokultivace Sepse Primrn patogen jen v krevnm eiti po i.v. aplikaci liv, drog Sekundrn v tle je primrn loisko a sekundrn se patogeny vyplav do

krevnho obhu Katetrov pvodce pochz z kolonizace zavedenho cvnho katetru Pvodci sepse Rann sepse Streptococcus pyogenes, Staphylococcus aureus

Urosepse Escherichia coli Intraabdominln sepse enterobakterie, anaeroby Nosokomiln sepse Pseudomonas aeruginosa, enterobakterie s produkc beta-laktamz, kvasinky, Staphylococcus koagulza negativn

Infekce centrlnho nervovho systmu Infekce centrlnho nervovho systmu Zdroj

Hematogenn meningokoky Per continuitatem pneumokoky, hemofily Podl nerv virus herpes simplex, virus vztekliny Pmo pi porann hlavy Meningitidy

Meningitidy aseptick virov Enteroviry, virus herpes simplex, varicellazoster, virus klov menigoencefalitidy Meningitidy purulentn Streptococcus agalactiae, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, Listeria

monocytogenes Meningokokov meningitidy Meningitidy Chronick meningitidy Mycobycterium tuberculosis (bazilrn

meningitida), Cryptococcus neoformans Encefalitidy Encefalitidy Akutn encefalitidy virov etiologie

Virus klov encefalitidy, virus herpes simplex, enteroviry, virus parotitidy Mozkov absces Mozkov abscesy Akutn bakteriln

Smen aerobn a anaerobn flra, Staphylococcus aureus, nokardie Chronick bakteriln, mykotick, parazitrn Mycobacterium tuberculosis, Nocardia asteroides

Cryptococcus neoformans, Aspergillus spp. Cysticerkosa (Taenia solium), echinokokosa Infekce nosu Respiran infekce Infekce nosu a nosohltanu

Rma, znt nosohltanu Rhinoviry,koronaviry Haemophilus influenzae, Staphylococcus aureus,Streptococcus pneumoniae Nosistv Neisseria meningitidis

Angna Infekce dutiny stn a mandl Virov Rhinoviry, koronaviry, adenoviry, EB virov tonsilitida, herpangna

Bakteriln : angna Streptococcus pyogenes, Corynebacterium diphteriae, anaerobn Plautova-Vincentova Kvasinkov soor

Infekce ucha Infekce stednho ucha a vedlejch nosnch dutin Akutn znt stednho ucha a dutin Respiran viry

bakteriln: Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catharralis, Staphylococcus aureus, Streptococcus pyogenes, Bacteroides spp., Peptostreptococcus spp. Infekce stednho ucha a vedlejch

nosnch dutin Chronick bakteriln: Pseudomonas aeruginosa, Proteus mirabilis, peptostreptokoky Epiglotitis

Infekce pklopky hrtanov Epiglottitis Haemophilus influenzae typ b Infekce laryngu a trachey Virov Viry influenzy, parainfluenzy, RS virus

Chlamydia pneumoniae, Mycoplasma pneumoniae Bakteriln Corynebacterium diphteriae, ostatn infekce sekundrn po virech

Infekce bronch Virov Viry chipky, adenoviry, RS virus Bakteriln primrn: Mycoplasma pneumoniae, Chlamydia pneumoniae, Bordetella pertussis

Sekundrn: Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catharralis, Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia Infekce plic

Infekce plic Akutn znt Chipka A,B, RS virus Mycoplasma pneumoniae, Chlamydia pneumoniae Streptococcus pneumoniae, Haemophilus

influenzae, Staphylococcus aureus, Branhamella catarrhalis, Klebsiella pneumoniae Infekce plic u oslabench jedinc

Enterobakterie Klebsiella pneumoniae Legionella pneumophila

Pneumocystis jirovecii Nocardia asteroides Aspergillus spp. Cytomegalovirus Ventiltorov pneumonie asn

Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Branhaella catharralis Pozdn Klebsilella pneumoniae, Pseudomonas aeruginosa

Pneumonie chronick Mycobacterium tuberculosis, Mycobacterium bovis Aspiran pneumonie - anaeroby

Infekce ran, kost a mkkch tkn Infekce ran Povrchov zrann Staphylococcus aureus, Streptococcus pyogenes Anaerobn traumatosy Clostridium perfringens, Clostridium septicum,

Clostridium tetani (toxin) Infekce operanch ran Infekce endogenn z okol rny, ze steva: Staphylococcus aureus, Streptococcus pyogenes, ele Enterobacteriacae,

Bacteroides sp. Infekce endogenn (nozokomiln): Klebsiella pneumoniae, Enterobacter sp., Pseudomonas aeruginosa Infekce po kontaktu se zvetem

Infekce po kontaktu se zvetem Pokousn - stn mikroflra zvete Stapfylococcus aureus, Pasteurella multocida, Capnocytophaga canimorsus Kontakt bez kousnut (zoonzy) Francisella tularensis, Erysipelothrix

rhusiopathiae, Bartonella henselae Osteomyelitidy Akutn: Staphylococcus aureus, Streptococcus pyogenes, Haemophilus influenzae, Salmonella spp. Chronick: Pseudomonas aeruginosa,

enterobakterie, Mycobacterium tuberculosis Infekce ke Bakteriln Impetigo: Staphylococcus aureus, Streptococcus pyogenes

Folliculitis : Staphylococcus aureus Acne vulgaris: Propionibacterium acne Erysipel: Streptococcus pyogenes Infekce projevujc se na ki Bakteriln infekce projevujc se na

ki Produkce toxin zpsobujcch vyrky: Spla Streptococcus pyogenes Syndrom toxickho oku Staphylococcus aureus Neisseria meningitidis disseminovan

intravaskulrn koagulopatie Erytema chronicum migrans Borrelia spp. Virov onemocnn projevujc se na ki Exantematick virzy

Spalniky, zardnky, erytema infectiosum (5.dtsk nemoc, parvovirus B19), exantema subitum (HHV 6) Vesikulrn exantm (puchky) Herpesviry, poxviry Bradavice

Papillomaviry Petechie Hemoragick horeky (Lassa, Ebola, u ns Hantaan) Kon mykosy Candida albicans intertrigo,

vulvovaginitida, soor Dermatofyta tinea pedis (Trichophyton rubrum) Parazitrn onemocnn ke Parazitrn onemocnn ke

Svrab Pedikulza zaviven Potpn lenovci Infekn prjmy Infekn prjmy

Bakteriln Salmonely, shigely, kampylobaktery, yersinie Enterotoxick, enteroinvazivn enterohemoragick Eschericha coli Clostridium difficile Aeromonas spp., Plesiomonas shigeloides

Infekn prjmy Virov Rotaviry, adenoviry, kaliciviry (Norwalk), astroviry, noroviry Parazitrn Giardia lamblia, Entamoeba hystolytica,

Cryptosporidium parvum Otravy z potravin Otravy z potravin Bakterie vyluujc toxiny Staphylococcus aureus, Bacillus cereus,

Clostridium botulinum Moov infekce Moov infekce Escherichia coli, Enterococcus faecalis, Streptococcus agalactiae

Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis Candida albicans Trichomonas vaginalis Sexuln penosn choroby

Sexuln penosn infekce Bakteriln Neisseria gonorrhoeae, Treponema pallidum, (Haemophilus ducrey, Calymmatobacterium granulomatis Chlamydia trachomatis

Virov HIV, HSV 2, papilomaviry, molluscum contagiosum, Hepadnavirus (hepatitida B) Parazitrn Trichomonas vaginalis, ektoparazit

Infekce v thotenstv Infekce v souvislosti s thotenstvm Virov infekce se zvanm prbhem Hepatitida E, chipka Bakteriln infekce

Streptococcus pyogenes (porod i potrat, horeka omladnic), Staphylococcus aureus, Streptococcus agalactiae (mastitidy) Infekce plodu a novorozence Infekce plodu a novorozence

Vrozen Virov: zardnky, cytomegalovirus,varicellazoster, HIV Bakteriln: syfilis, listeriosa Parazitrn: toxoplasmosa Infekce plodu a novorozence Perinatln a neonatln

Bakteriln: Neisseria gonorrhoeae, Streptococcus agalactiae, Listeria monocytogenes Chlamydia trachomatis Virov: hepatitida B, HIV, Nosokomiln infekce

Nosokomiln infekce Nkazy zskan v souvislosti s pobytem ve zdravotnickm zazen Endogenn infekce vlastn mikroflrou Exogenn infekce zavleen zven (ruce personlu)

Nosokomiln infekce Bakteriln Bakterie citliv na ATB Bakterie rezistentn na ATB Selekce rezistentnch kmen psobenm ATB na citliv kmeny

MRSA, VRE, Pseudomonas aeruginosa, Stenotrophomonas maltophilia Indukce tvorby betalaktamz psobenm ATB irokospektr batalaktamzy, induktivn betalaktamzy Nosokomiln infekce

Virov Hepatitidy, rotaviry, adenoviry Parazitrn Roupy, svrab Dkuji za pozornost