Zoonosis Gnccb Ps Leg Aok m 2009

7/25/2019 Zoonosis Gnccb Ps Leg Aok m 2009

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ZoonosisokLegionellosis

Pseudomonas csoports Acinetobacter



Dr.Dr. BerekBerek ZsuzsannaZsuzsanna2008 Okt2008 Oktber 29ber 29


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GRAM NEGATIV PLCK

AEROB

BordetellaBrucella(Z)Francisella(Z)

PseudomonasAcinetobacterLegionella

FAKULTATIV ANAEROB

HaemophilusPasteurella (Z)

Familia:EnterobacteriaceaeVibrionaceae

CardiobacteriumEikenellaKingella

Actinobacillus

ANAEROB

BacteroidesPrevotellaPorphyromonas

Fusobacterium

MIKROAEROPHILCampylobacter

Helicobacter


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Zoonosisokoonosisok: BrucellaBrucella

Francisella Pasteurella s a

rancisella Pasteurella s a

Pestis

estis

1. Brucella1. Brucella

Sir David Bruce (1855-1931)www.lshtm.ac.uk/.../archives/images/bruce1.jpg


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rucellae

Morphologia:Gram negativ Coccobacillus

Tenyszts:Agar - dsts(Serum, Glycerine)CO2

21 nap

Rezisztens!


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Description: Brucella spp. Colony Characteristics: - A. Fastidious, usually not

visible at 24h. - B. Grows slowly on most standard laboratory media (e.g. sheepblood, chocolate and trypticase soy agars). Pinpoint, smooth, entire translucent,non-hemolytic at 48h

staff.v

bi.vt.e

du/pathport/p

athinfo_

images/Bru...


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rucellae

Pathogenesis, Infectio, Krkpek

B. melitensis kecske mltai lzB. abortus szarvasmarha Morbus BangB. suis serts serts Brucellosis

Anthropozoonosis MIND BrucellosisFebris undulans RES!(hullmz = undull lz)

-forrs beteg llatok (hs, tej)-tvitel direkt Kontaktus vagy kontaminldott lelmiszer

-behatols b

rsrls vagy conjunctiva vagy blnylkahrtya


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Brucella fertzs forrsa

Medmicro


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Brucella behatolsi kapuk

Figure

28-1Portalsof

entryforBruc

ellaspecies.

Medmicro


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Brucella sztterjeds

Medmicro


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Figure.Acute unilateral scrotal swellingin a 27-year-old man with brucellosis.

www.medscape.com/.../art-iim441224.fig.jpg


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Fig.13.36 Brucellosis. Arthritis of theleft knee. This was accompanied by

fever, malaise, generalized myalgia anddepression.Fig. 13.37 Orchitis B. abortus


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Brucellosis - diagnosis


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Diagnosistenyszts: min. 5 napSzerologia

Ellenanyag kimutatsCs-agglutinatio (Wright)IgM Chromatographia

ELISA

Therapia:

Doxycyclin, Rifampicin, StreptomycinProphylaxis:Biztonsgi/munkavdelmi rendszablyok

Beteg llatok gygytsa, megsemmistseWHO Bioterrorkategoria B!!!

Brucella IgM

www.kit.nl

ru ellosis


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2. Francisella2. Francisella

Zoonosisok

oonosisok

: Brucella

Brucella



Pestisestis

Tulare Lake; California, USA
http://upload.wikimedia.org/wikipedia/commons/3/34/Pine_Flat_Lake_1.jpghttp://upload.wikimedia.org/wikipedia/commons/3/34/Pine_Flat_Lake_1.jpg


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Francisella tularensis

Morphologia:Gram negativ plck

Hidegtr!

Tenyszteni tilos!Csak specilis laboratriumokban

WHO Bioterrorkategoria A!!!

Pathogenesis, Infectio- forrs: Beteg llatok- tvitel: direkt kontaktusvagy belgzs vagy per os vagy via Ektoparasitk

EMBERRL EMBERRE NEM TERJED!


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Francisella tularensis

Krkpek:TULARAEMIAnyirokcsomkban, apr granulomk

+ feklyek+ necrosisPrimer Komplex

cutano-, oculo-, tonsilloglandularis, (ltszik!)thoracalis, abdominalis - (nem ltszik!) formkGeneralisatio Granuloma kpzds!

Diagnosis: SzerologiaProphylaxis:Expositios - prophylaxis

Therapia:Streptomycin, Doxycyclin,Ciprofloxacin


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A reported case ofexposure of a patient toa wild rabbit, whichsubsequently died,

suggested that tularemiawas the likely etiology

staff.vbi.vt.edu/.../Ftularensis


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Description: Cervical Lymphadenitisin a Patient WithPharyngeal Tularemia;

Patient has marked swelling and fluctuant suppuration of several anteriorcervical nodes. Infection was acquired by ingestion of contaminated food orwater. Source: World Health Organization

staff.vbi.vt.e

du/.../Ftular

ensis


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Description: Chest

Radiograph of a Patient WithPulmonary Tularemia

Description: TheseFrancisellatularensis colonies show characteristicopalescence on cysteine heart agar

with sheep blood (cultured at 37 C for72 hours). Note: On cysteine heartagar, F tularensis colonies arecharacteristically opalescent and do

not discolor the medium

staff.vbi.vt.edu/.../Ftularensis


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Zoonosen

oonosen

: Brucella

Brucella

Francisella Pasteurella und

rancisella Pasteurella und

Pestest

3. Pasteurella3. Pasteurella

Louis Pasteur (1822-1895)

upload.wikimedia.org/.../4/42/Louis_Pasteur.jpg
http://www.pasteur.fr/http://www.pasteur.fr/


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medecinepharmacie.univ-fcomte.frPasteurella multocida

Morphologia:Gram negatv, kicsi plck

Pathogenesis:

Macska vagy kutya haraps

immunkrosodott: Sepsis!

Therapia: sebszi, Penicillinek

Tenyszts:Vres- s csokold agar


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aapredbook.aappublications.org

Pasteurella multocida

Fig. 10.55 Animal bite.Infected wound of fingerfollowing bite of domestic

cat. P. multocida wasisolated from the wound.


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aapredbook.aappublications.org

Pasteurella

multocidacellulitissecondary tomultiple cat

bites about theface of a one-year-old child

?


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?


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4. Feketehall4. Feketehall Yersinia pestisYersinia pestis

Zoonosisok

oonosisok

: Brucella

Brucella



Pestisestis

1863 - 1943


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Yersinia pestis

genus: Enterobacteriaceae!

Morphologia: Gramnegativ plck bipolaris festds

www.lonlygunmen.deGiemsa fests www.mja.com.au


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www.idph.state.il.us, www2.cnrs.fr, ww.knowledgenews.net,

Yersinia pestis

TENYSZTS: TILOS!Csak specilis laboratriumokbanWHO Bioterror kategria A!!!

Pestis - XIV. sz.
http://www.idph.state.il.us/http://www.knowledgenews.net/http://www.knowledgenews.net/http://www.idph.state.il.us/


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Pestis XIV. sz.


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Yersinia pestis

VIRULENCIA FAKTOROK

TOK Protein!V Antigen (Protein) AntiphagocyterW Antigen = Endotoxin

Extracellularis

- Plasminogen Aktivator Protein (Pla)sztterjeds, fibrinolysis

-Toxin (egr)


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Yersinia pestis

Pathogenesis, Infectio:forrs:

Patkny (s ms rgcslk) Patknyirts!!!

tvitel:

direkt kontaktus,Patknybolha cspse

behatols: br

Yersinia pestis


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Figure 29-4 Pathogenesis ofY. pestis in plague patients.

Medmicro


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Krkpek:1)Bub pestis

(nyirokcsommegnagyobbods)

2) Szeptikus forma haemorrhagis gyullads

3) Tdpestis = Pneumonia (haemorrhagis) direkt aerogen tvitel, emberrl emberre(cseppfertzs primer tdpestis)!

Yersinia pestis


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Fig. 13.55 Plague. Enlarged tender inguinal lymphnodes in a Vietnamesechild with bubonic plague.Fig. 13.56 Advanced stage of inguinal lymphadenitis in bubonoc plague.The nodes have undergone suppuration and the lesion has drained

spontaneously.By courtesy of Dr. J.R. Cantey

Bubopestis

N i f


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Necrosis offinger tips of

septicemicplague.

www.imcworldwide.org

Cutaneous Hemorrhages in Plague. Source www.cdc.gov

Sepsis


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www.imcworldwide.orgTdpestis


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Yersinia pestis

DiagnosisKlinikaiDirekt kimutats - Mikroszkpos

Szerologia cs-agglutinatio, IF

Therapia:

Doxycyclin, Streptomycin

Biolgiai fegyverek bioterrorizmus


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Biolgiai fegyverek: Organismusok, Toxinok,Vrusok

Cl: megbetegtse s/vagy elpuszttsaegyneknek, kzssgeknek (populci) gazdasgi krokozs

Biolgiai hadvisels (katonai konfliktus)Bioterrorismus (ideolgiai motivci)

Biolgiai bncselekmny (szemlyes clok,indttatsok)



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Kategrik: A, B, Clegveszlyesebb: A

B. anthracis, C. botulinum, F. tularensis, Y. pestis

Egyszertenyszteni

Egyszerterjeszteni: cseppfertzs, lgutakMagas hallozs

Therapia?Hirtelen kezdet (derlt gbl a villmcsaps)Nagy szm ldozat



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L i ll i

L i ll i


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LegionellosisL eg i o n el l a p n eu m op h i l a

LegionellosisL eg i o n el l a p n eu m op h i l a

Morphologie:Gram negatv plca

Aerob

www.lf3.cuni.cz


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Legionella


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www.waterscan.co.yu

Legionella


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Legionella


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mcb.berkeley.edu

Legionella pneumophila


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Tenyszts:Specilis tptalaj!

BCYE (lesztkivonat, aktv szn)

(pH=9; hmsklet 35C; 3 nap)vresagar

BCYE


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Legionella

tenyszet

www.lf3.cuni.cz

BCYE


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ww

w.contractla

boratory.com

Legionellatenyszet

medecinepharmacie.univ-fcomte.fr
http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htm


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Legionella

http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/examicro_divers.htm


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Pathogenesis-1:Fertzs forrsa, elfordulsa:

ubiquiter(klma berendezsek, vzvezetkek,

nedves talaj, biofilm!)

tvitel:aerogen - cseppfertzs!


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www.ratsteachmicro.com


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www.eco-khlamx.com



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Pathogenesis-2:Fakultatv intracellularis!

Vzben: ProtozoonEmberben:Leukocyta,gyullads,Protease-ok,

Phospholipase-ok

www.lifespan.org

Legionella samoeba


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FIGURE 40-7Electronmicrograph

showingL. pneumophila

serogroup 1 in theprocess of

dividing (arrows)within a vesicle ofan amoeba(Hartmanella

veriformis) cell.

amoeba

Pathogenic cycle of Legionella


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microbewiki.kenyon.edu


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textbookofbacteriology.net/Legionella.jpeg


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Krkpek:Legionellosis1) Pneumonia

Lgionrius betegsg

2) Pontiac-lz (non-pneumonis forma)Diagnosis:Krkokoz kimutatsa Biopsia! BAL: direkt IFtenysztsAntigen detektls vizeletblvizeletbl

Antitest kimutats Szerologia; ELISAProphylaxis: Legionella tartalm aerosol kerlse

Therapia:Erythromycin, Tetracyclin, Rifampicin, FQ


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Fig. 2.29 Legionnaires disease. Chest radiograph showing extensive

consolidation affecting parts of all lobes of the lungs.


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Fig. 2.28 Legionella pneumophila. Specimen from bronchial biopsy taken through

fibreoptic bronchoscope in a patient with fulminant Legionnairess disease. The organismcan be isolated on selective culture media or by guinea pig inoculation. By courtesy of Dr.S. Fischer-Hoch

Diagnose


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Fig. 2.30 Legionnaires disease. Autospy specimen showingconsolidation of upper and lower lobes of right lung.

Zoonosis

Zoonosis


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ZoonosisLegionellosis


ZoonosisLegionellosis



Pseudomonas csoport

Pseudomonas csoport


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Pseudomonas csoportPseudomonas csoport

Pseudomonas P. aeruginosa P

Burkholderia B. malleiP

B. pseudomalleiPB. cepacia

Stenotrophomonas S. maltophilia(Xanthomonas)

P = pathogen

Pseu d om on a s a er u g i n osa


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Morphologia s tenyszts:Gram negativ plca, 1-2 m,ignytelen; Biofilm kpzs!



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Pigmentek:

1. Pyocianin2. Fluorescein

Haemolysis ()

Pseu d om on a s a er u g i n o sa


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NAGYON REZISZTENS!

-rezisztenshrefnyre

kiszradsra

ferttlentre

Antibiotikumokra



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ANTIGENEK S VIRULENCIA FAKTOROK:Adhaesio s colonisatio- "0", "H", Pili/Fimbriae-TOK = Glycocalyx- Alginate slime = mukoid Exopolysaccharid Biofilm kpzsInvasio, Penetratio- Extracellularis Protease-ok, Exoenzymek (sok!)

- Cytotoxin = Leukocidin s Haemolysinek- PigmentekDisseminatio

-Exotoxin AProteinsynthesis gtl (EF2 mint Diphtheria)- Exotoxin/Exoenzym S gsek!; vrbl kimutathat- Endotoxin

LD50

gsi srls esetn 30Normal brfelszn 108

Pili/Fimbriae (megtapads)

Flagellum (Motilits) TOK;


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Pseudomonas aeruginosa Struktura

Extracellularis anyagok

Alginate slime

Medmicro


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No single factor isdecisive for virulence.

Egyik sem kizrlagostnyeza virulenciban!

www.ratsteachmicro.com

Pseudomonas aeruginosaToxin-A hatsmechanizmus


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Inaktiv Molekula

Proteinsynthesis gtlsa

Pseudomonas aeruginosa elmi



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Pathogenesis, Infectio:

elforduls: mindenhol, ubiquiterfld, vz (uszoda, medence!), szennyvzBlcsatorna emberlgutak: llatok

Fertzs forrsa:betegek, hordozk

Kontaminldott krnyezetoldatok (nedves krnyezet!) manyagok

tvitel: direkt, indirekt Kontaktus



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Krkpek:Krhzi fertzsek

- Meningitis, Pneumonia (llegeztets!)- Sepsis- gsi srlsek! br, sebek

- hgyuti fertzsek (Katheter),- Blfertzs = hasmens (!), csecsemk- Otitis media, externa- szem + Kontaktlencse

Cystikus Fibrosis /CF/ (mukoid trzsek)


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Fig. 10.2 Pseudomonas folliculitis. Papulopustuler rash over thebuttocks and thights following use of a spa pool.


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Fig. 13-6 Ecthyma gangrenosum. Necrotic round lesion on the buttock of a childwith Pseudomonas septicaemia associated with immunodeficiency.


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Diffuseinfiltrate

Thinned corneal stoma


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Fig. 12.47 Bacterial keratitis, in this case due to P. aeruginosa. Aninfiltrate is seen with corneal thinning. By courtesy of Mr. P.A. Hunter

Edge ofepithelium

Thinned corneal stoma


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Fig. 12.48 Bacterial keratitis. A massive inflammatory response inanterior uveitis leads to precipitation of the cells as pus in the anteriorchamber. This is called hypopyon. By courtesy of Mr. S. Harding


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Fig. 12.49 Bacterial keratitis. P. aeruginosa eye infection showing

corneal ulceration and hypopyon formation in this rapidly progressiveeye infection.


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Diagnosis:Krokoz kimutatsa, identifikls, Oxidase +

Therapia s Prophylaxis:Antibiogram!!!Aminoglykosidok, Carbenicillin,antipseudomonas Cephalosporinok, Fluoroquinolonok

Expositios prophylaxis: TISZTASG. Ferttlents.Aktv immunizls cystikus fibrosis

Vakcina


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A conjugate vaccine in the final clinical phase is Aerugen, the first and onlyvaccine for the prophylaxis of fatal Pseudomonas aeruginosa infections incystic fibrosis patients. The polyvalent conjugate vaccine combines 8 prevalentP. aeruginosa serotypes and the bacterial exotoxin A. It is the first conjugatevaccine based on a lipopolysaccharide component.

www.bernabiotech.com

Bu r k h o l d er i a m a l l ei


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Krkp: Malleus (takonykr) l, szamrFoglalkozsi betegsg (magas hallozs)Bioterrorkategoria B!

microbewiki.kenyon.edu/images/3/39/Horse.jpg

A horse withglanders and withpositive mallein test

www.vef.hr/vetarhiv/pap

ers/68-5/alani2

.jpg

Bu r k h o l d er i a p seu d om a l l ei


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Krkp:Melioidosis

Pneumonia,Sepsis

Szubtrpusi,trpusividken

(utazs!)


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B. pseudomallei

www.co.collin.tx.us

www.asm.org


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B. pseudomallei

B. pseudomallei onAshdown's agar afterincubation at 37C in air for 3days

Bu r k h o l d er i a cep a ci a ,

St t h l t h i l i


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St en o t r op h om on a s m a l t op h i l i a

Krhzi fertzsek

Figure 1. Electron micrographs showing expression of flagella by SMDP92.Stenotrophomonas maltophilia strains can have one (A) to several flagella(B,C). The flagella on these bacteria show a polar disposition. Bars, 0.5 m

www.cdc.gov/.../web%20images/01-0535-8t.jpg

Figure 8. Ultrastructuralanalysis ofStenotrophomonas

maltophiliaadhering to

l i (A) S i


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plastic. (A) Scanningelectron micrographsshowing the tight adhesionof SMDP92 to the plasticsurface. (B) Structures

resembling flagella seem tobe protruding andinterconnecting bacteria(arrowheads) or connectingbacteria to the plastic

(arrows). (C) In addition tothe flagellalike filaments(arrowheads), high-powermagnification shows thepresence of thin fibrillar

structures connectingbacteria to the abioticsurface. Bars: A 10 mm, B1 mm, C 2 mm.

www.cdc.gov/.../web%20images/01-0535-8t.jpg


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Stenotrophomonas maltophilia www.uni-ulm.de


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www.oregon.govBurkholderia sp.


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www.uni-ulm.deB. cepacia

Acinetobacter spp.

Acinetobacter spp.


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Morphologia:Gram negatv dimorph

plck, coccobacillusok

www.acinetobacter.org

A ci n et ob a ct er sp p .

T t

www.acinetobacter.org


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Tenyszts:Agar, vresagarfontos: hmrsklet 40-44CNem mozog akinesis

Pathogenesis s Krkpek:mint Pseudomonas aeruginosa

Krhzi fertzsek

Multirezisztens!


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VGEIstanbul, 2006

Zoonosis Gnccb Ps Leg Aok m 2009

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