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PNEUMOKOKUS INVASIF:
STUDI DARI NEGARA ASEAN
Pratiwi Sudarmono,Dr,PhD,SpMK
STREPTOCOCCUS
PNEUMONIAE
• Gram positive,diplococci
• Possessing a capsule of polysacharide
• Normal inhabitants of the upper respiratory
tract of humans
• Can cause pneumonia, sinusitis, otitis,
bronchitis, bacteremia, meningitis, and
other infection processes
PATHOGENESIS
• A.Type of pneumococci :
in adults, type 1-8
are responsible for about 75% of cases of
pneumococcal pneumonia, and
bacteremia. In Children, types 6,14, 19,
and 23 are frequent cases
PATHOGENESIS
B.PRODUCTION OF DISEASES
- Pneumococci produce disease through their
ability to multiply in the tissue.
- No toxin significance
- The virulence of the organism is a
function of its capsule, which prevents or
delays ingestion of encapsulated cells by
phagocytes
PATHOGENESIS
• C. LOSS OF NATURAL RESISTANCE
• Since 40 – 70% of humans are at some
time carriers of virulent pneumococci, the
normal respiratory mucosa must possess
great natural resistance to the
pneumococcus: thus predispose to infection
are : abnormalities of the resp.tract of any
kinds
The increasing global incidence
of S.pneumoniae resistance
• Penicillin resistance has increased
dramatically throughout the world
• PRSP: first reported in 1967
• 1977: hospital centered outbreaks in South
Africa
• 1996: proven from 20 countries in the world
that PRSP 10,4% and Pen.intermediate
strains 10,2%
PEN-I and PRSP : data 1996
• Hongkong : 59,1%
• Riyadh : 55,5%
• Mexico City : 47,1%
• Barcelona : 41,2%
• Johannesburg: 34,9%
• Ohio : 30,3 %
• New York : 28,1 %
• INDONESIA : 20%
DATA MICRO FKUI 2000
• PEN : 17%
• AMX : 3%
• CEFOTIAM : 5 %
• CEFUROXIM : 0 %
• CEFTAZIDIME : 0%
• CEFTRIAXONE : 11%
DATA MICRO FKUI :2000
• Erythromycin : 19%
• Azithromycin : 19%
• CIPROFLOXACIN : 35%
• OFLOXACIN : 11%
• LEVOFLOXACIN : 0%
• DATA MICRO-FKUI 2002 :
MOXIFLOXACIN : 0%
ANSORP STUDY 1996-1997
• From 996 clinical isolates of
S.pneumoniae:
• PRSP found in :
• KOREA 79,7% Taiwan 38,7%
• Japan 65,3% Singapore 23,1%
• Vietnam 60,8% Indonesia 21%
• Thailand 57,9% China 9,8%
• Srilanka 41,2% Malaysia 9%
Bell JM, Turnidge JD, Jones RN; SENTRY
Regional Participants Group.
, Adelaide, Australia