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FASTIDIOSOS Final MANUAL DE MICROBIOLOGÍA CLÍNICA DE LA ASOCIACIÓN ARGENTINA DE MICROBIOLOGÍA VOLUMEN I Bacterias de Importancia Clínica Editores HORACIO A. LOPARDO Consultor Honorario del Servicio de Microbiología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" Profesor Consulto de Microbiología Clínica. Facultad de Ciencias Excatas. Universidad Nacional de La Plata Miembro de la Comisión Directiva de SADEBAC, Asociación Argentina de Microbiología SILVIA C. PREDARI Jefa del Departamento de Microbiología del Instituto de Investigaciones Médicas Alfredo Lanari. Universidad de Buenos Aires Directora de la Revista Argentina de Microbiología, publicación científica oficial de la Asociación Argentina de Microbiología Coordinadora del Comité de Emergencias Biológicas de la Red de Hospitales e Institutos de la Universidad de Buenos Aires Miembro de la Subcomisión de Bacterias Anaerobias, SADEBAC, Asociación Argentina de Microbiología CARLOS VAY Profesor Asociado de Microbiología Clínica. Facultad de Farmacia y Bioquímica. Jefe Laboratorio de Bacteriología Departamento de Bioquímica Clínica. Hospital de Clínicas “Gral. José de San Martín” Director Carrera de Especialización en Bacteriología Clínica. Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires. 1 INDICE GENERAL Parte I. Temas generales de Microbiología Cínica Parte Ia. Taxonomía bacteriana Parte Ib. Métodos generales de identificación bacteriana ParteII. Microorganismos aerobios y anaerobios facultativos Parte IIa. Cocos gram positivos Parte IIa.1. Cocos gram positivos, catalasa positivos Capítulo IIa.1.1. Staphylococcus spp. Capítulo IIa.1.2. Otros géneros Apéndice I. Pruebas bioquímicas manuales: fundamento y método. Parte IIa.2. Cocos gram positivos, catalasa negativos Capítulo IIa.2.1. Estreptococos β-hemolíticos Capítulo IIa.2.2. Streptococcus pneumoniae Capítulo IIa.2.3 Estreptococos del grupo viridans Capítulo IIa.2.4. Enterococcus, Vagococcus, Lactococcus Capítulo IIa.2.5. Abiotrophia, Granulicatella, Gemella, Aerococcus y bacterias relacionadas Apéndice II. Pruebas bioquímicas manuales: fundamento y método. Parte IIb. Bacilos gram positivos Parte IIb.1. Esporulados Parte IIb.2. No esporulados Capítulo IIb.2.1 Corynebacterium spp. y bacterias relacionadas Capítulo IIb.2.2. Listeria Capítulo IIb.2.3. Nocardia Capítulo IIb.2.4. Bacilos gram positivos, catalasa negativos Capítulo IIb.2.5. Micobacterias Apéndice III. Pruebas bioquímicas manuales: fundamento y método. Parte IIc. Bacilos gram negativos Parte IIc.1. Enterobacterias Capítulo IIc.1.1. Diagnóstico y caracterización de Escherichia coli diarreigénico Capítulo IIc.1.2. Shigella spp. Capítulo IIc.1.3. Klebsiella, Enterobacter, Pantoea, Cronobacter, Raoultella y Serratia . Capítulo IIc.1.4. Salmonella, Edwardsiella y Citrobacter Capítulo IIc.1.5. Proteus, Morganella y Providencia Capítulo IIc.1.6. Yersinia y otras entrobacterias. Apéndice IV. Pruebas bioquímicas manuales: fundamento y método. Capítulo IIc.2. Bacilos gram negativos no fermentadores Capítulo IIc.2.1. Pseudomonas Capítulo IIc.2.2. Acinetobacter Capítulo IIc.2.3. Burkholderia Capítulo IIc.2.4. Flavobacterium, Chryseobacterium y Elizabethkingia Capítulo IIc.2.5. Stenotrophomonas 2 Apéndice V. Pruebas bioquímicas manuales: fundamento y método. Capítulo IIc.3. Bacilos gram negativos oxidasa positivos y fermentadores de lactosa Capítulo IIc.3.1. Vibrio Capítulo IIc.3.2 Aeromonas, Plesiomonas y Chromobacterium Capítulo IIc.3.3 Pasteurella Apéndice VI. Pruebas bioquímicas manuales: fundamento y método. Capítulo IIc.4. Bacilos gram negativos exigentes Capítulo IIc.4.1. Haemophilus Capítulo IIc.4.2 Bacilos gram-negativos del grupo HACEK (ACEKS) Capítulo IIc.4.3 Bordetella Capítulo IIc.4.4. Brucella Capítulo IIc.4.5 Helicobacter Capítulo IIc.4.6 Campylobacter Apéndice VII. Pruebas bioquímicas manuales: fundamento y método. Parte IId. Cocos gram negativos Apéndice VIII. Pruebas bioquímicas manuales: fundamento y método. Parte IIe. Bacterias atípicas Capítulo IIe.1 Bartonella y Afipia . Capítulo IIe.2 Legionella Parte III.3. Parte IIe.4. Chlamydia Parte IIe.5 Micoplasmas Parte IIe.6 Rickettsias y otras bacterias relacionadas Apéndice IX. Métodos de identificación: fundamento y método. Parte IIf. Espiroquetas Capítulo IIf.1 Treponema Capítulo IIf.2 Borrelia Capítulo IIf.3 Leptospira Parte III Microorganismos anaerobios Parte IIIa. Métodos de cultivo e identificación de microorganismos anaerobios Parte IIIb. Cocos gram positivos anaerobios Parte IIIc. Bacilos gram positivos anaerobios esporulados Parte IIId. Bacilos gram positivos anaerobios no esporulados Parte IIId. Bacilos gram negativos anaerobios Parte IIIe. Cocos gram negativos anaerobios Apéndice X. Pruebas bioquímicas manuales: fundamento y método. 3 Parte IIc.4 BACILOS GRAM NEGATIVOS EXIGENTES Editor responsable HORACIO A. LOPARDO Consultor Honorario del Servicio de Microbiología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" Profesor Consulto de Microbiología Clínica. Facultad de Ciencias Excatas. Universidad Nacional de La Plata Miembro de la Comisión Directiva de SADEBAC, Asociación Argentina de Microbiología 4 Índice Capítulo Título Pág Indice general 2 II c.4 Bacilos gram negativos exigentes 4 Índice 5 IIc. 4.1 Haemophilus 9 Aspectos taxonómicos 10 Portación y transmisión 12 Epidemiol ogía y significación clínica 14 Aspectos patogénicos 18 Factores de virulencia 19 Conservació n y transporte de 21 muestras clínicas Características microbiológicas 22 Examen directo 22 Métodos rápidos de detección de 23 antígenos capsulares Técnicas moleculares 24 Cultivo 25 Identificación a nivel de género y 31 especie Serotipificación capsular 37 Identificación capsular por técnicas 39 moleculares Sensibilidad a los antibióticos 42 Bibliografía 48 IIc. 4.2 Bacilos gram negativos del grupo 60 HACEK (ACEKS) y microorganismos relacionados Introducción 61 Aspectos taxonómicos 62 Haemophilus, Actinobacillus y 62 Pasteurella Cardiobacterium 62 Eikenella y Kingella 62 Pasteurella 63 Capnocytophaga 63 Dysgonomonas 64 Streptobacillus 64 Suttonella 64 Hábitat e impacto clínico 64 Aggregatibacter 66 Actinobacillus 68 5 Cardiobacterium 69 Simonsiella 69 Suttonella 69 Eikenella 70 Kingella 71 Capnocytophaga 73 Dysgonomonas 73 Leptotrichia 74 Pasteurella 74 Mannheimia haemolytica y otras 75 bacterias relacionadas Streptobacillus moniliformis 76 Experiencia argentina global 77 Orientación diagnóstica 78 Aislamiento 79 Identificación a nivel de género y 81 especie Actinobacillus y Aggregatibacter 81 Capnocytophaga 81 Cardiobacterium 82 Suttonella 83 Simonsiella 83 Dysgonomonas 83 Eikenella 84 Kingella 84 Pasteurella 85 Streptobacillus 85 Pruebas bioquímicas y serológicas 86 Métodos automatizados 90 Identificación por el método de 90 espectrometría de masa Métodos moleculares 91 Sensibilidad a los antibióticos 92 Algoritmo de identificación 96 dicotómica de microorganismos del grupo HACEK y géneros relacionados Bibliografía 100 IIc. 4.3 Bordetella 109 Aspectos taxonómicos y descripción 110 del género Factores de virulencia 114 Coqueluche, tos convulsa o 117 pertussis: enfermedad, transmisión y epidemiología Diagnóstico 123 Recolección, transporte y conservación 126 de muestras clínicas Diagnóstico microbiológico 127 Ensayos de inmunofluorescencia directa 132 6 Diagnóstico molecular 132 Diagnóstico serológico 136 Interpretación e importancia de los 139 resultados de laboratorio Sensibilidad a los antibióticos 140 Bibliografía 142 IIc. 4.4 Brucella 154 Introducción 155 Agente causal 156 Aspectos taxonómicos 157 Hábitat y epidemiología 161 Situación en la Argentina 162 Salud Pública 163 Impacto clínico 167 Definición de casos y clasificación 169 Factores de virulencia 171 Adherencia 173 Invasión 174 Diagnóstico microbiológico 178 Identificación a nivel de género y 178 especie Características del cultivo 180 Identificación y tipificación 182 Mantenimiento de los cultivos 185 Métodos moleculares 190 Diagnóstico serológico 195 Bioseguridad 198 Bioterrorismo 199 Tratamiento 200 Tratamiento de la brucelosis en adultos 201 Tratamiento de la brucelosis en niños 202 mayores de 8 años Tratamiento de la brucelosis en niños 202 menores de 8 años Tratamiento de la brucelosis en 203 embarazadas Tratamiento posexposición 203 Medidas preventivas 203 Bibliografía 205 IIc. 4.5 Helicobacter 213 Introducción 214 Aspectos taxonómicos 215 Helicobacter pylori 218 Morfología microscópica 218 Características culturales 219 Factores de virulencia 219 Hábitat, epidemiología e impacto clínico 225 Sensibilidad a los antibióticos 227 7 Diagnóstico de laboratorio 229 Consideraciones finales 238 Bibliografía 239 IIc. 4.6 Familia Campylobacteraceae 246 Características generales y constitución de la familia 247 Género Campylobacter 247 Epidemiología y características clínicas 251 Campylobacter jejuni 254 Campylobacter coli 259 Campylobacter lari 260 Otras especies de Campylobacter aisladas del hombre 260 Diagnóstico bacteriológico. Aislamiento e identificación 263 Sensibilidad a los antibióticos 271 Género Arcobacter 274 Arcobacter nitrofrigilis 276 Arcobacter cryaerophilus 276 Arcobacter butzleri 277 Arcobacter skirrowii 278 Arcobacter thereius 278 Bibliografía 279 Apéndice VII . Medios de cultivo y 292 pruebas bioquímicas manuales Haemophilus 292 Bordetella 293 Brucella 296 8 Capítulo II.c.4.1 Haemophilus ADRIANA EFRON Servicio Bacteriología Clínica, Instituto Nacional de Enfermedades Infecciosas ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires M. NANCY ORLANDO Sección Microbiología. Hospital de Niños Ricardo Gutiérrez Ciudad Autónoma de Buenos
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