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  3. UC Leuven-Limburg
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  5. Bachelor In De Vroedkunde
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  7. Microbiologie

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Samenvatting Microbiologie
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  • Course
  • Microbiologie
  • Institution
  • UC Leuven-Limburg

Dit vak wordt gegeven in eerste bachelor vroedkunde aan de UCLL. Ik heb aan de hand van de powerpoints en deeltjes uit het boek deze samenvatting gemaakt, en zal deze ook gebruiken voor het examen in juni.

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  • March 16, 2021
  • 108
  • 2020/2021
  • Summary

Subjects

  • microbiologie
  • vroedkunde
  • bachelor
  • ucll

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  • UC Leuven-Limburg
  • Bachelor In De Vroedkunde
  • Microbiologie
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Medische Microbiologie
Inhoud
Hoofdstuk 1: Microbiologie
1. Inleiding ............................................................................................................................. 9
2. Indeling Levende menselijke ziektekiemen ....................................................................... 9
2.1 Indeling onder 5 rijken ................................................................................................ 9
Prokaryoten ........................................................................................................................ 9
Protozoa: éencellige diertjes .............................................................................................. 9
Fungi: schimmels ............................................................................................................. 10
Wormen & geleedpotigen ................................................................................................ 10
Virussen ........................................................................................................................... 10
2.2 Indeling menselijke ziektekiemen volgens grootte ................................................... 11
2.3 Indeling menselijke ziektekiemen volgens habitat & ziekteverwekkend vermogen 11
1) Voorkomen in dode reservoirs .............................................................................. 11
2) Parasitair Bestaan .................................................................................................. 11
3. Naamgeving van een soort ............................................................................................... 11
4. Epidemiologie .................................................................................................................. 12
4.1 Overdracht van infecties............................................................................................ 12
4.1.1 Ingangspoorten ................................................................................................... 12
4.1.2 Besmettingsbronnen ........................................................................................... 12
4.1.3 Overdrachtswegen.............................................................................................. 13
4.2 Begrippen prevalentie en incidentie .......................................................................... 13
4.3 Verspreidingspatroon in de tijd ................................................................................. 13
4.4 Geografische verspreiding......................................................................................... 14
5. Beloopstadia van een infectieziekte ................................................................................. 14
5.1 Stadia van een acute infectie ..................................................................................... 14
Stadia van een acute infectie in relatie m bacteriële groeicurve ...................................... 14
Stadia van een acute infectie in relatie met afweermechanismen .................................... 15
Stadia recidief acute infectie in relatie met bacteriële groeicurve en secundaire
immuunrespons ................................................................................................................ 16
5.2 Stadia van een chronische infectie ............................................................................ 16




1

,Hoofdstuk 2: Bacteriologie
1. Structuur en organisatie van bacteriën ............................................................................. 17
1.1 Afmetingen ................................................................................................................ 17
1.2 Morfologie................................................................................................................. 17
1) Globale vorm ......................................................................................................... 17
2) Patroon van clustering ........................................................................................... 17
1.3 Opbouw van een bacterie of prokaryote cel .............................................................. 18
1.3.1 De celenvelop..................................................................................................... 18
1.3.2 Het cytoplasma................................................................................................... 19
1.3.3 Pili en flagellen .................................................................................................. 19
1.3.4 Nucleoïde kernequivalent .................................................................................. 19
1.3.5 Specifieke structuren (niet bij alle bacteria) ...................................................... 19
1.4 fysiologie van bacteriën ............................................................................................ 21
1.4.1 Voeding .............................................................................................................. 21
1.4.2 ATP-productie.................................................................................................... 21
1.4.3 T°-optimum ........................................................................................................ 21
1.4.4 pH-optimum ....................................................................................................... 21
1.4.5 Groei & vermenigvuldiging ............................................................................... 22
2. Bacteriële genetica ........................................................................................................... 22
2.1 Feno- & genotypische aanpassingen ......................................................................... 23
2.2 Wijzen van genotypische aanpassingen .................................................................... 23
2.2.1 Mutatie ............................................................................................................... 23
2.2.2 conjugatie ........................................................................................................... 23
2.2.3 Transformatie ..................................................................................................... 25
2.2.4 Transductie ......................................................................................................... 25
3. Ziekteverwekkend vermogen van bacteriën .................................................................... 27
3.1 Besmettelijkheid ........................................................................................................ 27
3.2 Pathogeen vermogen (virulentie) .............................................................................. 27
3.2.1 Lokale virulentie ................................................................................................ 28
3.2.2 SIRS → Sepsis → Septische shock ................................................................... 29
3.3 Pathogene vs. commensale stammen ........................................................................ 31
4. Verminderde weerstand ................................................................................................... 31
Hoofdstuk 3: Bacteriële toxi-infecties
1. Inleiding: Bacteriële toxi-infecties ................................................................................... 33
2. Gasgangreen (necrotiserende fasciitis-type II) ................................................................ 33

2

,3. Tetanus (klem) ................................................................................................................. 35
4. Botulisme ......................................................................................................................... 35
5. Voedselvergiftiging en gastro-enteritis ............................................................................ 36
5.1 Klassieke voedselvergiftiging ................................................................................... 36
5.2 Gastro-enteritis .......................................................................................................... 36
Hoofdstuk 4: Purulente bacteriële infecties
1. Inleiding: purulente bacteriële infecties ........................................................................... 39
1.1 Gelokaliseerde etterige infecties ............................................................................... 39
1.2 Lokalisatie spreidende etterige infecties ................................................................... 40
1.3 Metastatische (hematogene / secundaire) infectiehaarden ........................................ 40
1.3.1 Endocarditis ....................................................................................................... 40
1.3.2 Osteomyelitis ..................................................................................................... 41
1.3.3 Septische arthritis ............................................................................................... 41
1.4 Voornaamste pyogene bacteriën ............................................................................... 42
1.4.1 Staphylococcus aureus ....................................................................................... 42
1.4.2 Streptococcus pyegenes ..................................................................................... 44
1.4.3 Streptococcus Pneumoniae ................................................................................ 45
1.4.4 Haemophilus influenzae..................................................................................... 46
1.4.5 Neisseria meningitidis ........................................................................................ 46
1.4.6 Neisseria gonorrhea ........................................................................................... 47
1.4.7 Gramnegatieve darmbacteriën en anaëroben ..................................................... 47
1.4.8 Pseudomonas Aeruginosa (gr- bacil) ................................................................. 47
Hoofdstuk 5: Virologie
1. Bouw en morfologie ........................................................................................................ 49
2. Classificatie ...................................................................................................................... 50
3. Diagnostiek van een virusinfectie .................................................................................... 50
4. Virale replicatie ................................................................................................................ 52
4.1 Virale replicatie ......................................................................................................... 52
4.2 Reproductie RNA-virussen ....................................................................................... 53
4.3 Reproductie retro-virussen ........................................................................................ 54
4.4 Reproductie DNA-virussen ....................................................................................... 55
5. Verloop van een virale infectie ........................................................................................ 55
5.1 Lytische (snelle) virale infectie ................................................................................. 55
5.2 Chronisch persisterende/actieve infectie ................................................................... 55
5.3 Latente infectie .......................................................................................................... 56

3

, 5.4 Oncogene virussen .................................................................................................... 56
Hoofdstuk 6: Virale infecties
1. Influenzavirus .................................................................................................................. 57
1.1 Mutaties ..................................................................................................................... 57
1.1.1 Genetic Drift ...................................................................................................... 57
1.1.2 Genetic Shift ...................................................................................................... 57
1.1.3 Anti-genetic drift & shift ................................................................................... 58
1.2 Griep (ziekte verloop) ............................................................................................... 58
1.3 Seizoensgriep; een dodelijke infectie? ...................................................................... 58
2. Poliovirus → Poliomyelitis .............................................................................................. 59
3. Papillomavirussen ............................................................................................................ 59
3.1 Huidwratten ............................................................................................................... 59
3.2 Slijmvlieswratten ....................................................................................................... 59
4. Humane herpesvirussen ................................................................................................... 61
4.1 Herpes Simplex Virus I ............................................................................................. 61
4.1.1 Voorbeelden ....................................................................................................... 61
4.2 Herpes simplex II ...................................................................................................... 62
4.3 Varicella zoster virus (VZV) ..................................................................................... 63
4.3.1 Verloop primo-infectie....................................................................................... 63
4.3.2 Reactivatie = zona (gordelroos) ......................................................................... 64
4.4 Epstein-Barr virus (EBV) .......................................................................................... 65
4.4.1 EBV beloop ........................................................................................................ 65
4.4.2 EBV –> Klierkoorts ........................................................................................... 65
4.5 Cytomegalovirus (CMV)........................................................................................... 65
5. Hepatotrope virussen ....................................................................................................... 66
5.1 Hepatitis A virus → Soldatengeelzucht .................................................................... 66
5.2 Hepatitis B virus ........................................................................................................ 66
5.3 Hepatitis C virus ........................................................................................................ 66
5.3.1 Levercirrose ....................................................................................................... 67
Hoofdstuk 7: Mycologie
1. Bouw en eigenschappen van fungi .................................................................................. 69
2. Indeling van fungi ............................................................................................................ 71
2.1 Volgens verschijningsvorm ....................................................................................... 71
2.2 Volgens aspect seksuele voortplantingsorganen ....................................................... 71
3. Soorten mycosen .............................................................................................................. 72

4

,4. Diagnosestelling ............................................................................................................... 72
Hoofdstuk 8: Schimmelinfecties
1. Candida Albicans (Monilia) ............................................................................................. 73
2. Pityrosporum Ovale → Seborroïsch eczeem ................................................................... 74
3. Dermatofyten ................................................................................................................... 75
Hoofdstuk 9: Parasitologie
1. Definitie parasiet en soorten parasitisme ......................................................................... 77
2. Indeling parasieten ........................................................................................................... 77
2.1 Eencellige parasieten (protozoa) ............................................................................... 77
2.2 Meercellige parasieten (metazoa).............................................................................. 78
3. Parasitaire ontwikkelingscyclus ....................................................................................... 78
Hoofdstuk 10: Parasitaire infecties
1. Entamoebe histolytica ...................................................................................................... 79
2. Naeglaeria fowleri ............................................................................................................ 79
3. Balantidium Coli .............................................................................................................. 80
4. Giardia Lamblia ............................................................................................................... 80
5. Trichomonas Vaginalis .................................................................................................... 81
6. Trypanosoma Gambiense (slaapziekte) ........................................................................... 81
7. Plasmodium...................................................................................................................... 82
8. Toxoplasma gondii........................................................................................................... 82
9. Taenia saginata / solium (runder- & varkenslintworm) ................................................... 83
10. Fasciola hepatica (leverbot) .......................................................................................... 83
11. Schistosoma .................................................................................................................. 84
12. Oxyurus / enterobius Vermicularis (aarsmade) ............................................................ 84
13. Ascaris Lumbricoides (spoelworm) .............................................................................. 84
14. Pediculus humanis (hoofdluis) ...................................................................................... 85
15. Pulex irritans (vlo) ........................................................................................................ 85
16. Ixodes daminii (teek) .................................................................................................... 85
17. Scabies: schurft ............................................................................................................. 85
Hoofdstuk 11: Diagnostische onderzoeken
1. Microbiologische staalafname ......................................................................................... 87
1.1 Mogelijke afnames .................................................................................................... 87
1.1.1 keelsecreet .......................................................................................................... 87
1.1.2 Oorsecreet .......................................................................................................... 88


5

, 1.1.3 Sputum ............................................................................................................... 88
1.1.4 Faeces ................................................................................................................. 88
1.1.5 Urine .................................................................................................................. 88
1.1.6 Urethaal / cervixsecreet...................................................................................... 89
1.1.7 Genitaalsecreet ................................................................................................... 89
1.1.8 Huid- en wondinfecties, huidabcessen ............................................................... 89
1.1.9 Cerebrospinaal vocht ......................................................................................... 89
1.1.10 Bloed .................................................................................................................. 89
2. Labo-onderzoeken............................................................................................................ 90
2.1 RMO (rechtstreeks microscopisch onderzoek) ......................................................... 90
2.1.1 Lichtmicroscoop ................................................................................................ 90
2.1.2 fluorescentiemicroscopie ................................................................................... 90
2.1.3 Fasecontrast microscoop .................................................................................... 90
2.1.4 Donkerverldmicroscoop ..................................................................................... 91
2.1.5 Elektronenmicroscoop ....................................................................................... 91
2.1.6 RMO van sputum ............................................................................................... 91
2.1.7 RMO van etter.................................................................................................... 91
2.1.8 RMO van bloeduitstrijkje .................................................................................. 92
2.1.9 RMO met telkamer ............................................................................................ 92
2.2 Kweek (van bacteriën en schimmels)........................................................................ 92
2.2.1 Met oog op identificatie en typering van een kiem............................................ 92
2.2.2 Meng- & reincultuur .......................................................................................... 92
2.2.3 Antibiogram m snelle schijfjesmethoden........................................................... 93
2.2.4 Bepaling van antibioticum gevoeligheid (MIC) ahv dilutie-methode ............... 93
2.2.5 Kwantitatieve kweek v urine, tellen van het aantal CFU’s ................................ 94
2.2.6 Semi-kwantitatieve kweek v urine op “dipslide”............................................... 94
2.3 Urinestrips ................................................................................................................. 95
2.4 Serologisch onderzoek .............................................................................................. 95
2.5 Antigendetectie.......................................................................................................... 95
2.5.1 Sandwich ELISA-methode ................................................................................ 95
2.6 RNA/DNA-detectie ................................................................................................... 96
Hoofdstuk 12: Antimicrobiële middelen
1. Inleiding ........................................................................................................................... 97
2. Begrippen en definities .................................................................................................... 97
3. Werkingsmechanismen .................................................................................................... 99

6

, 3.1 Antimetabolieten ....................................................................................................... 99
3.2 Interferentie met de celwandsynthese ....................................................................... 99
3.3 Verhogen permeabiliteit celmembraan ................................................................... 100
3.4 Remming v bacteriële eiwitsynthese ....................................................................... 100
3.5 Interferentie met DNA-synthese ............................................................................. 100
3.6 Combinaties van antibiotica (AB) ........................................................................... 100
4. Resistentie v bacteriën aan antibiotica ........................................................................... 101
4.1 Uitbreiding verworven resistentie in een populatie................................................. 101
4.2 Mechanismen aan basis v AB resistentie ................................................................ 101
4.3 Preventie van resistentie .......................................................................................... 102
4.4 Meest bekende (multi-) resistente (ZH) kiemen ..................................................... 102
5. MRSA problematiek ...................................................................................................... 102
5.1 Inleiding .................................................................................................................. 102
5.2 Epidemiologie ......................................................................................................... 102
5.3 Preventie en controlemaatregelen ........................................................................... 103
Hoofdstuk 13: Commensale flora
1. Verwerven van de normale flora.................................................................................... 105
2. Aard vd micro-organismen ............................................................................................ 105
3. Plaats van voorkomen .................................................................................................... 105
4. Voor- en nadelen ............................................................................................................ 106
5. Residentiële flora van verschillende organen ................................................................ 107
5.1 De huid .................................................................................................................... 107
5.2 Luchtwegen ............................................................................................................. 107
5.2.1 Mond, neus en keel (>109).............................................................................. 107
5.2.2 Rest vh ademhalingsstelsel is steriel ................................................................ 108
5.3 Darmkanaal ............................................................................................................. 108
5.4 Urine- & geslachtswegen ........................................................................................ 108




7

,8

,Hoofdstuk 1: Microbiologie
1. Inleiding
Medische microbiologie: Bestudeert verwekkers van infectueuze ziekten, nl. menselijke
ziektekiemen / pathogenen
• Bacteriën
• Schimmels
• Parasieten:
o Protozoa (1-cellig)
o Wormen , geleedpotigen

2. Indeling Levende menselijke ziektekiemen
2.1 Indeling onder 5 rijken
5 rijken:
- Prokaryoten
- Planten
- Fungi: Gisten en zwammen Eukaryoten
- Eencellige dieren: Protozoa
- Meercellige dieren
!! Virussen: geen levende organismen !!
• Geen eigen voortplanting
• Hebben anderen nodig voor leven
Prokaryoten
• Oudste levensvorm
• Geen kern, maar kernequivalent: Nucleoïd
• Genofoor: 1 enkel circulair DNA
• Stijve celwand
• Geen organellen, enkel ribosomen
• Binaire splijting
• Soms vorming v endosporen, onder ongunstige
omstandigheden
Protozoa: éencellige diertjes
• 1 of meer kernen (haploïd / diploïd)
• Voortbeweging adhv
o Pseudopoden
o Flagella
o Sommigen onbeweeglijk
• Voortplanting:
o Ongeslachtelijk: mitose / Knopvorming
o Geslachtelijk: meiose met vorming v gameten

9

, • Ongunstige omstandigheden → Resistente cysten
Fungi: schimmels
• kernen
• Organellen
• Celwand
• Onbeweeglijk
• 1-cellig / Meercellig
• Voortplanting
o Ongeslachtelijk, mitosporen, knopvorming
o Geslachtelijk do meiose m vorming v meiosporen
Wormen & geleedpotigen
• Meercellig → Celdifferentiatie
• Hebben GI-buis & monddelen
• 1 diploïde kern + organellen
• Geen celwand
• Geslachtelijke voortplanting
Virussen
• Niet-levende, besmettelijke partikels
• Eiwitmantel rond DNA / RNA
• Intracellulaire ziektekiemen
• Na opname id cel → Replicatie do cellulaire enzymen
vo transcriptie & translatie → °miljoenen nieuwe virions
→ Cel spat open


SAMENVATTING




10

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