通过呼吸道感染的微生物.ppt

Themicrobesinfectedviarespiratorytract,Mainpathogenicmicrobes(Bacteria),Mycobacteriumtuberculosis结核分枝杆菌Streptococcuspneumoniae肺炎链球菌Corynebacteriumdiphtheriae白喉棒状杆菌B.pertusis百日咳鲍特菌,Mainpathogenicmicrobes(virus),Influenzavirus流行性感冒病毒Varicella-Zostervirus,VZV水痘-带状疱疹病毒Mumpsvirus腮腺炎病毒Measlesvirus麻疹病毒Rubellavirus风疹病毒,Othermainpathogenicmicrobes,Mycoplasmapneumoniae肺炎支原体Chlamydiapneuminiae肺炎衣原体,1、Mycobacteriumtuberculosis,acid-fastrodscapsulateobligateaerobedoublingtimeabout1824hLowenstein-Jensenmediumvariation,resistancedryingacidsandalkaliesdyes(malachitegreen)sensitivemoistheat70%ethylalcoholultravioletlight,1)Biologicproperties:,Mycobacteriumtuberculosis,2)Pathogenicity,capsulelipidscordfactor(索状因子),damagemitochondriamembranephosphatides(磷脂),tuberculessulfatides(硫酸脑苷脂),inhibitphagosome-lysosomefusionwaxes(蜡质D)adjuvantproteinstuberculin,Infectiousreservoirspatients,carrierstransmittedways:respiratorytract、alimentarytract、skinpulmonarytuberculosisprimaryinfectionsecondaryinfectionextra-lunginfection,3)Diseasescaused,M.Tuberculosisinlung,4)Immunity,infectiousimmunityTcell-mediatedimmunityimmunityandhypersensitivityKochphenomenon,5)TuberculinTest,principiumreagentoldtuberculin,OTpurifiedproteinderivative,PPDmethodsignificance,preventionvaccination:BCGtreatmentrifampin(利福平)isoniazid(异烟肼)ethambutol(乙胺丁醇)streptomycin(链霉素),6)prevention&treatment,2、treptococcuspneumoniae,Gram-positivelancet-shapedInpairscapsulateautolysis,1)Biologicproperties:,Capsule,anti-phagocyticserotyping,2)Pathogenicity,Autolysis-identification,Bile,peptidoglycan,cellmembrane,teichoicacid-choline,autolysin,lobarpneumonia(大叶性肺炎)particularlyyoungandoldafterdamagetoupperrespiratorytracte.g.followingviralinfectionMeningitis(children)(脑膜炎）otitismedia(中耳炎）,3)Diseasescaused,3、Corynebacteriumdiphtheriae,rodshapeGrampositivemetachromaticgranuleaerobegrowthinLoefflersmediumtelluriteagar,1)Biologicproperties:,Corynebacteriumdiphtheriae,Corynebacteriumdiphtheriae,metachromaticgranule,Diptheriatoxin,BbindstohostcellAinhibitsproteinsynthesisinactiveelongationfactor2codedbyb-bacteriophagetoxgene,2)Pathogenicity,Diphtheria,infectionupperrespiratorytract(pharynx)pseudomembranechockingbacteriadonotspreadsystemically,菌,鼻咽部繁殖,局部炎症：假膜,早期致死,外毒素,心肌炎软腭麻痹声嘶肾上腺功能障碍,晚期致死,入血,3)Diseasescaused,Thischildhasdiphtheriaresultinginathickgraycoatingoverbackofthroat.Thiscoatingcaneventuallyexpanddownthroughairwayand,ifnottreated,thechildcoulddiefromsuffocationCDC,4、Influenzavirus,typeAantigenichighlyvariableworldwideepidemics(eg.1918)typeBantigenicchangesomestimesepidemicstypeCantigenicstablemildillness,Structure,core(-)ssRNA,separatedsegmentsseven（typeC)oreight(typeA,B)helicalnucleoprotein(NP)envelope:2layersM1protein:codedbyviruslipidbilayermembrame:fromhosthemagglutinin(HA)neuraminidase(NA),1)Biologicproperties:,hemagglutinin(HA)absorption,penetrationhemagglutinationantibodytotheHAprotein(HIAb)neutralizetheviruspreventinfectionneuraminidase(NA)release,spreadantibodytotheNAproteinslowthespreadofthevirus&noprotection,antigenicdriftminorchangesinHAorNAvarianceratio1%pointmutationLimitedspreadantigenicshiftmajorchangesinHAvarianceratio:20%50%newsubtypeWorldwidespread,variation,2)Pathogenesis,persontopersonviasmallparticleaerosolsviacontactinfectstheepithelialcellsoftherespiratorytractuncomplicatedinfluenzapneumoniamajorcausesofinfluenza-associateddeathbacterialpneumoniacardiacfailure,preventionvaccine:multivalenttwostrainsofinfluenzaAandoneofinfluenzaBtreatmentamantadineChinesetraditionalmedicineIFN-alfa,3)prevention&treatment,5、Mycoplasmalpneumoniae,primaryatypicalpneumoniaviaaerosolizeddropletsinconfinedpopulationsfamilies,schools,armybarracksinpersons5-20yearsofage,LaboratoryDiagnosisCultureSputumorthroatwashingsELISAPCRTreatmenttetracyclines,6、Chlamdiapneumoniae,pathogenesisviarespiratorydrople