双语球菌ppt课件

Chapter8Coccus球菌,1,Gramstain,2,Staphylococcus(gram-positive),3,E.coli(gram-negative),4,Categoriesofcocci,Staphylococcus（葡萄球菌属）Streptococcus（链球菌属）Neisseria（奈瑟菌属）,5,Section1Staphylococcus葡萄球菌属,Staphylococcusaureus（金黄色葡萄球菌）BiologicalcharacterizationPathogenesisandsymptomatologyLaboratorydiagnosisEpidemiology,treatmentandcontrolStaphylococcusepidermidis（表皮葡萄球菌）Staphylococcussaprophyticus（腐生葡萄球菌）,6,Biologicalcharacterization,Morphology:Gram-positivesphericalcellsarrangedingrape-likeclusters.LacksporeandflagellumCulturecharacteristics:Colonies:round,smooth,raised,glisteningPigments:fatsoluble;goldenyellow(pathogenic),whiteorlemonBloodagarplate:-hemolysis（溶血）(pathogenic),7,BiochemicalreactionsCatalase（触酶）test:+AntigensSPACapsularpolysaccharideOtherpolysaccharidesClassificationStaphylococcusaureus（金黄色葡萄球菌）Staphylococcusepidermidis（表皮葡萄球菌）Staphylococcussaprophyticus（腐生葡萄球菌）Resistance:relativelystrong,resistanttomanyantibiotics,8,S.aureusmorphology,9,S.aureusmorphology,10,Staphylococcuscoloniesoncommonagarplate,11,Pigments,S.aureus(goldenyellow),S.epidermidis(white),S.saprophyticus(lemon),12,Bloodagarplate,S.aureus,13,13,-hemolysis,14,Catalasetest,15,SPA,葡萄球菌A蛋白StaphylococcalProteinADefinition:AcellwallcomponentofmanyS.aureusstrainsthatbindstotheFcportionofIgGmoleculesexceptIgG3.Invitro,SPAhasbecomeanimportantreagentinimmunologyanddiagnosticlaboratorytechnology.Invivo,SPAcaneffectivelydiminishopsonization.,16,SPA,Staphylococcus,IgGFcreceptor,macrophage,Anti-phagocytosis（抗吞噬）,17,Coagglutinationtest（协同凝集试验）,18,Pathogenesisandsymptomatology,19,Pathogenicsubstances,EnzymesToxinsSurfacestructureproteinsAdhesin（黏附素）Capsule（荚膜）Peptidoglycan（肽聚糖）SPA,20,Enzymes,Coagulase（凝固酶）OtherenzymesFibrinolysinFibrinolysin（纤维蛋白溶酶）Heat-stablenuclease（耐热核酸酶）Hyaluronidase（透明质酸酶）Lipase（脂酶）,21,Coagulase（凝固酶）,Anenzyme-likeproteinproducedbyS.aureusthatclotsoxalatedorcitratedplasma.Itsproductionisconsideredasinvasivepathogenicpotential.Twotypes:Freecoagulase（游离凝固酶）Boundcoagulase（结合凝固酶）,22,S.aureuscoagulasetest,Positive,Negative,23,凝固酶的作用,保护作用：抗吞噬，抗杀菌物质感染病灶的病理特性：局限化、脓汁粘稠和形成血栓具有免疫原性,24,Toxins,Staphylolysin（葡萄球菌溶素）Leukocidin（杀白细胞素）Enterotoxin（肠毒素）Exfoliativetoxin（表皮剥脱毒素）TSST-1（毒性休克综合征毒素-1）,25,Staphylolysin（葡萄球菌溶素）,-toxinsCytotoxin.Itisapotenthemolysin(溶血素).Actsonabroadspectrumofeukaryoticcellmembranes.(RBCs,WBCs,platelets,hepatocytes,etc.),26,Leukocidin（杀白细胞素）,Cytotoxin.Damagethecellmembranesofneutrophilsandmacrophages.Inhibitphagocytosisandaggravatetissuedamage.,27,Enterotoxin（肠毒素）,Itisagroupofsolubleandheat-stableproteins.Resistanttotheactionofgutenzymes.Animportantcauseoffoodpoisoning(食物中毒).Ingestionofenerotoxinresultsinvomiting(呕吐)anddiarrhea.Itisansuperantigen.,28,食物中毒呕吐为主要症状,29,30,Exfoliativetoxin（表皮剥脱毒素）,Epidermolytictoxins(表皮溶解毒素)Theepidermolytictoxinsyieldthegeneralizeddesquamationofthestraphylococcalscaldedskinsyndrome（烫伤样皮肤综合征，SSSS）.,31,Toxicshocksyndrometoxin-1,毒性休克综合征毒素-1Ansuperantigen.Causestoxicshocksyndrome（TSS，毒性休克综合征）Associatedwithfever,shock,andmultisysteminvolvement.,32,Clinicalfindings,Invasivediseases(pyogenicinfection)Skinlesions:furuncle(疖),carbuncle(痈),impetigo(脓疮)Deeplesions:infectionsofbones,joints,deeporgans,andsofttissues.Systemicinfections:septicemiaandpyemiaToxin-mediateddiseasesStaphylococcalfoodpoisoning（食物中毒）Scaldedskinsyndrome(SSS)（烫伤样皮肤综合征）Toxicshocksyndrome(TSS)（毒性休克综合征）,33,CutaneouslesionsofS.aureus,34,Boil（疖）,35,36,LaboratoryDiagnosis,Gramstain:Gram-positivecocciinclustersGoldenyellowpigmentCatalasetestsCoagulasetestsAntibioticsusceptibilitytestsBloodcultures,37,Identificationofthepathogenicstaphylococcus,金黄色色素（+）溶血性（+）凝固酶（+）耐热核酸酶（+）发酵甘露醇（+）,38,Antibioticsusceptibilitytests,39,Section2Streptococcus链球菌属,40,ClassificationofStreptococcus,BasedonthecellwallantigensAH.KV20groups90%pathogenicstrainsbelongtogroupABasedonthehemolysisreactionshemolysisS.pneumoniaeandothers-hemolysisgroupA,B,C,GandsomeDstrains-hemolysis,41,Hemolysispatterns,hemolysis,hemolysis,nohemolysis,42,Classificationbasedonhemolysis,43,GroupAstreptococcus（A群链球菌）,BiologicalcharacterizationPathogenesisandsymptomatologyLaboratorydiagnosisEpidemiology,treatmentandcontrol,44,Biologicalcharacterization,Morphology:Gram-positivespherical/ovoidcocciarrangedinlongchains.Non-spore-forming,nonmotileCanformcapsulesandpilusCulturecharacteristics:Facultativeanaerobes(兼性厌氧)Mostarefastidiousandrequireenrichedmedia(营养要求较高).Colonies:small,round,smooth,nonpigmentedBloodagarplate:-hemolysis(pathogenic),45,BiochemicalreactionsCatalase（触酶）test:-AntigensPolysaccharideantigen(AntigenC)Groupspecificantigen（群特异性抗原）.MajorityofhumanpathogenicstreptococciaregroupA.ProteinantigenTypespecificantigen（型特异性抗原）ProteinMisamajorvirulencefactor.Nucleoproteinantigen(AntigenP):nonspecificResistance:Sensitivetodrying,heat,anddisinfectants,46,Streptococcus,47,Streptococcus,48,hemolysisStreptococcus,49,分20个群，A群致病（溶血性链球菌或化脓性链球菌）,根据蛋白抗原进一步分型（M蛋白）,多糖,肽聚糖,细胞膜,细胞质,荚膜,蛋白质,50,Pathogenesisandsymptomatology,51,Pathogenicsubstances,CellwallcomponentsAdhesin（黏附素）:LTA&proteinFProteinMPeptidoglycan（肽聚糖）ExotoxinsPyrogenicexotoxin（致热外毒素）Streptolysin（链球菌溶素）InvasiveenzymesHyaluronidase（透明质酸酶）Streptokinase（链激酶）Streptodonase（链道酶）,52,Adhesin（黏附素）,Lipoteichoicacid(LTA,脂磷壁酸)ProteinF(F蛋白)Bindtothecorrespondingreceptorsonhostcellsandfacilitatetheadherence.,53,ProteinM（M蛋白）,AmajorvirulencefactorofgroupAstreptococci.Facilitatestheadherence.Inhibitsphagocytosisandkillingofimmunecells.Acommonantigen(共同抗原).Contributestosomehypersensitivitydiseases.,54,Peptidoglycan（肽聚糖）,PyrogenicDamagesplateletsIncreasesvascularpermeabilityInducesexperimentalarthritis,55,Pyrogenicexotoxin,致热外毒素、红疹毒素、猩红热毒素Isassociatedwithstreptococcaltoxicshocksyndrome（链球菌毒性休克综合征）andscarletfever（猩红热）.PyrogenicHighlyantigenic.Actsasansuperantigen.,56,Streptolysin（链球菌溶素）,StreptolysinO(SLO,链球菌溶素O)Oxygen-labile(SHgroups)RapidlyinactivatedinthepresenceofoxygenHighlyantigenicAntistreptolysinOtest(ASOtest)StreptolysinS(SLS,链球菌溶素S)Oxygen-stableNotantigenic.-hemolysisonbloodagarplates.,bothcausecellandtissueinjury,DamageRBCs,WBCsandplatelets.,57,Hyaluronidase（透明质酸酶）,Splitshyaluronicacid（透明质酸）,animportantcomponentofthegroundsubstanceofconnectivetissue.Aidsinspreadinginfectingmicroorganisms.Spreadingfactor（扩散因子）.,58,Streptokinase（SK）,链激酶Streptococalfibrinolysase（链球菌溶纤维蛋白酶）Ittransformstheplasminogen(纤维蛋白酶原)ofhumanplasmaintoplasmin(纤维蛋白酶),anactiveproteolyticenzymethatdigestsfibrin(纤维蛋白)andotherproteins.Spreadingfactor（扩散因子）,59,Streptodonase（SD）,链道酶Streptococaldeoxyribonuclease（链球菌DNA酶）DepolymerizesDNA.Spreadingfactor（扩散因子）,链球菌感染病灶特点：脓汁稀薄，病灶扩散，边界不清,60,Clinicalfindings,Pyogenicinfections（化脓性感染）InfectionsofskinandsubcutaneoustissuesInfectionsofothertissues:tonsillitis,pharyngitis,tympanitis,etc.Toxin-mediateddiseases（中毒性疾病）Scarletfever（猩红热）Streptococcaltoxicshocksyndrome（链球菌毒性休克综合征）Allergicdiseases（超敏反应性疾病）Acuterheumaticfever(ARF)（风湿热）Acuteglomerulonephritis（急性肾小球肾炎）,61,Streptococcalskininfections,62,Pharyngitis（咽炎）andtonsillitis（扁桃体炎）,63,Streptococcalsorethroat（咽炎）,64,Scarletfever猩红热,65,Laboratorydiagnosis,66,Laboratorydiagnosis,Specimens（标本采集）:Tobeobtaineddependuponthenatureofthestraptococcalinfection.Smears（涂片）:G+,spherical/ovoidcocci,arrangedinlongchains.Culture:bloodagarplates(hemolysis)Serologicaltests:ASOtest,67,ASOtest,抗链球菌溶素O试验AntistreptolysinOtestisameasureofthebloodplasmalevelsofantistreptolysinOantibodiesusedintestsforthediagnosisofastreptococcalinfectionorindicateapastexposuretostreptococci.Itisusedtohelpdiagnosepost-streptococcalsequelaeofrheumaticfever(风湿热)andglomerulonephritis(肾小球肾炎).,68,Streptococcusphenumoniae（肺炎链球菌）,BiologicalcharacterizationPathogenesisandsymptomatologyLaboratorydiagnosisEpidemiology,treatmentandcontrol,69,Biologicalcharacterization,Morphology:Gram-positive,lancet-shapeddiplococciNon-spore-forming,nonmotileCanformcapsulesCulturecharacteristics:Facultativeanaerobes(兼性厌氧)MostarefastidiousandrequireenrichedmediaColonies:small,round,smoothBloodagarplate:-hemolysisAutolysis(自溶现象),70,BiochemicalreactionsBilebacteriolysistest:+Resistance:Sensitivetodrying,heat,anddisinfectants,left：hemolyticstreptococcusnegative（turbidity）right：S.Pneumoniaepositive（clear、transparent）,71,Capsule,S.Pneumoniae,72,S.Pneumoniae,Capsule,73,S.Pneumoniae,74,S.Pneumoniaeinsputum（Gramstain,1000）,75,S.Pneumoniae,bloodagarplate（hemolysis）,76,Pathogenicity,PathogenicsubstancesCapsulePneumolysinOLipoteichoicacidNeuraminidase,ClinicalfindingsPneumococcalpneumoniaPneumococcalmeningitisOthercomplications,77,Laboratorydiagnosis,SmearsCultivationDistinguishedfromviridans(草绿色)streptococcusBilesolubilityOptochinsensitivityQuellungreactionAnimaltoxicexperiment,78,Neisseria（奈瑟菌属）,Gram-negativecocciPairsPathogenicforhumans:Neisseriameningitidis（脑膜炎奈瑟菌）Neisseriagonorrhoeae（淋病奈瑟菌）,79,NeisseriaMeningitidis(脑膜炎奈瑟菌),80,Biologicalcharacterization,Morphology:Gram-negative,kidney-shapeddiplococciCanformcapsulesandpiliCulturecharacteristics:Enrichedmedia:modifiedThayer-MartinmediumColonies:convex,glistening,elevated,mucoidAutolysis(自溶现象)Resistance:weak,81,82,露滴状菌落,83,84,Pathogenicity,PathogenicsubstancesCapsuleAdhesivefimbriaeIgAproteaseLipooligosaccharide(LOS),Epidemicmeningitis流行性脑脊髓膜炎Naturehosts:hu