中南大学七年制球菌.ppt

中南大学基础医学院微生物学系,Coccus(球菌),Pathogeniccoccus(病原性球菌),Staphylococcus(葡萄球菌属)S.aureus(金黄色葡萄球菌)coagulase-negativestaphylococcus(凝固酶阴性葡萄球菌)Streptococcus(链球菌属)Streptococcuspyogenes(化脓性链球菌)S.pneumoniae(肺炎链球菌)Neisseria(奈瑟菌属)Neisseriameningitis(脑膜炎奈瑟菌)Neisseriagonorrhea(淋病奈瑟菌),Classification,StaphylococcusandStreptococcus(葡萄球菌属与链球菌),Biologicalcharacters(生物学特性),1.Morphology,2.Culture,S.aureus,S.epidermidis,S.saprophyticus,Incompletehemolysis,greenzonearoundcolonies,Completehemolysis,clearzonearoundcolonies,3Antigenicstructure,SPA的生物学作用1抗吞噬作用,在吞噬反应中抑制IgG调理素促吞噬和杀菌作用。2对人类B细胞具有促有丝分裂因子的作用等。3.损伤血小板及引起超敏反应。4A蛋白还有激活补体替代途等活性。,它与人及多种哺乳动物血清中的lgG1、lgG2、lgG4的Fc段非特异结合，因而可用含SPA的葡萄球菌作为载体，结合特异性抗体，进行协同凝集试验(coagglutination)，用于多种抗原的检测。,医学意义：,3Antigenicstructure,4.Classification,Accrodingtothepigmentorhemolyticactivityonbloodagar,5Resistance,Pathogenicity(致病性),1.Virulencefactors,coagulase,Coagulase(血浆凝固酶),VirulencefactorsofStaphylococcus,生物学作用：1抗吞噬2保护细胞免受环境中有害物质的损伤3使感染局限化及形成血栓,1.Virulencefactors,(2)pyrogenicexotoxin(scarletfevertoxin)producedbymoststrainsofgroupAstreptococcicausescarletfever（致热）heatstableprotien（耐热）possessantigenicity,antitoxinspecificallyneutralizethetoxin,DiseasescausedbyStaphylococciandStreptococcus,1.purulentinfection(infectiousdiseases)2.Toxin-Mediateddiseases3.poststerptococcaldiseases(hypersensitivedisease):onlycausedbyStreptococcus.(1)acuteglomerulonephritis(groupA)(2)Rheumaticfever,防治原则,Neisseria(奈瑟菌属),Gramnegativecocci,usuallyarrangedinpairs.Mostofthemarenormalinhabitantsinrespiratorytract.Othersarehumanpathogens(eg:gonococcus,meningococcus),Commonbiologicalcharacteristics,Gramnegativecocci,kidney-shaped,arrangedinpairs,withcapsulesandpili.2.culture:Needenrichedmedium(chocolatebloodagar),510%CO2.3.Resistance:veryweak，“fragile”,extremelysensitivetodrying,heatandcold.,Neisseriagonorrhoeae(淋病奈瑟菌),Pili(菌毛):attachtoepithelialcells(urinary-gentital,RBC)IgA1-protease(蛋白酶):breakdownsurfaceIgAantibodies.Outermembraneprotein(OMP,外膜蛋白)脂寡糖：由脂质A和核心多糖组成，具内毒素活性。,Pathogenicfactors,Diseases,Gonorrhea(淋病)(STD:sexuallytransmitteddisease)acuteurethritis(尿道炎)(male);pelvicinflammatory(盆腔炎)(female)Ophthalmia(结膜炎)neonatorumblindness(失明)新生儿眼结膜炎,penicillin(青霉素)Gonorrheasilvernitrate(硝酸银)ophthalmia(neonatorum),Preventionandtreatment,Neisseriameningitidis(脑膜炎奈氏菌),1.Pathogenicity:(1)Humanistheonlynaturalhostforpathogenicmeningococci.Child:susceptible(2)virulencefactor:*Piliattachtonasopharyngealmucosa*capsuleantiphagocytosis*endotoxinmainpathogenicsubstancecapillarytube,smallbloodvessel,Pathogenicityandimmunity,2.Pathogenesis:epidemiccerebrospinalmeningitis流行性脑脊髓膜炎clinicaltyping:common,outbreak,septicemictype,3.Immunity:group-specificantibody,cross-immunitybetweengroups.,Preventionandtreatment,1.Isolateandcurepatients2.antibiotics:suchasPenicillin;cefotaxime,sulfanilamide3.Polysaccharidevaccine(groupA,C),病原性球菌的共同点：1均可引起化脓性炎症。2无芽胞，鞭毛，多数有荚膜。3对青霉素、磺胺、红霉素、庆大霉素等敏感，但葡萄球菌、肺炎链球菌、淋球菌等易产生耐药性。4病后免疫力一般均不强。,思考题,一、名词解释：1.SPA2.ASO试验二、简述葡萄球菌、A族链球菌、脑膜炎奈瑟菌的主要致病物质及致病机制。,病历摘要：患者，男，22岁。以咽痛伴发热2d就诊。5d前有不洁性交并口交，同时有泌尿系感染表现。检查：咽