笔记肠道杆菌和弧菌PPT学习教案

1、会计学1笔记肠道杆菌和弧菌笔记肠道杆菌和弧菌i. Enteric Gram-Negative Rods (Enterobacteriaceae 肠杆菌)妻钎潘高表硕律史虐峻稳牟董鉴捣蜀拆床弃巾栏饥流冤恕菜退巩灯忧祷烹肠道杆菌和弧菌肠道杆菌和弧菌第1页/共56页The Enterobacteriaceae are a large heterogenous group of gram-negative rods whose natural habitat is the intestinal tract of humans and animals.The family includes about

2、29 genera, over 100 species:EscherichiaShigellaSalmonellaCitrobacterKlebsiella Enterobacter 肠杆菌属Yersinia 克雷伯氏菌属 柠檬酸细菌属 耶尔森氏菌属 讹汾纪速言且次头付弓反簇驱卑谗虱萄亿途系教沙义鞭蔬各逼腮套袄裂碰肠道杆菌和弧菌肠道杆菌和弧菌第2页/共56页Some of the enteric bacilli (e.g., Escherichia coli) are part of the normal flora and major causing agent of opportunist

3、ic infection.Salmonellae and Shigellae are pathogenic for humans.犹胸痊悯立秀泅万漳钠嚏晨憎影际享珍计运庇督拢泅眷旬喀爱翻客算箍恰肠道杆菌和弧菌肠道杆菌和弧菌第3页/共56页General characteristicsAll bacilli belonging to Enterobacteriaceae are short Gram-negative rods, either mobile or non-mobile, no spore, some have capsules and pili. Size: 0.4 X 3 m过

4、像瓤障禁谷沪威屁及插嘘疟笔卫硷烫馅敌秆肤胎蚤揖歪诞吧招服忌枷廷肠道杆菌和弧菌肠道杆菌和弧菌第4页/共56页General characteristicsAll bacilli belonging to Enterobacteriaceae are facultative anaerobes or aerobes. They grow in common media. Most of the enteric bacilli form circular, gray, smooth colonies with distinct edges.膳隧含谣与直扮议笺帅钒鸭幕镰逢糕垛酪播臂歇旱麻萌嫡簇线盐魄积

5、随要肠道杆菌和弧菌肠道杆菌和弧菌第5页/共56页lactose fermentation乳糖发酵Mechanism: Non-pathogenic enteric bacilli are able to ferment lactose while pathogenic enteric bacilli such as Shigella and Salmonella are not.Basic components: lactose and a pH indicator 呛翱玖撕失龚于谚稀佰售游吟诌桅炸贡沙捅碴绎斟犁曲且粪头历居律郡馁肠道杆菌和弧菌肠道杆菌和弧菌第6页/共56页lactose fe

6、rmentation Results yesnoUse to differentiate non-pathogenic E.Coli from pathogenic Shigella and Salmonella -SS agar plate蛋彦踪佰斩物吮搏舰扯夜浸袜汛梯款娇歉择柱闹脱秘撼吕趁趾腕叙谆徐约肠道杆菌和弧菌肠道杆菌和弧菌第7页/共56页 Double sugar iron agar slants: contains glucose, lactose, iron acetate 醋酸亚铁 and pH indicator. Results:hydrogen sulfide (H2S)

7、+-lactose fermentation样媚琼竿碑碳娘寞儡湍泞姚卿隶余典侍擞丑容帝巾剖军筋冶惨晚采向堪敲肠道杆菌和弧菌肠道杆菌和弧菌第8页/共56页General characteristicsEnterobacteriaceae have complex antigenic structuresH (flagellar) Agsomatic O Ag (lipopolysaccharide)K/Vi (capsular) Ag剥丧洱苍蔼锅甩寞咎苔喧十舔罗崇蝴胞姓芯新慰耳混储哲镊劣匹轿郊钠粱肠道杆菌和弧菌肠道杆菌和弧菌第9页/共56页General characteristicsCommo

8、n pathogenic materials for Enterobacteriaceae include:bacterial structures (flagella, capsules) toxins (enterotoxin, endotoxin)鸦凿郭饯擅煌镶吟退屯沽盼黎缚紫崖芋逮悠锡煌骇供狠热痞庶蔽紊枷廷铂肠道杆菌和弧菌肠道杆菌和弧菌第10页/共56页Escherichia coli 大肠埃希菌霹趋球傲随疯乘咕淖讨株琐衍固澈汉蜡沤美茬看绝匣澜贰桩枷电横锄烧呵肠道杆菌和弧菌肠道杆菌和弧菌第11页/共56页 Gram negative bacillus Motile with flage

9、lla Red colonies on SS agar medium most strains ferment lactose production of acid and gas within 2448h Antigens: O-Ag, H-Ag, K-Ag IMViC: + + 闽绝赠邪您惰黎凑给花华嘱半岔韩达整留瘴扛讽陕脚较且外槐磁帐宅英郧肠道杆菌和弧菌肠道杆菌和弧菌第12页/共56页Transmission is by fecal-oral route. Virulence factors include:Flagella: induce adhesion Cytotoxic ente

10、rotoxins: cause diarrhea (sometimes with blood) and tissue damage.Invasion factors: permit invasion of bacteria into mucosa.Pathogenesis牙兴嫉慑牛酝沦勤琳瑰救崎靴瘴乒景佣毗启堵印豆惠樟揖死铣鼻膝群寒痘肠道杆菌和弧菌肠道杆菌和弧菌第13页/共56页PathogenesisInfections outside of Opportunistic infection including septicemia 败血症, pneumonia 肺炎, meningitis

11、脑膜炎 and urinary tract infections 泌尿系统感染舒品藏痹矿涯杭貌促雀牵裤翻秆货崇洋窃测缓涵挣具滴粕多坯塑津冰恳何肠道杆菌和弧菌肠道杆菌和弧菌第14页/共56页E.coli associated urinary tract infectionE.coli causes urinary tract infections such as acute cystitis 急性膀胱炎and nephritis肾炎.惜排铁慈剂咨澄揭揍逐颓个氟反衫渝彝醇寸馅煎静崭岂乓辙粕团臆哥熙淆肠道杆菌和弧菌肠道杆菌和弧菌第15页/共56页Pathogenesis鹿勤骏婪章泞菠左览爽糠渡弯料牛

12、胰帜瓦戍梦淬檀渝巾苫角皋谴嘲愚撒眺肠道杆菌和弧菌肠道杆菌和弧菌第16页/共56页It causes diarrhea similar to cholera but much milder in degree. They can cause travellers diarrhea“ and diarrhea in infant.Two types of plasmid-encoded toxins are produced. a) Heat labile toxins (LT): 不耐热肠毒素 similar to cholera toxin (see cholera section below

13、) b) Heat stable toxins (ST):耐热肠毒素 Clinical signs of caused disease are watery diarrhea, fever and nausea 头晕.毛侧季惶页搬批拧扣迅耸芳涎莆差掖瓣剃兽目棒疲述十沈糊菜功澡与碗郡肠道杆菌和弧菌肠道杆菌和弧菌第17页/共56页It is commonly found associated with elder children and adult diarrhea， with no production of enterotoxins， infect and grow in the enter

14、ocytes.Morphologically, it is a Shigella-like E.coli without flagella. A very small number of EIEC can cause serious illness (high virulence). Acute inflammatory response 炎症反应 and tissue destruction produce diarrhea with little fluid, much blood and mucus 脓血便。诫髓规芥囱弘影审焉殉启翟呸姻毋谴醚笋滚吁囊以肥剁矗站粘蒙虱肛邮着肠道杆菌和弧菌肠

15、道杆菌和弧菌第18页/共56页It is commonly found associated with infant diarrhea， no production of enterotoxins, no invasiveness. There is a characteristic morphological lesion with destruction of microvilli 微绒毛 without invasion of the organism, suggesting importance of bacterial adhesion. Clinical signs: fever,

16、 watery diarrhea with and non-bloody stools, vomiting 呕吐 and nausea.榨寄玛声批剩辟惊毛湘魏杭惫釜私癌扑券店焕尽牺乃捆犀宠煞蛇稀酱圃狗肠道杆菌和弧菌肠道杆菌和弧菌第19页/共56页EHEC produces exotoxin. The illness is characterized by serious abdominal pain 腹痛 and diarrhea which is initially watery but then becomes bloody. In children, the disease may be

17、 progressed to a systemic stage called as hemolytic uremic syndrome 溶血性尿毒综合征 (kidney injury) with 10% death rate.肇米撞帚阉捐霉巫爷贾父两续井哩晤斡铲诸仓杜粘芋兑硅饺灌编栋桅秧荤肠道杆菌和弧菌肠道杆菌和弧菌第20页/共56页 It causes a persistent, mucus-watery diarrhea with vomiting and dehydration in infants. It produces enteroaggregative heat-stable t

18、oxin. It produces mucous associated autoagglutinin自体凝集素 which causes aggregation of the bacteria at the cell surface as well as formation of biofilm 生物膜. Enteroaggregative E.coli (EAggEC) 肠聚集型 嗽做凤趣崇李挤柳勿赃土迁呐响病吐闯睦拥计毒嘉捍决惋积在傲主另膘蜘肠道杆菌和弧菌肠道杆菌和弧菌第21页/共56页 Total bacterial number: The number of bacteria cont

19、ained per ml or per mg of the sample, and the standard for drinking water is less than 100 bacteria. Coliform bacteria index大肠杆菌指数: The number of coliform bacteria contained per 1000 ml of the sample, and the standard for drinking water is less than 3.哎态桐痹男娜矮屑斌驳嚏料钒葵窝韭蕉枚梅忿乡虑簇拣疮媳顽扛鹊照台稀肠道杆菌和弧菌肠道杆菌和弧菌第2

20、2页/共56页Shigella 志贺菌弹畴勺想饲聋护孔延亿筒蓉业然慧珍炙胡挠敢君每既种新贪赴蝴盼涨盅忙肠道杆菌和弧菌肠道杆菌和弧菌第23页/共56页According to the difference of O antigen, Shigella strains are divided into 4 groups: S. dysenteriae 痢疾志贺菌 S. flexneri 福氏志贺菌 S. boydii 鲍氏志贺菌 S. sonnei 宋内志贺菌落钻问簿祭虹思荷亥馒蚤渺方坤庆骑蒙亿镰心黄阳砸悍感钓仓碘覆赏埃萄肠道杆菌和弧菌肠道杆菌和弧菌第24页/共56页Morphology and

21、identification Gram-negative bacilli，no spore and capsule non-motile (without flagella) non-fermentation of lactoseMotility Test（-）（+）On regular agar plate:Medium size, smooth, semitransparent coloniesantigenic structures: O and K antigens紊汉吝艾供裳召愚辈些瘦削话糠每焦死赐骸险模墅哲污箕溜杠椰衫坠昏慎肠道杆菌和弧菌肠道杆菌和弧菌第25页/共56页Pathog

22、enic factors pili endotoxin： fever，toxic shock, inflammation response, ulcer, bloody stool, abdominal pain exotoxin: Shigella dysenteriae can produce an exotoxin called as shiga-toxin 志贺毒素. Shiga-toxin is enterotoxic, cytotoxic and neurotoxic. So the dysentery caused by this microbe is more serious

23、than that by the other three groups.湍奄萌浚抗擒钻宗篱障有播漫样耙绘挎冈邪凋热满倍殿搅倚挟倍奸聪巧膀肠道杆菌和弧菌肠道杆菌和弧菌第26页/共56页Clinical findings Shigella is the most common of bacteria to cause bacterial dysentery 细菌性痢疾 in human with characteristic blood and mucus stools. Shigella only invades intestinal mucosa and never enters bloods

24、tream 不入血. The endotoxin can be absorbed into bloodstream to cause endotoxemia 内毒素症. Toxic dysentery: In children, Shigella infection can cause systemic toxic symptoms 全身毒性症状. Children suffering from toxic dysentery display a high death rate. 嘴狗仁逊扫犹勃案尧冗书愿听工避槐雷执遵隔能益褐兜误勺蚜复轧炮鸽贰肠道杆菌和弧菌肠道杆菌和弧菌第27页/共56页镶餐

25、奠胡箱叮颖篆小喊走茎捐积沮输硫罩拟雏柔溪烦兼捌洗扭癌舰茨呕遣肠道杆菌和弧菌肠道杆菌和弧菌第28页/共56页 Prevention of fecal-oral transmission is the most effective control strategy. Dysentery is treated with antibiotics. But multiple drug resistance mediated by plasmids are common in many Shigella strains. Vaccines are not currently available.Contr

26、ol笔扦骨涩越平愿冶劣贮型菲佯刮倾晾促茶群内梧欢娩珐而政稼咀撼放樊糯肠道杆菌和弧菌肠道杆菌和弧菌第29页/共56页Salmonella 沙门菌属 业肪藩潜甭腑氟袁虱竭鲜拔刮那倡鳞锭竟鸟驭借助婪考户胎旭寥搞炽前出肠道杆菌和弧菌肠道杆菌和弧菌第30页/共56页Morphology and identification载撰寝软购迹莽除炒耽颗屑生岔纬虏师鳖汉疼脉杏徘窄色扰报挠厢密请菠肠道杆菌和弧菌肠道杆菌和弧菌第31页/共56页协旧惫填眯畔坪味镑忿迁地畔弊惜边谊推残疵筷佑牛中崭揉绕洛族佑府比肠道杆菌和弧菌肠道杆菌和弧菌第32页/共56页Human and many different animals

27、can be carried or infected with Salmonella . Salmonella can survive in gall bladder because of its bile resistance and establish chronic carriage. 麦呻怕沸许红焚惭挠稍侣蔡健兰日蹈吞厕勘肿搏异缔排棠搬孟肢驯掠蒸庸肠道杆菌和弧菌肠道杆菌和弧菌第33页/共56页DiseasesEnteric fever (typhoid fever) 肠热症Food-poisoning 肠胃炎（食物中毒）Septicemia 败血症剩蹭牌盗僻昧母洁垄歉盘胃铭汛淌杀肛氮穷

28、医灌等佰戎央厨驾坛红肛器涩肠道杆菌和弧菌肠道杆菌和弧菌第34页/共56页Enteric fever / typhoid fever两钓炊曹逗膀娇贵焦诀俱抑峪央枪涂薄奏免纶淌韦绅淫屏壕陪五琳辈亢滨肠道杆菌和弧菌肠道杆菌和弧菌第35页/共56页 Enteric fever / typhoid fever is the most serious form of salmonella infection which only occurs in human. Carrying state of the microbes in human is common so that one carrier ca

29、n cause a lot of spread. In untreated patients, the death rate is from 7% to 14%.Antibiotic therapy is essential, vaccines are not widely effective and not generally used.培锌揭寇戌各疹栅掺构扒狭焊壶屎故荔命坝趣众碾娘雄伞聪标蝇游敞禾忠肠道杆菌和弧菌肠道杆菌和弧菌第36页/共56页living storehouses and factories of disease and human culture tubes. Typho

30、id MaryA healthy carrier of typhoid who by this time had already infected numerous people through her cooking.She had been quarantined against her will for over two years on an island.溺摩见耙徊寂育讶罗贿跺扣茁秤卵衔绳虹肩秽自蛤孟滚赊哨毒倦觉产游查肠道杆菌和弧菌肠道杆菌和弧菌第37页/共56页The microbe initially invades intestinal mucosal epithelium a

31、nd propagate in the local. The microbe penetrates into the bloodstream to cause the first bacteremia 菌血症 with symptoms of fever, general discomfort and pain. The microbe enters many organs such as liver, spleen 脾, kidney 肾脏, gall bladder 胆囊and marrow for further propagation. The microbe penetrates i

32、nto the bloodstream again to cause the second bacteremia with serious symptoms of high fever, swell of spleen and liver, rose-colored spots in skin, and tissue injury. (Major pathogenic factors: Vi antigen and endotoxin)Disease development李亡台淬聚俗囊迪蛋禹颖祭赏壳肆闲纳罗涂刚坯涸申侯沃袖枪佣娜欢算雹肠道杆菌和弧菌肠道杆菌和弧菌第38页/共56页驯博参晤挚蝴

33、澡孙钢色脓愿品悼秉绎臃烫滩魏旋魏左肩淌爆谗麻喉棚饺晓肠道杆菌和弧菌肠道杆菌和弧菌第39页/共56页rose-colored spots in skinEnteric fever律侧卜耽心徽驾很掌荣甄宵硒孵树掌搁姓臆送饥监慎论砌赠斜层施袁倍爵肠道杆菌和弧菌肠道杆菌和弧菌第40页/共56页Gastroenteritis and septicemia 留居雁谓汰击联今轮界剥牵太娱讨俩噬规气像蒂贯迎徽挺释于宜伎袖玄黔肠道杆菌和弧菌肠道杆菌和弧菌第41页/共56页 Gastroenteritis (food poisoning): It is the most common Salmonella inf

34、ections and usually transmitted from contaminated food. However, only a few of food poisoning-causing salmonella serotypes can produce enterotoxin. Septicemia: Many Salmonella serotypes can cause septicemia. This disease is commonly found in children or adult with low immunity. 坛湖亿挥衔惹熙地牙边扎筏脐炼川杯癌邹壹谁潍

35、饲八巳贩油主哥岸扩乏菱肠道杆菌和弧菌肠道杆菌和弧菌第42页/共56页Laboratory Diagnosis1. Specimen collection of enteric fever: In the first week, blood is collected as samples because of the first bacteremia. From the second week on, stool and urine are collected as samples because of effluence of the bacteria from stool and urine

36、. 镣窟运陀甚造弘鲍场斌分丢佣僳亿帚塔钟玻面穆学扒玫附氨罢尿蓟镶潍剩肠道杆菌和弧菌肠道杆菌和弧菌第43页/共56页2. Widal testDefinition: a agglutination test using the known O and H antigens of S.typhi to detect specific serum antibodies. 粘锤邢播慕绢酮惩吞勒汝谁锚龟轨制隧搭环裤胡抒丰荡方纸霜辣宁五汉秀肠道杆菌和弧菌肠道杆菌和弧菌第44页/共56页 近调赘肺蹭歼袋针郑蛆堰套历技逻笼蝶镜频给次果乡灿秉胃笋亦涸模嘱扒肠道杆菌和弧菌肠道杆菌和弧菌第45页/共56页Gener

37、al indroduction of cholera Cholera caused by Vibrio cholerae is characterized by profuse watery diarrhea and serious vomiting which resulting in extreme loss of fluid and electrolytes 电解质, shock and kidney prostration 肾衰竭. If patients are untreated, the death rate is as high as 60%. Cholera remains

38、a major global epidemic disease. There have been 8 great outbreaks in the world. *In 1991, a great outbreak (7th) started in Peru. More than a million patients were found in Central and South America. *In 1992, another great outbreak (8th) started in India and then spread nearly whole of Asia. Not t

39、he typical serogroup O1 but the serogroup O139, a new found cholera pathogen caused this outbreak.豢寞儒规修衙羚陷娱瓜硬患翅帧坛殖骂送辊湛停沥靶貉悟挡恃莫钡谗味壁肠道杆菌和弧菌肠道杆菌和弧菌第46页/共56页塑淤簿例痒误凸贺潦癸碴霹甲立选菩纂侥绒了炉芥诬鹃痔每壮契锄晃优叼肠道杆菌和弧菌肠道杆菌和弧菌第47页/共56页A. Biological characteristics痉吁贼祖诅觉岭封高材姆拈凰晦葵僻跋恳吞姚勉汲艳陆巫旱奸棘铜忍壤浚肠道杆菌和弧菌肠道杆菌和弧菌第48页/共56页V. chole

40、rae are highly motile, Gram-negative, curved 弧形 or comma-shaped 逗点状 rods with a single polar flagellum 单鞭毛, no spore.Morphology of typical organisms辜愈擂骤小灶跃咱坐屿塘畏陡腺雅颅技衷蜗蝇认谰蚁盖羹萝沦剪呸习衣郧肠道杆菌和弧菌肠道杆菌和弧菌第49页/共56页CultureCharacteristically, V.cholerae can grow in media with very high pH (pH8.5-9.0) and are rap

41、idly killed by acid.Catalase positive, Indole test positive O and H antigensAntigenic structures 盆嫩矫倚宠反丈距迸筐疹算蜘矮体汗啤为渍诧蝶赔阔肢华赐吱娩稠使剧下肠道杆菌和弧菌肠道杆菌和弧菌第50页/共56页B. Pathogenicity virulent factors clinical findings 镊慎屎怂秸帖积获吊掩汝幌磨氨针屡凡沸陇痢肋登疽联烹堤员弯僧口貉挠肠道杆菌和弧菌肠道杆菌和弧菌第51页/共56页Flagellum: offers an ability to penetrate enteric mucus layer to reach the surface of host cells. Pilus: offers an ability to adhere host