5章细菌感染的检查与防治-课件7

1、Chapter 5 Bacterial infectious diagnosis and prevention Chapter 5Diagnosis Diagnosis Signs and symptoms vary according to the site and severity of infection. Diagnosis requires a composite of information, including history, physical examination, radiographic findings, and laboratory data. Signs and

2、symptoms vary laboratory AssaysMorphological assaysLight or electron microscopyIsolation and differentiationSerological assaysAntigen-antibody assays Molecular assaysMicroorganisms gene (DNA & RNA)laboratory AssaysMorphological Diagnosis of Etiology: Golden standard is to detect the pathogenic bacte

3、rium Diagnosis of Etiology: Specimen Collection and ProcessingObtain specimens from the infected siteAvoid contamination from the normal floraTransporting and storing correctlyBefore antimicrobial drugs are administered. Providing essential information Specimen Collection and Proce5章细菌感染的检查与防治-课件7 G

4、eneral procedure for collecting and processing specimens for aerobic and/or anaerobic bacterial culture General procedure for c5章细菌感染的检查与防治-课件7 Direct assay Morphological Assay Element Assay Toxin Assay Direct assay Morphological As Morphological AssayNon-stained microscopic observationDark-field mi

5、croscopyObserving the movement of live bacteriaStained microscopic observationsGram stainAcid-fast stainFluorescence stain Morphological AssayNon-staine5章细菌感染的检查与防治-课件75章细菌感染的检查与防治-课件75章细菌感染的检查与防治-课件7 Element AssayAntigen detectionNucleic acid detectionToxin detection Element AssayAntigen detectioAn

6、tigen detectionCoagglutination testPrecipitation testELISAFluoroimmunoassay, FIA Radioimmunoassay, RIAAntigen detectionCoagglutination testCoagglutination testPrecipitation testPrecipitation testFluoroimmunoassay, FIAFluoroimmunoassay, FIANucleic acid detectionNucleotide hybridizationPCRGene chipNuc

7、leic acid detection5章细菌感染的检查与防治-课件7PCRPCR5章细菌感染的检查与防治-课件7Gene Chip / microarrayGene Chip / microarrayToxin detectionEndotoxin detection - Limulus testExotoxin detection - Elek plate testAnimal test - LD50, ID50Toxin detectionLimulus testLimulus testElek plate testElek plate test Culture & Identify I

8、solation & Culture Identify Morphological identify Biochemical reaction Serological assays Antibiotics susceptibility test Others Culture & Identify Isolation Isolation & Culture: ColonySizeShapeColorSurface featuresSmooth - RoughTransparencyHemolysis Isolation & Culture: ColonySi Biochemical Reacti

9、ons Sugar Fermentation H2S Test Citrate utilization Biochemical Reactions Sugar5章细菌感染的检查与防治-课件7 Diffusion Method Diffusion Method MIC & MBCMinimum Inhibitory Concentration，MICMinimum Bactericidal Concentration，MBCBactericidal drugs usually have an MBC equal or very similar to the MICBacteriostatic d

10、rugs usually have an MBC significantly higher than the MIC MIC & MBCMinimum Inhibitory C5章细菌感染的检查与防治-课件7E testDiffusion method +Dilution methodE testDiffusion method Serological Diagnosis Detection antibodies in the patients serum A current infection should be IgM positive A 4-fold or greater rise o

11、n antibody titer between the acute serum sample and the convalescent serum sample Serological Diagnosis Detect Agglutination test Complement fixation test Neutralization test ELISAWestern blot analysis Species Agglutination test Species A single IgG antibody titer is difficult to interpret because i

12、t is unclear whether it represents a current or a previous infection the convalescent sample is usually taken 10-14 days after the acute sample. By this time, the patient has often recovered and the diagnosis becomes a retrospective one Major disadvantage A single IgG antibody titer iPrevention and

13、Treatment of bacterial infectionPrevention and Treatment of baPreventionArtificialimmunityInnateimmunityActive immunityPassive immunity Specific PreventionActive immunityPassive immunityPreventionArtificialInnateActiPreventionPassiveimmunityActiveimmunityVaccinesAdjuvantsCytokine, LAK cellAntiserum

14、,AntitoxinsToxoidsImmunoglobulinPreventionPassiveActiveVaccine Vaccines are antigens prepared from pathogens that can raise a protective immune response, yet do not cause illness. Artificial active immunity Vaccines are antigeVaccinesInactivated vaccinesLive (attenuated) vaccinesSubunit vaccinesGene

15、 engineered vaccineDNA vaccinesToxoidVaccinesInactivated vaccinesLInactivated vaccine & Attenuated vaccine较高，维持35年甚至更长较低，维持数月2年免疫效果不易保存，4数周易保存，约1年保存及有效期量较小，1次量较大，23次接种剂量与特点活减毒株死，强毒株制剂特点活疫苗死疫苗区别点Inactivated vaccine & AttenuatAntitoxin: e.g. Tetanus antitoxin and diphtheria antitoxin AntiserumSpecific

16、 immunoglobulinCytokine Artificial passive immunityAntitoxin: Artificial passiveinvolves giving both a vaccine to provide long-term protection (preventive infection) and immune globulin to provide immediate protection (therapeutic and preventive infectious disease). Active-passive immunityinvolves g

17、iving both a vaccineArtificial active and passive immunity Treat or emergency prevebtionPreventionMain usageshort，23WLong,several years several monthsDurationFastslow，24WTime of responseAntibody, cytokineAntigensubstancePassive immunityAvtive immunityitmsArtificial active and passive 国家免疫规划疫苗: 2008年

18、2月 以前:乙肝疫苗、卡介苗、脊灰疫苗、百白破疫苗、麻 疹疫苗、白破疫苗08: 甲肝疫苗、流脑疫苗、乙脑疫苗、麻风腮疫苗重点人群和地区：出血热疫苗、炭疽疫苗、钩体疫苗国家免疫规划疫苗: 2008年2月预防的传染病15种: 乙肝、结核、脊灰、百日咳、白喉、破伤风、麻疹、甲肝、流脑、乙脑、风疹、腮腺炎、出血热、炭疽、钩体预防的传染病15种: Antimicrobial chemotherapyChemotherapy as a science began with Paul Ehrlich in the first decade of the 20th century. Ehrlichs experiments led to the arsphenamines(胂凡纳明 )for syphilis, the first planned chemotherapy. Antimicrobial chemotherapyCh5章细菌感染的检查与防治-课件7金葡菌菌血症的死亡率