内容教程成果spirochetes mycoplasma reckettsia chlamydia mycology

MedicalDanniDepartmentofMedicalMicrobiologyandparasitologyRoom510,Buiding5 17thOctober,1LectureChapter39Treponema,Borrelia,andChapter40 smaand Chapter41RickettsiaandChapter42Ehrlichia, sma,andChapter43ChlamydiaandChapters65-752Gram-negative,Gram-negative,thin,螺旋形的motileEndoflagellastainedbyasilverimpregnationmethod33Threegeneraofspirochetescausehuman Borrelia ）Lyme

B.

epidemicrelapsing B.

4Treponemapallidumsubsp. Cannotbegrownin LimitedgrowthoftheorganismhasbeenachievedinculturedrabbitepithelialcellsSensitivetotemperature(50℃5min;4℃3d)anddryingSensitiveto5Humanaretheacquiredsyphilisintimate congenital pregnantwomen,their 6Stagesof

+hard

+maculopapularrash 肿

necrosis坏死7Primary+hard+淋肿maculopapular疹necrosis ⅠPrimaryhard9Secondary+hard+淋肿maculopapular疹necrosis

Maculopapula1rush+hard+淋肿maculopapular疹necrosis Gummasmaybefoundinbone,skin,andotherCongenital Abortionfetus Othersarebornlivebutdevelopthesignsofcongenitalsyphilisinchildhood:interstitialkeratitis间质性角膜炎,Hutchinson‘steeth锯齿形牙,saddlenose马鞍鼻,andavarietyofcentralnervoussystemanomalies中枢神经系统异

saddleInfection - withactiveorlatentappearstoberesistanttosuperinfectionwithT.pallidum.However,ifearlysyphilisistreated yandtheinfectioniseradicated,theindividualagainesfullyCellularimmunityismore细胞免疫比体液免疫重 DiagnosticLaboratory−Thelesionofprimaryorsecondary Microscopic−DarkfieldmicroscopyorfluorescentstainsSerologicNontreponemalantigenantigen(beefheartcardiolipin)→ smareagintest Advantages:Specific,confirmatorytest(可用作 Commonlyusedtests常用方法Fluorescenttreponemalantibody-absorption(FTA-ABS)testTreponemapallidumparticleagglutination(TP-PA)testSpecificenzymeimmunoassays(EIAs)MicrohemagglutinationassayT.pallidum(MHA-TP)testPreventionandProtectivevaccinearenotSyphiliscanbecontrolledonlythroughthepracticeofsafe- techniquesandadequatecontact.PenicillinortetracyclineisBorreliaburgdorferiLymediseasetransmittedbyasmallreservoirhost:wildStage1(early–erythemamigransbeginsasaflatreddenednearthetickbiteandslowlyStage2(earlyFlu-likearthralgia&arthritisneurologicmanifestations(meningitis,facialnervepalsy面神经瘫痪)cardiacdiseaseStage3–chronicskin,nervoussystem,orjointLeptospiraNonpathogenicspecies：LeptospiraPathogenicspecies：Leptospiragrowbestunderaerobicconditionsat28-30℃inrabbitserum-containingmedia(Korthof').

cansurviveforweeksinwaterandmoistsoil worldwidezoonosisanimalhostsmice,swine，wildrodents,dogs,andcattleHumansare (dead-end)hostsleptospirescanthroughtheskinabrasionsorconjunctivaenterintothebodyinfluenza-like(fever,muscleseveresystemicSerovar-specificSerumfromconvalescentpatientsprotectsexperimentalanimalsagainstanotherwisefatalinfection.ReinfectionwithdifferentserovarsmayDiagnosticLaboratoryMicroscopicexaminationfirst10days:blood;afterfirstweek:发病10天内取血液; Culture:KorthofAnimalInoculationIntraperitoneal腹腔内inoculationofyounghamstersorguineapigswithfresh smaorurineSerology:microscopicagglutinationPreventionandReducingtheprevalenceindomesticanimalsviavaccinereduceshumanAninactivatedvaccineisPenicillinortetracyclineis smaThesmallestprokaryoticorganisms（0.3-can -livinginalsogrowonlaboratorynocellwall（Pleomorphiccellmembranecontainssterols固醇canpassthrough0.45-μmInNocardfoundMyco smafromthecattlethathadpleurop InIn1937,DienesisloatedMycopusofpatients.Oncetheywerenamedpleurop likeorgnism(类胸膜炎微生物)In1962,Chanocksucceededincultivating

Myco smaUrea sma

PathogenicM. oniaeM.U.UrealyticumMGenitaliumMPenetraus Structure(underelectronThreelayers:outerandinnerlayerscontainproteinandglycogenmeddlelayeriscomposedoflipid(cholesterol胆takesup36%)Theonlycellularorgan-BothDNAandHighNutritionalrequirements:cardin(牛心浸液),serum,yeaststeep(酵母浸液)InpH7.8-8.0growth(below7.0Need5%-10%SlowGrowth,lifecycle:1-Liguidmedium:DifficulttoseetheSolidmedium:Atypicalconolywasfriedegg“FriedEgg”Coloniesofsome smaandL-form L-FORMNocell SometimesformsacellCellmembranecontainssterols,eg.cholesterol.StableinordinaryGrowslowly,formsmallcolonies(diameter0.3-0.5mm)Lowturbidity浊度inliquidmedium

CellmembranedoesnotcontainNeedhyperosmoticFormlargercolonies(diameter0.5-1.0mm)Highturbidityinliquidmedium,mayadheretothewallorbottomofthetubeThebiologicalBiochemicalactivityofhuman Myco M.p ——M. ＋—M. ——M. ＋—U.urealyticum—＋ThebiologicalAntigenicThemajorantigenicdeterminantsarecomposedofproteinsandglycolipids糖脂.Sensitivetophysical chemicalResistanttoCrystalviolet结晶紫、thalliumacetate乙酸铊、topenicillin. ①P1theprimaryvirulence③CapusleorBothlocalandsystemicspecificimmuneresponsesoccur.Immunityisnotcomplete,andreinfectionisM. Clinicalstartscoughbutnon-productive,sorethroat咽喉痛,fever,malaise,headache–then5-10%progressto self-limiting–lessthan1%transmittedfrom bymeansofinfectedrespiratorysecretionMicrobiologicalSputum(usuallyscant)orthroatCultureisessentialforadefinitive Coldagglutinins

Warning:Coldagglutinationisnotsensitiveorspecific. ELISA-ThereisanewELISAforIgMthathasbeenusedfordiagnosisofacuteinfection. PreventionandAvoidanceofcontacts,ifVaccineshaveprovedTetracycline,erythromycinorchloramphenicolareeffective.KeyThedefinitionandstructurecharacteristicsofThebiologicalproperties,pathogenicityimmunityofThepathogenicityofB.ThelaboratorydiagnosisofThedefinitionof Thepropertiesincultureand Thedifferencesbetween smaandL-Rickettsia,Ehrlichia,Coxiellawerehistoricallyclassifiedinasinglefamily,Rickettsiaceae.GeneralSmall（0.6～2μm）,gram-negative,obligateintracellularcoccobacillibacteriaInfect lsandarthropodsRickettsiaaretransmittedintheContainbothDNAandIssensitivetoBilogicalVariableGramMicrocapsuleandslimCulture:grownincellculture,embryonatedeggs,:sensitivetoheat,resistanttocoolanddryconditionsAntigenicGroupspecificantigenWeil-Felixreaction AtestforthepresenceandtypeofrickettsialdiseasebasedontheagglutinationofO ofProteusvulgariswiththe edRickettsiainapatient'sbloodserum.Bitefromabloodsuckingarthropodeg.Mites螨虫,fleas蚤,andlice虱VirulenceEndotoxin,PhospholipaseA磷脂酶vascularsystemproducingvasculitisCharacteristictriadofsymptoms:fever,headacheandrashPathogenicEndotoxin、PhospholipaseABiteorfecesofarthropodvectorLocal(smallbloodvesselsinlymphoid(FirstFever,headache,rashPathogenicPathogenic

Insect

humanbodylouse人

epidemicRtyphi斑疹伤寒立

ratflea蚤,ratlice C.

chiggerredmiteticks蜱

QR.Humanbody

R.

ratflea、rat tissueSerologicalWeil-FelixreactionImmunofluorescentantibodiesSanitary:ArthropodandrodentImmunological:NovaccinesarecurrentlyChemotherapeutic:Tetracyclineorchloramphenicolaredrugsofchoice.EhrlichiaSmall,gram-negative,obligateintracellularcoccobacillibacteriaReservoirswhite-taileddeerwhite-footedmouse,chipmunks金花鼠,voles田鼠,Inhibitionofphagosome-lysosomefusionlikehumanana ClinicalHumanMonocyticE.Suddenonsetoffeverchillsheadacheandmyalgia肌痛Norashinmost(80%)Leukopenia,thrombocytopeniaandelevatedserumtransaminases白血球减少、 LowmortalityratesMicroscopicobservationofmorulainblood,smearisrareCultureispossiblebutrarelySerologytestmostDNAprobesarePreventionandAvoidanceofticksprotectiveclothinginsectrepellents杀虫剂,removalofembeddedticks.VaccinesarenotObligateDistinctivedevelopmentalCanpassthroughbacterialfilters(0.45Chlamydiaceaecausinghumandisease:CtrachomatisC C CommonobligateContainbothDNAandSusceptibletonumerousantibacterialReplicatebyauniqueintracellulargrowthLifeCycleofCultureObligateEmbryonatedeggyolksacinoculationCellculture(Hela299,McCoycellSensitivetoheat,disinfectors Resistanttohypothermia耐低温Endotoxin-likeMajoroutermemberaneDelayed-typehypersensitivityTheimmunitytochlamydiaisDifferentiationofChlamydiaceaethatcausehuman HostPrimarilyhumanPrimarilyhumanPrimarilyanimalinfectshumansoculartrachoma沙眼,oculogenitaldisease,infantChlamydiatrachomatisSourceofinfection:Serotype：A,B,Ba,andChronicinfectionoftheconjunctivaAleadingcauseofpreventableChlamydialinfectionsoftheconjunctivalepitheliumProliferation,InclusionbodiesLocalinfl discharge,conjunctivalhyperemia结膜充血andfollicularhypertrophy滤泡增生Conjunctivalscar,eyelidtrichiasis倒睫),pannus血管翳Blurredvision,even

immunofluorescentstaining Isolation:embryonatedeggyolksacorcontinuouscelllineNucleicacidtesting:Immunological:NovaccinesarecurrentlyErythromycin，sulfanilamideorKeyThedefinitionofMajorpathogenicThecommonfeaturesofThepathogenicityofThediagnosisandthepreventionandtreatmentofRickettsia.WhatistheWeil-FelixThedefinitionofThedevelopmentalcycleofThepathogenicityofC.trachomatisThecommonfeaturesofWhatareFungiareeukaryoticorganismsthatscientistsonceconfusedwith nts.However,scientistshavefoundthat,atthecelllevel,thefungiaremorelikeanimalsthantheyarelike WhatareMushrooms,yeastsandMorethan50,000speciesoffungi,mostarebeneficialtohumankind,Onlyabout300cancause

UsefulSaccharomycescerevisiae:winemaking,baking,Aspergillusoryzae:sakebrewing,makingmisoandBotrytiscinerea:makingsweetdessertAspergillusThebadsideofThrushThrushMastitisMastitisGeneralEukaryoticAsingle-celledormulticellularReproducebymeansofspores,usuallyCausesStructureofCellCellCellwall(chitinandglucan)Cellmembraneergosterol麦角固醇)DiagramofafungalComparisonoffungiandMitochondria线粒体and质网presentMitochondriaandCellSterolsCellualandaualsporesforreproductionEndosporesforsurvival,notforRequireorganiccarbon;noobligateanaerobesMaydonotorganiccarbon;manyobligate Unicellularfungi(单细胞真菌,yeast)Multicellularfungi多细胞真菌,mould)Hypha(菌丝mycelium(vegetativeaerialorreproductive). ualual UnicellularCandida

Cryptococcus

ParacoccidioidesMulticellular

ualSporangiospore孢子囊孢子Blastospore芽生孢子Chlamydospore厚膜孢子Arthrospore关节孢子ualZygospore结合孢子Ascospore子囊孢子Basidiospore担子孢子Dimorphism（二相性真菌Dimorphicfungiarethosefungithatexisteitherinyeastformorasmold(mycelialform)dependingonenvironmentalconditions,physiologicalconditionsofthefungusorthegeneticcharacteristics.MedicallyimportantIncludes4 ualreproductioninasackcalledanascuswiththeproduction inasackcalledabasidiumwiththeproductionofZygomycotina（接合菌亚门）- ualreproductionbygametesanda ualreproductionwiththeformationofDeutermycotina（半知菌亚门）-norecognizableform ualreproduction.Includesmostpathogenicycotina（子囊菌亚门

Sabouraudculturemedium pH4-22-28℃or37typesofcolonies–UnicellularMuticellularMultiplication:budding,hyphaformation,branchingordisruptionofhypha,sporeformationResistanttodrying,sunlight,UVlightandmanychemicalsSensitivetowet5TypesofMycoticPathogenicfungalinfection致病性真 exogenousinfection,egdermatophytes皮肤癣菌,dimorphicOpportunisticfungalinfection条件致病性真 endogenousinfection，occuronlybecauseofcompromisingsituations Manyfungiproducepoisonoussubstancescalledmycotoxins.Mycotoxicosismayresultfromingestionofcontaminatedfoods.Aflatoxin黄曲霉毒素,Fusariumtoxin镰刀菌毒素local,seasonal,non-infectiousFungiandCancer真菌和肿瘤AflatoxinsproducedbyAspergillusflavusareconidiaandsporesstimulateandelicitstrongallergicreactions引起超敏反应rhinitis鼻炎,bronchialasthma支气管哮喘,alveolitis齿槽炎，TheusualrouteofinfectionformycosisisviainhalationofenterintotheMicrobiologicalSpecimens(hair,skin,nail-10%KOH-DirectIsolationandSerologicalNonspecificSpecific theskincleanandWashingaftertouchingotherpeopleoranimals.

a.Miconazole;b.DeepSkin,hair,andDonotelicitimmuneNoCosmeticLimitedtostratum层4PityriasisversicolorTineanigraBlackBlackpiedra头皮毛孢子菌Malasseziafurfur糠 Pityriasisversicolor花斑癣（汗斑RichinsebaceousglandsMediaissupplementedwithfattyExistinbuddingyeast,occasionallyRemovaloftheorganismSeleniumsulfideThiosulfateSalicylicacidInhibitionofergosterolby:CutaneousMycosesSkin,Hair,EvokecellularimmuneUnabletogrowat37℃orinthepresenceofHavedevelopedkeratinaseselastasesandotherIdentification:colonialappearance菌落外形andmicroscopicmorphologyaftergrowthfor2weeksat25onSDA)AsinglespeciescancausemorethanonetypeofAsingleinfectioncanbecausedbymorethanone

Accountfor80-90ofallClinicaltineapedis(Athlete’sFoottineacorporis

tineacruris

tineacapitis

Examinationof10%KOH-treatedskinscalesfromtheinfectedarea;CultureoftheorganismSkin–Hair-SubcutaneousBlackmolds:Fonsecaeapedrosoi,Cladosporiumcarrionii,Phialophora Fonsecaea Examinationof10%KOH-treatedskinscalesfromtheinfectedarea;CultureoftheorganismHeatOpportunisticSomecircumstancethatleadtoinfection(e.g.,HIV,cancer,diabetes ,advancedageand孢菌素病,penicillosis青霉病…***Anyfungusfoundinnaturemaygiverisetoopportunisticmycoses***Incidenceandcase-fatalityratiosofSelectedinvasivefungalinfectionsCandidaMostcommoninvasivefungalinfectioninpromisedpatientsCommensals:skin,oral,胃肠,andgenitalmucosal 黏膜SpeciesimplicatedinhumanmostC.C.C.C.krusei(fluconazoleC.C.lusitaniae(amphotericinB

CandidaSabouraud’sagarorordinarywithayeastodor

endogenousendogenousinfection,opportunisticMucousmembraneinfectionsCutaneousUrinarytractDisseminated(systemic,SystemicCusedbyindwellingcatheters留置导管，surgery,intravenousdrugabuseanywhere,especiallythekidney,skin,eye,heart,andmeninges.CandidemiaCandidasppbloodstreaminfection-hospital-acquired-highmortalityVaginal

Oralthrush

Diaper

Chronicmucocutaneous

Cell-mediatedimmuneresponsesCD4cells,

superficialinfectionsystemicinfection

hair,skin,nailsputum,blood,CSFexamineddirectlyunderthemicroscope–hair,skin,nail---mountedinKOHCu