【教学】第章 呼吸道传播的病原微生物其他细菌

1、Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin

2、Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University白喉棒状杆菌（鼻咽腔）飞沫、污染物品鼻 咽喉气管局部细菌和毒素的作用灰白色假膜粘膜水肿及假膜脱落，引起呼吸道阻塞，甚至窒息死亡。外毒素入血毒血症心肌肝肾上腺外周神经内脏出血心肌炎软腭麻痹 声嘶 肾上腺功能障碍2-7天潜伏期Department of Microbiology, Harbin Medical UniversityDepartment o

3、f Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical Univ

4、ersityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University百日咳鲍特菌革兰染色百日咳鲍特菌革兰染色 Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartme

5、nt of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University分类军团菌属军团菌属(Legionella) 属于军团菌科属于军团菌科（Legionellaceae）常见的与人类疾病有关的军团菌：常见的与人类疾病有关的军团菌：嗜肺军团菌（嗜肺军团菌（Legionella pneumophila）米克戴德军团菌（米克戴德军团菌（L. micdadei）长滩军团菌

6、（长滩军团菌（L. longbeachae）杜莫夫军团菌（杜莫夫军团菌（L. dumoffii）波兹曼军团菌（波兹曼军团菌（L. bozemanii） Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment o

7、f Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical Univ

8、ersityDepartment of Microbiology, Harbin Medical University微生物学检验微生物学检验Department of Microbiology, Harbin Medical University 标本标本（痰、支气管分泌物、血液、）（痰、支气管分泌物、血液、） 涂片染色镜检涂片染色镜检 （Giemsa染色染色） 分离培养分离培养（BEYE琼脂）琼脂）鉴定试验鉴定试验结果报告结果报告形态染色形态染色菌落特征菌落特征氧化酶、触酶氧化酶、触酶荧光抗体染色等荧光抗体染色等Department of Microbiology, Harbin Medi

9、cal UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University军军 团团 菌菌 感感 染染 诊诊 断断 试试 验验 Department of Microbiology, Harbin Medical University适 应 症：军团菌病、肺炎支原体肺炎、肺炎衣原体肺炎、沙眼衣原体结膜炎、厌氧菌所致口腔感染、空

10、肠弯曲菌肠炎、百日咳等。Department of Microbiology, Harbin Medical University嗜血杆菌属嗜血杆菌属是一类革兰阴性短小杆菌、是一类革兰阴性短小杆菌、常呈多形态性、无鞭毛、无芽胞，可形成常呈多形态性、无鞭毛、无芽胞，可形成荚膜，营养要求高，需要特殊物质才能生荚膜，营养要求高，需要特殊物质才能生长的一类细菌。长的一类细菌。Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University 几种主要嗜血杆菌

11、常栖部位及所致疾病几种主要嗜血杆菌常栖部位及所致疾病Department of Microbiology, Harbin Medical University（H.influenzae）为例）为例1.形态与染色形态与染色 Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Ha

12、rbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDNA探针杂交探针杂交（快速检测）（快速检测）血液血液脑脊液脑脊液脓汁脓汁痰痰 分离培养分离培养(巧克力琼脂巧克力琼脂) 涂片、镜检涂片、镜检荚膜肿胀试验（初步报告）荚膜肿胀试验（初步报告）标记抗体检测抗原标记抗体检测抗原涂片、荚膜肿胀

13、试验（初步报告）涂片、荚膜肿胀试验（初步报告）菌落形态、卫星现象、血清学现象菌落形态、卫星现象、血清学现象报告结果报告结果 嗜血杆菌的检验程序嗜血杆菌的检验程序增菌培养增菌培养35 5-10%CO2X、V因子需求试验因子需求试验吲哚、尿素酶、鸟氨酸脱吲哚、尿素酶、鸟氨酸脱羧酶（生物分型）羧酶（生物分型）Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University菌落特征：巧克力琼脂培养基小、无色透明菌落菌落特征：巧克力琼脂培养基小、无色透明菌落

14、 流感嗜血杆菌巧克力琼脂养基菌落流感嗜血杆菌巧克力琼脂养基菌落 Department of Microbiology, Harbin Medical University卫星现象(satellite phenomenon) Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University注：D为不同结果嗜血杆菌属中种的特征嗜血杆菌属中种的特征Department of Microbiology, Harbin Medical UniversityD

15、epartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University肺肺 炎炎 衣衣 原原 体体（只有一个血清型：只有一个血清型：TWARTWAR株株）（一）生物学特性：（一）生物学特性： 1、原体平均直径，梨形，有周浆间隙，、原体平均直径，梨形，有周浆间隙，原体无质粒原体无质粒DNA； 2、与其他衣原体同源性小于、与其他衣原体同源性小于10%，但，但不同来源的不同来源的TWAR同源性高（大于同源性高（大于94%）；）； 3、只有一个血清型；、只有一个血清型； 4、用、用HEp-2和和HL细胞系易分离和传代，细胞系易分离和传代，但在第一代细胞内很少形成包涵体。但在第一代细胞内很少形成包涵体。Department of Microbiology, Harbin Medical University 传播途径传播途径：经飞沫或呼吸道分泌物传播，扩