大二下学习-微生物课件7.第7章

1Chapter7Coccus2Pyogeniccocci

Gram-positivecocci

Staphylococcusaureus 金黄色葡萄球菌

Streptococcuspyogenes 化脓性链球菌

Streptococcuspneumoniae肺炎链球菌

Gram-negativecocci

Neisseriameningitides 脑膜炎奈瑟菌

Neisseriagonorrhoeae 淋病奈瑟菌

3

Staphylococcus

StreptococcusE.enterococcusNeisseriaOutline4Staphylococcus51.Biologicalcharacteristics1.1Shapeandstructure1μmindiametersphericalGrape-likearrangementgram-positiveCapsule671.2Cultivation All-purposemedia Facultativeanaerobes T37℃,pH7.4 ColonyMediumsizeSmoothVariouspigmentΒ-hemolytic81.3BiochemicalreactionsCatalasetest:positiveMannitolfermentation:positive

Catalasetest

(-)(+)91.4AntigeniccompositionCarbohydrateantigens--Capsules:11type--Teichoicacid:AandBgroup--PeptidoglycanProteinantigen--SPA

10SPA(StaphylococcalProteinA)Characteristics:NonspecificbindtotheFcfragmentofIgGFunction:CoagglutinationtestVirulencefactor11Coagglutinationtest(协同凝集试验）

12131.5Classification1.5.1ClassificationI

Saureus

Sepidermidis

Ssaprophyticus14PropertiesS.aureusS.epidermidisS.saprophyticusPigmentGoldyellowWhiteCitrineα-hemolysin+－－Mannitolfermentation+－－SPA+－－Coagulase+－－Thermostablenuclease+－－PathogenicityPotentWeakWeak15PrimarycriterionsofpathogeniconesCoagulasetestHemolysisGoldyellowpigmentationThermostablenucleaseMannitolfermentation16Basedonthephages4groupsand23types1.5.2ClassificationII

GroupⅠ:Severesepticemia;TSST-1producedstrainsGroupⅡ:ExfoliativetoxinproducedstrainsGroupⅢ:Enterotoxinproducedstrains17ResistanceDryingHeatHighconcentrationofsalt(10-15%NaCl)SensitivityBasicdyes(e.g.,crystalviolet)Severalantibiotics(e.g.,penicillin,ycin)*MRSA(methicillin-resistantS.aureus)1.6Resistance181.7GenomiccharactersOveralllength2.81Mb,including2600ORF2pathogenicityislandMoreISandtransposonsMorerepetitivesequencecodingsuperantigen192.PathogenesisSurfacestructures--teichoicacid,peptidoglycan,SPA,capsuleEnzymes--coagulase,heat-stablenuclease,lipase,ectExotoxins--Hemolysin,Leukocidin,Enterotoxin,Exfoliativetoxin,TSST-12.1Virulencefactors202.1.2CoagulaseItiscriterionforidentificationofpathogenicityClassification--Freecoagulase游离凝固酶

--Boundcoagulase结合凝固酶

21CoagulaseCancausecoagulationofplasma,ThenAntiphagocytosisandthedamageofbactericidalsubstancesFormationoflimitedabscess222.1.2StaphylolysinTypes:

、、、CandamagecellmembraneofVariouscells

e.g,RBC,WBC,platelet,livercells,vascularsmoothmuscle,etc2.1.3Leukocidin

CandamagemembraneofWBC232.1.4Staphylococcalenterotoxin

Source:30~50%S.aureusTypes:A、B、C1-3、D、E、G、HHeatstable;ResistanttogutenzymesMechanism:ActonvomitingcenterSuperantigenDisease:foodpoisoning242.1.5ToxicShockSyndromeToxin1

(TSST-1)

Source:phagegroupⅠofS.aureusBiologicalactivity Fever,Shock,Rash Increasethesensitivitytoendotoxin SuperantigenDisease:TSS

252.1.6Exfoliativetoxin

Source

phagegroupⅡofS.aureusBiologicalactivity GM4receptor;proteaseactivity

DiseaseStaphylococcalscaldedskinsyndrome(SSSS)26Invasivedisease/pyogenicdisease--Localizedinfection,SystemicinfectionToxin-mediateddiseases--Foodpoisoning,TSS,SSSS,Staphylococcalenteritis2.2Disease27282.2.1Localizedinfectionskinandsubmucousinfection

hairfolliculitis毛囊炎;boil疖

;carbuncle痈

;impetigo脓疱病organinfection

pneumonia;meningitisendocarditis292.2.2SystemicinfectionSepticemiapyemia30Toxin:staphylococcalenterotoxinClinicalmanifestation:acuteviolentvomitingnofeverself-limited

2.2.3Foodpoisoning312.2.4TSS(ToxicShockSyndrome)Toxin:TSST-1Clinicalmanifestation:severehighfeverscarlatiniformrash(猩红热样皮疹）

hypotensioncardiacandrenalfailure322.2.5SSSS

StaphylococcalScaldedSkinSyndromeToxin:ExfoliativetoxinClinicalmanifestation:

neonatesandinfantsepidermalsplitting332.2.6StaphylococcalenteritisEssence:antibiotic-associateddiarrhea(dysbacteriosis)Clinicalmanifestation:feverabdominalcrampdiarrhea343.ImmunityNaturaldefenseWeak354.LaboratorydiagnosisDirectsmearandGramstainIsolationandidentification

Animaltest:forenterotoxinAntibioticsusceptibilitytest36375.ControlPreventionhygienequarantine，cleanlinessTreatmentantibioticsauto-vaccine3839CNS

(Coagulase-NegativeStaphylococci)Mostcommon:S.epidermidis,SsaprophyticusHospitalinfectionAntibiotic-resistance40Streptococcus41医学常见链球菌链球菌血清群溶血诊断要点引起常见疾病化脓性链球菌A群β溶血；杆菌肽敏感皮肤感染，咽炎，风湿热，肾炎无乳链球菌B群β溶血；杆菌肽不敏感

新生儿败血症和脑膜炎牛链球菌D群不溶血；不耐6.5%NaCl败血症，心内膜炎肺炎链球菌

—α溶血；胆盐敏感肺炎，脑膜炎，败血症草绿色链球菌—α或不溶血；胆盐不敏感龋齿，心内膜炎421.ClassificationI

-Basedonhemolyticactivity-hemolyticstreptococcus--pletehemolysis--Opportunisticpathogens(S.viridans)-hemolyticstreptococcus--Completehemolysis--Majorhumanpathogens-streptococcus--non-hemolytic--nopathogenicityI.Classification

432.ClassificationII

-Basedonantigenstructure

BasedonCantigen–-20group(90%pathogenicstrainisparttoAgroupBasedonMprotein–-Agroupisdividedinto100type44II.Streptococcuspyogenes

451.Biologicalcharacteristics1.1Shapeandstructure 1.0μmindiameterSpherical Inchains Gramstain:G+Capsule(hyaluronicacid)Pilus-like(LTA-Mprotein) 461.2CultivationBloodplateFacultativeanaerobeT370C,pH7.4Colonyproperties:SmallsizeSmoothΒ-hemolyticwithoutpigment471.3Biochemicalreactions

Catalasetest:NegativeSynanthrintest(菊糖发酵试验）:NegativeBilelysozymetest(胆汁溶菌实验）:Negative481.4AntigeniccompositionPantigenCantigenSurfaceantigenM,R,S,TMantigenCantigen491.5GenomiccharactersOveralllength1.85Mb,including1752ORFVirulencegeneoutnumber50502.PathogenesisSurfacestructures

--LTA,Fprotein,MproteinEnzymes

--Hyaluronidase,Streptokinase(SK),Streptodornase

(SD)Exotoxins--Streptolysin,Pyrogenicexotoxin(致热外毒素）2.1Virulencefactors51AdhesionAnti-phagocytosisCross-reactiveantigen

2.1.1LipoteichoicAcidandM-protein52FibronectinF-proteinepithelialcells2.2.2F-proteinAdhesion53

Hyaluronidase(Spreadingfactor)Strpetokinase(SK;Fibrinolysin)Streptodornase(SD;Deoxyribonuclease)2.2.3InvasiveEnzymes542.2.4StretolysinSLOaproteinthatsensitivetooxygencandestryerythrocytesandvariouscellsAnti-OhighersuggestrecentinfectionSLSaglycopeptidestabletooxygencandestryWBCandvariouscellscausehemolyticzoneonthebloodplate552.2.5PyrogenicexotoxinProducedbylysogenicgroupAstreptococciBiologicalactivity: --fever --Increasethesensitivitytoendotoxin --superantigenBeassociatedwithstreptococciTSSandscarletfever(猩红热）562.2DiseaseInvasivedisease/pyogenicdisease--Localizedinfection,TissueinfectionToxin-mediateddiseases--Scarletfever(猩红热）Hypersensitivedisease--Acuteglomerulonephritis,Rheumaticfever5758skinandsubcutaneousinfection --pyoderma脓皮病,erysipelas丹毒

cellulitis蜂窝织炎otherorgans--pharyngitis咽炎,puerperalfever产褥热Necrotizingfascitis(坏死性筋膜炎）2.2.1Pyogenicdisease592.2.2Toxin-mediateddiseasesScarletfever(猩红热）STSS（链球菌毒性休克综合征）

602.2.3HypersensitivediseaseRheumaticfever--Itisfoundmainlyin5~12olderchildren.--Itisfoundin3%angina--arthritis,carditis,endocarditis,etcAcuteglomerulonephritis.--Mostofchildrennephritisbelongtoit--Itisfoundinanginaandskininfection--Prognosisisgood613.ImmunityObtainlastingimmunityafterinfectionType-specificanti-toxinimmunity624.LaboratorydiagnosisDirectexaminationIsolateandCulturePYR(L-吡咯酮β萘胺）Tests

--Detectionofaminopeptidase(氨基肽酶）ASOtest--AideddiagnosisofRheumaticfever(风湿热）

orAcuteglomerulonephritis（急性肾小球肾炎）Anti-DNaseBtest63645.ControlPrevention

Treatprimaryinfection(e.g.,pharyngitis)intimeTreatment

antibiotics(penicillin,thefirstchoice)65IIIS.pneumoniae1.Generalproperties1.1Shape&structureG+lancet-shapedarrangedinpairThickcapsule661.2CultivationFacultativeanaerobeFastidious5~10%CO2Onbloodagar:α-hemolysis,autolysis

67Autolysis:autolyticenzymeSynanthrintest(菊糖发酵试验）:positiveBilesolubilitytest(胆汁溶菌实验）:positive

1.3Chemicalactivity681.4Antigenicstructures

capsularpolysaccharide--type-specific,84type--primaryvirulencefactor

692.PathogenesisVirulencefactor

Capsule LTA pneumolysin肺炎链球菌溶素

neuraminidase神经氨酸酶Disease transmission:respiratorytract disease:lobarpneumonia703.DiagnosisBilesolubilitytest胆汁溶菌试验Optochinsensitivitytest奥普托欣试验Capsularswelling荚膜肿胀试验

positivenegative714.ControlPrevention:polysaccharidevaccine(forchildrenandelderly)Treatment:penicillin，ycin72Neisseria73Neisseria

脑膜炎奈瑟菌（N.meningitidis）

淋病奈瑟菌（N.gonorrhoeae） 干燥奈瑟菌（N.sicca） 浅黄奈瑟菌（N.subflava） 金黄奈瑟菌（N.flavescens） 粘膜奈瑟菌（N.mucosa） 乳酰胺奈瑟菌（N.lactamica） 卡他奈瑟菌（N.catarrhalis）

741.GeneralpropertiesShape&structureG-kidney-shapedarrangedinpairslipooligosaccharide(LOS)脂寡糖capsulesandpili75UsingtheGramstaininpatientspecimens,theorganismsaremostoftenobservedinpolymorphonuclearleukocytes

762.CultivationChocolateagarplateObligateaerobes,5～10%CO2

T35-370CpH7.2~7.6Mcolony:dewdrip773.ChemicalactivityAutolysisOxidasepositiveCatalasepositive784.Resistant:

veryweakcool,heat,sunlight,drying,disinfectants79CapsuleLOSN.meningitidisVirulenceFactors:Similar,butdifferencesinutilizationHemolysinIgAproteasePILIOuterMembraneProteinsN.gonorrhoeaePILIOuterMembraneProteins

LOS

IgAproteaseCapsule2.Pathogenesis802.1N.Meningitidis-Pathogenesis2.1.1VirulencefactorsCapsulePiliIgAIproteaseLOS

812.1.2DiseaseSource:patientsandcarriersTransmission:respiratorytractDisease:epidemicmeningitis(流行性脑脊髓膜炎)nasopharynx→localinfection→bacteremia→meningitis822.2N.gonorrhoeae-pathogenesis

2.2.1VirulencefactorsPiliOutermembraneproteinLOS83

Porinproteins(Por,PI)preventphagolysosomefusionallowintracellularsurvivalOpacityproteins(Opa,PII)bindingoforganismstoepitheliumReduction-modifiableproteins(Rmp,PIII)protectionagainstbactericidalantibodiesOutermembraneprotein842.2.2DiseaseSource--patientsandcarriersTransmission--sexualcontactforadults --birthcanalfornewbornsDisease--gonorrhea--Gonococcalophthalmianeonatorum(newborns)853.LaboratorydiagnosisSmearandstainG-,diplococciinoroutofPMNsOxidasetest:positiveMaltosefermentation

N.meningitidis+;N.gonorrhoeae-ELISAPCR864.ControlN.Meningitidis–Prevention capsulepolysaccharideTreatment penicillin:thefirstofchoice

4.1N.Meningitidis–Control874.2N.gonorrhoeae-control

Prevention --Gonorrhea:

novaccine --Ophthalmianeonatorum:0.5％erythromycinointmentor1％AgNO3

Treatment

Antibiotics(penicillin,spectinomycin大观霉素)88ThedifferenceofNeisseriaePropertiesN.meningitidisN.gonorrhoeaeGramstainGram-negativeGram-negativeCapsuleYesYesPotalofentryRespiratorytractGenitaltractVirulencefactorsPiliCapsuleLOSIgA-proteasePiliOutermembraneproteinLOSIgA-proteaseDiseaseEpidemiccerebrospinalmeningitisGonorrhea(adults)Ophthalmianeonatorum(newborns)PreventionPolysaccharidevaccineerythromycinointmentorAgNO3forophthalmiaNovaccineforgonorrhea89Briefsummary

葡萄球菌的生物学特性及致病性；致病性葡萄球菌鉴别要点；链球菌的溶血现象；A群链球菌的生物学特性及致病性；链球菌溶血素和临床的关系；肺炎链球菌、脑膜炎球菌及淋球菌的典型生物学特性、主要致病物质及所致疾病90Questions1.试比较葡萄球菌与链球菌在生物学性状上的主要区别2.致病性葡萄球菌具有哪些特性？3.简述葡萄球菌与链球菌的致病物质及所致疾病4.简述血浆凝固酶在葡萄球菌感染中的作用5.举例说明侵袭性酶在链球菌感染中的意义6.简述奈瑟菌属细菌的生物学特性及致病性91化脓性球菌pyogeniccoccus金黄色葡萄球菌S.aureus