中南大學七年制球菌

1、中南大學基礎醫(yī)學院中南大學基礎醫(yī)學院微生物學系微生物學系coccus (球菌)pathogenic coccus (病原性球菌病原性球菌)staphylococcus (葡萄球菌屬葡萄球菌屬) s.aureus (金黃色葡萄球菌金黃色葡萄球菌) coagulase-negative staphylococcus (凝固酶陰性葡萄球菌凝固酶陰性葡萄球菌)streptococcus (鏈球菌屬鏈球菌屬) streptococcus pyogenes (化膿性鏈球菌化膿性鏈球菌) s.pneumoniae (肺炎鏈球菌肺炎鏈球菌)neisseria (奈瑟菌屬奈瑟菌屬) neisseria meni

2、ngitis (腦膜炎奈瑟菌腦膜炎奈瑟菌) neisseria gonorrhea (淋病奈瑟菌淋病奈瑟菌)classification staphylococcus (葡萄球菌葡萄球菌) g+ streptococcus (鏈球菌鏈球菌) meningococcus (腦膜炎球菌腦膜炎球菌)g- gonococcus (淋球菌淋球菌) pyogenic coccus(化膿性球菌化膿性球菌)staphylococcus and streptococcus(葡萄球菌屬與鏈球菌葡萄球菌屬與鏈球菌)biological characters(生物學特性生物學特性)1. morphologystaph

3、ylococcusstreptococcuscoccus，g+ grape-like clusterscoccus，g+，pairs or chains 2. culturestaphylococcusstreptococcus 均為兼性厭氧菌，營養(yǎng)要求均為兼性厭氧菌，營養(yǎng)要求不高。不高。 individual colony is circular, 23 mm in diameter with a smooth, shiny surface; appear opaque and are often pigmented 多數(shù)菌株為兼性厭氧菌，營多數(shù)菌株為兼性厭氧菌，營養(yǎng)要求較高。養(yǎng)要求較高。

4、after 24 hours of incubation on blood agar, 0.50.75 mm white colonies with or without zones of hemolysis are observed s.aureuss.epidermidiss.saprophyticus-hemolytic streptococcus-hemolytic streptococcus-streptococcus incomplete hemolysis, green zone around coloniescomplete hemolysis, clear zone arou

5、nd coloniesstaphylococcusstreptococcus 葡萄球菌抗原結構復葡萄球菌抗原結構復雜，有莢膜抗原、磷壁酸雜，有莢膜抗原、磷壁酸抗原、肽聚糖抗原及蛋白抗原、肽聚糖抗原及蛋白質抗原等，其中以葡萄球質抗原等，其中以葡萄球菌菌a a蛋白蛋白(staphylococcus (staphylococcus a proteina protein，spa )spa )最為重最為重要。要。 鏈球菌抗原結構亦較鏈球菌抗原結構亦較復雜，有復雜，有c c多糖抗原、多糖抗原、m m蛋蛋白抗原及核蛋白抗原。白抗原及核蛋白抗原。3antigenic structurespaspa的生物學作用

6、的生物學作用1 1抗吞噬作用抗吞噬作用, ,在吞噬反應中抑制在吞噬反應中抑制iggigg調理調理 素促吞噬和殺菌作用。素促吞噬和殺菌作用。2 2對人類對人類b b細胞具有促有絲分裂因子的作細胞具有促有絲分裂因子的作 用等。用等。 3. 3. 損傷血小板及引起超敏反應。損傷血小板及引起超敏反應。4 4a a蛋白還有激活補體替代途等活性。蛋白還有激活補體替代途等活性。 它與人及多種哺乳動物血清中的它與人及多種哺乳動物血清中的lgg1、lgg2、lgg4的的 fc 段非特異結合，因而可用含段非特異結合，因而可用含spa的葡萄球菌作為載體，結合特異性抗體，的葡萄球菌作為載體，結合特異性抗體，進行協(xié)同凝

7、集試驗進行協(xié)同凝集試驗(coagglutination) ，用于多，用于多種抗原的檢測。種抗原的檢測。醫(yī)學意義：醫(yī)學意義：staphylococcusstreptococcus 葡萄球菌抗原結構復葡萄球菌抗原結構復雜，有莢膜抗原、磷壁酸雜，有莢膜抗原、磷壁酸抗原、肽聚糖抗原及蛋白抗原、肽聚糖抗原及蛋白質抗原等，其中以葡萄球質抗原等，其中以葡萄球菌菌a a蛋白蛋白(staphylococcus (staphylococcus a proteina protein，spa )spa )最為重最為重要。要。 鏈球菌抗原結構亦較鏈球菌抗原結構亦較復雜，有復雜，有c c多糖抗原、多糖抗原、m m蛋蛋白抗

8、原及核蛋白抗原。白抗原及核蛋白抗原。3antigenic structurestaphylococcusstreptococcuspigment:s.aureuss.epidermidiss.saprophyticushemolytic activity(溶血性溶血性): -hemolytic streptococcus -hemolytic/pyogenic streptococcus -streptococcus 4.classification accroding to the pigment or hemolytic activity on blood agarantigenicity

9、:polysaccharide antigen (多糖抗多糖抗原原): 20 groups(av) group a streptococci are main human pathogensprotein antigen (蛋白抗原蛋白抗原): a群群100多型多型 m protein b群群4 型型 c群群13型型bacteriophage typing: there are 4 groups 23 phagetypes of s. aureusstreptococcusstaphylococcusstaphylococcusstreptococcus 為無芽胞菌中抵抗力最強者為無芽胞菌中抵

10、抗力最強者耐熱耐熱: 60 1h或或80 30min耐鹽：耐鹽：能在能在10%15%nacl中中 生長。生長。 對常用消毒劑較耐受對常用消毒劑較耐受耐藥：耐藥：多重耐藥多重耐藥 耐甲氧西林耐甲氧西林(methicillin-resistant s.aureus，mrsa) 鏈球菌抵抗力弱，不耐熱，鏈球菌抵抗力弱，不耐熱，對常用消毒劑及抗菌藥物敏感，對常用消毒劑及抗菌藥物敏感，較少發(fā)現(xiàn)耐藥菌株，但對干燥較少發(fā)現(xiàn)耐藥菌株，但對干燥耐受能力較強。耐受能力較強。 5resistancepathogenicity(致病性致病性)1.virulence factorsstaphylococcusstrep

11、tococcussurface structure: spainvasive enzyme : toxin: staphylolysin() leucocidin(殺白細胞素殺白細胞素) enterotoxin(腸毒素腸毒素) exfoliatin(剝脫毒素剝脫毒素) tsst-1(毒性休克綜合征毒素毒性休克綜合征毒素-1)adhesion(粘附素粘附素) lta（脂磷壁酸）（脂磷壁酸） m protein invasive enzyme: hyaluronidase(透明質酸酶透明質酸酶) streptokinase(鏈激酶鏈激酶) dnaase(dna酶酶)toxin streptolys

12、in (鏈球菌溶血素鏈球菌溶血素) pyrogenic exotoxin(致熱外毒素致熱外毒素) (scarlet fever toxin)coagulasecoagulase(血漿凝固酶血漿凝固酶)free coagulase(游離凝固酶游離凝固酶) converts fibrinogen in citrated plasma into fibrin 纖維蛋白原纖維蛋白原 纖維蛋白纖維蛋白 血漿凝固血漿凝固bound coagulase(結合凝固酶結合凝固酶) 與纖維蛋白原結合與纖維蛋白原結合 細菌凝聚細菌凝聚virulence factors of staphylococcus生物學作用：

13、生物學作用：1 1抗吞噬抗吞噬2 2保護細胞免受環(huán)境中有害物質的損傷保護細胞免受環(huán)境中有害物質的損傷3 3使感染局限化及形成血栓使感染局限化及形成血栓1.virulence factorsstaphylococcusstreptococcussurface structure: spainvasive enzyme : coagulasetoxin: staphylolysin() leucocidin(殺白細胞素殺白細胞素) enterotoxin(腸毒素腸毒素) exfoliatin(剝脫毒素剝脫毒素) tsst-1(毒性休克綜合征毒素毒性休克綜合征毒素-1)invasive enzyme

14、: hyaluronidase(透明質酸酶透明質酸酶) streptokinase(鏈激酶鏈激酶) dnaase(dna酶酶)adhesion(粘附素粘附素) lta（脂磷壁酸）（脂磷壁酸） m protein toxin streptolysin (鏈球菌溶血素鏈球菌溶血素) pyrogenic exotoxin(致熱外毒素致熱外毒素) (scarlet fever toxin)(2) pyrogenic exotoxin (scarlet fever toxin) produced by most strains of group a streptococci cause scarlet

15、fever（致熱）（致熱） heat stable protien（耐熱）（耐熱） possess antigenicity, antitoxin specifically neutralize the toxindiseases caused by staphylococci and streptococcus1. purulent infection(infectious diseases)2. toxin-mediated diseases 3. poststerptococcal diseases (hypersensitive disease): only caused by str

16、eptococcus.(1) acute glomerulonephritis ( group a)(2) rheumatic fever 葡萄球菌葡萄球菌鏈球菌鏈球菌1 1合理使用抗生素合理使用抗生素1 1首選青毒素首選青毒素g g2 2注意衛(wèi)生，防止醫(yī)源性感染注意衛(wèi)生，防止醫(yī)源性感染2 2徹底治療原發(fā)感染徹底治療原發(fā)感染3 3自身菌苗的應用自身菌苗的應用3 3空氣消毒空氣消毒防治原則防治原則neisseria(奈瑟菌屬奈瑟菌屬) gram negative cocci, usually arranged in pairs. most of them are normal inhabitan

17、ts in respiratory tract. others are human pathogens (eg: gonococcus, meningococcus )common biological characteristics1. gram negative cocci, kidney-shaped, arranged in pairs, with capsules and pili.2. culture: need enriched medium (chocolate blood agar ), 510%co2 .3. resistance: very weak ，“fragile”

18、, extremely sensitive to drying, heat and cold.neisseria gonorrhoeae(淋病奈瑟菌淋病奈瑟菌) pili(菌毛菌毛): attach to epithelial cells (urinary-gentital, rbc) iga1-protease(蛋白酶蛋白酶): break down surface iga antibodies. outer membrane protein (omp,外膜蛋白外膜蛋白) 脂寡糖：由脂質脂寡糖：由脂質a和核心多糖組成，具內和核心多糖組成，具內 毒素活性。毒素活性。pathogenic fac

19、torsdiseases gonorrhea (淋病淋病) (std: sexually transmitted disease) acute urethritis(尿道炎尿道炎)(male); pelvic inflammatory(盆腔炎盆腔炎)(female) ophthalmia(結膜炎結膜炎) neonatorumblindness(失明失明) 新生兒眼結膜炎新生兒眼結膜炎penicillin(青霉素青霉素) gonorrheasilver nitrate(硝酸銀硝酸銀) ophthalmia (neonatorum)prevention and treatmentneisseria

20、 meningitidis(腦膜炎奈氏菌腦膜炎奈氏菌)1. pathogenicity: (1) human is the only natural host for pathogenic meningococci. child: susceptible (2) virulence factor: *pili attach to nasopharyngeal mucosa *capsule antiphagocytosis *endotoxin main pathogenic substance capillary tube, small blood vesselpathogenicity a

21、nd immunity2.pathogenesis: epidemic cerebrospinal meningitis 流行性腦脊髓膜炎流行性腦脊髓膜炎 clinical typing: common, outbreak, septicemic type 3. immunity: group-specific antibody, cross-immunity between groups. prevention and treatment1. isolate and cure patients2. antibiotics: such as penicillin; cefotaxime, sulfanilamide3. polysaccharide vaccine (group a, c)病原性球菌的共同點：病原性球菌的共同點：