Pathogenic cocci病原性球菌課件

1.Pathogeniccocci2.Otherbacteria1.PathogeniccocciConceptofpathogenicbacteria13minStaphylococcus(Esp.,S.aureus)

56minStreptococcus(Esp.,S.pyogenes)38minEnterococcusspeciesandVRE5minNeisseriameningitidesNeisseriagonorrhoeae13min2.OtherbacteriaPseudomonasaeruginosa10min

HighlightsofcontentUptoeverypathogen,thefollowingwillbetalked:Biologicalproperties

PathogenicityImmunityMicrobiologicaldetectionsPreventionandtreatmentPustule(膿皰)

byS.aureusParonychia(甲溝炎)

byS.aureusSorethroat(咽喉炎)

byS.pyogenesUntreatederysipelas(丹毒)byS.pyogenes

withskinsloughingandnecrosis

NecrotizingFasciitis(壞死性筋膜炎)byflesh-eatingbacteria(S.pyogenes,anaerobicbacteria,etc.),andinsects(bee,etc.)stingingMeningococcalsepticemia(腦膜炎球菌性敗血癥)byN.meningitidis,widespreadecchymoses

Causativeagentsofaboveclinicaldiseases?Pathogeniccocci

Importantcocci

Gramstain

Bacterialgenera

G+

Genusstaphylococcus

Genus

streptococcus

G-

GenusNeisseria

(N.meningitides

N.gonorrhoeae)StaphylococcusaureusImportantpyogeniccoccusLeadingpathogenofwoundinfections

(includingotherstaphylococci)

Shape,Stain&Culture

spherical,elliptical,irregular

grape-likeclusterGram+

(G+)GrowwellonbasicmediumBiologicalpropertiesCoagglutinationtestwithinertparticles(e.g.,heat-killedS.aureusor

latexbeads)SPAmayresistphagocytosisbycompetivelybindingwithFcreceptorsofphagocytesImportant

Propertiesof3Main

SpeciesofStaphylococciPathogenicity&immunityCoagulaseFreeCoagulaseFreeCoagulase

staphylothrombin(游離凝固酶)

(葡萄球菌凝血酶)FibrinogenFibrinPlasmatobecloted

Tubecoagulasetest

activatedconvert

VirulenceProtectionactionsInfectionlocalized

Boundcoagulase(結(jié)合凝固酶)or

clumpingfactor(凝聚因子)

plasmatobecloted

or

bacteriatocoagulate

Slidecoagulasetest

classifiedinto-,-,-,&-toxin

-toxin—makesporesincellmembranesStaphylolysin(葡萄球菌溶素)

includingtypeA&typeBcausesstaphylococcalscaldedskinsyndrome

(SSSS)Exfoliatin(表皮剝奪毒素)includingserotypeA,B,C1-3,D,E,G,&Hresponsibleforfoodpoisoning(食物中毒)

mainlycausevomiting

alsoactsassuperantigen(超抗原)Enterotoxin(腸毒素)causestoxicshocksyndrome

(TSS)

onekindofsuperantigensToxicshocksyndrometoxin1(TSST-1)

(毒性休克綜合征毒素-1)Othersheat-stablenuclease(耐熱核酸酶)ClinicaldiseasesInvasivediseasesToxin-mediateddiseasesPyogenicinfections

-localinfections-systemicinfections-foodpoisoning-staphylococcalscaldedskinsyndrome(SSSS)-toxicshocksyndrome

(TSS)Folliculitis(毛囊炎)byS.aureusBullousImpetigobyS.aureusAS.aureusinfectionona12-year-oldchild'scheekPathogenesisofstaphylococcalinfectionsMicrobiologicaldiagnosisAnimaltestSamplesPus,blood,food,orvomitusIsolationCoagulasetestMannitefermentationHeat-stablenucleaseSmearµscopyG+staphylococciColonypigments&hemolysisBiochemicalreactionsEnterotoxinsdetectionIdentificationofpathogenicstaphylococci

Coagulase

(+)

Heat-stablenuclease(+)

Goldenpigment(+)

Hemolyzation

(+)

Mannitefermentation(+)Prevention&treatmentPreventionpreventingnosocomialinfectionTreatmentantibioticssensitivitytestpersonalhygienesterilisation&detentionself-bacterialvaccinetherapypreventingdrugresistanceMethicillin-resistantS.aureus,MRSA

(耐甲氧西林金黃色葡萄球菌)Coagulase-negativestaphylococci(CNS)

(凝固酶陰性葡萄球菌)Comparethefeaturesofcommonpyogenicbacteria.DiscussthepathogenicfeaturesandidentificationpointsofStaphylococcusaureus.Questions:Streptococci

G+,

spherical,elliptical,arrangedinchain

Growwellonnutrientmediumw/bloodBiologicalpropertiesShape,Stain&CultureAntigenicstructureProteinantigen

—surfaceAg,outsideCantigen—type-specific—includingM,T,R,SinGroupA

Polysaccharidantigen

—C

Ag—group-specific

Nucleoprotein

—P

Ag—non-specific

CellcytoplasmCellmembranePeptidoglycanCapsuleCellwallClassificationAccordingto

-hemolytic

Streptococcus

-hemolytic

Streptococcus

-StreptococcusHemolysis

groupA-V,total20groupsamongpathogenicstreptococci

90%isgroupA

over100typesaccordingtoM

Ag

groupB,C,D,&GoccasionallyAntigenicstructurePathogenicityGroupAStreptococci

(S.pyogenes)Pathogenicsubstances

ProteinG:

similartoProteinA

adhesins

-lipoteichoicacid(LTA)

-fibronectinbindingprotein(FBP,proteinF)

(纖絲蛋白結(jié)合蛋白,F蛋白)

-proteinMBacterialstructure

Streptolysin

(SL,鏈球菌溶素)

Streptococcalpyrogenic

exotoxin

(SPE,鏈球菌致熱外毒素)

Hyaluronidase

(透明質(zhì)酸酶)

Streptokinase

(SK,鏈激酶)

Streptodornase

(SD,鏈道酶)Toxins&enzymesStreptolysinS(SLS,鏈球菌溶素S)

-lowMWglycopeptide

-oxygen-stable

-causes-hemolysisonBloodAgarplate

-non-antigenicStreptolysinO(SLO,鏈球菌溶素O)

-proteinw/SHgroup

-oxygen-labile

-destroysmanykinds

ofcells

-anti-SLOtest(ASOtest)helpfulfordiagnosisStreptolysin-codedbylysogenicbacteriophage-proteinsincludingserotypeA,B,C-causesscarletfever

(猩紅熱)-onekindofsuperantigens-also

causesTSSStreptococcalpyrogenicexotoxin(SPE)

(鏈球菌致熱外毒素)Streptokinase

(SK,鏈激酶)-alsocalledasstreptococcalfibrinolysin

(鏈球菌溶纖維蛋白酶)Streptodornase(SD,鏈道酶)-hydrolyzesDNAHyaluronidase(透明質(zhì)酸酶)-alsocalledas

spreadingfactor(擴(kuò)散因子)-hydrolyzeshyaluronicacidinconnectivetissue-helpfulforspreadingofbacteriaClinicaldiseasesPyogenicinfectionsToxin-mediateddiseasesAllergicdiseases(latecomplications)-scarletfever

(猩紅熱)-Streptococcaltoxin-mediatedTSS-rheumaticfever

(風(fēng)濕熱)-acuteglomeruloniphritis

(急性腎小球腎炎)Erysipelas(丹毒)byS.pyogenesCellulitis(蜂窩組織炎)

byS.pyogenes"Honey-crust"lesiontypicalofS.pyogenesimpetigoPathogenesisofS.pyogenesinfectionsSamplesPus,Blood,NasopharynxswabIsolationw/bloodagarplatedistinguishingfromS.pneumoniaeSmearµscopyG+streptococcidistinguishingfromstaphylococciOtherstreptococci-hemolysisAssist-diagnosisforrheumaticfever-hemolysisASOtestMicrobiologicaldiagnosis

S.pneumoniae

GroupBstreptococci

GroupDstreptococci

Viridans(-hemolytic)streptococciStreptococcussuis

(豬鏈球菌)

Enterococcus

species(腸球菌)&

VREOtherstreptococciEnterococcusspeciesandVREEnterococcusspp.(腸球菌)Previouslyclassifiedas

GroupDstreptococciIn1984,namedasgenusEnterococcusGram+

cocciinpairsorshortchainsMostarefacultativeanaerobesComplexnutritionalrequirementsGroupDspecificteichoicacidantigenEnterococcusspp.viewedbydirectfluorescentantibody(FA)reactionEnterococcusspp.Commonlyfoundintheintestinesofnormalhealthyindividuals(humansandanimals).

2importanthumandiseases-relatedspp.

E.faecalis

(糞腸球菌)

andE.faecium

(屎腸球菌)

CauseUrinarytractinfections

Bacteremia&septicaemia

Subacute

endocarditisWoundinfections

FoodbornediseasesMeningitis

NosocomialinfectionsOneofimportantlife-threatening

nosocomial

pathogens

VancomycinResistantEnterococci

(VRE,耐萬(wàn)古霉素腸球菌)Since1986,VREinfectionshasbecomeagrowingproblem1.DiscussthepathogenicfeaturesofStreptococcuspyogenes.2.Discussidentificationpointsbetweenhemolyticstreptococciandotherpyogenicbacteria.Questions:Neisseriagonorrhoeae

(淋病奈瑟菌)BiologicalpropertiesShapeandstain

-G-diplococciinoronPMNsonpussmear

-Noendospore&flagellum,&w/capsule&

piliCulture

-Obligateaerobes,need5%CO2whileprimaryisolation

-Highnutritionalrequirement

“ChocolateBloodAgarPlate”

Antigenicstructureandclassification

-Pilusproteinantigens

-Outermembraneproteinantigens：PI,PII,&PIII

-LOS(lipooligosaccharide,脂寡糖),

LPS-likeN.gonorrhoeaecoloniesonChocolateBloodAgarPlatePathogenesisVirulentfactors-Pili-Outermembraneproteins-LOS-IgA1protease-OthersClinicalfindings-Gonorrhea-GonococcalconjunctivitisGonorrheasymptoms-Urethritis-Vaginitis-Cervicitis-Salpingitis-Pelvicinflammation-AnorectalGonorrhea-GonococcalPharyngitis-GonococcalConjunctivitis-GonococcalArthritisinWomen-Urethritis-Epididymitis-Prostatitis-AnorectalGonorrhea-GonococcalPharyngitis-GonococcalConjunctivitis-GonococcalArthritisinMenClinicalmanifestationsofN.

gonorrhoeaeinfection

Immunity

Humoralimmunitymoreeffective

Nopersistentimmuneresponses

Infectiontrendto

-chronic&repeatedoccurrenceMicrobiologicaldetectionsNucleicacidsdetection,&soonSamplesPussecretafromgenito-urinarytracts,eyes,&othersIsolationOxidasetestSugarfermentationtestImmunofluorescenceassaySmearµscopyG-diplococciinoronPMNs

ColoniesµscopicfindingsBiochemicalreactions&serologictestsOthertestsPrevention&treatment

Takepreventionsasmainmeasure

Choose

penicillin

asNo.1drug，takecareofproblemsofdrugs-resistantbacterialstains1.WhatarethemaindifferencesbetweenNeisseriameningitidesandNeisseria