雙語細(xì)菌的感染與免疫演示文稿

雙語細(xì)菌的感染與免疫演示文稿現(xiàn)在是1頁\一共有67頁\編輯于星期三雙語細(xì)菌的感染與免疫現(xiàn)在是2頁\一共有67頁\編輯于星期三BacterialInfection細(xì)菌的感染Theprocessofbacteriainvadinginthebody,growinginthetissues,producingtoxinsandcausingdiseasesiscalledbacterialinfection.現(xiàn)在是3頁\一共有67頁\編輯于星期三Pathogen（病原菌）Pathogenicbacterium（致病菌）Abacteriumwhichcancauseadiseaseiscalledpathogen.

Nonpathogen（非病原菌）Nonpathogenicbacterium（非致病菌）Abacteriumthatdoesnotcausediseaseiscallednonpathogen.現(xiàn)在是4頁\一共有67頁\編輯于星期三Opportunisticpathogen（機(jī)會致病菌）Conditionedpathogen（條件致病菌）Somebacteriaarecapableofcausingdiseasesonlyundercertainconditions.Theseorganismscancausediseaseonlyifoneormoreoftheusualdefencemechanismshumanshaveevolvedtorestrictmicroorganismsfromtheirusuallysterileinternalorgansandtissuearebreachedbyaccident,byintent(e.g.surgery),orbyanunderlyingmetabolicoraninfectiousdisorder(e.g.AIDS).現(xiàn)在是5頁\一共有67頁\編輯于星期三OutlineNormalfloraandopportunisticpathogenBacterialpathogenesisThehostimmunedefencesystemTheinitiationandcourseofinfectionHospitalinfection現(xiàn)在是6頁\一共有67頁\編輯于星期三Section1

Normalfloraandopportunisticpathogen

正常菌群與機(jī)會致病菌現(xiàn)在是7頁\一共有67頁\編輯于星期三★Normalflora（正常菌群）Normalmicrobialflora（正常微生物群）Thepopulationofmicroorganismsthatinhabittheskinandmucousmembranesofhealthypersons.Theyareusuallyharmless,someevenbeneficial,tohuman’shealth.現(xiàn)在是8頁\一共有67頁\編輯于星期三LocationsSurfacetissuesofskinOralcavityRespiratorytractGastrointestinaltractGenitourinarytract現(xiàn)在是9頁\一共有67頁\編輯于星期三Normalfloraonintestinalmucosa現(xiàn)在是10頁\一共有67頁\編輯于星期三腸道的正常菌群現(xiàn)在是11頁\一共有67頁\編輯于星期三現(xiàn)在是12頁\一共有67頁\編輯于星期三★BeneficialeffectsofthenormalfloraBiologicalantagonism（生物拮抗）Productionofessentialnutrients（營養(yǎng)作用）Primingofimmunesystem（免疫作用）Anti-aging（抗衰老作用）現(xiàn)在是13頁\一共有67頁\編輯于星期三Biologicalantagonism(生物拮抗)Biologicalbarriers（生物屏障）orReceptorcompetition（受體競爭)Harmfulmetabolites（有害代謝產(chǎn)物）Nutrientcompetition（營養(yǎng)競爭）現(xiàn)在是14頁\一共有67頁\編輯于星期三Conditionedpathogen（條件致病菌）Somebacteriaarecapableofcausingdiseasesonlyundercertainconditions.Thesebacteriaarecalledopportunistic(conditioned)pathogensandthiskindofinfectioniscalledopportunisticinfection（機(jī)會性感染）.★

Opportunisticpathogen（機(jī)會致病菌）現(xiàn)在是15頁\一共有67頁\編輯于星期三★

ConditionsofopportunisticinfectionChangeofinhabitingplaces（寄居部位改變）Immunesystemcompromise（宿主免疫功能低下）Dysbacteriosis（菌群失調(diào)）現(xiàn)在是16頁\一共有67頁\編輯于星期三Dysbacteriosis（菌群失調(diào)）Iffloradisequilibriumoccurs,forexample,whentheresidentfloraisdisturbed,somelittlesignificantmicroorganismsmaycolonize,proliferate,andproducedisease,whichiscalleddysbacteriosis.Dysbacteriosismainlyresultedfromlongtermandlargedosesantibioticstaken.現(xiàn)在是17頁\一共有67頁\編輯于星期三Superinfection（重疊感染）Afrequentcomplicationofdrugtherapyformicrobialinfection.Itmayresultfromopportunisticcolonizationfollowingimmunosuppressionbytheprimarypathogenandcanbeinfluencedbythetimeintervalbetweeninfections,microbialphysiology,orhostresistance.現(xiàn)在是18頁\一共有67頁\編輯于星期三Dysbacteriosisandsuperinfection現(xiàn)在是19頁\一共有67頁\編輯于星期三腸道的正常菌群健康青壯年糞便涂片健康老年糞便涂片（雙歧桿菌）現(xiàn)在是20頁\一共有67頁\編輯于星期三Probiotics（益生菌）現(xiàn)在是21頁\一共有67頁\編輯于星期三Probiotics（益生菌）&Prebiotics（益生元）現(xiàn)在是22頁\一共有67頁\編輯于星期三Section2

BacterialPathogenesis

細(xì)菌的致病作用BasictermsBacterialPathogenicity

BacterialvirulenceNumberofinvadingorganismsPortalofentry現(xiàn)在是23頁\一共有67頁\編輯于星期三Pathogenicity（致病性）

isusedtodescribethecapacityofbacteriatoinitiatediseases.Thetermofvirulence（毒力）

isusedasacomparisonofpathogenicityinthequantitativesense.ID50（medianinfectiousdose,半數(shù)感染量）:Infectiousdoseofbacteriafor50%ofthetestpopulation.LD50

（medianlethaldose,半數(shù)致死量）

:Lethaldoseofbacteriafor50%ofthetestpopulation.BasicTerms現(xiàn)在是24頁\一共有67頁\編輯于星期三ExotoxinPili(Fimbrial)CapsuleVirulentEnzymeAdhesinsFlagellaIronbindingproteinVirulencesurfaceproteinBacterialvirulencefactors（細(xì)菌毒力因子）現(xiàn)在是25頁\一共有67頁\編輯于星期三Bacterialvirulence（細(xì)菌的毒力）Virulence（毒力）Invasiveness（侵襲力）Toxin（毒素）Adherence&permanentplanting（黏附與定植）Multiplication&diffusion（增殖與擴(kuò)散）Anti-defensefunctionofhost（免疫逃逸）Endotoxin（內(nèi)毒素）Exotoxin（外毒素）現(xiàn)在是26頁\一共有67頁\編輯于星期三Adhesionandfieldplanting（黏附與定植）Invasion（侵入）Multiplicationanddiffusion（繁殖與擴(kuò)散）Localdiffusion（局部擴(kuò)散）Systemicdiffusion（全身性擴(kuò)散）現(xiàn)在是27頁\一共有67頁\編輯于星期三★

Invasiveness（侵襲力）Definition:Bacterialcapabilitythatcanbreakthroughthephysiologicbarriers(skin,mucosa),settledown,multiply,andspreadinthehost.Adhesivefactors:adhesinandcapsuleInvasivesubstancesBacterialbiofilm現(xiàn)在是28頁\一共有67頁\編輯于星期三1.Adhesin（黏附素）Protiensonbacterialsurfaceassociatedwithadhesion.Adhesinsbindtoadhesinreceptorsonhostcells.Classification:Pilus(fimbriae)adhesin(菌毛黏附素)Non-fimbriaeadhesin(非菌毛黏附素)現(xiàn)在是29頁\一共有67頁\編輯于星期三AdhesinAdhesinEpitheliumReceptorBacterium現(xiàn)在是30頁\一共有67頁\編輯于星期三Capsule(莢膜)ofstreptococcuspneumoniaeMicrocapsule（微莢膜）

Slimelayer（黏液層）現(xiàn)在是31頁\一共有67頁\編輯于星期三ProtectthecellwallagainstattackbydrugsInhibitingestionandkillingbyphagocytesPlayaroleintheadherenceofhumantissueAntigenicity2.Capsule（莢膜）現(xiàn)在是32頁\一共有67頁\編輯于星期三3.Invasiveenzymes侵襲性酶類

Somebacteriamaygenerateinvasiveenzymes,whichcandamagebodytissuesandpromotetheinvasionanddiffusionofthebacteria.現(xiàn)在是33頁\一共有67頁\編輯于星期三4.Invasin侵襲素Encodedbyinvasivegenes（侵襲基因）Mediateinvadingadjacentepithelialcells現(xiàn)在是34頁\一共有67頁\編輯于星期三5.Bacterialbiofilm細(xì)菌生物被膜：

Themembraneousbacterialcommunitycomposedofbacteriaandtheextracellularpolymerssecretedbybacteriaaftertheyadheretothesurfaceoflivingornonlivingmaterials.現(xiàn)在是35頁\一共有67頁\編輯于星期三5.Bacterialbiofilm細(xì)菌生物被膜FacilitatesbacterialadhesionBafflesthepenetrationofantibioticandtherejectionofimmunesystemProfitssignalcommunicationamongbacteria.現(xiàn)在是36頁\一共有67頁\編輯于星期三Bacterialbiofilm現(xiàn)在是37頁\一共有67頁\編輯于星期三現(xiàn)在是38頁\一共有67頁\編輯于星期三Biofilmintheendoscope（內(nèi)窺鏡）現(xiàn)在是39頁\一共有67頁\編輯于星期三Staphylococcusepidermidis（表皮葡萄球菌）biofilminthesurfaceofvenouscatheter（靜脈導(dǎo)管）現(xiàn)在是40頁\一共有67頁\編輯于星期三ExotoxinsEndotoxinsExcretedbylivingcells;highconcentrationsinliquidmedium.IntegralpartofthecellwallofG-bacteria.Releasedonbacterialdeathandinpartduringgrowth.Maynotneedtobereleasedtohavebiologicactivity.ProducedbybothG+andG-bacteria.FoundonlyinG-bacteria.PolypeptidesLPS(lipidAportionprobablyresponsiblefortoxicity.)Relativelyunstable;toxicityoftendestroyedrapidlybyheatingattemperaturesabove60℃.Relativelystable;withstandheatingattemperaturesabove60℃forhourswithoutlossoftoxicity.現(xiàn)在是41頁\一共有67頁\編輯于星期三ExotoxinsEndotoxinsHighlyantigenic;stimulateformationofhigh-titerantitoxin(抗毒素).Antitoxinneutralizestoxin.Weaklyimmunogenic;antibodiesareantitoxicandprotective.Relationshipbetweenantibodytitersandprotectionfromdiseaseislessclearthanwithexotoxins.Convertedtoantigenic,nontoxictoxoids(類毒素)byformalin,acid,heat,etc.Toxoidsareusedtoimmunize.Notconvertedtotoxoids.Highlytoxic;fataltoanimalsinmicrogramquantitiesorless.Moderatelytoxic;fatalforanimalsintenstohundredsofmicrograms.現(xiàn)在是42頁\一共有67頁\編輯于星期三ExotoxinsEndotoxinsUsuallybindtospecificreceptorsoncells.Specificreceptorsnotfoundoncells.Usuallydonotproducefeverinthehost.Selectivetoxicityandspecificclinicalsyndromes.Neurotoxins(神經(jīng)毒素)Cytotoxins(細(xì)胞毒素)Enterotoxins(腸毒素)UsuallyproducefeverinthehostbyreleaseofIL-1andothermediators.Frequentlycontrolledbyextrachromosomalgenes(e.g.plasmids).Synthesisdirectedbychromosomalgenes.現(xiàn)在是43頁\一共有67頁\編輯于星期三區(qū)別要點外毒素內(nèi)毒素來源革蘭陽性菌與部分革蘭陰性菌革蘭陰性菌編碼基因質(zhì)粒、前噬菌體或染色體基因染色體基因存在部分從活菌分泌出，少數(shù)菌崩解后釋出細(xì)胞壁組分，菌裂解后釋出化學(xué)成分蛋白質(zhì)脂多糖穩(wěn)定性60～80℃，30分鐘破壞160℃，2～4小時破壞毒性作用強，對組織器官有選擇性毒害效應(yīng)，引起特殊的臨床表現(xiàn)較弱，各菌的毒性效應(yīng)大致相同，引起發(fā)熱、白細(xì)胞增多、微循環(huán)障礙、休克、DIC等抗原性強，刺激機(jī)體產(chǎn)生抗毒素；甲醛液處理脫毒形成類毒素弱，刺激機(jī)體產(chǎn)生的中和抗體作用弱；甲醛液不能脫毒形成類毒素現(xiàn)在是44頁\一共有67頁\編輯于星期三SpecificpolysaccharideLPS現(xiàn)在是45頁\一共有67頁\編輯于星期三Procedure現(xiàn)在是46頁\一共有67頁\編輯于星期三Neurotoxin（神經(jīng)毒素）Tetanustoxin（破傷風(fēng)毒素）現(xiàn)在是47頁\一共有67頁\編輯于星期三Cytotoxins（細(xì)胞毒素）Diphtheriatoxin（白喉毒素）inhibitsproteinsynthesisinmammaliancellsandcausesnecrosisofcellsDiphtheriamembraneonthroat現(xiàn)在是48頁\一共有67頁\編輯于星期三Enterotoxin（腸毒素）Choleraenterotoxin現(xiàn)在是49頁\一共有67頁\編輯于星期三BiologicalrolesofendotoxinFever（發(fā)熱）Leukopeniaandleukocytosis（白細(xì)胞反應(yīng)）Endotoxemiaandshock（內(nèi)毒素血癥與休克）現(xiàn)在是50頁\一共有67頁\編輯于星期三EndotoxinActivatesmacrophagesActivatescomplementActivatesHagemanfactorIL-1,TNF,NitricoxideFeverandhypotensionC3a,C5aHypotensionEdemaCoagulationcascadeDIC現(xiàn)在是51頁\一共有67頁\編輯于星期三Section4

theinitiationandprocessofinfectionSourcesofinfectionPathwayofbacterialentranceTypesofbacterialinfection現(xiàn)在是52頁\一共有67頁\編輯于星期三Exogenousinfection（外源性感染）PatientsCarriers（帶菌者）AnimalsEnodogenousinfection（內(nèi)源性感染）OpportunisticpathogensSourcesofinfection現(xiàn)在是53頁\一共有67頁\編輯于星期三Pathwayofpathogenentrance

RespiratoryGastrointestinalGenitalSkinandmucosaAnimalbitesBloodSexualtransmission現(xiàn)在是54頁\一共有67頁\編輯于星期三TypesofbacterialinfectionInapparentinfection（隱性感染）Apparentinfection（顯性感染）Carrierstate（帶菌狀態(tài)）現(xiàn)在是55頁\一共有67頁\編輯于星期三Inapparentinfection（隱性感染）Subclinicalinfection（亞臨床型感染）Aninfectionthathasnoobservablesymptoms.Itoccurswhenthehostimmunityispotentorthepathogenicityofthepathogenisweak.現(xiàn)在是56頁\一共有67頁\編輯于星期三Thetipoftheiceberg

現(xiàn)在是57頁\一共有67頁\編輯于星期三Apparentinfection（顯性感染）AcuteinfectionChronicinfectionLocalinfectionGeneralizedinfection★Toxemia(毒血癥)Endotoxemia(內(nèi)毒素血癥)Bacteremia(菌血癥)Septicemia(敗血癥)Pyemia(膿毒血癥)現(xiàn)在是58頁\一共有67頁\編輯于星期三Toxemia（毒血癥）Bacteriamutiplyatinvadinglocationanddonotenterbloodstream,buttheexotoxins（外毒素）enterbloodandcausecorrespondingtoxicsymptoms.Endotoxemia（內(nèi)毒素血癥）Gram-negativebacteriamutiplyatlocationorinbloodstream,releasealotofamountendotoxin（內(nèi)毒素）

releasedfrombacterialcellrupture.現(xiàn)在是59頁\一共有67頁\編輯于星期三Bacteremia（菌血癥）Afterenteringblood,bacteriacirculatebutnotmultiplyintheblood.Septicemia（敗血癥）Bacteriacirculateandmultiplyintheblood,inwhichbacteriaproducetoxicproductsandcausehighswingingtypeoffeverandothertoxicsymptoms.現(xiàn)在是60頁\一共有67頁\編輯于星期三Pyemia（膿毒血癥）Pyogenic（化膿性）bacteriaproducesepticemiawithmultipleabscesses（膿腫）ininternalorganssuchasspleen,liverandkidneys.現(xiàn)在是61頁\一共有67頁\編輯于星期三★

Carrierstate（帶菌狀態(tài)）Afterinapparentinfectionorapparentinfec