【教學(xué)】第章 呼吸道傳播的病原微生物其他細(xì)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白喉棒狀桿菌（鼻咽腔）飛沫、污染物品鼻 咽喉氣管局部細(xì)菌和毒素的作用灰白色假膜粘膜水腫及假膜脫落，引起呼吸道阻塞，甚至窒息死亡。外毒素入血毒血癥心肌肝腎上腺外周神經(jīng)內(nèi)臟出血心肌炎軟腭麻痹 聲嘶 腎上腺功能障礙2-7天潛伏期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百日咳鮑特菌革蘭染色百日咳鮑特菌革蘭染色 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分類軍團(tuán)菌屬軍團(tuán)菌屬(Legionella) 屬于軍團(tuán)菌科屬于軍團(tuán)菌科（Legionellaceae）常見(jiàn)的與人類疾病有關(guān)的軍團(tuán)菌：常見(jiàn)的與人類疾病有關(guān)的軍團(tuán)菌：嗜肺軍團(tuán)菌（嗜肺軍團(tuán)菌（Legionella pneumophila）米克戴德軍團(tuán)菌（米克戴德軍團(tuán)菌（L. micdadei）長(zhǎng)灘軍團(tuán)菌

6、（長(zhǎng)灘軍團(tuán)菌（L. longbeachae）杜莫夫軍團(tuán)菌（杜莫夫軍團(tuán)菌（L. dumoffii）波茲曼軍團(tuán)菌（波茲曼軍團(tuán)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微生物學(xué)檢驗(yàn)微生物學(xué)檢驗(yàn)Department of Microbiology, Harbin Medical University 標(biāo)本標(biāo)本（痰、支氣管分泌物、血液、）（痰、支氣管分泌物、血液、） 涂片染色鏡檢涂片染色鏡檢 （Giemsa染色染色） 分離培養(yǎng)分離培養(yǎng)（BEYE瓊脂）瓊脂）鑒定試驗(yàn)鑒定試驗(yàn)結(jié)果報(bào)告結(jié)果報(bào)告形態(tài)染色形態(tài)染色菌落特征菌落特征氧化酶、觸酶氧化酶、觸酶熒光抗體染色等熒光抗體染色等Department of Microbiology, Harbin Medi

9、cal UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University軍軍 團(tuán)團(tuán) 菌菌 感感 染染 診診 斷斷 試試 驗(yàn)驗(yàn) Department of Microbiology, Harbin Medical University適 應(yīng) 癥：軍團(tuán)菌病、肺炎支原體肺炎、肺炎衣原體肺炎、沙眼衣原體結(jié)膜炎、厭氧菌所致口腔感染、空

10、腸彎曲菌腸炎、百日咳等。Department of Microbiology, Harbin Medical University嗜血桿菌屬嗜血桿菌屬是一類革蘭陰性短小桿菌、是一類革蘭陰性短小桿菌、常呈多形態(tài)性、無(wú)鞭毛、無(wú)芽胞，可形成常呈多形態(tài)性、無(wú)鞭毛、無(wú)芽胞，可形成莢膜，營(yíng)養(yǎng)要求高，需要特殊物質(zhì)才能生莢膜，營(yíng)養(yǎng)要求高，需要特殊物質(zhì)才能生長(zhǎng)的一類細(xì)菌。長(zhǎng)的一類細(xì)菌。Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University 幾種主要嗜血桿菌

11、常棲部位及所致疾病幾種主要嗜血桿菌常棲部位及所致疾病Department of Microbiology, Harbin Medical University（H.influenzae）為例）為例1.形態(tài)與染色形態(tài)與染色 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探針雜交探針雜交（快速檢測(cè)）（快速檢測(cè)）血液血液腦脊液腦脊液膿汁膿汁痰痰 分離培養(yǎng)分離培養(yǎng)(巧克力瓊脂巧克力瓊脂) 涂片、鏡檢涂片、鏡檢莢膜腫脹試驗(yàn)（初步報(bào)告）莢膜腫脹試驗(yàn)（初步報(bào)告）標(biāo)記抗體檢測(cè)抗原標(biāo)記抗體檢測(cè)抗原涂片、莢膜腫脹

13、試驗(yàn)（初步報(bào)告）涂片、莢膜腫脹試驗(yàn)（初步報(bào)告）菌落形態(tài)、衛(wèi)星現(xiàn)象、血清學(xué)現(xiàn)象菌落形態(tài)、衛(wèi)星現(xiàn)象、血清學(xué)現(xiàn)象報(bào)告結(jié)果報(bào)告結(jié)果 嗜血桿菌的檢驗(yàn)程序嗜血桿菌的檢驗(yàn)程序增菌培養(yǎng)增菌培養(yǎng)35 5-10%CO2X、V因子需求試驗(yàn)因子需求試驗(yàn)吲哚、尿素酶、鳥(niǎo)氨酸脫吲哚、尿素酶、鳥(niǎo)氨酸脫羧酶（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：巧克力瓊脂培養(yǎng)基小、無(wú)色透明菌落菌落特征：巧克力瓊脂培養(yǎng)基小、無(wú)色透明菌落

14、 流感嗜血桿菌巧克力瓊脂養(yǎng)基菌落流感嗜血桿菌巧克力瓊脂養(yǎng)基菌落 Department of Microbiology, Harbin Medical University衛(wèi)星現(xiàn)象(satellite phenomenon) Department of Microbiology, Harbin Medical UniversityDepartment of Microbiology, Harbin Medical University注：D為不同結(jié)果嗜血桿菌屬中種的特征嗜血桿菌屬中種的特征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 體體（只有一個(gè)血清型：只有一個(gè)血清型：TWARTWAR株株）（一）生物學(xué)特性：（一）生物學(xué)特性： 1、原體平均直徑，梨形，有周漿間隙，、原體平均直徑，梨形，有周漿間隙，原體無(wú)質(zhì)粒原體無(wú)質(zhì)粒DNA； 2、與其他衣原體同源性小于、與其他衣原體同源性小于10%，但，但不同來(lái)源的不同來(lái)源的TWAR同源性高（大于同源性高（大于94%）；）； 3、只有一個(gè)血清型；、只有一個(gè)血清型； 4、用、用HEp-2和和HL細(xì)胞系易分離和傳代，細(xì)胞系易分離和傳代，但在第一代細(xì)胞內(nèi)很少形成包涵體。但在第一代細(xì)胞內(nèi)很少形成包涵體。Department of Microbiology, Harbin Medical University 傳播途徑傳播途徑：經(jīng)飛沫或呼吸道分泌物傳播，擴(kuò)