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双语09-衣原体

2013-02-17 28页 ppt 1MB 18阅读

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双语09-衣原体null第17章其他原核细胞微生物 Sction 3 chlamydiae 衣原体 第17章其他原核细胞微生物 Sction 3 chlamydiae 衣原体 -is a prokaryote --is an obligate intracellular parasite --has a distinctive developmental cycle --can pass through bacterial filters (0.45μm). 一类严格细胞内寄生,有独特发育周期,能通过细菌滤器的原...
双语09-衣原体
null第17章其他原核细胞微生物 Sction 3 chlamydiae 衣原体 第17章其他原核细胞微生物 Sction 3 chlamydiae 衣原体 -is a prokaryote --is an obligate intracellular parasite --has a distinctive developmental cycle --can pass through bacterial filters (0.45μm). 一类严格细胞内寄生,有独特发育周期,能通过细菌滤器的原核细胞型微生物 . bacterial filter共同特征( common features) 共同特征( common features) G-,round or elliptical)革兰阴性,圆形或椭圆形 the outer cell wall resembles the cell wall of G- bacteria) 具有细胞壁,其组成与革兰阴性菌相似; a distinctive developmental cycle and division by binary fission ) 有独特的发育周期,行二分裂方式繁殖; contain prokaryotic ribosomes and complex enzymes,are obligate intracellular parasites because they can not produce ATP and must depend on the host cell for energy requirement,and are sensitive to certain antibiotics.) 有核糖体和较复杂的酶类,但缺乏供代谢所需的能量来源,营专性细胞内寄生,对多种抗生素敏感null1生物学性状 (biological characteristics ) (1) developmental cycle(发育周期) elementary body(EB )原体 initial body(始体) or reticulate body,RB(网状体)nullnull (2)培养特点(culture characteristics)(2)培养特点(culture characteristics) ————专性细胞内寄生 (obligate intracellular parasites) a.鸡胚培养(embryonated egg yolk sac inoculation) b.动物接种( animal inoculation) 如,小鼠(mouse) c.细胞培养(Hela 299,McCoy等) (cell culture--------- Hela 299, McCoy cell lines) null汤飞凡(1897-1958),1955,首次分离出沙眼衣原体 (Professor Feifan Tang isolated Chlamydia trachomatis for the first time in 1955) (3)resistance(3)resistancesusceptible to heat;disinfectants;certain antibiotics, such as erythromycin and tetracycline. resistant to hypothermia 对热敏感 对消毒剂敏感 耐低温 对抗生素敏感 2 致病性与免疫性 (Pathogenicity and immunity ) 2 致病性与免疫性 (Pathogenicity and immunity )(1)致病性 内毒素样物质(endotoxin-like substance, ELS) --------抑制细胞代谢,破坏细胞(inhibit metabolism and cause lysis of host cells) 主要外膜蛋白(major outer member protein, MOMP) -------与吸附、侵入及阻止吞噬体和溶酶体融合有关 (related to adsorption ,invasion and inhibit the fusion of phagosomes and lysosomes) Ⅳ型超敏反应(delayed-type hypersensitivity) 人类衣原体病: 沙眼、包涵体结膜炎、泌尿生殖道感染(非淋菌性尿道炎、宫颈炎等)、性病淋巴肉芽肿、肺炎(2)immunity(2)immunity the immunity to chlamydia is weak. The host is liable to persistent infection and recurrent infection of chlamydiae) 免疫力不强,易造成持续感染和反复感染 3. Main pathogenic chlamydia主要致病性衣原体   (1)Chlamydia trachomatis 沙眼衣原体  a.沙眼(trachoma) 3. Main pathogenic chlamydia主要致病性衣原体   (1)Chlamydia trachomatis 沙眼衣原体  a.沙眼(trachoma) 传染源(source of infection):人 传播途径:眼---眼,眼---手---眼: (route of transmission:eye-hand-eye ; eye-eye) 沙眼亚种A、B、Ba和C血清型 (Cause: Biovar trachoma A, B, Ba and C ) null感染眼结膜上皮细胞 (chlamydial infections of the conjunctival epithelium→ 增殖,包涵体 proliferation, Inclusion bodies 局部炎症local inflammation 早期流泪、有粘液脓性分泌物、结膜充血及滤泡增生 (lacrimation,mucopurulent discharge ,conjunctival hyperemia,and follicular hypertrophy 后期结膜瘢痕、眼睑内翻、倒睫以及角膜血管翳引起的角膜损害→ conjunctival scar,eyelid deformities(entropion,trichiasis),pannus 影响视力或致盲 (→blurred vision ,even blindness.)nullb.包涵体结膜炎(inclusion conjunctivitis) 由沙眼亚种B、Ba、D、Da、E、F、G、H 、I、Ia、J、及K血清型引起 (Cause: Biovar trachoma B、Ba、D、Da、E、F、G、H 、I、Ia、J、,K) 婴儿—产道传染 (infants -------infection via birth canal) 成人(adults) 由性接触经手传染至眼(sexual contacts) 通过游泳池水传染至眼(contaminated water → eye) null inclusion conjuncticitis has similar symptoms to trachoma except for corneal pannus and scar,and can heals spontaneously over several weeks or months 症状类似沙眼,但不出现角膜血管翳,不形成结膜斑痕,一般经数周或数月可痊愈。 null inclusion conjunctivitis 包涵体性结膜炎nullc. urogenital tract infection 泌尿生殖道感染 ——non-gonococcal urethritis,NGU(非淋菌性尿道炎) sexual contacts (性接触) male: urethritis 尿道炎 female:尿道炎、宫颈炎cervisitis、输卵管炎salpingitis、盆腔感染pelvic infection等。 尿道炎宫颈炎输卵管炎盆腔感染immunityimmunityshort duration of antibody 抗体持续时间短 weak immunity,predisposing to re-infection) 免疫力不强,易再受感染微生物学检查法 microbiological diagnosis 微生物学检查法 microbiological diagnosis scrapings of pathological site →Giemsa,iodine, fluorescent antibody staining →look for inclusion bodies in the epithelia cell) 病变部位刮片→ Giemsa、碘液或荧光抗体染色镜检,检查上皮细胞内有无包涵体 (isolation: embryonated egg yolk sac or continuous cell line) 分离培养 接种鸡胚卵黄囊或传代细胞 Nucleic acid testing:PCR , etc. with high sensitivity and specificity ) 核酸检测 PCR等核酸扩增技术,敏感度高,特异性强。 null包涵体含糖原(glycogen),被碘液染 为棕褐色(brown)nullEBFluorescent inclusion body of C trachomatis in epithelial Cell(conjunctival scraping)防治原则 prevention and treatment防治原则 prevention and treatment预防---无特异预防方法 (prevention-------no specific prevention methods a.注意个人卫生,不用公共毛巾、脸盆等。 (pay attention to sanitation, not share towels and basin) b.注意自我防护,提倡健康性行为 (pay attention to self-protection and advocate safe sex) 治疗:磺胺类、大环内酯类、喹诺酮类。 (treatment: sulfonamides, macrolides, quinolones,etc.) (2)性病淋巴肉芽肿亚种biovar lymphogranuloma venereum,LGV(2)性病淋巴肉芽肿亚种biovar lymphogranuloma venereum,LGV血清型(L1、L2、L2a及L3) 致病性(pathogenecity) 传染源(source of infection):人 传播途径(route of transmission):性接触(sexual contacts ) 侵犯淋巴组织(involvement of lymphatic tissues) 男性→腹股沟淋巴结→化脓性淋巴结炎和慢性淋巴肉芽肿→瘘管。 (male:inguinal nodes are involved →purulent lymphadenitis and chronic lymphogranuloma→nstula cannulas ) null 女性→会阴、肛门和直肠→肠皮肤瘘管,会阴-肛门-直肠狭窄和梗阻 (female:perineum,anus and rectum are involved →bowel-skin fistula ,rectal strictures and rectosigmoid obstruction.)null性病淋巴肉芽肿 (lymphogranuloma venereum)︸直肠狭窄rectal strictures微生物学检查(Microbiological Diagnosis ) 微生物学检查(Microbiological Diagnosis ) 病灶部位淋巴结脓液涂片→检查有无衣原体颗粒或包涵体 (smear of involved lymph node aspirate →look for chlamydia particle or inclusion bodies)  血清学检查:补体结合反应 (serological test:complement fixing reaction) 防治原则(prevention and treatment)  预防同其他性病相同(similar to other STDs)  治疗:利福平、四环素、红霉素等 (treatment: rifampin, tetracycline, and erythromycin,etc.)  (3)肺炎衣原体 Chlamydia pneumoniae (3)肺炎衣原体 Chlamydia pneumoniae 只有一个血清型:TWAR株(only one serotype-----TWAR strain) 传染源:人(source of infection-------patients) 传播途径:呼吸道(route of transmission-----respiratory tract) 所致疾病:呼吸道感染,可引起肺炎、支气管炎、咽炎、鼻窦炎等. (respiratory infection pneumonitis, Bronchitis, pharyngitis,sinusitis,etc. 可引起心包炎、心肌炎、心内膜炎(pericarditis , myocarditis ,endocarditis) 可能与冠心病(coronary heart disease)和心肌梗塞(myocardial infarction)有关null     (chlamydial pneumonia)sinusitispharyngitisBronchitis,pericarditis myocarditiscoronary heart diseasemyocardial infarction微生物学检查(microbiological diagnosis)微生物学检查(microbiological diagnosis)1 标本采集(specimen collection ) : 咽拭子或支气管肺泡灌洗液(throat swabs and bronchoalveolar lavage (BAL) ) 2 直接涂片(direct smear) ELISA或直接免疫荧光法 3 分离培养(isolation and culture) Hep-2和Hela细胞株培养 (Hep-2 and Hela cell culture) 防治原则(prevention and control) 预防:隔离(isolation ) 治疗:大环内酯类、诺氟沙星等(macrolides and norfloxacin)
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