病原性球菌课件

1.Pathogenic cocci 2.Other bacteria 1.Pathogenic cocci1.Pathogenic cocciConcept of pathogenic bacteria 13minStaphylococcus(Esp.,S.aureus)56minStreptococcus(Esp.,S.pyogenes)38minEnterococcus species and VRE 5minNeisseria meningitides Neisseria gonorrhoeae 13min2.Other bacteriaPseudomonas aeruginosa 10min Highlights of content1.Pathogenic cocciHighlights Up to every pathogen,the following will be talked:Biological properties Pathogenicity Immunity Microbiological detections Prevention and treatmentUp to every pathogen,the follPustule(脓疱脓疱)by S.aureusPustule(脓疱)by S.aureusPustule(脓疱脓疱)by S.aureusParonychia(甲沟炎甲沟炎)by S.aureusPustule(脓疱)by S.aureusParonSore throat(咽喉炎咽喉炎)by S.pyogenesSore throat(咽喉炎)by S.pyogenUntreated erysipelas(丹毒丹毒)by S.pyogenes with skin sloughing and necrosis Untreated erysipelas(丹毒)by Necrotizing Fasciitis Necrotizing Fasciitis(坏死性坏死性坏死性坏死性筋膜炎筋膜炎筋膜炎筋膜炎)by by flesh-eating bacteriaflesh-eating bacteria (S.pyogenesS.pyogenes,anaerobic anaerobic bacteria,etc.bacteria,etc.),and),and insects(bee,etc.)insects(bee,etc.)stingingstingingNecrotizing Fasciitis(坏死性筋膜炎)Chest x-ray Film 1Chest x-ray Film 1just a few hours of rigors just a few hours of rigors and productive coughand productive cough Chest x-ray Film 2Chest x-ray Film 212 hours later12 hours laterconsolidation in the consolidation in the right upper loberight upper lobe Lobar pneumonia Lobar pneumonia(大叶性大叶性肺炎肺炎)by by S.pneumoniaeS.pneumoniaeChest x-ray Film 1Chest x-ray Meningococcal septicemia Meningococcal septicemia(脑膜炎球菌性败血症脑膜炎球菌性败血症脑膜炎球菌性败血症脑膜炎球菌性败血症)by by N.meningitidisN.meningitidis,w widespread ecchymosesidespread ecchymoses Meningococcal septicemia(脑膜炎球Gonococcal conjunctivitis(淋菌性结膜炎淋菌性结膜炎)by N.gonorrhoeae Gonococcal conjunctivitis(淋菌性Causative agents of above clinical diseases?Pathogenic cocciCausative agents of above clin What is Pathogenic cocci?also called Pyogenic cocci(化脓性球菌化脓性球菌)Including -Staphylococcus(S.aureus&S.epidermidis)(金黄色葡萄球菌与表皮葡萄球菌金黄色葡萄球菌与表皮葡萄球菌 )-Streptococcus(Group A Streptococci,S.pyogenes)(A群链球菌群链球菌 or 化脓性链球菌化脓性链球菌)-Streptococcus pneumoniae(肺炎链球菌肺炎链球菌)-Neisseria gonorrhoeae(淋病奈瑟菌淋病奈瑟菌)-Neisseria meningitidis(脑膜炎奈瑟菌脑膜炎奈瑟菌)What is Pathogenic cocci?In Important cocci Gram stain Bacterial genera G+Genus staphylococcus Genus streptococcus G-Genus Neisseria (N.meningitides N.gonorrhoeae)Important cocci Gram stain Staphylococcus aureusImportant pyogenic coccusLeading pathogen of wound infections (including other staphylococci)Staphylococcus aureusImportant ShapeShape,Stain,Stain&Culture Culture spherical,elliptical,irregular grape-like cluster Gram+(G+)Grow well on basic mediumBiological properties Shape,Stain&CultureBiologi病原性球菌课件病原性球菌课件 Antigenic structureAntigenic structure Staphylococcal protein A(SPA)(SPA)One kind of surface protein in cell wall Single chain peptide Actions Binds(bacterium)to hosts to hosts IgG1,IgG2&IgG1,IgG2&IgG4IgG4 coagglutination testcoagglutination test Competes w/Fc receptors of phagocytesw/Fc receptors of phagocytes resists phagocytosisresists phagocytosis Antigenic structureCoagglutination test with inert particles Coagglutination test with inert particles(e.g.,heat-killed(e.g.,heat-killed S.aureus S.aureus oror latex beadslatex beads)Coagglutination test with inerSPA may resist phagocytosis by competively binding with Fc receptors of phagocytesSPA may resist phagocytosis by Capsule Teichoic acid(polysaccharide)(polysaccharide)polysaccharide A S.aureus polysaccharide B S.epidermidisPhases of phagocytosis CapsulePhases of phagocytosisImportant Properties of 3 Main Species of StaphylococciImportant Properties of 3 MainPathogenicity&immunityPathogenicity&immunityCoagulaseCoagulase,Fibrinolysin,Heat,Fibrinolysin,Heat stable nuclease,stable nuclease,Hyaluronidase,&LipaseHyaluronidase,&LipaseEnzymesPathogenic substancesCytotoxins Cytotoxins(Staphylolysin(Staphylolysin ,&,&,Leukocidin),Leukocidin),Exfoliatin,Enterotoxins,Exfoliatin,Enterotoxins,&TSST-1&TSST-1ToxinsAdhesin,Capsule,&Adhesin,Capsule,&PeptidoglycanPeptidoglycanOthersCoagulase,Fibrinolysin,Heat CoagulaseCoagulase Free CoagulaseFree Coagulase staphylothrombinstaphylothrombin(游离凝固酶游离凝固酶游离凝固酶游离凝固酶)(葡萄球菌凝血酶葡萄球菌凝血酶葡萄球菌凝血酶葡萄球菌凝血酶)Fibrinogen Fibrin Plasma to be Plasma to be cloted cloted Tube coagulase test Tube coagulase test activatedconvertCoagulase Free Coagulaseactiva Virulence Protection actions Infection localized Bound coagulase(结合凝固酶结合凝固酶)or clumping factor(凝聚因子凝聚因子)plasma to be cloted or bacteria to coagulate Slide coagulase testSlide coagulase test Virulence Bound coagulase(结合凝 classified into -,-,-,&-toxin -toxin makes pores in cell membranesStaphylolysin(葡萄球菌溶素葡萄球菌溶素)classified into-,-,-,&leukocidin杀白细胞素杀白细胞素 kills or degranulates neutrophils¯ophagesleukocidin kills or degranulat including type A type A&type B type B causes staphylococcal scalded skin staphylococcal scalded skin syndromesyndrome (SSSS)Exfoliatin(表皮剥夺毒素表皮剥夺毒素)including type A&type BExfo including serotype A,B,C1-3,D,E,G,serotype A,B,C1-3,D,E,G,&H H responsible for food poisoning(食物中毒食物中毒)mainly cause vomiting also acts as superantigen(超抗原超抗原)Enterotoxin(肠毒素肠毒素)causes toxic shock syndrometoxic shock syndrome (TSS)one kind of superantigensToxic shock syndrome toxin 1(TSST-1)(毒性休克综合征毒素毒性休克综合征毒素-1)-1)including serotype A,B,C1-3病原性球菌课件Othersheat-stable nuclease(耐热核酸酶耐热核酸酶)Othersheat-stable nuclease(耐热病原性球菌课件病原性球菌课件Clinical diseasesInvasive Invasive diseasesdiseasesToxin-mediated Toxin-mediated diseasesdiseasesPyogenic infections -local infections-systemic infections-food poisoning-staphylococcal scalded skin syndromestaphylococcal scalded skin syndrome(SSSS)-toxic shock syndrome(TSS)Clinical diseasesInvasive diseFolliculitis(毛囊炎毛囊炎)by S.aureusFolliculitis(毛囊炎)by S.aureuBullous Impetigo by S.aureusBullous Impetigo by S.aureusA S.aureus infection on a 12-year-old childs cheek A S.aureus infection on a 12-Pathogenesis of staphylococcal infectionsPathogenesis of staphylococcalMicrobiological diagnosisAnimal testSamplesSamplesPus,blood,food,or vomitusIsolatiIsolationonCoagulase testCoagulase testCoagulase testCoagulase testMannite Mannite Mannite Mannite fermentationfermentationfermentationfermentationHeat-stable Heat-stable Heat-stable Heat-stable nucleasenucleasenucleasenucleaseSmear SmearµscopymicroscopyG+staphylococciColony pigments&hemolysisBiochemical reactionsEnterotoxins detectionMicrobiological diagnosisAnimaIdentification of pathogenic staphylococci Coagulase(+)Heat-stable nuclease(+)Golden pigment(+)HemolyzationHemolyzation (+)Mannite fermentation(+)Identification of pathogenic sPrevention&treatmentPreventionPreventionpreventing preventing preventing preventing nosocomial nosocomial nosocomial nosocomial infectioninfectioninfectioninfectionTreatmentTreatmentantibiotics antibiotics antibiotics antibiotics sensitivity sensitivity sensitivity sensitivity testtesttesttestpersonal personal personal personal hygienehygienehygienehygienesterilisatsterilisatsterilisatsterilisation&ion&ion&ion&detentiondetentiondetentiondetentionselfselfselfself-bacterial bacterial bacterial bacterial vaccine vaccine vaccine vaccine therapy therapy therapy therapy preventing preventing preventing preventing drug drug drug drug resistanceresistanceresistanceresistancePrevention&treatmentPreventiMethicillin-resistant S.aureus,MRSA (耐甲氧西林金黄色葡萄球菌耐甲氧西林金黄色葡萄球菌)Coagulase-negative staphylococci(CNS)(凝固酶阴性葡萄球菌凝固酶阴性葡萄球菌)Methicillin-resistant S.aureu1.Compare the features of common pyogenic bacteria.2.Discuss the pathogenic features and identification points of Staphylococcus aureus.Questions:Compare the features of commonStreptococciStreptococci G+,spherical,elliptical,arranged in chainin chain Grow well on nutrient medium w/bloodBiological propertiesShape,Shape,Stain Stain&CultureCulture G+,spherical,elliptical,ar病原性球菌课件病原性球菌课件Antigenic Antigenic structurestructure Protein antigen surface Agsurface Agsurface Agsurface Ag,outside C antigen,outside C antigen type-specifictype-specific including including M M M M,T,R,S in Group A,T,R,S in Group A Polysaccharid antigen C C C C AgAgAgAg group-specificgroup-specific Nucleoprotein P P P P AgAgAgAg non-specificnon-specific Cell cytoplasm Cell cytoplasm Cell membraneCell membranePeptidoglycanPeptidoglycanCapsuleCapsuleCell wallCell wallAntigenic structure Protein anClassificationAccording According toto -hemolytic Streptococcus -hemolytic Streptococcus -StreptococcusHemolysis group A-V,total 20 groupsgroup A-V,total 20 groups among among pathogenic pathogenic pathogenic pathogenic streptococcistreptococcistreptococcistreptococci 90%is group A90%is group A over 100 types over 100 types according to according to M M M M AgAgAgAg group B,C,D,&G occasionallygroup B,C,D,&G occasionallyAntigenic structureClassificationAccording to-hPathogenicityPathogenicityGroup A Streptococci (S.pyogenes)Group A Streptococci (S.pyogPathogenic Pathogenic substancessubstances Protein GProtein G:similar to Protein Asimilar to Protein A adhesinsadhesins -lipoteichoic acid(LTA)lipoteichoic acid(LTA)-fibronectin binding protein(FBP,fibronectin binding protein(FBP,protein F)protein F)(纤丝蛋白结合蛋白纤丝蛋白结合蛋白纤丝蛋白结合蛋白纤丝蛋白结合蛋白,F,F,F,F 蛋白蛋白蛋白蛋白)-protein Mprotein MBacterial structurePathogenic substances Protein Streptolysin(SL,(SL,链球菌溶素链球菌溶素)Streptococcal pyrogenic exotoxin (SPE,(SPE,链链球菌致热外毒素球菌致热外毒素)Hyaluronidase(透明质酸酶透明质酸酶)Streptokinase(SK,(SK,链激酶链激酶)Streptodornase(SD,(SD,链道酶链道酶)Toxins&enzymes Streptolysin(SL,链球菌溶素)ToxinStreptolysin S(SLS,(SLS,链球菌溶素链球菌溶素S)S)-low MW glycopeptidelow MW glycopeptide -oxygen-stableoxygen-stable -causes causes -hemolysis on Blood Agar platehemolysis on Blood Agar plate -non-antigenicnon-antigenicStreptolysin O(SLO,(SLO,链球菌溶素链球菌溶素O)O)-protein w/SH groupprotein w/SH group -oxygen-labileoxygen-labile -destroysdestroys many kinds many kinds of cellsof cells -anti-SLO test(ASO test)anti-SLO test(ASO test)helpful for diagnosis helpful for diagnosisStreptolysinStreptolysin S(SLS,链球菌溶素S)St-coded by lysogenic bacteriophage-proteins including serotype A,B,Cserotype A,B,C-causes scarlet fever(猩红热猩红热)-one kind of superantigens-also causes TSSStreptococcal pyrogenic exotoxin(SPE)(链球菌致热外毒素链球菌致热外毒素)-coded by lysogenic bacteriophStreptokinase(SK,(SK,链激酶链激酶)-also called as streptococcal fibrinolysin (链球菌溶纤维蛋白酶链球菌溶纤维蛋白酶)Streptodornase(SD,(SD,链道酶链道酶)-hydrolyzes DNAHyaluronidase(透明质酸酶透明质酸酶)-also called as spreading factor(扩散因子扩散因子)-hydrolyzes hyaluronic acid in connective tissue-helpful for spreading of bacteriaStreptokinase(SK,链激酶)Strepto病原性球菌课件Clinical diseasesPyogenic infectionsToxin-mediated diseasesAllergic diseases(late complications)-scarlet fever(猩红热猩红热)-Streptococcal toxin-mediated TSS-rheumatic fever(风湿热风湿热)-acute glomeruloniphritis(急性肾小球肾炎急性肾小球肾炎)Clinical diseasesPyogenic infeErysipelas(丹毒丹毒)by S.pyogenesErysipelas(丹毒)by S.pyogenesCellulitis(蜂窝组织炎蜂窝组织炎)by S.pyogenesCellulitis(蜂窝组织炎)by S.pyogeHoney-crust lesion typical of S.pyogenes impetigoHoney-crust lesion typical oPathogenesis of S.pyogenes infectionsPathogenesis of S.pyogenes inSamplesPus,Blood,Nasopharynx swabIsolation w/Isolation w/blood agar blood agar plateplatedistinguishdistinguishing from ing from S.pneumoniaeS.pneumoniaeSmear SmearµscopymicroscopyG+streptococcidistinguishing distinguishing from from staphylococcistaphylococciOther streptococciOther streptococci-hemolysisAssist-diagnosis for rheumatic fever-hemolysisASO ASO testtestMicrobiological diagnosisSamplesPus,Blood,Nasopharynx S.pneumoniae Group B streptococci Group D streptococci Viridans(-hemolytic)streptococci Streptococcus suis(猪链球菌猪链球菌)Enterococcus species(肠球菌肠球菌)&VRE Other streptococci S.pneumoniaeOther streptococEnterococcus species and VRE Enterococcus species and VRE Enterococcus spp.(肠球菌肠球菌)Previously classified as Group D streptococci In 1984,named as genus Enterococcus Gram+cocci in pairs or short chains Most are facultative anaerobes Complex nutritional requirements Group D specific teichoic acid antigenEnterococcus spp.Previously cEnterococcusEnterococcus spp.viewed by direct spp.viewed by direct fluorescent antibody(FA)reactionfluorescent antibody(FA)reactionEnterococcus spp.viewed by diEnterococcus spp.Commonly found in the intestines of normal Commonly found in the intestines of normal healthy individuals(humans and animals).healthy individuals(humans and animals).2 important human diseases-related spp.2 important human diseases-related spp.E.faecalis E.faecalis(粪肠球菌粪肠球菌粪肠球菌粪肠球菌)andand E.faecium E.faecium(屎肠球菌屎肠球菌屎肠球菌屎肠球菌)Cause Cause Urinary tract infections Urinary tract infections Bacteremia&septicaemia Bacteremia&septicaemia Subacute endocarditis Subacute endocarditis Wound infections Wound infections Foodborne diseases Foodborne diseases Meningitis Meningitis Nosocomial infections Nosocomial infectionsEnterococcus spp.Commonly fou One of important life-threatening nosocomial pathogens Vancomycin Resistant Enterococci (VRE,耐万古霉素肠球菌耐万古霉素肠球菌)Since 1986,VRE infections has become a growing problem One of important life-threate1.Discuss the pathogenic features of Streptococcus pyogenes.2.Discuss identification points between hemolytic streptococci and other pyogenic bacteria.Questions:1.Discuss the pathogenic featNeisseria gonorrhoeae(淋病奈瑟菌淋病奈瑟菌)Neisseria gonorrhoeaeBiological properties Shape and stain Shape and stain -G-diplococci in or on PMNs on pus smear -No endospore&flagellum,&w/capsule&piliBiological properties Shape an病原性球菌课件 Culture Culture -Obligate aerobes,need 5%CO2 while primary isolation -High nutritional requirement “Chocolate Blood Agar Plate”Antigenic structure and Antigenic structure and classificationclassification -Pilus protein antigens -Outer membrane protein antigens：PI,PII,&PIII -LOS(lipooligosaccharide,LOS(lipooligosaccharide,脂寡糖脂寡糖脂寡糖脂寡糖),),LPS-likeLPS-like Culture Antigenic structure aN.gonorrhoeae colonies on Chocolate Blood Agar PlateN.gonorrhoeae colonies PathogenesisVirulent factorsVirulent factors-Pili-Outer membrane proteins-LOS-IgA1 protease-OthersPathogenesisVirulent factorsClinical Clinical findingsfindings-Gonorrhea-Gonococcal conjunctivitisClinical findingsGonorrhea symptoms-Urethritis-Urethritis-Vaginitis-Vaginitis-Cervicitis-Cervicitis-Salpingitis-Salpingitis-Pelvic inflammation-Pelvic inflammation-Anorectal Gonorrhea-Anorectal Gonorrhea-Gonococcal Pharyngitis-Gonococcal Pharyngitis-Gonococcal Conjunctivitis-Gonococcal Conjunctivitis-Gonococcal Arthritis-Gonococcal Arthritis in Women-Urethritis-Urethritis-Epididymitis-Epididymitis-Prostatitis-Prostatitis-Anorectal Gonorrhea-Anorectal Gonorrhea-Gonococcal Pharyngitis-Gonococcal Pharyngitis-Gonococcal Conjunctivitis-Gonococcal Conjunctivitis-Gonococcal Arthritis-Gonococcal Arthritisin MenGonorrhea symptoms-UrethritisiClinical manifestations of N.gonorrhoeae infection Clinical manifestations of N.Immunity Humoral immunity more effective No persistent immune responses Infection trend to -chronic&repeated occurrenceImmunity Humoral immunity moreMicrobiological detectionsNucleic acids detection,&so onNucleic acids detection,&so onSamplesSamplesPus secreta from genito-urinary tracts,eyes,&othersPus secreta from genito-urinary tracts,eyes,&othersIsolatiIsolationonOxidase testOxidase testSugar fermentation testSugar fermentation testImmunofluorescenceImmunofluorescence assay assaySmear SmearµscopymicroscopyG G-diplococci diplococci in or on PMNsin or on PMNs Coloniesµscopic findingsColoniesµscopic findingsBiochemical reactions&serologic testsOther Other teststestsMicrobiological detectionsNuclPrevention&treatment Take Take preventionspreventions as as main measuremain measure Choose penicillinpenicillin as No.1 drug，take care of problems of drugs-resistant bacterial stainsPrevention&treatment Take pr1.What are the main differences between Neisseria meningitides and Neisseria gonorrhoeae.Question:1.What are the main differencPseudomonas aeruginosa(铜绿假单胞菌铜绿假单胞菌)P190Pseudomonas aeruginosaP190 Shape,Stain Shape,Stain&Culture Culture G bacili single terminal flagellum appears capsule in some bacterial strains grows readily and rapidly on many media produces several kinds of water-soluble pigmentsBiological properties Shape,Stain&CultureBiologiPseudomonas aeruginosa colonies on agar platesPseudomonas aeruginosa coloniePathogenicity&immunityPathogenicity&immunity adhesins pilus non-pilus adhesin polysaccharide capsule endotoxin lipopolysaccharide(LPS)Pathogenic Pathogenic substancessubstances adhesinsPathogenic substances exotoxins exotoxin A -mode of action similar to diphtheria toxin exotoxin S(exoenzyme S)(exoenzyme S)-inhibits phagocytosis -acts in vitro in the same way as the toxins of Vibrio cholerae elastase(弹性蛋白酶弹性蛋白酶)-Las-A(丝氨酸蛋白酶丝氨酸蛋白酶)Las-B(锌金属蛋白酶锌金属蛋白酶)exotoxins phosphoesterase C(磷脂酶磷脂酶 C C)pyocyanin(绿脓菌素绿脓菌素)Cytolysin:e.g.leukocidin phosphoesterase C(磷脂酶 C)Clinical Clinical diseasesdiseasesOpportunistic pathogen infections following burn hospital-acquired infectionsPulmonary infectionsPrimary skin infectionsUrinary infectionsClinical diseasesOpportunisticPrimary skin infections of Pseudomonas aeruginosa Primary skin infections of Ps1.Discuss the pathogenic features of Pseudomonas aeruginosa.Question:1.Discuss the pathogenic feat