化脓菌肠道菌分离鉴定过程（四）

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,化脓菌/肠道菌分离鉴定过程（四）,1,甘露醇发酵试验,药敏实验,2,细菌的抑菌环直径解释标准和相应的MIC解释标准（来源于CLSI M100-S17和NCCLS M31-A2）,3,碳青霉烯类,厄他培南Ertapenem,1,10,15,1618,19,亚胺培南Imipenem,1,2,10,13,1415,16,美洛培南Meropenem,1,2,10,13,1415,16,单环内酰胺类,氨曲南Aztreonam,1,30,15,1621,22,氨基糖甙类,庆大霉素Gentamicin,1,2,10,12,1314,15,3,120,6,7-9,10,卡那霉素Kanamycin,1,2,30,13,1417,18,妥布霉素Tobramycin,1,2,10,12,1314,15,大环内酯类,阿奇霉素Azithromycin,2,15,13,1417,18,四环素类,四环素Tetracycline,1,2,3,30,14,1518,19,诺氟沙星Norfloxacin,1,2,3,10,12,1316,17,氧氟沙星Ofloxacin,1,5,12,1315,16,2,5,14,1517,18,氟洛沙星Fleroxacin,1,2,5,15,1618,19,氯霉素Chloramphenicol,1,2,3,30,12,1317,18,利福平Rifampin,2,5,16,1719,20,万古霉素Vancomycin,2,30,-,-,15,2,30,-,-,15,3,-,-,-,-,克林霉素Clindamycin,2,2,14,1520,21,1,：肠杆菌科,2,：葡萄球菌属,（,2-1,凝固酶阳性葡萄球菌，2-2凝固酶阴性葡萄球菌）3：肠球菌属,4,Bacteriological Detection,5,Serological diagnosis,Samples:,Widals test - S. typhi and paratyphi,Weil-Felix Test - Richettsia(,立克次体属),6,Widals Reaction,Definition:,a specific reaction consisting in agglutination of typhoid bacilli or paratyphoid bacilli when mixed with serum from a patient having typhoid fever or other salmonella infection and constituting a test for the disease .,Usage: to assist to diagnosis typhoid fever or,other salmonella infection.,7,Materials,Antigens: TO TH PA PB,Antibody: serum of suspected patient,Normal saline,Reaction plate,Straws,8,PROCEDURE,Make the mark,Add reagents as the following:,Reagent,(ml),1 2 3 4 5 6 7,Saline 0.25 0.25 0.25 0.25 0.25 0.25 0.25,Patient serum 0.25 0.25 0.25 0.25 0.25 0.25,discard,Serum dilution 1:20 1:40 1:80 1:160 1:320 1:640 -,Bacteria suspension,0.25 0.25 0.25 0.25 0.25 0.25 0.25,Final serum 1:40 1:80 1:160 1:320 1:640 1:1280 -,dilution,Shaking several times, put it in 37,water bath for,2 hours.Then let it stand at room temperature over night.,Bacteria suspension: TO TH PA PB,9,Observation,:,1. Control tube: no agglutination (-),2. Lowest titer tube: absolutely agglutination (+),3. Other tubes:,three quarters agglutination(+) half agglutination (+),one quarter agglutination (+) no agglutination (-),Judgment:,Agglutination titer: the highest dilution of serum,which appears (+) bacteria agglutination.,10,H抗体与O抗体的性质及其消长的意义,O抗体,IgM,出现较早,维持时间短,H抗体,IgG,出现较晚,维持时间长,伤寒的可能性很大,高,高,高,低,感染早期,O凝集的交叉反应,低,高,预防接种 非特异性回忆反应,抗体类型,体内出现情况,与正常值比较,Analysis,11,Precautions,Make the mark,Make sure the procedure,carefully use the straws,Correctly Judge the results,12,细菌特殊结构观察,荚膜,荚膜染色法：菌体紫色，荚膜无色或淡紫色,芽孢,芽孢染色法：菌体蓝色，芽孢红色,鞭毛,鞭毛染色法：菌体红色，鞭毛红色,异染颗粒,异染颗粒染色法：菌体浅黄色，异染颗粒深蓝紫色,抗酸染色,抗酸性细菌：红色,非抗酸性细菌：蓝色,13,模拟题,在SS琼脂平板上，致病性肠道杆菌菌落特征是_，非致病性肠道杆菌的菌落特征是_。,斜面培养基主要用于 _；半固体培养基主要用于_。,分离肠道杆菌常用_培养基。,现有一名患者，伤口化脓性感染，请问你如何进行鉴定？,14,