athogeniccocci病原性球菌.ppt
1.Pathogenic cocci 2.Other bacteria1.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 contentUp to every pathogen,the following will be talked:Biological properties Pathogenicity Immunity Microbiological detections Prevention and treatmentPustule(脓疱脓疱)by S.aureusPustule(脓疱脓疱)by S.aureusParonychia(甲沟炎甲沟炎)by S.aureusSore throat(咽喉炎咽喉炎)by S.pyogenesUntreated erysipelas(丹毒丹毒)by S.pyogenes with skin sloughing and necrosis 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.)stingingstingingChest 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.pneumoniaeMeningococcal 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 Gonococcal conjunctivitis(淋菌性结膜炎淋菌性结膜炎)by N.gonorrhoeae Causative agents of above clinical diseases?Pathogenic cocci 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)Important cocci Gram stain Bacterial genera G+Genus staphylococcus Genus streptococcus G-Genus Neisseria (N.meningitides N.gonorrhoeae)Staphylococcus aureusImportant pyogenic coccusLeading pathogen of wound infections (including other staphylococci)Shape,Stain Shape,Stain&Culture Culture spherical,elliptical,irregular grape-like cluster Gram+(G+)Grow well on basic mediumBiological properties 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&IgG4IgG1,IgG2&IgG4 coagglutination testcoagglutination test Competes w/Fc receptors of phagocytesw/Fc receptors of phagocytes resists phagocytosisresists phagocytosis Coagglutination 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)SPA may resist phagocytosis by competively binding with Fc receptors of phagocytes Capsule Teichoic acid(polysaccharide)(polysaccharide)polysaccharide A S.aureus polysaccharide B S.epidermidisPhases of phagocytosisImportant Properties of 3 Main Species of StaphylococciPathogenicity&immunityCoagulaseCoagulase,Fibrinolysin,Heat stable,Fibrinolysin,Heat stable nuclease,Hyaluronidase,&Lipasenuclease,Hyaluronidase,&LipaseEnzymesPathogenic substancesCytotoxins Cytotoxins(Staphylolysin(Staphylolysin ,&,&,Leukocidin),Leukocidin),Exfoliatin,Exfoliatin,Enterotoxins,&TSST-1Enterotoxins,&TSST-1ToxinsAdhesin,Capsule,&PeptidoglycanAdhesin,Capsule,&PeptidoglycanOthersCoagulaseCoagulase 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 cloted Plasma to be cloted Tube coagulase test Tube coagulase test activatedconvert 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 classified into -,-,-,&-toxin -toxin makes pores in cell membranesStaphylolysin(葡萄球菌溶素葡萄球菌溶素)leukocidin杀白细胞素杀白细胞素 kills or degranulates neutrophils¯ophages including type A type A&type B type B causes staphylococcal scalded skin syndromestaphylococcal scalded skin syndrome (SSSS)Exfoliatin(表皮剥夺毒素表皮剥夺毒素)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)Othersheat-stable nuclease(耐热核酸酶耐热核酸酶)Clinical diseasesInvasive diseasesInvasive diseasesToxin-mediated diseasesToxin-mediated diseasesPyogenic infections -local infections-systemic infections-food poisoning-staphylococcal scalded skin syndromestaphylococcal scalded skin syndrome(SSSS)-toxic shock syndrome(TSS)Folliculitis(毛囊炎毛囊炎)by S.aureusBullous Impetigo by S.aureusA S.aureus infection on a 12-year-old childs cheek Pathogenesis of staphylococcal infectionsMicrobiological diagnosisAnimal testSamplesSamplesPus,blood,food,or vomitusIsolationIsolationCoagulase testCoagulase testCoagulase testCoagulase testMannite fermentationMannite fermentationMannite fermentationMannite fermentationHeat-stable nucleaseHeat-stable nucleaseHeat-stable nucleaseHeat-stable nucleaseSmear SmearµscopymicroscopyG+staphylococciColony pigments&hemolysisBiochemical reactionsEnterotoxins detectionIdentification of pathogenic staphylococci Coagulase(+)Heat-stable nuclease(+)Golden pigment(+)HemolyzationHemolyzation (+)Mannite fermentation(+)Prevention&treatmentPreventionPreventionpreventing preventing preventing preventing nosocomial nosocomial nosocomial nosocomial infectioninfectioninfectioninfectionTreatmentTreatmentantibiotics antibiotics antibiotics antibiotics sensitivity testsensitivity testsensitivity testsensitivity testpersonal personal personal personal hygienehygienehygienehygienesterilisation sterilisation sterilisation sterilisation&detention&detention&detention&detentionselfselfselfself-bacterial bacterial bacterial bacterial vaccine vaccine vaccine vaccine therapy therapy therapy therapy preventing preventing preventing preventing drug drug drug drug resistanceresistanceresistanceresistanceMethicillin-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)1.Compare the features of common pyogenic bacteria.2.Discuss the pathogenic features and identification points of Staphylococcus aureus.Questions:Streptococci G+,spherical,elliptical,arranged in chainin chain Grow well on nutrient medium w/bloodBiological propertiesShape,Shape,Stain Stain&CultureCultureAntigenic structureAntigenic structure Protein antigen surface Agsurface Agsurface Agsurface Ag,outside C antigen,outside C antigen type-specifictype-specific including including MMMM,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 wallClassificationAccording toAccording to -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 MMMM AgAgAgAg group B,C,D,&G occasionallygroup B,C,D,&G occasionallyAntigenic structurePathogenicityGroup A Streptococci (S.pyogenes)Pathogenic substancesPathogenic substances 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 structure 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&enzymesStreptolysin 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 diagnosisStreptolysin-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)Streptokinase(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 bacteriaClinical 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)Erysipelas(丹毒丹毒)by S.pyogenesCellulitis(蜂窝组织炎蜂窝组织炎)by S.pyogenesHoney-crust lesion typical of S.pyogenes impetigoPathogenesis of S.pyogenes infectionsSamplesPus,Blood,Nasopharynx swabIsolation w/Isolation w/blood agar plateblood agar platedistinguishdistinguishing from ing from S.pneumoniaeS.pneumoniaeSmear SmearµscopymicroscopyG+streptococcidistinguishing distinguishing from from staphylococcistaphylococciOther streptococciOther streptococci-hemolysisAssist-diagnosis for rheumatic fever-hemolysisASO testASO testMicrobiological diagnosis 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 streptococciEnterococcus 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 antigenEnterococcusEnterococcus spp.viewed by direct spp.viewed by direct fluorescent antibody(FA)reactionfluorescent antibody(FA)reactionEnterococcus 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 infections 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 problem1.Discuss the pathogenic features of Streptococcus pyogenes.2.Discuss identification points between hemolytic streptococci and other pyogenic bacteria.Questions:Neisseria gonorrhoeae(淋病奈瑟菌淋病奈瑟菌)Biological properties Shape and stain Shape and stain -G-diplococci in or on PMNs on pus smear -No endospore&flagellum,&w/capsule&pili Culture Culture -Obligate aerobes,need 5%CO2 while primary isolation -High nutritional requirement “Chocolate Blood Agar Plate”Antigenic structure and classification Antigenic structure and classification -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-likeN.gonorrhoeae colonies on Chocolate Blood Agar PlatePathogenesisVirulent factorsVirulent factors-Pili-Outer membrane proteins-LOS-IgA1 protease-OthersClinical findingsClinical findings-Gonorrhea-Gonococcal conjunctivitisGonorrhea 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 MenClinical manifestations of N.gonorrhoeae infection Immunity Humoral immunity more effective No persistent immune responses Infection trend to -chronic&repeated occurrenceMicrobiological detectionsNucleic acids detection,&so onNucleic acids detection,&so onSamplesSamplesPus secreta from genito-urinary tracts,eyes,&othersPus secreta from genito-urinary tracts,eyes,&othersIsolationIsolationOxidase 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 testsOther testsPrevention&treatment Take Take preventionspreventions as as main measuremain measure Choose penicillinpenicillin as No.1 drug，take care of problems of drugs-resistant bacterial stains1.What are the main differences between Neisseria meningitides and Neisseria gonorrhoeae.Question:Pseudomonas aeruginosa(铜绿假单胞菌铜绿假单胞菌)P190 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 propertiesPseudomonas aeruginosa colonies on agar platesPathogenicity&immunity adhesins pilus non-pilus adhesin polysaccharide capsule endotoxin lipopolysaccharide(LPS)Pathogenic substancesPathogenic 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)phosphoesterase C(磷脂酶磷脂酶 C C)pyocyanin(绿脓菌素绿脓菌素)Cytolysin:e.g.leukocidinClinical diseasesClinical diseasesOpportunistic pathogen infections following burn hospital-acquired infectionsPulmonary infectionsPrimary skin infectionsUrinary infectionsPrimary skin infections of Pseudomonas aeruginosa 1.Discuss the pathogenic features of Pseudomonas aeruginosa.Question:
