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1、The microbes infected via respiratory tract1通过呼吸道感染的微生物 Main pathogenic microbes(Bacteria)wMycobacterium tuberculosis 结核分枝杆菌结核分枝杆菌结核分枝杆菌结核分枝杆菌wStreptococcus pneumoniae肺炎链球菌肺炎链球菌肺炎链球菌肺炎链球菌wCorynebacterium diphtheriae白喉棒状杆菌白喉棒状杆菌白喉棒状杆菌白喉棒状杆菌wB. pertusis百日咳鲍特菌百日咳鲍特菌百日咳鲍特菌百日咳鲍特菌2通过呼吸道感染的微生物 Main pathoge
2、nic microbes(virus)wInfluenza virus流行性感冒病毒流行性感冒病毒流行性感冒病毒流行性感冒病毒wVaricella-Zoster virus, VZV水痘水痘水痘水痘- -带带带带状疱疹病毒状疱疹病毒状疱疹病毒状疱疹病毒wMumps virus 腮腺炎病毒腮腺炎病毒腮腺炎病毒腮腺炎病毒wMeasles virus麻疹病毒麻疹病毒麻疹病毒麻疹病毒wRubella virus风疹病毒风疹病毒风疹病毒风疹病毒3通过呼吸道感染的微生物 Other main pathogenic microbeswMycoplasma pneumoniae肺炎支原体肺炎支原体肺炎支原体肺
3、炎支原体wChlamydia pneuminiae肺炎衣原体肺炎衣原体肺炎衣原体肺炎衣原体4通过呼吸道感染的微生物1、 Mycobacterium tuberculosis5通过呼吸道感染的微生物6通过呼吸道感染的微生物7通过呼吸道感染的微生物acid-fast rodscapsulate obligate aerobedoubling time about 1824h Lowenstein-Jensen mediumvariation wresistance dryingacids and alkaliesdyes (malachite green)wsensitive moist heat
4、70% ethyl alcoholultraviolet light1) Biologic properties:8通过呼吸道感染的微生物9通过呼吸道感染的微生物Mycobacterium tuberculosis10通过呼吸道感染的微生物2) Pathogenicitywcapsulewlipidscord factor(索状因子索状因子) , damage mitochondria membranephosphatides(磷脂磷脂), tuberculessulfatides(硫酸脑苷脂硫酸脑苷脂), inhibit phagosome-lysosome fusionwaxes(蜡质蜡质
5、D) adjuvantproteins tuberculin11通过呼吸道感染的微生物wInfectious reservoirs patients,carrierswtransmitted ways:respiratory tract 、alimentary tract、skinwpulmonary tuberculosisprimary infectionsecondary infectionwextra-lung infection3) Diseases caused12通过呼吸道感染的微生物M.Tuberculosis in lung13通过呼吸道感染的微生物4) Immunity4)
6、 Immunity winfectious immunitywT cell-mediated immunity wimmunity and hypersensitivityKoch phenomenon14通过呼吸道感染的微生物5) Tuberculin Testwprincipiumwreagentold tuberculin, OT purified protein derivative, PPDwmethodwsignificance15通过呼吸道感染的微生物wprevention vaccination: BCGw treatmentrifampin (利福平利福平利福平利福平)iso
7、niazid (异烟肼异烟肼异烟肼异烟肼)ethambutol(乙胺丁醇乙胺丁醇乙胺丁醇乙胺丁醇)streptomycin(链霉素链霉素链霉素链霉素)6) prevention & treatment16通过呼吸道感染的微生物2、 treptococcus pneumoniae17通过呼吸道感染的微生物wGram-positivewlancet-shaped wIn pairswcapsulatewautolysis1) Biologic properties:18通过呼吸道感染的微生物19通过呼吸道感染的微生物Capsuleanti-phagocytic serotyping2) Patho
8、genicity20通过呼吸道感染的微生物Autolysis - identificationBileBilepeptidoglycanpeptidoglycancell cell membranemembraneteichoic acidteichoic acid-choline-cholineautolysinautolysin21通过呼吸道感染的微生物22通过呼吸道感染的微生物 lobar pneumonia( (大叶性肺炎大叶性肺炎大叶性肺炎大叶性肺炎) )particularly young and oldafter damage to upper respiratory tract
9、e.g. following viral infectionMeningitis(children)( (脑膜炎）脑膜炎）脑膜炎）脑膜炎）otitis media( (中耳炎）中耳炎）中耳炎）中耳炎）3) Diseases caused23通过呼吸道感染的微生物3、Corynebacterium diphtheriae24通过呼吸道感染的微生物w rod shapewGram positivew metachromatic granule w aerobew growth in Loefflers medium w tellurite agar1) Biologic properties:25
10、通过呼吸道感染的微生物Corynebacterium diphtheriaeCorynebacterium diphtheriaeCorynebacterium diphtheriae26通过呼吸道感染的微生物metachromatic granule27通过呼吸道感染的微生物Diptheria toxinwB binds to host cellwA inhibits protein synthesis inactive elongation factor 2 wcoded by b b-bacteriophage tox gene2) Pathogenicity28通过呼吸道感染的微生物D
11、iphtheriawinfection upper respiratory tract (pharynx) pseudomembrane chocking bacteria do not spread systemically菌菌鼻咽部繁殖鼻咽部繁殖局部炎症：局部炎症：假膜假膜早期致死早期致死外毒素外毒素心肌炎心肌炎软腭麻痹软腭麻痹声嘶声嘶肾上腺功能障碍肾上腺功能障碍晚期致死晚期致死入血入血3) Diseases caused29通过呼吸道感染的微生物This child has diphtheria resulting in a thick gray coating over back of
12、 throat. This coating can eventually expand down through airway and, if not treated, the child could die from suffocation CDC 30通过呼吸道感染的微生物4、Influenza virus 31通过呼吸道感染的微生物wtype Aantigenic highly variableantigenic highly variableworldwide epidemics (eg. 1918)worldwide epidemics (eg. 1918)wtype Bantige
13、nic changeantigenic changesomestimes epidemicssomestimes epidemicswtype Cantigenic stableantigenic stablemild illnessmild illness32通过呼吸道感染的微生物Structure corew(-)ss RNA, separated segmentsseven（type C)or eight (type A, B) whelical nucleoprotein (NP) envelope: 2 layerswM1 protein: coded by virus wlipid
14、 bilayer membrame: from hosthemagglutinin (HA)neuraminidase (NA) 1) Biologic properties:33通过呼吸道感染的微生物34通过呼吸道感染的微生物whemagglutinin (HA) absorption, penetrationhemagglutinationwantibody to the HA protein (HIAb) neutralize the virus prevent infectionw neuraminidase (NA)release,spreadwantibody to the NA
15、proteinslow the spread of the virus & no protection35通过呼吸道感染的微生物wantigenic driftminor changes in HA or NAminor changes in HA or NAvariance ratio1%variance ratio1%point mutationpoint mutationLimited spreadwantigenic shiftmajor changes in HA major changes in HA variance ratio:20%50%variance ratio:20%5
16、0%new subtypenew subtypeWorldwide spreadvariation36通过呼吸道感染的微生物37通过呼吸道感染的微生物2) Pathogenesis wperson to person via small particle aerosolsvia small particle aerosols via contact via contact winfects the epithelial cells of the respiratory tractuncomplicated influenzauncomplicated influenzapneumoniapne
17、umoniaw major causes of influenza-associated death bacterial pneumoniabacterial pneumonia cardiac failure cardiac failure38通过呼吸道感染的微生物wpreventionvaccine:multivalentw wtwo strains of influenza A and one of two strains of influenza A and one of influenza Binfluenza B wtreatmentamantadineChinese tradit
18、ional medicineIFN-alfa3) prevention & treatment39通过呼吸道感染的微生物5、Mycoplasmal pneumoniae40通过呼吸道感染的微生物wprimary atypical pneumoniaw via aerosolized droplets w in confined populations families, schools, army barracksw in persons 5-20 years of age41通过呼吸道感染的微生物 wLaboratory DiagnosisCulture w wSputum or throa
19、t washingsSputum or throat washingsELISAPCRwTreatmenttetracyclines 42通过呼吸道感染的微生物6、Chlamdia pneumoniae43通过呼吸道感染的微生物wpathogenesis via respiratory droplets via respiratory droplets causes bronchitis, sinusitis and pneumoniacauses bronchitis, sinusitis and pneumoniapotential link to atherosclerosis coro
20、nary potential link to atherosclerosis coronary arteryarterywlaboratory diagnosisculture culture ：difficult difficult serological test serological test ：most commonmost commonw wa four-fold rise in titer in paired samplea four-fold rise in titer in paired sample44通过呼吸道感染的微生物The other microbes45通过呼吸道感染的微生物
