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1、Bacillus, Corynebacterium, Nocardia, Mycobacterium, Clostridium, anaerobic, non-spore-forming Gram-positive Bacteria, anaerobic Gram-negative BacteriaSpore-Forming Gram-positive Bacteria (Bacillus, Clostridum)Anaerobes including anaerobic Gram-negative BacteriaSectionIGrampositiverodsSporeformingNon
2、sporeformingAnaerobicAerobicClostridium sppBacillus sppCorynebacteriumGramPositiveBacilliBacillusspp.B. anthracis and B. cereus.B. anthracisisresponsibleforthediseaseanthrax.B. cereusispredominantlyresponsibleforfoodpoisoninginhumans.Theemetictype,associatedwithfriedriceThediarrhealtype,associatedwi
3、thmeatdishesandsauces B. anthracisgram-positivespore-formingrod-shapedSporesareresistanttoharshconditions,includingheat,radiation,disinfectants,desiccation,andsoon.The2001anthraxattacksCapitolHillduringtheanthraxattacksBruceIThebioterrorismeventresultedin22casesofanthrax:11inhalationand11cutaneous.F
4、B. anthracis:pathogenesisAnthraxisprimarilyadiseaseofherbivores(goats,sheep,cattle,horses,etc),humansbecomeinfectedincidentallybycontactwithinfectedanimalsortheirproducts.Cutaneous(injuredskin)themostcommonform,causesalocalizedinflammatoryblacknecroticlesion(eschar焦痂焦痂)Pulmonaryhighlyfatalandcharact
5、erizedbysuddenmassivechestedemafollowedbycardiovascularshockGastrointestinal(mucousmembranes)rarebutalsofatal(causesdeathto25%)typeresultsfromingestionofsporesPathogenesisVirulencefactorsi)capsule(containspoly-D-glutamicacidwhichisantiphagocytic),encodedbyplasmidpXO2;strainswithoutcapsuleareusuallyn
6、otvirulentii)exotoxinsencodedonplasmidpXO1,threeproteins;tobeactive,theLFandEFneedtocombinewithPA.1.protectiveantigen(PA),bindstospecificcellreceptors2.lethalfactor(LF),+PAformlethaltoxin,causeofdeath3.edemafactor(EF),anadenylatecyclase,+PAformedemafactorANTHRAX TOXINSLFEFPAPAPALFHostProteaseHOST CE
7、LL20 kDaulethaltoxin(PA+LF) oredemafactor (PA+EF) is internalized by endocytosis u the LF or EF cross the membrane into the cell via PA-mediated channelsEndospores are phagocytosed by macrophages and germinateMacrophages containing bacilli detach and migrate to the regional lymph node.Vegetative ant
8、hrax bacilli grow in the lymph node, creating regional hemorrhagic lymphadenitisBacteria spread through the blood and lymph and increase to high numbers, causing severe septicemiaHigh levels of exotoxins are produced that are responsible for overt symptoms and death.ClinicalfindingsInhumans,approxim
9、ately95%ofcasesarecutaneousanthraxand5%areinhalation.largeblackskinlesions(eschar)DiagnosticlaboratorytestsStainedsmearsfromthelocallesionorofbloodfromdeadanimalsoftenshowchainsoflargegrampositiverods.AnELISAhasbeendevelopedtomeasureantibodiesagainstedemaandlethaltoxins,butthetesthasnotbeenextensive
10、lystudied.Somepublichealthlaboratoriesmayalsohavenucleicacidamplificationassaysavailable.TreatmentManyantibioticsareeffectiveagainstanthraxinhumans,buttreatmentmustbestartedearly.Ciprofloxacinisrecommended.AfterthepotentialexposuretoB. anthracisasanagentofbiologicalwarfare,prophylaxiswithciprofloxac
11、inordoxycyclineshouldbecontinuedfor4weekswhilethreedosesofvaccinearebeinggiven,orfor8weeksifnovaccineisadministered.EpidemiologyandcontrolSoiliscontaminatedwithanthraxsporesfromthecarcassesofdeadanimals.Thesesporesremainviablefordecades.Grazinganimalsinfectedthroughinjuredmucousmembranesservetoperpe
12、tuatethechainofinfection.Controlmeasuresinclude1)disposalofanimalcarcasses,2)decontaminationofanimalproducts,3)protectiveclothingandglovesforhandlingpotentiallyinfectedmaterials,4)activeimmunizationofdomesticanimalswithliveattenuatedvaccines.Personswithhighoccupationalriskshouldbeimmunized.Anaerobic
13、organismAnanaerobic organismoranaerobeisanyorganismthatdoesnotrequireoxygenforgrowth.Itcouldpossiblyreactnegativelyandmayevendieifoxygenispresent.Therearethreetypes:obligateanaerobes,whichcannotuseoxygenforgrowthandareevenharmedbyitaerotolerantorganisms,whichcannotuseoxygenforgrowth,buttoleratethepr
14、esenceofitfacultativeanaerobes,whichcangrowwithoutoxygenbutcanutilizeoxygenifitispresent1:Obligateaerobic(oxygen-needing)bacteriagatheratthetopofthetesttubeinordertoabsorbmaximalamountofoxygen.2:Obligateanaerobicbacteriagatheratthebottomtoavoidoxygen.3:Facultativebacteriagathermostlyatthetop,sinceae
15、robicrespirationisthemostbeneficialone;but,aslackofoxygendoesnothurtthem,theycanbefoundallalongthetesttube.4:Microaerophilesgatherattheupperpartofthetesttubebutnotatthetop.Theyrequireoxygenbutatalowconcentration.5:Aerotolerantbacteriaarenotaffectedatallbyoxygen,andtheyareevenlyspreadalongthetesttube
16、.no oxidative phosphorylationfermentationkilled by oxygenlack certain enzymescatalase *H2O2 H20 + O2peroxidase *H2O2 H20 /NAD to NADH Obligate (strict) anaerobesInsteadofoxygen,obligateanaerobesusealternateelectronacceptorsforcellularrespirationsuchassulfate,nitrate,iron,manganese,mercury,andcarbonm
17、onoxide.Whystrictanaerobesaresensitivetooxygen?Dissolvedoxygenincreasestheredoxpotentialofasolution,andhighredoxpotentialinhibitsthegrowthofsomestrictanaerobes.Forexample,methanogensgrowataredoxpotentiallowerthan-0.3V.Sulfideisanessentialcomponentofsomeenzymes,andmolecularoxygenoxidizesthistoformdis
18、ulfide,thusinactivatingcertainenzymes.Organismsmaynotbeabletogrowwithoutthesedeactivatedenzymes.Growthmaybeinhibitedduetoalackofreducingequivalentsforbiosynthesis,becauseelectronsareexhaustedinreducingoxygen.Spore-forming:rod,Gram(+)-ClostridiumNonspore-forming:Rod,Gram(+)PropionibacteriumBifidobact
19、eriumLactobacillusEubacteriumActinomycesRod,Gram(-)BacteroidesFusobacteriumCampylobacterCocci,Gram(+)PeptococcusPeptostreptococcusCocci,Gram(-)VeillonellaCategoryBacterialFloraoftheBodySiteTotalBacteriaRatio(per/mlorgm)Anaerobes:AerobesUpperAirwayNasalWashings103-1043-5:1Saliva108-1091:1ToothSurface
20、 1010-10111:1GingivalCrevice1011-10121000:1GastrointestinalTractStomach102-1051:1SmallBowel102-1041:1Ileum104-1071:1Colon1011-10121000:1FemaleGenitalTractEndocervix108-1093-5:1Vagina108-1093-5:1 Enterobacteriaceae (facultative anaerobes) anormalpartofthegutflora playimportantrolesinnutrientassimilat
21、ion Strict anaerobes opportunistic pathogensInfectioncausedbystrictanaerobesSites throughout body Muscle, cutaneous/sub-cutaneous necrosisAbscesses PolymicrobialnatureMostanaerobicinfectionsareassociatedwithcontaminationoftissuebynormalfloraofthemucosaofthemouth,pharynx,gastrointestinaltract,orgenit
22、altract.Typically,multiplespeciesarefound,includingbothobligateandfacultativeanaerobes.Aerobicbacteriamayalsobepresent,butobligateaerobesaremuchlesscommonthananaerobesandfacultativeanaerobes.Generaldiagnosisofanaerobicinfections1.Foul-smellingdischarge(duetoshort-chainfatty-acidproductsofanaerobicme
23、tabolism)2.Infectioninproximitytoamucosalsurface(anaerobesarepartofthenormalflora)3.Gasintissues(productionofCO2andH2)4.NegativeaerobicculturesBesides,colonymorphology,pigmentation,andmetabolismarehelpfulinidentifyinganaerobes.The clostridia in human infectionsopportunistic pathogens- some of the de
24、adliest diseasesBotulismtetanusgasgangrene- less life-threatening diseasesfoodpoisoningpseudomembranouscolitisClostridum botulinum: BotulismC. botulism existsinsoil,thesporesfindtheirwayintopreservedorcannedfoodswithlowoxygenlevels,andnutrientsthatsupportgrowth.GaGram-positive,rodshapedbacteriumthat
25、producesneurotoxinsknownasbotulinumneurotoxinstypesA-G,whichcausesflaccidmuscularparalysisseeninbotulismananaerobicspore-former,whichproducesoval,subterminalendosporesBotulism, ToxinTypesofC. botulinumaredistinguishedbytheantigenictypeoftoxintheyproduce.Sporesoftheorganismarehighlyresistanttoheat,wi
26、thstanding100forseveralhours,HeatresistanceisdiminishedatacidpHorhighsaltconcentration.causesmuscularparalysisA14-year-oldwithbotulism Mechanism of botulism toxinBotoxaneurotoxin(tradenameBotox)thatisusedclinicallyinsmallquantitiestotreatstrabismusandfacialspasmsandotherneurologicaldisorderscharacte
27、rizedbyabnormalmusclecontractions;PathogenesisThemostcommonoffendersarespiced,smoked,vacuum-packed,orcannedalkalinefoodsthatareeatenwithoutcooking.Insuchfoods,sporesofC. botulinumgerminate;underanaerobicconditions,vegetativeformsgrowandproducetoxin.Ininfantbotulism,honeyisthemostfrequentvehicleofinf
28、ection.Thevegetativecellsproducetoxinastheymultiply;theneurotoxinthengetsabsorbedintothebloodstream.ClinicalfindingsSymptomsbegin18-24hoursafteringestionofthetoxicfood,withvisualdisturbances(incoordinationofeyemuscles,doublevision),inabilitytoswallow,andspeechdifficulty;signsofbulbarparalysisareprog
29、ressive,anddeathoccursfromrespiratoryparalysisorcardiacarrest.Gastrointestinalsymptomsarenotregularlyprominent.Thereisnofever.Themortalityrateishigh.Patientswhorecoverdonotdevelopanti-toxinintheblood.Infantbotulismmaybeoneofthecausesofsuddeninfantdeathsyndrome.C. botulinum andbotulinumtoxinarefoundi
30、nfecesbutnotinserum.DiagnosticlaboratorytestsToxincanoftenbedemonstratedinserumfromthepatient,andtoxinmaybefoundinleftoverfood.Ininfantbotulism,C. botulinum andtoxincanbedemonstratedinbowelcontentsbutnotinserum.Toxinmaybedemonstratedbypassivehemagglutinationorradioimmunoassay.TreatmentBotulinumneuro
31、toxinsarethemostpotenttoxinsknownbutcanbeneutralizedbyspecificantibodies.Potentantitoxinstothreetypesofbotulinumtoxins,trivalent(A,B,E).Antitoxinmustbepromptlyadministeredintravenouslywithcustomaryprecautions.Adequateventilationmustbemaintainedbymechanicalrespirator,ifnecessary.Thesemeasureshaveredu
32、cedthemortalityratefrom65%tobelow25%.Epidemiology,preventionandcontrolSincesporesofC. botulinum arewidelydistributedinsoil,theyoftencontaminatevegetables,fruits,andothermaterials.Strictregulationofcommercialcanninghaslargelyovercomethedangerofwidespreadoutbreaks.Theriskfromhome-cannedfoodscanbereduc
33、edifthefoodisboiledformorethan20minutesbeforeconsumption.ToxoidsareusedforactiveimmunizationofcattleinSouthAfrica.Botulinumtoxinisconsideredtobeamajoragentforbioterrorismandbiologicalwarfare.C. tetaniGrowthonCookedMeatMedium(left)Biological traitsBiological traitsPathogenesisofC. tetanicausestetanus
34、notinvasive,strictlylocalizedMajortoxins tetanospasmin（破伤风痉挛毒素（破伤风痉挛毒素) tetanolysin （破伤风溶血毒素（破伤风溶血毒素)Tetanospasminastrongneurotoxin,thelethaldosagetohumanislessthan1gTetanustoxinspreadsthroughtissuespacesintothelymphaticandvascularsystems.Itentersthenervoussystemattheneuromuscularjunctionsandmigrate
35、sthroughnervetrunksandintothecentralnervoussystem.Sensitivetoheat，ineffectiveafter65,30min Mechanism of TetanospasminTypicalsymptomsThename“tetani”derivesfromofatension,referringtothetension(causedbytetanus)inthemuscles.DiagnosisRestsontheclinicalpictureandahistoryofinjury:(1)Infectiongenerallyoccur
36、sthroughwoundcontaminationandofteninvolvesacutordeeppuncturewound;(2)Astheinfectionprogresses,musclespasmsdevelopinthejaw(thusthename“lockjaw”)andelsewhereinthebody.Theprimarydifferentialdiagnosisoftetanusisstrychninepoisoning.！Neitherpreventivenortherapeuticuseofantitoxinshouldbewithheldpendingdemo
37、nstrationofC. tetani existence.Immunity&Prevention！Thetoxin(tetanospasmin)bindtotheneuronsisirreversible.Controlmeasuresarenotpossiblebecauseofthewidedisseminationoftheorganisminthesoilandthelongsurvivalofitsspores.Tetanuscanbepreventedbyvaccinationwithtetanustoxoid.Acombinedvaccine,DPTvaccine,which
38、includesvaccinesagainstdiphtheria,pertussis,andtetanus.TheUS-CDCrecommendsthatadultsreceiveaboostervaccineeverytenyearsTreatmentDeadandinfectedtissueshouldberemovedbysurgicaldebridement.Prophylacticuseofantitoxin,tetanusantitoxin,TATAntibiotics:metronidazole,penicillin C. perfingensfoodsafetynetwork
39、.caacommoncauseoffoodpoisoningIllnessresultswhenalargenumberofbacteriaareconsumed,usuallyfromafoodthathasremainedbetween4oCand60oCforanextendedperiodoftime.Thebacteriasporulateinthepersonsintestinesandreleaseatoxinwhichresultsinsymptoms.Thesporessurviveextremelyharshconditions,includingboilingforove
40、ranhour.WhereisC. perfringensfound?Thebacteriaarenotroutinelypasseddirectlybetweenpeople,butratherthroughcross-contaminationoffoods.C. perfringensisanaerobicmeaningitgrowswithoutoxygen,therebymakingthicksoups,graviesandpiesanidealenvironmentforgrowth.C. perfringensiswidelydistributedintheenvironment
41、.Healthyanimalsandhumanscanharbourthisbacteriumintheirintestines.Sporescanalsobefoundinsoil,dustandvegetation. (lactose)highgas(H2andCO2)production,stormyfermentation,hemolysisNaglersreaction,-toxinC. perfringens, ToxinAnenterotoxinofC. perfringensisacommoncauseoffoodpoisoning.Whenmorethan108vegetat
42、ivecellsareingestedandsporulateinthegut,enterotoxinisformed.Manyofthesetoxinshavelethal,necrotizing,andhemolyticproperties.The-toxinofC. perfringenstypeAisalecithinase.TheactionofC. perfringensenterotoxininvolvesmarkedhypersecretioninthejejunumandileum,withlostoffluidsandelectrolytesindiarrhea.Muchl
43、essfrequentsymptomsincludenausea,vomiting,andfever.PathogenesisAmixedinfectionistherule.Inadditiontothetoxigenicclostridia,proteolyticclostridiaandvariouscocciandgram-negativeorganismsarealsousuallypresent.Clostridialbacteremiaisafrequentoccurrenceinpatientswithneoplasms.InNewGuinea,C. perfringensty
44、peCproducesanecrotizingenteritis(pigbel)thatcanbehighlyfatalinchildren.ImmunizationwithtypeCtoxoidappearstohavepreventivevalue.GasgangreneOccurswhenasofttissuewoundiscontaminatedby C. perfringens,asoccursintrauma,septicabortion,andwarwounds.CClinicalfindingsFromacontaminatedwound,theinfectionspreads
45、in1-3daystoproducecrepitationinthesubcutaneoustissueandmuscle,foul-smellingdischarge,rapidlyprogressingnecrosis,fever,hemolysis,toxemia,shock,anddeath.C. perfringensfoodpoisoningusuallyfollowstheingestionoflargenumbersofclostridiathathavegrowninwarmedmeatdishes.Thetoxinformswhentheorganismssporulate
46、inthegut,withtheonsetofdiarrheausuallywithoutvomittingorfever-in6-18hours.Theillnesslastsonly1-2days.DiagnosticlaboratorytestsSpecimensconsistofmaterialfromwounds,pus,andtissue.Thepresenceoflargegram-positiverodsinGram-stainedsmearssuggestsgasgangreneclostridia;sporesarenotregularlypresent.Aclottorn
47、bygasin24hoursissuggestiveofC. perfringens.Oncepurecultureshavebeenobtained,couldbeidentifiedbybiochemicalreactions,hemolysis,andcolonyform.Lecithinaseactivityisevaluatedbytheprecipitateformedaroundcoloniesoneggyolkmedia.Finalidentificationrestsontoxinproductionandneutralizationbyspecificantitoxin.T
48、reatmentMostimportantly,promptandextensivesurgicaldebridementoftheinvolvedareaandexcisionofalldevitalizedtissue,inwhichtheorganismsarepronetogrow.Administrationofantimicrobialdrugs,particularlypenicillin,isbegunatthesametime.Hyperbaricoxygenmaybeofhelpinthemedicalmanagementofclostridialtissueinfecti
49、ons,Itissaidto“detoxify”patientsrapidly.Antitoxinsareavailable,usuallyintheformofconcentratedimmuneglobulins.Thereislimitedevidenceforitsefficacy.PseudomembranouscolitisClostridum difficile Clostridiaareanaerobic,spore-formingrods(bacilli).C. difficileisthemostseriouscauseofantibiotic-associateddiar
50、rhea(AAD)andcanleadtopseudomembranouscolitis,asevereinfectionofthecolon,oftenresultingfromeradicationofthenormalgutflorabyantibiotics.(H&Estain)C. difficile relativelyresistanttomostcommonlyusedantibiotics.-Associatedwithorfollowingantibioticuse,thenormalgastrointestinalfloraissuppressedandC. diffic
51、ileproliferates,producingcytopathictoxinandenterotoxin.-Thediagnosisismadebydemonstratingneutralizablecytotoxininthestool. C. difficile, toxin&clinicalfindingsAdministrationofantibioticsresultsinproliferationofdrug-resistantC. difficilethatproducestwotoxins.ToxinA,apotententerotoxinthatalsohassomecy
52、totoxicactivity,bindstothebrushbordermembranesofthegutatreceptorsites.ToxinBisapotentcytotoxin.Bothtoxinsarefoundinthestoolsofpatientswithpseudomembranouscolitis.DiagnosticlaboratorytestsCytotoxicityassayC. difficiletoxinshaveacytopathiceffectincellculture,andneutralizedwithspecificanti-seraisthepra
53、cticalgoldstandardforstudiesinvestigatingnewdiagnostictechniques.ToxinELISA AssessmentoftheAandBtoxinsbyELISAfortoxinAorB(orboth)hasasensitivityof6399%andaspecificityof93100%.Otherstooltests Stoolleukocytemeasurementsandstoollactoferrinlevelshavealsobeenproposedasdiagnostictests,butmayhavelimiteddia
54、gnosticaccuracy.Real-TimePCRBytheendof2009,3differentReal-TimePCRtestshadachieved510(k)clearancefromtheFDA.Foreachtest,sensitivitiesaregenerallyreportedas95-99%andspecificitiesas92-96%,dependingonthetestsandthesizeofthepatientpool.TreatmentAsymptomaticcolonizationwithC. difficileiscommon.Mildcasesge
55、nerallydonotrequirespecifictreatment.PatientsshouldbetreatedassoonaspossiblewhenthediagnosisofClostridium difficilecolitisismadetoavoidfranksepsisorbowelperforation.Toreducecomplications,physiciansoftenbegintreatmentbasedonclinicalpresentationbeforedefinitiveresultsareavailable.Knowledgeofthelocalep
56、idemiologyofintestinalfloraofaparticularinstitutioncanguidetherapy.Inaddition,oralrehydrationtherapyisusefulinretainingfluidsduringthedurationofdiarrhoea.PreventionandcontrolThemosteffectivemethodisproperantimicrobialprescribing.Infectioncontrolmeasures,suchaswearinggloveswhencaringforpatients,haveb
57、eenproventobeeffectiveatprevention.ThisworksbylimitingthespreadofC. difficileinthehospitalsetting.Inaddition,washingwithsoapandwaterwilleliminatethesporesfromcontaminatedhands,butalcohol-basedhandrubsareineffective.Bacteriotherapy?Treatmentwithvariousoralsupplementscontaininglivebacteriahasbeenstudi
58、edineffortstopreventC. difficile-associatedinfection/disease.ArandomizedcontrolledtrialusingaprobioticdrinkcontainingLactobacillus casei,L bulgaricus,andStreptococcus salivarius subsp. thermophiluswasreportedtohavesomeefficacy.Spore-forming:rod,Gram(+)-ClostridiumNonspore-forming:Rod,Gram(+)Propioni
59、bacteriumBifidobacteriumLactobacillusEubacteriumActinomycesRod,Gram(-)BacteroidesFusobacteriumCampylobacterCocci,Gram(+)PeptococcusPeptostreptococcusCocci,Gram(-)VeillonellaCategoryBifidobacterium,aGram+non-spore-forminganaerobenon-motile,oftenbranchedbacillusendosymbioticinhabitantsofthegastrointes
60、tinaltract,vaginaandmouth(B. dentium)oneofthemajorgeneraofbacteriathatmakeupthecolonfloraSomebifidobacteriaareusedasprobiotics B. adolescentistotreatconstipation,diarrheaBacteroides fragilis, aGram-non-spore-forminganaerobebacillusbacteria couldcauseinfectionsafterabdominalsurgery Prominent capsule
61、anti-phagocytic abscess formation Endotoxin low toxicity EpidemiologyNormalfloraofmouth,URT,intestinaltract,urogenitaltractPathogenicity(opportunisticpathogen)Wounds,abscessesinbodysitesbelowthediaphragmBacteremia(败血症)B. fragilisB. fragilisPalestaining,pleomorphicrodwithroundedends;safetypinappearan
62、ceLookforgrowthonBBE,seeesculinhydrolysisaroundthecolony,whiteprecipitationCanuseantibioticdisk,GLCforidentificationLabDiagnosisReview: Problems in identification of anaerobic infectionsair in sample (sampling, transportation)no growthidentification takes several days or longerlimiting usefulnessoft
63、en derived from normal flora sample contamination can confuse Review:CharacteristicsofAnaerobicInfections1.Most anaerobes are usually commensalsOriginatefromourownfloraBadguysdoexist2.Predisposing ConditionsBreechesinthemucocutaneousbarrierdisplacenormalfloraCompromisedvascularsupplyTraumawithtissue
64、destructionAntecedentinfectionReview:CharacteristicsofAnaerobicInfections3.Complex FloraMultiplespeciesAbdominalInfectionAvgof5speciesLesscomplexthennormalfloraFecalflora400differentspeciesThosepredominantinstoolarenotinfectingspeciesVeillonella,BifidobacteriumrarelypathogenicSpeciesuniquelysuitedto
65、causeinfectionpredominate4.Synergistic Mixture of Aerobes & AnaerobesE. coliConsumeO2AllowgrowthofanaerobesAnaerobespromotegrowthofotherbacteriabybeingantiphagocyticandproducing-lactamasesReview:Othercommonvirulencefactors1.Anti-phagocyticcapsuleAlsopromoteabscessformation2.TissuedestructiveenzymesB
66、. fragilisproducesvarietyofenzymes(lipases,proteases, collagenases) that destroy tissue AbscessFormation3.Beta-lactamaseproductionB. fragilis protectthemselvesandotherspeciesinmixedinfections4.SuperoxidedismutaseproductionProtectsbacteriafromtoxicO2radicalsastheymoveoutofusualnicheTranslationofKeyte
67、rmsAnaerobic bacteria 厌氧性细菌厌氧性细菌Clostridium 厌氧芽孢梭菌属厌氧芽孢梭菌属C. tetani 破伤风梭菌破伤风梭菌Tetanospasmin 破伤风痉挛毒素破伤风痉挛毒素Tetani antitoxin , TAT 破伤风抗毒素破伤风抗毒素C. perfringens 产气荚膜梭菌产气荚膜梭菌Nagler reaction 卵磷脂酶试验卵磷脂酶试验Stormy fermentation 汹涌发酵汹涌发酵Gas gangrene 气性坏疽气性坏疽TranslationofKeytermsC. botulinum 肉毒梭菌肉毒梭菌C. difficile
68、艰难梭菌艰难梭菌Bacteroides 类杆菌属类杆菌属B. fragilis 脆弱类杆菌脆弱类杆菌Bifidobacterium 双歧杆菌属双歧杆菌属ReviewQuestions1.Whatclues/symptomsareconsideredaspossibleanaerobicInfection(s)?2.Whatisthegeneralprincipleontreatmentofanaerobicinfection(s)?3.Selectonebacteriumcoveredinthislecture,summarizetherelatedknowledgeyouhavelearned.4.Refertootherreviewquestionsinthebookchapter.ReferencesandCitationJawetz,Melnick,&AdelbergsMedicalMicrobiology,25th,26th(McGraw-HillEducation)http:/en.wikipedia.org,http:/http:/
