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1、The microbes infected via respiratory tract 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 Main pathogenic microbes(virus)wInfl
2、uenza 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 Other main pathogenic microbeswMycoplasma pneumoniae肺炎支原体肺炎支原体肺炎支原体肺炎支原体wChlamydia pneuminiae肺炎衣原体肺炎衣原体肺
3、炎衣原体肺炎衣原体1、 Mycobacterium tuberculosisacid-fast rodscapsulate obligate aerobedoubling time about 1824h Lowenstein-Jensen mediumvariation wresistance dryingacids and alkaliesdyes (malachite green)wsensitive moist heat70% ethyl alcoholultraviolet light1) Biologic properties:Mycobacterium tuberculosis2
4、) 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D) adjuvantproteins tuberculinwInfectious reservoirs patients,carrierswtransmitted ways:respiratory tract 、alimentary tra
5、ct、skinwpulmonary tuberculosisprimary infectionsecondary infectionwextra-lung infection3) Diseases causedM.Tuberculosis in lung4) Immunity4) Immunity winfectious immunitywT cell-mediated immunity wimmunity and hypersensitivityKoch phenomenon5) Tuberculin Testwprincipiumwreagentold tuberculin, OT pur
6、ified protein derivative, PPDwmethodwsignificancewprevention vaccination: BCGw treatmentrifampin (利福平利福平利福平利福平)isoniazid (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 & treatment2、 treptococcus pneumoniaewGram-positivewlancet-shaped wIn pairswcapsulatewautolysis1)
7、 Biologic properties:Capsuleanti-phagocytic serotyping2) PathogenicityAutolysis - identificationBileBilepeptidoglycanpeptidoglycancell cell membranemembraneteichoic acidteichoic acid-choline-cholineautolysinautolysin 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
8、upper respiratory tracte.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 caused3、Corynebacterium diphtheriaew rod shapewGram positivew metachromatic granule w aerobew growth in Loefflers medium w tellurite agar1) Biologic properties:Coryn
9、ebacterium diphtheriaeCorynebacterium diphtheriaeCorynebacterium diphtheriaemetachromatic granuleDiptheria toxinwB binds to host cellwA inhibits protein synthesis inactive elongation factor 2 wcoded by b b-bacteriophage tox gene2) PathogenicityDiphtheriawinfection upper respiratory tract (pharynx) p
10、seudomembrane 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 causedThis child has diphtheria resulting in a thick gray coating over back of throat. This coating can eventually expand down through airway and,
11、 if not treated, the child could die from suffocation CDC 4、Influenza virus wtype Aantigenic highly variableantigenic highly variableworldwide epidemics (eg. 1918)worldwide epidemics (eg. 1918)wtype Bantigenic changeantigenic changesomestimes epidemicssomestimes epidemicswtype Cantigenic stableantig
12、enic stablemild illnessmild illnessStructure corew(-)ss RNA, separated segmentsseven（type C)or eight (type A, B) whelical nucleoprotein (NP) envelope: 2 layerswM1 protein: coded by virus wlipid bilayer membrame: from hosthemagglutinin (HA)neuraminidase (NA) 1) Biologic properties:whemagglutinin (HA)
13、 absorption, penetrationhemagglutinationwantibody to the HA protein (HIAb) neutralize the virus prevent infectionw neuraminidase (NA)release,spreadwantibody to the NA proteinslow the spread of the virus & no protectionwantigenic driftminor changes in HA or NAminor changes in HA or NAvariance ratio1%
14、variance ratio1%point mutationpoint mutationLimited spreadwantigenic shiftmajor changes in HA major changes in HA variance ratio:20%50%variance ratio:20%50%new subtypenew subtypeWorldwide spreadvariation2) Pathogenesis wperson to person via small particle aerosolsvia small particle aerosols via cont
15、act via contact winfects the epithelial cells of the respiratory tractuncomplicated influenzauncomplicated influenzapneumoniapneumoniaw major causes of influenza-associated death bacterial pneumoniabacterial pneumonia cardiac failure cardiac failurewpreventionvaccine:multivalentw wtwo strains of inf
16、luenza A and one of two strains of influenza A and one of influenza Binfluenza B wtreatmentamantadineChinese traditional medicineIFN-alfa3) prevention & treatment5、Mycoplasmal pneumoniaewprimary atypical pneumoniaw via aerosolized droplets w in confined populations families, schools, army barracksw
17、in persons 5-20 years of age wLaboratory DiagnosisCulture w wSputum or throat washingsSputum or throat washingsELISAPCRwTreatmenttetracyclines 6、Chlamdia pneumoniaewpathogenesis via respiratory droplets via respiratory droplets causes bronchitis, sinusitis and pneumoniacauses bronchitis, sinusitis a
18、nd pneumoniapotential link to atherosclerosis coronary 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 sampleThe other microbes
