コアカリキュラム B2-1 生体と微生物 (1) <> Gram stain slime layer mesosome cell membrane (Safranine) pilus (pl. pili) gram-negative bacterium outer membrane capsule flagellum (pl. flagella) (Crystal Violet) slime layer mesosome cell membrane pilus (pl. pili) Gram(-) Gram(+) cell wall gram-positive bacterium peptidoglycan +,- outer membrane capsule, slime layer LPS Lipopolysaccharide endotoxin cell wall (LPS ) flagella pili mesosomeetc (mesosome ) capsule flagellum (pl. flagella) coccus bacillo spirillum coccus bacillo spirillum Staphylococcus Streptococcus Diplococcus Tetragena Sarcina Bacillus Clostridium Actinomyces Fusobacterium Corynebacterium Vibrio Spirillum Leptospira Treponema Borrelia 1. 2. Gram stain 3. () 4. identification DNA (2) parasite hostinfection apparent infection inapparent infection (transmission)
STD zoonosis ex ex parasitepathogenicitycommunicabilityhost resistancevirulence host-parasite relationship (3) keywords: indigenous bacterial flora, compromised host, substituted microbism opportunistic infection- hostparasite relationship inapparent infection bacteremia sepsis pathogenesis transmission infection inapparent infection/ crisis infection colonization proliferation crisis inapparent infection carrier indigenous bacterial flora indigenous bacterial flora Staphylococcus Lactobacillus Streptococcus Peptococcus Neisseriaceae Bacteroides Spirochete Bacillus coli normal intestinal flora (- host-parasite relationship) host parasite host parasite host parasite allergy normal infectious disease
pathogenesity = virulence + sensitivity :: host sensitivity :: compromised host opportunistic infection: substituted microbism: Pneumocystis carinii Cryptococcus Candida Pseudomonas aeruginosa Proteus vulgaris Klebsiella pneumoniae Serratia Virus herpes simplex virus cytomegalovirus :: virulence :: Shigella Salmonella typhi / S.paratyphi A Vibrio cholerae virulence factor local infection systematic infection () bacteremia sepsis bacteremia septis
(4) exotoxin endotoxin endotoxin exotoxin lipopolysaccharide LPS LPS Lipid A Lipid A LPS Repeat Unit Core P O P Lipid A 1/5 4 α (5) Staphylococcus Streptococcus Gram positive coccus (GPC) Gram stain ()(LPS) 5-1. Staphylococcus <> Gram positive Micrococcaceae Staphylococcus 1µm facultative anaerobic () () catalase positive GC 30~40% 10~15%NaCl S.aureus Staphylococcus S.aureus (@)
:: Staphylococcus aureus :: S.aureus capsule protein layer peptidoglycan cell membrane anti-phagocytic anti-killing anti-absorption (protein layer) Protein A coagulase M Protein A Fibronectin binding protein Collagen bp Vitonectin bp Laminin bp Mucin bp Host S.aureus 3 () α-toxin hemolysin coagulase mannnitol <> 1. Supprative Infections Furncle( 癤 ) Carbuncle() 2 Phlegmon() Acne() Sweat grand abscess impetigo () FcFab (... 2. Toxic Diseases enterotoxin () intoxication Staphylococcal Toxic Shock Syndrome (STSS): MOF(Multiple Organ Failure ) TSST-1(toxic shock syndrome toxin-1 I ) T-cell Staphylococcal Scaleded Skin Syndrome (SSSS) Ritter s disease Exofoliatin 3. substituted microbism pneumonia enterocolitis sepsis empyema
coagulase free coagulase bond coagulase coagulase Fibrinogen Fibrin () () fibrin M bond coagulasefibrin M S C C free coagulase free coagulasefibrin S S C S S coagulase fibrinolysin fibrin β-lactamase MRSA Methicillin-resistant Staphylococcus aureus Penicillin Cephalosporine β-lactam β-lactamase 5-2. Streptococcus A Streptococcus pyogenes S.pyogenes 1. α β γ () 2. Lancefield A~V 1. 1. puerperal fever 2. Scarlet fever Streptococcal pyrogenic exotoxin (SPE) : Strawberry tongue Mouth pallar : Dick test (Anti-erythrogenic toxin) 3. Streptococcal toxic shock syndrome(stss) 4. : S.pneumoniae 5. erysipelas: 6. impetigo: Penicillin 7. glomerulonephritis rheumatic fever
() Neisseria gonorrhoeae Neiseria meningitidis 20 Waterhouse- Friderichsen DIC DIC life cycle Bacillus Clostridium endospore germination 121 20 (7) Cl.tetani Cl.perfringens Cl.botulinum Corynebacterium diphteriae Clostridium Clostridium Cl.botulinum Cl.tetani Cl.perfringens 3 Clostridium botulinum botulism S.aureus enterotoxin Ach 18~96hrs. (18)(96) Spore Germination Vegetative cell boturism () 10010 Sudden Infant Death Syndrome:SIDS
Clostridium tetani tetanus or () 4~5 tetanus (DTP ) DTP: Diphtheria-Tetanus-Pertussis Clostridium perfringens, Cl.novi, Cl.septicum, Cl.bifermentans, Cl. histolyticum Cl.perfringens (() Cl.welchii ) Enterotoxin (Enterotoxin AC stimulate [camp]) αβετ Corynebacterium diphteriae (Coryne) 2 (tox gene) β-pahage Neisser Schick test Behring DPT - Moloney test:
Escherichia coli Shigella Salmonella Salmonella typhi Yersinia pestis Vibrio cholerae Bordetella pertussis Vibrio parahaemolyticus Pseudomonas aeruginosa Brucella Legionella pneumophila Haemophilus influenzae ex. ex. Salmonella (Salmonella choleraesuis) Salmonella typhisalmonella paratyphisalmonella enteritidis VW PH TCBS 1 TCBS Bordet-Gengou K O FHA
B. abortus B. melitensis B. suis B. canis 1976 24 b XY 2 3 (9) Helicobacter Pylori 20 25%40 60~80% 1982 Marshall et al. 10 Mycobacterium tuberculosis M.kansasiiM.intracellulare
(11) Aspergillus Cryptococcus Candida Mucor Aspergillus Aspergillus fumigatus, A.flavus Cryptococcus neoformans Candida Candida albicans,c.glabrata 1() aspergilloma (fungus ball) 2. invasive aspergillosis Mucorales Rhizopus () () dimorphismlike ) Coccidiodes immitis: 4 @U.S.A.Carifornia,Arizona AIDS 6 B amphotericin B, Flucytosine, Miconazole, Fluconazole, Itraconazole, micafungin(2003 )
(12) Spirochaeta Mycoplasma Rickettsia Clamydia or DNA RNA 2 anti-kiling (phagolysosome ) (STD) (C.trachomatis) elementary body leticulate body intermediate form STD 1975 PAP C.trachomatis: (STD) () C.psittaci influenza C.pneumoniae: + 1/25/2005